Sample records for study provide direct

  1. Influenza vaccination and decisional conflict among regulated and unregulated direct nursing care providers in long-term-care homes.

    PubMed

    Sullivan, Shannon M; Pierrynowski-Gallant, Donna; Chambers, Larry; O'Connor, Annette; Bowman, Sherry; McNeil, Shelly; Strang, Robert; Knoefel, Frank

    2008-02-01

    The purpose of this study was to determine whether direct nursing care providers have decisional conflict about receiving influenza vaccinations and characteristics associated with decisional conflict. The researchers used a self-administered questionnaire mailed to direct nursing care providers in two long-term-care organizations. Most direct nursing care providers in both organizations (80% and 93%, respectively) intended to get the influenza vaccine. Unregulated direct nursing care providers had more decisional conflict than regulated providers, especially related to feeling uninformed about the pros and cons of influenza vaccination. Unclear valuing of the pros and cons of influenza vaccination was related to the age of the direct care providers in both organizations. Decisional conflict and influenza vaccination practices may be determined, in part, by age and by the culture of a health care organization. A decision aid to improve knowledge and clarify values may improve decision quality and increase influenza vaccination rates.

  2. Phenotypic selection in natural populations: what limits directional selection?

    PubMed

    Kingsolver, Joel G; Diamond, Sarah E

    2011-03-01

    Studies of phenotypic selection document directional selection in many natural populations. What factors reduce total directional selection and the cumulative evolutionary responses to selection? We combine two data sets for phenotypic selection, representing more than 4,600 distinct estimates of selection from 143 studies, to evaluate the potential roles of fitness trade-offs, indirect (correlated) selection, temporally varying selection, and stabilizing selection for reducing net directional selection and cumulative responses to selection. We detected little evidence that trade-offs among different fitness components reduced total directional selection in most study systems. Comparisons of selection gradients and selection differentials suggest that correlated selection frequently reduced total selection on size but not on other types of traits. The direction of selection on a trait often changes over time in many temporally replicated studies, but these fluctuations have limited impact in reducing cumulative directional selection in most study systems. Analyses of quadratic selection gradients indicated stabilizing selection on body size in at least some studies but provided little evidence that stabilizing selection is more common than disruptive selection for most traits or study systems. Our analyses provide little evidence that fitness trade-offs, correlated selection, or stabilizing selection strongly constrains the directional selection reported for most quantitative traits.

  3. Changing effects of direct-to-consumer broadcast drug advertising information sources on prescription drug requests.

    PubMed

    Lee, Annisa Lai

    2009-06-01

    This study tracks the changes of the effects of 4 information sources for direct-to-consumer drug advertising on patients' requests for prescription drugs from physicians since the inception of the "Guidance for Industry about Consumer-directed Broadcast Advertisements." The Guidance advises pharmaceuticals to use four information sources for consumers to seek further information to supplement broadcast drug advertisements: small-print information, the Internet, a toll-free number, and health-care providers (nurses, doctors, and pharmacists). Logistic models were created by using survey data collected by the Food and Drug Administration in 1999 and 2002. Results show that throughout the years, health-care providers remain the most used and strongest means associated with patients' direct requests for nonspecific and specific prescription drugs from doctors. The small-print information source gains power and changes from an indirect means associated with patients' discussing drugs with health-care providers to a direct means associated with patients' asking about nonspecific and specific drugs from their doctors. The Internet is not directly related to drug requests, but the effect of its association with patients seeking information from health-care providers grew 11-fold over the course of the study. The toll-free number lost its power altogether for both direct request for a prescription drug and further discussion with health-care providers. Patient demographics will be considered for specific policy implications.

  4. Factors Influencing Implementation of a Physical Activity Intervention in Residential Children's Homes.

    PubMed

    Lau, Erica Y; Saunders, Ruth P; Pate, Russell R

    2016-11-01

    The Environmental Intervention in Children's Homes (ENRICH) study was the first published physical activity intervention undertaken in residential children's homes (RCHs). The study revealed differences in implementation across the homes, which may be a key factor that affects program effectiveness. The purpose of this study was to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation of the ENRICH intervention. This study analyzed the ENRICH process evaluation data collected from 24 RCHs. Bayesian Path analysis was used to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation. Level of implementation across RCHs was variable, ranging from 38 to 97 % (M = 68.3, SD = 14.45). Results revealed that organizational capacity and provider characteristics had significant direct associations with level of implementation. Neither direct nor indirect associations between quality of prevention support system and level of implementation reached statistical significance. Conducting formative assessments on organizational capacity and provider characteristics and incorporating such information in implementation planning may increase the likelihood of achieving higher levels of implementation in future studies.

  5. Case study: Comparison of motivation for achieving higher performance between self-directed and manager-directed aerospace engineering teams

    NASA Astrophysics Data System (ADS)

    Erlick, Katherine

    "The stereotype of engineers is that they are not people oriented; the stereotype implies that engineers would not work well in teams---that their task emphasis is a solo venture and does not encourage social aspects of collaboration" (Miner & Beyerlein, 1999, p. 16). The problem is determining the best method of providing a motivating environment where design engineers may contribute within a team in order to achieve higher performance in the organization. Theoretically, self-directed work teams perform at higher levels. But, allowing a design engineer to contribute to the team while still maintaining his or her anonymity is the key to success. Therefore, a motivating environment must be established to encourage greater self-actualization in design engineers. The purpose of this study is to determine the favorable motivational environment for design engineers and describe the comparison between two aerospace design-engineering teams: one self-directed and the other manager directed. Following the comparison, this study identified whether self-direction or manager-direction provides the favorable motivational environment for operating as a team in pursuit of achieving higher performance. The methodology used in this research was the case study focusing on the team's levels of job satisfaction and potential for higher performance. The collection of data came from three sources, (a) surveys, (b) researcher observer journal and (c) collection of artifacts. The surveys provided information regarding personal behavior characteristics, potentiality for higher performance and motivational attributes. The researcher journal provided information regarding team dynamics, individual interaction, conflict and conflict resolution. The milestone for performance was based on the collection of artifacts from the two teams. The findings from this study illustrated that whether the team was manager-directed or self-directed does not appear to influence the needs and wants of the team members. The self-directed team was more motivated to learn their topic than was the manager-directed team, but they struggled with their path in following their vision whereas the manager-directed team kept their focus under the guidance of their manager. Finally, both teams are in fact effective; however specific circumstances may be an important objective when deciding to utilize either a self-directed or manager-directed team.

  6. Directional cell elongation through filopodia-steered lamellipodial extension on patterned silk fibroin films.

    PubMed

    You, Renchuan; Li, Xiufang; Luo, Zuwei; Qu, Jing; Li, Mingzhong

    2015-03-05

    Micropatterned biomaterials have been used to direct cell alignment for specific tissue engineering applications. However, the understanding of how cells respond to guidance cues remains limited. Plasticity in protrusion formation has been proposed to enable cells to adapt their motility mode to microenvironment. In this study, the authors investigated the key role of protrusion response in cell guidance on patterned silk fibroin films. The results revealed that the ability to transform between filopodia and small lamellipodia played important roles in directional cell guidance. Filopodia did not show directional extension on patterned substrates prior to spreading, but they transduced topographical cues to the cell to trigger the formation of small lamellipodia along the direction of a microgrooved or parallel nanofiber pattern. The polar lamellipodia formation provided not only a path with directionality, but a driving force for directional cell elongation. Moreover, aligned nanofibers coating provided better mechanical support for the traction of filopodia and lamellipodia, promoting cell attachment, spreading, and migration. This study provides new insight into how cells respond to guidance cues and how filopodia and lamellipodia control cell contact guidance on micropatterned biomaterial surfaces.

  7. A method for the direct measurement of electronic site populations in a molecular aggregate using two-dimensional electronic-vibrational spectroscopy

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

    Lewis, Nicholas H. C.; Dong, Hui; Oliver, Thomas A. A.

    2015-09-28

    Two dimensional electronic spectroscopy has proven to be a valuable experimental technique to reveal electronic excitation dynamics in photosynthetic pigment-protein complexes, nanoscale semiconductors, organic photovoltaic materials, and many other types of systems. It does not, however, provide direct information concerning the spatial structure and dynamics of excitons. 2D infrared spectroscopy has become a widely used tool for studying structural dynamics but is incapable of directly providing information concerning electronic excited states. 2D electronic-vibrational (2DEV) spectroscopy provides a link between these domains, directly connecting the electronic excitation with the vibrational structure of the system under study. In this work, we derivemore » response functions for the 2DEV spectrum of a molecular dimer and propose a method by which 2DEV spectra could be used to directly measure the electronic site populations as a function of time following the initial electronic excitation. We present results from the response function simulations which show that our proposed approach is substantially valid. This method provides, to our knowledge, the first direct experimental method for measuring the electronic excited state dynamics in the spatial domain, on the molecular scale.« less

  8. A method for the direct measurement of electronic site populations in a molecular aggregate using two-dimensional electronic-vibrational spectroscopy

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

    Lewis, Nicholas H. C.; Dong, Hui; Oliver, Thomas A. A.

    2015-09-28

    Two dimensional electronic spectroscopy has proved to be a valuable experimental technique to reveal electronic excitation dynamics in photosynthetic pigment-protein complexes, nanoscale semiconductors, organic photovoltaic materials, and many other types of systems. It does not, however, provide direct information concerning the spatial structure and dynamics of excitons. 2D infrared spectroscopy has become a widely used tool for studying structural dynamics but is incapable of directly providing information concerning electronic excited states. 2D electronic-vibrational (2DEV) spectroscopy provides a link between these domains, directly connecting the electronic excitation with the vibrational structure of the system under study. In this work, we derivemore » response functions for the 2DEV spectrum of a molecular dimer and propose a method by which 2DEV spectra could be used to directly measure the electronic site populations as a function of time following the initial electronic excitation. We present results from the response function simulations which show that our proposed approach is substantially valid. This method provides, to our knowledge, the first direct experimental method for measuring the electronic excited state dynamics in the spatial domain, on the molecular scale.« less

  9. A method for the direct measurement of electronic site populations in a molecular aggregate using two-dimensional electronic-vibrational spectroscopy.

    PubMed

    Lewis, Nicholas H C; Dong, Hui; Oliver, Thomas A A; Fleming, Graham R

    2015-09-28

    Two dimensional electronic spectroscopy has proved to be a valuable experimental technique to reveal electronic excitation dynamics in photosynthetic pigment-protein complexes, nanoscale semiconductors, organic photovoltaic materials, and many other types of systems. It does not, however, provide direct information concerning the spatial structure and dynamics of excitons. 2D infrared spectroscopy has become a widely used tool for studying structural dynamics but is incapable of directly providing information concerning electronic excited states. 2D electronic-vibrational (2DEV) spectroscopy provides a link between these domains, directly connecting the electronic excitation with the vibrational structure of the system under study. In this work, we derive response functions for the 2DEV spectrum of a molecular dimer and propose a method by which 2DEV spectra could be used to directly measure the electronic site populations as a function of time following the initial electronic excitation. We present results from the response function simulations which show that our proposed approach is substantially valid. This method provides, to our knowledge, the first direct experimental method for measuring the electronic excited state dynamics in the spatial domain, on the molecular scale.

  10. Coordination of palliative cancer care in the community: "unfinished business".

    PubMed

    Brazil, Kevin; Bainbridge, Daryl; Sussman, Jonathan; Whelan, Tim; O'Brien, Mary Ann; Pyette, Nancy

    2009-07-01

    This study assessed the degree to which services in south-central Ontario, Canada, were coordinated to meet the supportive care needs of palliative cancer patients and their families. Programs within the region that were identified as providing supportive care to palliative cancer patients and their families were eligible to participate in the study. Program administrators participated in a semi-structured interview and direct-care providers completed a survey instrument. Administrators from 37 (97%) of 38 eligible programs and 109 direct-care providers representing 26 (70%) programs participated in the study. Most administrator and direct-care respondents felt that existing services in the community were responsive to palliative care patients' individual needs. However, at a system level, most respondents in both groups felt that required services were not available and that resources were inadequate. The most frequently reported unmet supportive care need identified by both respondent groups was psychological/social support. Most administrator (69%) and direct-care (64%) respondents felt that palliative care services were not available when needed. The majority of administrator and direct-care respondents were satisfied with the exchange of patient information within and between programs, although direct-care staff identified a deficit in information transferred on palliative care patients' social/psychological status. The study demonstrated the value of a theory-based approach to evaluate the coordination of palliative cancer care services. The findings revealed that service programs faced significant challenges in their efforts to provide coordinated care.

  11. Understanding Barriers for Communicating Injury Prevention Messages and Strategies Moving Forward: Perspectives from Community Stakeholders.

    PubMed

    Mack, Diane E; Aymar, Matt; Cosby, Jarold; Wilson, Philip M; Bradley, Christina; Walters Gray, Casey

    2016-01-01

    The primary objective of this study was to elicit the perspectives of direct care providers on barriers and facilitators to communicating injury prevention messages to parents/caregivers of children under 4 years of age. The secondary objective was to examine characteristics of an injury prevention messaging strategy preferred by direct care providers. This qualitative study was conducted across four regions in Ontario Canada. Fifty-nine direct care providers were purposefully sampled and data interpreted using focus group analysis. Transcripts were analyzed verbatim using content and discourse analysis. Several barriers to communicating injury prevention messages were identified encompassing (a) role, (b) parental, (c) social determinants, and (d) evidence impediments. In an effort to offset some of these barriers, participants endorsed the development of a tailored multicomponent injury prevention strategy adopting action-based messages. The results of this study provide an in-depth exploration of direct care providers perceptions that can inform the design of materials and dissemination strategies to help increase and optimize access to injury prevention information. Injury prevention messages should be action-oriented, specifically tailored to the stage of child development, and disseminated through both face-to-face interactions and mobile technology. © 2015 Wiley Periodicals, Inc.

  12. Encounters With Health-Care Providers and Advance Directive Completion by Older Adults.

    PubMed

    Koss, Catheryn

    2018-01-01

    The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by patients. To examine whether encounters with various types of health-care providers were associated with higher odds of completing advance directives by older patients. Logistic regression using longitudinal data from the 2012 and 2014 waves of the Health and Retirement Study. Participants were 3752 US adults aged 65 and older who reported not possessing advance directives in 2012. Advance directive was defined as a living will and/or durable power of attorney for health care. Four binary variables measured whether participants had spent at least 1 night in a hospital, underwent outpatient surgery, received home health or hospice care, or spent at least one night in a nursing home between 2012 and 2014. Older adults who received hospital, nursing home, or home health/hospice care were more likely to complete advance directives. Outpatient surgery was not associated with advance directive completion. Older adults with no advance directive in 2012 who encountered health-care providers covered by the PSDA were more likely to have advance directives by 2014. The exception was outpatient surgery which is frequently provided in freestanding surgery centers not subject to PSDA mandates. It may be time to consider amending the PSDA to cover freestanding surgery centers.

  13. Communication Skills for OMRDD Direct Care Workers: Distance Learning Study Guide. Instructor's Manual.

    ERIC Educational Resources Information Center

    Denny, Verna Haskins

    This instructor's manual provides an overview, directions, and answer keys for working with the study guide for direct care workers who are enrolled in a self-directed communication skills distance learning program for developmental disabilities workers. It begins with a list of the 12 theme areas and 105 units into which the theme areas are…

  14. Self-Directed Learning: Application and Research.

    ERIC Educational Resources Information Center

    Long, Huey B.; And Others

    These 23 papers provide as complete a picture as possible of the current efforts in self-directed learning application and research. The papers are: "Learning about Self-Directed Learning" (Long); "Philosophical, Psychological, and Practical Justifications for Studying Self-Direction in Learning" (Long); "In Search of…

  15. US hospital-based direct access with radiology referral: an administrative case report.

    PubMed

    Keil, Aaron; Brown, Suzanne Robben

    2015-01-01

    Legislative gains in the US allow physical therapists to function in expanded scopes of practice including direct access and referral to specialists. The combination of direct access with privileges to order imaging studies directly offers a desirable practice status for many physical therapists, especially in musculoskeletal focused settings. Although direct access is legal in all US jurisdictions, institutional-based physical therapy settings have not embraced these practices. Barriers cited to implementing direct access with advanced practice are concerns over medical and administrative opposition, institutional policies, provider qualifications and reimbursement. This administrative case report describes the process taken to allow therapists to see patients without a referral and to order diagnostic imaging studies at an academic medical center. Nine-month implementation results show 66 patients seen via direct access with 15% referred for imaging studies. Claims submitted to 20 different insurance providers were reimbursed at 100%. While institutional regulations and reimbursement are reported as barriers to direct access, this report highlights the process one academic medical center used to implement direct access and advanced practice radiology referral by updating policies and procedures, identifying advanced competencies and communicating with necessary stakeholder groups. Favorable reimbursement for services is documented.

  16. Dynamics of dense direct-seeded stands of southern pines

    Treesearch

    J.C.G. Goelz

    2006-01-01

    Direct seeding of southern pines is an effective method of artificial regeneration, producing extremely dense stands when survival exceeds expectations. Long-term studies of dense direct-seeded stands provide ideal data for exploring development of stands as they approach the limit of maximum stand density. I present data from seven studies with ages of stands ranging...

  17. Legitimate Textual Borrowing: Direct Quotation in L2 Student Writing

    ERIC Educational Resources Information Center

    Petric, Bojana

    2012-01-01

    Using textual analysis and interviews with student writers, this study aims to provide an insight into second language students' use of direct quotations in their MA theses by comparing direct quotations in high-rated and low-rated Master's theses, and by exploring student writers' own motivations to quote directly from sources. The corpus…

  18. Direct Lending: How To Improve Implementation.

    ERIC Educational Resources Information Center

    Jepsen, Keith

    This evaluation study developed 29 recommendations concerning the implementation of direct loans in providing financial assistance to postsecondary school students. The investigation included examination of a current Department of Education (ED) pilot program, a video teleconference to discuss direct lending with 23 individuals in education…

  19. A Framework for Analysis of Case Studies of Reading Lessons

    ERIC Educational Resources Information Center

    Carlisle, Joanne F.; Kelcey, Ben; Rosaen, Cheryl; Phelps, Geoffrey; Vereb, Anita

    2013-01-01

    This paper focuses on the development and study of a framework to provide direction and guidance for practicing teachers in using a web-based case studies program for professional development in early reading; the program is called Case Studies Reading Lessons (CSRL). The framework directs and guides teachers' analysis of reading instruction by…

  20. Fluid inclusion geothermometry

    USGS Publications Warehouse

    Cunningham, C.G.

    1977-01-01

    Fluid inclusions trapped within crystals either during growth or at a later time provide many clues to the histories of rocks and ores. Estimates of fluid-inclusion homogenization temperature and density can be obtained using a petrographic microscope with thin sections, and they can be refined using heating and freezing stages. Fluid inclusion studies, used in conjunction with paragenetic studies, can provide direct data on the time and space variations of parameters such as temperature, pressure, density, and composition of fluids in geologic environments. Changes in these parameters directly affect the fugacity, composition, and pH of fluids, thus directly influencing localization of ore metals. ?? 1977 Ferdinand Enke Verlag Stuttgart.

  1. Analytic TOF PET reconstruction algorithm within DIRECT data partitioning framework

    NASA Astrophysics Data System (ADS)

    Matej, Samuel; Daube-Witherspoon, Margaret E.; Karp, Joel S.

    2016-05-01

    Iterative reconstruction algorithms are routinely used for clinical practice; however, analytic algorithms are relevant candidates for quantitative research studies due to their linear behavior. While iterative algorithms also benefit from the inclusion of accurate data and noise models the widespread use of time-of-flight (TOF) scanners with less sensitivity to noise and data imperfections make analytic algorithms even more promising. In our previous work we have developed a novel iterative reconstruction approach (DIRECT: direct image reconstruction for TOF) providing convenient TOF data partitioning framework and leading to very efficient reconstructions. In this work we have expanded DIRECT to include an analytic TOF algorithm with confidence weighting incorporating models of both TOF and spatial resolution kernels. Feasibility studies using simulated and measured data demonstrate that analytic-DIRECT with appropriate resolution and regularization filters is able to provide matched bias versus variance performance to iterative TOF reconstruction with a matched resolution model.

  2. A boundedness result for the direct heuristic dynamic programming.

    PubMed

    Liu, Feng; Sun, Jian; Si, Jennie; Guo, Wentao; Mei, Shengwei

    2012-08-01

    Approximate/adaptive dynamic programming (ADP) has been studied extensively in recent years for its potential scalability to solve large state and control space problems, including those involving continuous states and continuous controls. The applicability of ADP algorithms, especially the adaptive critic designs has been demonstrated in several case studies. Direct heuristic dynamic programming (direct HDP) is one of the ADP algorithms inspired by the adaptive critic designs. It has been shown applicable to industrial scale, realistic and complex control problems. In this paper, we provide a uniformly ultimately boundedness (UUB) result for the direct HDP learning controller under mild and intuitive conditions. By using a Lyapunov approach we show that the estimation errors of the learning parameters or the weights in the action and critic networks remain UUB. This result provides a useful controller convergence guarantee for the first time for the direct HDP design. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Experimental Overview of Direct Photon Results in Heavy Ion Collisions

    NASA Astrophysics Data System (ADS)

    Novitzky, Norbert

    2016-07-01

    Direct photons are color blind probes and thus they provide unique opportunities to study the colored medium created in heavy ion collisions. There are many different sources of direct photons each probing different physics processes as the system evolves. In basic 2 → 2 processes the prompt photons from primary hard scatterings offer the most precise measurements of the outgoing parton energy in the opposite direction. In heavy ion collisions the created medium emits photons as thermal radiation, whose rate and anisotropies provide a unique prospective on the properties and evolution of the system. Recent results on direct photons from the LHC and RHIC experiments are briefly summarized in this paper.

  4. Baseline Management Practices at Providers in Better Jobs Better Care

    ERIC Educational Resources Information Center

    Stott, Amy L.; Brannon, S. Diane; Vasey, Joseph; Dansky, Kathryn H.; Kemper, Peter

    2007-01-01

    High turnover and difficult recruitment of direct care workers are challenges for long-term care providers. This study reports the extent and variation of the use of management practices for direct care workers and their supervisors across four long-term care settings in the Better Jobs Better Care demonstration. Overall, there is limited use of…

  5. 75 FR 373 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-05

    ... Request; Experimental Study: Presentation of Quantitative Effectiveness Information to Consumers in Direct... clearance. Experimental Study: Presentation of Quantitative Effectiveness Information to Consumers in Direct... research has proposed that providing quantitative information about product efficacy enables consumers to...

  6. The Mechanisms of Manual Therapy in the Treatment of Musculoskeletal Pain: A Comprehensive Model

    PubMed Central

    Bialosky, Joel E; Bishop, Mark D; Price, Don D; Robinson, Michael E; George, Steven Z

    2009-01-01

    Prior studies suggest manual therapy (MT) as effective in the treatment of musculoskeletal pain; however, the mechanisms through which MT exerts its effects are not established. In this paper we present a comprehensive model to direct future studies in MT. This model provides visualization of potential individual mechanisms of MT that the current literature suggests as pertinent and provides a framework for the consideration of the potential interaction between these individual mechanisms. Specifically, this model suggests that a mechanical force from MT initiates a cascade of neurophysiological responses from the peripheral and central nervous system which are then responsible for the clinical outcomes. This model provides clear direction so that future studies may provide appropriate methodology to account for multiple potential pertinent mechanisms. PMID:19027342

  7. Directing 101.

    ERIC Educational Resources Information Center

    Pintoff, Ernest

    Providing an introduction to anyone considering directing as a field of study or career, this book takes a broad look at the process of directing and encourages students and professionals alike to look outside of the movie industry for inspiration. Chapters in the book discuss selecting and acquiring material; budgeting and financing; casting and…

  8. Teaching Directional Skills to Preschool and Kindergarten Children

    ERIC Educational Resources Information Center

    Sterritt, Graham M.; And Others

    1976-01-01

    Studied a new device and training procedure for teaching the directional orientation and sentence tracking skills used in reading and writing western languages. Left-right and up-down directional confusion were shown to be rapidly corrected in normal children by the use of a simple electronic device providing clear feedback. (Author)

  9. Providing haptic feedback in robot-assisted minimally invasive surgery: a direct optical force-sensing solution for haptic rendering of deformable bodies.

    PubMed

    Ehrampoosh, Shervin; Dave, Mohit; Kia, Michael A; Rablau, Corneliu; Zadeh, Mehrdad H

    2013-01-01

    This paper presents an enhanced haptic-enabled master-slave teleoperation system which can be used to provide force feedback to surgeons in minimally invasive surgery (MIS). One of the research goals was to develop a combined-control architecture framework that included both direct force reflection (DFR) and position-error-based (PEB) control strategies. To achieve this goal, it was essential to measure accurately the direct contact forces between deformable bodies and a robotic tool tip. To measure the forces at a surgical tool tip and enhance the performance of the teleoperation system, an optical force sensor was designed, prototyped, and added to a robot manipulator. The enhanced teleoperation architecture was formulated by developing mathematical models for the optical force sensor, the extended slave robot manipulator, and the combined-control strategy. Human factor studies were also conducted to (a) examine experimentally the performance of the enhanced teleoperation system with the optical force sensor, and (b) study human haptic perception during the identification of remote object deformability. The first experiment was carried out to discriminate deformability of objects when human subjects were in direct contact with deformable objects by means of a laparoscopic tool. The control parameters were then tuned based on the results of this experiment using a gain-scheduling method. The second experiment was conducted to study the effectiveness of the force feedback provided through the enhanced teleoperation system. The results show that the force feedback increased the ability of subjects to correctly identify materials of different deformable types. In addition, the virtual force feedback provided by the teleoperation system comes close to the real force feedback experienced in direct MIS. The experimental results provide design guidelines for choosing and validating the control architecture and the optical force sensor.

  10. An Incubatable Direct Current Stimulation System for In Vitro Studies of Mammalian Cells

    PubMed Central

    Panitch, Alyssa; Caplan, Michael; Sweeney, James D.

    2012-01-01

    Abstract The purpose of this study was to provide a simplified alternative technology and format for direct current stimulation of mammalian cells. An incubatable reusable stimulator was developed that effectively delivers a regulated current and does not require constant monitoring. PMID:23514694

  11. Construction engineering inspection direct cost survey.

    DOT National Transportation Integrated Search

    2014-07-01

    The objective of the study was to provide a rationale to Georgia Department of Transportation : (GDOT) for Direct Costs in terms of salary and wages charged by qualified independent : contractors performing Construction Engineering Inspection (CEI) s...

  12. Parenting in Direct Provision: Parents' Perspectives Regarding Stresses and Supports

    ERIC Educational Resources Information Center

    Ogbu, Helen Uchechukwu; Brady, Bernadine; Kinlen, Louise

    2014-01-01

    The Irish direct provision system for asylum seekers is acknowledged as providing a very challenging and exclusionary living environment for adults and children. To date, there has been little research focused specifically on the ways in which the direct provision environment impacts on the parenting role. This qualitative study explores the…

  13. The impact of a Critical Care Information System (CCIS) on time spent charting and in direct patient care by staff in the ICU: a review of the literature.

    PubMed

    Mador, Rebecca L; Shaw, Nicola T

    2009-07-01

    The introduction of a Critical Care Information System (CCIS) into an intensive care unit (ICU) is purported to reduce the time health care providers (HCP) spend on documentation and increase the time available for direct patient care. However, there is a paucity of rigorous empirical research that has investigated these assertions. Moreover, those studies that have sought to elucidate the relationship between the introduction of a CCIS and the time spent by staff on in/direct patient care activities have published contradictory findings. The objective of this literature review is to establish the impact of a CCIS on time spent documenting and in direct patient care by staff in the ICU. Five electronic databases were searched including PubMed Central, EMBASE, CINAHL, IEEE Xplore, and the Cochrane Database of Systematic Reviews. Reference lists of all published papers were hand searched, and citations reviewed to identify extra papers. We included studies that were empirical articles, published in English, and provided original data on the impact of a CCIS on time spent documenting and in direct patient care by staff in the ICU. In total, 12 articles met the inclusion criteria. Workflow analysis (66%) and time-and-motion analysis (25%) were the most common forms of data collection. Three (25%) studies found an increase in time spent charting, five (42%) found no difference, and four (33%) studies reported a decrease. Results on the impact of a CCIS on direct patient care were similarly inconclusive. Due to the discrepant findings and several key methodological issues, the impact of a CCIS on time spent charting and in direct patient care remains unclear. This review highlights the need for an increase in rigorous empirical research in this area and provides recommendations for the design and implementation of future studies.

  14. The cost of HIV medication adherence support interventions: results of a cross-site evaluation.

    PubMed

    Schackman, B R; Finkelstein, R; Neukermans, C P; Lewis, L; Eldred, L

    2005-11-01

    The objective of this study was to determine the direct cost of HIV adherence support programmes participating in a cross-site evaluation in the US. Data on the frequency, type, and setting of adherence encounters; providers' professions; and adherence tools provided were collected for 1,122 patients enrolled in 13 interventions at 9 sites. The site staff estimated the average duration of each type of encounter and national wage rates were used for labour costs. The median (range) adherence encounters/year among interventions was 16.5 (4.3-104.6) per patient; encounters lasted 24.6 (8.9-40.9) minutes. Intervention direct cost was correlated with the average frequency of encounters (r = 0.57), but not with encounter duration or providers' professions. The median direct cost/month was 35 dollars(5 dollars-58 dollars) per patient, and included direct provider costs (66%); incentives (17%); reminders and other tools (8%); and direct administrative time, provider transportation, training, and home delivery (9%). The median direct cost/month from a societal perspective, which includes patient time and travel costs, was 47 dollars(24 dollars-114 dollars) per patient. Adherence interventions with moderate efficacy costing < or =100 dollars/month have been estimated to meet a cost-effectiveness threshold that is generally accepted in the US. Payers should consider enhanced reimbursement for adherence support services.

  15. Questioning Questions: Elementary Teachers' Adaptations of Investigation Questions Across the Inquiry Continuum

    NASA Astrophysics Data System (ADS)

    Biggers, Mandy

    2018-02-01

    Questioning is a central practice in science classrooms. However, not every question translates into a "good" science investigation. Questions that drive science investigations can be provided by many sources including the teacher, the curriculum, or the student. The variations in the source of investigation questions were explored in this study. A dataset of 120 elementary science classroom videos and associated lesson plans from 40 elementary teachers (K-5) across 21 elementary school campuses were scored on an instrument measuring the amount of teacher-direction or student-direction of the lessons' investigation questions. Results indicated that the investigation questions were overwhelmingly teacher directed in nature, with no opportunities for students to develop their own questions for investigation. This study has implications for researchers and practitioners alike, calling attention to the teacher-directed nature of investigation questions in existing science curriculum materials, and the need for teacher training in instructional strategies to adapt their existing curriculum materials across the continuum of teacher-directed and student-directed investigation questions. Teachers need strategies for adapting the teacher-directed questions provided in their existing curriculum materials in order to allow students the opportunity to engage in this essential scientific practice.

  16. Analytic TOF PET reconstruction algorithm within DIRECT data partitioning framework

    PubMed Central

    Matej, Samuel; Daube-Witherspoon, Margaret E.; Karp, Joel S.

    2016-01-01

    Iterative reconstruction algorithms are routinely used for clinical practice; however, analytic algorithms are relevant candidates for quantitative research studies due to their linear behavior. While iterative algorithms also benefit from the inclusion of accurate data and noise models the widespread use of TOF scanners with less sensitivity to noise and data imperfections make analytic algorithms even more promising. In our previous work we have developed a novel iterative reconstruction approach (Direct Image Reconstruction for TOF) providing convenient TOF data partitioning framework and leading to very efficient reconstructions. In this work we have expanded DIRECT to include an analytic TOF algorithm with confidence weighting incorporating models of both TOF and spatial resolution kernels. Feasibility studies using simulated and measured data demonstrate that analytic-DIRECT with appropriate resolution and regularization filters is able to provide matched bias vs. variance performance to iterative TOF reconstruction with a matched resolution model. PMID:27032968

  17. The Content of Education for Direct Caregivers

    ERIC Educational Resources Information Center

    Kusmaul, Nancy

    2016-01-01

    Direct caregivers in nursing homes are the certified nursing assistants (CNAs) who provide the majority of hands-on care. This study administered a knowledge instrument to a sample of CNAs () employed at nursing homes in a northeastern city to evaluate their knowledge in the domains of aging, cognition, and mental health. This study found that…

  18. Examining the Support Peer Supporters Provide Using Structural Equation Modeling: Nondirective and Directive Support in Diabetes Management.

    PubMed

    Kowitt, Sarah D; Ayala, Guadalupe X; Cherrington, Andrea L; Horton, Lucy A; Safford, Monika M; Soto, Sandra; Tang, Tricia S; Fisher, Edwin B

    2017-12-01

    Little research has examined the characteristics of peer support. Pertinent to such examination may be characteristics such as the distinction between nondirective support (accepting recipients' feelings and cooperative with their plans) and directive (prescribing "correct" choices and feelings). In a peer support program for individuals with diabetes, this study examined (a) whether the distinction between nondirective and directive support was reflected in participants' ratings of support provided by peer supporters and (b) how nondirective and directive support were related to depressive symptoms, diabetes distress, and Hemoglobin A1c (HbA1c). Three hundred fourteen participants with type 2 diabetes provided data on depressive symptoms, diabetes distress, and HbA1c before and after a diabetes management intervention delivered by peer supporters. At post-intervention, participants reported how the support provided by peer supporters was nondirective or directive. Confirmatory factor analysis (CFA), correlation analyses, and structural equation modeling examined the relationships among reports of nondirective and directive support, depressive symptoms, diabetes distress, and measured HbA1c. CFA confirmed the factor structure distinguishing between nondirective and directive support in participants' reports of support delivered by peer supporters. Controlling for demographic factors, baseline clinical values, and site, structural equation models indicated that at post-intervention, participants' reports of nondirective support were significantly associated with lower, while reports of directive support were significantly associated with greater depressive symptoms, altogether (with control variables) accounting for 51% of the variance in depressive symptoms. Peer supporters' nondirective support was associated with lower, but directive support was associated with greater depressive symptoms.

  19. Preliminary design study of a regenerative life support system information management and display system

    NASA Technical Reports Server (NTRS)

    Parker, C. D.; Tommerdahl, J. B.

    1972-01-01

    The instrumentation requirements for a regenerative life support systems were studied to provide the earliest possible indication of a malfunction that will permit degradation of the environment. Four categories of parameters were investigated: environmental parameters that directly and immediately influence the health and safety of the cabin crew; subsystems' inputs to the cabin that directly maintain the cabin environmental parameters; indications for maintenance or repair; and parameters useful as diagnostic indicators. A data averager concept is introduced which provides a moving average of parameter values that is not influenced by spurious changes, and is convenient for detecting parameter rates of change. A system is included to provide alarms at preselected parameter levels.

  20. Debiasing comparative optimism and increasing worry for health outcomes.

    PubMed

    Rose, Jason P

    2012-11-01

    Comparative optimism - feeling at less personal risk for negative outcomes than one's peers - has been linked to reduced prevention efforts. This study examined a novel debiasing technique aimed at simultaneously reducing both indirectly and directly measured comparative optimism. Before providing direct comparative estimates, participants provided absolute self and peer estimates in a joint format (same computer screen) or a separate format (different computer screens). Relative to the separate format condition, participants in the joint format condition showed (1) lower comparative optimism in absolute/indirect measures, (2) lower direct comparative optimism, and (3) heightened worry. Implications for risk perception screening are discussed.

  1. 34 CFR 674.9 - Student eligibility.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... professional student at the institution, whether or not engaged in a program of study abroad approved for...) who is pursuing a course of study at an institution of higher education is considered to have no... the support it provides; and (3) Directs the member to pursue the course of study or provides...

  2. 34 CFR 674.9 - Student eligibility.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... professional student at the institution, whether or not engaged in a program of study abroad approved for...) who is pursuing a course of study at an institution of higher education is considered to have no... the support it provides; and (3) Directs the member to pursue the course of study or provides...

  3. 34 CFR 674.9 - Student eligibility.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... professional student at the institution, whether or not engaged in a program of study abroad approved for...) who is pursuing a course of study at an institution of higher education is considered to have no... the support it provides; and (3) Directs the member to pursue the course of study or provides...

  4. 34 CFR 674.9 - Student eligibility.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... professional student at the institution, whether or not engaged in a program of study abroad approved for...) who is pursuing a course of study at an institution of higher education is considered to have no... the support it provides; and (3) Directs the member to pursue the course of study or provides...

  5. 34 CFR 674.9 - Student eligibility.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... professional student at the institution, whether or not engaged in a program of study abroad approved for...) who is pursuing a course of study at an institution of higher education is considered to have no... the support it provides; and (3) Directs the member to pursue the course of study or provides...

  6. Using fuzzy gap analysis to measure service quality of medical tourism in Taiwan.

    PubMed

    Ho, Li-Hsing; Feng, Shu-Yun; Yen, Tieh-Min

    2015-01-01

    The purpose of this paper is intended to create a model to measure quality of service, using fuzzy linguistics to analyze the quality of service of medical tourism in Taiwan so as to find the direction for improvement of service quality in medical tourism. The study developed fuzzy questionnaires based on the characteristics of medical tourism quality of service in Taiwan. Questionnaires were delivered and recovered from February to April 2014, using random sampling according to the proportion of medical tourism companies in each region, and 150 effective samples were obtained. The critical quality of service level is found through the fuzzy gap analysis using questionnaires examining expectations and perceptions of customers, as the direction for continuous improvement. From the study, the primary five critical service items that improve the quality of service for medical tourism in Taiwan include, in order: the capability of the service provider to provide committed medical tourism services reliably and accurately, facility service providers in conjunction with the services provided, the cordial and polite attitude of the service provider eliciting a sense of trust from the customer, professional ability of medical (nursing) personnel in hospital and reliability of service provider. The contribution of this study is to create a fuzzy gap analysis to assess the performance of medical tourism service quality, identify key quality characteristics and provide a direction for improvement and development for medical tourism service quality in Taiwan.

  7. Impact of Implementation of Direct Cash Transfer Program 2008/2009 on Household Consumption in Central Java Province

    NASA Astrophysics Data System (ADS)

    Subanti, S.; Hakim, A. R.; Hakim, I. M.

    2017-04-01

    This study aims to see the impact of direct cash transfer program for 2008/2009 on household consumption of food, nonfood, education, and health in Central Java Province. The study is expected to provide important findings for the improvement of a similar program in the future. This study findings that (1) the increasing in food and non-food consumption for direct cash transfer recipients than non direct cash transfer recipients; (2) the impact of households expenditure on education for direct cash transfer recipients is higher than non direct cash transfer recipients; (3) the impact of households expenditure on health for direct cash transfer recipients is lower than non direct cash transfer recipients. This study recommended that (1) implementation of direct cash transfer program 2008/2009 must be managed to be better because this program can defend household welfare. It shows from several indicators of well-being such as consumption spending, education, and health; (2) data targets for poor households (very poor, poor, nearly poor) must be updated.

  8. Awareness and Perceptions of Food Safety Risks and Risk Management in Poultry Production and Slaughter: A Qualitative Study of Direct-Market Poultry Producers in Maryland.

    PubMed

    Baron, Patrick; Frattaroli, Shannon

    2016-01-01

    The objective of this study was to document and understand the perceptions and opinions of small-scale poultry producers who market directly to consumers about microbial food safety risks in the poultry supply chain. Between January and November 2014, we conducted semi-structured, in-depth interviews with a convenience sample of 16 owner-operators of Maryland direct-market commercial poultry farms. Three overarching thematic categories emerged from these interviews that describe: 1) characteristics of Maryland direct-market poultry production and processing; 2) microbial food safety risk awareness and risk management in small-scale poultry production, slaughter and processing; and 3) motivations for prioritizing food safety in the statewide direct-market poultry supply chain. Key informants provided valuable insights on many topics relevant to evaluating microbial food safety in the Maryland direct-market poultry supply chain, including: direct-market poultry production and processing practices and models, perspectives on issues related to food safety risk management, perspectives on direct-market agriculture economics and marketing strategies, and ideas for how to enhance food safety at the direct-market level of the Maryland poultry supply chain. The findings have policy implications and provide insights into food safety in small-scale commercial poultry production, processing, distribution and retail. In addition, the findings will inform future food safety research on the small-scale US poultry supply chain.

  9. Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework

    PubMed Central

    Corazzini, Kirsten; Twersky, Jack; White, Heidi K.; Buhr, Gwendolen T.; McConnell, Eleanor S.; Weiner, Madeline; Colón-Emeric, Cathleen S.

    2015-01-01

    Purpose of the Study: To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. Design and Methods: The study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership. Results: Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. Implications: Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges. PMID:24451896

  10. Cost-of-illness studies.

    PubMed

    Oderda, Gary M

    2003-01-01

    Cost-of-illness studies measure the overall economic impact of a disease on society. Such studies are important in setting public health priorities and for economic evaluation of new treatments. These studies should take the societal perspective and include both direct and indirect costs. Often indirect costs exceed direct costs. Comparison of cost-of-illness studies from different countries is difficult because of differences in population, currency, the way health care is provided, and other social and political factors.

  11. The Relationship among Stress, Burnout, and Locus of Control of School Psychologists

    ERIC Educational Resources Information Center

    Reece, Shana J.

    2010-01-01

    The purpose of this study was to determine how stress, burnout, and locus of control are related for school psychologists providing direct services in the Metropolitan Nashville Public School System. This knowledge is essential in providing the needed experience and outlook of working as a school psychologist. The current study provided school…

  12. Effects of librarian-provided services in healthcare settings: a systematic review

    PubMed Central

    Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

    2014-01-01

    Objective To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Materials and methods Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Results Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Conclusions Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. PMID:24872341

  13. Esthetics and Biocompatibility of Composite Dental Laminates.

    PubMed

    D'Souza, Dsj; Kumar, M

    2010-07-01

    Advances in modern dental materials provide patients with a choice of natural looking veneers to provide esthetic restorations. These may be directly fabricated composite resin veneers or indirectly fabricated veneers. This study was carried out to evaluate the clinical effect of new generation indirect veneering composites and to compare them with veneers fabricated from direct composite restorations. The present study was carried out in the Prosthodontics department of a medical college. A total of forty patients requiring restoration of the anterior teeth using composite veneers were selected and either of the two materials was used to fabricate the veneers. Clinical evaluation was done for esthetics and periodontal health. Statistical analysis showed that there were no significant changes to the periodontal health during the period of the study. The evidence obtained from this study indicates that both direct as well as indirect composite materials had clinically acceptable outcomes in terms of restoration of esthetics. Biocompatibility with the periodontal tissues of both materials was also evident by the improvement in oral health indices used in the study.

  14. Orthographic Facilitation of First Graders' Vocabulary Learning: Does Directing Attention to Print Enhance the Effect?

    ERIC Educational Resources Information Center

    Chambré, Susan J.; Ehri, Linnea C.; Ness, Molly

    2017-01-01

    Orthographic facilitation refers to the boost in vocabulary learning that is provided when spellings are shown during study periods, but not during testing. The current study examined orthographic facilitation in beginning readers and whether directing their attention to print enhances the effect. In an experiment, first graders (N = 45) were…

  15. A Cross-Disciplinary and Cross-Cultural Study of Directives in Discussions and Conclusions of Research Articles

    ERIC Educational Resources Information Center

    Jalilifar, Alireza; Mehrabi, Khodayar

    2014-01-01

    The current study provided cross-cultural and cross-disciplinary analyses of the distribution of directives in discussion and conclusion sections of English and Persian research articles (RAs) in disciplines of physics, chemistry, counseling, and sociology, representing hard and soft sciences, respectively. To that aim, 80 RAs from both English…

  16. Supervisory Intervention: Improving Data Reporting by Direct-Care Staff at a Child Services Program

    ERIC Educational Resources Information Center

    Flood, William A.; Luiselli, James K.

    2012-01-01

    We report a study that addressed behavior data recording by direct-care staff at a child services program. In response to a decreasing percentage of daily data recording in two community-based group homes, a supervisory intervention was implemented, consisting of a revised data recording form and providing performance feedback to the direct-care…

  17. Teachers' Self-Directed Professional Development: Science and Mathematics Teachers' Adoption of ICT as a Professional Development Strategy

    ERIC Educational Resources Information Center

    Mushayikwa, Emmanuel

    2013-01-01

    This paper is part of a larger study that was carried out to investigate the use of Information and Communication Technology (ICT) in the self-directed professional development on the self-directed professional development (SDPD) of mathematics and science teachers in Zimbabwe. The educational context provides an example of how teachers…

  18. A study of direct moxibustion using mathematical methods.

    PubMed

    Liu, Miao; Kauh, Sang Ken; Lim, Sabina

    2012-01-01

    Direct moxibustion is an important and widely used treatment method in traditional medical science. The use of a mathematical method to analyse direct moxibustion treatment is necessary and helpful in exploring the new direct moxibustion instruments and their standardisation. Thus, this paper aims to use a mathematical method to study direct moxibustion in skin to demonstrate a direct relationship between direct moxibustion and skin stimuli. In this paper, the transient thermal response of skin layers is analysed to study direct moxibustion using the data got from standardised method to measure the temperature of a burning moxa cone. Numerical simulations based on an appropriate finite element model are developed to predict the heat transfer, thermal damage and thermal stress distribution of barley moxa cones and jujube moxa cones in the skin tissue. The results are verified by the ancient literatures of traditional Chinese medicine and clinical application, and showed that mathematical method can be a good interface between moxa cone and skin tissue providing the numerical value basis for moxibustion.

  19. Is Beauty in the Hand of the Writer? Influences of Aesthetic Preferences through Script Directions, Cultural, and Neurological Factors: A Literature Review

    PubMed Central

    Page, Alexander G.; McManus, Chris; González, Carmen P.; Chahboun, Sobh

    2017-01-01

    Human experience surrounding the appreciation of beauty is not static. Many factors such as script direction and cultural differences directly impact whether, how and why we consider images beautiful. In an earlier study, Pérez González showed that 19th-century Iranian and Spanish professional photographers manifest lateral biases linked to reading writing direction in their compositions. The present paper aims to provide a general review on this topic and intends to highlight the most relevant studies reporting preferences in the appreciation of beauty in individuals with different reading and writing directions and belonging to different cultural backgrounds. PMID:28824504

  20. Assessment of dynamic balance via measurement of lower extremities tortuosity.

    PubMed

    Eltoukhy, Moataz; Kuenze, Christopher; Jun, Hyung-Pil; Asfour, Shihab; Travascio, Francesco

    2015-03-01

    Tortuosity describes how twisted or how much curvature is present in an observed movement or path. The purpose of this study was to investigate the differences in segmental tortuosity between Star Excursion Balance Test (SEBT) reach directions. Fifteen healthy participants completed this study. Participants completed the modified three direction (anterior, posteromedial, posterolateral) SEBT with three-dimensional motion analysis using an 8 camera BTS Smart 7000DX motion analysis system. The tortuosity of stance limb retro-reflective markers was then calculated and compared between reach directions using a 1 × 3 ANOVA with repeated measures, while the relationship between SEBT performance and tortuosity was established using Pearson product moment correlations. Anterior superior iliac spine tortuosity was significantly greater (p < 0.001) and lateral knee tortuosity was lesser (p = 0.018) in the anterior direction compared to the posteromedial and posterolateral directions. In addition, second metatarsal tortuosity was greater in the anterior reach direction when compared to posteromedial direction (p = 0.024). Tortuosity is a novel biomechanical measurement technique that provides an assessment of segmental movement during common dynamic tasks such as the SEBT. This enhanced level of detail compared to more global measures of joint kinematic may provide insight into compensatory movement strategies adopted following lower extremity joint injury.

  1. In vivo detection of brain Krebs cycle intermediate by hyperpolarized magnetic resonance.

    PubMed

    Mishkovsky, Mor; Comment, Arnaud; Gruetter, Rolf

    2012-12-01

    The Krebs (or tricarboxylic acid (TCA)) cycle has a central role in the regulation of brain energy regulation and metabolism, yet brain TCA cycle intermediates have never been directly detected in vivo. This study reports the first direct in vivo observation of a TCA cycle intermediate in intact brain, namely, 2-oxoglutarate, a key biomolecule connecting metabolism to neuronal activity. Our observation reveals important information about in vivo biochemical processes hitherto considered undetectable. In particular, it provides direct evidence that transport across the inner mitochondria membrane is rate limiting in the brain. The hyperpolarized magnetic resonance protocol designed for this study opens the way to direct and real-time studies of TCA cycle kinetics.

  2. Balancing collaborative and independent practice roles in clinical pharmacy: a qualitative research study.

    PubMed

    McCullough, Megan B; Solomon, Jeffrey L; Petrakis, Beth Ann; Park, Angela M; Ourth, Heather; Morreale, Anthony P; Rose, Adam J

    2015-02-01

    Clinical pharmacists (CPs) with a scope of practice operate as direct care providers and health care team members. Research often focuses on one role or the other; little is understood about the dynamic relationship between roles in practice settings. To identify the challenges CPs face in balancing dual roles as direct care providers and health care team members and the implications for CP effectiveness and quality of care. Pharmacists were interviewed with a primary purpose of informing an implementation effort. Besides the implementation, there were emergent themes regarding the challenges posed for CPs in negotiating dual roles. This study is, therefore, a secondary analysis of semistructured interviews and direct observation of 48 CPs, addressing this phenomenon. Interview data were entered into NVivo 10 and systematically analyzed using an emergent thematic coding strategy. Pharmacists describe role ambiguity, where they perform as direct providers or team members simultaneously or in quick succession. They note the existence of a "transaction cost," where switching causes loss of momentum or disruption of work flow. Additionally, pharmacists feel that fellow providers lack an understanding of what they do and that CP contributions are not evaluated accurately by other health professionals. It is a challenge for CPs to balance the distinct roles of serving as collaborators and primary providers. Frequent role switching is not conducive to optimal work efficiency or patient care. Our findings suggest concrete steps that medical centers can take to improve both CP worklife and quality of patient care. © The Author(s) 2014.

  3. The effect of accuracy motivation on anchoring and adjustment: do people adjust from provided anchors?

    PubMed

    Simmons, Joseph P; LeBoeuf, Robyn A; Nelson, Leif D

    2010-12-01

    Increasing accuracy motivation (e.g., by providing monetary incentives for accuracy) often fails to increase adjustment away from provided anchors, a result that has led researchers to conclude that people do not effortfully adjust away from such anchors. We challenge this conclusion. First, we show that people are typically uncertain about which way to adjust from provided anchors and that this uncertainty often causes people to believe that they have initially adjusted too far away from such anchors (Studies 1a and 1b). Then, we show that although accuracy motivation fails to increase the gap between anchors and final estimates when people are uncertain about the direction of adjustment, accuracy motivation does increase anchor-estimate gaps when people are certain about the direction of adjustment, and that this is true regardless of whether the anchors are provided or self-generated (Studies 2, 3a, 3b, and 5). These results suggest that people do effortfully adjust away from provided anchors but that uncertainty about the direction of adjustment makes that adjustment harder to detect than previously assumed. This conclusion has important theoretical implications, suggesting that currently emphasized distinctions between anchor types (self-generated vs. provided) are not fundamental and that ostensibly competing theories of anchoring (selective accessibility and anchoring-and-adjustment) are complementary. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  4. Behavioral and neuroimaging evidence for overreliance on habit learning in alcohol-dependent patients

    PubMed Central

    Sjoerds, Z; de Wit, S; van den Brink, W; Robbins, T W; Beekman, A T F; Penninx, B W J H; Veltman, D J

    2013-01-01

    Substance dependence is characterized by compulsive drug-taking despite negative consequences. Animal research suggests an underlying imbalance between goal-directed and habitual action control with chronic drug use. However, this imbalance, and its associated neurophysiological mechanisms, has not yet been experimentally investigated in human drug abusers. The aim of the present study therefore was to assess the balance between goal-directed and habit-based learning and its neural correlates in abstinent alcohol-dependent (AD) patients. A total of 31 AD patients and 19 age, gender and education matched healthy controls (HC) underwent functional magnetic resonance imaging (fMRI) during completion of an instrumental learning task designed to study the balance between goal-directed and habit learning. Task performance and task-related blood oxygen level-dependent activations in the brain were compared between AD patients and healthy matched controls. Findings were additionally associated with duration and severity of alcohol dependence. The results of this study provide evidence for an overreliance on stimulus-response habit learning in AD compared with HC, which was accompanied by decreased engagement of brain areas implicated in goal-directed action (ventromedial prefrontal cortex and anterior putamen) and increased recruitment of brain areas implicated in habit learning (posterior putamen) in AD patients. In conclusion, this is the first human study to provide experimental evidence for a disturbed balance between goal-directed and habitual control by use of an instrumental learning task, and to directly implicate cortical dysfunction to overreliance on inflexible habits in AD patients. PMID:24346135

  5. Behavioral and neuroimaging evidence for overreliance on habit learning in alcohol-dependent patients.

    PubMed

    Sjoerds, Z; de Wit, S; van den Brink, W; Robbins, T W; Beekman, A T F; Penninx, B W J H; Veltman, D J

    2013-12-17

    Substance dependence is characterized by compulsive drug-taking despite negative consequences. Animal research suggests an underlying imbalance between goal-directed and habitual action control with chronic drug use. However, this imbalance, and its associated neurophysiological mechanisms, has not yet been experimentally investigated in human drug abusers. The aim of the present study therefore was to assess the balance between goal-directed and habit-based learning and its neural correlates in abstinent alcohol-dependent (AD) patients. A total of 31 AD patients and 19 age, gender and education matched healthy controls (HC) underwent functional magnetic resonance imaging (fMRI) during completion of an instrumental learning task designed to study the balance between goal-directed and habit learning. Task performance and task-related blood oxygen level-dependent activations in the brain were compared between AD patients and healthy matched controls. Findings were additionally associated with duration and severity of alcohol dependence. The results of this study provide evidence for an overreliance on stimulus-response habit learning in AD compared with HC, which was accompanied by decreased engagement of brain areas implicated in goal-directed action (ventromedial prefrontal cortex and anterior putamen) and increased recruitment of brain areas implicated in habit learning (posterior putamen) in AD patients. In conclusion, this is the first human study to provide experimental evidence for a disturbed balance between goal-directed and habitual control by use of an instrumental learning task, and to directly implicate cortical dysfunction to overreliance on inflexible habits in AD patients.

  6. Future Directions in Distance Learning and Communication Technologies

    ERIC Educational Resources Information Center

    Shih, Timothy; Hung, Jason

    2007-01-01

    Future Directions in Distance Learning and Communication Technologies presents theoretical studies and practical solutions for engineers, educational professionals, and graduate students in the research areas of e-learning, distance education, and instructional design. This book provides readers with cutting-edge solutions and research directions…

  7. Age-related differences in the motor planning of a lower leg target matching task.

    PubMed

    Davies, Brenda L; Gehringer, James E; Kurz, Max J

    2015-12-01

    While the development and execution of upper extremity motor plans have been well explored, little is known about how individuals plan and execute rapid, goal-directed motor tasks with the lower extremities. Furthermore, the amount of time needed to integrate the proper amount of visual and proprioceptive feedback before being able to accurately execute a goal-directed movement is not well understood; especially in children. Therefore, the purpose of this study was to initially interrogate how the amount of motor planning time provided to a child before movement execution may influence the preparation and execution of a lower leg goal-directed movement. The results displayed that the amount of pre-movement motor planning time provided may influence the reaction time and accuracy of a goal directed leg movement. All subjects in the study had longer reaction times and less accurate movements when no pre-movement motor planning time was provided. In addition, the children had slower reaction times, slower movements, and less accurate movements than the adults for all the presented targets and motor planning times. These results highlight that children may require more time to successfully plan a goal directed movement with the lower extremity. This suggests that children may potentially have less robust internal models than adults for these types of motor skills. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Implementation issues for consumer-directed programs: comparing views of policy experts, consumers, and representatives.

    PubMed

    Simon-Rusinowitz, Lori; Marks, Lori N; Loughlin, Dawn M; Desmond, Sharon M; Mahoney, Kevin J; Zacharias, B Lee; Squillace, Marie R; Allison, Ann Marie

    2002-01-01

    An increasing number of aging community providers and consumers support consumer-direction (CD) in long-term care services. In regard to devolution, consumer-direction goes beyond the usual approach of shifting responsibilities from the federal government to state governments to bring programs "closer to the people." Consumer-direction goes even further by placing resources directly in the hands of consumers. Yet, many questions remain unanswered regarding how to implement CD personal assistance services in general, and especially for older persons. This article describes the importance of examining views from multiple key stakeholders involved in implementing CD programs. We report on three background studies that have informed the Cash and Counseling Demonstration and Evaluation (CCDE) design and implementation-policy expert interviews as well as surveys and focus groups with consumers and representatives. As a fourth data source, we drew upon experiences in designing the CCDE and initial results from the first year of implementation. Each of the three studies on its own provided essential information for planning the CCDE. However, when we examined the studies together, and added CCDE design and implementation experiences, views expressed by the different stakeholders formed a type of multi-perspective "dialogue" that expanded our knowledge about implementing CD services. We hope this increased knowledge will help expand the availability of such services for consumers of any age who want to direct their own care.

  9. Increasing Toy Play among Toddlers with Multiple Disabilities in an Inclusive Classroom: A More-to-Less, Child-Directed Intervention Continuum.

    ERIC Educational Resources Information Center

    DiCarlo, Cynthia F.; Reid, Dennis H.; Stricklin, Sarintha B.

    2003-01-01

    A study evaluated a more-to-less, child-directed continuum of intervention to increase toy play among six toddlers with multiple disabilities. Toddlers were provided with repeated choices of preferred toys in a child-directed manner. Nonprompted toy play for two toddlers increased. Toy play also increased for another child after staff prompts and…

  10. Awareness and Perceptions of Food Safety Risks and Risk Management in Poultry Production and Slaughter: A Qualitative Study of Direct-Market Poultry Producers in Maryland

    PubMed Central

    Baron, Patrick; Frattaroli, Shannon

    2016-01-01

    The objective of this study was to document and understand the perceptions and opinions of small-scale poultry producers who market directly to consumers about microbial food safety risks in the poultry supply chain. Between January and November 2014, we conducted semi-structured, in-depth interviews with a convenience sample of 16 owner-operators of Maryland direct-market commercial poultry farms. Three overarching thematic categories emerged from these interviews that describe: 1) characteristics of Maryland direct-market poultry production and processing; 2) microbial food safety risk awareness and risk management in small-scale poultry production, slaughter and processing; and 3) motivations for prioritizing food safety in the statewide direct-market poultry supply chain. Key informants provided valuable insights on many topics relevant to evaluating microbial food safety in the Maryland direct-market poultry supply chain, including: direct-market poultry production and processing practices and models, perspectives on issues related to food safety risk management, perspectives on direct-market agriculture economics and marketing strategies, and ideas for how to enhance food safety at the direct-market level of the Maryland poultry supply chain. The findings have policy implications and provide insights into food safety in small-scale commercial poultry production, processing, distribution and retail. In addition, the findings will inform future food safety research on the small-scale US poultry supply chain. PMID:27341034

  11. Four dimensional studies in earth space

    NASA Technical Reports Server (NTRS)

    Mather, R. S.

    1972-01-01

    A system of reference which is directly related to observations, is proposed for four-dimensional studies in earth space. Global control network and polar wandering are defined. The determination of variations in the earth's gravitational field with time also forms part of such a system. Techniques are outlined for the unique definition of the motion of the geocenter, and the changes in the location of the axis of rotation of an instantaneous earth model, in relation to values at some epoch of reference. The instantaneous system referred to is directly related to a fundamental equation in geodynamics. The reference system defined would provide an unambiguous frame for long period studies in earth space, provided the scale of the space were specified.

  12. Direct writing of metal nanostructures: lithographic tools for nanoplasmonics research.

    PubMed

    Leggett, Graham J

    2011-03-22

    Continued progress in the fast-growing field of nanoplasmonics will require the development of new methods for the fabrication of metal nanostructures. Optical lithography provides a continually expanding tool box. Two-photon processes, as demonstrated by Shukla et al. (doi: 10.1021/nn103015g), enable the fabrication of gold nanostructures encapsulated in dielectric material in a simple, direct process and offer the prospect of three-dimensional fabrication. At higher resolution, scanning probe techniques enable nanoparticle particle placement by localized oxidation, and near-field sintering of nanoparticulate films enables direct writing of nanowires. Direct laser "printing" of single gold nanoparticles offers a remarkable capability for the controlled fabrication of model structures for fundamental studies, particle-by-particle. Optical methods continue to provide a powerful support for research into metamaterials.

  13. Unresolved legal questions in cross-border health care in Europe: liability and data protection.

    PubMed

    van der Molen, I N; Commers, M J

    2013-11-01

    Directive 2011/24/EU was designed to clarify the rights of EU citizens in evaluating, accessing and obtaining reimbursement for cross-border care. Based on three regional case studies, the authors attempted to assess the added value of the Directive in helping clarify issues in to two key areas that have been identified as barriers to cross-border care: liability and data protection. Qualitative case study employing secondary data sources including research of jurisprudence, that set up a Legal framework as a base to investigate liability and data protection in the context of cross-border projects. By means of three case studies that have tackled liability and data protection hurdles in cross-border care implementation, this article attempts to provide insight into legal certainty and uncertainty regarding cross-border care in Europe. The case studies reveal that the Directive has not resolved core uncertainties related to liability and data protection issues within cross-border health care. Some issues related to the practice of cross-border health care in Europe have been further clarified by the Directive and some direction has been given to possible solutions for issues connected to liability and data protection. Directive 2011/24/EU is clearly a transposition of existing regulations on data protection and ECJ case law, plus a set of additional, mostly, voluntary rules that might enhance regional border cooperation. Therefore, as shown in the case studies, a practical and case by case approach is still necessary in designing and providing cross-border care. © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. Establishing pan-European clinical trials: regulatory compliance and other practical considerations.

    PubMed

    Grienenberger, Aurelie

    2004-01-01

    There are currently many concerns in the pharmaceutical and scientific community working in or around clinical research on the EU Directive 2001/20/EC or Clinical Trials Directive. The Directive introduces regulatory requirements for all phases of study in human subjects, drawing no distinction between commercially funded drug trials and non-commercial/academic research. The Directive makes Good Clinical Practice (GCP) a legal requirement in Europe and all clinical research will be subjected to the same rigorous standards including GCP and Good Manufacturing Practice (GMP) application even at the early clinical phases as well as exhaustive pharmacovigilance and protection of trial subjects. Some of these requirements may be seen as additional burden and a brake to clinical research in Europe. However, the application of the directive should provide a single and highly regulated market of 25 European countries for investigational medicinal products. This article reviews the main aspects and areas of concern of the Directive and provide US sponsor with useful references.

  15. Effects of librarian-provided services in healthcare settings: a systematic review.

    PubMed

    Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

    2014-01-01

    To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Providing Academic Leadership in Universities in Cross River State, Nigeria: Assessment of Departmental Heads' Effectiveness

    ERIC Educational Resources Information Center

    Akuegwu, Basil A.; Nwi-ue, Felix D.

    2017-01-01

    This study assessed Heads of Departments' effectiveness in providing academic leadership at the departmental level. I research question and 2 hypotheses were formulated to give direction to this investigation. Survey design was adopted for the study. The population of the study comprised 110 Heads of Departments from 2 universities in Cross River…

  17. Exploring how nurses and managers perceive shared governance.

    PubMed

    Wilson, Janet; Speroni, Karen Gabel; Jones, Ruth Ann; Daniel, Marlon G

    2014-07-01

    Nurse managers have a pivotal role in the success of unit-based councils, which include direct care nurses. These councils establish shared governance to provide innovative, quality-based, and cost-effective nursing care. This study explored differences between direct care nurses' and nurse managers' perceptions of factors affecting direct care nurses' participation in unit-based and general shared governance activities and nurse engagement. In a survey research study, 425 direct care RNs and nurse managers were asked to complete a 26-item research survey addressing 16 shared governance factors; 144 participated (response rate = 33.8%). Most nurse participants provided direct care (N = 129, 89.6%; nurse managers = 15, 10.4%), were older than 35 (75.6%), had more than 5 years of experience (76.4%), and worked more than 35 hours per week (72.9%). Direct care nurses' and managers' perceptions showed a few significant differences. Factors ranked as very important by direct care nurses and managers included direct care nurses perceiving support from unit manager to participate in shared governance activities (84.0%); unit nurses working as a team (79.0%); direct care nurses participating in shared governance activities won't disrupt patient care (76.9%); and direct care nurses will be paid for participating beyond scheduled shifts (71.3%). Overall, 79.2% had some level of engagement in shared governance activities. Managers reported more engagement than direct care nurses. Nurse managers and unit-based councils should evaluate nurses' perceptions of manager support, teamwork, lack of disruption to patient care, and payment for participation in shared governance-related activities. These research findings can be used to evaluate hospital practices for direct care nurse participation in unit-based shared governance activities.

  18. Barriers and facilitators to using NHS Direct: a qualitative study of 'users' and 'non-users'.

    PubMed

    Cook, Erica J; Randhawa, Gurch; Large, Shirley; Guppy, Andy; Chater, Angel M; Ali, Nasreen

    2014-10-25

    NHS Direct, introduced in 1998, has provided 24/7 telephone-based healthcare advice and information to the public in England and Wales. National studies have suggested variation in the uptake of this service amongst the UK's diverse population. This study provides the first exploration of the barriers and facilitators that impact upon the uptake of this service from the perspectives of both 'users' and 'non- users'. Focus groups were held with NHS Direct 'users' (N = 2) from Bedfordshire alongside 'non-users' from Manchester (N = 3) and Mendip, Somerset (N = 4). Each focus group had between five to eight participants. A total of eighty one people aged between 21 and 94 years old (M: 58.90, SD: 22.70) took part in this research. Each focus group discussion lasted approximately 90 minutes and was audiotape-recorded with participants' permission. The recordings were transcribed verbatim. A framework approach was used to analyse the transcripts. The findings from this research uncovered a range of barriers and facilitators that impact upon the uptake of NHS Direct. 'Non-users' were unaware of the range of services that NHS Direct provided. Furthermore, 'non-users' highlighted a preference for face-to face communication, identifying a lack of confidence in discussing healthcare over the telephone. This was particularly evident among older people with cognitive difficulties. The cost to telephone a '0845' number from a mobile was also viewed to be a barrier to access NHS Direct, expressed more often by 'non-users' from deprived communities. NHS Direct 'users' identified that awareness, ease of use and convenience were facilitators which influenced their decision to use the service. An understanding of the barriers and facilitators which impact on the access and uptake of telephone-based healthcare is essential to move patients towards the self-care model. This research has highlighted the need for telephone-based healthcare services to increase public awareness; through the delivery of more targeted advertising to promote the service provision available.

  19. The Eyes Are the Windows to the Mind: Direct Eye Gaze Triggers the Ascription of Others' Minds.

    PubMed

    Khalid, Saara; Deska, Jason C; Hugenberg, Kurt

    2016-12-01

    Eye gaze is a potent source of social information with direct eye gaze signaling the desire to approach and averted eye gaze signaling avoidance. In the current work, we proposed that eye gaze signals whether or not to impute minds into others. Across four studies, we manipulated targets' eye gaze (i.e., direct vs. averted eye gaze) and measured explicit mind ascriptions (Study 1a, Study 1b, and Study 2) and beliefs about the likelihood of targets having mind (Study 3). In all four studies, we find novel evidence that the ascription of sophisticated humanlike minds to others is signaled by the display of direct eye gaze relative to averted eye gaze. Moreover, we provide evidence suggesting that this differential mentalization is due, at least in part, to beliefs that direct gaze targets are more likely to instigate social interaction. In short, eye contact triggers mind perception. © 2016 by the Society for Personality and Social Psychology, Inc.

  20. In vivo detection of brain Krebs cycle intermediate by hyperpolarized magnetic resonance

    PubMed Central

    Mishkovsky, Mor; Comment, Arnaud; Gruetter, Rolf

    2012-01-01

    The Krebs (or tricarboxylic acid (TCA)) cycle has a central role in the regulation of brain energy regulation and metabolism, yet brain TCA cycle intermediates have never been directly detected in vivo. This study reports the first direct in vivo observation of a TCA cycle intermediate in intact brain, namely, 2-oxoglutarate, a key biomolecule connecting metabolism to neuronal activity. Our observation reveals important information about in vivo biochemical processes hitherto considered undetectable. In particular, it provides direct evidence that transport across the inner mitochondria membrane is rate limiting in the brain. The hyperpolarized magnetic resonance protocol designed for this study opens the way to direct and real-time studies of TCA cycle kinetics. PMID:22990416

  1. Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review.

    PubMed

    Luu, Ngoc-Phuong; Pitts, Samantha; Petty, Brent; Sawyer, Melinda D; Dennison-Himmelfarb, Cheryl; Boonyasai, Romsai Tony; Maruthur, Nisa M

    2016-04-01

    Most research on transitions of care has focused on the transition from acute to outpatient care. Little is known about the transition from outpatient to acute care. We conducted a systematic review of the literature on the transition from outpatient to acute care, focusing on provider-to-provider communication and its impact on quality of care. We searched the MEDLINE, CINAHL, Scopus, EMBASE, and Cochrane databases for English-language articles describing direct communication between outpatient providers and acute care providers around patients presenting to the emergency department or admitted to the hospital. We conducted double, independent review of titles, abstracts, and full text articles. Conflicts were resolved by consensus. Included articles were abstracted using standardized forms. We maintained search results via Refworks (ProQuest, Bethesda, MD). Risk of bias was assessed using a modified version of the Downs' and Black's tool. Of 4009 citations, twenty articles evaluated direct provider-to-provider communication around the outpatient to acute care transition. Most studies were cross-sectional (65%), conducted in the US (55%), and studied communication between primary care and inpatient providers (62%). Of three studies reporting on the association between communication and 30-day readmissions, none found a significant association; of these studies, only one reported a measure of association (adjusted OR for communication vs. no communication, 1.08; 95% CI 0.92-1.26). The literature on provider-to-provider communication at the transition from outpatient to acute care is sparse and heterogeneous. Given the known importance of communication for other transitions of care, future studies are needed on provider-to-provider communication during this transition. Studies evaluating ideal methods for communication to reduce medical errors, utilization, and optimize patient satisfaction at this transition are especially needed.

  2. Three-axis orthogonal transceiver coil for eddy current sounding

    NASA Astrophysics Data System (ADS)

    Sukhanov, D.; Zavyalova, K.; Goncharik, M.

    2017-08-01

    We propose the new structure of three-axis transceiver magnetic-induction coil for eddy current probing. Due to the orientation of the coils, the direct signal from the transmitting coil to the receiving coil is minimized, which provided a high dynamic range. Sensitivity in all directions is provided by combining coils of different orientations. Numerical simulation and experimental studies of such a system have been carried out and confirmed the applicability of the proposed method and the mathematical model.

  3. Natural history collections as windows on evolutionary processes.

    PubMed

    Holmes, Michael W; Hammond, Talisin T; Wogan, Guinevere O U; Walsh, Rachel E; LaBarbera, Katie; Wommack, Elizabeth A; Martins, Felipe M; Crawford, Jeremy C; Mack, Katya L; Bloch, Luke M; Nachman, Michael W

    2016-02-01

    Natural history collections provide an immense record of biodiversity on Earth. These repositories have traditionally been used to address fundamental questions in biogeography, systematics and conservation. However, they also hold the potential for studying evolution directly. While some of the best direct observations of evolution have come from long-term field studies or from experimental studies in the laboratory, natural history collections are providing new insights into evolutionary change in natural populations. By comparing phenotypic and genotypic changes in populations through time, natural history collections provide a window into evolutionary processes. Recent studies utilizing this approach have revealed some dramatic instances of phenotypic change over short timescales in response to presumably strong selective pressures. In some instances, evolutionary change can be paired with environmental change, providing a context for potential selective forces. Moreover, in a few cases, the genetic basis of phenotypic change is well understood, allowing for insight into adaptive change at multiple levels. These kinds of studies open the door to a wide range of previously intractable questions by enabling the study of evolution through time, analogous to experimental studies in the laboratory, but amenable to a diversity of species over longer timescales in natural populations. © 2016 John Wiley & Sons Ltd.

  4. Natural history collections as windows on evolutionary processes

    PubMed Central

    Holmes, Michael W.; Hammond, Talisin T.; Wogan, Guinevere O.U.; Walsh, Rachel E.; LaBarbera, Katie; Wommack, Elizabeth A.; Martins, Felipe M.; Crawford, Jeremy C.; Mack, Katya L.; Bloch, Luke M.; Nachman, Michael W.

    2016-01-01

    Natural history collections provide an immense record of biodiversity on Earth. These repositories have traditionally been used to address fundamental questions in biogeography, systematics, and conservation. However, they also hold the potential for studying evolution directly. While some of the best direct observations of evolution have come from long-term field studies or from experimental studies in the lab, natural history collections are providing new insights into evolutionary change in natural populations. By comparing phenotypic and genotypic changes in populations through time, natural history collections provide a window into evolutionary processes. Recent studies utilizing this approach have revealed some dramatic instances of phenotypic change over short time scales in response to presumably strong selective pressures. In some instances evolutionary change can be paired with environmental change, providing a context for potential selective forces. Moreover, in a few cases, the genetic basis of phenotypic change is well understood, allowing for insight into adaptive change at multiple levels. These kinds of studies open the door to a wide range of previously intractable questions by enabling the study of evolution through time, analogous to experimental studies in the laboratory, but amenable to a diversity of species over longer timescales in natural populations. PMID:26757135

  5. The Influence of Adult Learners' Self-Directed Learning Readiness and Network Literacy on Online Learning Effectiveness: A Study of Civil Servants in Taiwan

    ERIC Educational Resources Information Center

    Lai, Horng-Ji

    2011-01-01

    This study examined the effect of civil servants' Self-Directed Learning Readiness (SDLR) and network literacy on their online learning effectiveness in a web-based training program. Participants were 283 civil servants enrolled in an asynchronous online learning program through an e-learning portal provided by the Regional Civil Service…

  6. The Myth of Spatial Reuse with Directional Antennas in Indoor Wireless Networks

    NASA Astrophysics Data System (ADS)

    Lakshmanan, Sriram; Sundaresan, Karthikeyan; Rangarajan, Sampath; Sivakumar, Raghupathy

    Interference among co-channel users is a fundamental problem in wireless networks, which prevents nearby links from operating concurrently. Directional antennas allow the radiation patterns of wireless transmitters to be shaped to form directed beams. Conventionally, such beams are assumed to improve the spatial reuse (i.e. concurrency) in indoor wireless networks. In this paper, we use experiments in an indoor office setting of Wifi Access points equipped with directional antennas, to study their potential for interference mitigation and spatial reuse. In contrast to conventional wisdom, we observe that the interference mitigation benefits of directional antennas are minimal. On analyzing our experimental traces we observe that directional links do not reduce interference to nearby links due to the lack of signal confinement due to indoor multipath fading. We then use the insights derived from our study to develop an alternative approach that provides better interference reduction in indoor networks compared to directional links.

  7. Do the same traffic rules apply? Directional chromosome segregation by SpoIIIE and FtsK.

    PubMed

    Besprozvannaya, Marina; Burton, Briana M

    2014-08-01

    Over a decade of studies have tackled the question of how FtsK/SpoIIIE translocases establish and maintain directional DNA translocation during chromosome segregation in bacteria. FtsK/SpoIIIE translocases move DNA in a highly processive, directional manner, where directionality is facilitated by sequences on the substrate DNA molecules that are being transported. In recent years, structural, biochemical, single-molecule and high-resolution microscopic studies have provided new insight into the mechanistic details of directional DNA segregation. Out of this body of work, a series of models have emerged and, ultimately, yielded two seemingly opposing models: the loading model and the target search model. We review these recent mechanistic insights into directional DNA movement and discuss the data that may serve to unite these suggested models, as well as propose future directions that may ultimately solve the debate. © 2014 John Wiley & Sons Ltd.

  8. Silk Film Topography Directs Collective Epithelial Cell Migration

    PubMed Central

    Rosenblatt, Mark I.

    2012-01-01

    The following study provides new insight into how surface topography dictates directed collective epithelial cell sheet growth through the guidance of individual cell movement. Collective cell behavior of migrating human corneal limbal-epithelial cell sheets were studied on highly biocompatible flat and micro-patterned silk film surfaces. The silk film edge topography guided the migratory direction of individual cells making up the collective epithelial sheet, which resulted in a 75% increase in total culture elongation. This was due to a 3-fold decrease in cell sheet migration rate efficiency for movement perpendicular to the topography edge. Individual cell migration direction is preferred in the parallel approach to the edge topography where localization of cytoskeletal proteins to the topography’s edge region is reduced, which results in the directed growth of the collective epithelial sheet. Findings indicate customized biomaterial surfaces may be created to direct both the migration rate and direction of tissue epithelialization. PMID:23185573

  9. Experimental Study on the Anisotropic Stress-Strain Behavior of Polycrystalline Ni-Mn-Ga in Directional Solidification

    NASA Astrophysics Data System (ADS)

    Teng, Yao; Shi, Tao; Zhu, Yuping; Li, Zongbin; Deng, Tao; Bai, Guonan

    2016-03-01

    A polycrystalline Ni-Mn-Ga ferromagnetic shape memory alloy produced by directional solidification is the subject of this research paper. The compressive stress-strain curves of the material for different cutting angles to the solidification direction are tested. The martensite Young's modulus, macroscopic reorientation strain, and phase transition critical stress are analyzed experimentally. The results show that mechanical behaviors in the loading-unloading cycle of the material present nonlinear and anisotropic characteristics, which are all closely related to the material's orientation to the solidification direction. The martensite Young's modulus, macroscopic reorientation strain, and phase transition critical stress achieve maximum values in the solidification direction. A 50° orientation to the solidification direction is the cut-off direction of the mechanical properties, where the martensite Young's modulus and reorientation start critical stress reach minimum values. The present study is expected to provide sound guidance for practical applications.

  10. Provider-patient adherence dialogue in HIV care: results of a multisite study.

    PubMed

    Laws, M Barton; Beach, Mary Catherine; Lee, Yoojin; Rogers, William H; Saha, Somnath; Korthuis, P Todd; Sharp, Victoria; Wilson, Ira B

    2013-01-01

    Few studies have analyzed physician-patient adherence dialogue about ARV treatment in detail. We comprehensively describe physician-patient visits in HIV care, focusing on ARV-related dialogue, using a system that assigns each utterance both a topic code and a speech act code. Observational study using audio recordings of routine outpatient visits by people with HIV at specialty clinics. Providers were 34 physicians and 11 non-M.D. practitioners. Of 415 patients, 66% were male, 59% African-American. 78% reported currently taking ARVs. About 10% of utterances concerned ARV treatment. Among those using ARVs, 15% had any adherence problem solving dialogue. ARV problem solving talk included significantly more directives and control parameter utterances by providers than other topics. Providers were verbally dominant, asked five times as many questions as patients, and made 21 times as many directive utterances. Providers asked few open questions, and rarely checked patients' understanding. Physicians respond to the challenges of caring for patients with HIV by adopting a somewhat physician-centered approach which is particularly evident in discussions about ARV adherence.

  11. New Electrocatalysts for Direct Oxidation of Organic Fuels

    DTIC Science & Technology

    2009-06-12

    ambient temperature . [28,29] While 13C-NMR provides information on the nature of the adsorbate and the electronic environment at the active surface of...our study to unsupported electrocatalysts that are of greater interest for direct methanol and direct ethanol fuel cells. We have developed a new in...coverage, and type of surface site on the relative adsorption rate and electrooxidative activity of the electrocatalyst. Figure 2 shows sample

  12. Collaborative Memory and Part-Set Cuing Impairments: The Role of Executive Depletion in Modulating Retrieval Disruption

    PubMed Central

    Barber, Sarah J.; Rajaram, Suparna

    2011-01-01

    When people are exposed to a subset of previously studied list items they recall fewer of the remaining items compared to a condition where none of the studied items are provided during recall. This occurs both when the subset of items is provided by the experimenter (i.e., the part-set cuing deficit in individual recall) and when they are provided during the course of a collaborative discussion (i.e., the collaborative inhibition effect in group recall). Previous research has identified retrieval disruption as a common mechanism underlying both effects; however, less is known about the factors that may make individuals susceptible to such retrieval disruption. In the current studies we tested one candidate factor, namely, executive control. Using an executive depletion paradigm we directly manipulated an individual’s level of executive control during retrieval. Results revealed no direct role of executive depletion in modulating retrieval disruption. In contrast, executive control abilities were indirectly related to retrieval disruption through their influence at encoding. Together, these results suggest that executive control does not directly affect retrieval disruption at the retrieval stage, and that the role of this putative mechanism may be limited to the encoding stage. PMID:21678155

  13. Direction of Contents Development for SMART Education

    ERIC Educational Resources Information Center

    Park, YoungSun; An, SangJin; Lee, YoungJun

    2013-01-01

    The aim of this study is to suggest a direction of developing SMART education contents for its effective implementation by analyzing the status of educational informatization policies in Korea. Korean government has built the information and communication infrastructure, and provided teachers and students with various kinds of contents. And, in…

  14. Does the vestibular system contribute to head direction cell activity in the rat?

    NASA Technical Reports Server (NTRS)

    Brown, J. E.; Yates, B. J.; Taube, J. S.; Oman, C. M. (Principal Investigator)

    2002-01-01

    Head direction cells (HDC) located in several regions of the brain, including the anterior dorsal nucleus of the thalamus (ADN), postsubiculum (PoS), and lateral mammillary nuclei (LMN), provide the neural substrate for the determination of head direction. Although activity of HDC is influenced by various sensory signals and internally generated cues, lesion studies and some anatomical and physiological evidence suggest that vestibular inputs are critical for the maintenance of directional sensitivity of these cells. However, vestibular inputs must be transformed considerably in order to signal head direction, and the neuronal circuitry that accomplishes this signal processing has not been fully established. Furthermore, it is unclear why the removal of vestibular inputs abolishes the directional sensitivity of HDC, as visual and other sensory inputs and motor feedback signals strongly affect the firing of these neurons and would be expected to maintain their directional-related activity. Further physiological studies will be required to establish the role of vestibular system in producing HDC responses, and anatomical studies are needed to determine the neural circuitry that mediates vestibular influences on determination of head direction.

  15. A work sampling study of provider activities in school-based health centers.

    PubMed

    Mavis, Brian; Pearson, Rachel; Stewart, Gail; Keefe, Carole

    2009-06-01

    The purpose of this study was to describe provider activities in a convenience sample of School-Based Health Centers (SBHCs). The goal was to determine the relative proportion of time that clinic staff engaged in various patient care and non-patient care activities. All provider staff at 4 urban SBHCs participated in this study; 2 were in elementary schools, 1 in a middle school, and 1 in a school with kindergarten through grade 8. The study examined provider activity from 6 days sampled at random from the school year. Participants were asked to document their activities in 15-minute intervals from 8:00 a.m. to 5:00 p.m. A structured recording form was used that included 35 activity categories. Overall, 1492 records were completed, accounting for 2708 coded activities. Almost half (48%) of all staff activities were coded as direct patient contact, with clinic operations the second largest category. Limited variations in activities were found across clinic sites and according to season. A significant amount of provider activity was directed at the delivery of health care; direct patient care and clinic operations combined accounted for approximately 75% of clinic activity. Patient, classroom, and group education activities, as well as contacts with parents and school staff accounted for 20% of all clinic activity and represent important SBHC functions that other productivity measures such as billing data might not consistently track. Overall, the method was acceptable to professional staff as a means of tracking activity and was adaptable to meet their needs.

  16. Large fraction of crystal directions leads to ion channeling

    NASA Astrophysics Data System (ADS)

    Nordlund, K.; Djurabekova, F.; Hobler, G.

    2016-12-01

    It is well established that when energetic ions are moving in crystals, they may penetrate much deeper if they happen to be directed in some specific crystal directions. This `channeling' effect is utilized for instance in certain ion beam analysis methods and has been described by analytical theories and atomistic computer simulations. However, there have been very few systematic studies of channeling in directions other than the principal low-index ones. We present here a molecular dynamics-based approach to calculate ion channeling systematically over all crystal directions, providing ion `channeling maps' that easily show in which directions channeling is expected. The results show that channeling effects can be quite significant even at energies below 1 keV, and that in many cases, significant planar channeling occurs also in a wide range of crystal directions between the low-index principal ones. In all of the cases studied, a large fraction (˜20 -60 % ) of all crystal directions show channeling. A practical implication of this is that modern experiments on randomly oriented nanostructures will have a large probability of channeling. It also means that when ion irradiations are carried out on polycrystalline samples, channeling effects on the results cannot a priori be assumed to be negligible. The maps allow for easy selection of good `nonchanneling' directions in experiments or alternatively finding wide channels for beneficial uses of channeling. We implement channeling theory to also give the fraction of channeling directions in a manner directly comparable to the simulations. The comparison shows good qualitative agreement. In particular, channeling theory is very good at predicting which channels are active at a given energy. This is true down to sub-keV energies, provided the penetration depth is not too small.

  17. Do Example Sentences Work in Direct Vocabulary Learning?

    ERIC Educational Resources Information Center

    Baicheng, Zhang

    2009-01-01

    In the present study of language learning, three presentation modes (varying from providing or not providing example sentences by the teacher and by the students themselves) have been utilised to examine the effectiveness of using example sentences in vocabulary presentation and learning activities. The study is of 58 English majors as the…

  18. A laboratory study of nonlinear changes in the directionality of extreme seas

    NASA Astrophysics Data System (ADS)

    Latheef, M.; Swan, C.; Spinneken, J.

    2017-03-01

    This paper concerns the description of surface water waves, specifically nonlinear changes in the directionality. Supporting calculations are provided to establish the best method of directional wave generation, the preferred method of directional analysis and the inputs on which such a method should be based. These calculations show that a random directional method, in which the phasing, amplitude and direction of propagation of individual wave components are chosen randomly, has benefits in achieving the required ergodicity. In terms of analysis procedures, the extended maximum entropy principle, with inputs based upon vector quantities, produces the best description of directionality. With laboratory data describing the water surface elevation and the two horizontal velocity components at a single point, several steep sea states are considered. The results confirm that, as the steepness of a sea state increases, the overall directionality of the sea state reduces. More importantly, it is also shown that the largest waves become less spread or more unidirectional than the sea state as a whole. This provides an important link to earlier descriptions of deterministic wave groups produced by frequency focusing, helps to explain recent field observations and has important practical implications for the design of marine structures and vessels.

  19. Training Evaluation: Clients' Roles.

    ERIC Educational Resources Information Center

    Hashim, Junaidah

    2001-01-01

    A study was conducted of 262 training providers in Malaysia, where providers must be government approved. Government regulation, client demands for high quality, and an economic downturn that focused attention on training costs have all influenced evaluation in a positive direction. (SK)

  20. Optimal cure cycle design for autoclave processing of thick composites laminates: A feasibility study

    NASA Technical Reports Server (NTRS)

    Hou, Jean W.

    1985-01-01

    The thermal analysis and the calculation of thermal sensitivity of a cure cycle in autoclave processing of thick composite laminates were studied. A finite element program for the thermal analysis and design derivatives calculation for temperature distribution and the degree of cure was developed and verified. It was found that the direct differentiation was the best approach for the thermal design sensitivity analysis. In addition, the approach of the direct differentiation provided time histories of design derivatives which are of great value to the cure cycle designers. The approach of direct differentiation is to be used for further study, i.e., the optimal cycle design.

  1. 20 CFR 661.310 - Under what limited conditions may a Local Board directly be a provider of core services...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Board directly be a provider of core services, intensive services, or training services, or act as a One... Board directly be a provider of core services, intensive services, or training services, or act as a One-Stop Operator? (a) A Local Board may not directly provide core services, or intensive services, or be...

  2. 20 CFR 661.310 - Under what limited conditions may a Local Board directly be a provider of core services...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Board directly be a provider of core services, intensive services, or training services, or act as a One... Board directly be a provider of core services, intensive services, or training services, or act as a One-Stop Operator? (a) A Local Board may not directly provide core services, or intensive services, or be...

  3. 48 CFR 9.505-1 - Providing systems engineering and technical direction.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... engineering and technical direction. 9.505-1 Section 9.505-1 Federal Acquisition Regulations System FEDERAL... of Interest 9.505-1 Providing systems engineering and technical direction. (a) A contractor that provides systems engineering and technical direction for a system but does not have overall contractual...

  4. 48 CFR 9.505-1 - Providing systems engineering and technical direction.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... engineering and technical direction. 9.505-1 Section 9.505-1 Federal Acquisition Regulations System FEDERAL... of Interest 9.505-1 Providing systems engineering and technical direction. (a) A contractor that provides systems engineering and technical direction for a system but does not have overall contractual...

  5. 48 CFR 9.505-1 - Providing systems engineering and technical direction.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... engineering and technical direction. 9.505-1 Section 9.505-1 Federal Acquisition Regulations System FEDERAL... of Interest 9.505-1 Providing systems engineering and technical direction. (a) A contractor that provides systems engineering and technical direction for a system but does not have overall contractual...

  6. 48 CFR 9.505-1 - Providing systems engineering and technical direction.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... engineering and technical direction. 9.505-1 Section 9.505-1 Federal Acquisition Regulations System FEDERAL... of Interest 9.505-1 Providing systems engineering and technical direction. (a) A contractor that provides systems engineering and technical direction for a system but does not have overall contractual...

  7. 48 CFR 9.505-1 - Providing systems engineering and technical direction.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... engineering and technical direction. 9.505-1 Section 9.505-1 Federal Acquisition Regulations System FEDERAL... of Interest 9.505-1 Providing systems engineering and technical direction. (a) A contractor that provides systems engineering and technical direction for a system but does not have overall contractual...

  8. Design, methods, and participant characteristics of the Impact of Personal Genomics (PGen) Study, a prospective cohort study of direct-to-consumer personal genomic testing customers.

    PubMed

    Carere, Deanna Alexis; Couper, Mick P; Crawford, Scott D; Kalia, Sarah S; Duggan, Jake R; Moreno, Tanya A; Mountain, Joanna L; Roberts, J Scott; Green, Robert C

    2014-01-01

    Designed in collaboration with 23andMe and Pathway Genomics, the Impact of Personal Genomics (PGen) Study serves as a model for academic-industry partnership and provides a longitudinal dataset for studying psychosocial, behavioral, and health outcomes related to direct-to-consumer personal genomic testing (PGT). Web-based surveys administered at three time points, and linked to individual-level PGT results, provide data on 1,464 PGT customers, of which 71% completed each follow-up survey and 64% completed all three surveys. The cohort includes 15.7% individuals of non-white ethnicity, and encompasses a range of income, education, and health levels. Over 90% of participants agreed to re-contact for future research.

  9. Direct Observation Through In Situ Transmission Electron Microscope of Early States of Crystallization in Nanoscale Metallic Glasses

    NASA Astrophysics Data System (ADS)

    Xie, Y.; Sohn, S.; Schroers, J.; Cha, J. J.

    2017-11-01

    Crystallization is a complex process that involves multiscale physics such as diffusion of atomic species over multiple length scales, thermodynamic energy considerations, and multiple possible intermediate states. In situ crystallization experiments inside a transmission electron microscope (TEM) using nanostructured metallic glasses (MGs) provide a unique platform to study directly crystallization kinetics and pathways. Here, we study the embryonic state of eutectic growth using Pt-Ni-Cu-P MG nanorods under in situ TEM. We directly observe the nucleation and growth of a Ni-rich polymorphic phase, followed by the nucleation and slower growth of a Cu-rich phase. The suppressed growth kinetics of the Cu-rich phase is attributed to locally changing chemical compositions. In addition, we show that growth can be controlled by incorporation of an entire nucleus instead of individual atoms. Such a nucleus has to align with the crystallographic orientation of a larger grain before it can be incorporated into the crystal. By directly observing the crystallization processes, particularly the early stages of non-polymorphic growth, in situ TEM crystallization studies of MG nanostructures provide a wealth of information, some of which can be applied to typical bulk crystallization.

  10. An International Study of the Ability and Cost-Effectiveness of Advertising Methods to Facilitate Study Participant Self-Enrolment Into a Pilot Pharmacovigilance Study During Early Pregnancy

    PubMed Central

    2016-01-01

    Background Knowledge of the fetal effects of maternal medication use in pregnancy is often inadequate and current pregnancy pharmacovigilance (PV) surveillance methods have important limitations. Patient self-reporting may be able to mitigate some of these limitations, providing an adequately sized study sample can be recruited. Objective To compare the ability and cost-effectiveness of several direct-to-participant advertising methods for the recruitment of pregnant participants into a study of self-reported gestational exposures and pregnancy outcomes. Methods The Pharmacoepidemiological Research on Outcomes of Therapeutics by a European Consortium (PROTECT) pregnancy study is a non-interventional, prospective pilot study of self-reported medication use and obstetric outcomes provided by a cohort of pregnant women that was conducted in Denmark, the Netherlands, Poland, and the United Kingdom. Direct-to-participant advertisements were provided via websites, emails, leaflets, television, and social media platforms. Results Over a 70-week recruitment period direct-to-participant advertisements engaged 43,234 individuals with the study website or telephone system; 4.78% (2065/43,234) of which were successfully enrolled and provided study data. Of these 90.4% (1867/2065) were recruited via paid advertising methods, 23.0% (475/2065) of whom were in the first trimester of pregnancy. The overall costs per active recruited participant were lowest for email (€23.24) and website (€24.41) advertisements and highest for leaflet (€83.14) and television (€100.89). Website adverts were substantially superior in their ability to recruit participants during their first trimester of pregnancy (317/668, 47.5%) in comparison with other advertising methods (P<.001). However, we identified international variations in both the cost-effectiveness of the various advertisement methods used and in their ability to recruit participants in early pregnancy. Conclusions Recruitment of a pregnant cohort using direct-to-participant advertisement methods is feasible, but the total costs incurred are not insubstantial. Future research is needed to identify advertising strategies capable of recruiting large numbers of demographically representative pregnant women, preferentially in early pregnancy. PMID:27227148

  11. An International Study of the Ability and Cost-Effectiveness of Advertising Methods to Facilitate Study Participant Self-Enrolment Into a Pilot Pharmacovigilance Study During Early Pregnancy.

    PubMed

    Richardson, Jonathan Luke; Stephens, Sally; Thomas, Simon Hugh Lynton; Jamry-Dziurla, Anna; de Jong-van den Berg, Lolkje; Zetstra-van der Woude, Priscilla; Laursen, Maja; Hliva, Valerie; Mt-Isa, Shahrul; Bourke, Alison; Dreyer, Nancy A; Blackburn, Stella Cf

    2016-01-01

    Knowledge of the fetal effects of maternal medication use in pregnancy is often inadequate and current pregnancy pharmacovigilance (PV) surveillance methods have important limitations. Patient self-reporting may be able to mitigate some of these limitations, providing an adequately sized study sample can be recruited. To compare the ability and cost-effectiveness of several direct-to-participant advertising methods for the recruitment of pregnant participants into a study of self-reported gestational exposures and pregnancy outcomes. The Pharmacoepidemiological Research on Outcomes of Therapeutics by a European Consortium (PROTECT) pregnancy study is a non-interventional, prospective pilot study of self-reported medication use and obstetric outcomes provided by a cohort of pregnant women that was conducted in Denmark, the Netherlands, Poland, and the United Kingdom. Direct-to-participant advertisements were provided via websites, emails, leaflets, television, and social media platforms. Over a 70-week recruitment period direct-to-participant advertisements engaged 43,234 individuals with the study website or telephone system; 4.78% (2065/43,234) of which were successfully enrolled and provided study data. Of these 90.4% (1867/2065) were recruited via paid advertising methods, 23.0% (475/2065) of whom were in the first trimester of pregnancy. The overall costs per active recruited participant were lowest for email (€23.24) and website (€24.41) advertisements and highest for leaflet (€83.14) and television (€100.89). Website adverts were substantially superior in their ability to recruit participants during their first trimester of pregnancy (317/668, 47.5%) in comparison with other advertising methods (P<.001). However, we identified international variations in both the cost-effectiveness of the various advertisement methods used and in their ability to recruit participants in early pregnancy. Recruitment of a pregnant cohort using direct-to-participant advertisement methods is feasible, but the total costs incurred are not insubstantial. Future research is needed to identify advertising strategies capable of recruiting large numbers of demographically representative pregnant women, preferentially in early pregnancy.

  12. Microscopic description of elastic and direct inelastic nucleon scattering off spherical nuclei

    NASA Astrophysics Data System (ADS)

    Dupuis, M.

    2017-05-01

    The purpose of this study is to improve the modeling of nucleon direct inelastic scattering to the continuum using a microscopic and parameter-free approach. For the first time, direct elastic scattering, inelastic scattering to discrete excitations and to the continuum are described within a microscopic approach without adjustable parameters. Proton scattering off 90Zr and 208Pb are the reactions used as test case examples of the calculations. The model uses the Melbourne g-matrix and the Random Phase Approximation description of nuclear states, implemented with the Gogny D1S interaction. The relevant optical and transition potentials in a finite nucleus are calculated within a local density approximation. As we use the nuclear matter approach we limit our study to incident energies above 40 MeV. We first checked that this model provides an accurate account of measured cross sections for elastic scattering and inelastic scattering to discrete states. It is then applied to the direct inelastic scattering to the continuum considering all one-phonon excitations predicted within the RPA approach. This accounts for a part of the direct pre-equilibrium emission, often labeled as the one-step direct process in quantum-based approaches. Our approach provides a very accurate description of angular distributions where the one-step process dominates. The impact of collective excitations is shown to be non negligible for energy transfer to the target up to 20 MeV, decreasing as the incident energy increases. For incident energies above 80 MeV, our modeling provides a good account of direct proton emission for an energy transfer to the target up to 30 MeV. However, the proton emission we predict underestimates the measured cross sections for incident energies below 80 MeV. We compare our prediction to those of the phenomenological exciton model to help interpret this result. Directions that may improve our modeling are discussed.

  13. Are consumer-directed home care beneficiaries satisfied? Evidence from Washington state.

    PubMed

    Wiener, Joshua M; Anderson, Wayne L; Khatutsky, Galina

    2007-12-01

    This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study, we developed an 8-item Satisfaction With Paid Personal Assistance Scale as the measure of satisfaction. In predicting satisfaction with personal assistance services, we estimated an ordinary least squares regression model that was right-censored to account for the large percentage of respondents who were highly satisfied with their care. Among the older population, but not younger people with disabilities, beneficiaries receiving consumer-directed services were more satisfied than individuals receiving agency-directed care. There was no evidence that quality of care was less with consumer-directed services. In addition, overall satisfaction levels with paid home care were very high. This study supports the premise that consumer satisfaction, an important measure of quality, in consumer-directed home care is not inferior to that in agency-directed care. The positive effect of consumer direction for older people underlines the fact that this service option is relevant for this population. In addition, this research provides evidence that home- and community-based services are of high quality, at least on one dimension.

  14. Cruel intentions on television and in real life: can viewing indirect aggression increase viewers' subsequent indirect aggression?

    PubMed

    Coyne, Sarah M; Archer, John; Eslea, Mike

    2004-07-01

    Numerous studies have shown that viewing violence in the media can influence an individual's subsequent aggression, but none have examined the effect of viewing indirect aggression. This study examines the immediate effect of viewing indirect and direct aggression on subsequent indirect aggression among 199 children ages 11 to 14 years. They were shown an indirect, direct, or no-aggression video and their subsequent indirect aggression was measured by negative evaluation of a confederate and responses to a vignette. Participants viewing indirect or direct aggression gave a more negative evaluation of and less money to a confederate than participants viewing no-aggression. Participants viewing indirect aggression gave less money to the confederate than those viewing direct aggression. Participants viewing indirect aggression gave more indirectly aggressive responses to an ambiguous situation and participants viewing direct aggression gave more directly aggressive responses. This study provides the first evidence that viewing indirect aggression in the media can have an immediate impact on subsequent aggression.

  15. Prognostic value of resident clinical performance ratings.

    PubMed

    Williams, Reed G; Dunnington, Gary L

    2004-10-01

    This study investigated the concurrent and predictive validity of end-of-rotation (EOR) clinical performance ratings. Surgeon EOR ratings of residents were collected and compared with end-of-year (EOY) progress decisions and to EOR and EOY confidential judgments of resident ability to provide patient care without direct supervision. Eighty percent to 85% of EOR ratings were Excellent or Very Good. Five percent or fewer were Fair or Poor. Almost all residents receiving Excellent or Very Good EOR ratings also received positive EOR judgments about ability to provide patient care without direct supervision. Residents rated Fair or Poor received negative EOR judgments about ability to provide patient care without direct supervision. As the cumulative percent of Good, Fair, and Poor EOR ratings increased, the number of residents promoted without stipulations at the end of the year decreased and the percentage of faculty members who judged the residents capable of providing effective patient care without direct supervision at the end of the year declined. All residents receiving 40% or more EOR ratings below Very Good had stipulations associated with their promotion. Despite use of descriptive anchors on the scale, clinical performance ratings have no direct meaning. Their meaning needs to be established in the same manner as is done in setting normal values for diagnostic tests, ie, by establishing the relationship between EOR ratings and practice outcomes.

  16. Consumers' views of direct-to-consumer genetic information.

    PubMed

    McBride, Colleen M; Wade, Christopher H; Kaphingst, Kimberly A

    2010-01-01

    In this report, we describe the evolution and types of genetic information provided directly to consumers, discuss potential advantages and disadvantages of these products, and review research evaluating consumer responses to direct-to-consumer (DTC) genetic testing. The available evidence to date has focused on predictive tests and does not suggest that individuals, health care providers, or health care systems have been harmed by a DTC provision of genetic information. An understanding of consumer responses to susceptibility tests has lagged behind. The Multiplex Initiative is presented as a case study of research to understand consumers' responses to DTC susceptibility tests. Three priority areas are recommended for accelerated research activities to inform public policy regarding DTC genetic information: (a) exploring consumer's long-term responses to DTC genetic testing on a comprehensive set of outcomes, (b) evaluating optimal services to support decision making about genetic testing, and (c) evaluating best practices in promoting genetic competencies among health providers.

  17. Rules of performance in the nursing home: A grounded theory of nurse-CNA communication.

    PubMed

    Madden, Connie; Clayton, Margaret; Canary, Heather E; Towsley, Gail; Cloyes, Kristin; Lund, Dale

    This study offers an initial theoretical understanding of nurse-CNA communication processes from the perspectives of nurses and CNAs who are providing direct care to residents in nursing homes. A grounded theory approach provided an understanding of nurse-CNA communication process within the complexities of the nursing home setting. Four themes (maintaining information flow, following procedure, fostering collegiality, and showing respect) describe the "rules of performance" that intertwine in nuanced relationships to guide nurse-CNA communication processes. Understanding how these rules of performance guide nurse-CNA communication processes, and how they are positively and negatively influenced, suggests that nurse-CNA communication during direct care of nursing home residents could be improved through policy and education that is specifically designed to be relevant and applicable to direct care providers in the nursing home environment. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Fluid dynamic modeling of nano-thermite reactions

    NASA Astrophysics Data System (ADS)

    Martirosyan, Karen S.; Zyskin, Maxim; Jenkins, Charles M.; Yuki Horie, Yasuyuki

    2014-03-01

    This paper presents a direct numerical method based on gas dynamic equations to predict pressure evolution during the discharge of nanoenergetic materials. The direct numerical method provides for modeling reflections of the shock waves from the reactor walls that generates pressure-time fluctuations. The results of gas pressure prediction are consistent with the experimental evidence and estimates based on the self-similar solution. Artificial viscosity provides sufficient smoothing of shock wave discontinuity for the numerical procedure. The direct numerical method is more computationally demanding and flexible than self-similar solution, in particular it allows study of a shock wave in its early stage of reaction and allows the investigation of "slower" reactions, which may produce weaker shock waves. Moreover, numerical results indicate that peak pressure is not very sensitive to initial density and reaction time, providing that all the material reacts well before the shock wave arrives at the end of the reactor.

  19. Fluid dynamic modeling of nano-thermite reactions

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

    Martirosyan, Karen S., E-mail: karen.martirosyan@utb.edu; Zyskin, Maxim; Jenkins, Charles M.

    2014-03-14

    This paper presents a direct numerical method based on gas dynamic equations to predict pressure evolution during the discharge of nanoenergetic materials. The direct numerical method provides for modeling reflections of the shock waves from the reactor walls that generates pressure-time fluctuations. The results of gas pressure prediction are consistent with the experimental evidence and estimates based on the self-similar solution. Artificial viscosity provides sufficient smoothing of shock wave discontinuity for the numerical procedure. The direct numerical method is more computationally demanding and flexible than self-similar solution, in particular it allows study of a shock wave in its early stagemore » of reaction and allows the investigation of “slower” reactions, which may produce weaker shock waves. Moreover, numerical results indicate that peak pressure is not very sensitive to initial density and reaction time, providing that all the material reacts well before the shock wave arrives at the end of the reactor.« less

  20. Foliar water uptake: a common water acquisition strategy for plants of the redwood forest.

    PubMed

    Limm, Emily Burns; Simonin, Kevin A; Bothman, Aron G; Dawson, Todd E

    2009-09-01

    Evaluations of plant water use in ecosystems around the world reveal a shared capacity by many different species to absorb rain, dew, or fog water directly into their leaves or plant crowns. This mode of water uptake provides an important water subsidy that relieves foliar water stress. Our study provides the first comparative evaluation of foliar uptake capacity among the dominant plant taxa from the coast redwood ecosystem of California where crown-wetting events by summertime fog frequently occur during an otherwise drought-prone season. Previous research demonstrated that the dominant overstory tree species, Sequoia sempervirens, takes up fog water by both its roots (via drip from the crown to the soil) and directly through its leaf surfaces. The present study adds to these early findings and shows that 80% of the dominant species from the redwood forest exhibit this foliar uptake water acquisition strategy. The plants studied include canopy trees, understory ferns, and shrubs. Our results also show that foliar uptake provides direct hydration to leaves, increasing leaf water content by 2-11%. In addition, 60% of redwood forest species investigated demonstrate nocturnal stomatal conductance to water vapor. Such findings indicate that even species unable to absorb water directly into their foliage may still receive indirect benefits from nocturnal leaf wetting through suppressed transpiration. For these species, leaf-wetting events enhance the efficacy of nighttime re-equilibration with available soil water and therefore also increase pre-dawn leaf water potentials.

  1. Communication Skills for OMRDD Direct Care Workers: Distance Learning Study Guide.

    ERIC Educational Resources Information Center

    Denny, Verna Haskins

    This self-directed, self-paced adult distance education program provides developmental aides and transitional employees with practice in job-related reading, writing, math, and problem solving. Participants use e-mail, print materials, and videotapes to do assignments. An introductory brochure precedes materials for 12 theme areas and 105 units…

  2. Stakeholder Perspectives on Policies to Support Family Caregivers of Older Adults with Dementia

    ERIC Educational Resources Information Center

    Putnam, Michelle; Pickard, Joseph G.; Rodriguez, Carroll; Shear, Erin

    2010-01-01

    Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to…

  3. Directional Microphone Hearing Aids in School Environments: Working toward Optimization

    ERIC Educational Resources Information Center

    Ricketts, Todd A.; Picou, Erin M.; Galster, Jason

    2017-01-01

    Purpose: The hearing aid microphone setting (omnidirectional or directional) can be selected manually or automatically. This study examined the percentage of time the microphone setting selected using each method was judged to provide the best signalto-noise ratio (SNR) for the talkers of interest in school environments. Method: A total of 26…

  4. Meditation, restoration, and the management of mental fatigue

    Treesearch

    Stephen Kaplan

    2001-01-01

    An analysis of the underlying similarities between the Eastern meditation tradition and attention restoration theory (ART) provides a basis for an expanded framework for studying directed attention. The focus of the analysis is the active role the individual can play in the preservation and recovery of the directed attention capacity. Two complementary strategies are...

  5. National land-cover pattern data

    Treesearch

    Kurt H. Riitters; James D. Wickham; James E. Vogelmann; K. Bruce Jones

    2000-01-01

    Land cover and its spatial patterns are key ingredients in ecological studies that consider large regions and the impacts of human activities. Because humanity is a principal driver of land-cover change over large regions (Turner et al. 1990), land-cover data provide direct measures of human activity, and both direct and indirect measures of ecological conditions...

  6. Social vs. Self-Directed Events among Japanese and Americans

    ERIC Educational Resources Information Center

    Smith, Herman W.; Francis, Linda E.

    2005-01-01

    Cultural expectations provide meaning to human perceptions of who-does-what-to-whom-where. However, the effects of actions directed at oneself have been much less systematically studied. This article replicates the American factorial design of Britt and Heise (1992) in a Japanese setting. The analysis demonstrates both cultural similarities and…

  7. Movement Structure in Young and Elderly Adults during Goal-Directed Movements of the Left and Right Arm

    ERIC Educational Resources Information Center

    Poston, Brach; Van Gemmert, Arend W. A.; Barduson, Beth; Stelmach, George E.

    2009-01-01

    Elderly adults often exhibit performance deficits during goal-directed movements of the dominant arm compared with young adults. Recent studies involving hemispheric lateralization have provided evidence that the dominant and non-dominant hemisphere-arm systems are specialized for controlling different movement parameters and that hemispheric…

  8. A COMPARISON OF URINARY ARSENIC SPECIATION VIA DIRECT NEBULIZATION AND ON-LINE PHOTOOXIDATION-HYDRIDE GENERATION WITH DETECTION BY INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY

    EPA Science Inventory

    Arsenic speciation continues to be important in assessing human and environmental exposure risk. Urinary arsenic analysis provides information on recent arsenic exposure. In this study, two sample introduction pathways: direct nebulization (DN) and hydride generation (HG) were ut...

  9. The Value of Geriatric Care Enhancement Training for Direct Service Workers

    ERIC Educational Resources Information Center

    Coogle, Constance L.; Parham, Iris A.; Jablonski, Rita; Rachel, Jason S.

    2007-01-01

    This study reports on the evaluation of a skills-enhancement training series for direct service providers in home care that was part of a federally funded state-level initiative to improve employee recruitment and retention. The gerontological training curriculum included content to improve problem-solving, communication, and stress management…

  10. Direct Measurements of Quantum Kinetic Energy Tensor in Stable and Metastable Water near the Triple Point: An Experimental Benchmark.

    PubMed

    Andreani, Carla; Romanelli, Giovanni; Senesi, Roberto

    2016-06-16

    This study presents the first direct and quantitative measurement of the nuclear momentum distribution anisotropy and the quantum kinetic energy tensor in stable and metastable (supercooled) water near its triple point, using deep inelastic neutron scattering (DINS). From the experimental spectra, accurate line shapes of the hydrogen momentum distributions are derived using an anisotropic Gaussian and a model-independent framework. The experimental results, benchmarked with those obtained for the solid phase, provide the state of the art directional values of the hydrogen mean kinetic energy in metastable water. The determinations of the direction kinetic energies in the supercooled phase, provide accurate and quantitative measurements of these dynamical observables in metastable and stable phases, that is, key insight in the physical mechanisms of the hydrogen quantum state in both disordered and polycrystalline systems. The remarkable findings of this study establish novel insight into further expand the capacity and accuracy of DINS investigations of the nuclear quantum effects in water and represent reference experimental values for theoretical investigations.

  11. Geostatistical analysis of allele presence patterns among American black bears in eastern North Carolina

    USGS Publications Warehouse

    Thompson, L.M.; Van Manen, F.T.; King, T.L.

    2005-01-01

    Highways are one of the leading causes of wildlife habitat fragmentation and may particularly affect wide-ranging species, such as American black bears (Ursus americanus). We initiated a research project in 2000 to determine potential effects of a 4-lane highway on black bear ecology in Washington County, North Carolina. The research design included a treatment area (highway construction) and a control area and a pre- and post-construction phase. We used data from the pre-construction phase to determine whether we could detect scale dependency or directionality among allele occurrence patterns using geostatistics. Detection of such patterns could provide a powerful tool to measure the effects of landscape fragmentation on gene flow. We sampled DNA from roots of black bear hair at 70 hair-sampling sites on each study area for 7 weeks during fall of 2000. We used microsatellite analysis based on 10 loci to determine unique multi-locus genotypes. We examined all alleles sampled at ???25 sites on each study area and mapped their presence or absence at each hair-sample site. We calculated semivariograms, which measure the strength of statistical correlation as a function of distance, and adjusted them for anisotropy to determine the maximum direction of spatial continuity. We then calculated the mean direction of spatial continuity for all examined alleles. The mean direction of allele frequency variation was 118.3?? (SE = 8.5) on the treatment area and 172.3?? (SE = 6.0) on the control area. Rayleigh's tests showed that these directions differed from random distributions (P = 0.028 and P < 0.001, respectively), indicating consistent directional patterns for the alleles we examined in each area. Despite the small spatial scale of our study (approximately 11,000 ha for each study area), we observed distinct and consistent patterns of allele occurrence, suggesting different directions of gene flow between the study areas. These directions seemed to coincide with the primary orientation of the best habitat areas. Furthermore, the patterns we observed suggest directions of potential source populations beyond the 2 study areas. Indeed, nearby areas classified as core black bear habitat exist in the directions indicated by our analysis. Geostatistical analysis of allele occurrence patterns may provide a useful technique to identify potential barriers to gene flow among bear populations.

  12. Interdisciplinary team communication among forensic nurses and rape victim advocates.

    PubMed

    Patterson, Debra

    2014-01-01

    Victim advocates and forensic nurses provide integrated care to address the complex legal, medical, and mental health needs of rape survivors. Research suggests that conflict exists between nurses and advocates, but it remains unknown how their communication patterns contribute to or resolve these conflicts. Utilizing a qualitative case study approach, the current study interviewed 24 nurses and advocates from a Midwest organization to better understand team communication patterns when addressing conflicts. The findings suggest that most nurses communicate concerns directly while advocates avoid direct communication. Factors that influenced direct and indirect communication and their implications for practice will be discussed.

  13. On-line sulfur isotope analysis of organic material by direct combustion: Preliminary results and potential applications

    USGS Publications Warehouse

    Kester, C.L.; Rye, R.O.; Johnson, C.A.; Schwartz, C.H.; Holmes, C.H.

    2001-01-01

    Sulfur isotopes have received little attention in ecology studies because plant and animal materials typically have low sulfur concentrations (< 1 wt.%) necessitating labor-intensive chemical extraction prior to analysis. To address the potential of direct combustion of organic material in an elemental analyzer coupled with a mass spectrometer, we compared results obtained by direct combustion to results obtained by sulfur extraction with Eschka's mixture. Direct combustion of peat and animal tissue gave reproducibility of better than 0.5??? and on average, values are 0.8??? higher than values obtained by Eschka extraction. Successful direct combustion of organic material appears to be a function of sample matrix and sulfur concentration. Initial results indicate that direct combustion provides fast, reliable results with minimal preparation. Pilot studies underway include defining bear diets and examining fluctuations between freshwater and brackish water in coastal environments.

  14. Predictors of human rotation.

    PubMed

    Stochl, Jan; Croudace, Tim

    2013-01-01

    Why some humans prefer to rotate clockwise rather than anticlockwise is not well understood. This study aims to identify the predictors of the preferred rotation direction in humans. The variables hypothesised to influence rotation preference include handedness, footedness, sex, brain hemisphere lateralisation, and the Coriolis effect (which results from geospatial location on the Earth). An online questionnaire allowed us to analyse data from 1526 respondents in 97 countries. Factor analysis showed that the direction of rotation should be studied separately for local and global movements. Handedness, footedness, and the item hypothesised to measure brain hemisphere lateralisation are predictors of rotation direction for both global and local movements. Sex is a predictor of the direction of global rotation movements but not local ones, and both sexes tend to rotate clockwise. Geospatial location does not predict the preferred direction of rotation. Our study confirms previous findings concerning the influence of handedness, footedness, and sex on human rotation; our study also provides new insight into the underlying structure of human rotation movements and excludes the Coriolis effect as a predictor of rotation.

  15. The Effects of Computer-Mediated Synchronous and Asynchronous Direct Corrective Feedback on Writing: A Case Study

    ERIC Educational Resources Information Center

    Shintani, Natsuko

    2016-01-01

    This case study investigated the characteristics of computer-mediated synchronous corrective feedback (SCF, provided while students wrote) and asynchronous corrective feedback (ACF, provided after students had finished writing) in an EFL writing task. The task, designed to elicit the use of the hypothetical conditional, was completed by two…

  16. Direct costs of emergency medical care: a diagnosis-based case-mix classification system.

    PubMed

    Baraff, L J; Cameron, J M; Sekhon, R

    1991-01-01

    To develop a diagnosis-based case mix classification system for emergency department patient visits based on direct costs of care designed for an outpatient setting. Prospective provider time study with collection of financial data from each hospital's accounts receivable system and medical information, including discharge diagnosis, from hospital medical records. Three community hospital EDs in Los Angeles County during selected times in 1984. Only direct costs of care were included: health care provider time, ED management and clerical personnel excluding registration, nonlabor ED expense including supplies, and ancillary hospital services. Indirect costs for hospitals and physicians, including depreciation and amortization, debt service, utilities, malpractice insurance, administration, billing, registration, and medical records were not included. Costs were derived by valuing provider time based on a formula using annual income or salary and fringe benefits, productivity and direct care factors, and using hospital direct cost to charge ratios. Physician costs were based on a national study of emergency physician income and excluded practice costs. Patients were classified into one of 216 emergency department groups (EDGs) on the basis of the discharge diagnosis, patient disposition, age, and the presence of a limited number of physician procedures. Total mean direct costs ranged from $23 for follow-up visit to $936 for trauma, admitted, with critical care procedure. The mean total direct costs for the 16,771 nonadmitted patients was $69. Of this, 34% was for ED costs, 45% was for ancillary service costs, and 21% was for physician costs. The mean total direct costs for the 1,955 admitted patients was $259. Of this, 23% was for ED costs, 63% was for ancillary service costs, and 14% was for physician costs. Laboratory and radiographic services accounted for approximately 85% of all ancillary service costs and 38% of total direct costs for nonadmitted patients versus 80% of ancillary service costs and 51% of total direct costs for admitted patients. We have developed a diagnosis-based case mix classification system for ED patient visits based on direct costs of care designed for an outpatient setting which, unlike diagnosis-related groups, includes the measurement of time-based cost for physician and nonphysician services. This classification system helps to define direct costs of hospital and physician emergency services by type of patient.

  17. Mixed Methods Research on the Role of Pupils as Assessors in Quality Assurance of Schools in Malta

    ERIC Educational Resources Information Center

    Pulis, Angele

    2018-01-01

    This article describes a study conducted in Malta on pupil voice in the role of assessor. The purpose of the study was to provide a fresh perspective on school quality assurance in Malta, by asking those who are directly affected--the pupils themselves. The data provided by the study could help educational leaders, together with the whole school…

  18. Laboratory infrared studies of molecules of atmospheric and astrophysical interest

    NASA Technical Reports Server (NTRS)

    Rao, N. N.

    1982-01-01

    Nineteen reprints on the molecular species are compiled. Much of the work was done by using the Doppler-limited resolution provided by diode lasers. The diode laser was used as a source to a grating spectrometer which has been used earlier for high resolution studies. This technique provided many advantages. Wherever possible, the studies have been directed to intensity determinations of infrared bands.

  19. Grief after patient death: direct care staff in nursing homes and homecare.

    PubMed

    Boerner, Kathrin; Burack, Orah R; Jopp, Daniela S; Mock, Steven E

    2015-02-01

    Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience. To 1) determine how grief symptoms typically reported by bereaved family caregivers are experienced among direct care staff, 2) explore how prepared the staff members were for the death of their patients, and 3) identify characteristics associated with their grief. This was a cross-sectional study of direct care staff experiencing recent patient death. Participants were 140 certified nursing assistants and 80 homecare workers. Standardized assessments and structured questions addressed staff (e.g., preparedness for death), institutional (e.g., support availability), and patient/relational factors (e.g., relationship quality). Data analyses included bivariate group comparisons and hierarchical regression. Grief reactions of staff reflected many of the core grief symptoms reported by bereaved family caregivers in a large-scale caregiving study. Feelings of being "not at all prepared" for the death and struggling with "acceptance of death" were prevalent among the staff. Grief was more intense when staff-patient relationships were closer, care was provided for longer, and staff felt emotionally unprepared for the death. Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  20. Grazing-incidence small angle x-ray scattering studies of nanoscale polymer gratings

    NASA Astrophysics Data System (ADS)

    Doxastakis, Manolis; Suh, Hyo Seon; Chen, Xuanxuan; Rincon Delgadillo, Paulina A.; Wan, Lingshu; Williamson, Lance; Jiang, Zhang; Strzalka, Joseph; Wang, Jin; Chen, Wei; Ferrier, Nicola; Ramirez-Hernandez, Abelardo; de Pablo, Juan J.; Gronheid, Roel; Nealey, Paul

    2015-03-01

    Grazing-Incidence Small Angle X-ray Scattering (GISAXS) offers the ability to probe large sample areas, providing three-dimensional structural information at high detail in a thin film geometry. In this study we exploit the application of GISAXS to structures formed at one step of the LiNe (Liu-Nealey) flow using chemical patterns for directed self-assembly of block copolymer films. Experiments conducted at the Argonne National Laboratory provided scattering patterns probing film characteristics at both parallel and normal directions to the surface. We demonstrate the application of new computational methods to construct models based on scattering measured. Such analysis allows for extraction of structural characteristics at unprecedented detail.

  1. The Human Retrosplenial Cortex and Thalamus Code Head Direction in a Global Reference Frame.

    PubMed

    Shine, Jonathan P; Valdés-Herrera, José P; Hegarty, Mary; Wolbers, Thomas

    2016-06-15

    Spatial navigation is a multisensory process involving integration of visual and body-based cues. In rodents, head direction (HD) cells, which are most abundant in the thalamus, integrate these cues to code facing direction. Human fMRI studies examining HD coding in virtual environments (VE) have reported effects in retrosplenial complex and (pre-)subiculum, but not the thalamus. Furthermore, HD coding appeared insensitive to global landmarks. These tasks, however, provided only visual cues for orientation, and attending to global landmarks did not benefit task performance. In the present study, participants explored a VE comprising four separate locales, surrounded by four global landmarks. To provide body-based cues, participants wore a head-mounted display so that physical rotations changed facing direction in the VE. During subsequent MRI scanning, subjects saw stationary views of the environment and judged whether their orientation was the same as in the preceding trial. Parameter estimates extracted from retrosplenial cortex and the thalamus revealed significantly reduced BOLD responses when HD was repeated. Moreover, consistent with rodent findings, the signal did not continue to adapt over repetitions of the same HD. These results were supported by a whole-brain analysis showing additional repetition suppression in the precuneus. Together, our findings suggest that: (1) consistent with the rodent literature, the human thalamus may integrate visual and body-based, orientation cues; (2) global reference frame cues can be used to integrate HD across separate individual locales; and (3) immersive training procedures providing full body-based cues may help to elucidate the neural mechanisms supporting spatial navigation. In rodents, head direction (HD) cells signal facing direction in the environment via increased firing when the animal assumes a certain orientation. Distinct brain regions, the retrosplenial cortex (RSC) and thalamus, code for visual and vestibular cues of orientation, respectively. Putative HD signals have been observed in human RSC but not the thalamus, potentially because body-based cues were not provided. Here, participants encoded HD in a novel virtual environment while wearing a head-mounted display to provide body-based cues for orientation. In subsequent fMRI scanning, we found evidence of an HD signal in RSC, thalamus, and precuneus. These findings harmonize rodent and human data, and suggest that immersive training procedures provide a viable way to examine the neural basis of navigation. Copyright © 2016 the authors 0270-6474/16/366371-11$15.00/0.

  2. View from My Classroom: A Spectrophotometry Unit for Advanced Chemistry Students.

    ERIC Educational Resources Information Center

    Diehl-Jones, Susan M.

    1983-01-01

    Rationale, objectives, and instructional strategies for a directed study course on spectrophotometry are provided. Descriptions of three experiments and four student research projects are also provided. Objectives, laboratory procedures, advantages, and disadvantages for the experiments and projects are included. (JN)

  3. Relationships in consumer-directed care: An integrative literature review.

    PubMed

    Cash, Tracee; Moyle, Wendy; O'Dwyer, Siobhan

    2017-09-01

    To undertake an integrative review of the literature on relationships between community aged care recipients, family carers and care providers under consumer-directed care (CDC). Seven databases were systematically searched. Peer-reviewed and grey literature on CDC between 1998 and 2014 were assessed using an integrative literature review (ILR) framework. Search terms included CDC, self-directed care, direct payments, community aged care, community dwelling and older adults. Full-text copies were assessed against the inclusion criteria. Fifteen studies met the inclusion criteria. This ILR found no research with a specific focus on caregiving relationships for older adults. The literature did however identify relational issues such as support, planning and provider attitude as fundamental to the success of CDC. Relationships within the caregiving triad have important implications for the way CDC is enacted, particularly when the care recipient has dementia, suggesting this population as a priority for future research. © 2017 AJA Inc.

  4. Atom probe tomographic mapping directly reveals the atomic distribution of phosphorus in resin embedded ferritin

    DOE PAGES

    Perea, Daniel E.; Liu, Jia; Bartrand, Jonah A. G.; ...

    2016-02-29

    In this study, we report the atomic-scale analysis of biological interfaces using atom probe tomography. Embedding the protein ferritin in an organic polymer resin lacking nitrogen provided chemical contrast to visualize atomic distributions and distinguish organic-organic and organic-inorganic interfaces. The sample preparation method can be directly extended to further enhance the study of biological, organic and inorganic nanomaterials relevant to health, energy or the environment.

  5. Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis.

    PubMed

    Sjöström, Susanne; Kopp Kallner, Helena; Simeonova, Emilia; Madestam, Andreas; Gemzell-Danielsson, Kristina

    2016-01-01

    The objective of the present study is to calculate the cost-effectiveness of early medical abortion performed by nurse-midwifes in comparison to physicians in a high resource setting where ultrasound dating is part of the protocol. Non-physician health care professionals have previously been shown to provide medical abortion as effectively and safely as physicians, but the cost-effectiveness of such task shifting remains to be established. A cost effectiveness analysis was conducted based on data from a previously published randomized-controlled equivalence study including 1180 healthy women randomized to the standard procedure, early medical abortion provided by physicians, or the intervention, provision by nurse-midwifes. A 1.6% risk difference for efficacy defined as complete abortion without surgical interventions in favor of midwife provision was established which means that for every 100 procedures, the intervention treatment resulted in 1.6 fewer incomplete abortions needing surgical intervention than the standard treatment. The average direct and indirect costs and the incremental cost-effectiveness ratio (ICER) were calculated. The study was conducted at a university hospital in Stockholm, Sweden. The average direct costs per procedure were EUR 45 for the intervention compared to EUR 58.3 for the standard procedure. Both the cost and the efficacy of the intervention were superior to the standard treatment resulting in a negative ICER at EUR -831 based on direct costs and EUR -1769 considering total costs per surgical intervention avoided. Early medical abortion provided by nurse-midwives is more cost-effective than provision by physicians. This evidence provides clinicians and decision makers with an important tool that may influence policy and clinical practice and eventually increase numbers of abortion providers and reduce one barrier to women's access to safe abortion.

  6. Determinants of patient loyalty to healthcare providers: An integrative review.

    PubMed

    Zhou, Wei-Jiao; Wan, Qiao-Qin; Liu, Cong-Ying; Feng, Xiao-Lin; Shang, Shao-Mei

    2017-08-01

    Patient loyalty is key to business success for healthcare providers and also for patient health outcomes. This study aims to identify determinants influencing patient loyalty to healthcare providers and propose an integrative conceptual model of the influencing factors. PubMed, CINAHL, OVID, ProQuest and Elsevier Science Direct databases were searched. Publications about determinants of patient loyalty to health providers were screened, and 13 articles were included. Date of publication, location of the research, sample details, objectives and findings/conclusions were extracted for 13 articles. Thirteen studies explored eight determinants: satisfaction, quality, value, hospital brand image, trust, commitment, organizational citizenship behavior and customer complaints. The integrated conceptual model comprising all the determinants demonstrated the significant positive direct impact of quality on satisfaction and value, satisfaction on trust and commitment, trust on commitment and loyalty, and brand image on quality and loyalty. This review identifies and models the determinants of patient loyalty to healthcare providers. Further studies are needed to explore the influence of trust, commitment, and switching barriers on patient loyalty. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  7. Trust in leadership: meta-analytic findings and implications for research and practice.

    PubMed

    Dirks, Kurt T; Ferrin, Donald L

    2002-08-01

    In this study, the authors examined the findings and implications of the research on trust in leadership that has been conducted during the past 4 decades. First, the study provides estimates of the primary relationships between trust in leadership and key outcomes, antecedents, and correlates (k = 106). Second, the study explores how specifying the construct with alternative leadership referents (direct leaders vs. organizational leadership) and definitions (types of trust) results in systematically different relationships between trust in leadership and outcomes and antecedents. Direct leaders (e.g., supervisors) appear to be a particularly important referent of trust. Last, a theoretical framework is offered to provide parsimony to the expansive literature and to clarify the different perspectives on the construct of trust in leadership and its operation.

  8. The Spectropolarimeter for Planetary Exploration: SPEX

    NASA Astrophysics Data System (ADS)

    Laan, Erik; Stam, Daphne; Snik, Frans; Karalidi, Theodora; Keller, Christoph; ter Horst, Rik; Navarro, Ramon; Oomen, Gijsbert; de Vries, Johan; Hoogeveen, Ruud

    2017-11-01

    SPEX (Spectropolarimeter for Planetary EXploration) is an innovative, compact remotesensing instrument for measuring and characterizing aerosols in the atmosphere. The shoebox size instrument is capable of accurate full linear spectropolarimetry without moving parts or liquid crystals. High precision polarimetry is performed through encoding the degree and angle of linear polarization of the incoming light in a sinusoidal modulation of the spectrum. Measuring this intensity spectrum thus provides the spectral dependence of the degree and angle of linear polarization. Polarimetry has proven to be an excellent tool to study microphysical properties of atmospheric particles. Such information is essential to better understand the weather and climate of a planet. Although SPEX can be used to study any planetary atmosphere, including the Earth's, the current design of SPEX is tailored to study Martian dust and clouds from an orbiting platform. SPEX' 9 entrance pupils can simultaneously measure intensity spectra from 0.4 to 0.8 microns, in different directions along the flight direction (including two limb viewing directions). This way, the scattering phase functions of dust and cloud particles within a ground pixel are sampled while flying over it. SPEX can provide synergy with instruments on rovers and landers, as it provides an overview of spatial and temporal variations of the Martian atmosphere.

  9. Provider Perspectives on School-Based Mental Health for Urban Minority Youth: Access and Services

    ERIC Educational Resources Information Center

    Gamble, Brandon E.; Lambros, Katina M.

    2014-01-01

    This article provides results from a qualitative study on the efforts of school-based mental health providers (SBMHPs) who serve students in urban, suburban, and ethnically diverse settings to help families access quality mental health services. School-based mental health plays a key role in the provision of direct and indirect intervention…

  10. Curriculum-Based Measurement Performance Indicators: A Tool for Undergraduate Calculus Students to Inform and Direct Their Learning Behavior

    ERIC Educational Resources Information Center

    Sturges, Linda W.

    2010-01-01

    The present study investigated the extent to which providing students with individualized performance feedback informed and directed their learning behavior. Individualized performance feedback was delivered to students using curriculum-based measurement progress indicators, either as a visual representation of ongoing performance in the form of a…

  11. Morphosyntactic Development in a Second Language: An Eye-Tracking Study on the Role of Attention

    ERIC Educational Resources Information Center

    Issa, Bernard Ibrahim, II

    2015-01-01

    One common claim in second language (L2) acquisition research is that attention is crucial for development to occur. Although previous empirical research supports this claim, methodological approaches have not been able to directly measure attention. This thesis utilized eye-tracking to directly measure attention and thus provide converging…

  12. Distance Learning as a Viable Staff Development Alternative for Behavioral Healthcare Direct Support Professionals

    ERIC Educational Resources Information Center

    Gill, James G., Jr.

    2011-01-01

    This quasi-experiment utilized three groups of direct service staff to explore the effectiveness of three methods of training and an optional survey was offered after the study. The researcher used a counterbalance design. Three courses developed by an independent distance learning company were utilized to provide the learning experience. Each…

  13. Facilitating Self-Directed Learning (SDL) and Satisfaction with SDL among Pre-University Students

    ERIC Educational Resources Information Center

    Yeoh, Miranda P.; Cazan, Ana-Maria; Ierardi, Enzo; Jacic, Ljubomir A.

    2017-01-01

    The aim of the study was to evaluate our practice of self-directed learning (SDL) among pre-university students in Malaysia. Respondents provided data on their previous school learning experiences besides present SDL experiences in college. We carried out exploratory factor analysis based on the school data. We did a confirmatory factor analysis…

  14. The Arts and Handicapped People: Defining the National Direction.

    ERIC Educational Resources Information Center

    Bureau of Education for the Handicapped (DHEW/OE), Washington, DC. Div. of Innovation and Development.

    Proceedings from an April, 1977 conference focus on the current status and future directions of arts programming for the handicapped. M. Appell provides an overview of the field; while W. Kalenius, Jr. reviews data from 138 current research studies which indicate that handicapped children were able to learn the art forms, enjoyed the activities,…

  15. Direct Mail Marketing Strategies for Educational Computer Software and Why Purchase Decisions Are Made.

    ERIC Educational Resources Information Center

    Hatcher, Myron E.; Miller, William

    1987-01-01

    The study compared effects of two direct-mail educational software marketing strategies: (1) brochure only and (2) brochure and sample program provided by a journal. Those responding to Strategy 1 rated the programs higher because of less knowledge. However, those responding to Strategy 2 exhibited more respect for the journal. (CH)

  16. Non-directed aromatic C–H amination: catalytic and mechanistic studies enabled by Pd catalyst and reagent design†

    PubMed Central

    Bandara, H. M. D.; Jin, D.; Mantell, M. A.; Field, K. D.; Wang, A.; Narayanan, R. P.; Deskins, N. A.; Emmert, M. H.

    2016-01-01

    This manuscript describes the systematic development of pyridine-type ligands, which promote the Pd catalyzed, non-directed amination of benzene in combination with novel, hydroxylamine-based electrophilic amination reagents. DFT calculations and mechanistic experiments provide insights into the factors influencing the arene C–H amination protocol. PMID:28066540

  17. Welfare to Work. JOBS Automated Systems Do Not Focus on Program's Employment Objective. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Accounting and Information Management Div.

    A study examined states' development of automated systems for the Job Opportunities and Basic Skills (JOBS) program administered by the states, with the Administration for Children and Families (ACF) responsible for program oversight and direction. Results indicated that ACF had not provided direction and focus in its systems development guidance…

  18. Teaching Applied Behavior Analysis Knowledge Competencies to Direct-Care Service Providers: Outcome Assessment and Social Validation of a Training Program

    ERIC Educational Resources Information Center

    Luiselli, James K.; Bass, Jennifer D.; Whitcomb, Sara A.

    2010-01-01

    Staff training is a critical performance improvement objective within behavioral health care organizations. This study evaluated a systematic training program for teaching applied behavior analysis knowledge competencies to newly hired direct-care employees at a day and residential habilitation services agency for adults with intellectual and…

  19. Experiences of Families with Relatives with Intellectual and Developmental Disabilities in a Consumer-Directed Support Program

    ERIC Educational Resources Information Center

    Caldwell, Joe

    2007-01-01

    The current study explores the experiences of families with relatives with intellectual and developmental disabilities participating in a consumer-directed support program in the USA. The Illinois Home Based Support Services Program provides a limited budget to purchase and manage services. However, within recent years the program has faced cuts…

  20. Congruency between Occupational Daydreams and Self Directed Search (SDS) Scores among College Students

    ERIC Educational Resources Information Center

    Miller, Mark J.; Springer, Thomas P.; Tobacyk, Jerome; Wells, Don

    2004-01-01

    In this study, the relationship of expressed occupational daydreams and scores on the Self-Directed Search (SDS) were examined. Results were consistent with Holland's theory of careers. Implications for career counselors are discussed. Students were asked to provide specific biographical data (i. e., age, gender, race) and to write down their…

  1. Intrinsic K-Ras dynamics: A novel molecular dynamics data analysis method shows causality between residue pair motions

    NASA Astrophysics Data System (ADS)

    Vatansever, Sezen; Gümüş, Zeynep H.; Erman, Burak

    2016-11-01

    K-Ras is the most frequently mutated oncogene in human cancers, but there are still no drugs that directly target it in the clinic. Recent studies utilizing dynamics information show promising results for selectively targeting mutant K-Ras. However, despite extensive characterization, the mechanisms by which K-Ras residue fluctuations transfer allosteric regulatory information remain unknown. Understanding the direction of information flow can provide new mechanistic insights for K-Ras targeting. Here, we present a novel approach -conditional time-delayed correlations (CTC) - using the motions of all residue pairs of a protein to predict directionality in the allosteric regulation of the protein fluctuations. Analyzing nucleotide-dependent intrinsic K-Ras motions with the new approach yields predictions that agree with the literature, showing that GTP-binding stabilizes K-Ras motions and leads to residue correlations with relatively long characteristic decay times. Furthermore, our study is the first to identify driver-follower relationships in correlated motions of K-Ras residue pairs, revealing the direction of information flow during allosteric modulation of its nucleotide-dependent intrinsic activity: active K-Ras Switch-II region motions drive Switch-I region motions, while α-helix-3L7 motions control both. Our results provide novel insights for strategies that directly target mutant K-Ras.

  2. Architecture Studies Done for High-Rate Duplex Direct Data Distribution (D4) Services

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A study was sponsored to investigate a set of end-to-end system concepts for implementing a high-rate duplex direct data distribution (D4) space-to-ground communications link. The NASA Glenn Research Center is investigating these systems (both commercial and Government) as a possible method of providing a D4 communications service between NASA spacecraft in low Earth orbit and the respective principal investigators using or monitoring instruments aboard these spacecraft. Candidate commercial services were assessed regarding their near-term potential to provide a D4 type of service. The candidates included K-band and V-band geostationary orbit and nongeostationary orbit satellite relay services and direct downlink (D3) services. Internet protocol (IP) networking technologies were evaluated to enable the user-directed distribution and delivery of science data. Four realistic, near-future concepts were analyzed: 1) A duplex direct link (uplink plus downlink communication paths) between a low-Earth-orbit spacecraft and a principal-investigator-based autonomous Earth station; 2) A space-based relay using a future K-band nongeosynchronous-orbit system to handle both the uplink and downlink communication paths; 3) A hybrid link using both direct and relay services to achieve full duplex capability; 4) A dual-mode concept consisting of both a duplex direct link and a space relay duplex link operating independently. The concepts were analyzed in terms of contact time between the NASA spacecraft and the communications service and the achievable data throughput. Throughput estimates for the D4 systems were based on the infusion of advanced communications technology products (single and multibeam K-band phased-arrays and digital modems) being developed by Glenn. Cost estimates were also performed using extrapolated information from both terrestrial and current satellite communications providers. The throughput and cost estimates were used to compare the concepts.

  3. Expanding oral care opportunities: direct access care provided by dental hygienists in the United States.

    PubMed

    Naughton, Doreen K

    2014-06-01

    Dental hygienists expand access to oral care in the United States. Many Americans have access to oral health care in traditional dental offices however millions of Americans have unmet dental needs. For decades dental hygienists have provided opportunities for un-served and under-served Americans to receive preventive services in a variety of alternate delivery sites, and referral to licensed dentists for dental care needs. Publications, state practice acts, state public health departments, the American Dental Hygienists' Association, and personal interviews of dental hygiene practitioners were accessed for information and statistical data. Dental hygienists in 36 states can legally provide direct access care. Dental hygienists are providing preventive services in a variety of settings to previously un-served and under-served Americans, with referral to dentists for dental needs. Dental hygienists have provided direct access to care in the United States for decades. The exact number of direct access providers in the United States is unknown. Limited research and anecdotal information demonstrate that direct access care has facilitated alternate entry points into the oral health systems for thousands of previously un-served and underserved Americans. Older adults, persons with special needs, children in schools, pregnant women, minority populations, rural populations, and others have benefited from the availability of many services provided by direct access dental hygienists. Legislatures and private groups are becoming increasingly aware of the impact that direct access has made on the delivery of oral health care. Many factors continue to drive the growth of direct access care. Additional research is needed to accumulate qualitative and quantitative outcome data related to direct access care provided by dental hygienists and other mid level providers of oral health services. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Apparatus for providing directional permeability measurements in subterranean earth formations

    DOEpatents

    Shuck, Lowell Z.

    1977-01-01

    Directional permeability measurements are provided in a subterranean earth formation by injecting a high-pressure gas from a wellbore into the earth formation in various azimuthal directions with the direction having the largest pressure drop being indicative of the maximum permeability direction. These measurements are provided by employing an inflatable boot containing a plurality of conduits in registry with a like plurality of apertures penetrating the housing at circumferentially spaced-apart locations. These conduits are, in turn, coupled through a valved manifold to a source of pressurized gas so that the high-pressure gas may be selectively directed through any conduit into the earth formation defining the bore with the resulting difference in the pressure drop through the various conduits providing the permeability measurements.

  5. Thermal imitators with single directional invisibility

    NASA Astrophysics Data System (ADS)

    Wang, Ruizhe; Xu, Liujun; Huang, Jiping

    2017-12-01

    Thermal metamaterials have been intensively studied during the past years to achieve the long-standing dream of invisibility, illusion, and other inconceivable thermal phenomena. However, many thermal metamaterials can only exhibit omnidirectional thermal response, which take on the distinct feature of geometrical isotropy. In this work, we theoretically design and experimentally fabricate a pair of thermal imitators by applying geometrical anisotropy provided by elliptical/ellipsoidal particles and layered structures. This pair of thermal imitators possesses thermal invisibility in one direction, while having thermal opacity in other directions. This work may open a gate in designing direction-dependent thermal metamaterials.

  6. Advanced parking management systems : a cross-cutting study : taking the stress out of parking

    DOT National Transportation Integrated Search

    2007-01-01

    This study examines advanced parking management systems (APMSs) in three venues: airports, central business districts, and transit park-and-ride locations. Specifically, the systems examined in this study provide directional and space availability in...

  7. Revision of Environmental Factors for Mil-HDBK-217B

    DTIC Science & Technology

    1980-09-01

    and directions for application have been included. Apprpriate revision sheets to MIL-OMK-217 hee been provided as an appendix to the final report. 7...ef this study. In anticipation of insufficient data for direct statistical analysis ir, r11 categories of the study, it was determined that expert...reliability was alreadv known. The resuilting mode failure rates were too low by a factor of about 8 to 1. This methid was more accurate than Lhe average part

  8. Validation of oxygen extraction fraction measurement by qBOLD technique.

    PubMed

    He, Xiang; Zhu, Mingming; Yablonskiy, Dmitriy A

    2008-10-01

    Measurement of brain tissue oxygen extraction fraction (OEF) in both baseline and functionally activated states can provide important information on brain functioning in health and disease. The recently proposed quantitative BOLD (qBOLD) technique is MRI-based and provides a regional in vivo OEF measurement (He and Yablonskiy, MRM 2007, 57:115-126). It is based on a previously developed analytical BOLD model and incorporates prior knowledge about the brain tissue composition including the contributions from grey matter, white matter, cerebrospinal fluid, interstitial fluid and intravascular blood. The qBOLD model also allows for the separation of contributions to the BOLD signal from OEF and the deoxyhemoglobin containing blood volume (DBV). The objective of this study is to validate OEF measurements provided by the qBOLD approach. To this end we use a rat model and compare qBOLD OEF measurements against direct measurements of the blood oxygenation level obtained from venous blood drawn directly from the superior sagittal sinus. The cerebral venous oxygenation level of the rat was manipulated by utilizing different anestheisa methods. The study demonstrates a very good agreement between qBOLD approach and direct measurements. (c) 2008 Wiley-Liss, Inc.

  9. Valence evaluation with approaching or withdrawing cues: directly testing valence-arousal conflict theory.

    PubMed

    Wang, Yan Mei; Li, Ting; Li, Lin

    2017-07-19

    The valence-arousal conflict theory assumes that both valence and arousal will trigger approaching or withdrawing tendencies. It also predicts that the speed of processing emotional stimuli will depend on whether valence and arousal trigger conflicting or congruent motivational tendencies. However, most previous studies have provided evidence of the interaction between valence and arousal only, and have not provided direct proof of the interactive links between valence, arousal and motivational tendencies. The present study provides direct evidence for the relationship between approach-withdrawal tendencies and the valence-arousal conflict. In an empirical test, participants were instructed to judge the valence of emotional words after visual-spatial cues that appeared to be either approaching or withdrawing from participants. A three-way interaction (valence, arousal, and approach-withdrawal tendency) was observed such that the response time was shorter if participants responded to a negative high-arousal stimulus after a withdrawing cue, or to a positive low-arousal stimulus after an approaching cue. These findings suggest that the approach-withdrawal tendency indeed plays a crucial role in valence-arousal conflict, and that the effect depends on the congruency of valence, arousal and tendency at an early stage of processing.

  10. Effects of feature-based attention on the motion aftereffect at remote locations.

    PubMed

    Boynton, Geoffrey M; Ciaramitaro, Vivian M; Arman, A Cyrus

    2006-09-01

    Previous studies have shown that attention to a particular stimulus feature, such as direction of motion or color, enhances neuronal responses to unattended stimuli sharing that feature. We studied this effect psychophysically by measuring the strength of the motion aftereffect (MAE) induced by an unattended stimulus when attention was directed to one of two overlapping fields of moving dots in a different spatial location. When attention was directed to the same direction of motion as the unattended stimulus, the unattended stimulus induced a stronger MAE than when attention was directed to the opposite direction. Also, when the unattended location contained either uncorrelated motion or had no stimulus at all an MAE was induced in the opposite direction to the attended direction of motion. The strength of the MAE was similar regardless of whether subjects attended to the speed or luminance of the attended dots. These results provide further support for a global feature-based mechanism of attention, and show that the effect spreads across all features of an attended object, and to all locations of visual space.

  11. Direct writing of bio-functional coatings for cardiovascular applications.

    PubMed

    Perkins, Jessica; Hong, Yi; Ye, Sang-Ho; Wagner, William R; Desai, Salil

    2014-12-01

    The surface modification of metallic biomaterials is of critical importance to enhance the biocompatibility of surgical implant materials and devices. This article investigates the use of a direct-write inkjet technique for multilayer coatings of a biodegradable polymer (polyester urethane urea (PEUU)) embedded with an anti-proliferation drug paclitaxel (Taxol). The direct-write inkjet technique provides selective patterning capability for depositing multimaterial coatings on three-dimensional implant devices such as pins, screws, and stents for orthopedic and vascular applications. Drug release profiles were studied to observe the influence of drug loading and coating thickness for obtaining tunable release kinetics. Platelet deposition studies were conducted following ovine blood contact and significant reduction in platelet deposition was observed on the Taxol loaded PEUU substrate compared with the unloaded control. Rat smooth muscle cells were used for cell proliferation studies. Significant reduction in cell growth was observed following the release of anti-proliferative drug from the biopolymer thin film. This research provides a basis for developing anti-proliferative biocompatible coatings for different biomedical device applications. © 2014 Wiley Periodicals, Inc.

  12. [Impact of directly compressed auxiliary materials on powder property of fermented cordyceps powder].

    PubMed

    Chen, Li-Hua; Yue, Guo-Chao; Guan, Yong-Mei; Yang, Ming; Zhu, Wei-Feng

    2014-01-01

    To investigate such physical indexes as hygroscopicity, angle of repose, bulk density, fillibility of compression of mixed powder of directly compressed auxiliary materials and fermented cordyceps powder by using micromeritic study methods. The results showed that spray-dried lactose Flowlac100 and microcrystalline cellulose Avicel PH102 had better effect in liquidity and compressibility on fermented cordyceps powder than pregelatinized starch. The study on the impact of directly compressed auxiliary materials on the powder property of fermented cordyceps powder had guiding significant to the research of fermented cordyceps powder tablets, and could provide basis for the development of fermented cordyceps powder tablets.

  13. Advance Directives in Hospice Healthcare Providers: A Clinical Challenge.

    PubMed

    Luck, George R; Eggenberger, Terry; Newman, David; Cortizo, Jacqueline; Blankenship, Derek C; Hennekens, Charles H

    2017-11-01

    On a daily basis, healthcare providers, especially those dealing with terminally ill patients, such as hospice workers, witness how advance directives help ensure the wishes of patients. They also witness the deleterious consequences when patients fail to document the care they desire at their end of life. To the best of our knowledge there are no data concerning the prevalence of advance directives among hospice healthcare providers. We therefore explored the prevalence and factors influencing completion rates in a survey of hospice healthcare providers. Surveys that included 32 items to explore completion rates, as well as barriers, knowledge, and demographics, were e-mailed to 2097 healthcare providers, including employees and volunteers, at a nonprofit hospice. Of 890 respondents, 44% reported having completed an advance directive. Ethnicity, age, relationship status, and perceived knowledge were all significant factors influencing the completion rates, whereas years of experience or working directly with patients had no effect. Procrastination, fear of the subject, and costs were common reasons reported as barriers. Upon completion of the survey, 43% said they will now complete an advance directive, and 45% will talk to patients and families about their wishes. The majority of hospice healthcare providers have not completed an advance directive. These results are very similar to those for other healthcare providers treating patients with terminal diseases, specifically oncologists. Because, at completion, 43% said that they would now complete an advance directive, such a survey of healthcare providers may help increase completion rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. ICU Telemedicine Comanagement Methods and Length of Stay.

    PubMed

    Hawkins, Helen A; Lilly, Craig M; Kaster, David A; Groves, Robert H; Khurana, Hargobind

    2016-08-01

    Studies have identified processes that are associated with more favorable length of stay (LOS) outcomes when an ICU telemedicine program is implemented. Despite these studies, the relation of the acceptance of ICU telemedicine management services by individual ICUs to LOS outcomes is unknown. This is a single ICU telemedicine center study that compares LOS outcomes among three groups of intensivist-staffed mixed medical-surgical ICUs that used alternative comanagement strategies. The proportion of provider orders recorded by an ICU telemedicine provider to all recorded orders was compared among ICUs that used a monitor and notify comanagement approach, a direct intervention with timely notification process, and ICUs that used a mix of these two approaches. The primary outcome was acuity-adjusted hospital LOS. ICUs that used the direct intervention with timely notification strategy had a significantly larger proportion of provider orders recorded by ICU telemedicine physicians than the mixed methods of comanagement group, which had a larger proportion than ICUs that used the monitor and notify method (P < .001). Acuity-adjusted hospital LOS was significantly lower for the direct intervention with timely notification comanagement strategy (0.68; 0.65-0.70) compared with the mixed methods group (0.70 [0.69-0.72]; P = .01), which was significantly lower than the monitor and notify group (0.83 [0.80-0.86]; P < .001). Direct intervention with timely notification strategies of ICU telemedicine comanagement were associated with shorter LOS outcomes than monitor and notify comanagement strategies. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. A comparison of consumer-directed and agency-directed personal assistance services programmes.

    PubMed

    Hagglund, Kristofer; Clark, Mary; Farmer, Janet; Sherman, Ashley

    2004-05-06

    To compare a consumer-directed personal assistance services (PAS) programme with an agency-directed PAS programme. A convenience sample was used for this cross-sectional study with one data collection point. Outcomes were compared for consumer-directed and agency-directed PAS. Hierarchical regressions were also used to determine the predictors of outcomes across PAS programmes. In-home interviews were conducted by a trained data collector from April 2000 to December 2001. Participants in the consumer-directed programme reported more choices over PAS and satisfaction with PAS. Self-reported outcomes were primarily predicted by the following variables: service arrangement, type of provider, importance of directing PAS, health status, number of personal assistants used in past 12 months, sufficient PAS hours received, and social support. Consumer-directed PAS enhances outcomes for many persons with disabilities. Self-reported outcomes are affected by many factors that could be addressed in PAS programme development.

  16. Onsite-effects of dual-hemisphere versus conventional single-hemisphere transcranial direct current stimulation: A functional MRI study.

    PubMed

    Kwon, Yong Hyun; Jang, Sung Ho

    2012-08-25

    We performed functional MRI examinations in six right-handed healthy subjects. During functional MRI scanning, transcranial direct current stimulation was delivered with the anode over the right primary sensorimotor cortex and the cathode over the left primary sensorimotor cortex using dual-hemispheric transcranial direct current stimulation. This was compared to a cathode over the left supraorbital area using conventional single-hemispheric transcranial direct current stimulation. Voxel counts and blood oxygenation level-dependent signal intensities in the right primary sensorimotor cortex regions were estimated and compared between the two transcranial direct current stimulation conditions. Our results showed that dual-hemispheric transcranial direct current stimulation induced greater cortical activities than single-hemispheric transcranial direct current stimulation. These findings suggest that dual-hemispheric transcranial direct current stimulation may provide more effective cortical stimulation than single-hemispheric transcranial direct current stimulation.

  17. Cryptochrome, Phytochrome, and Anthocyanin Production

    PubMed Central

    Mancinelli, Alberto L.; Rossi, Federica; Moroni, Anna

    1991-01-01

    Anthocyanin production in cabbage (Brassica oleracea L.) and tomato (Lycopersicon esculentum Mill.) seedlings exposed to prolonged irradiations was studied under conditions that allowed discrimination, within certain limits, between the contribution of cryptochrome and phytochrome in the photoregulation of the response. The results of the study provide confirming evidence for the involvement of cryptochrome and direct evidence for a significant contribution of cryptochrome to the fluence rate dependence of the response to blue. The results provide some preliminary, direct indication for an interaction between cryptochrome and phytochrome in the photoregulation of anthocyanin production in seedlings exposed to the prolonged irradiations required for a high level of expression of the response. The type and degree of interaction between the two photoreceptors vary significantly, depending on the species and experimental conditions. PMID:16668301

  18. Extending student knowledge and interest through super-curricular activities

    NASA Astrophysics Data System (ADS)

    Zetie, K. P.

    2018-03-01

    Any teacher of physics is likely to consider super-curricular reading as an important strategy for successful students. However, there are many more ways to extend a student’s interest in a subject than reading books, and undirected reading (such as providing a long out of date reading list) is not likely to be as helpful as targeted or directed study. I present an approach to directing and supporting additional study pioneered at St Paul’s School in the last 2 years based on two significant steps: • Providing a large, searchable database of reading and other material such as podcasts rather than simply a reading list. • Encouraging students to visualise and plot their trajectory toward a specific goal using a graph

  19. A systematic worldwide review of the direct monetary losses in cattle due to bovine viral diarrhoea virus infection.

    PubMed

    Richter, Veronika; Lebl, Karin; Baumgartner, Walter; Obritzhauser, Walter; Käsbohrer, Annemarie; Pinior, Beate

    2017-02-01

    Bovine viral diarrhoea virus (BVDV) is an important infectious agent of cattle worldwide that affects herd productivity and reproduction. In this systematic review of the impact of BVDV, studies were analysed with a particular focus on the monetary implications and types of direct losses, the initial infection status of herds, production systems, time periods of assessment, calculation level, study types and whether or not country-specific assessments were published. A linear mixed model was applied to analyse factors that influence the level of monetary direct losses due to BVDV infection. The 44 studies included in this review covered 15 countries and assessed direct monetary losses due to BVDV incurred over the past 30 years. Direct losses between and within countries were largely heterogeneous with respect to the monetary level and types of direct losses, ranging from 0.50 to 687.80 US dollars (USD) per animal. 1 Average direct losses per naïve dairy cow were USD24.85 higher than per beef cow. Country-specific assessments of direct losses due to BVDV were provided in 38/44 (86.4%) studies. Mortality, morbidity, premature culling, stillbirths, abortion, reinfection, country and study type had a significant influence on the monetary level of direct losses (r 2  = 0.69). Countries recording direct losses were more likely to carry out voluntary or compulsory control and eradication programmes (odds ratio = 10.2; 95% confidence interval 1.7-81.9; P = 0.004). Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  20. Anxiety and burnout in young athletes: The mediating role of cognitive appraisal.

    PubMed

    Gomes, A R; Faria, S; Vilela, C

    2017-12-01

    This study tested the relationship between trait anxiety, cognitive appraisal, and athletes' burnout proposing two hypotheses: (a) there is a direct relationship between athletes' trait anxiety and cognitive appraisal and burnout, and (b) cognitive appraisal mediates the relationship between trait anxiety and burnout, and this mediation occurs despite the competitive level and sport records of athletes. The study included 673 young athletes and provided measures of trait anxiety, cognitive appraisal, and burnout. Structural equation modeling indicated that cognitive appraisal mediates the relationship between trait anxiety and burnout, confirming hypothesis 2, and this model provided better fit than the direct model of hypothesis 1. However, the mediation also indicated that the direct relationship between trait anxiety and burnout should be considered. The mediating model was invariant according to competitive levels and sport records. In conclusion, cognitive appraisal is an important variable in explaining athletes' burnout. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Direct solar pumping of semiconductor lasers: A feasibility study

    NASA Technical Reports Server (NTRS)

    Anderson, Neal G.

    1991-01-01

    The primary goals of the feasibility study are the following: (1) to provide a preliminary assessment of the feasibility of pumping semiconductor lasers in space directly focused sunlight; and (2) to identify semiconductor laser structures expected to operate at the lowest possible focusing intensities. It should be emphasized that the structures under consideration would provide direct optical-to-optical conversion of sunlight into laser light in a single crystal, in contrast to a configuration consisting of a solar cell or battery electrically pumping a current injection laser. With external modulation, such lasers may prove to be efficient sources for intersatellite communications. We proposed to develop a theoretical model of semiconductor quantum-well lasers photopumped by a broadband source, test it against existing experimental data where possible, and apply it to estimating solar pumping requirements and identifying optimum structures for operation for operation at low pump intensities. This report outlines our progress toward these goals. Discussion of several technical details are left to the attached summary abstract.

  2. Preparation for frontline end-of-life care: exploring the perspectives of paramedics and emergency medical technicians.

    PubMed

    Waldrop, Deborah P; Clemency, Brian; Maguin, Eugene; Lindstrom, Heather

    2014-03-01

    Prehospital emergency providers (emergency medical technicians [EMTs] and paramedics) who respond to emergency calls for patients near the end of life (EOL) make critical decisions in the field about initiating care and transport to an emergency department. To identify how a sample of prehospital providers learned about EOL care, their perceived confidence with and perspectives on improved preparation for such calls. This descriptive study used a cross-sectional survey design with mixed methods. One hundred seventy-eight prehospital providers (76 EMT-basics and 102 paramedics) from an emergency medical services agency participated. Multiple choice and open-ended survey questions addressed how they learned about EOL calls, their confidence with advance directives, and perspectives on improving care in the field. The response rate was 86%. Education about do-not-resuscitate (DNR) orders was formal (92%), experiential (77%), and self-directed (38%). Education about medical orders for life-sustaining treatment (MOLST) was formal (72%), experiential (67%), and self-directed (25%). Ninety-three percent were confident in upholding a DNR order, 87% were confident interpreting MOLST, and 87% were confident sorting out conflict between differing patient and family wishes. Qualitative data analysis yielded six themes on improving preparation of prehospital providers for EOL calls: (1) prehospital provider education; (2) public education; (3) educating health care providers on scope of practice; (4) conflict resolution skills; (5) handling emotional families; and (6) clarification of transfer protocols. These study results suggest the need for addressing the potential interrelationship between prehospital and EOL care through improved education and protocols for care in the field.

  3. Sources and remedies for restraint system discomfort and inconveniences

    DOT National Transportation Integrated Search

    1974-11-01

    This study examines possible causes of failure of autombile occupants to wear restraint systems provided by the manufacturers. Attention is directed primarily to confusion, incovenience and discomfort factors in seat belt usage. Study phases consiste...

  4. Nickel on the Swedish market. Follow-up after implementation of the Nickel Directive.

    PubMed

    Lidén, Carola; Norberg, Kristina

    2005-01-01

    The Nickel Directive aims at the prevention of sensitization and elicitation of nickel dermatitis. It limits nickel release from, and nickel content in, certain items. The Directive came into full force by July 2001. The aim of this study was to investigate the frequency on the market of items that release nickel and of nickel content in piercing posts, 2 years after coming into force of the Directive. Of special interest was to study changes compared to the situation in 1999, when a baseline study had been carried out. Nickel release from 786 items covered by the Nickel Directive was tested with the dimethylglyoxime (DMG) test, and nickel content in 18 piercing posts was analysed. Nickel release was shown from 8% of items intended for direct and prolonged contact with the skin, and 17% of the piercing posts contained too much nickel, a decrease compared to 1999. There has been significant adaptation to the requirements of the Nickel Directive. The DMG test is useful for screening for nickel release and for monitoring the market. Provided there is further adaptation to the requirements, the risk of sensitization and elicitation of nickel dermatitis will be significantly reduced.

  5. Integration of radiographic images with an electronic medical record.

    PubMed Central

    Overhage, J. M.; Aisen, A.; Barnes, M.; Tucker, M.; McDonald, C. J.

    2001-01-01

    Radiographic images are important and expensive diagnostic tests. However, the provider caring for the patient often does not review the images directly due to time constraints. Institutions can use picture archiving and communications systems to make images more available to the provider, but this may not be the best solution. We integrated radiographic image review into the Regenstrief Medical Record System in order to address this problem. To achieve adequate performance, we store JPEG compressed images directly in the RMRS. Currently, physicians review about 5% of all radiographic studies using the RMRS image review function. PMID:11825241

  6. A Systematic Review of Strategies for Implementing Empirically Supported Mental Health Interventions

    PubMed Central

    Powell, Byron J.; Proctor, Enola K.; Glass, Joseph E.

    2013-01-01

    Objective This systematic review examines experimental studies that test the effectiveness of strategies intended to integrate empirically supported mental health interventions into routine care settings. Our goal was to characterize the state of the literature and to provide direction for future implementation studies. Methods A literature search was conducted using electronic databases and a manual search. Results Eleven studies were identified that tested implementation strategies with a randomized (n = 10) or controlled clinical trial design (n = 1). The wide range of clinical interventions, implementation strategies, and outcomes evaluated precluded meta-analysis. However, the majority of studies (n = 7; 64%) found a statistically significant effect in the hypothesized direction for at least one implementation or clinical outcome. Conclusions There is a clear need for more rigorous research on the effectiveness of implementation strategies, and we provide several suggestions that could improve this research area. PMID:24791131

  7. Direct patterning of a cyclotriveratrylene derivative for directed self-assembly of C60

    NASA Astrophysics Data System (ADS)

    Osner, Zachary R.; Nyamjav, Dorjderem; Holz, Richard C.; Becker, Daniel P.

    2011-07-01

    A novel apex-modified cyclotriveratrylene (CTV) derivative with an attached thiolane-containing lipoic acid linker was directly patterned onto gold substrates via dip-pen nanolithography (DPN). The addition of a dithiolane-containing linker to the apex of CTV provides a molecule that can adhere to a gold surface with its bowl-shaped cavity directed away from the surface, thereby providing a surface-bound CTV host that can be used for the directed assembly of guest molecules. Subsequent exposure of these CTV microarrays to C60 in toluene resulted in the directed assembly of predesigned, spatially controlled, high-density microarrays of C60. The molecular recognition capabilities of this CTV template toward C60 provides proof-of-concept that supramolecular CTV scaffolds can be directly patterned onto surfaces providing a foundation for the development of organic electronic and optoelectronic materials.

  8. Transcranial direct current stimulation in psychiatric disorders

    PubMed Central

    Tortella, Gabriel; Casati, Roberta; Aparicio, Luana V M; Mantovani, Antonio; Senço, Natasha; D’Urso, Giordano; Brunelin, Jerome; Guarienti, Fabiana; Selingardi, Priscila Mara Lorencini; Muszkat, Débora; Junior, Bernardo de Sampaio Pereira; Valiengo, Leandro; Moffa, Adriano H; Simis, Marcel; Borrione, Lucas; Brunoni, André R

    2015-01-01

    The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation (tDCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally, we provide an overview of tDCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding tDCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding tDCS efficacy in psychiatry. PMID:25815258

  9. Love, Money, or Flexibility: What Motivates People to Work in Consumer-Directed Home Care?

    ERIC Educational Resources Information Center

    Howes, Candace

    2008-01-01

    Purpose: The purpose of this study was to investigate the impact of wages and benefits (relative to other jobs available to workers), controlling for personal characteristics, on the recruitment and retention of providers working in a consumer-directed home care program. Design and Methods: I used the results of focus groups to design a survey…

  10. Rapid, sensitive and direct analysis of exopolysaccharides from biofilm on aluminum surfaces exposed to sea water using MALDI-TOF MS.

    PubMed

    Hasan, Nazim; Gopal, Judy; Wu, Hui-Fen

    2011-11-01

    Biofilm studies have extensive significance since their results can provide insights into the behavior of bacteria on material surfaces when exposed to natural water. This is the first attempt of using matrix-assisted laser desorption/ionization-mass spectrometry (MALDI-MS) for detecting the polysaccharides formed in a complex biofilm consisting of a mixed consortium of marine microbes. MALDI-MS has been applied to directly analyze exopolysaccharides (EPS) in the biofilm formed on aluminum surfaces exposed to seawater. The optimal conditions for MALDI-MS applied to EPS analysis of biofilm have been described. In addition, microbiologically influenced corrosion of aluminum exposed to sea water by a marine fungus was also observed and the fungus identity established using MALDI-MS analysis of EPS. Rapid, sensitive and direct MALDI-MS analysis on biofilm would dramatically speed up and provide new insights into biofilm studies due to its excellent advantages such as simplicity, high sensitivity, high selectivity and high speed. This study introduces a novel, fast, sensitive and selective platform for biofilm study from natural water without the need of tedious culturing steps or complicated sample pretreatment procedures. Copyright © 2011 John Wiley & Sons, Ltd.

  11. Guided waves and defect scattering in metal matrix composite plates

    NASA Technical Reports Server (NTRS)

    Datta, Subhendu K.; Bratton, Robert L.; Shah, Arvind H.

    1989-01-01

    Guided Rayleigh-Lamb waves in a continuous graphite fiber reinforced magnesium plate has been studied. The interest in this material arises from its high thermal stability and because it provides high strength-to-weight ratio. Previous studies have shown that for wavelengths much larger than the fiber diameters and spacing, the material can be characterized as transversely isotropic with the symmetry axis aligned with the fiber direction. Because of the high longitudinal stiffness of the graphite fibers, the material shows strong anisotropy, with very high modulus in the fiber direction. For this reason, dispersion of guided waves is strongly influenced by the deviation of the direction of propagation from the symmetry axis. Results are given for propagation in different directions and for scattering of antiplane shear waves by surface-breaking cracks and delaminations.

  12. The direct and indirect costs of both overweight and obesity: a systematic review

    PubMed Central

    2014-01-01

    Background The rising prevalence of overweight and obesity places a financial burden on health services and on the wider economy. Health service and societal costs of overweight and obesity are typically estimated by top-down approaches which derive population attributable fractions for a range of conditions associated with increased body fat or bottom-up methods based on analyses of cross-sectional or longitudinal datasets. The evidence base of cost of obesity studies is continually expanding, however, the scope of these studies varies widely and a lack of standardised methods limits comparisons nationally and internationally. The objective of this review is to contribute to this knowledge pool by examining direct costs and indirect (lost productivity) costs of both overweight and obesity to provide comparable estimates. This review was undertaken as part of the introductory work for the Irish cost of overweight and obesity study and examines inconsistencies in the methodologies of cost of overweight and obesity studies. Studies which evaluated the direct costs and indirect costs of both overweight and obesity were included. Methods A computerised search of English language studies addressing direct and indirect costs of overweight and obesity in adults between 2001 and 2011 was conducted. Reference lists of reports, articles and earlier reviews were scanned to identify additional studies. Results Five published articles were deemed eligible for inclusion. Despite the limited scope of this review there was considerable heterogeneity in methodological approaches and findings. In the four studies which presented separate estimates for direct and indirect costs of overweight and obesity, the indirect costs were higher, accounting for between 54% and 59% of the estimated total costs. Conclusion A gradient exists between increasing BMI and direct healthcare costs and indirect costs due to reduced productivity and early premature mortality. Determining precise estimates for the increases is mired by the large presence of heterogeneity among the available cost estimation literature. To improve the availability of quality evidence an international consensus on standardised methods for cost of obesity studies is warranted. Analyses of nationally representative cross-sectional datasets augmented by data from primary care are likely to provide the best data for international comparisons. PMID:24739239

  13. The direct and indirect costs of both overweight and obesity: a systematic review.

    PubMed

    Dee, Anne; Kearns, Karen; O'Neill, Ciaran; Sharp, Linda; Staines, Anthony; O'Dwyer, Victoria; Fitzgerald, Sarah; Perry, Ivan J

    2014-04-16

    The rising prevalence of overweight and obesity places a financial burden on health services and on the wider economy. Health service and societal costs of overweight and obesity are typically estimated by top-down approaches which derive population attributable fractions for a range of conditions associated with increased body fat or bottom-up methods based on analyses of cross-sectional or longitudinal datasets. The evidence base of cost of obesity studies is continually expanding, however, the scope of these studies varies widely and a lack of standardised methods limits comparisons nationally and internationally. The objective of this review is to contribute to this knowledge pool by examining direct costs and indirect (lost productivity) costs of both overweight and obesity to provide comparable estimates. This review was undertaken as part of the introductory work for the Irish cost of overweight and obesity study and examines inconsistencies in the methodologies of cost of overweight and obesity studies. Studies which evaluated the direct costs and indirect costs of both overweight and obesity were included. A computerised search of English language studies addressing direct and indirect costs of overweight and obesity in adults between 2001 and 2011 was conducted. Reference lists of reports, articles and earlier reviews were scanned to identify additional studies. Five published articles were deemed eligible for inclusion. Despite the limited scope of this review there was considerable heterogeneity in methodological approaches and findings. In the four studies which presented separate estimates for direct and indirect costs of overweight and obesity, the indirect costs were higher, accounting for between 54% and 59% of the estimated total costs. A gradient exists between increasing BMI and direct healthcare costs and indirect costs due to reduced productivity and early premature mortality. Determining precise estimates for the increases is mired by the large presence of heterogeneity among the available cost estimation literature. To improve the availability of quality evidence an international consensus on standardised methods for cost of obesity studies is warranted. Analyses of nationally representative cross-sectional datasets augmented by data from primary care are likely to provide the best data for international comparisons.

  14. The role of satellite directional wave spectra for the improvement of the ocean-waves coupling

    NASA Astrophysics Data System (ADS)

    Aouf, Lotfi; Hauser, Danièle; Chapron, Bertrand

    2017-04-01

    Swell waves are well captured by the Synthetic Aperture Radar (SAR) which provides the directional wave spectra for waves roughly larger than 200 m. Since the launch of sentinel-1A and 1B SAR directional wave spectra are available to improve the swell wave forecasting and the coupling processes at the air-sea interface. Moreover next year CFOSAT mission will provide directional wave spectra for waves with wavelengths comprised between 70 to 500 m. This study aims to evaluate the assimilation of SAR and synthetic CFOSAT wave spectra on the coupling between the wave model MFWAM and the ocean model NEMO. Three coupling processes as described in Breivik et al. (2014) of Stokes-Coriolis forcing, the ocean side stress and the turbulence injected by the wave breaking in the ocean mixed layer have been used. a coupling run is performed with and without assimilation of directional wave spectra. the impact of SAR wave data on key parameters such as surface sea temperature, currents and salinity is investigated. Particular attention is carried out for ocean areas with swell dominant wave climate.

  15. Recent Developments in the Classification, Evaluation, Pathophysiology, and Management of Scleroderma Renal Crisis.

    PubMed

    Ghossein, Cybele; Varga, John; Fenves, Andrew Z

    2016-01-01

    Scleroderma renal crisis (SRC) is an uncommon complication of systemic sclerosis. Despite the advent of angiotensin-converting inhibitor therapy, SRC remains a life-threatening complication. Recent studies have contributed to a better understanding of SRC, but much remains unknown regarding its pathophysiology, risk factors, and optimal management. Genetic studies provide evidence that immune dysregulation might be a contributing factor, providing hope that further research in this direction might illuminate pathogenesis and provide novel predictors for this complication.

  16. The Development of Young Children's Understanding of the Process of Evaporation.

    ERIC Educational Resources Information Center

    Beveridge, Michael

    1985-01-01

    This investigation of the development of young children's concept of evaporation examines their intuitive explanations of real world events involving evaporation. A study of the effects of providing evidence contradicting their explanations and of directing their attention to relevant situational features provides insight into the development of…

  17. Information Technology Infusion Case Study: Integrating Google Earth(Trademark) into the A-Train Data Depot

    NASA Technical Reports Server (NTRS)

    Smith, Peter; Kempler, Steven; Leptoukh, Gregory; Chen, Aijun

    2010-01-01

    This poster paper represents the NASA funded project that was to employ the latest three dimensional visualization technology to explore and provide direct data access to heterogeneous A-Train datasets. Google Earth (tm) provides foundation for organizing, visualizing, publishing and synergizing Earth science data .

  18. Aircraft noise synthesis system: Version 4 user instructions

    NASA Technical Reports Server (NTRS)

    Mccurdy, David A.; Sullivan, Brenda M.; Grandle, Robert E.

    1987-01-01

    A modified version of the Aircraft Noise Synthesis System with improved directivity and tonal content modeling has been developed. The synthesis system is used to provide test stimuli for studies of community annoyance to aircraft flyover noise. The computer-based system generates realistic, time-varying audio simulations of aircraft flyover noise at a specified observer location on the ground. The synthesis takes into account the time-varying aircraft position relative to the observer; specified reference spectra consisting of broadband, narrowband, and pure tone components; directivity patterns; Doppler shift; atmospheric effects; and ground effects. These parameters can be specified and controlled in such a way as to generate stimuli in which certain noise characteristics such as duration or tonal content are independently varied while the remaining characteristics such as broadband content are held constant. The modified version of the system provides improved modeling of noise directivity patterns and an increased number of pure tone components. User instructions for the modified version of the synthesis system are provided.

  19. Substance use disorders and self- and other-directed violence among adults: Results from the National Survey on Drug Use And Health.

    PubMed

    Harford, Thomas C; Yi, Hsiao-Ye; Chen, Chiung M; Grant, Bridget F

    2018-01-01

    Previous studies have identified a violence typology of self- and other-directed violence. This study examines the extent to which substance use disorders (SUDs) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), independent of serious psychological distress, major depressive episodes, assault arrest, and criminal justice involvement, are associated with these violence categories. Data were obtained from the National Survey on Drug Use and Health (NSDUH) pooled across survey years 2008-2015, with a combined sample of 314,881 adult respondents. According to self-report data on suicide attempt (self-directed) and attacking someone with the intent for serious injury (other-directed), violence was categorized in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression was used to estimate the adjusted odds ratios associated with the risk factors for different forms of violence. Nicotine dependence and the number of DSM-IV SUDs criteria (except the criterion of legal problems) for alcohol, marijuana, and pain reliever use disorders are significantly associated with the self-/other-directed violence categories. Cross-sectional data do not allow assessment of directionality of important factors. The identification of the combined self- and other-directed violence among adults in the general population extends studies in the adolescent population, and significant correlation between self- and other-directed violence provides additional support for clinical studies that established this association. Findings expand the associated risk factors identified in previous studies for the adult population. Prevention and treatment programs need to address both forms of violence and suicidality. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Neurotization to innervate the deltoid and biceps: 3 cases.

    PubMed

    Dy, Christopher J; Kitay, Alison; Garg, Rohit; Kang, Lana; Feinberg, Joseph H; Wolfe, Scott W

    2013-02-01

    To describe our experience using direct muscle neurotization as a treatment adjunct during delayed surgical reconstruction for traumatic denervation injuries. Three patients who had direct muscle neurotization were chosen from a consecutive series of patients undergoing reconstruction for brachial plexus injuries. The cases are presented in detail, including long-term clinical follow-up at 2, 5, and 10 years with accompanying postoperative electrodiagnostic studies. Postoperative motor strength using British Medical Research Council grading and active range of motion were retrospectively extracted from the clinical charts. Direct muscle neurotization was performed into the deltoid in 2 cases and into the biceps in 1 case after delays of up to 10 months from injury. Two patients had recovery of M4 strength, and the other patient had recovery of M3 strength. All 3 patients had evidence on electrodiagnostic studies of at least partial muscle reinnervation after neurotization. Direct muscle neurotization has shown promising results in numerous basic science investigations and a limited number of clinical cases. The current series provides additional clinical and electrodiagnostic evidence that direct muscle neurotization can successfully provide reinnervation, even after lengthy delays from injury to surgical treatment. Microsurgeons should consider direct muscle neurotization as a viable adjunct treatment and part of a comprehensive reconstructive plan, especially for injuries associated with avulsion of the distal nerve stump from its insertion into the muscle. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Direct contracting: a Minnesota case study.

    PubMed

    Burrows, S N; Moravec, R C

    1997-08-01

    During 1996, HealthEast Care, Inc., a healthcare provider-owned and governed direct-contracting company, successfully responded to a request for proposal from the metropolitan Minneapolis-St. Paul-based Buyers Health Care Action Group (BHCAG), a coalition of self-insured employers, to provide healthcare services to members of BHCAG's Choice Plus health plan. HealthEast Care developed a care system proposal for BHCAG that balanced consumer and purchaser expectations with historical healthcare costs. Providers are reimbursed for contracted healthcare services according to a unique fee-for-service, budget-based payment model. BHCAG chose to contract with HealthEast Care and 23 other care systems in the metropolitan Minneapolis-St. Paul area and other parts of Minnesota to serve more than 117,500 Choice Plus enrollees.

  2. A Novel Augmented Reality-Based Navigation System in Perforator Flap Transplantation - A Feasibility Study.

    PubMed

    Jiang, Taoran; Zhu, Ming; Zan, Tao; Gu, Bin; Li, Qingfeng

    2017-08-01

    In perforator flap transplantation, dissection of the perforator is an important but difficult procedure because of the high variability in vascular anatomy. Preoperative imaging techniques could provide substantial information about vascular anatomy; however, it cannot provide direct guidance for surgeons during the operation. In this study, a navigation system (NS) was established to overlie a vascular map on surgical sites to further provide a direct guide for perforator flap transplantation. The NS was established based on computed tomographic angiography and augmented reality techniques. A virtual vascular map was reconstructed according to computed tomographic angiography data and projected onto real patient images using ARToolKit software. Additionally, a screw-fixation marker holder was created to facilitate registration. With the use of a tracking and display system, we conducted the NS on an animal model and measured the system error on a rapid prototyping model. The NS assistance allowed for correct identification, as well as a safe and precise dissection of the perforator. The mean value of the system error was determined to be 3.474 ± 1.546 mm. Augmented reality-based NS can provide precise navigation information by directly displaying a 3-dimensional individual anatomical virtual model onto the operative field in real time. It will allow rapid identification and safe dissection of a perforator in free flap transplantation surgery.

  3. Healthcare financing systems for increasing the use of tobacco dependence treatment.

    PubMed

    Reda, Ayalu A; Kotz, Daniel; Evers, Silvia M A A; van Schayck, Constant Paul

    2012-06-13

    We hypothesized that provision of financial assistance for smokers trying to quit, or reimbursement of their care providers, could lead to an increased rate of successful quit attempts. The primary objective of this review was to assess the impact of reducing the costs of providing or using smoking cessation treatment through healthcare financing interventions on abstinence from smoking. The secondary objectives were to examine the effects of different levels of financial support on the use and/or prescription of smoking cessation treatment and on the number of smokers making a quit attempt. We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2012. We considered randomised controlled trials (RCTs), controlled trials and interrupted time series studies involving financial benefit interventions to smokers or their healthcare providers or both. Two reviewers independently extracted data and assessed the quality of the included studies. Risk ratios (RR) were calculated for individual studies on an intention-to-treat basis and meta-analysis was performed using a random-effects model. We included economic evaluations when a study presented the costs and effects of two or more alternatives. We found eleven trials involving financial interventions directed at smokers and healthcare providers.Full financial interventions directed at smokers had a statistically significant favourable effect on abstinence at six months or greater when compared to no intervention (RR 2.45, 95% CI 1.17 to 5.12, I² = 59%, 4 studies). There was also a significant effect of full financial interventions when compared to no interventions on the number of participants making a quit attempt (RR 1.11, 95% CI 1.04 to 1.32, I² = 15%) and use of smoking cessation treatment (NRT: RR 1.83, 95% CI 1.55 to 2.15, I² = 43%; bupropion: RR 3.22, 95% CI 1.41 to 7.34, I² = 71%; behavioural therapy: RR 1.77, 95% CI 1.19 to 2.65). There was no evidence of an effect on smoking cessation when we pooled two trials of financial incentives directed at healthcare providers (RR 1.16, CI 0.98 to 1.37, I² = 0%). Comparisons of full coverage with partial coverage, partial coverage with no coverage, and partial coverage with another partial coverage intervention did not detect significant effects. Comparison of full coverage with partial or no coverage resulted in costs per additional quitter ranging from $119 to $6450. Full financial interventions directed at smokers when compared to no financial interventions increase the proportion of smokers who attempt to quit, use smoking cessation treatments, and succeed in quitting.  The absolute differences are small but the costs per additional quitter are low to moderate. We did not detect an effect on smoking cessation from financial incentives directed at healthcare providers. The methodological qualities of the included studies need to be taken into consideration when interpreting the results.

  4. Burnout intervention studies for inpatient elderly care nursing staff: systematic literature review.

    PubMed

    Westermann, Claudia; Kozak, Agnessa; Harling, Melanie; Nienhaus, Albert

    2014-01-01

    Staff providing inpatient elderly and geriatric long-term care are exposed to a large number of factors that can lead to the development of burnout syndrome. Burnout is associated with an increased risk of absence from work, low work satisfaction, and an increased intention to leave. Due to the fact that the number of geriatric nursing staff is already insufficient, research on interventions aimed at reducing work-related stress in inpatient elderly care is needed. The aim of this systematic review was to identify and analyse burnout intervention studies among nursing staff in the inpatient elderly and geriatric long-term care sector. A systematic search of burnout intervention studies was conducted in the databases Embase, Medline and PsycNet published from 2000 to January 2012. We identified 16 intervention studies. Interventions were grouped into work-directed (n=2), person-directed (n=9) and combined approaches (work- and person-directed, n=5). Seven out of 16 studies observed a reduction in staff burnout. Among them are two studies with a work-directed, two with a person-directed and three with a combined approach. Person-directed interventions reduced burnout in the short term (up to 1 month), while work-directed interventions and those with a combined approach were able to reduce burnout over a longer term (from 1 month to more than 1 year). In addition to staff burnout, three studies observed positive effects relating to the client outcomes. Only three out of ten Randomised Control Trials (RCT) found that interventions had a positive effect on staff burnout. Work-directed and combined interventions are able to achieve beneficial longer-term effects on staff burnout. Person-directed interventions achieve short-term results in reducing staff burnout. However, the evidence is limited. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Pointing control using a moving base of support.

    PubMed

    Hondzinski, Jan M; Kwon, Taegyong

    2009-07-01

    The purposes of this study were to determine whether gaze direction provides a control signal for movement direction for a pointing task requiring a step and to gain insight into why discrepancies previously identified in the literature for endpoint accuracy with gaze directed eccentrically exist. Straight arm pointing movements were performed to real and remembered target locations, either toward or 30 degrees eccentric to gaze direction. Pointing occurred in normal room lighting or darkness while subjects sat, stood still or side-stepped left or right. Trunk rotation contributed 22-65% to gaze orientations when it was not constrained. Error differences for different target locations explained discrepancies among previous experiments. Variable pointing errors were influenced by gaze direction, while mean systematic pointing errors and trunk orientations were influenced by step direction. These data support the use of a control strategy that relies on gaze direction and equilibrium inputs for whole-body goal-directed movements.

  6. The acceptability to patients of PhysioDirect telephone assessment and advice services; a qualitative interview study.

    PubMed

    Pearson, Jennifer; Richardson, Jane; Calnan, Michael; Salisbury, Chris; Foster, Nadine E

    2016-03-28

    In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a randomised control trial (RCT) in four PCTs, with a total of 2252 patients that compared this approach with usual physiotherapy care. This nested qualitative study aimed to explore the acceptability of the PhysioDirect telephone assessment and advice service to patients with musculoskeletal conditions. We conducted 57 semi-structured interviews with adults from 4 PCTs who were referred from general practice to physiotherapy with musculoskeletal conditions and were participating in the PhysioDirect trial. The Framework method was used to analyse the qualitative data. The PhysioDirect service was largely viewed as acceptable although some saw it as a first step to subsequent face-to-face physiotherapy. Most participants found accessing the PhysioDirect service straightforward and smooth, and they valued the faster access to physiotherapy advice offered by the telephone service. Participants generally viewed both the PhysioDirect service and the physiotherapists providing the service as helpful. Participants' preferences and priorities for treatment defined the acceptable features of PhysioDirect but the acceptable features were traded off against less acceptable features. Some participants felt that the PhysioDirect service was impersonal and impaired the development of a good relationship with their physiotherapist, which made the service feel remote and less valuable. The PhysioDirect service was broadly acceptable to participants since it provided faster access to physiotherapy advice for their musculoskeletal conditions. Participants felt that it is best placed as one method of accessing physiotherapy services, in addition to, rather than as a replacement for, more traditional face-to-face physiotherapy assessment and treatment.

  7. Regular Decompositions for H(div) Spaces

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

    Kolev, Tzanio; Vassilevski, Panayot

    We study regular decompositions for H(div) spaces. In particular, we show that such regular decompositions are closely related to a previously studied “inf-sup” condition for parameter-dependent Stokes problems, for which we provide an alternative, more direct, proof.

  8. Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study.

    PubMed

    Song, Fujian; Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

    2011-08-16

    To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. The study included 112 independent trial networks (including 1552 trials with 478,775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence.

  9. Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study

    PubMed Central

    Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

    2011-01-01

    Objective To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Design Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Main outcome measure Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. Results The study included 112 independent trial networks (including 1552 trials with 478 775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Conclusions Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence. PMID:21846695

  10. Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.

    PubMed

    Corazzini, Kirsten; Twersky, Jack; White, Heidi K; Buhr, Gwendolen T; McConnell, Eleanor S; Weiner, Madeline; Colón-Emeric, Cathleen S

    2015-08-01

    To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. The study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership. Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Fitting a circular distribution based on nonnegative trigonometric sums for wind direction in Malaysia

    NASA Astrophysics Data System (ADS)

    Masseran, Nurulkamal; Razali, Ahmad Mahir; Ibrahim, Kamarulzaman; Zaharim, Azami; Sopian, Kamaruzzaman

    2015-02-01

    Wind direction has a substantial effect on the environment and human lives. As examples, the wind direction influences the dispersion of particulate matter in the air and affects the construction of engineering structures, such as towers, bridges, and tall buildings. Therefore, a statistical analysis of the wind direction provides important information about the wind regime at a particular location. In addition, knowledge of the wind direction and wind speed can be used to derive information about the energy potential. This study investigated the characteristics of the wind regime of Mersing, Malaysia. A circular distribution based on Nonnegative Trigonometric Sums (NNTS) was fitted to a histogram of the average hourly wind direction data. The Newton-like manifold algorithm was used to estimate the parameter of each component of the NNTS model. Next, the suitability of each NNTS model was judged based on a graphical representation and Akaike's Information Criteria. The study found that the NNTS model with six or more components was able to fit the wind directional data for the Mersing station.

  12. Single-trial classification of auditory event-related potentials elicited by stimuli from different spatial directions.

    PubMed

    Cabrera, Alvaro Fuentes; Hoffmann, Pablo Faundez

    2010-01-01

    This study is focused on the single-trial classification of auditory event-related potentials elicited by sound stimuli from different spatial directions. Five naϊve subjects were asked to localize a sound stimulus reproduced over one of 8 loudspeakers placed in a circular array, equally spaced by 45°. The subject was seating in the center of the circular array. Due to the complexity of an eight classes classification, our approach consisted on feeding our classifier with two classes, or spatial directions, at the time. The seven chosen pairs were 0°, which was the loudspeaker directly in front of the subject, with all the other seven directions. The discrete wavelet transform was used to extract features in the time-frequency domain and a support vector machine performed the classification procedure. The average accuracy over all subjects and all pair of spatial directions was 76.5%, σ = 3.6. The results of this study provide evidence that the direction of a sound is encoded in single-trial auditory event-related potentials.

  13. Direct-Y: Fast Acquisition of the GPS PPS Signal

    NASA Technical Reports Server (NTRS)

    Namoos, Omar M.; DiEsposti, Raymond S.

    1996-01-01

    The NAVSTAR Global Positioning System (GPS) provides positioning and time information to military users via the Precise Positioning Service (PPS) which typically allows users a significant margin of precision over the commercially available Standard Positioning Service (SPS), Military sets that rely on first acquiring the SPS Coarse Acquisition (C/A) code, read from the data message the handover word (HOW) that provides the time-of-signal transmission needed to acquire and lock onto the PPS Y-code. Under extreme battlefield conditions, the use of GPS would be denied to the warfighter who cannot pick up the un-encrypted C/A code. Studies are underway at the GPS Joint Program Office (JPO) at the Space and Missile Center, Los Angeles Air Force Base that are aimed at developing the capability to directly acquire Y-code without first acquiring C/A code. This paper briefly outlines efforts to develop 'direct-Y' acquisition, and various approaches to solving this problem. The potential ramifications of direct-Y to military users are also discussed.

  14. Redesigning nursing work in long-term care environments.

    PubMed

    Hall, L M; O'Brien-Pallas, L

    2000-01-01

    The authors present a highly statistically oriented argument for examining work attitudes and activities among three groups of caregivers [RNs, RPNs, and HCAs] working in long-term care. The investigators used both work sampling, written surveys, and interviews with a sample of 46 caregivers in a large university-affiliated LTC facility in Toronto, Canada. While RNs stated their strong affinity for direct patient care activities, they perform the lowest percentage of direct care, chiefly due to their accountability for planning and coordinating the care provided by others. The HCAs who provided the bulk of direct patient care "valued it the least," apparently finding little gratification with this aspect of their role. This study suggests that there is a need to examine and clarify work roles and perceptions for all caregivers as part of any work redesign process. A higher level of RN involvement in direct patient care activities, along with "attention to enhancing the importance" of these activities for staff employed in the HCA role, could be beneficial.

  15. Twenty and thirty GHz millimeter wave experiments with the ATS-6 satellite

    NASA Technical Reports Server (NTRS)

    Ippolito, L. J. (Compiler)

    1975-01-01

    The ATS-6 millimeter wave experiment, provided the first direct measurements of 20 and 30 GHz earth-space links from an orbiting satellite. Studies at eleven locations in the continental United States were directed at an evaluation of rain attenuation effects, scintillations, depolarization, site diversity, coherence bandwidth, and analog and digital communications techniques. In addition to direct measurements on the 20 and 30 GHz links, methods of attenuation prediction with radars, rain gages, and radiometers were developed and compared with the directly measured attenuation. Initial data results of the ATS-6 millimeter wave experiment from the major participating organizations are presented.

  16. Nurse staffing, direct nursing care hours and patient mortality in Taiwan: the longitudinal analysis of hospital nurse staffing and patient outcome study

    PubMed Central

    2012-01-01

    Background Studies over the past decades have shown an association between nurse staffing and patient outcomes, however, most of these studies were conducted in the West. Accordingly, the purpose of this study aimed to provide an overview of the research/evidence base which has clarified the relationship between nurse staffing and patient mortality of acute care hospital wards under a universal health insurance system and attempted to provide explanations for some of the phenomena that are unique in Taiwan. Methods Through stratified random sampling, a total of 108 wards selected from 32 hospitals in Taiwan were collected over a consecutive seven month period. The mixed effect logit model was used to explore the relationship between nurse staffing and patient mortality. Results The medians of direct-nursing-care-hour, and nurse manpower were 2.52 h, and 378 persons, respectively. The OR for death between the long direct-nursing-care-hour (> median) group and the short direct-nursing-care-hour (≦median) group was 0.393 (95% CI = [0.245, 0.617]). The OR for death between the high (> median) and the low (≦median) nurse manpower groups was 0.589 (95% CI = [0.381, 0.911]). Conclusions Findings from this study demonstrate an association of nurse staffing and patient mortality and are consistent with findings from similar studies. These findings have policy implications for strengthening the nursing profession, nurse staffing, and the hospital quality associated with nursing. Additional research is necessary to demonstrate adequate nurse staffing ratios of different wards in Taiwan. PMID:22348278

  17. The cost of warfarin treatment for stroke prevention in patients with non-valvular atrial fibrillation in Russia from a collective perspective.

    PubMed

    Briere, J B; Bowrin, K; Wood, R; Roberts, J; Tatarsky, B

    2017-06-01

    Vitamin K antagonists (VKAs) are used for stroke prevention in patients with non-valvular atrial fibrillation (NVAF), but necessitate regular monitoring of prothrombin time via international normalized ratio (INR) testing. This study explores the economic burden of VKA therapy for Russian patients with NVAF. Cardiologists provided clinical characteristics and healthcare resource use data relating to the patient's first year of treatment. Data were used to quantify direct medical costs (INR testing, consultations, drug costs). The same patients completed a questionnaire providing data on direct non-medical costs (travel/expenses for attendance at VKA appointments) and indirect costs (opportunity cost and reduced work productivity). Mean costs per patient per year are described (US dollars). Cardiologists (n = 50) provided data on 400 patients (mean age = 63, 47% female), and 351 patients (88%) completed the patient questionnaire. Patients had a mean of nine INR tests. Estimated direct medical costs totaled $151.06, and 18.5% of direct medical costs were attributable to drug costs. Estimated annual direct non-medical costs were $22.89 per patient, and indirect costs were $275.59 per patient. Included patients had been treated for 12-24 months, so are not fully representative of the broader treatment population. Although VKA drugs costs are relatively low, regular INR testing and consultations drive the economic burden for Russian NVAF patients treated with VKA.

  18. AB064. Estimation of direct and indirect costs and quality of life of patients with chronic obstructive pulmonary disease and their burden on Greek Health System

    PubMed Central

    Zarogoulidou, Vasiliki; Arbanitidou-Bagiona, Maria; Papakosta, Despoina; Zarogoulidis, Paul; Porpodis, Konstantinos; Panagopoulou, Evaggelia; Chaidits, Athanasios Basileio; Kontakiotis, Theodore; Zarogoulidis, Konstantinos

    2016-01-01

    Background The aim of this study was to make an attempt to estimate the direct and indirect costs of chronic obstructive pulmonary disease since in Greece very few attempts have been done to measure these costs and data available are insufficient. Our research focused on evaluating these direct and indirect costs according to demographic factors, response to treatment, patient survival, quality of life and patient satisfaction from the health care services provided. Methods This study was performed in Pulmonary Department of Aristotle University of Thessaloniki, General Hospital “G. Papanikolaou” and 110 patients with chronic obstructive pulmonary disease were enrolled. The follow-up duration of the patients was two years from the time of diagnosis. First, for study purposes the calculation of direct and indirect costs were performed and their correlations with patients’ demographics (gender, age, profession, place of residence), number of exacerbations, response to treatment and survival. In parallel, every three months from the time of diagnosis patients’ quality of life was recorded, using questionnaires, which was also correlated with the direct and indirect costs of each disease under investigation. The exploration of patient satisfaction from the health services provided was performed once for each patient during the first hospital stay in the Pulmonary Department of Aristotle University of Thessaloniki, General Hospital “G. Papanikolaou”. Results The total mean costs per patient in a one year follow-up was: total mean direct cost: 3.889,08€, total mean indirect cost: 18.01€. In chronic obstructive pulmonary disease (COPD) higher costs were observed in patients over 70 years old, of secondary education and pensioners, while for bronchial asthma higher costs were observed mainly in women. The disease severity, the frequency of exacerbations and the need for hospitalization significantly increased the economic burden of Greek health care system. The increase of the medication and patients’ monitoring cost resulted in improved control of the disease. Patients with COPD showed stable or deteriorating quality of life during the 12 month period of time. At 24 months of follow-up, patients with COPD reported improved quality of life compared to diagnosis. Improved the quality of life was associated with increased direct and indirect costs. The increased costs that were partly the result of frequent examinations, treatments and visits to the doctor, seemed to have negatively affected the emotional state of patients. Improved quality of life in COPD patients was related with reduced direct and indirect costs. Patient satisfaction from the provided health services could not be assessed as there was no homogeneity among the questions of the questionnaire used for the study. Future research should be made for the development of a reliable tool for recording patient satisfaction from the provided health services in hospitals of our country. Conclusions The higher annual burden of COPD patients is probably due to the infectious exacerbations COPD patients experience, which usually leads them to hospitalization. Patients quality of life is influenced from a variety of factors and was correlated with direct or/and indirect hospitalisation and/or monitoring cost.

  19. Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011). User's Manual for the ECLS-K:2011 Kindergarten Data File and Electronic Codebook, Public Version. NCES 2015-074

    ERIC Educational Resources Information Center

    Tourangeau, Karen; Nord, Christine; Lê, Thanh; Sorongon, Alberto G.; Hagedorn, Mary C.; Daly, Peggy; Najarian, Michelle

    2015-01-01

    This manual provides guidance and documentation for users of the kindergarten (or base year) data of the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011). It begins with an overview of the ECLS-K:2011. Subsequent chapters provide details on the study data collection instruments and methods; the direct and indirect…

  20. Technical Review of Water-Resources Investigations of the Tule Desert, Lincoln County, Southern Nevada

    USGS Publications Warehouse

    Berger, David L.; Halford, Keith J.; Belcher, Wayne R.; Lico, Michael S.

    2008-01-01

    The Nevada State Engineer in Ruling No. 5181 required Lincoln County and Vidler Water Company, Inc., to provide results from additional water-resources studies of Tule Desert in southern Nevada to support water-rights application 64692. As outlined by the ruling, the additional studies were to include the determination of the amount of ground water available from the Tule Desert basin, ground-water recharge to the Tule Desert, and the direction of ground-water flow. Results of these additional studies were published in five reports prepared for Lincoln County and Vidler Water Company, Inc. The National Park Service formally requested that the U.S. Geological Survey provide technical reviews of these five reports. The Nevada State Engineer in Ruling No. 5181 required Lincoln County and Vidler Water Company, Inc., to provide results from additional water-resources studies of Tule Desert in southern Nevada to support water-rights application 64692. As outlined by the ruling, the additional studies were to include the determination of the amount of ground water available from the Tule Desert basin, ground-water recharge to the Tule Desert, and the direction of ground-water flow. Results of these additional studies were published in five reports prepared for Lincoln County and Vidler Water Company, Inc. The National Park Service formally requested that the U.S. Geological Survey provide technical reviews of these five reports.

  1. A general geometric theory of attitude determination from directional sensing

    NASA Technical Reports Server (NTRS)

    Fang, B. T.

    1976-01-01

    A general geometric theory of spacecraft attitude determination from external reference direction sensors was presented. Outputs of different sensors are reduced to two kinds of basic directional measurements. Errors in these measurement equations are studied in detail. The partial derivatives of measurements with respect to the spacecraft orbit, the spacecraft attitude, and the error parameters form the basis for all orbit and attitude determination schemes and error analysis programs and are presented in a series of tables. The question of attitude observability is studied with the introduction of a graphical construction which provides a great deal of physical insight. The result is applied to the attitude observability of the IMP-8 spacecraft.

  2. Experimental study of directionally solidified ferromagnetic shape memory alloy under multi-field coupling

    NASA Astrophysics Data System (ADS)

    Zhu, Yuping; Chen, Tao; Teng, Yao; Liu, Bingfei; Xue, Lijun

    2016-11-01

    Directionally solidified, polycrystalline Ni-Mn-Ga is studied in this paper. The polycrystalline Ni-Mn-Ga samples were cut at different angles to solidification direction. The magnetic field induced strain under constant stress and the temperature-induced strain under constant magnetic field during the loading-unloading cycle were measured. The experimental results show that the mechanical behavior during the loading-unloading cycle of the material is nonlinear and anisotropic. Based on the experimental results, the effects of multi-field coupling factors, such as stress, magnetic field, temperature and cutting angle on the mechanical behaviors were analyzed. Some useful conclusions were obtained, which will provide guidance for practical applications.

  3. Protecting count queries in study design

    PubMed Central

    Sarwate, Anand D; Boxwala, Aziz A

    2012-01-01

    Objective Today's clinical research institutions provide tools for researchers to query their data warehouses for counts of patients. To protect patient privacy, counts are perturbed before reporting; this compromises their utility for increased privacy. The goal of this study is to extend current query answer systems to guarantee a quantifiable level of privacy and allow users to tailor perturbations to maximize the usefulness according to their needs. Methods A perturbation mechanism was designed in which users are given options with respect to scale and direction of the perturbation. The mechanism translates the true count, user preferences, and a privacy level within administrator-specified bounds into a probability distribution from which the perturbed count is drawn. Results Users can significantly impact the scale and direction of the count perturbation and can receive more accurate final cohort estimates. Strong and semantically meaningful differential privacy is guaranteed, providing for a unified privacy accounting system that can support role-based trust levels. This study provides an open source web-enabled tool to investigate visually and numerically the interaction between system parameters, including required privacy level and user preference settings. Conclusions Quantifying privacy allows system administrators to provide users with a privacy budget and to monitor its expenditure, enabling users to control the inevitable loss of utility. While current measures of privacy are conservative, this system can take advantage of future advances in privacy measurement. The system provides new ways of trading off privacy and utility that are not provided in current study design systems. PMID:22511018

  4. Protecting count queries in study design.

    PubMed

    Vinterbo, Staal A; Sarwate, Anand D; Boxwala, Aziz A

    2012-01-01

    Today's clinical research institutions provide tools for researchers to query their data warehouses for counts of patients. To protect patient privacy, counts are perturbed before reporting; this compromises their utility for increased privacy. The goal of this study is to extend current query answer systems to guarantee a quantifiable level of privacy and allow users to tailor perturbations to maximize the usefulness according to their needs. A perturbation mechanism was designed in which users are given options with respect to scale and direction of the perturbation. The mechanism translates the true count, user preferences, and a privacy level within administrator-specified bounds into a probability distribution from which the perturbed count is drawn. Users can significantly impact the scale and direction of the count perturbation and can receive more accurate final cohort estimates. Strong and semantically meaningful differential privacy is guaranteed, providing for a unified privacy accounting system that can support role-based trust levels. This study provides an open source web-enabled tool to investigate visually and numerically the interaction between system parameters, including required privacy level and user preference settings. Quantifying privacy allows system administrators to provide users with a privacy budget and to monitor its expenditure, enabling users to control the inevitable loss of utility. While current measures of privacy are conservative, this system can take advantage of future advances in privacy measurement. The system provides new ways of trading off privacy and utility that are not provided in current study design systems.

  5. The Use of Self-Directed Relapse Prevention Booklets to Assist in Maintaining Abstinence after a 6-Week Group Smoking Cessation Treatment Program: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Veldheer, Susan; Hrabovsky, Shari; Yingst, Jessica; Sciamanna, Chris; Berg, Arthur; Foulds, Jonathan

    2018-01-01

    Background: Identifying effective relapse prevention interventions is a vital step to help smokers maintain abstinence for the long term. Aims: The purpose of this study is to determine if providing recently quit smokers with self-directed relapse prevention booklets is effective at maintaining abstinence after intensive group smoking cessation…

  6. The Direct Impact of Team Cohesiveness and Athletes' Perception of Coaching Leadership Functions on Team Success in NCAA Division I Women's Basketball

    ERIC Educational Resources Information Center

    Palmer, Mary E.

    2013-01-01

    This study investigated the direct impact of team cohesiveness and student-athletes' perceptions of coaching behavior/leadership functions on the success of NCAA Division I Women's basketball, based on the teams' win/loss records. The research collection was quantitative in nature. Statistical design and analysis provided justification for the use…

  7. Total Marketing: A Study of Image

    DTIC Science & Technology

    1990-08-01

    marketing , and advertising are all successful in creating an initial awareness of the military. Potential recruits see recruiters at their schools, they...Direct mail marketing is impressive at first but soon wears out. It does not seem to provide new information. " Advertising , to the extent that it...awareness, current recruiting efforts net out as: Recruiter Contact - Negative Advertising - Neutral Direct Marketing - Neutral * 2. Recruitment Stage

  8. A Comprehensive Peer Network Intervention to Improve Social Communication of Children with Autism Spectrum Disorders: A Randomized Trial in Kindergarten and First Grade

    ERIC Educational Resources Information Center

    Kamps, Debra; Thiemann-Bourque, Kathy; Heitzman-Powell, Linda; Schwartz, Ilene; Rosenberg, Nancy; Mason, Rose; Cox, Suzanne

    2015-01-01

    The purpose of this randomized control group study was to examine the effects of a peer network intervention that included peer mediation and direct instruction for Kindergarten and First-grade children with autism spectrum disorders. Trained school staff members provided direct instruction for 56 children in the intervention group, and 39…

  9. Spatial averaging errors in creating hemispherical reflectance (albedo) maps from directional reflectance data

    NASA Technical Reports Server (NTRS)

    Kimes, D. S.; Kerber, A. G.; Sellers, P. J.

    1993-01-01

    Spatial averaging errors which may occur when creating hemispherical reflectance maps for different cover types from direct nadir technique to estimate the hemispherical reflectance are assessed by comparing the results with those obtained with a knowledge-based system called VEG (Kimes et al., 1991, 1992). It was found that hemispherical reflectance errors provided by using VEG are much less than those using the direct nadir techniques, depending on conditions. Suggestions are made concerning sampling and averaging strategies for creating hemispherical reflectance maps for photosynthetic, carbon cycle, and climate change studies.

  10. Systematic review and meta-analysis of hemodynamic-directed feedback during cardiopulmonary resuscitation in cardiac arrest.

    PubMed

    Chopra, A S; Wong, N; Ziegler, C P; Morrison, L J

    2016-04-01

    Physiologic monitoring of resuscitative efforts during cardiac arrest is gaining in importance, as it provides a real-time window into the cellular physiology of patients. The aim of this review is to assess the quality of evidence surrounding the use of physiologic monitoring to guide cardiopulmonary resuscitation (CPR), and to examine whether the evidence demonstrates an improvement in patient outcome when comparing hemodynamic-directed CPR versus standard CPR. Studies were obtained through a search of the PubMed, Embase and Cochrane databases. Peer-reviewed randomized trials, case-control studies, systematic reviews, and cohort studies that titrated CPR to physiologic measures, compared results to standard CPR, and examined patient outcome were included. Six studies met inclusion criteria, with all studies conducted in animal populations. Four studies examined the effects of hemodynamic-directed CPR on survival, with 35/37 (94.6%) animals surviving in the hemodynamic-directed CPR groups and 12/35 (34.3%) surviving in the control groups (p<0.001). Two studies examined the effects of hemodynamic-directed CPR on ROSC, with 22/30 (73.3%) achieving ROSC in the hemodynamic-directed CPR group and 19/30 (63.3%) achieving ROSC in the control group (p=0.344). These results suggest a trend in survival from hemodynamic-directed CPR over standard CPR, however the small sample size and lack of human data make these results of limited value. Future human studies examining hemodynamic-directed CPR versus current CPR standards are needed to enhance our understanding of how to effectively use physiologic measures to improve resuscitation efforts and ultimately incorporate concrete targets into international resuscitation guidelines. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Discovering Successful Pathways in Children's Development: Mixed Methods in the Study of Childhood and Family Life. The John D. and Catherine T. MacArthur Foundation Series on Mental Health and Development

    ERIC Educational Resources Information Center

    Weisner, Thomas S., Ed.

    2005-01-01

    "Discovering Successful Pathways in Children's Development" provides a new perspective on the study of childhood and family life. Successful development is enhanced when communities provide meaningful life pathways that children can seek out and engage. Successful pathways include both a culturally valued direction for development and competence…

  12. Implementation of Prolonged Exposure in the Army: Is Consultation Necessary for Effective Dissemination

    DTIC Science & Technology

    2015-10-01

    study team implemented various efforts to re-educate providers regarding the goal of the study, including holding individual provider meetings...of these changes was developed in direct response to the challenges faced at Ft. Carson, but these changes required IRB approval, resulting in...constitutes a key step towards the ultimate goal of increased access to evidence-based treatment among soldiers suffering from PTSD and related

  13. Direct imaging of exoplanets.

    PubMed

    Lagrange, Anne-Marie

    2014-04-28

    Most of the exoplanets known today have been discovered by indirect techniques, based on the study of the host star radial velocity or photometric temporal variations. These detections allowed the study of the planet populations in the first 5-8 AU from the central stars and have provided precious information on the way planets form and evolve at such separations. Direct imaging on 8-10 m class telescopes allows the detection of giant planets at larger separations (currently typically more than 5-10 AU) complementing the indirect techniques. So far, only a few planets have been imaged around young stars, but each of them provides an opportunity for unique dedicated studies of their orbital, physical and atmospheric properties and sometimes also on the interaction with the 'second-generation', debris discs. These few detections already challenge formation theories. In this paper, I present the results of direct imaging surveys obtained so far, and what they already tell us about giant planet (GP) formation and evolution. Individual and emblematic cases are detailed; they illustrate what future instruments will routinely deliver for a much larger number of stars. I also point out the limitations of this approach, as well as the needs for further work in terms of planet formation modelling. I finally present the progress expected in direct imaging in the near future, thanks in particular to forthcoming planet imagers on 8-10 m class telescopes.

  14. Spillover effects in epidemiology: parameters, study designs and methodological considerations

    PubMed Central

    Benjamin-Chung, Jade; Arnold, Benjamin F; Berger, David; Luby, Stephen P; Miguel, Edward; Colford Jr, John M; Hubbard, Alan E

    2018-01-01

    Abstract Many public health interventions provide benefits that extend beyond their direct recipients and impact people in close physical or social proximity who did not directly receive the intervention themselves. A classic example of this phenomenon is the herd protection provided by many vaccines. If these ‘spillover effects’ (i.e. ‘herd effects’) are present in the same direction as the effects on the intended recipients, studies that only estimate direct effects on recipients will likely underestimate the full public health benefits of the intervention. Causal inference assumptions for spillover parameters have been articulated in the vaccine literature, but many studies measuring spillovers of other types of public health interventions have not drawn upon that literature. In conjunction with a systematic review we conducted of spillovers of public health interventions delivered in low- and middle-income countries, we classified the most widely used spillover parameters reported in the empirical literature into a standard notation. General classes of spillover parameters include: cluster-level spillovers; spillovers conditional on treatment or outcome density, distance or the number of treated social network links; and vaccine efficacy parameters related to spillovers. We draw on high quality empirical examples to illustrate each of these parameters. We describe study designs to estimate spillovers and assumptions required to make causal inferences about spillovers. We aim to advance and encourage methods for spillover estimation and reporting by standardizing spillover parameter nomenclature and articulating the causal inference assumptions required to estimate spillovers. PMID:29106568

  15. Implications for Educational Leaders as They Consider Technology Development

    ERIC Educational Resources Information Center

    Sorensen, Bret J.; Shepherd, Craig E.; Range, Bret G.

    2013-01-01

    This study examined the make-up and training of school technology assistants who directly help teachers to integrate technology in K-12 classrooms. Fifty-six respondents from one school district in the western United States completed a questionnaire about technology assistance they provide, whether they provide this assistance on a full or part…

  16. Solid Waste/Energy Curriculum.

    ERIC Educational Resources Information Center

    Vivan, V. Eugene; And Others

    Provided are solid waste/energy curriculum materials for grades K-2, 3-4, 5-6, 7-9, and 10-12. Separate folders containing units of study (focusing on trash, litter, and recycling) are provided for kindergarten (four units), grade 1 (two units), and grade 2 (two units). Folders contain teachers' directions and activity cards which include picture…

  17. Using Literature-Based Prompts To Teach Writing Competencies: Directed Reading and Writing Lessons.

    ERIC Educational Resources Information Center

    Gelsinger, Barry D.

    Intended to help teachers integrate writing instruction with the study of literature, this teaching guide offers a philosophy of writing instruction, describes a procedure for teaching reading and writing lessons, and provides a sequence of writing skills. For various literature selections, the guide defines vocabulary, provides topic discussion…

  18. Housing and Employment Outcomes for Mental Health Self-Direction Participants.

    PubMed

    Croft, Bevin; İsvan, Nilüfer; Parish, Susan L; Mahoney, Kevin J

    2018-05-15

    In self-direction, participants control individual budgets, allocating service dollars according to needs and preferences within program parameters to meet self-defined recovery goals. Mental health self-direction is associated with enhanced wellness and recovery outcomes at lower or similar cost than traditional service arrangements. This study compared outcomes of housing independence and employment between individuals who participated in self-direction and those who did not. This quasi-experimental study involved administrative data from 271 self-directing participants. Using coarsened exact matching with observed demographic, diagnostic, and other characteristics, the authors constructed a comparison group of non-self-directing individuals (N=1,099). The likelihood of achieving positive outcomes between first and last assessments during the approximately four-year study period was compared for self-directing and non-self-directing individuals. Self-directing participants were more likely than nonparticipants to increase days worked for pay or maintain days worked at 20 or more days in the past 30 days (number needed to treat [NNT]=18; small effect size) and maintain or attain independent housing (NNT=16; small effect size), when analyses controlled, to the extent possible, for observed individual characteristics. Based on data from the nation's largest and longest-standing program of its kind, results suggest that mental health self-direction is associated with modest improvements or maintenance of positive outcomes in employment and housing independence. This research adds to the literature examining self-direction in the context of mental health and begins to fill the need for a greater understanding of self-direction's relationship to outcomes of interest to service users and families, providers, and system administrators.

  19. Just one look: Direct gaze briefly disrupts visual working memory.

    PubMed

    Wang, J Jessica; Apperly, Ian A

    2017-04-01

    Direct gaze is a salient social cue that affords rapid detection. A body of research suggests that direct gaze enhances performance on memory tasks (e.g., Hood, Macrae, Cole-Davies, & Dias, Developmental Science, 1, 67-71, 2003). Nonetheless, other studies highlight the disruptive effect direct gaze has on concurrent cognitive processes (e.g., Conty, Gimmig, Belletier, George, & Huguet, Cognition, 115(1), 133-139, 2010). This discrepancy raises questions about the effects direct gaze may have on concurrent memory tasks. We addressed this topic by employing a change detection paradigm, where participants retained information about the color of small sets of agents. Experiment 1 revealed that, despite the irrelevance of the agents' eye gaze to the memory task at hand, participants were worse at detecting changes when the agents looked directly at them compared to when the agents looked away. Experiment 2 showed that the disruptive effect was relatively short-lived. Prolonged presentation of direct gaze led to recovery from the initial disruption, rather than a sustained disruption on change detection performance. The present study provides the first evidence that direct gaze impairs visual working memory with a rapidly-developing yet short-lived effect even when there is no need to attend to agents' gaze.

  20. Direct-to-consumer advertising of pharmaceuticals.

    PubMed

    Gellad, Ziad F; Lyles, Kenneth W

    2007-06-01

    Since the US Food and Drug Administration (FDA) released new guidelines on broadcast direct-to-consumer advertising in 1997, the prevalence of direct-to-consumer advertising of prescription drugs has increased exponentially. The impact on providers, patients, and the health care system is varied and dynamic, and the rapid changes in the last several years have markedly altered the health care landscape. To continue providing optimal medical care, physicians and other health care providers must be able to manage this influence on their practice, and a more thorough understanding of this phenomenon is an integral step toward this goal. This review will summarize the history of direct-to-consumer drug advertisements and the current regulations governing them. It will summarize the evidence concerning the impact of direct-to-consumer advertising on the public, providers, and the health care system, and conclude with observations regarding the future of direct-to-consumer advertising.

  1. Direct-to-Consumer Advertising of Pharmaceuticals

    PubMed Central

    Gellad, Ziad F.; Lyles, Kenneth W.

    2014-01-01

    Since the FDA released new guidelines on broadcast direct-to-consumer advertising in 1997, the prevalence of direct-to-consumer advertising of prescription drugs has increased exponentially. The impact on providers, patients and the health care system is varied and dynamic, and the rapid changes in the last several years have markedly altered the health care landscape. To continue providing optimal medical care, physicians and other health-care providers must be able to manage this influence on their practice, and a more thorough understanding of this phenomenon is an integral step toward this goal. This review will summarize the history of direct-to-consumer drug advertisements and the current regulations governing them. It will summarize the evidence concerning the impact of direct-to-consumer advertising on the public, providers and the health care system and conclude with observations regarding the future of direct-to-consumer advertising. PMID:17524744

  2. Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review.

    PubMed

    Robinson, Luke Steven; Sarkies, Mitchell; Brown, Ted; O'Brien, Lisa

    2016-12-01

    Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs. It aims to provide economic cost estimates of burden and discuss the cost components used in international literature. A search of cost-of-illness studies and health economic evaluations of acute hand and wrist injuries in various databases was conducted. Data extracted for each included study were: design, population, intervention, and estimates and measurement methodologies of direct, indirect and intangible costs. Reported costs were converted into US-dollars using historical exchange rates and then adjusted into 2015 US-dollars using an inflation calculator RESULTS: The search yielded 764 studies, of which 21 met the inclusion criteria. Twelve studies were cost-of-illness studies, and seven were health economic evaluations. The methodology used to derive direct, indirect and intangible costs differed markedly across all studies. Indirect costs represented a large portion of total cost in both cost-of-illness studies [64.5% (IQR 50.75-88.25)] and health economic evaluations [68% (IQR 49.25-73.5)]. The median total cost per case of all injury types was US$6951 (IQR $3357-$22,274) for cost-of-illness studies and US$8297 (IQR $3858-$33,939) for health economic evaluations. Few studies reported intangible cost data associated with acute hand and wrist injuries. Several studies have attempted to estimate the direct, indirect and intangible costs associated with acute hand and wrist injuries in various countries using heterogeneous methodologies. Estimates of the economic costs of different acute hand and wrist injuries varied greatly depending on the study methodology, however, by any standards, these injuries should be considered a substantial burden on the individual and society. Further research using standardised methodologies could provide guidance to relevant policy makers on how to best distribute limited resources by identifying the major disorders and exposures resulting in the largest burden. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Case study: use of problem-based learning to develop students' technical and professional skills

    NASA Astrophysics Data System (ADS)

    Warnock, James N.; Mohammadi-Aragh, M. Jean

    2016-03-01

    Problem-based learning (PBL) is a pedagogy that has attracted attention for many biomedical engineering curricula. The aim of the current study was to address the research question, 'Does PBL enable students to develop desirable professional engineering skills?' The desirable skills identified were communication, teamwork, problem solving and self-directed learning. Forty-seven students enrolled in a biomedical materials course participated in the case study. Students worked in teams to complete a series of problems throughout the semester. The results showed that students made significant improvements in their problem-solving skills, written communication and self-directed learning. Students also demonstrated an ability to work in teams and communicate orally. In conclusion, this case study provides empirical evidence of the efficacy of PBL on student learning. We discuss findings from our study and provide observations of student performance and perceptions that could be useful for faculty and researchers interested in PBL for biomedical engineering education.

  4. A novel use of Twitter to provide feedback and evaluations.

    PubMed

    Desai, Bobby

    2014-04-01

    Inconsistencies in work schedules and faculty supervision are barriers to monthly emergency medicine (EM) resident doctor evaluations. Direct and contemporaneous feedback may be effective in providing specific details that determine a resident's evaluation. To determine whether Twitter, an easy to use application that is available on the Internet via smartphones and desktops, can provide direct and contemporaneous feedback that is easily accessible, and easy to store and refer back to. First- to third-year EM residents were administered a survey to assess their thoughts on the current monthly evaluation system. Subsequently, residents obtained a Twitter account and were instructed to follow a single general faculty Twitter account for ease of data collection. Following completion of an 8-week study period, a second survey was administered to assess resident thoughts on contemporaneous feedback and evaluations versus the traditional form. Of the 24 EM residents, 13 were available for study. A total of 220 'tweets' were provided by seven faculty members, with a mean of 11 tweets (range 8-17) per resident. The 13 residents received a total of eight formal evaluations from 19 faculty members. The second survey demonstrated that this method provided more detailed evaluations and increased the volume of feedback. Contemporaneous feedback and evaluation provides a greater volume of feedback that is more detailed than end-of-course evaluations. Twitter is an effective and easy means to provide this feedback. Limitations included the length of study time and the inability to have all of the EM residents involved in the study. © 2014 John Wiley & Sons Ltd.

  5. Results of an Oncology Clinical Trial Nurse Role Delineation Study.

    PubMed

    Purdom, Michelle A; Petersen, Sandra; Haas, Barbara K

    2017-09-01

    To evaluate the relevance of a five-dimensional model of clinical trial nursing practice in an oncology clinical trial nurse population. 
. Web-based cross-sectional survey.
. Online via Qualtrics.
. 167 oncology nurses throughout the United States, including 41 study coordinators, 35 direct care providers, and 91 dual-role nurses who provide direct patient care and trial coordination.
. Principal components analysis was used to determine the dimensions of oncology clinical trial nursing practice.
. Self-reported frequency of 59 activities.
. The results did not support the original five-dimensional model of nursing care but revealed a more multidimensional model.
. An analysis of frequency data revealed an eight-dimensional model of oncology research nursing, including care, manage study, expert, lead, prepare, data, advance science, and ethics.
. This evidence-based model expands understanding of the multidimensional roles of oncology nurses caring for patients with cancer enrolled in clinical trials.

  6. Ethics and incentives: an evaluation and development of stakeholder theory in the health care industry.

    PubMed

    Elms, Heather; Berman, Shawn; Wicks, Andrew C

    2002-10-01

    This paper utilizes a qualitative case study of the health care industry and a recent legal case to demonstrate that stakeholder theory's focus on ethics, without recognition of the effects of incentives, severely limits the theory's ability to provide managerial direction and explain managerial behavior. While ethics provide a basis for stakeholder prioritization, incentives influence whether managerial action is consistent with that prioritization. Our health care examples highlight this and other limitations of stakeholder theory and demonstrate the explanatory and directive power added by the inclusion of the interactive effects of ethics and incentives in stakeholder ordering.

  7. Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions

    PubMed Central

    Mitchell, John T.; Zylowska, Lidia; Kollins, Scott H.

    2015-01-01

    Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Two case study examples are provided to demonstrate relevant clinical issues for practitioners interested in this approach. Directions for future research, including mindfulness meditation as a standalone treatment and as a complementary approach to cognitive-behavioral therapy, are provided. PMID:25908900

  8. Does climate directly influence NPP globally?

    PubMed

    Chu, Chengjin; Bartlett, Megan; Wang, Youshi; He, Fangliang; Weiner, Jacob; Chave, Jérôme; Sack, Lawren

    2016-01-01

    The need for rigorous analyses of climate impacts has never been more crucial. Current textbooks state that climate directly influences ecosystem annual net primary productivity (NPP), emphasizing the urgent need to monitor the impacts of climate change. A recent paper challenged this consensus, arguing, based on an analysis of NPP for 1247 woody plant communities across global climate gradients, that temperature and precipitation have negligible direct effects on NPP and only perhaps have indirect effects by constraining total stand biomass (Mtot ) and stand age (a). The authors of that study concluded that the length of the growing season (lgs ) might have a minor influence on NPP, an effect they considered not to be directly related to climate. In this article, we describe flaws that affected that study's conclusions and present novel analyses to disentangle the effects of stand variables and climate in determining NPP. We re-analyzed the same database to partition the direct and indirect effects of climate on NPP, using three approaches: maximum-likelihood model selection, independent-effects analysis, and structural equation modeling. These new analyses showed that about half of the global variation in NPP could be explained by Mtot combined with climate variables and supported strong and direct influences of climate independently of Mtot , both for NPP and for net biomass change averaged across the known lifetime of the stands (ABC = average biomass change). We show that lgs is an important climate variable, intrinsically correlated with, and contributing to mean annual temperature and precipitation (Tann and Pann ), all important climatic drivers of NPP. Our analyses provide guidance for statistical and mechanistic analyses of climate drivers of ecosystem processes for predictive modeling and provide novel evidence supporting the strong, direct role of climate in determining vegetation productivity at the global scale. © 2015 John Wiley & Sons Ltd.

  9. Turboprop cargo aircraft systems study

    NASA Technical Reports Server (NTRS)

    Muehlbauer, J. C.; Hewell, J. G., Jr.; Lindenbaum, S. P.; Randall, C. C.; Searle, N.; Stone, R. G., Jr.

    1981-01-01

    The effects of using advanced turboprop propulsion systems to reduce the fuel consumption and direct operating costs of cargo aircraft were studied, and the impact of these systems on aircraft noise and noise prints around a terminal area was determined. Parametric variations of aircraft and propeller characteristics were investigated to determine their effects on noiseprint areas, fuel consumption, and direct operating costs. From these results, three aircraft designs were selected and subjected to design refinements and sensitivity analyses. Three competitive turbofan aircraft were also defined from parametric studies to provide a basis for comparing the two types of propulsion.

  10. Imaging transcranial direct current stimulation (tDCS) of the prefrontal cortex-correlation or causality in stimulation-mediated effects?

    PubMed

    Wörsching, Jana; Padberg, Frank; Ertl-Wagner, Birgit; Kumpf, Ulrike; Kirsch, Beatrice; Keeser, Daniel

    2016-10-01

    Transcranial current stimulation approaches include neurophysiologically distinct non-invasive brain stimulation techniques widely applied in basic, translational and clinical research: transcranial direct current stimulation (tDCS), oscillating transcranial direct current stimulation (otDCS), transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS). Prefrontal tDCS seems to be an especially promising tool for clinical practice. In order to effectively modulate relevant neural circuits, systematic research on prefrontal tDCS is needed that uses neuroimaging and neurophysiology measures to specifically target and adjust this method to physiological requirements. This review therefore analyses the various neuroimaging methods used in combination with prefrontal tDCS in healthy and psychiatric populations. First, we provide a systematic overview on applications, computational models and studies combining neuroimaging or neurophysiological measures with tDCS. Second, we categorise these studies in terms of their experimental designs and show that many studies do not vary the experimental conditions to the extent required to demonstrate specific relations between tDCS and its behavioural or neurophysiological effects. Finally, to support best-practice tDCS research we provide a methodological framework for orientation among experimental designs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Is goal-directed attentional guidance just intertrial priming? A review.

    PubMed

    Lamy, Dominique F; Kristjánsson, Arni

    2013-07-01

    According to most models of selective visual attention, our goals at any given moment and saliency in the visual field determine attentional priority. But selection is not carried out in isolation--we typically track objects through space and time. This is not well captured within the distinction between goal-directed and saliency-based attentional guidance. Recent studies have shown that selection is strongly facilitated when the characteristics of the objects to be attended and of those to be ignored remain constant between consecutive selections. These studies have generated the proposal that goal-directed or top-down effects are best understood as intertrial priming effects. Here, we provide a detailed overview and critical appraisal of the arguments, experimental strategies, and findings that have been used to promote this idea, along with a review of studies providing potential counterarguments. We divide this review according to different types of attentional control settings that observers are thought to adopt during visual search: feature-based settings, dimension-based settings, and singleton detection mode. We conclude that priming accounts for considerable portions of effects attributed to top-down guidance, but that top-down guidance can be independent of intertrial priming.

  12. Risk versus direct protective factors and youth violence: Seattle social development project.

    PubMed

    Herrenkohl, Todd I; Lee, Jungeun; Hawkins, J David

    2012-08-01

    Numerous studies have examined predictors of youth violence associated with the individual child, the family, school, and the surrounding neighborhood or community. However, few studies have examined predictors using a systematic approach to differentiate and compare risk and direct protective factors. This study examines risk and protective factors associated with youth violence in an ongoing longitudinal panel study of 808 students from 18 Seattle public elementary schools followed since 1985 when they were in 5th grade. Predictors span the individual, family, school, peer, and neighborhood domains. Data were collected annually, beginning in 1985, to age 16 years, and then again at age 18 years. This paper provides findings of analyses in which continuous predictor variables, measured at ages 10-12 years, were trichotomized to reflect a risk end of the variable, a direct protective end, and a middle category of scores. Youth violence was measured at ages 13-14 years and 15-18 years. Bivariate analyses of risk and direct protective factors identified the following predictors of violence at ages 13-14 years and 15-18 years. Risk for violence was increased by earlier antisocial behavior (e.g., prior violence, truancy, nonviolent delinquency), attention problems, family conflict, low school commitment, and living in a neighborhood where young people were in trouble. Direct protective factors at ages 10-12 years include a low level of attention problems, low risk-taking, refusal skills, school attachment, and low access and exposure to marijuana at ages 10-12 years. Multivariate regressions showed neighborhood risk factors to be among the most salient and consistent predictors of violence after accounting for all other variables in the tested models. Relatively few direct protective factors were identified in these statistical tests, suggesting the need for further review and possible refinement of the measures and methods that were applied. Implications provide important information for programs and policy. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  13. The direct and indirect association of cervical microbiota with the risk of cervical intraepithelial neoplasia.

    PubMed

    Zhang, Chaoting; Liu, Ying; Gao, Weijiao; Pan, Yaqi; Gao, Yunong; Shen, Jing; Xiong, Hongchao

    2018-05-01

    Cervical microbiota composition is associated with cervical HPV infection and CIN severity. Previous studies only assessed the total association between cervical microbiota and HPV infections or CINs, and yet no study reported the direct and indirect associations between cervical microbiota and CINs mediated by HPV infection, respectively. The aim of this study was to investigate the direct and indirect associations between microbiotas and CIN severity. Cervical microbiota of 126 women with CIN 1- (normal cytology and CIN 1) and 40 with CIN 2+ (CIN 2 and CIN 3) were analyzed using Illumina sequencing based on the 16S rRNA gene. HPV was detected using a highly sensitive PCR primer set (SPF1/GP6+). Indirect effects of Pseudomonas stutzeri, Bacteroides fragilis, Lactobacillus delbrueckii, Atopobium vaginae, and Streptococcus agalactiae mediated by HPV infection on CIN status were observed. The directions of the direct and the indirect associations between CIN status and Ps. stutzeri were opposite. The directions of the direct and the indirect associations between CIN status and A. vaginae were the same. B. fragilis, L. delbrueckii, and S. agalactiae only had indirect association with CIN status. In summary, our study provided suggestive evidence that some microbial populations could have direct or indirect effects mediated by affecting HPV infection on CIN progression. Besides HPV infection, microbial community composition possibly plays a role in cervical carcinogenesis. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  14. Awakening Consumer Stewardship of Health Benefits: Prevalence and Differentiation of New Health Plan Models

    PubMed Central

    Rosenthal, Meredith; Milstein, Arnold

    2004-01-01

    Context Despite widespread publicity of consumer-directed health plans, little is known about their prevalence and the extent to which their designs adequately reflect and support consumerism. Objective We examined three types of consumer-directed health plans: health reimbursement accounts (HRAs), premium-tiered, and point-of-care tiered benefit plans. We sought to measure the extent to which these plans had diffused, as well as to provide a critical look at the ways in which these plans support consumerism. Consumerism in this context refers to efforts to enable informed consumer choice and consumers' involvement in managing their health. We also wished to determine whether mainstream health plans—health maintenance organization (HMO), point of service (POS), and preferred provider organization (PPO) models—were being influenced by consumerism. Data Sources/Study Setting Our study uses national survey data collected by Mercer Human Resource Consulting from 680 national and regional commercial health benefit plans on HMO, PPO, POS, and consumer-directed products. Study Design We defined consumer-directed products as health benefit plans that provided (1) consumer incentives to select more economical health care options, including self-care and no care, and (2) information and support to inform such selections. We asked health plans that offered consumer-directed products about 2003 enrollment, basic design features, and the availability of decision support. We also asked mainstream health plans about their activities that supported consumerism (e.g., proactive outreach to inform or influence enrollee behavior, such as self-management or preventive care, reminders sent to patients with identified medical conditions.) Data Collection/Extraction Methods We analyzed survey responses for all four product lines in order to identify those plans that offer health reimbursement accounts (HRAs), premium-tiered, or point-of-care tiered models as well as efforts of mainstream health plans to engage informed consumer decision making. Principal Findings The majority of enrollees in consumer-directed health plans are in tiered models (primarily point-of-care tiered networks) rather than HRAs. Tiers are predominantly determined based on both cost and quality criteria. Enrollment in HRAs has grown substantially, in part because of the entry of mainstream managed care plans into the consumer-directed market. Health reimbursement accounts, tiered networks, and traditional managed care plans vary in their capacity to support consumers in managing their health risks and selection of provider and treatment options, with HRAs providing the most and mainstream plans the least. Conclusions While enrollment in consumer-directed health plans continues to grow steadily, it remains a tiny fraction of all employer-sponsored coverage. Decision support in these plans, a critical link to help consumers make more informed choices, is also still limited. This lack may be of concern in light of the fact that only a minority of such plans report that they monitor claims to protect against underuse. Tiered benefit models appear to be more readily accepted by the market than HRAs. If they are to succeed in optimizing consumers' utility from health benefit spending, careful attention needs to be paid to how well these models inform consumers about the consequences of their selections. PMID:15230911

  15. Direct Loans: A Better Way To Borrow. William D. Ford Federal Direct Loan Program.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC. Student Financial Assistance.

    The Web site http://www.ed.gov/DirectLoan/ provides information on the William D. Ford Federal Direct Loan Program for both professionals and borrowers. For professionals, it provides information on conferences, promissory notes, regulations, laws, and relevant links, as well as technical assistance, and other publications and guides. For…

  16. The post-stroke rehabilitation outcomes project.

    PubMed

    Jette, Alan M

    2005-12-01

    Jette AM. The Post-Stroke Rehabilitation Outcomes Project. The Post-Stroke Rehabilitation Outcomes Project (PSROP) provides an important example of the value of observational study designs in rehabilitation. The strength of the PSROP lies in the extensive, in-depth data collected on the specific rehabilitation interventions provided to patients and their relationship to short-term outcomes as well as the wide generalizability of the study's findings. Although providing valuable insights, one has to be extremely cautious in drawing direct practice recommendations from the PSROP given several internal validity threats inherent in the PSROP design.

  17. Mealworms in the Classroom.

    ERIC Educational Resources Information Center

    McGlathery, Glenn

    1989-01-01

    Describes a lesson in which the life-cycle of an insect is studied. Provides information on the purchase and care of the animal and directions for student observations. Questions and activities are included. (RT)

  18. Assessment of Interobserver Reliability in Nutrition Studies that Use Direct Observation of School Meals

    PubMed Central

    BAGLIO, MICHELLE L.; BAXTER, SUZANNE DOMEL; GUINN, CAROLINE H.; THOMPSON, WILLIAM O.; SHAFFER, NICOLE M.; FRYE, FRANCESCA H. A.

    2005-01-01

    This article (a) provides a general review of interobserver reliability (IOR) and (b) describes our method for assessing IOR for items and amounts consumed during school meals for a series of studies regarding the accuracy of fourth-grade children's dietary recalls validated with direct observation of school meals. A widely used validation method for dietary assessment is direct observation of meals. Although many studies utilize several people to conduct direct observations, few published studies indicate whether IOR was assessed. Assessment of IOR is necessary to determine that the information collected does not depend on who conducted the observation. Two strengths of our method for assessing IOR are that IOR was assessed regularly throughout the data collection period and that IOR was assessed for foods at the item and amount level instead of at the nutrient level. Adequate agreement among observers is essential to the reasoning behind using observation as a validation tool. Readers are encouraged to question the results of studies that fail to mention and/or to include the results for assessment of IOR when multiple people have conducted observations. PMID:15354155

  19. Harm to Those Who Serve: Effects of Direct and Vicarious Customer-Initiated Workplace Aggression.

    PubMed

    Dupré, Kathryne E; Dawe, Kimberly-Anne; Barling, Julian

    2014-09-01

    While there is a large body of research on the effects of being a direct target of workplace aggression, there is far less research on the vicarious experience of aggression at work, despite the fact that more people experience workplace aggression vicariously (i.e., observe it or hear about it) than they do directly. In this study, we develop and test a model of the effects of direct and vicarious exposure to aggression that is directed at employees by customers. Structural equation modeling provided support for the proposed model, in which direct and vicarious workplace aggression influences the perceived risk of future workplace aggression, which in turn affects organizational attachment (affective commitment and turnover intentions) and individual well-being (psychological and physical). Conceptual research and policy implications are discussed. © The Author(s) 2014.

  20. Geomagnetic field models for satellite angular motion studies

    NASA Astrophysics Data System (ADS)

    Ovchinnikov, M. Yu.; Penkov, V. I.; Roldugin, D. S.; Pichuzhkina, A. V.

    2018-03-01

    Four geomagnetic field models are discussed: IGRF, inclined, direct and simplified dipoles. Geomagnetic induction vector expressions are provided in different reference frames. Induction vector behavior is compared for different models. Models applicability for the analysis of satellite motion is studied from theoretical and engineering perspectives. Relevant satellite dynamics analysis cases using analytical and numerical techniques are provided. These cases demonstrate the benefit of a certain model for a specific dynamics study. Recommendations for models usage are summarized in the end.

  1. Caries: Review of Human Genetics Research

    PubMed Central

    Vieira, Alexandre R.; Modesto, Adriana; Marazita, Mary L.

    2014-01-01

    The NIH Consensus Development Program released a statement in 2001 (NIH Consensus Statement, 2001) and listed six major clinical caries research directions. One of these directions was the need for genetic studies to identify genes and genetic markers of diagnostic, prognostic, and therapeutic value. This last decade has seen a steep increase in studies investigating the presence of genetic factors influencing individual susceptibility to caries. This review revisits recent caries human genetic studies and provides a perspective for future studies in order to fulfill their promise of revolutionizing our understanding of and the standard of care for the most prevalent bacteria-mediated non-contagious disease in the world. PMID:24853115

  2. Evaluating opportunities for direct contracting between employers and physician-hospital organizations.

    PubMed

    Straley, P F; Swaim, C R

    1994-01-01

    Employers seeking to reduce health care expenditures are turning to direct contracting as a way to control provider cost increases. In a direct contract, the participation of third parties is minimized. The health care provider and a corporate buyer directly negotiate a price agreement for the delivery of health care services. However, as managed care penetration increases, the ability of hospitals and physicians to assume risk while providing high quality, cost effective care will be paramount. Physicians and hospitals who choose to work together may find a physician-hospital organization an effective vehicle to meet the current and future market challenges of direct contracting.

  3. Talking heads or talking eyes? Effects of head orientation and sudden onset gaze cues on attention capture.

    PubMed

    van der Wel, Robrecht P; Welsh, Timothy; Böckler, Anne

    2018-01-01

    The direction of gaze towards or away from an observer has immediate effects on attentional processing in the observer. Previous research indicates that faces with direct gaze are processed more efficiently than faces with averted gaze. We recently reported additional processing advantages for faces that suddenly adopt direct gaze (abruptly shift from averted to direct gaze) relative to static direct gaze (always in direct gaze), sudden averted gaze (abruptly shift from direct to averted gaze), and static averted gaze (always in averted gaze). Because changes in gaze orientation in previous study co-occurred with changes in head orientation, it was not clear if the effect is contingent on face or eye processing, or whether it requires both the eyes and the face to provide consistent information. The present study delineates the impact of head orientation, sudden onset motion cues, and gaze cues. Participants completed a target-detection task in which head position remained in a static averted or direct orientation while sudden onset motion and eye gaze cues were manipulated within each trial. The results indicate a sudden direct gaze advantage that resulted from the additive role of motion and gaze cues. Interestingly, the orientation of the face towards or away from the observer did not influence the sudden direct gaze effect, suggesting that eye gaze cues, not face orientation cues, are critical for the sudden direct gaze effect.

  4. Gelatin-based laser direct-write technique for the precise spatial patterning of cells.

    PubMed

    Schiele, Nathan R; Chrisey, Douglas B; Corr, David T

    2011-03-01

    Laser direct-writing provides a method to pattern living cells in vitro, to study various cell-cell interactions, and to build cellular constructs. However, the materials typically used may limit its long-term application. By utilizing gelatin coatings on the print ribbon and growth surface, we developed a new approach for laser cell printing that overcomes the limitations of Matrigel™. Gelatin is free of growth factors and extraneous matrix components that may interfere with cellular processes under investigation. Gelatin-based laser direct-write was able to successfully pattern human dermal fibroblasts with high post-transfer viability (91% ± 3%) and no observed double-strand DNA damage. As seen with atomic force microscopy, gelatin offers a unique benefit in that it is present temporarily to allow cell transfer, but melts and is removed with incubation to reveal the desired application-specific growth surface. This provides unobstructed cellular growth after printing. Monitoring cell location after transfer, we show that melting and removal of gelatin does not affect cellular placement; cells maintained registry within 5.6 ± 2.5 μm to the initial pattern. This study demonstrates the effectiveness of gelatin in laser direct-writing to create spatially precise cell patterns with the potential for applications in tissue engineering, stem cell, and cancer research.

  5. Hemispheric differences in the voluntary control of spatial attention: direct evidence for a right-hemispheric dominance within frontal cortex.

    PubMed

    Duecker, Felix; Formisano, Elia; Sack, Alexander T

    2013-08-01

    Lesion studies in neglect patients have inspired two competing models of spatial attention control, namely, Heilman's "hemispatial" theory and Kinsbourne's "opponent processor" model. Both assume a functional asymmetry between the two hemispheres but propose very different mechanisms. Neuroimaging studies have identified a bilateral dorsal frontoparietal network underlying voluntary shifts of spatial attention. However, lateralization of attentional processes within this network has not been consistently reported. In the current study, we aimed to provide direct evidence concerning the functional asymmetry of the right and left FEF during voluntary shifts of spatial attention. To this end, we applied fMRI-guided neuronavigation to disrupt individual FEF activation foci with a longer-lasting inhibitory patterned TMS protocol followed by a spatial cueing task. Our results indicate that right FEF stimulation impaired the ability of shifting spatial attention toward both hemifields, whereas the effects of left FEF stimulation were limited to the contralateral hemifield. These results provide strong direct evidence for right-hemispheric dominance in spatial attention within frontal cortex supporting Heilman's "hemispatial" theory. This complements previous TMS studies that generally conform to Kinsbourne's "opponent processor" model after disruption of parietal cortex, and we therefore propose that both theories are not mutually exclusive.

  6. Hospital-Based Outpatient Direct Access to Physical Therapist Services: Current Status in Wisconsin.

    PubMed

    Boissonnault, William G; Lovely, Karen

    2016-11-01

    Direct access to physical therapist services is available in all 50 states, with reported benefits including reduced health care costs, enhanced patient satisfaction, and no apparent compromised patient safety. Despite the benefits and legality of direct access, few data exist regarding the degree of model adoption, implementation, and utilization. The purposes of the study were: (1) to investigate the extent of implementation and utilization of direct access to outpatient physical therapist services in Wisconsin hospitals and medical centers, (2) to identify barriers to and facilitators for the provisioning of such services, and (3) to identify potential differences between facilities that do and do not provide direct access services. A descriptive survey was conducted. Eighty-nine survey questionnaires were distributed via email to the directors of rehabilitation services at Wisconsin hospitals and medical centers. The survey investigated facility adoption of the direct access model, challenges to and resources utilized during model implementation, and current barriers affecting model utilization. Forty-seven (52.8%) of the 89 survey questionnaires were completed and returned. Forty-two percent of the survey respondents (20 of 47) reported that their facility offered direct access to physical therapist services, but fewer than 10% of patients were seen via direct access at 95% of the facilities offering such services. The most frequently reported obstacles to model implementation and utilization were lack of health care provider, administrator, and patient knowledge of direct access; its legality in Wisconsin; and physical therapists' differential diagnosis and medical screening abilities. Potential respondent bias and limited generalizability of the results are limitations of the study. These findings apply to hospitals and medical centers located in Wisconsin, not to facilities located in other geographic regions. Respondents representing direct access organizations reported more timely access to physical therapist services, enhanced patient satisfaction, decreased organizational health care costs, and improved efficiency of resource utilization as benefits of model implementation. For organizations without direct access, not being an organizational priority, concerns from referral sources, and concerns that the physician-patient relationship would be negatively affected were noted as obstacles to model adoption. © 2016 American Physical Therapy Association.

  7. Observations with the ROWS instrument during the Grand Banks calibration/validation experiments

    NASA Technical Reports Server (NTRS)

    Vandemark, D.; Chapron, B.

    1994-01-01

    As part of a global program to validate the ocean surface sensors on board ERS-1, a joint experiment on the Grand Banks of Newfoundland was carried out in Nov. 1991. The principal objective was to provide a field validation of ERS-1 Synthetic Aperture Radar (SAR) measurement of ocean surface structure. The NASA-P3 aircraft measurements made during this experiment provide independent measurements of the ocean surface along the validation swath. The Radar Ocean Wave Spectrometer (ROWS) is a radar sensor designed to measure direction of the long wave components using spectral analysis of the tilt induced radar backscatter modulation. This technique greatly differs from SAR and thus, provides a unique set of measurements for use in evaluating SAR performance. Also, an altimeter channel in the ROWS gives simultaneous information on the surface wave height and radar mean square slope parameter. The sets of geophysical parameters (wind speed, significant wave height, directional spectrum) are used to study the SAR's ability to accurately measure ocean gravity waves. The known distortion imposed on the true directional spectrum by the SAR imaging mechanism is discussed in light of the direct comparisons between ERS-1 SAR, airborne Canadian Center for Remote Sensing (CCRS) SAR, and ROWS spectra and the use of the nonlinear ocean SAR transform.

  8. Social support and social undermining as explanatory factors for health-related quality of life in people living with HIV/AIDS.

    PubMed

    Oetzel, John; Wilcox, Bryan; Archiopoli, Ashley; Avila, Magdalena; Hell, Cia; Hill, Ricky; Muhammad, Michael

    2014-01-01

    This study aimed to examine the influence of social support (from personal networks and health care providers) and social undermining (from personal networks) on health-related quality of life (HRQOL; general health perceptions, physical functioning, and depression). Specifically, the authors aimed to identify the nature of the effects (direct, mediating, or moderating) of social support and social undermining on HRQOL. A total of 344 people living with HIV/AIDS and who were patients in a federally funded clinic in New Mexico completed a self-report survey questionnaire. The major findings of this study are the following: (a) social support and social undermining had direct and indirect effects on HRQOL-there was no evidence of a moderating effect of social support and social undermining; (b) for direct effects, social undermining was a stronger predictor of HRQOL than social support with social support variables having positive relations and social undermining variables having negative relations with HRQOL; and (c) for indirect effects, providers' social support partially mediated the influence of unstable employment/unemployment and social undermining on HRQOL.

  9. Animal models of the serotonin syndrome: a systematic review.

    PubMed

    Haberzettl, Robert; Bert, Bettina; Fink, Heidrun; Fox, Meredith A

    2013-11-01

    The serotonin syndrome (SS) is a potentially life-threatening disorder in humans which is induced by ingestion of an overdose or by combination of two or more serotonin (5-HT)-enhancing drugs. In animals, acute administration of direct and indirect 5-HT agonists also leads to a set of behavioral and autonomic responses. In the current review, we provide an overview of the existing versions of the animal model of the SS. With a focus on studies in rats and mice, we analyze the frequency of behavioral and autonomic responses following administration of 5-HT-enhancing drugs and direct 5-HT agonists administered alone or in combination, and we briefly discuss the receptor mediation of these responses. Considering species differences, we identify a distinct set of behavioral and autonomic responses that are consistently observed following administration of direct and indirect 5-HT agonists. Finally, we discuss the importance of a standardized assessment of SS responses in rodents and the utility of animal models of the SS in translational studies, and provide suggestions for future research. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Using Snow to Teach Geology.

    ERIC Educational Resources Information Center

    Roth, Charles

    1991-01-01

    A lesson plan, directed at middle school students and older, describes using snow to study the geological processes of solidification of molten material, sedimentation, and metamorphosis. Provides background information on these geological processes. (MCO)

  11. The theory and method of variable frequency directional seismic wave under the complex geologic conditions

    NASA Astrophysics Data System (ADS)

    Jiang, T.; Yue, Y.

    2017-12-01

    It is well known that the mono-frequency directional seismic wave technology can concentrate seismic waves into a beam. However, little work on the method and effect of variable frequency directional seismic wave under complex geological conditions have been done .We studied the variable frequency directional wave theory in several aspects. Firstly, we studied the relation between directional parameters and the direction of the main beam. Secondly, we analyzed the parameters that affect the beam width of main beam significantly, such as spacing of vibrator, wavelet dominant frequency, and number of vibrator. In addition, we will study different characteristics of variable frequency directional seismic wave in typical velocity models. In order to examine the propagation characteristics of directional seismic wave, we designed appropriate parameters according to the character of direction parameters, which is capable to enhance the energy of the main beam direction. Further study on directional seismic wave was discussed in the viewpoint of power spectral. The results indicate that the energy intensity of main beam direction increased 2 to 6 times for a multi-ore body velocity model. It showed us that the variable frequency directional seismic technology provided an effective way to strengthen the target signals under complex geological conditions. For concave interface model, we introduced complicated directional seismic technology which supports multiple main beams to obtain high quality data. Finally, we applied the 9-element variable frequency directional seismic wave technology to process the raw data acquired in a oil-shale exploration area. The results show that the depth of exploration increased 4 times with directional seismic wave method. Based on the above analysis, we draw the conclusion that the variable frequency directional seismic wave technology can improve the target signals of different geologic conditions and increase exploration depth with little cost. Due to inconvenience of hydraulic vibrators in complicated surface area, we suggest that the combination of high frequency portable vibrator and variable frequency directional seismic wave method is an alternative technology to increase depth of exploration or prospecting.

  12. Direct Speaker Gaze Promotes Trust in Truth-Ambiguous Statements.

    PubMed

    Kreysa, Helene; Kessler, Luise; Schweinberger, Stefan R

    2016-01-01

    A speaker's gaze behaviour can provide perceivers with a multitude of cues which are relevant for communication, thus constituting an important non-verbal interaction channel. The present study investigated whether direct eye gaze of a speaker affects the likelihood of listeners believing truth-ambiguous statements. Participants were presented with videos in which a speaker produced such statements with either direct or averted gaze. The statements were selected through a rating study to ensure that participants were unlikely to know a-priori whether they were true or not (e.g., "sniffer dogs cannot smell the difference between identical twins"). Participants indicated in a forced-choice task whether or not they believed each statement. We found that participants were more likely to believe statements by a speaker looking at them directly, compared to a speaker with averted gaze. Moreover, when participants disagreed with a statement, they were slower to do so when the statement was uttered with direct (compared to averted) gaze, suggesting that the process of rejecting a statement as untrue may be inhibited when that statement is accompanied by direct gaze.

  13. Direct Speaker Gaze Promotes Trust in Truth-Ambiguous Statements

    PubMed Central

    Kessler, Luise; Schweinberger, Stefan R.

    2016-01-01

    A speaker’s gaze behaviour can provide perceivers with a multitude of cues which are relevant for communication, thus constituting an important non-verbal interaction channel. The present study investigated whether direct eye gaze of a speaker affects the likelihood of listeners believing truth-ambiguous statements. Participants were presented with videos in which a speaker produced such statements with either direct or averted gaze. The statements were selected through a rating study to ensure that participants were unlikely to know a-priori whether they were true or not (e.g., “sniffer dogs cannot smell the difference between identical twins”). Participants indicated in a forced-choice task whether or not they believed each statement. We found that participants were more likely to believe statements by a speaker looking at them directly, compared to a speaker with averted gaze. Moreover, when participants disagreed with a statement, they were slower to do so when the statement was uttered with direct (compared to averted) gaze, suggesting that the process of rejecting a statement as untrue may be inhibited when that statement is accompanied by direct gaze. PMID:27643789

  14. Approximately One In Three US Adults Completes Any Type Of Advance Directive For End-Of-Life Care.

    PubMed

    Yadav, Kuldeep N; Gabler, Nicole B; Cooney, Elizabeth; Kent, Saida; Kim, Jennifer; Herbst, Nicole; Mante, Adjoa; Halpern, Scott D; Courtright, Katherine R

    2017-07-01

    Efforts to promote the completion of advance directives implicitly assume that completion rates of these documents, which help ensure care consistent with people's preferences in the event of incapacity, are undesirably low. However, data regarding completion of advance directives in the United States are inconsistent and of variable quality. We systematically reviewed studies published in the period 2011-16 to determine the proportion of US adults with a completed living will, health care power of attorney, or both. Among the 795,909 people in the 150 studies we analyzed, 36.7 percent had completed an advance directive, including 29.3 percent with living wills. These proportions were similar across the years reviewed. Similar proportions of patients with chronic illnesses (38.2 percent) and healthy adults (32.7 percent) had completed advance directives. The findings provide benchmarks for gauging future policies and practices designed to motivate completion of advance directives, particularly among those people most likely to benefit from having these documents on record. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Comparing consumer-directed and agency models for providing supportive services at home.

    PubMed

    Benjamin, A E; Matthias, R; Franke, T M

    2000-04-01

    To examine the service experiences and outcomes of low-income Medicaid beneficiaries with disabilities under two different models for organizing home-based personal assistance services: agency-directed and consumer-directed. A survey of a random sample of 1,095 clients, age 18 and over, who receive services in California's In-Home Supportive Services (IHSS) program funded primarily by Medicaid. Other data were obtained from the California Management and Payrolling System (CMIPS). The sample was stratified by service model (agency-directed or consumer-directed), client age (over or under age 65), and severity. Data were collected on client demographics, condition/functional status, and supportive service experience. Outcome measures were developed in three areas: safety, unmet need, and service satisfaction. Factor analysis was used to reduce multiple outcome measures to nine dimensions. Multiple regression analysis was used to assess the effect of service model on each outcome dimension, taking into account the client-provider relationship, client demographics, and case mix. Recipients of IHSS services as of mid-1996 were interviewed by telephone. The survey was conducted in late 1996 and early 1997. On various outcomes, recipients in the consumer-directed model report more positive outcomes than those in the agency model, or they report no difference. Statistically significant differences emerge on recipient safety, unmet needs, and service satisfaction. A family member present as a paid provider is also associated with more positive reported outcomes within the consumer-directed model, but model differences persist even when this is taken into account. Although both models have strengths and weaknesses, from a recipient perspective the consumer-directed model is associated with more positive outcomes. Although health professionals have expressed concerns about the capacity of consumer direction to assure quality, particularly with respect to safety, meeting unmet needs, and technical quality, our findings suggest that the consumer-directed service model is a viable alternative to the agency model. Because public programs are under growing pressure to address the long-term care needs of low-income people of all ages with disabilities, the Medicaid personal assistance benefit needs to be reassessed in light of these findings. Consumer-directed models may offer a less elaborate and possibly less costly option for organizing supportive services at home. Study limitations may limit the generalizability of these findings. This was a natural experiment, in which only some counties offered both service models and counties assigned recipients to a service model. The use of a telephone survey excluded important recipient subsets, notably people with severe cognitive impairments. A more definitive study would include direct observations as well as survey approaches.

  16. Newer influenza antivirals, biotherapeutics and combinations.

    PubMed

    Hayden, Frederick G

    2013-01-01

    This summary provides an overview of investigational antiviral agents for influenza and of future directions for development of influenza therapeutics. While progress in developing clinically useful antiviral agents for influenza has been generally slow, especially with respect to seriously ill and high-risk patients, important clinical studies of intravenous neuraminidase inhibitors, antibodies and drug combinations are currently in progress. The current decade offers the promise of developing small molecular weight inhibitors with novel mechanisms of action, including host-directed therapies, new biotherapeutics and drug combinations, that should provide more effective antiviral therapies and help mitigate the problem of antiviral resistance. Immunomodulatory interventions also offer promise but need to be based on better understanding of influenza pathogenesis, particularly in seriously ill patients. The development of combination interventions, immunomodulators and host-directed therapies presents unique clinical trial design and regulatory hurdles that remain to be addressed. © 2012 Blackwell Publishing Ltd.

  17. Does direct-to-consumer advertising affect patients' choice of pain medications?

    PubMed

    Liu, Yifei; Doucette, William R

    2008-04-01

    In the United States, direct-to-consumer advertising (DTCA) has grown rapidly to promote prescription medications, including analgesics. Few studies in the literature directly examine the association between DTCA and patients' choice of pain medications. This article discusses how DTCA affects such choice from a behavioral perspective, because DTCA-prompted behaviors are important indicators of DTCA's influence. After DTCA exposure, patients may request prescriptions, seek further medication information, and ask about advertised conditions. Patients who suffer from pain may seek more communication with their health care providers because they are cautious about the information quality of DTCA, mainly because of the recall of rofecoxib (Vioxx; Merck, Whitehouse Station, NJ). However, the availability and DTCA of over-the-counter analgesics complicate their treatment choice. Patients could use DTCA as a tool to launch health communication and make an informed treatment choice with the guidance of their health care providers.

  18. Direct chemical profiling of olive (Olea europaea) fruit epicuticular waxes by direct electrospray-ultrahigh resolution mass spectrometry.

    PubMed

    Vichi, Stefania; Cortés-Francisco, Nuria; Romero, Agustí; Caixach, Josep

    2015-03-01

    In the present paper, an electrospray ionization (ESI)-Orbitrap method is proposed for the direct chemical profiling of epicuticular wax (EW) from Olea europaea fruit. It constitutes a rapid and efficient tool suitable for a wide-ranging screening of a large number of samples. In a few minutes, the method provides a comprehensive characterization of total EW extracts, based on the molecular formula of their components. Accurate mass measurements are obtained by ultrahigh resolution mass spectrometry, and compositional restrictions are set on the basis of the information available from previous studies of olive EW. By alternating positive and negative ESI modes within the same analysis, complementary results are obtained and a wide range of chemical species is covered. This provides a detailed compositional overview that otherwise would only be available by applying multiple analytical techniques. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Computer simulation modeling of recreation use: Current status, case studies, and future directions

    Treesearch

    David N. Cole

    2005-01-01

    This report compiles information about recent progress in the application of computer simulation modeling to planning and management of recreation use, particularly in parks and wilderness. Early modeling efforts are described in a chapter that provides an historical perspective. Another chapter provides an overview of modeling options, common data input requirements,...

  20. Information Processing from Infancy to 11 Years: Continuities and Prediction of IQ

    ERIC Educational Resources Information Center

    Rose, Susan A.; Feldman, Judith F.; Jankowski, Jeffery J.; Van Rossem, Ronan

    2012-01-01

    This study provides the first direct evidence of cognitive continuity for multiple specific information processing abilities from infancy and toddlerhood to pre-adolescence, and provides support for the view that infant abilities form the basis of later childhood abilities. Data from a large sample of children (N = 131) were obtained at five…

  1. Exploring Doctoral Students' Perceptions of Language Use in Supervisory Written Feedback Practices--Because "Feedback Is Hard to Have"

    ERIC Educational Resources Information Center

    Stracke, Elke; Kumar, Vijay

    2016-01-01

    The mastery of academic writing is essential in doctoral writing. Supervisory feedback provides opportunities for students to improve their writing. It is a communicative tool that can be categorised based on fundamental functions of speech: referential, directive, and expressive. This study provides some understanding of the impact that language…

  2. Meeting the Social and Behavioral Health Needs of Students: Rethinking the Relationship between Teachers and School Social Workers

    ERIC Educational Resources Information Center

    Berzin, Stephanie Cosner; O'Brien, Kimberly H. McManama; Frey, Andy; Kelly, Michael S.; Alvarez, Michelle E.; Shaffer, Gary L.

    2011-01-01

    Background: While school-based mental health professionals obviously must provide mental health services to students directly, the literature is increasingly identifying an empowerment role for these professionals, whereby they support teachers as primary service providers. The purpose of this study was to identify subtypes of school social…

  3. A small-diameter NMR logging tool for groundwater investigations

    USGS Publications Warehouse

    Walsh, David; Turner, Peter; Grunewald, Elliot; Zhang, Hong; Butler, James J.; Reboulet, Ed; Knobbe, Steve; Christy, Tom; Lane, John W.; Johnson, Carole D.; Munday, Tim; Fitzpatrick, Andrew

    2013-01-01

    A small-diameter nuclear magnetic resonance (NMR) logging tool has been developed and field tested at various sites in the United States and Australia. A novel design approach has produced relatively inexpensive, small-diameter probes that can be run in open or PVC-cased boreholes as small as 2 inches in diameter. The complete system, including surface electronics and various downhole probes, has been successfully tested in small-diameter monitoring wells in a range of hydrogeological settings. A variant of the probe that can be deployed by a direct-push machine has also been developed and tested in the field. The new NMR logging tool provides reliable, direct, and high-resolution information that is of importance for groundwater studies. Specifically, the technology provides direct measurement of total water content (total porosity in the saturated zone or moisture content in the unsaturated zone), and estimates of relative pore-size distribution (bound vs. mobile water content) and hydraulic conductivity. The NMR measurements show good agreement with ancillary data from lithologic logs, geophysical logs, and hydrogeologic measurements, and provide valuable information for groundwater investigations.

  4. Integrated source and channel encoded digital communications system design study

    NASA Technical Reports Server (NTRS)

    Huth, G. K.

    1974-01-01

    Studies on the digital communication system for the direct communication links from ground to space shuttle and the links involving the Tracking and Data Relay Satellite (TDRS). Three main tasks were performed:(1) Channel encoding/decoding parameter optimization for forward and reverse TDRS links,(2)integration of command encoding/decoding and channel encoding/decoding; and (3) modulation coding interface study. The general communication environment is presented to provide the necessary background for the tasks and to provide an understanding of the implications of the results of the studies.

  5. Consumers' and workers' perspectives about consumer-directed services in the United States.

    PubMed

    Swaine, Jamie G; Parish, Susan L; Igdalsky, Leah; Powell, Robyn M

    2016-07-01

    Consumer direction is a service delivery model that shifts decision-making from agencies to the individuals they serve. Using government funding, consumers hire, supervise, and schedule their own staff and maintain control over the delivery of their services. This study sought to understand the process of consumer direction as well as the experiences and perspectives of both the consumers and employees. The study also sought to better understand if and how consumer direction allows the consumer to direct his or her life, the impact consumer direction may have on the individual's health and health care, and how employment in consumer directed programs impacts the workers providing direct care services. This qualitative study included interviews with consumers (N = 20) and workers (N = 15) in Virginia, a southern state in the US. Semi-structured phone interviews were conducted by one member of the research team and transcribed and coded for themes by the research team using grounded theory methodology. Consumers reported greater control over their services and increased access to health care, compared to what they previously received with traditional services. Conversely, consumers reported challenges in managing their staff and fulfilling the role of an employer. Employees reported a lack of training prior to starting their jobs, as well as an inability to live off on low hourly wages. Still, the majority of employees reported job satisfaction and fulfillment. Policymakers should expand and strengthen the consumer directed program. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Variables affecting learning in a simulation experience: a mixed methods study.

    PubMed

    Beischel, Kelly P

    2013-02-01

    The primary purpose of this study was to test a hypothesized model describing the direct effects of learning variables on anxiety and cognitive learning outcomes in a high-fidelity simulation (HFS) experience. The secondary purpose was to explain and explore student perceptions concerning the qualities and context of HFS affecting anxiety and learning. This study used a mixed methods quantitative-dominant explanatory design with concurrent qualitative data collection to examine variables affecting learning in undergraduate, beginning nursing students (N = 124). Being ready to learn, having a strong auditory-verbal learning style, and being prepared for simulation directly affected anxiety, whereas learning outcomes were directly affected by having strong auditory-verbal and hands-on learning styles. Anxiety did not quantitatively mediate cognitive learning outcomes as theorized, although students qualitatively reported debilitating levels of anxiety. This study advances nursing education science by providing evidence concerning variables affecting learning outcomes in HFS.

  7. Tool-specific performance of vibration-reducing gloves for attenuating fingers-transmitted vibration

    PubMed Central

    Welcome, Daniel E.; Dong, Ren G.; Xu, Xueyan S.; Warren, Christopher; McDowell, Thomas W.

    2016-01-01

    BACKGROUND Fingers-transmitted vibration can cause vibration-induced white finger. The effectiveness of vibration-reducing (VR) gloves for reducing hand transmitted vibration to the fingers has not been sufficiently examined. OBJECTIVE The objective of this study is to examine tool-specific performance of VR gloves for reducing finger-transmitted vibrations in three orthogonal directions (3D) from powered hand tools. METHODS A transfer function method was used to estimate the tool-specific effectiveness of four typical VR gloves. The transfer functions of the VR glove fingers in three directions were either measured in this study or during a previous study using a 3D laser vibrometer. More than seventy vibration spectra of various tools or machines were used in the estimations. RESULTS When assessed based on frequency-weighted acceleration, the gloves provided little vibration reduction. In some cases, the gloves amplified the vibration by more than 10%, especially the neoprene glove. However, the neoprene glove did the best when the assessment was based on unweighted acceleration. The neoprene glove was able to reduce the vibration by 10% or more of the unweighted vibration for 27 out of the 79 tools. If the dominant vibration of a tool handle or workpiece was in the shear direction relative to the fingers, as observed in the operation of needle scalers, hammer chisels, and bucking bars, the gloves did not reduce the vibration but increased it. CONCLUSIONS This study confirmed that the effectiveness for reducing vibration varied with the gloves and the vibration reduction of each glove depended on tool, vibration direction to the fingers, and finger location. VR gloves, including certified anti-vibration gloves do not provide much vibration reduction when judged based on frequency-weighted acceleration. However, some of the VR gloves can provide more than 10% reduction of the unweighted vibration for some tools or workpieces. Tools and gloves can be matched for better effectiveness for protecting the fingers. PMID:27867313

  8. Direct solar pumping of semiconductor lasers: A feasibility study

    NASA Technical Reports Server (NTRS)

    Anderson, Neal G.

    1992-01-01

    This report describes results of NASA Grant NAG-1-1148, entitled Direct Solar Pumping of Semiconductor Lasers: A Feasibility Study. The goals of this study were to provide a preliminary assessment of the feasibility of pumping semiconductor lasers in space with directly focused sunlight and to identify semiconductor laser structures expected to operate at the lowest possible focusing intensities. It should be emphasized that the structures under consideration would provide direct optical-to-optical conversion of sunlight into laser light in a single crystal, in contrast to a configuration consisting of a solar cell or storage battery electrically pumping a current injection laser. With external modulation, such lasers could perhaps be efficient sources for intersatellite communications. We proposed specifically to develop a theoretical model of semiconductor quantum-well lasers photopumped by a broadband source, test it against existing experimental data where possible, and apply it to estimating solar pumping requirements and identifying optimum structures for operation at low pump intensities. These tasks have been accomplished, as described in this report of our completed project. The report is organized as follows: Some general considerations relevant to the solar-pumped semiconductor laser problem are discussed in Section 2, and the types of structures chosen for specific investigation are described. The details of the laser model we developed for this work are then outlined in Section 3. In Section 4, results of our study are presented, including designs for optimum lattice-matched and strained-layer solar-pumped quantum-well lasers and threshold pumping estimates for these structures. It was hoped at the outset of this work that structures could be identified which could be expected to operate continuously at solar photoexcitation intensities of several thousand suns, and this indeed turned out to be the case as described in this section. Our project is summarized in Section 5, and information on publications resulting from this work is provided in Section 6.

  9. West Virginia 511 feasibility study.

    DOT National Transportation Integrated Search

    2011-06-01

    Procedure for requesting a copy of the full report : Please submit your request, in writing, directly to the contact provided below. : Director of the Traffic Engineering Division : West Virginia Department of Transportation, Division of Highways : B...

  10. It takes two: the role of partner ethnicity and age characteristics on condom negotiations of heterosexual Chinese and Filipina American college women.

    PubMed

    Lam, Amy G; Barnhart, James E

    2006-02-01

    To date, limited attention is paid to how partners influence the condom negotiation process. This study examined whether partner ethnicity and age were associated with condom negotiations (i.e., verbal-direct, verbal-indirect, nonverbal-direct, nonverbal-indirect) in heterosexual Chinese and Filipina American college women. Results from 181 women across four California universities indicated significant effects of partner ethnicity and age on condom negotiation strategies. Asian women with non-Asian partners were more likely to use nonverbal-direct strategies than those with Asian partners. Asian women with older partners were less likely to use verbal strategies (verbal-direct, verbal-indirect) than those with same-age partners. This study suggests that Asian women's safer sex communication varies by partner characteristics. Obtaining information such as partner ethnicity and age can help health educators provide more culturally appropriate sexual communication skills to clients.

  11. Modeling the directional reflectance from complete homogeneous vegetation canopies with various leaf-orientation distributions

    NASA Technical Reports Server (NTRS)

    Kimes, D. S.

    1984-01-01

    The directional-reflectance distributions of radiant flux from homogeneous vegetation canopies with greater than 90 percent ground cover are analyzed with a radiative-transfer model. The model assumes that the leaves consist of small finite planes with Lambertian properties. Four theoretical canopies with different leaf-orientation distributions were studied: erectophile, spherical, planophile, and heliotropic canopies. The directional-reflectance distributions from the model closely resemble reflectance distributions measured in the field. The physical scattering mechanisms operating in the model explain the variations observed in the reflectance distributions as a function of leaf-orientation distribution, solar zenith angle, and leaf transmittance and reflectance. The simulated reflectance distribution show unique characteristics for each canopy. The basic understanding of the physical scattering properties of the different canopy geometries gained in this study provide a basis for developing techniques to infer leaf-orientation distributions of vegetation canopies from directional remote-sensing measurements.

  12. On the concept of sloped motion for free-floating wave energy converters.

    PubMed

    Payne, Grégory S; Pascal, Rémy; Vaillant, Guillaume

    2015-10-08

    A free-floating wave energy converter (WEC) concept whose power take-off (PTO) system reacts against water inertia is investigated herein. The main focus is the impact of inclining the PTO direction on the system performance. The study is based on a numerical model whose formulation is first derived in detail. Hydrodynamics coefficients are obtained using the linear boundary element method package WAMIT. Verification of the model is provided prior to its use for a PTO parametric study and a multi-objective optimization based on a multi-linear regression method. It is found that inclining the direction of the PTO at around 50° to the vertical is highly beneficial for the WEC performance in that it provides a high capture width ratio over a broad region of the wave period range.

  13. On the concept of sloped motion for free-floating wave energy converters

    PubMed Central

    Payne, Grégory S.; Pascal, Rémy; Vaillant, Guillaume

    2015-01-01

    A free-floating wave energy converter (WEC) concept whose power take-off (PTO) system reacts against water inertia is investigated herein. The main focus is the impact of inclining the PTO direction on the system performance. The study is based on a numerical model whose formulation is first derived in detail. Hydrodynamics coefficients are obtained using the linear boundary element method package WAMIT. Verification of the model is provided prior to its use for a PTO parametric study and a multi-objective optimization based on a multi-linear regression method. It is found that inclining the direction of the PTO at around 50° to the vertical is highly beneficial for the WEC performance in that it provides a high capture width ratio over a broad region of the wave period range. PMID:26543397

  14. Older people's experiences of patient-centered treatment for chronic pain: a qualitative study.

    PubMed

    Teh, Carrie F; Karp, Jordan F; Kleinman, Arthur; Reynolds Iii, Charles F; Weiner, Debra K; Cleary, Paul D

    2009-04-01

    Older adults with chronic pain who seek treatment often are in a health care environment that emphasizes patient-directed care, a change from the patriarchal model of care to which many older adults are accustomed. To explore the experiences of older adults seeking treatment for chronic pain, with respect to patient-directed care and the patient-provider relationship. In-depth interviews with 15 Caucasian older adults with chronic pain who had been evaluated at a university-based pain clinic. All interviews were audiotaped and the transcripts were analyzed using a grounded theory based approach. Older adults with chronic pain vary in their willingness to be involved in their treatment decisions. Many frequently participate in decisions about their pain treatment by asking for or refusing specific treatments, demanding quality care, or operating outside of the patient-provider relationship to manage pain on their own. However, others prefer to let their provider make the decisions. In either case, having a mutually respectful patient-provider relationship is important to this population. Specifically, participants described the importance of "being heard" and "being understood" by providers. As some providers switch from a patriarchal model of care toward a model of care that emphasizes patient activation and patient-centeredness, the development and cultivation of valued patient-provider relationships may change. While it is important to encourage patient involvement in treatment decisions, high-quality, patient-centered care for older adults with chronic pain should include efforts to strengthen the patient-provider relationship by attending to differences in patients' willingness to engage in patient-directed care and emphasizing shared decision-making.

  15. Directional connectivity in hydrology and ecology.

    PubMed

    Larsen, Laurel G; Choi, Jungyill; Nungesser, Martha K; Harvey, Judson W

    2012-12-01

    Quantifying hydrologic and ecological connectivity has contributed to understanding transport and dispersal processes and assessing ecosystem degradation or restoration potential. However, there has been little synthesis across disciplines. The growing field of ecohydrology and recent recognition that loss of hydrologic connectivity is leading to a global decline in biodiversity underscore the need for a unified connectivity concept. One outstanding need is a way to quantify directional connectivity that is consistent, robust to variations in sampling, and transferable across scales or environmental settings. Understanding connectivity in a particular direction (e.g., streamwise, along or across gradient, between sources and sinks, along cardinal directions) provides critical information for predicting contaminant transport, planning conservation corridor design, and understanding how landscapes or hydroscapes respond to directional forces like wind or water flow. Here we synthesize progress on quantifying connectivity and develop a new strategy for evaluating directional connectivity that benefits from use of graph theory in ecology and percolation theory in hydrology. The directional connectivity index (DCI) is a graph-theory based, multiscale metric that is generalizable to a range of different structural and functional connectivity applications. It exhibits minimal sensitivity to image rotation or resolution within a given range and responds intuitively to progressive, unidirectional change. Further, it is linearly related to the integral connectivity scale length--a metric common in hydrology that correlates well with actual fluxes--but is less computationally challenging and more readily comparable across different landscapes. Connectivity-orientation curves (i.e., directional connectivity computed over a range of headings) provide a quantitative, information-dense representation of environmental structure that can be used for comparison or detection of subtle differences in the physical-biological feedbacks driving pattern formation. Case-study application of the DCI to the Everglades in south Florida revealed that loss of directional hydrologic connectivity occurs more rapidly and is a more sensitive indicator of declining ecosystem function than other metrics (e.g., habitat area) used previously. Here and elsewhere, directional connectivity can provide insight into landscape drivers and processes, act as an early-warning indicator of environmental degradation, and serve as a planning tool or performance measure for conservation and restoration efforts.

  16. Directional connectivity in hydrology and ecology

    USGS Publications Warehouse

    Larsen, Laurel G.; Choi, Jungyill; Nungesser, Martha K.; Harvey, Judson W.

    2012-01-01

    Quantifying hydrologic and ecological connectivity has contributed to understanding transport and dispersal processes and assessing ecosystem degradation or restoration potential. However, there has been little synthesis across disciplines. The growing field of ecohydrology and recent recognition that loss of hydrologic connectivity is leading to a global decline in biodiversity underscore the need for a unified connectivity concept. One outstanding need is a way to quantify directional connectivity that is consistent, robust to variations in sampling, and transferable across scales or environmental settings. Understanding connectivity in a particular direction (e.g., streamwise, along or across gradient, between sources and sinks, along cardinal directions) provides critical information for predicting contaminant transport, planning conservation corridor design, and understanding how landscapes or hydroscapes respond to directional forces like wind or water flow. Here we synthesize progress on quantifying connectivity and develop a new strategy for evaluating directional connectivity that benefits from use of graph theory in ecology and percolation theory in hydrology. The directional connectivity index (DCI) is a graph-theory based, multiscale metric that is generalizable to a range of different structural and functional connectivity applications. It exhibits minimal sensitivity to image rotation or resolution within a given range and responds intuitively to progressive, unidirectional change. Further, it is linearly related to the integral connectivity scale length—a metric common in hydrology that correlates well with actual fluxes—but is less computationally challenging and more readily comparable across different landscapes. Connectivity-orientation curves (i.e., directional connectivity computed over a range of headings) provide a quantitative, information-dense representation of environmental structure that can be used for comparison or detection of subtle differences in the physical-biological feedbacks driving pattern formation. Case-study application of the DCI to the Everglades in south Florida revealed that loss of directional hydrologic connectivity occurs more rapidly and is a more sensitive indicator of declining ecosystem function than other metrics (e.g., habitat area) used previously. Here and elsewhere, directional connectivity can provide insight into landscape drivers and processes, act as an early-warning indicator of environmental degradation, and serve as a planning tool or performance measure for conservation and restoration efforts.

  17. Continuing debates on direct social perception: Some notes on Gallagher's analysis of "the new hybrids".

    PubMed

    Bohl, Vivian

    2015-11-01

    This commentary argues that Gallagher's account of direct social perception has remained underdeveloped in several respects. Gallagher has not provided convincing evidence to support his claim that mindreading is rare in social situations. He and other direct perception theorists have not offered a substantive critique of standard theories of mindreading because they have attacked a much stronger claim about the putative unobservability of mental states than most theories of mindreading imply. To provide a genuine alternative to standard theories of mindreading, the direct perception theorist needs to provide more detailed answers to the following questions: What are the criteria for distinguishing perceptual processes from non-perceptual processes? How exactly does direct social perception function on the subpersonal level? What is the content of direct social perception? How does direct perception theory relate to more recent developments in the mindreading literature? Copyright © 2015 Elsevier Inc. All rights reserved.

  18. A preliminary report on the magnetic measurements of samples 72275 and 72255. [direction and magnitude of remanent magnetization

    NASA Technical Reports Server (NTRS)

    Banerjee, S. K.

    1974-01-01

    The direction and magnitude of natural remanent magnetization of five approximately 3-g subsamples of 72275 and 72255 and the high field saturation magnetization, coercive force, and isothermal remanent magnetization of 100-mg chip from each of these samples, were studied. Given an understanding of the magnetization processes, group 1 experiments provide information about the absolute direction of the ancient magnetizing field and a qualitative estimate of its size (paleointensity). The group 2 experiments yield a quantitative estimate of the iron content and a qualitative ideal of the grain sizes.

  19. Predictors of advance directives among nursing home residents with dementia.

    PubMed

    Huang, Hsiu-Li; Shyu, Yea-Ing Lotus; Weng, Li-Chueh; Chen, Kang-Hua; Hsu, Wen-Chuin

    2018-03-01

    ABSTRACTBackground:Advance directives are important for nursing home residents with dementia; for those with advanced dementia, surrogates determine medical decisions. However, in Taiwan, little is known about what influences the completion of these advance directives. The purpose of this study was to identify factors, which influence the presence of advance directives for nursing home residents with dementia in Taiwan. Our cross-sectional study analyzed a convenience sample of 143 nursing home dyads comprised of residents with dementia and family surrogates. Documentation of residents' advance directives, physical and cognitive status was obtained from medical charts. Surrogates completed the stress of end-of-life care decision scale and a questionnaire regarding their demographic characteristics. Nursing home characteristics were obtained from each chief administrator. Less than half of the nursing home residents (39.2%) had advance directives and most (96.4%) had been completed by family surrogates. The following were predictors of an advance directive: surrogates had previously signed a do-not-resuscitate as a proxy and had been informed of advance directives by a healthcare provider; nursing homes had policies for advance directives and a religious affiliation. Advance directives were uncommon for nursing home residents with dementia. Presence of an advance directive was associated with surrogate characteristics and the nursing home facilities; there was no association with characteristics of the nursing home resident. Our findings emphasize the need to develop policies and strategies, which ensure that all residents of nursing homes and their surrogates are aware of their right to an advance directive.

  20. Report of the Social Studies Task Force.

    ERIC Educational Resources Information Center

    Gathman, John; And Others

    In 1982 the Colorado Board of Education directed the State Board of Education to organize task forces to address a variety of state educational needs. This report, presented by the Social Studies Task Force, explains the group's purposes and concerns, provides a social studies definition, and outlines the Colorado grades K-12 social studies…

  1. Research on Written Composition: New Directions for Teaching.

    ERIC Educational Resources Information Center

    Hillocks, George, Jr.

    Reflecting changes in the focus and methodology of writing research over the past 20 years, this book provides a meta-analysis of studies on teaching approaches and focuses on composition instruction at the elementary, secondary, and college levels. The first chapter of the book examines general studies of the composing process, studies of process…

  2. Welder's Helper. Coordinator's Guide. Individualized Study Guide. General Metal Trades.

    ERIC Educational Resources Information Center

    Dean, James W.

    This guide provides information to enable coordinators to direct learning activities for students using an individualized study guide on being a welder's helper. The study material is designed for students enrolled in cooperative part-time training and employed, or desiring to be employed, as welders' helpers. Contents include a sample progress…

  3. Writing and Publishing Qualitative Studies in Early Childhood Education

    ERIC Educational Resources Information Center

    Saracho, Olivia N.

    2017-01-01

    When a study is published in a respected professional journal, it not only verifies that the research has been completed but also that it has been subjected to anonymous peer review. Published results from studies in early childhood education contribute to the field's knowledge and provide direction to guide future early childhood education…

  4. 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…

  5. Thirty years of change in forest soils of the Allegheny Plateau, Pennsylvania

    Treesearch

    S.W. Bailey; S.B. Horsley; R.P. Long

    2005-01-01

    Numerous studies have investigated the potential depletion of available base cation pools from forest soils in regions impacted by acid deposition. However, these studies mostly used indirect methods. Retrospective studies, providing direct evidence of chemical changes in forest soils, are relatively rare due to a lack of appropriate sampling, documentation, and...

  6. Lathe Operator. Coordinator's Guide. Individualized Study Guide. General Metal Trades.

    ERIC Educational Resources Information Center

    East Texas State Univ., Commerce. Occupational Curriculum Lab.

    This guide provides information to enable coordinators to direct learning activities for students using an individualized study guide on operating a lathe. The study material is designed for students enrolled in cooperative part-time training and employed, or desiring to be employed, as lathe operators. Contents include a sample progress chart,…

  7. Household Food Security Study Summaries. 2001 Edition.

    ERIC Educational Resources Information Center

    Seavey, Dorie; Sullivan, Ashley F.

    This report provides the most recent data on the food security of United States households. Based on studies using the Food Security Core Module (FSCM), a tool facilitating direct documentation of the extent of food insecurity and hunger caused by income limitations, this report summarizes 35 studies representing 20 states and Canada. The report…

  8. A Framework for Studying Organizational Innovation in Research Libraries

    ERIC Educational Resources Information Center

    Jantz, Ronald C.

    2012-01-01

    The objective of this paper is two-fold: to propose a theoretical framework and model for studying organizational innovation in research libraries and to set forth propositions that can provide directions for future empirical studies of innovation in research libraries. Research libraries can be considered members of a class of organizations…

  9. Direct composite fillings: an optical coherence tomography and microCT investigation

    NASA Astrophysics Data System (ADS)

    Negrutiu, Meda L.; Sinescu, Cosmin; Borlea, Mugurel V.; Manescu, Adrian; Duma, Virgil F.; Rominu, Mihai; Podoleanu, Adrian G.

    2015-03-01

    The treatment of carious lesions requires removal of affected dental tissue thus creating cavities that are to be filled with dedicated materials. There are several methods known which are used to assess the quality of direct dental restorations, but most of them are invasive. Optical tomographic techniques are of particular importance in the medical imaging field, because these techniques can provide non-invasive diagnostic images. Using an en-face version of OCT, we have recently demonstrated real time thorough evaluation of quality of dental fillings. The major aim of this study was to analyses the optical performance of adhesives modified with zirconia particles in different concentrations in order to improve the contrast of OCT imaging of the interface between the tooth structure, adhesive and composite resin. The OCT investigations were validated by micro CT using synchrotron radiation. The OCT Swept Source is a valuable investigation tool for the clinical evaluation of class II direct composite restorations. The unmodified adhesive layer shows poor contrast on regular OCT investigations. Adding zirconia particles to the adhesive layer provides a better scattering which allows a better characterization and quantification of direct restorations.

  10. Quantifying the direct use value of Condor seamount

    NASA Astrophysics Data System (ADS)

    Ressurreição, Adriana; Giacomello, Eva

    2013-12-01

    Seamounts often satisfy numerous uses and interests. Multiple uses can generate multiple benefits but also conflicts and impacts, calling, therefore, for integrated and sustainable management. To assist in developing comprehensive management strategies, policymakers recognise the need to include measures of socioeconomic analysis alongside ecological data so that practical compromises can be made. This study assessed the direct output impact (DOI) of the relevant marine activities operating at Condor seamount (Azores, central northeast Atlantic) as proxies of the direct use values provided by the resource system. Results demonstrated that Condor seamount supported a wide range of uses yielding distinct economic outputs. Demersal fisheries, scientific research and shark diving were the top-three activities generating the highest revenues, while tuna fisheries, whale watching and scuba-diving had marginal economic significance. Results also indicated that the economic importance of non-extractive uses of Condor is considerable, highlighting the importance of these uses as alternative income-generating opportunities for local communities. It is hoped that quantifying the direct use values provided by Condor seamount will contribute to the decision making process towards its long-term conservation and sustainable use.

  11. Challenges with implementing malaria rapid diagnostic tests at primary care facilities in a Ghanaian district: a qualitative study.

    PubMed

    Boadu, Nana Yaa; Amuasi, John; Ansong, Daniel; Einsiedel, Edna; Menon, Devidas; Yanow, Stephanie K

    2016-02-27

    Rapid diagnostic Tests (RDTs) for malaria enable diagnostic testing at primary care facilities in resource-limited settings, where weak infrastructure limits the use of microscopy. In 2010, Ghana adopted a test-before-treat guideline for malaria, with RDT use promoted to facilitate diagnosis. Yet healthcare practitioners still treat febrile patients without testing, or despite negative malaria test results. Few studies have explored RDT implementation beyond the notions of provider or patient acceptability. The aim of this study was to identify the factors directly influencing malaria RDT implementation at primary care facilities in a Ghanaian district. Qualitative interviews, focus groups and direct observations were conducted with 50 providers at six purposively selected primary care facilities in the Atwima-Nwabiagya district. Data were analysed thematically. RDT implementation was hampered by: (1) healthcare delivery constraints (weak supply chain, limited quality assurance and control, inadequate guideline emphasis, staffing limitations); (2) provider perceptions (entrenched case-management paradigms, limited preparedness for change); (3) social dynamics of care delivery (expected norms of provider-patient interaction, test affordability); and (4) limited provider engagement in policy processes leading to fragmented implementation of health sector reform. Limited health system capacity, socio-economic, political, and historical factors hampered malaria RDT implementation at primary care facilities in the study district. For effective RDT implementation providers must be: (1) adequately enabled through efficient allocation and management of essential healthcare commodities; (2) appropriately empowered with the requisite knowledge and skill through ongoing, effective professional development; and (3) actively engaged in policy dialogue to demystify socio-political misconceptions that hinder health sector reform policies from improving care delivery. Clear, consistent guideline emphasis, with complementary action to address deep-rooted provider concerns will build their confidence in, and promote uptake of recommended policies, practices, and technology for diagnosing malaria.

  12. Direct purchase contracts carry risks, benefits.

    PubMed

    Fine, A

    1991-05-01

    To better control their purchasing of healthcare services, some employers are seeking direct managed care contracts with healthcare facilities. Along with evaluating potential markets introduced by a proposed contract, a provider should develop a pricing strategy, a monitoring system, and a process for internal audit before entering into a direct purchase contract. With the proper checks in place, direct purchase contracts can be mutually beneficial to providers and purchasers.

  13. The direct impact of landslides on household income in tropical regions: A case study from the Rwenzori Mountains in Uganda.

    PubMed

    Mertens, K; Jacobs, L; Maes, J; Kabaseke, C; Maertens, M; Poesen, J; Kervyn, M; Vranken, L

    2016-04-15

    Landslides affect millions of people worldwide, but theoretical and empirical studies on the impact of landslides remain scarce, especially in Sub-Saharan Africa. This study proposes and applies a method to estimate the direct impact of landslides on household income and to investigate the presence of specific risk sharing and mitigation strategies towards landslides in a tropical and rural environment. An original cross-sectional household survey is used in combination with geographical data to acquire detailed information on livelihoods and on hazards in the Rwenzori mountains, Uganda. Ordinary least square regressions and probit estimations with village fixed effects are used to estimate the impact of landslides and the presence of mitigation strategies. Geographical information at household level allows to disentangle the direct impact from the indirect effects of landslides. We show that the income of affected households is substantially reduced during the first years after a landslide has occurred. We find that members of recently affected households participate more in wage-employment or in self-employed activities, presumably to address income losses following a landslide. Yet, we see that these jobs do not provide sufficient revenue to compensate for the loss of income from agriculture. Given that landslides cause localized shocks, finding a significant direct impact in our study indicates that no adequate risk sharing mechanisms are in place in the Rwenzori sub-region. These insights are used to derive policy recommendations for alleviating the impact of landslides in the region. By quantifying the direct impact of landslides on household income in an agricultural context in Africa this study draws the attention towards a problem that has been broadly underestimated so far and provides a sound scientific base for disaster risk reduction in the region. Both the methodology and the findings of this research are applicable to other tropical regions with high landslide densities. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. EEG-based decoding of error-related brain activity in a real-world driving task

    NASA Astrophysics Data System (ADS)

    Zhang, H.; Chavarriaga, R.; Khaliliardali, Z.; Gheorghe, L.; Iturrate, I.; Millán, J. d. R.

    2015-12-01

    Objectives. Recent studies have started to explore the implementation of brain-computer interfaces (BCI) as part of driving assistant systems. The current study presents an EEG-based BCI that decodes error-related brain activity. Such information can be used, e.g., to predict driver’s intended turning direction before reaching road intersections. Approach. We executed experiments in a car simulator (N = 22) and a real car (N = 8). While subject was driving, a directional cue was shown before reaching an intersection, and we classified the presence or not of an error-related potentials from EEG to infer whether the cued direction coincided with the subject’s intention. In this protocol, the directional cue can correspond to an estimation of the driving direction provided by a driving assistance system. We analyzed ERPs elicited during normal driving and evaluated the classification performance in both offline and online tests. Results. An average classification accuracy of 0.698 ± 0.065 was obtained in offline experiments in the car simulator, while tests in the real car yielded a performance of 0.682 ± 0.059. The results were significantly higher than chance level for all cases. Online experiments led to equivalent performances in both simulated and real car driving experiments. These results support the feasibility of decoding these signals to help estimating whether the driver’s intention coincides with the advice provided by the driving assistant in a real car. Significance. The study demonstrates a BCI system in real-world driving, extending the work from previous simulated studies. As far as we know, this is the first online study in real car decoding driver’s error-related brain activity. Given the encouraging results, the paradigm could be further improved by using more sophisticated machine learning approaches and possibly be combined with applications in intelligent vehicles.

  15. Modeling Study for Tangier Island Jetties, Tangier Island, Virginia

    DTIC Science & Technology

    2015-03-01

    meteorological and oceanographic (metocean) inputs used as forcing conditions. CENAO provided survey data available for Tangier Is- land from a...and 5 ft or 1.5 m). Wave direction is meteorological (e.g., direction waves coming from). Figure 55. Ten selected locations (black squares) in Alt...given in the previous sections. The Hud- son equation is well known and has been used for years to determine ar- mor stability ( Hudson 1959; Shore

  16. Supersonic Cruise/Transonic Maneuver Wing Section Development Study.

    DTIC Science & Technology

    1980-06-01

    duct. The inlet is contoured to fit the blended forebody and results in a high-aspect-ratio, minimum height duct which facilitates clearance of the...following. Most of the changes were directed toward reducing the supersonic wave drag. The winglet was removed to reduce supersonic volume and camber...drag and skin friction drag. The primary function of the winglet was to provide directional stability at high angles of attack. Analysis of the HiMAT

  17. Ending an Insurgency Violently: The Samar and Batangas Punitive Campaigns

    DTIC Science & Technology

    2010-03-01

    outrage over charges of excessive cruelty and war crimes. In contrast, the Batangas campaign plan, under the direction of BG J. Franklin Bell, is... cruelty and war crimes. In contrast, the Batangas campaign plan, under the direction of BG J. Franklin Bell, is remembered as a balanced strategy of...over charges of excessive cruelty and war crimes. Nevertheless, both campaigns provide an opportunity to study the proper balance of attraction and

  18. Does Self-Directed and Web-Based Support for Parents Enhance the Effects of Viewing a Reality Television Series Based on the Triple P--Positive Parenting Programme?

    ERIC Educational Resources Information Center

    Sanders, Matthew; Calam, Rachel; Durand, Marianne; Liversidge, Tom; Carmont, Sue Ann

    2008-01-01

    Background: This study investigated whether providing self-directed and web-based support for parents enhanced the effects of viewing a reality television series based on the Triple P--Positive Parenting Programme. Method: Parents with a child aged 2 to 9 (N=454) were randomly assigned to either a standard or enhanced intervention condition. In…

  19. Impact of European Union Legislation On The Wash Catchment, U.k.

    NASA Astrophysics Data System (ADS)

    Daldorph, P.; Wheater, H.; Saunders, A.

    A case study is presented which shows the impact of existing European Legislation (Urban Waste Water Directive, Nitrate Directive, Bathing Waters Directive, Habitats Directive) on aquatic nutrient concentrations in the 16112 km2 catchment area of The Wash in eastern England , including both the inland and coastal zones. Information is provided on the implementation process (administrative and economic) and the observed impacts of measures to reduce environmental nutrient levels. Impacts are compared with simulations of nutrients in the inland and coastal zones, and the modeling tools are further used to predict impacts of future management change, e.g. to meet possible requirements of the Water Framework Directive. The issues in setting future environmental targets and research needs to underpin this process are discussed in the context of developing river basin management plans to support the Common Implementation Strategy for the Water Framework Directive.

  20. Direct Support Workforce Development.

    ERIC Educational Resources Information Center

    Impact, 1998

    1998-01-01

    The fourteen brief articles in this theme issue all examine challenges in the development of direct support staff working with people who have developmental disabilities. The articles also include the views of direct support providers and people with developmental disabilities themselves, as well as examples of strategies used by provider agencies…

  1. Geochemistry and origin of regional dolomites

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

    Hanson, G.N.; Meyers, W.J.

    1991-01-01

    This grant supports the geochemical aspects of the research directed by Profs. W.J. Meyers and G.N. Hanson on the origins of regional dolomites. The field aspects and the stipend for most of the graduate students is provided by donations from oil companies and by grants from NSF and ACS-PRF. Eleven graduate students are involved in dolomite projects allowing diverse range of studies. Each student's results provide new insights to the others which invigorates all of the studies.

  2. Management practices and performance of mergers and acquisitions in Pakistan: mediating role of psychological contract.

    PubMed

    Bari, Muhammad Waseem; Fanchen, Meng; Baloch, Muhammad Awais

    2016-01-01

    The objective of this study is to examine the direct and indirect effect of management practices (procedural justice, coordination approach, communication system, integration strategy, and coping programs) on merger and acquisition (M&A) performance in the Pakistan banking industry. Psychological contract (PC) acts as a mediator between Management practices and M&A performance. The Present study distributes a structured questionnaire to 700 bank employees of different management cadres. The useful response rate is 76 % (536 employees). It uses PLS-SEM technique for data analysis. (1) procedural justice is a key strategy which has highly significant direct and indirect effect on M&A performance; however integration strategy and the communication system have an only direct effect. (2) PC performs partial mediation at different levels between management practices and M&A financial and non-financial performance. This study provides an effective solution to solve the soft issues during and post-M&A process. This is one of the few studies which effectively integrate the five constructs into a single framework to study their effects on M&A performance. Limitations and future research directions are presented in the last section of the study.

  3. Role of the media in influencing trajectories of youth smoking.

    PubMed

    Wakefield, Melanie; Flay, Brian; Nichter, Mark; Giovino, Gary

    2003-05-01

    This paper summarizes results of empirical studies on cigarette advertising and promotions, antismoking advertising, product placement in movies, on television and in music media and news coverage about smoking. In addition, we provide an overview of some of the theoretical literature relevant to the study of media uses and effects. Finally, we discuss empirical findings in the context of these theories to draw some conclusions about media influences on smoking and identify issues for further research. We conclude that (a) the media both shape and reflect social values about smoking; (b) the media provide new information about smoking directly to audiences; (c) the media act as a source of observational learning by providing models which teenagers may seek to emulate; (d) exposure to media messages about smoking also provides direct reinforcement for smoking or not smoking; (e) the media promote interpersonal discussion about smoking; (f) the media can influence "intervening" behaviors that may make teenage smoking less likely; and (g) antismoking media messages can also set the agenda for other change at the community, state or national level. We outline priorities for further research which emphasize the need for longitudinal studies, multi-level studies, an awareness of the probably dynamic relationship between tobacco advertising and antismoking advertising, the importance of determining appraisal of tobacco industry youth smoking prevention efforts and the dearth of research on news coverage about smoking.

  4. Spatial hearing in Cope’s gray treefrog: II. Frequency-dependent directionality in the amplitude and phase of tympanum vibrations

    PubMed Central

    Lee, Norman; Schrode, Katrina M.; Johns, Anastasia R.; Christensen-Dalsgaard, Jakob; Bee, Mark A.

    2014-01-01

    Anuran ears function as pressure difference receivers, and the amplitude and phase of tympanum vibrations are inherently directional, varying with sound incident angle. We quantified the nature of this directionality for Cope’s gray treefrog, Hyla chrysoscelis. We presented subjects with pure tones, advertisement calls, and frequency-modulated sweeps to examine the influence of frequency, signal level, lung inflation, and sex on ear directionality. Interaural differences in the amplitude of tympanum vibrations were 1–4 dB greater than sound pressure differences adjacent to the two tympana, while interaural differences in the phase of tympanum vibration were similar to or smaller than those in sound phase. Directionality in the amplitude and phase of tympanum vibration were highly dependent on sound frequency, and directionality in amplitude varied slightly with signal level. Directionality in the amplitude and phase of tone- and call-evoked responses did not differ between sexes. Lung inflation strongly affected tympanum directionality over a narrow frequency range that, in females, included call frequencies. This study provides a foundation for further work on the biomechanics and neural mechanisms of spatial hearing in H. chrysoscelis, and lends valuable perspective to behavioral studies on the use of spatial information by this species and other frogs. PMID:24504183

  5. Spatial hearing in Cope's gray treefrog: II. Frequency-dependent directionality in the amplitude and phase of tympanum vibrations.

    PubMed

    Caldwell, Michael S; Lee, Norman; Schrode, Katrina M; Johns, Anastasia R; Christensen-Dalsgaard, Jakob; Bee, Mark A

    2014-04-01

    Anuran ears function as pressure difference receivers, and the amplitude and phase of tympanum vibrations are inherently directional, varying with sound incident angle. We quantified the nature of this directionality for Cope's gray treefrog, Hyla chrysoscelis. We presented subjects with pure tones, advertisement calls, and frequency-modulated sweeps to examine the influence of frequency, signal level, lung inflation, and sex on ear directionality. Interaural differences in the amplitude of tympanum vibrations were 1-4 dB greater than sound pressure differences adjacent to the two tympana, while interaural differences in the phase of tympanum vibration were similar to or smaller than those in sound phase. Directionality in the amplitude and phase of tympanum vibration were highly dependent on sound frequency, and directionality in amplitude varied slightly with signal level. Directionality in the amplitude and phase of tone- and call-evoked responses did not differ between sexes. Lung inflation strongly affected tympanum directionality over a narrow frequency range that, in females, included call frequencies. This study provides a foundation for further work on the biomechanics and neural mechanisms of spatial hearing in H. chrysoscelis, and lends valuable perspective to behavioral studies on the use of spatial information by this species and other frogs.

  6. Skeletal status and soft tissue composition in astronauts. Tissue and fluid changes by radionuclide absorptiometry in vivo

    NASA Technical Reports Server (NTRS)

    Cameron, J. R.; Mazess, R. B.; Wilson, C. R.

    1973-01-01

    A device has been constructed and tested which provides immediate readout of bone mineral content and bone width from absorptiometric scans with low energy radionuclides. The basis of this analog system is a logarithmic converter-integrator coupled with a precision linear ratemeter. The system provided accurate and reliable results on standards and ashed bone sections. Clinical measurements were made on about 100 patients with the direct readout system, and these were highly correlated with the results from digital scan data on the same patients. The direct readout system has been used successfully in field studies and surveys as well as for clinical observations.

  7. Community-directed interventions for priority health problems in Africa: results of a multicountry study.

    PubMed

    2010-07-01

    To determine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. A three-year experimental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Cameroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions - vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients - were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. With the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problems with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa.

  8. Success of Intubation Rescue Techniques after Failed Direct Laryngoscopy in Adults: A Retrospective Comparative Analysis from the Multicenter Perioperative Outcomes Group.

    PubMed

    Aziz, Michael F; Brambrink, Ansgar M; Healy, David W; Willett, Amy Wen; Shanks, Amy; Tremper, Tyler; Jameson, Leslie; Ragheb, Jacqueline; Biggs, Daniel A; Paganelli, William C; Rao, Janavi; Epps, Jerry L; Colquhoun, Douglas A; Bakke, Patrick; Kheterpal, Sachin

    2016-10-01

    Multiple attempts at tracheal intubation are associated with mortality, and successful rescue requires a structured plan. However, there remains a paucity of data to guide the choice of intubation rescue technique after failed initial direct laryngoscopy. The authors studied a large perioperative database to determine success rates for commonly used intubation rescue techniques. Using a retrospective, observational, comparative design, the authors analyzed records from seven academic centers within the Multicenter Perioperative Outcomes Group between 2004 and 2013. The primary outcome was the comparative success rate for five commonly used techniques to achieve successful tracheal intubation after failed direct laryngoscopy: (1) video laryngoscopy, (2) flexible fiberoptic intubation, (3) supraglottic airway as part of an exchange technique, (4) optical stylet, and (5) lighted stylet. A total of 346,861 cases were identified that involved attempted tracheal intubation. A total of 1,009 anesthesia providers managed 1,427 cases of failed direct laryngoscopy followed by subsequent intubation attempts (n = 1,619) that employed one of the five studied intubation rescue techniques. The use of video laryngoscopy resulted in a significantly higher success rate (92%; 95% CI, 90 to 93) than other techniques: supraglottic airway conduit (78%; 95% CI, 68 to 86), flexible bronchoscopic intubation (78%; 95% CI, 71 to 83), lighted stylet (77%; 95% CI, 69 to 83), and optical stylet (67%; 95% CI, 35 to 88). Providers most frequently choose video laryngoscopy (predominantly GlideScope [Verathon, USA]) to rescue failed direct laryngoscopy (1,122/1,619; 69%), and its use has increased during the study period. Video laryngoscopy is associated with a high rescue intubation success rate and is more commonly used than other rescue techniques.

  9. Community-directed interventions for priority health problems in Africa: results of a multicountry study

    PubMed Central

    2010-01-01

    Abstract Objective To determine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. Methods A three-year experimental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Cameroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions – vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients – were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. Findings With the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problems with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. Conclusion The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa. PMID:20616970

  10. Recoil Directionality Studies in Two-Phase Liquid Argon TPC Detectors

    NASA Astrophysics Data System (ADS)

    Cadeddu, Matteo; Batignani, Giovanni; Marcello Bonivento, Walter; Bottino, Bianca; Campajola, Luigi; Caravati, Mauro; Catalanotti, Sergio; Cicalò, Corrado; Cocco, Alfredo; Covone, Giovanni; De Rosa, Gianfranca; Devoto, Alberto; Dionisi, Carlo; Fiorillo, Giuliana; Giagu, Stefano; Gulino, Marisa; Kuss, Michael; Lissia, Marcello; Lista, Luca; Longo, Giuseppe; Pallavicini, Marco; Pandola, Luciano; Razeti, Marco; Rescigno, Marco; Rossi, Biagio; Rossi, Nicola; Testera, Gemma; Trinchese, Pasquale; Walker, Susan; Zullo, Maurizio

    2017-12-01

    Projects attempting the direct detection of WIMP dark matter share the common problem of eliminating sources of background or using techniques to distinguish background events from true signals. Although experiments such as DarkSide have achieved essentially background free exposures through careful choice of materials and application of efficient veto techniques, there will still be a high burden of proof to convince the greater scientific community when a discovery is claimed. A directional signature in the data would provide extremely strong evidence to distinguish a true WIMP signal from that of an isotropic background. Two-phase argon time projection chambers (TPCs) provide an experimental apparatus which can both be scaled to the ton-scale size required to accommodate the low cross-section expected for WIMP interactions and have an anisotropy that could be exploited to evaluate the polar angles of the resulting nuclear recoils from WIMP collisions with target nuclei. Our studies show that even a modest resolution in the polar angle reconstruction would offer a powerful tool to detect a directional signature. In this contribution, the status of the ReD experiment, which is under construction at Naples University, will be also shown. The aim of the project is to assess and enhance the directionality of two-phase argon TPCs. ReD will use a small TPC exposed to a beam of mono-energetic neutrons to study the so called "columnar recombination" in liquid argon. This development could have high impact on the future experiments in the field, opening up the potential to find conclusive evidence for dark matter or disprove the WIMP hypothesis at and above the mass range explored by planned accelerator experiments.

  11. An assessment of interstate safety investment properties in Washington state.

    DOT National Transportation Integrated Search

    2014-12-01

    The Washington State Department of Transportation (WSDOT) commissioned the current study, targeting the entire interstate : mainline network in Washington State, to provide strategic direction to multi-biennial investment interstate locations that of...

  12. Archaeological Chemistry.

    ERIC Educational Resources Information Center

    Zurer, Pamela S.

    1983-01-01

    Research projects and methodology in archeochemistry are discussed. Topics include radiocarbon dating, thermoluminescence, amino acid dating, obsidian hydration dating, bone studies, metals/metallurgy, pottery, stone/glass, and future directions. Includes reports on funding, insights into nuclear waste/environmental problems provided by…

  13. 15 CFR 806.3 - Reporting requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... determined to be necessary to carry out the surveys and studies provided for by the Act. (b) Such reports may be required from among others, U.S. persons which have direct investment abroad, U.S. persons in...

  14. 15 CFR 806.3 - Reporting requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... determined to be necessary to carry out the surveys and studies provided for by the Act. (b) Such reports may be required from among others, U.S. persons which have direct investment abroad, U.S. persons in...

  15. Family well-being in a participant-directed autism waiver program: the role of relational coordination.

    PubMed

    Warfield, M E; Chiri, G; Leutz, W N; Timberlake, M

    2014-12-01

    Massachusetts is one of a very limited number of states exclusively employing participant-direction to deliver autism waiver services to children. A crucial element of this waiver program is the work conducted by the state's Department of Developmental Services (DDS) staff and state-approved providers with waiver families to facilitate the implementation of the participant-direction model. Our study investigates the effect of the collaboration between state providers and family caregivers on family well-being. We conducted a survey of 74 families who have been utilising waiver services for at least 6 months. Participants were asked to rate the coordination with providers as well as to report on parenting stress and impact of waiver services on family functioning. Data from in-home child and family assessments conducted by the state were also abstracted from program records. After controlling for a host of variables hypothesised to affect the outcomes of interest, we found that the family's view of how well they coordinated with formal providers is significantly associated all of the outcomes. Families who reported greater coordination with state providers experienced lower parenting stress and reported a more positive impact on family functioning. Child externalising behavioural problems and caregiver's health rating also contributed to parenting stress and family functioning. Our findings highlight the importance of establishing a collaborative partnership with waiver families in promoting family well-being. These results suggest that training and/or resources that foster team building and communication can positively impact family functioning among families with young children with autism. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  16. 42 CFR 418.110 - Condition of participation: Hospices that provide inpatient care directly.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... direct patient care. (c) Standard: Physical environment. The hospice must maintain a safe physical environment free of hazards for patients, staff, and visitors. (1) Safety management. (i) The hospice must...: Organizational Environment § 418.110 Condition of participation: Hospices that provide inpatient care directly. A...

  17. Eliciting Provider and Patient Perspectives on New Obesity Management Services in a Team-Based Primary Care Organization.

    PubMed

    Royall, Dawna; Brauer, Paula; Atta-Konadu, Edwoba; Dwyer, John J M; Edwards, A Michelle; Hussey, Tracy; Kates, Nick

    2017-09-01

    Both providers and patients may have important insights to inform the development of obesity prevention and management services in Canadian primary care settings. In this formative study, insights for new obesity management services were sought from both providers and patients in 1 progressive citywide organization (150 physicians, team services, separate offices). Seven focus groups with interprofessional health providers (n = 56) and 4 focus groups with patients (n = 34) were conducted. Two clinical vignettes (adult, child) were used to focus discussion. Four analysts coded for descriptive content and interpretative themes on possible tools and care processes using NVivo. Participants identified numerous strategies for care processes, most of which could be categorized into 1 or more of 11 themes: 6 directed at clinical care of patients (raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support) and 5 directed at the organization (coordination/collaboration, creating awareness among health professionals, adding new expertise to the team, marketing, and lobbying/advocacy). The approach was successful in generating an extensive list of diverse activities to be considered for implementation studies. Both patients and providers identified that multiple strategies and systems approaches will be needed to address obesity management in primary care.

  18. INDIVIDUALIZING UNIVERSITY INSTRUCTION, EXPLORING COMPUTER POTENTIAL TO AID COLLEGE TEACHERS BY DIRECTING THE LEARNING PROCESS. INTER-UNIVERSITY PROJECT ONE, PUBLICATIONS SERIES.

    ERIC Educational Resources Information Center

    FALL, CHARLES R.

    THIS DOCUMENT CONCLUDES THAT INSTRUCTION BY COMPUTER-BASED RESOURCE UNITS CAN FACILITATE LEARNING AND PROVIDE THE INSTRUCTOR WITH VALUABLE ASSISTANCE. BY PRE-PLANNING THE TEACHING-LEARNING SITUATION, RESOURCE UNITS CAN FREE THE INSTRUCTOR FOR DECISION-MAKING TASKS. RESOURCE UNITS CAN ALSO PROVIDE APPROPRIATE LEARNING GOALS AND STUDY GUIDES TO EACH…

  19. [New views about the skin].

    PubMed

    Guimberteau, J-C; Delage, J-P; Wong, J

    2010-08-01

    As the follow up article to "Introduction to the knowledge of subcutaneous sliding system in humans" published in the "Annales de chirurgie plastique" we further investigate the architecture of the skin and comment on the subcutaneous multifibrillar and microvacuolar arrangements that provide form, mobility, adaptability and resistance to force of gravity. The study aimed to highlight the direct link between the skin and subcutaneous environment in dynamic living tissue. Through high resolution endoscopic observations made during live surgery it is revealed how microvacuoles and microspaces can provide dynamic structure and form during movement between the epidermis, dermis and hypodermis. The study reveals intriguing morphodynamics which are necessary to maintain mobility and continuity to neighboring tissues. The polyhedric design of the skin surface directly relates to multifibrillar pillars beneath the skin which dictate their patterning and movement. The concept of tissue continuity is realised by the chaotic and fractal organisation of multifibrils interlaced with cellular components which characteristics alter depending on the state of hydration. Understanding the integral arrangement that provides continuity of all the structures below the skin provides an appreciation to how skin behaves in relation to movement of the rest of the body. 2009. Published by Elsevier SAS.

  20. Short wavelength ion waves upstream of the earth's bow shock

    NASA Technical Reports Server (NTRS)

    Fuselier, S. A.; Gurnett, D. A.

    1984-01-01

    The identification and explanation of short wavelength antenna interference effects observed in spacecraft plasma wave data have provided an important new method of determining limits on the wavelength, direction of propagation, and Doppler shift of short wavelength electrostatic waves. Using the ISEE-1 wideband electric field data, antenna interference effects have been identified in the ion waves upstream of the earth's bow shock. This identification implies that wavelengths of the upstream ion waves are shorter than the antenna length. The interference effects also provide new measurements of the direction of propagation of the ion waves. The new measurements show that the wave vectors of the ion waves are not parallel to the interplanetary magnetic field (IMF) as previously reported. The direction of propagation does not appear to be controlled by the IMF. In addition, analysis of the Doppler shift of the short wavelength ion waves has provided a measurement of the dispersion relation. The upper limit of the rest frame frequency was found to be on the order of the ion plasma frequency. At this frequency, the wavelength is on the order of a few times the Debye length. The results of this study now provide strong evidence that the ion waves in the upstream region are Doppler-shifted ion acoustic waves. Previously announced in STAR as N83-36328

  1. A case study of assigning conservation value to dispersed habitat units for conservation planning

    USGS Publications Warehouse

    Rohweder, Jason J.; Sara C. Vacek,; Crimmins, Shawn M.; Thogmartin, Wayne E.

    2015-01-01

    Resource managers are increasingly tasked with developing habitat conservation plans in the face of numerous, sometimes competing, objectives. These plans must often be implemented across dispersed habitat conservation units that may contribute unequally to overall conservation objectives. Using U.S. Fish and Wildlife Service waterfowl production areas (WPA) in western Minnesota as our conservation landscape, we develop a landscape-scale approach for evaluating the conservation value of dispersed habitat conservation units with multiple conservation priorities. We evaluated conservation value based on a suite of variables directly applicable to conservation management practices, thus providing a direct link between conservation actions and outcomes. We developed spatial models specific to each of these conservation objectives and also developed two freely available prioritization tools to implement these analyses. We found that some WPAs provided high conservation value across a range of conservation objectives, suggesting that managing these specific areas would achieve multiple conservation goals. Conversely, other WPAs provided low conservation value for some objectives, suggesting they would be most effectively managed for a distinct set of specific conservation goals. Approaches such as ours provide a direct means of assessing the conservation value of dispersed habitat conservation units and could be useful in the development of habitat management plans, particularly when faced with multiple conservation objectives.

  2. Continuous Particulate Filter State of Health Monitoring Using Radio Frequency Sensing

    DOE PAGES

    Sappok, Alexander; Ragaller, Paul; Herman, Andrew; ...

    2018-04-03

    Reliable means for on-board detection of particulate filter failures or malfunctions are needed to meet diagnostics (OBD) requirements. Detecting these failures, which result in tailpipe particulate matter (PM) emissions exceeding the OBD limit, over all operating conditions is challenging. Current approaches employ differential pressure sensors and downstream PM sensors, in combination with particulate filter and engine-out soot models. These conventional monitors typically operate over narrowly-defined time windows and do not provide a direct measure of the filter’s state of health. In contrast, radio frequency (RF) sensors, which transmit a wireless signal through the filter substrate provide a direct means formore » interrogating the condition of the filter itself. Here, this study investigated the use of RF sensors for the continuous measurement of filter trapping efficiency, which was compared to downstream measurements with an AVL Microsoot Sensor, and a PM sampling probe simulating the geometry and installation configuration of a conventional PM sensor. The study included several particulate filter failure modes, both above and below the OBD threshold. Finally, the results confirmed the use of RF sensors to provide a direct and continuous measure of the particulate filter’s state of health over a range of typical in-use operating conditions, thereby significantly increasing the time window over which filter failures may be detected.« less

  3. Continuous Particulate Filter State of Health Monitoring Using Radio Frequency Sensing

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

    Sappok, Alexander; Ragaller, Paul; Herman, Andrew

    Reliable means for on-board detection of particulate filter failures or malfunctions are needed to meet diagnostics (OBD) requirements. Detecting these failures, which result in tailpipe particulate matter (PM) emissions exceeding the OBD limit, over all operating conditions is challenging. Current approaches employ differential pressure sensors and downstream PM sensors, in combination with particulate filter and engine-out soot models. These conventional monitors typically operate over narrowly-defined time windows and do not provide a direct measure of the filter’s state of health. In contrast, radio frequency (RF) sensors, which transmit a wireless signal through the filter substrate provide a direct means formore » interrogating the condition of the filter itself. Here, this study investigated the use of RF sensors for the continuous measurement of filter trapping efficiency, which was compared to downstream measurements with an AVL Microsoot Sensor, and a PM sampling probe simulating the geometry and installation configuration of a conventional PM sensor. The study included several particulate filter failure modes, both above and below the OBD threshold. Finally, the results confirmed the use of RF sensors to provide a direct and continuous measure of the particulate filter’s state of health over a range of typical in-use operating conditions, thereby significantly increasing the time window over which filter failures may be detected.« less

  4. Directive and nondirective social support in the workplace – is this social support distinction important for subjective health complaints, job satisfaction, and perception of job demands and job control?

    PubMed Central

    Johnsen, Tone Langjordet; Eriksen, Hege Randi; Indahl, Aage; Tveito, Torill Helene

    2017-01-01

    Aims: Social support is associated with well-being and positive health outcomes. However, positive outcomes of social support might be more dependent on the way support is provided than the amount of support received. A distinction can be made between directive social support, where the provider resumes responsibility, and nondirective social support, where the receiver has the control. This study examined the relationship between directive and nondirective social support, and subjective health complaints, job satisfaction and perception of job demands and job control. Methods: A survey was conducted among 957 Norwegian employees, working in 114 private kindergartens (mean age 40.7 years, SD = 10.5, 92.8% female), as part of a randomized controlled trial. This study used only baseline data. A factor analysis of the Norwegian version of the Social Support Inventory was conducted, identifying two factors: nondirective and directive social support. Hierarchical regression analyses were then performed. Results: Nondirective social support was related to fewer musculoskeletal and pseudoneurological complaints, higher job satisfaction, and the perception of lower job demands and higher job control. Directive social support had the opposite relationship, but was not statistically significant for pseudoneurological complaints. Conclusions: It appears that for social support to be positively related with job characteristics and subjective health complaints, it has to be nondirective. Directive social support was not only without any association, but had a significant negative relationship with several of the variables. Nondirective social support may be an important factor to consider when aiming to improve the psychosocial work environment. Trial registration: Clinicaltrials.gov: NCT02396797. Registered 23 March 2015. PMID:28820017

  5. Directive and nondirective social support in the workplace - is this social support distinction important for subjective health complaints, job satisfaction, and perception of job demands and job control?

    PubMed

    Johnsen, Tone Langjordet; Eriksen, Hege Randi; Indahl, Aage; Tveito, Torill Helene

    2018-05-01

    Social support is associated with well-being and positive health outcomes. However, positive outcomes of social support might be more dependent on the way support is provided than the amount of support received. A distinction can be made between directive social support, where the provider resumes responsibility, and nondirective social support, where the receiver has the control. This study examined the relationship between directive and nondirective social support, and subjective health complaints, job satisfaction and perception of job demands and job control. A survey was conducted among 957 Norwegian employees, working in 114 private kindergartens (mean age 40.7 years, SD = 10.5, 92.8% female), as part of a randomized controlled trial. This study used only baseline data. A factor analysis of the Norwegian version of the Social Support Inventory was conducted, identifying two factors: nondirective and directive social support. Hierarchical regression analyses were then performed. Nondirective social support was related to fewer musculoskeletal and pseudoneurological complaints, higher job satisfaction, and the perception of lower job demands and higher job control. Directive social support had the opposite relationship, but was not statistically significant for pseudoneurological complaints. It appears that for social support to be positively related with job characteristics and subjective health complaints, it has to be nondirective. Directive social support was not only without any association, but had a significant negative relationship with several of the variables. Nondirective social support may be an important factor to consider when aiming to improve the psychosocial work environment. Clinicaltrials.gov: NCT02396797. Registered 23 March 2015.

  6. First-principles study of direct and indirect optical absorption in BaSnO3

    NASA Astrophysics Data System (ADS)

    Kang, Youngho; Peelaers, Hartwin; Krishnaswamy, Karthik; Van de Walle, Chris G.

    2018-02-01

    We report first-principles results for the electronic structure and the optical absorption of perovskite BaSnO3 (BSO). BSO has an indirect fundamental gap, and hence, both direct and indirect transitions need to be examined. We assess direct absorption by calculations of the dipole matrix elements. The phonon-assisted indirect absorption spectrum at room temperature is calculated using a quasiclassical approach. Our analysis provides important insights into the optical properties of BSO and addresses several inconsistencies in the results of optical absorption experiments. We shed light on the variety of bandgap values that have been previously reported, concluding that the indirect gap is 2.98 eV and the direct gap is 3.46 eV.

  7. Outdoor Activities for Environmental Studies.

    ERIC Educational Resources Information Center

    Knapp, Clifford E.

    This booklet is a compilation of field-tested outdoor activities introducing basic projects for small group or individualized study in monitoring certain aspects of the environment. Its purpose is to provide teachers with new ways to involve children directly in meaningful and developmental learning activities and to help students become more…

  8. The Transcultural Study Guide. Second Edition.

    ERIC Educational Resources Information Center

    Darrow, Kenneth, Ed.; Palmquist, Bradley, Ed.

    This guide contains practical questions designed to facilitate inquiry into any country or culture. A small group called Volunteers in Asia, which provides volunteer work and study opportunities in Asia, wrote the guide because they believe that direct observation and participation, when complemented by systematic inquiry, can lead to a clearer…

  9. Linking Mechanisms of Work-Family Conflict and Segmentation

    ERIC Educational Resources Information Center

    Michel, Jesse S.; Hargis, Michael B.

    2008-01-01

    Despite the abundance of work and family research, few studies have compared the linking mechanisms specified in theoretical models of work-family conflict and segmentation. Accordingly, the current study provides a greater degree of empirical clarity concerning the interplay of work and family by directly examining the indirect effects of…

  10. Observations of bi-directional leader development in a triggered lightning flash

    NASA Technical Reports Server (NTRS)

    Laroche, P.; Idone, V.; Eybert-Berard, A.; Barret, L.

    1991-01-01

    Observations of a modified form of rocket triggered lightning are described. A flash triggered during the summer of 1989 is studied as part of an effort to model bidirectional discharge. It is suggested that the altitude triggering technique provides a realistic means of studying the attachment process.

  11. Motivations, Sacrifices, and Challenges: Black Parents' Decisions to Home School

    ERIC Educational Resources Information Center

    Fields-Smith, Cheryl; Williams, Meca

    2009-01-01

    This study examines home schooling among Black parents by providing insight to Black families' beliefs, concerns, and desires for their children's education. To date, the literature remains void of empirical work related to home education among African American families. However, the present study directly addresses this void. Findings…

  12. A Systematic Review of Strategies for Implementing Empirically Supported Mental Health Interventions

    ERIC Educational Resources Information Center

    Powell, Byron J.; Proctor, Enola K.; Glass, Joseph E.

    2014-01-01

    Objective: This systematic review examines experimental studies that test the effectiveness of strategies intended to integrate empirically supported mental health interventions into routine care settings. Our goal was to characterize the state of the literature and to provide direction for future implementation studies. Method: A literature…

  13. Morphological Priming by Itself: A Study of Portuguese Conjugations

    ERIC Educational Resources Information Center

    Verissimo, Joao; Clahsen, Harald

    2009-01-01

    Does the language processing system make use of abstract grammatical categories and representations that are not directly visible from the surface form of a linguistic expression? This study examines stem-formation processes and conjugation classes, a case of "pure" morphology that provides insight into the role of grammatical structure in…

  14. A Case Study of Servant Leadership in the NHL

    ERIC Educational Resources Information Center

    Crippen, Carolyn

    2017-01-01

    An examination of the organizational culture of the Vancouver Canucks of the NHL provides exemplars for all learning institutions. A culture connected directly to a servant-leader philosophy was identified through a cumulative qualitative case study of key personnel within the organization. Data included transcribed interviews, archival research,…

  15. Expanding Cooperative Extension's Audience: Establishing a Relationship with Cowboy Church Members

    ERIC Educational Resources Information Center

    Williams, Katy; Strong, Robert; Lockett, Landry

    2013-01-01

    The study reported here provided a descriptive report on cowboy churches, while identifying the potential for Extension-cowboy church collaborations and examining the direct implications to Extension. The diffusion of innovations conceptualized the qualitative study. Semi-structured, face-to-face and phone interviews were conducted with 10 adults…

  16. Treatment of Narcolepsy and other Hypersomnias of Central Origin

    PubMed Central

    Wise, Merrill S.; Arand, Donna L.; Auger, R. Robert; Brooks, Stephen N.; Watson, Nathaniel F.

    2007-01-01

    Objective: The purpose of this paper is to summarize current knowledge about treatment of narcolepsy and other hypersomnias of central origin. Methods: The task force performed a systematic and comprehensive review of the relevant literature and graded the evidence using the Oxford grading system. This paper discusses the strengths and limitations of the available evidence regarding treatment of these conditions, and summarizes key information about safety of these medications. Our findings provide the foundation for development of evidence-based practice parameters on this topic by the Standards of Practice Committee of the American Academy of Sleep Medicine. Results: The majority of recent papers in this field provide information about use of modafinil or sodium oxybate for treatment of sleepiness associated with narcolepsy. Several large randomized, placebo-controlled studies indicate that modafinil and sodium oxybate are effective for treatment of hypersomnia due to narcolepsy. We identified no studies that report direct comparison of these newer medications versus traditional stimulants, or that indicate what proportion of patients treated initially with these medications require transition to traditional stimulants or to combination therapy to achieve adequate alertness. As with the traditional stimulants, modafinil and sodium oxybate provide, at best, only moderate improvement in alertness rather than full restoration of alertness in patients with narcolepsy. Several large randomized placebo-controlled studies demonstrate that sodium oxybate is effective for treatment of cataplexy associated with narcolepsy, and earlier studies provide limited data to support the effectiveness of fluoxetine and tricyclic antidepressants for treatment of cataplexy. Our findings indicate that very few reports provide information regarding treatment of special populations such as children, older adults, and pregnant or breastfeeding women. The available literature provides a modest amount of information about improvement in quality of life in association with treatment, patient preferences among the different medications, or patient compliance. Conclusion: Several recent studies provide evidence that modafinil and sodium oxybate are effective for treatment of hypersomnia due to narcolepsy. No studies were identified that report direct comparison of these newer medications with traditional stimulants. Despite significant advances in understanding the pathophysiology of narcolepsy, we do not have an ideal treatment to restore full and sustained alertness. Future investigations should be directed toward development of more effective and better tolerated therapies, and primary prevention. Citation: Wise MS; Arand DL; Auger RR; Brooks SN; Watson NF. Treatment of Narcolepsy and other Hypersomnias of Central Origin. SLEEP 2007;30(12):1712-1727. PMID:18246981

  17. Direct volume estimation without segmentation

    NASA Astrophysics Data System (ADS)

    Zhen, X.; Wang, Z.; Islam, A.; Bhaduri, M.; Chan, I.; Li, S.

    2015-03-01

    Volume estimation plays an important role in clinical diagnosis. For example, cardiac ventricular volumes including left ventricle (LV) and right ventricle (RV) are important clinical indicators of cardiac functions. Accurate and automatic estimation of the ventricular volumes is essential to the assessment of cardiac functions and diagnosis of heart diseases. Conventional methods are dependent on an intermediate segmentation step which is obtained either manually or automatically. However, manual segmentation is extremely time-consuming, subjective and highly non-reproducible; automatic segmentation is still challenging, computationally expensive, and completely unsolved for the RV. Towards accurate and efficient direct volume estimation, our group has been researching on learning based methods without segmentation by leveraging state-of-the-art machine learning techniques. Our direct estimation methods remove the accessional step of segmentation and can naturally deal with various volume estimation tasks. Moreover, they are extremely flexible to be used for volume estimation of either joint bi-ventricles (LV and RV) or individual LV/RV. We comparatively study the performance of direct methods on cardiac ventricular volume estimation by comparing with segmentation based methods. Experimental results show that direct estimation methods provide more accurate estimation of cardiac ventricular volumes than segmentation based methods. This indicates that direct estimation methods not only provide a convenient and mature clinical tool for cardiac volume estimation but also enables diagnosis of cardiac diseases to be conducted in a more efficient and reliable way.

  18. Treatment of intrahepatic congenital portosystemic shunts in dogs: a systematic review.

    PubMed

    Tivers, M S; Lipscomb, V J; Brockman, D J

    2017-09-01

    The aim of this study was to establish the evidence base for the treatment of intrahepatic congenital portosystemic shunts in dogs through a systematic review of the pertinent literature. Studies were filtered for evidence to answer the question "Which of the treatment options for intrahepatic CPSS in dogs offers the best short- and long-term outcome?" Studies were assigned a level of evidence based on a system published by the Oxford Centre for Evidence-Based Medicine. Thirty-two studies were included in the review. Twenty-six provided level 4 evidence and six provided level 5 evidence. There were no level 1, 2 or 3 studies. One study compared surgical treatment with medical management and one study compared suture ligation with ameroid constrictor placement. The remaining studies were case series describing the outcome for one treatment method alone. Methods and timings of assessments of short- and long-term outcomes were highly varied, making direct comparisons challenging. The evidence regarding the treatment of intrahepatic congenital portosystemic shunts in dogs is weak, with only two studies directly comparing treatments. There is a lack of evidence regarding short- and long-term outcomes on which to base clinical decisions. © 2017 British Small Animal Veterinary Association.

  19. Comparison of Diffusion MRI Acquisition Protocols for the In Vivo Characterization of the Mouse Spinal Cord: Variability Analysis and Application to an Amyotrophic Lateral Sclerosis Model

    PubMed Central

    Marcuzzo, Stefania; Bonanno, Silvia; Padelli, Francesco; Moreno-Manzano, Victoria; García-Verdugo, José Manuel; Bernasconi, Pia; Mantegazza, Renato; Bruzzone, Maria Grazia; Zucca, Ileana

    2016-01-01

    Diffusion-weighted Magnetic Resonance Imaging (dMRI) has relevant applications in the microstructural characterization of the spinal cord, especially in neurodegenerative diseases. Animal models have a pivotal role in the study of such diseases; however, in vivo spinal dMRI of small animals entails additional challenges that require a systematical investigation of acquisition parameters. The purpose of this study is to compare three acquisition protocols and identify the scanning parameters allowing a robust estimation of the main diffusion quantities and a good sensitivity to neurodegeneration in the mouse spinal cord. For all the protocols, the signal-to-noise and contrast-to noise ratios and the mean value and variability of Diffusion Tensor metrics were evaluated in healthy controls. For the estimation of fractional anisotropy less variability was provided by protocols with more diffusion directions, for the estimation of mean, axial and radial diffusivity by protocols with fewer diffusion directions and higher diffusion weighting. Intermediate features (12 directions, b = 1200 s/mm2) provided the overall minimum inter- and intra-subject variability in most cases. In order to test the diagnostic sensitivity of the protocols, 7 G93A-SOD1 mice (model of amyotrophic lateral sclerosis) at 10 and 17 weeks of age were scanned and the derived diffusion parameters compared with those estimated in age-matched healthy animals. The protocols with an intermediate or high number of diffusion directions provided the best differentiation between the two groups at week 17, whereas only few local significant differences were highlighted at week 10. According to our results, a dMRI protocol with an intermediate number of diffusion gradient directions and a relatively high diffusion weighting is optimal for spinal cord imaging. Further work is needed to confirm these results and for a finer tuning of acquisition parameters. Nevertheless, our findings could be important for the optimization of acquisition protocols for preclinical and clinical dMRI studies on the spinal cord. PMID:27560686

  20. Field study suggests that sex determination in sea lamprey is directly influenced by larval growth rate.

    PubMed

    Johnson, Nicholas S; Swink, William D; Brenden, Travis O

    2017-03-29

    Sex determination mechanisms in fishes lie along a genetic-environmental continuum and thereby offer opportunities to understand how physiology and environment interact to determine sex. Mechanisms and ecological consequences of sex determination in fishes are primarily garnered from teleosts, with little investigation into basal fishes. We tagged and released larval sea lamprey ( Petromyzon marinus ) into unproductive lake and productive stream environments. Sex ratios produced from these environments were quantified by recapturing tagged individuals as adults. Sex ratios from unproductive and productive environments were initially similar. However, sex ratios soon diverged, with unproductive environments becoming increasingly male-skewed and productive environments becoming less male-skewed with time. We hypothesize that slower growth in unproductive environments contributed to the sex ratio differences by directly influencing sex determination. To the best of our knowledge, this is the first study suggesting that growth rate in a fish species directly influences sex determination; other studies have suggested that the environmental variables to which sex determination is sensitive (e.g. density, temperature) act as cues for favourable or unfavourable growth conditions. Understanding mechanisms of sex determination in lampreys may provide unique insight into the underlying principles of sex determination in other vertebrates and provide innovative approaches for their management where valued and invasive. © 2017 The Author(s).

  1. Field study suggests that sex determination in sea lamprey is directly influenced by larval growth rate

    USGS Publications Warehouse

    Johnson, Nicholas; Swink, William D.; Brenden, Travis O.

    2017-01-01

    Sex determination mechanisms in fishes lie along a genetic-environmental continuum and thereby offer opportunities to understand how physiology and environment interact to determine sex. Mechanisms and ecological consequences of sex determination in fishes are primarily garnered from teleosts, with little investigation into basal fishes. We tagged and released larval sea lamprey (Petromyzon marinus) into unproductive lake and productive stream environments. Sex ratios produced from these environments were quantified by recapturing tagged individuals as adults. Sex ratios from unproductive and productive environments were initially similar. However, sex ratios soon diverged, with unproductive environments becoming increasingly male-skewed and productive environments becoming less male-skewed with time. We hypothesize that slower growth in unproductive environments contributed to the sex ratio differences by directly influencing sex determination. To the best of our knowledge, this is the first study suggesting that growth rate in a fish species directly influences sex determination; other studies have suggested that the environmental variables to which sex determination is sensitive (e.g. density, temperature) act as cues for favourable or unfavourable growth conditions. Understanding mechanisms of sex determination in lampreys may provide unique insight into the underlying principles of sex determination in other vertebrates and provide innovative approaches for their management where valued and invasive.

  2. Laboratory studies in ultraviolet solar physics

    NASA Technical Reports Server (NTRS)

    Parkinson, W. H.; Kohl, J. L.; Gardner, L. D.; Raymond, J. C.; Smith, P. L.

    1991-01-01

    The research activity comprised the measurement of basic atomic processes and parameters which relate directly to the interpretation of solar ultraviolet observations and to the development of comprehensive models of the component structures of the solar atmosphere. The research was specifically directed towards providing the relevant atomic data needed to perform and to improve solar diagnostic techniques which probe active and quiet portions of the solar chromosphere, the transition zone, the inner corona, and the solar wind acceleration regions of the extended corona. The accuracy with which the physical conditions in these structures can be determined depends directly on the accuracy and completeness of the atomic and molecular data. These laboratory data are used to support the analysis programs of past and current solar observations (e.g., the Orbiting solar Observatories, the Solar Maximum Mission, the Skylab Apollo Telescope Mount, and the Naval Research Laboratory's rocket-borne High Resolution Telescope and Spectrograph). In addition, we attempted to anticipate the needs of future space-borne solar studies such as from the joint ESA/NASA Solar and Heliospheric Observatory (SOHO) spacecraft. Our laboratory activities stressed two categories of study: (1) the measurement of absolute rate coefficients for dielectronic recombination and electron impact excitation; and (2) the measurement of atomic transition probabilities for solar density diagnostics. A brief summary of the research activity is provided.

  3. Economic valuation of landslide damage in hilly regions: a case study from Flanders, Belgium.

    PubMed

    Vranken, Liesbet; Van Turnhout, Pieter; Van Den Eeckhaut, Miet; Vandekerckhove, Liesbeth; Poesen, Jean

    2013-03-01

    Several regions around the globe are at risk of incurring damage from landslides, but only few studies have concentrated on a quantitative estimate of the overall damage caused by landslides at a regional scale. This study therefore starts with a quantitative economic assessment of the direct and indirect damage caused by landslides in a 2,910 km study area located west of Brussels, a low-relief region susceptible to landslides. Based on focus interviews as well as on semi-structured interviews with homeowners, civil servants and the owners and providers of lifelines such as electricity and sewage, a quantitative damage assessment is provided. For private properties (houses, forest and pasture land) we estimate the real estate and production value losses for different damage scenarios, while for public infrastructure the costs of measures to repair and prevent landslide induced damage are estimated. In addition, the increase in amenity value of forests and grasslands due to the occurrence of landslides is also calculated. The study illustrates that a minority of land (only 2.3%) within the study area is used for dwellings, roads and railway lines, but that these land use types are responsible for the vast majority of the economic damage due to the occurrence of landslides. The annual cost of direct damage due to landsliding amounts to 688,148 €/year out of which 550,740 €/year for direct damage to houses, while the annual indirect damage augments to 3,020,049 €/year out of which 2,007,375 €/year for indirect damage to real estate. Next, the study illustrates that the increase of the amenity value of forests and grasslands outweighs the production value loss. As such the study does not only provide quantitative input data for the estimation of future risks, but also important information for government officials as it clearly informs about the costs associated with certain land use types in landslide areas. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Land observation from geosynchronous earth orbit (LOGEO): Mission concept and preliminary engineering analysis

    NASA Astrophysics Data System (ADS)

    Román-Colón, Miguel O.; Strahler, Alan H.

    2007-06-01

    We propose an Earth-observation mission Land Observation from Geosynchronous Earth Orbit (LOGEO) to place two spin-scan-stabilized 500-m resolution 9-band VNIR-SWIR imagers in a near-geosynchronous inclined orbit, allowing 15 min observations with a full range of daily sun angles and 30∘ variations in view angle. LOGEO drifts westward at about 4∘ per day, providing geostationary-style coverage for all points on the globe eight times per year. This unique imaging geometry allows accurate retrievals of daily changes in surface bidirectional reflectance, which in turn enhances direct retrieval of biophysical properties, as well as long term and consistent land surface parameters for modeling studies that seek to understand the Earth system and its interactions. For studies of climate and environmental dynamics, LOGEO provides accurate observations of atmospheric aerosols, clouds, as well as other atmospheric constituents across a diverse number of spatial and temporal scales. This collection of land, atmospheric, and climate data products are directly applicable to seven of the nine GEOSS societal benefits areas, providing great opportunities for international collaboration. We also present an overview of LOGEO's systems architecture, as well as top-level design-trade studies and orbital scenarios.

  5. 'Nurses don't deal with these issues': nurses' role in advance care planning for lesbian, gay, bisexual and transgender patients.

    PubMed

    Carabez, Rebecca; Scott, Megan

    2016-12-01

    We used a question from the Healthcare Equality Index to explore nurses' knowledge and understanding of medical advance directives, medical power of attorney and other legal documents for lesbian, gay, bisexual and transgender patients. Until the landmark ruling in Obergefell vs. Hodges, lesbian, gay, bisexual and transgender individuals and same-sex couples have had limited relationship rights as only a few states recognised marriages and provided legal protections for same-sex couples. Health care providers' knowledge of and attitudes towards advance care planning plays a significant role in determining whether or not individuals successfully complete advance directives, yet advance care planning for lesbian, gay, bisexual and transgender individuals is poorly understood among both health care providers and same-sex couples. These data were part of a larger research study that explored the current state of lesbian, gay, bisexual and transgender-sensitive nursing practice. Undergraduate nursing students recruited and interviewed nurse key informants (n = 268) about medical advance directives, medical power of attorney and other legal documents for lesbian, gay, bisexual and transgender patients. Nearly 50% of key informants indicated a lack of knowledge of advance directives, over 26% reported the difficulties nurses face regarding advance directives are the same for both lesbian, gay, bisexual and transgender and heterosexual patients, and nearly 25% indicated difficulties including having to decide who has the legal right to make decisions for the patient. The study demonstrated the need for education and training for practising nurses in advance care planning for lesbian, gay, bisexual and transgender patients and same-sex couples. Nurses are in a position to act as educators, advocates and decision makers for their patients. Nurse's lack of understanding of advance care planning may negatively impact the type and quality of care lesbian, gay, bisexual and transgender patients receive. © 2016 John Wiley & Sons Ltd.

  6. Chemical Analysis through CL-Detection Assisted by Periodate Oxidation

    PubMed Central

    Evmiridis, Nicholaos P.; Vlessidis, Athanasios G.; Thanasoulias, Nicholas C.

    2007-01-01

    The progress of the research work of the author and his colleagues on the field of CL-emission generated by pyrogallol oxidation and further application for the direct determination of periodate and indirect or direct determination of other compounds through flow-injection manifold/CL-detection set up is described. The instrumentation used for these studies was a simple flow-injection manifold that provides good reproducibility, coupled to a red sensitive photomultiplier that gives sensitive CL-detection. In addition, recent reports on studies and analytical methods based on CL-emission generated by periodate oxidation by other authors are included. PMID:17611611

  7. Year 2015 transportation plan : Huntsville Area Transportation Study

    DOT National Transportation Integrated Search

    1995-04-01

    The Year 2015 Transportation Plan is an intermodal plan that considers all modes of the existing transportation system, identifies needs, provides policy direction and defines the goals for planning and : project development in the Huntsville urban a...

  8. Remote sensing tools to study ocean biogeochemistry: state of the art

    NASA Technical Reports Server (NTRS)

    Carr, M. E.

    2001-01-01

    Remote sensing of the world ocean presently provides measurements of sea-surface temperature, sea surface height, wind speed and direction, and ocean color, from which chlorophyll concentration and aerosol optical thickness are obtained.

  9. A comparison of direct and indirect analytical approaches to measuring total nicotine equivalents in urine.

    PubMed

    Taghavi, Taraneh; Novalen, Maria; Lerman, Caryn; George, Tony P; Tyndale, Rachel F

    2018-05-31

    Total nicotine equivalents (TNE), the sum of nicotine and metabolites in urine, is a valuable tool for evaluating nicotine exposure. Most methods for measuring TNE involve two-step enzymatic hydrolysis for indirect quantification of glucuronide metabolites. Here, we describe a rapid, low-cost direct liquid chromatography - tandem mass spectrometry (LCMS) assay. In 139 smokers' urine samples, Bland-Altman, correlation, and regression analyses were used to investigate differences in quantification of nicotine and metabolites, TNE, and nicotine metabolite ratio (NMR) between direct and indirect LCMS methods. DNA from a subset (n=97 smokers) was genotyped for UGT2B10*2 and UGT2B17*2 and the known impact of these variants was evaluated using urinary ratios determined by the direct versus indirect method. The direct method showed high accuracy (0-9% bias) and precision (3-14% coefficient of variation) with similar distribution of nicotine metabolites to literary estimates and good agreement between the direct and indirect methods for nicotine, cotinine, and 3-hydroxycotinine (ratios 0.99-1.07), but less agreement for their respective glucuronides (ratios 1.16-4.17). The direct method identified urinary 3HC+3HC-GLUC/COT as having the highest concordance with plasma NMR and provided substantially better estimations of the established genetic impact of glucuronidation variants compared to the indirect method. Direct quantification of nicotine and metabolites is less time-consuming and less costly, and provides accurate estimates of nicotine intake, metabolism rate and the impact of genetic variation in smokers. Lower cost and maintenance combined with high accuracy and reproducibility make the direct method ideal for smoking biomarker, NMR and pharmacogenomics studies. Copyright ©2018, American Association for Cancer Research.

  10. Negative Capacitance in BaTiO3/BiFeO3 Bilayer Capacitors.

    PubMed

    Hou, Ya-Fei; Li, Wei-Li; Zhang, Tian-Dong; Yu, Yang; Han, Ren-Lu; Fei, Wei-Dong

    2016-08-31

    Negative capacitances provide an approach to reduce heat generations in field-effect transistors during the switch processes, which contributes to further miniaturization of the conventional integrated circuits. Although there are many studies about negative capacitances using ferroelectric materials, the direct observation of stable ferroelectric negative capacitances has rarely been reported. Here, we put forward a dc bias assistant model in bilayer capacitors, where one ferroelectric layer with large dielectric constant and the other ferroelectric layer with small dielectric constant are needed. Negative capacitances can be obtained when external dc bias electric fields are larger than a critical value. Based on the model, BaTiO3/BiFeO3 bilayer capacitors are chosen as study objects, and negative capacitances are observed directly. Additionally, the upward self-polarization effect in the ferroelectric layer reduces the critical electric field, which may provide a method for realizing zero and/or small dc bias assistant negative capacitances.

  11. Aqueous injection of quercetin: An approach for confirmation of its direct in vivo cardiovascular effects.

    PubMed

    Porcu, Elena Piera; Cossu, Massimo; Rassu, Giovanna; Giunchedi, Paolo; Cerri, Guido; Pourová, Jana; Najmanová, Iveta; Migkos, Thomas; Pilařová, Veronika; Nováková, Lucie; Mladěnka, Přemysl; Gavini, Elisabetta

    2018-04-25

    Potential positive effects of flavonol quercetin on humans were suggested by many studies. However, it is not clear if these effects are mediated by quercetin or its metabolites. The in vivo confirmation of quercetin effects is largely hindered by its low water solubility and thus impossibility to test directly its impact. Therefore, a solid dispersion of quercetin with polyvinylpyrrolidone (PVP) was developed to prepare an injectable formulation of water-soluble quercetin. The optimized formulation provided a 20,000-fold increase in quercetin solubility. This formulation was tested on conventional and spontaneously hypertensive rats; it lowered their blood pressure in both short- and long-term basis. Pharmacokinetic data are also provided. This study reports for the first time an injectable water-soluble formulation of quercetin suitable for confirmation of its vascular effect in vivo. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. A Comparison of the Effects of Direct Modeling and Video Modeling Provided by Peers to Students with Autism Who Are Attending in Rural Play Teaching in an Inclusive Setting

    ERIC Educational Resources Information Center

    Odluyurt, Serhat

    2013-01-01

    In the present research, the peers of children with autism at primary school level and in an inclusive environment were taught using direct modeling and video modeling education processes, and it was observed whether or not they could effectively and efficiently teach how to play games to their friends with autism. This study used adapted…

  13. Parametric models of reflectance spectra for dyed fabrics

    NASA Astrophysics Data System (ADS)

    Aiken, Daniel C.; Ramsey, Scott; Mayo, Troy; Lambrakos, Samuel G.; Peak, Joseph

    2016-05-01

    This study examines parametric modeling of NIR reflectivity spectra for dyed fabrics, which provides for both their inverse and direct modeling. The dye considered for prototype analysis is triarylamine dye. The fabrics considered are camouflage textiles characterized by color variations. The results of this study provide validation of the constructed parametric models, within reasonable error tolerances for practical applications, including NIR spectral characteristics in camouflage textiles, for purposes of simulating NIR spectra corresponding to various dye concentrations in host fabrics, and potentially to mixtures of dyes.

  14. Application of advanced technology to space automation

    NASA Technical Reports Server (NTRS)

    Schappell, R. T.; Polhemus, J. T.; Lowrie, J. W.; Hughes, C. A.; Stephens, J. R.; Chang, C. Y.

    1979-01-01

    Automated operations in space provide the key to optimized mission design and data acquisition at minimum cost for the future. The results of this study strongly accentuate this statement and should provide further incentive for immediate development of specific automtion technology as defined herein. Essential automation technology requirements were identified for future programs. The study was undertaken to address the future role of automation in the space program, the potential benefits to be derived, and the technology efforts that should be directed toward obtaining these benefits.

  15. Power Mobility and Socialization in Preschool: Follow-up Case Study of a Child with Cerebral Palsy

    PubMed Central

    Ragonesi, Christina B.; Chen, Xi; Agrawal, Sunil; Galloway, James Cole

    2011-01-01

    Purpose Our previous study found it feasible for a preschooler with cerebral palsy (CP) to use a power mobility device in his classroom but noted a lack of typical socialization. The purpose of this follow-up study was to determine the feasibility of providing mobility and socialization training for this child. Methods Will, a 3-year-old with CP, one comparison peer, two preschool teachers, and two therapists were filmed daily during a training and post-training phase. Adult-directed training was provided in the classroom by therapists and teachers during the training phase. Mobility and socialization measures were coded from video. Outcomes During training, Will demonstrated higher socialization but less mobility than the comparison peer. Post training, Will socialized less but was more mobile, though less mobile than the comparison peer. Discussion Short-term, adult-directed power mobility and socialization training appears feasible for the preschool classroom. Important issues regarding socialization and power mobility are discussed. PMID:22090084

  16. The Non-Human Primate Experimental Glaucoma Model

    PubMed Central

    Burgoyne, Claude F.

    2015-01-01

    The purpose of this report is to summarize the current strengths and weaknesses of the non-human primate (NHP) experimental glaucoma (EG) model through sections devoted to its history, methods, important findings, alternative optic neuropathy models and future directions. NHP EG has become well established for studying human glaucoma in part because the NHP optic nerve head (ONH) shares a close anatomic association with the human ONH and because it provides the only means of systematically studying the very earliest visual system responses to chronic IOP elevation, i.e. the conversion from ocular hypertension to glaucomatous damage. However, NHPs are impractical for studies that require large animal numbers, demonstrate spontaneous glaucoma only rarely, do not currently provide a model of the neuropathy at normal levels of IOP, and cannot easily be genetically manipulated, except through tissue-specific, viral vectors. The goal of this summary is to direct NHP EG and non-NHP EG investigators to the previous, current and future accomplishment of clinically relevant knowledge in this model. PMID:26070984

  17. Gelatin-Based Laser Direct-Write Technique for the Precise Spatial Patterning of Cells

    PubMed Central

    Schiele, Nathan R.; Chrisey, Douglas B.

    2011-01-01

    Laser direct-writing provides a method to pattern living cells in vitro, to study various cell–cell interactions, and to build cellular constructs. However, the materials typically used may limit its long-term application. By utilizing gelatin coatings on the print ribbon and growth surface, we developed a new approach for laser cell printing that overcomes the limitations of Matrigel™. Gelatin is free of growth factors and extraneous matrix components that may interfere with cellular processes under investigation. Gelatin-based laser direct-write was able to successfully pattern human dermal fibroblasts with high post-transfer viability (91% ± 3%) and no observed double-strand DNA damage. As seen with atomic force microscopy, gelatin offers a unique benefit in that it is present temporarily to allow cell transfer, but melts and is removed with incubation to reveal the desired application-specific growth surface. This provides unobstructed cellular growth after printing. Monitoring cell location after transfer, we show that melting and removal of gelatin does not affect cellular placement; cells maintained registry within 5.6 ± 2.5 μm to the initial pattern. This study demonstrates the effectiveness of gelatin in laser direct-writing to create spatially precise cell patterns with the potential for applications in tissue engineering, stem cell, and cancer research. PMID:20849381

  18. Synchrotron Intensity Gradients as Tracers of Interstellar Magnetic Fields

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

    Lazarian, A.; Yuen, Ka Ho; Lee, Hyeseung

    On the basis of the modern understanding of MHD turbulence, we propose a new way of using synchrotron radiation: using synchrotron intensity gradients (SIGs) for tracing astrophysical magnetic fields. We successfully test the new technique using synthetic data obtained with 3D MHD simulations and provide the demonstration of the practical utility of the technique by comparing the directions of magnetic fields that are obtained with PLANCK synchrotron intensity data to the directions obtained with PLANCK synchrotron polarization data. We demonstrate that the SIGs can reliably trace magnetic fields in the presence of noise and can provide detailed maps of magneticmore » field directions. We also show that the SIGs are relatively robust for tracing magnetic fields while the low spatial frequencies of the synchrotron image are removed. This makes the SIGs applicable to the tracing of magnetic fields using interferometric data with single-dish measurement absent. We discuss the synergy of using the SIGs together with synchrotron polarization in order to find the actual direction of the magnetic fields and quantify the effects of Faraday rotation as well as with other ways of studying astrophysical magnetic fields. We test our method in the presence of noise and the resolution effects. We stress the complementary nature of the studies using the SIG technique and those employing the recently introduced velocity gradient techniques that trace magnetic fields using spectroscopic data.« less

  19. Synchrotron Intensity Gradients as Tracers of Interstellar Magnetic Fields

    NASA Astrophysics Data System (ADS)

    Lazarian, A.; Yuen, Ka Ho; Lee, Hyeseung; Cho, J.

    2017-06-01

    On the basis of the modern understanding of MHD turbulence, we propose a new way of using synchrotron radiation: using synchrotron intensity gradients (SIGs) for tracing astrophysical magnetic fields. We successfully test the new technique using synthetic data obtained with 3D MHD simulations and provide the demonstration of the practical utility of the technique by comparing the directions of magnetic fields that are obtained with PLANCK synchrotron intensity data to the directions obtained with PLANCK synchrotron polarization data. We demonstrate that the SIGs can reliably trace magnetic fields in the presence of noise and can provide detailed maps of magnetic field directions. We also show that the SIGs are relatively robust for tracing magnetic fields while the low spatial frequencies of the synchrotron image are removed. This makes the SIGs applicable to the tracing of magnetic fields using interferometric data with single-dish measurement absent. We discuss the synergy of using the SIGs together with synchrotron polarization in order to find the actual direction of the magnetic fields and quantify the effects of Faraday rotation as well as with other ways of studying astrophysical magnetic fields. We test our method in the presence of noise and the resolution effects. We stress the complementary nature of the studies using the SIG technique and those employing the recently introduced velocity gradient techniques that trace magnetic fields using spectroscopic data.

  20. Should direct-to-consumer personalized genomic medicine remain unregulated?: a rebuttal of the defenses.

    PubMed

    Valles, Sean A

    2012-01-01

    Direct-to-consumer personalized genomic medicine has recently grown into a small industry that sells mail-order DNA sample kits and then provides disease risk assessments, typically based upon results from genome-trait association studies. The companies selling these services have been largely exempted from FDA regulation in the United States. Testing kit companies and their supporters have defended the industry's unregulated status using two arguments. First, defenders have argued that mere absence of harm is all that must be proved for mail-order tests to be acceptable. Second, defenders of mail-order testing have argued that there is an individual right to the tests' information. This article rebuts these arguments. The article demonstrates that the direct-to-consumer market has resulted in the sidelining of clinical utility (medical value to patients), leading to the development of certain mail-order tests that do not promote customers' interests and to defenders' downplaying of a potentially damaging empirical study of mail-order genomic testing's effects on consumers. The article also shows that the notion of an individual right to these tests rests on a flawed reading of the key service provided by mail-order companies, which is the provision of medical interpretations, not simply genetic information. Absent these two justifications, there is no reason to exempt direct-to-consumer personalized genomic medicine from stringent federal oversight.

  1. Does indirect speech promote nondirective genetic counseling? Results of a sociolinguistic investigation.

    PubMed

    Benkendorf, J L; Prince, M B; Rose, M A; De Fina, A; Hamilton, H E

    2001-01-01

    To date, research examining adherence to genetic counseling principles has focused on specific counseling activities such as the giving or withholding of information and responding to client requests for advice. We audiotaped 43 prenatal genetic counseling sessions and used data-driven, qualitative, sociolinguistic methodologies to investigate how language choices facilitate or hinder the counseling process. Transcripts of each session were prepared for sociolinguistic analysis of the emergent discourse that included studying conversational style, speaker-listener symmetry, directness, and other interactional patterns. Analysis of our data demonstrates that: 1) indirect speech, marked by the use of hints, hedges, and other politeness strategies, facilitates rapport and mitigates the tension between a client-centered relationship and a counselor-driven agenda; 2) direct speech, or speaking literally, is an effective strategy for providing information and education; and 3) confusion exists between the use of indirect speech and the intent to provide nondirective counseling, especially when facilitating client decision-making. Indirect responses to client questions, such as those that include the phrases "some people" or "most people," helped to maintain counselor neutrality; however, this well-intended indirectness, used to preserve client autonomy, may have obstructed direct explorations of client needs. We argue that the genetic counseling process requires increased flexibility in the use of direct and indirect speech and provide new insights into how "talk" affects the work of genetic counselors.

  2. STEMS pilot trial: a pilot cluster randomised controlled trial to investigate the addition of patient direct access to physiotherapy to usual GP-led primary care for adults with musculoskeletal pain

    PubMed Central

    Ogollah, Reuben O; Jowett, Sue; Kigozi, Jesse; Tooth, Stephanie; Protheroe, Joanne; Hay, Elaine M; Salisbury, Chris; Foster, Nadine E

    2017-01-01

    Introduction Around 17% of general practitioner (GP) consultations are for musculoskeletal conditions, which will rise as the population ages. Patient direct access to physiotherapy provides one solution, yet adoption in the National Health Service (NHS) has been slow. Setting A pilot, pragmatic, non-inferiority, cluster randomised controlled trial (RCT) in general practice and physiotherapy services in the UK. Objectives Investigate feasibility of a main RCT. Participants Adult patients registered in participating practices and consulting with a musculoskeletal problem. Interventions 4 general practices (clusters) randomised to provide GP-led care as usual or the addition of a patient direct access to physiotherapy pathway. Outcomes Process outcomes and exploratory analyses of clinical and cost outcomes. Data collection Participant-level data were collected via questionnaires at identification, 2, 6 and 12 months and through medical records. Blinding The study statistician and research nurses were blinded to practice allocation. Results Of 2696 patients invited to complete study questionnaires, 978 participated (intervention group n=425, control arm n=553) and were analysed. Participant recruitment was completed in 6 months. Follow-up rates were 78% (6 months) and 71% (12 months). No evidence of selection bias was observed. The direct access pathway was used by 90% of patients in intervention practices needing physiotherapy. Some increase in referrals to physiotherapy occurred from one practice, although waiting times for physiotherapy did not increase (28 days before, 26 days after introduction of direct access). No safety issues were identified. Clinical and cost outcomes were similar in both groups. Exploratory estimates of between group effect (using 36-item Short Form Health Survey (SF-36) Physical Component Summary (PCS)) at 6 months was −0.28 (95% CI −1.35 to 0.79) and at 12 months 0.12 (95% CI −1.27 to 1.51). Conclusions A full RCT is feasible and will provide trial evidence about the clinical and cost-effectiveness of patient direct access to physiotherapy. Trial registration number ISRCTN23378642. PMID:28286331

  3. 33 CFR 384.8 - How does the Corps of Engineers provide states an opportunity to comment on proposed Federal...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... provide states an opportunity to comment on proposed Federal financial assistance and direct Federal... Federal financial assistance and direct Federal development? (a) Except in unusual circumstances, the responsible Corps official gives state processes or directly affected state, areawide, regional and local...

  4. 45 CFR 100.8 - How does the Secretary provide states an opportunity to comment on proposed Federal financial...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... opportunity to comment on proposed Federal financial assistance and direct Federal development? 100.8 Section... provide states an opportunity to comment on proposed Federal financial assistance and direct Federal development? (a) Except in unusal circumstances, the Secretary gives state processes or directly affected...

  5. 33 CFR 384.8 - How does the Corps of Engineers provide states an opportunity to comment on proposed Federal...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... provide states an opportunity to comment on proposed Federal financial assistance and direct Federal... Federal financial assistance and direct Federal development? (a) Except in unusual circumstances, the responsible Corps official gives state processes or directly affected state, areawide, regional and local...

  6. 40 CFR 29.8 - How does the Administrator provide States an opportunity to comment on proposed Federal financial...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... States an opportunity to comment on proposed Federal financial assistance and direct Federal development... provide States an opportunity to comment on proposed Federal financial assistance and direct Federal development? (a) Except in unusual circumstances, the Administrator gives State processes or directly affected...

  7. 33 CFR 384.8 - How does the Corps of Engineers provide states an opportunity to comment on proposed Federal...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... provide states an opportunity to comment on proposed Federal financial assistance and direct Federal... Federal financial assistance and direct Federal development? (a) Except in unusual circumstances, the responsible Corps official gives state processes or directly affected state, areawide, regional and local...

  8. 33 CFR 384.8 - How does the Corps of Engineers provide states an opportunity to comment on proposed Federal...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... provide states an opportunity to comment on proposed Federal financial assistance and direct Federal... Federal financial assistance and direct Federal development? (a) Except in unusual circumstances, the responsible Corps official gives state processes or directly affected state, areawide, regional and local...

  9. 34 CFR 685.303 - Processing loan proceeds.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... cover the cost of attendance in a study abroad program and has a Direct Loan Program cohort rate, FFEL.... (4)(i) If a student is enrolled in the first year of an undergraduate program of study and has not... until 30 days after the first day of the student's program of study unless— (A)(1) Except as provided in...

  10. Family history assessment of personality disorders: II. Association with measures of psychosocial functioning in direct evaluations with relatives.

    PubMed

    Lara, M E; Ferro, T; Klein, D N

    1997-01-01

    To test the convergent validity of the Family History Interview for Personality Disorders (FHIPD), as well as the general utility of informants' reports of personality disorders, we explored the relationship between proband informant reports of Axis II diagnoses on the FHIPD and relative reports of various indices of psychosocial adjustment. Subjects were the first degree relatives (n = 454) of 224 probands participating in a family study of mood and personality disorders. Relatives provided information on the Structured Clinical Interview for DSM-III-R (SCID), the Personality Disorder Examination (PDE), and other variables reflecting aspects of psychosocial dysfunction that are common in personality disorders. Proband informants were interviewed about their relatives using the FHIPD Proband informant reports of personality disorders on the FHIPD were associated with a variety of forms of psychosocial dysfunction as determined in direct assessments with the relatives, even for those with no diagnosable Axis II psychopathology dysfunction as determined in direct assessments with the relatives, even for those with no diagnosable Axis II psychopathology on direct interview. These results support the convergent validity of the FHIPD, and suggest that informants may provide important information on Axis II psychopathology that is not obtained from direct interviews with the subjects themselves.

  11. Directional emittance surface measurement system and process

    NASA Technical Reports Server (NTRS)

    Puram, Chith K. (Inventor); Daryabeigi, Kamran (Inventor); Wright, Robert (Inventor); Alderfer, David W. (Inventor)

    1994-01-01

    Apparatus and process for measuring the variation of directional emittance of surfaces at various temperatures using a radiometric infrared imaging system. A surface test sample is coated onto a copper target plate provided with selective heating within the desired incremental temperature range to be tested and positioned onto a precision rotator to present selected inclination angles of the sample relative to the fixed positioned and optically aligned infrared imager. A thermal insulator holder maintains the target plate on the precision rotator. A screen display of the temperature obtained by the infrared imager, and inclination readings are provided with computer calculations of directional emittance being performed automatically according to equations provided to convert selected incremental target temperatures and inclination angles to relative target directional emittance values. The directional emittance of flat black lacquer and an epoxy resin measurements obtained are in agreement with the predictions of the electromagnetic theory and with directional emittance data inferred from directional reflectance measurements made on a spectrophotometer.

  12. The impact of services that offer individualised funds, shared management, person-centred relationships, and self-direction on the lived experiences of consumers with mental illness.

    PubMed

    Peterson, Sunila; Buchanan, Angus; Falkmer, Torbjorn

    2014-01-01

    Mental health service providers across Australia, including Western Australia (WA), have begun to offer individualised funds, shared management, person-centred and self-directed (SPS) services. No research exists on the impact of SPS services on the lived experiences of these particular consumers. This study explored the impact of a SPS service offered for the first time in WA to consumers with mental illness. Data on sixteen consumers' lived experiences were analysed using an abbreviated grounded theory approach. These data had been developed by the consumers, Guides (staff) and an independent evaluator, and most of it had been collected in the past prior to the commencement of the study. Three over-arching categories, and related subcategories, emerged indicating that 1) access to individualised funds enabled practical and psychological benefits to consumers; 2) consistent contact in shared management and person-centred relationships enhanced the provision of timely and meaningful staff support to consumers; and 3) high quality shared management and person-centred relationships with staff and the opportunity to self-direct enabled consumers' change and growth. SPS services enhanced consumers' lived experiences and enabled staff to provide and consumers to experience timely access to recovery resources, consistent contact, responsive and high quality support, and self-direction of services. In this, consumers changed, grew and achieved desired recovery experiences. The overall impact of the SPS service seemed to be founded on the goodness of fit between person characteristics of staff and consumers, which enabled rich support that provided for corrective emotional experiences. This enabled consumers to build meaningful and hopeful lives where they started to live with, and beyond, their mental illness.

  13. DAMIT: a database of asteroid models

    NASA Astrophysics Data System (ADS)

    Durech, J.; Sidorin, V.; Kaasalainen, M.

    2010-04-01

    Context. Apart from a few targets that were directly imaged by spacecraft, remote sensing techniques are the main source of information about the basic physical properties of asteroids, such as the size, the spin state, or the spectral type. The most widely used observing technique - time-resolved photometry - provides us with data that can be used for deriving asteroid shapes and spin states. In the past decade, inversion of asteroid lightcurves has led to more than a hundred asteroid models. In the next decade, when data from all-sky surveys are available, the number of asteroid models will increase. Combining photometry with, e.g., adaptive optics data produces more detailed models. Aims: We created the Database of Asteroid Models from Inversion Techniques (DAMIT) with the aim of providing the astronomical community access to reliable and up-to-date physical models of asteroids - i.e., their shapes, rotation periods, and spin axis directions. Models from DAMIT can be used for further detailed studies of individual objects, as well as for statistical studies of the whole set. Methods: Most DAMIT models were derived from photometric data by the lightcurve inversion method. Some of them have been further refined or scaled using adaptive optics images, infrared observations, or occultation data. A substantial number of the models were derived also using sparse photometric data from astrometric databases. Results: At present, the database contains models of more than one hundred asteroids. For each asteroid, DAMIT provides the polyhedral shape model, the sidereal rotation period, the spin axis direction, and the photometric data used for the inversion. The database is updated when new models are available or when already published models are updated or refined. We have also released the C source code for the lightcurve inversion and for the direct problem (updates and extensions will follow).

  14. Relationship Between Viremia and Specific Organ Damage in Ebola Patients: A Cohort Study.

    PubMed

    Lanini, Simone; Portella, Gina; Vairo, Francesco; Kobinger, Gary P; Pesenti, Antonio; Langer, Martin; Kabia, Soccoh; Brogiato, Giorgio; Amone, Jackson; Castilletti, Concetta; Miccio, Rossella; Capobianchi, Maria Rosaria; Strada, Gino; Zumla, Alimuddin; Di Caro, Antonino; Ippolito, Giuseppe

    2018-01-06

    Pathogenesis of Ebola virus disease remains poorly understood. We used concomitant determination of routine laboratory biomarkers and Ebola viremia to explore the potential role of viral replication in specific organ damage. We recruited patients with detectable Ebola viremia admitted to the EMERGENCY Organizzazione Non Governativa Organizzazione Non Lucrativa di Utilità Sociale (ONG ONLUS) Ebola Treatment Center in Sierra Leone. Repeated measure of Ebola viremia, alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), activated prothrombin time (aPTT), international normalized ratio (INR), creatinine, and blood urea nitrogen (BUN) were recorded. Patients were followed up from admission until death or discharge. One hundred patients (49 survivors and 51 nonsurvivors) were included in the analysis. Unadjusted analysis to compare survivors and nonsurvivors provided evidence that all biomarkers were significantly above the normal range and that the extent of these abnormalities was generally higher in nonsurvivors than in survivors. Multivariable mixed-effects models provided strong evidence for a biological gradient (suggestive of a direct role in organ damage) between the viremia levels and either ALT, AST, CPK LDH, aPTT, and INR. In contrast, no direct linear association was found between viremia and either creatinine, BUN, or bilirubin. This study provides evidence to support that Ebola virus may have a direct role in muscular damage and imbalance of the coagulation system. We did not find strong evidence suggestive of a direct role of Ebola virus in kidney damage. The role of the virus in liver damage remains unclear, but our evidence suggests that acute severe liver injury is not a typical feature of Ebola virus disease. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  15. Effects of sodium puddling on male mating success, courtship and flight in a swallowtail butterfly

    PubMed Central

    Mitra, Chandreyee; Reynoso, Edgar; Davidowitz, Goggy; Papaj, Daniel

    2016-01-01

    In many Lepidoptera species usually only males puddle for sodium. Two explanations have been offered for this: (1) neuromuscular activity: males need increased sodium for flight because they are more active flyers than females; and (2) direct benefits: sodium is a type of direct benefit provided by males to females via ejaculate during mating. Surprisingly, there is little direct experimental evidence for either of these. In this study, we examined both explanations using the pipevine swallowtail butterfly, Battus philenor L. If sodium increases neuromuscular activity, males consuming sodium should be better fliers than males without sodium. If males collect sodium for nuptial gifts that benefit their mates, males consuming sodium may have greater mating success than males without sodium. In that case, females then need an honest cue/signal of the quality of male-provided direct benefits that they can assess before mating. If sodium affects male courtship flight by increasing neuromuscular activity, how a male courts could serve as such a premating cue/signal of male benefit quality. Therefore, sodium may benefit males in terms of obtaining mates by increasing their neuromuscular activity. In this study we found that males that consumed sodium courted more vigorously and had greater mating success than males that consumed water. In addition, the courtship displays of males consuming sodium were significantly different from those of males consuming water, providing a possible honest cue/signal of male benefit quality that females can assess. Interestingly, we did not find evidence that sodium consumption affects male flight outside of courtship. That only aspects of male flight related to mating were affected by sodium, while aspects of general flight were not, is consistent with the idea that sodium may benefit males in terms of obtaining mates via effects on neuromuscular activity. PMID:27103748

  16. Older People’s Experiences of Patient-Centered Treatment for Chronic Pain: A Qualitative Study

    PubMed Central

    Teh, Carrie F.; Karp, Jordan F.; Kleinman, Arthur; Reynolds, Charles F.; Weiner, Debra K.; Cleary, Paul D.

    2010-01-01

    Introduction Older adults with chronic pain who seek treatment often are in a health care environment that emphasizes patient-directed care, a change from the patriarchal model of care to which many older adults are accustomed. Objective To explore the experiences of older adults seeking treatment for chronic pain, with respect to patient-directed care and the patient–provider relationship. Design In-depth interviews with 15 Caucasian older adults with chronic pain who had been evaluated at a university-based pain clinic. All interviews were audiotaped and the transcripts were analyzed using a grounded theory based approach. Results Older adults with chronic pain vary in their willingness to be involved in their treatment decisions. Many frequently participate in decisions about their pain treatment by asking for or refusing specific treatments, demanding quality care, or operating outside of the patient–provider relationship to manage pain on their own. However, others prefer to let their provider make the decisions. In either case, having a mutually respectful patient–provider relationship is important to this population. Specifically, participants described the importance of “being heard” and “being understood” by providers. Conclusions As some providers switch from a patriarchal model of care toward a model of care that emphasizes patient activation and patient-centeredness, the development and cultivation of valued patient–provider relationships may change. While it is important to encourage patient involvement in treatment decisions, high-quality, patient-centered care for older adults with chronic pain should include efforts to strengthen the patient–provider relationship by attending to differences in patients’ willingness to engage in patient-directed care and emphasizing shared decision-making. PMID:19207235

  17. Coordination Logic for Repulsive Resolution Maneuvers

    NASA Technical Reports Server (NTRS)

    Narkawicz, Anthony J.; Munoz, Cesar A.; Dutle, Aaron M.

    2016-01-01

    This paper presents an algorithm for determining the direction an aircraft should maneuver in the event of a potential conflict with another aircraft. The algorithm is implicitly coordinated, meaning that with perfectly reliable computations and information, it will in- dependently provide directional information that is guaranteed to be coordinated without any additional information exchange or direct communication. The logic is inspired by the logic of TCAS II, the airborne system designed to reduce the risk of mid-air collisions between aircraft. TCAS II provides pilots with only vertical resolution advice, while the proposed algorithm, using a similar logic, provides implicitly coordinated vertical and horizontal directional advice.

  18. TOOL ASSEMBLY WITH BI-DIRECTIONAL BEARING

    DOEpatents

    Longhurst, G.E.

    1961-07-11

    A two-direction motion bearing which is incorporated in a refueling nuclear fuel element trsnsfer tool assembly is described. A plurality of bi- directional bearing assembliesare fixed equi-distantly about the circumference of the transfer tool assembly to provide the tool assembly with a bearing surface- for both axial and rotational motion. Each bi-directional bearing assembly contains a plurality of circumferentially bulged rollers mounted in a unique arrangement which will provide a bearing surface for rotational movement of the tool assembly within a bore. The bi-direc tional bearing assembly itself is capable of rational motion and thus provides for longitudinal movement of the tool assembly.

  19. [Prevention of accidental needle sticks before the Directive 2010/32/EU in a sample of Italian hospitals].

    PubMed

    Di Bari, Virginia; De Carli, Gabriella; Puro, Vincenzo

    2015-05-04

    Needlesticks and cuts are the most common occupational injuries in healthcare workers (HCWs). Directive 2010/32/EU defines principles and preventive interventions. To assess, in hospitals participating in the Italian Study on Occupational Risk of HIV (SIROH) project, which are very active in prevention, the degree of application of the measures provided for by the Directive, prior to its incorporation into Italian law. An open questionnaire covering the 9 focal points of the Directive, as a guide for a presentation at the SIROH meeting in 2013. Of 100 SIROH hospitals, 97% and 96% respectively provide specific information and education initiatives (54% and 73% of which expressly for new employees). All centres reinforce the ban on recapping, and 30 monitor its application by inspecting sharps containers; all hospitals place containers on mobile trolleys and 78 provide operating procedures for their replacement; all introduced at least one needlestick-prevention device (NPD; 4 on average, range 1-11), most frequently intravenous catheters (91%) and winged needles (87%), but 39% only in selected units; 14 centres implemented initiatives to eliminate unnecessary needles. Regarding hepatitis B, all centres screen and vaccinate HCWs but only 78% monitor their response: 89% of HCWs were immunized. Post-exposure management protocols, although based on the same rationale, differ significantly causing considerable differences in  costs. Most of the preventive interventions covered by the Directive were implemented in SIROH hospitals. It is necessary to invest in NPD availability and dissemination, elimination of unnecessary needles, and streamline post-exposure protocols. The situation in the remaining Italian facilities should be investigated.

  20. Direct and indirect urban water footprints of the United States

    NASA Astrophysics Data System (ADS)

    Chini, Christopher M.; Konar, Megan; Stillwell, Ashlynn S.

    2017-01-01

    The water footprint of the urban environment is not limited to direct water consumption (i.e., municipal supplies); embedded water in imported resources, or virtual water transfers, provides an additional component of the urban water footprint. Using empirical data, our analysis extends traditional urban water footprinting analysis to quantify both direct and indirect urban resources for the United States. We determine direct water volumes and their embedded energy through open records requests of water utilities. The indirect component of the urban water footprint includes water indirectly consumed through energy and food, relating to the food-energy-water nexus. We comprehensively quantify the indirect water footprint for 74 metropolitan statistical areas through the combination of various databases, including the Commodity Flow Survey of the U.S. Census Bureau, the U.S. Department of Agriculture, the Water Footprint Network, and the Energy Information Administration. We then analyze spatial heterogeneity in both direct and indirect water footprints, determining the average urban water footprint in the United States to be 1.64 million gallons of water per person per year [6200 m3/person/yr or 17,000 L/person/d], dominated by indirect water. Additionally, our study of the urban water cycle extends beyond considering only water resources to include embedded energy and equivalent carbon dioxide emissions. The inclusion of multiple sectors of the urban water cycle and their underlying processes provides important insights to the overall urban environment, the interdependencies of the food-energy-water nexus, and water resource sustainability. Our results provide opportunities for benchmarking the urban energy-water nexus, water footprints, and climate change potential.

  1. Conceptualizing and Measuring Intergenerational Ambivalence in Later Life

    PubMed Central

    Gilligan, Megan; Pillemer, Karl

    2011-01-01

    Objectives. In this paper, we explored the association between direct and indirect measures of intergenerational ambivalence, making comparisons by generational position and child’s gender; furthermore, we examined whether these measures were similarly strong predictors of depressive symptoms and positive affect. Methods. Data for the analysis were collected from 254 mothers aged 72–82 years and a randomly selected adult child as part of a larger study of within-family differences in parent–adult child relations. Results. The findings provided evidence that direct and indirect measures were strongly associated among mothers but only weakly associated among adult children, particularly sons. The two measures were similarly strong predictors of mothers’, but not children’s, depressive symptoms and positive affect. The most pronounced differences in congruence between direct and indirect measures were found when comparing mothers and sons. Discussion. The analyses presented here suggest that direct and indirect measures of intergenerational ambivalence may not be tapping the same underlying construct, particularly in the case of adult children and especially sons. Furthermore, direct measures may have an advantage over indirect measures when including sons in the study design. We conclude that direct and indirect measures cannot be used interchangeably across the combination of generation and gender. PMID:22002969

  2. Analytical formulation of directly modulated OOFDM signals transmitted over an IM/DD dispersive link.

    PubMed

    Sánchez, C; Ortega, B; Wei, J L; Tang, J; Capmany, J

    2013-03-25

    We provide an analytical study on the propagation effects of a directly modulated OOFDM signal through a dispersive fiber and subsequent photo-detection. The analysis includes the effects of the laser operation point and the interplay between chromatic dispersion and laser chirp. The final expression allows to understand the physics behind the transmission of a multi-carrier signal in the presence of residual frequency modulation and the description of the induced intermodulation distortion gives us a detailed insight into the diferent intermodulation products which impair the recovered signal at the receiver-end side. Numerical comparisons between transmission simulations results and those provided by evaluating the expression obtained are carried out for different laser operation points. Results obtained by changing the fiber length, laser parameters and using single mode fiber with negative and positive dispersion are calculated in order to demonstrate the validity and versatility of the theory provided in this paper. Therefore, a novel analytical formulation is presented as a versatile tool for the description and study of IM/DD OOFDM systems with variable design parameters.

  3. Coupling single giant nanocrystal quantum dots to the fundamental mode of patch nanoantennas through fringe field

    DOE PAGES

    Wang, Feng; Karan, Niladri S.; Minh Nguyen, Hue; ...

    2015-09-23

    Through single dot spectroscopy and numerical simulation studies, we demonstrate that the fundamental mode of gold patch nanoantennas have fringe-field resonance capable of enhancing the nano-emitters coupled around the edge of the patch antenna. This fringe-field coupling is used to enhance the radiative rates of core/thick-shell nanocrystal quantum dots (g-NQDs) that cannot be embedded into the ultra-thin dielectric gap of patch nanoantennas due to their large sizes. We attain 14 and 3 times enhancements in single exciton radiative decay rate and bi-exciton emission efficiencies of g-NQDs respectively, with no detectable metal quenching. Our numerical studies confirmed our experimental results andmore » further reveal that patch nanoantennas can provide strong emission enhancement for dipoles lying not only in radial direction of the circular patches but also in the direction normal to the antennas surface. Finally, this provides a distinct advantage over the parallel gap-bar antennas that can provide enhancement only for the dipoles oriented across the gap.« less

  4. Opposite optimal current flow directions for induction of neuroplasticity and excitation threshold in the human motor cortex.

    PubMed

    Sommer, Martin; Norden, Christoph; Schmack, Lars; Rothkegel, Holger; Lang, Nicolas; Paulus, Walter

    2013-05-01

    Directional sensitivity is relevant for the excitability threshold of the human primary motor cortex, but its importance for externally induced plasticity is unknown. To study the influence of current direction on two paradigms inducing neuroplasticity by repetitive transcranial magnetic stimulation (rTMS). We studied short-lasting after-effects induced in the human primary motor cortex of 8 healthy subjects, using 5 Hz rTMS applied in six blocks of 200 pulses each, at 90% active motor threshold. We controlled for intensity, frequency, waveform and spinal effects. Only biphasic pulses with the effective component delivered in an anterioposterior direction (henceforth posteriorly directed) in the brain yielded an increase of motor-evoked potential (MEP) amplitudes outlasting rTMS. MEP latencies and F-wave amplitudes remained unchanged. Biphasic pulses directed posteroanterior (i.e. anteriorly) were ineffective, as were monophasic pulses from either direction. A 1 Hz study in a group of 12 healthy subjects confirmed facilitation after posteriorly directed biphasic pulses only. The anisotropy of the human primary motor cortex is relevant for induction of plasticity by subtreshold rTMS, with a current flow opposite to that providing lowest excitability thresholds. This is consistent with the idea of TMS primarily targeting cortical columns of the phylogenetically new M1 in the anterior bank of the central sulcus. For these, anteriorly directed currents are soma-depolarizing, therefore optimal for low thresholds, whereas posteriorly directed currents are soma-hyperpolarizing, likely dendrite-depolarizing and bested suited for induction of plasticity. Our findings should help focus and enhance rTMS effects in experimental and clinical settings. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Novice clinical nurse educator's experience of a self-directed learning, education and mentoring program: a qualitative study.

    PubMed

    Sheppard-Law, Suzanne; Curtis, Sharon; Bancroft, Jodie; Smith, Wendy; Fernandez, Ritin

    2018-06-05

    Transition from a registered nurse to a clinical nurse educator (CNE) poses several challenges. Providing professional development opportunities to ease the transition from a registered nurse to a CNE is considered critical to a successful career and to effectively teach. A self-directed educational program and mentoring (SEM) program was designed and implemented to support nurse's transition from a novice to a confident CNE. The aim of this study was to explore novice CNE's experience of learning and being mentored. Qualitative methodology was undertaken to conduct focus groups. All CNEs who completed the SEM program were invited to participate in the study. Willing participants provided informed consent to complete an in-depth semi-structured focus group and to record the focus group interview. Focus groups were facilitated by an independent researcher. A second researcher attended the focus groups to collect detailed notes. Data were transcribed verbatim and participants were de-identified. Simple thematic analyses were undertaken. A total of 11 (58%) CNEs participated in the focus groups. Overall participants described their experience of the SEM program as positive. Three themes were identified: (1) perceived transformation of CNE practice, (2) beneficial relationships and (3) feeling connected. Mentoring relationships for some participants have continued beyond the self-directed learning, education and mentoring program. Barriers to the mentoring program included a theme of lack of time, role ambiguity and insufficient face to face education. Study findings highlight the benefits of providing professional development opportunities and mentoring programs for novice CNEs. Programs, such as the SEM enable transformation of a novice educator's practice, and the consolidation of new knowledge, skills and confidence to effectively educate less experienced nurses.

  6. Anhedonia and the Relationship Between Other Depressive Symptoms and Aggressive Behavior.

    PubMed

    Salem, Taban; Winer, E Samuel; Jordan, D Gage; Nadorff, Michael R; Fanning, Jennifer R; Bryant, Jessica; Berman, Mitchell E; Veilleux, Jennifer C

    2018-05-01

    Depression has been linked to multiple forms of aggressive behavior in college students; however, it is unclear which aspects of depression explain this connection. Anhedonia, defined as the loss of interest and/or pleasure in previously enjoyed activities, may provide unique information about relationships between depression and aggression. Using cross-sectional data from two independent samples of college students ( N = 747 and N = 736 for Study 1 and Study 2, respectively), we examined whether anhedonia helped explain the relationship between broader depressive symptoms and different forms of aggressive and antisocial behavior. Anhedonia accounted for variance in both self-directed aggression and antisocial behavior independent of gender, hostility, anger, other depressive symptoms, and cognitive distortions (Study 2). In addition, there were significant indirect effects of depressive symptoms on self-directed aggression (Studies 1 and 2) and antisocial behavior (Study 2) via anhedonia. Hypotheses involving other-directed aggression received mixed support, with anhedonia atemporally associated with other-directed aggression independent of broader depressive symptoms in Study 1, but not in Study 2. The current findings suggest that anhedonia is an important individual difference that helps explain the relationship between depression and aggressive and antisocial acts and that anhedonia may be differentially associated with various types of aggressive and antisocial behavior.

  7. Agent-Based Modeling of Chronic Diseases: A Narrative Review and Future Research Directions

    PubMed Central

    Lawley, Mark A.; Siscovick, David S.; Zhang, Donglan; Pagán, José A.

    2016-01-01

    The United States is experiencing an epidemic of chronic disease. As the US population ages, health care providers and policy makers urgently need decision models that provide systematic, credible prediction regarding the prevention and treatment of chronic diseases to improve population health management and medical decision-making. Agent-based modeling is a promising systems science approach that can model complex interactions and processes related to chronic health conditions, such as adaptive behaviors, feedback loops, and contextual effects. This article introduces agent-based modeling by providing a narrative review of agent-based models of chronic disease and identifying the characteristics of various chronic health conditions that must be taken into account to build effective clinical- and policy-relevant models. We also identify barriers to adopting agent-based models to study chronic diseases. Finally, we discuss future research directions of agent-based modeling applied to problems related to specific chronic health conditions. PMID:27236380

  8. Agent-Based Modeling of Chronic Diseases: A Narrative Review and Future Research Directions.

    PubMed

    Li, Yan; Lawley, Mark A; Siscovick, David S; Zhang, Donglan; Pagán, José A

    2016-05-26

    The United States is experiencing an epidemic of chronic disease. As the US population ages, health care providers and policy makers urgently need decision models that provide systematic, credible prediction regarding the prevention and treatment of chronic diseases to improve population health management and medical decision-making. Agent-based modeling is a promising systems science approach that can model complex interactions and processes related to chronic health conditions, such as adaptive behaviors, feedback loops, and contextual effects. This article introduces agent-based modeling by providing a narrative review of agent-based models of chronic disease and identifying the characteristics of various chronic health conditions that must be taken into account to build effective clinical- and policy-relevant models. We also identify barriers to adopting agent-based models to study chronic diseases. Finally, we discuss future research directions of agent-based modeling applied to problems related to specific chronic health conditions.

  9. ERTS direct readout ground station study

    NASA Technical Reports Server (NTRS)

    1971-01-01

    A system configuration which provides for a wide variety of user requirements is described. Two distinct user types are considered and optimized configurations are provided. Independent satellite transmission systems allow simultaneous signal transmission to Regional Collection Centers via a high data rate channel and to local users who require near real time consumption of lower rate data. In order to maximize the ultimate utility of this study effort, a parametric system description is given such that in essence a shopping list is provided. To achieve these results, it was necessary to consider all technical disciplines associated with high resolution satellite imaging systems including signal processing, modulation and coding, recording, and display techniques. A total systems study was performed.

  10. Direct detection of Mycobacterium tuberculosis rifampin resistance in bio-safe stained sputum smears.

    PubMed

    Lavania, Surabhi; Anthwal, Divya; Bhalla, Manpreet; Singh, Nagendra; Haldar, Sagarika; Tyagi, Jaya Sivaswami

    2017-01-01

    Direct smear microscopy of sputum forms the mainstay of TB diagnosis in resource-limited settings. Stained sputum smear slides can serve as a ready-made resource to transport sputum for molecular drug susceptibility testing. However, bio-safety is a major concern during transport of sputum/stained slides and for laboratory workers engaged in processing Mycobacterium tuberculosis infected sputum specimens. In this study, a bio-safe USP (Universal Sample Processing) concentration-based sputum processing method (Bio-safe method) was assessed on 87 M. tuberculosis culture positive sputum samples. Samples were processed for Ziehl-Neelsen (ZN) smear, liquid culture and DNA isolation. DNA isolated directly from sputum was subjected to an IS6110 PCR assay. Both sputum DNA and DNA extracted from bio-safe ZN concentrated smear slides were subjected to rpoB PCR and simultaneously assessed by DNA sequencing for determining rifampin (RIF) resistance. All sputum samples were rendered sterile by Bio-safe method. Bio-safe smears exhibited a 5% increment in positivity over direct smear with a 14% increment in smear grade status. All samples were positive for IS6110 and rpoB PCR. Thirty four percent samples were RIF resistant by rpoB PCR product sequencing. A 100% concordance (κ value = 1) was obtained between sequencing results derived from bio-safe smear slides and bio-safe sputum. This study demonstrates that Bio-safe method can address safety issues associated with sputum processing, provide an efficient alternative to sample transport in the form of bio-safe stained concentrated smear slides and can also provide information on drug (RIF) resistance by direct DNA sequencing.

  11. Direct detection of Mycobacterium tuberculosis rifampin resistance in bio-safe stained sputum smears

    PubMed Central

    Lavania, Surabhi; Anthwal, Divya; Bhalla, Manpreet; Singh, Nagendra; Haldar, Sagarika; Tyagi, Jaya Sivaswami

    2017-01-01

    Direct smear microscopy of sputum forms the mainstay of TB diagnosis in resource-limited settings. Stained sputum smear slides can serve as a ready-made resource to transport sputum for molecular drug susceptibility testing. However, bio-safety is a major concern during transport of sputum/stained slides and for laboratory workers engaged in processing Mycobacterium tuberculosis infected sputum specimens. In this study, a bio-safe USP (Universal Sample Processing) concentration-based sputum processing method (Bio-safe method) was assessed on 87 M. tuberculosis culture positive sputum samples. Samples were processed for Ziehl-Neelsen (ZN) smear, liquid culture and DNA isolation. DNA isolated directly from sputum was subjected to an IS6110 PCR assay. Both sputum DNA and DNA extracted from bio-safe ZN concentrated smear slides were subjected to rpoB PCR and simultaneously assessed by DNA sequencing for determining rifampin (RIF) resistance. All sputum samples were rendered sterile by Bio-safe method. Bio-safe smears exhibited a 5% increment in positivity over direct smear with a 14% increment in smear grade status. All samples were positive for IS6110 and rpoB PCR. Thirty four percent samples were RIF resistant by rpoB PCR product sequencing. A 100% concordance (κ value = 1) was obtained between sequencing results derived from bio-safe smear slides and bio-safe sputum. This study demonstrates that Bio-safe method can address safety issues associated with sputum processing, provide an efficient alternative to sample transport in the form of bio-safe stained concentrated smear slides and can also provide information on drug (RIF) resistance by direct DNA sequencing. PMID:29216262

  12. Family history assessment of personality disorders: I. Concordance with direct interview and between pairs of informants.

    PubMed

    Ferro, T; Klein, D N

    1997-01-01

    The present study examined the concordance of the Family History Interview for Personality Disorders (FHIPD) with diagnoses based on direct interviews and between pairs of informants. Subjects were 224 probands participating in a series of studies of the familial transmission of mood and personality disorders and their first-degree relatives. Proband informants and relatives provided information about themselves on the Structured Clinical Interview for DSM-III-R (SCID), Personality Disorder Examination (PDE), and Eysenck Personality Questionnaire (EPQ). Information from informants about relatives was collected with the FHIPD. All assessments were made blindly and independently. Using Kappa, concordance between proband informants' family histories and relative direct reports on specific personality disorders was low, ranging from -.01 to .28, with a median of .10. Kappa for a diagnosis of any personality disorder was .16. When two independent informant reports were compared, Kappas for specific Axis II disorders ranged from .10 to .72, with a median of .28. Kappa for a diagnosis of any personality disorder was .36. These data suggest that subjects and informants provide different perspectives on Axis II psychopathology, and support the use of both sources of information whenever possible.

  13. Low-dose ionizing radiation induces direct activation of natural killer cells and provides a novel approach for adoptive cellular immunotherapy.

    PubMed

    Yang, Guozi; Kong, Qingyu; Wang, Guanjun; Jin, Haofan; Zhou, Lei; Yu, Dehai; Niu, Chao; Han, Wei; Li, Wei; Cui, Jiuwei

    2014-12-01

    Recent evidence indicates that limited availability and cytotoxicity have restricted the development of natural killer (NK) cells in adoptive cellular immunotherapy (ACI). While it has been reported that low-dose ionizing radiation (LDIR) could enhance the immune response in animal studies, the influence of LDIR at the cellular level has been less well defined. In this study, the authors aim to investigate the direct effects of LDIR on NK cells and the potential mechanism, and explore the application of activation and expansion of NK cells by LDIR in ACI. The authors found that expansion and cytotoxicity of NK cells were markedly augmented by LDIR. The levels of IFN-γ and TNF-α in the supernatants of cultured NK cells were significantly increased after LDIR. Additionally, the effect of the P38 inhibitor (SB203580) significantly decreased the expanded NK cell cytotoxicity, cytokine levels, and expression levels of FasL and perforin. These findings indicate that LDIR induces a direct expansion and activation of NK cells through possibly the P38-MAPK pathway, which provides a potential mechanism for stimulation of NK cells by LDIR and a novel but simplified approach for ACI.

  14. Then and Now: Examining How Consumer Communication and Attitudes of Direct-to-Consumer Pharmaceutical Advertising Have Changed in the Last Decade.

    PubMed

    Wood, Kelly S; Cronley, Maria L

    2014-09-01

    This study examines changes over a 10-year period in consumer reports of communication with health care providers about direct-to-consumer advertised (DTCA) medications. Two rounds of survey data were collected in 2003 and 2012 using repeated cross-sectional procedures to examine consumer willingness to discuss DTCA medications, content and tone of those conversations, and attitudes about the advertisements. In total, 472 surveys were analyzed. Generally, we found physician-patient conversations, attitudes, and behaviors regarding DTCA have changed. Consumers in 2012 reported talking significantly less about the names of the advertised drug, comparing the advertised drug with their current medication, and sharing general information than consumers in 2003. Attitudes toward the advertisements were significantly more negative in 2012 compared to 2003. Of those who specifically asked for a prescription, the proportion of patients who received the prescription was significantly lower in 2012, despite research suggesting increased rates of prescriptions. These results are interpreted in light of previous research about the lack of research examining the actual communication between physicians and patients on this topic. Limitations of the study are provided along with directions for future research about DTCA and physician-patient communication.

  15. Contributions of numerical simulation data bases to the physics, modeling and measurement of turbulence

    NASA Technical Reports Server (NTRS)

    Moin, Parviz; Spalart, Philippe R.

    1987-01-01

    The use of simulation data bases for the examination of turbulent flows is an effective research tool. Studies of the structure of turbulence have been hampered by the limited number of probes and the impossibility of measuring all desired quantities. Also, flow visualization is confined to the observation of passive markers with limited field of view and contamination caused by time-history effects. Computer flow fields are a new resource for turbulence research, providing all the instantaneous flow variables in three-dimensional space. Simulation data bases also provide much-needed information for phenomenological turbulence modeling. Three dimensional velocity and pressure fields from direct simulations can be used to compute all the terms in the transport equations for the Reynolds stresses and the dissipation rate. However, only a few, geometrically simple flows have been computed by direct numerical simulation, and the inventory of simulation does not fully address the current modeling needs in complex turbulent flows. The availability of three-dimensional flow fields also poses challenges in developing new techniques for their analysis, techniques based on experimental methods, some of which are used here for the analysis of direct-simulation data bases in studies of the mechanics of turbulent flows.

  16. Inter-informant agreement and prevalence estimates for mood syndromes: direct interview vs. family history method.

    PubMed

    Vandeleur, C L; Rothen, S; Lustenberger, Y; Glaus, J; Castelao, E; Preisig, M

    2015-01-15

    The use of the family history method is recommended in family studies as a type of proxy interview of non-participating relatives. However, using different sources of information can result in bias as direct interviews may provide a higher likelihood of assigning diagnoses than family history reports. The aims of the present study were to: (1) compare diagnoses for threshold and subthreshold mood syndromes from interviews to those relying on information from relatives; (2) test the appropriateness of lowering the diagnostic threshold and combining multiple reports from the family history method to obtain comparable prevalence estimates to the interviews; (3) identify factors that influence the likelihood of agreement and reporting of disorders by informants. Within a family study, 1621 informant-index subject pairs were identified. DSM-5 diagnoses from direct interviews of index subjects were compared to those derived from family history information provided by their first-degree relatives. (1) Inter-informant agreement was acceptable for Mania, but low for all other mood syndromes. (2) Except for Mania and subthreshold depression, the family history method provided significantly lower prevalence estimates. The gap improved for all other syndromes after lowering the threshold of the family history method. (3) Individuals who had a history of depression themselves were more likely to report depression in their relatives. Low proportion of affected individuals for manic syndromes and lack of independence of data. The higher likelihood of reporting disorders by affected informants entails the risk of overestimation of the size of familial aggregation of depression. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Biomechanical analysis of a new lumbar interspinous device with optimized topology.

    PubMed

    Chen, Chen-Sheng; Shih, Shih-Liang

    2018-01-06

    Interspinous spacers used stand-alone preserve joint movement but provide little protection for diseased segments of the spine. Used as adjuncts with fusion, interspinous spacers offer rigid stability but may accelerate degeneration on adjacent levels. Our new device is intended to balance the stability and preserves motion provided by the implant. A new interspinous spacer was devised according to the results of topology optimization studies. Four finite element (FE) spine models were created that consisted of an intact spine without an implant, implantation of the novel, the device for intervertebral assisted motion (DIAM system), and the Dynesys system. All models were loaded with moments, and their range of motions (ROMs), peak disc stresses, and facet contact forces were analyzed. The limited motion segment ROMs, shielded disc stresses, and unloaded facet contact forces of the new devices were greater than those of the DIAM and Dynesys system at L3-L4 in almost all directions of movements. The ROMs, disc stresses, and facet contact forces of the new devices at L2-L3 were slightly greater than those in the DIAM system, but much lower than those in the Dynesys system in most directions. This study demonstrated that the new device provided more stability at the instrumented level than the DIAM system did, especially in lateral rotation and the bending direction. The device caused fewer adjacent ROMs, lower disc stresses, and lower facet contact forces than the Dynesys system did. Additionally, this study conducted topology optimization to design the new device and created a smaller implant for minimal invasive surgery.

  18. Emergency Physicians’ Views of Direct Notification of Laboratory and Radiology Results to Patients Using the Internet: A Multisite Survey

    PubMed Central

    2015-01-01

    Background Patients are increasingly using the Internet to communicate with health care providers and access general and personal health information. Missed test results have been identified as a critical safety issue with studies showing up to 75% of tests for emergency department (ED) patients not being followed-up. One strategy that could reduce the likelihood of important results being missed is for ED patients to have direct access to their test results. This could be achieved electronically using a patient portal tied to the hospital’s electronic medical record or accessed from the relevant laboratory information system. Patients have expressed interest in accessing test results directly, but there have been no reported studies on emergency physicians’ opinions. Objective The aim was to explore emergency physicians’ current practices of test result notification and attitudes to direct patient notification of clinically significant abnormal and normal test results. Methods A cross-sectional survey was self-administered by senior emergency physicians (site A: n=50; site B: n=39) at 2 large public metropolitan teaching hospitals in Australia. Outcome measures included current practices for notification of results (timing, methods, and responsibilities) and concerns with direct notification. Results The response rate was 69% (61/89). More than half of the emergency physicians (54%, 33/61) were uncomfortable with patients receiving direct notification of abnormal test results. A similar proportion (57%, 35/61) was comfortable with direct notification of normal test results. Physicians were more likely to agree with direct notification of normal test results if they believed it would reduce their workload (OR 5.72, 95% CI 1.14-39.76). Main concerns were that patients could be anxious (85%, 52/61), confused (92%, 56/61), and lacking in the necessary expertise to interpret their results (90%, 55/61). Conclusions Although patients’ direct access to test results could serve as a safety net reducing the likelihood of abnormal results being missed, emergency physicians’ concerns need further exploration: which results are suitable and the timing and method of direct release to patients. Methods of access, including secure Web-based patient portals with drill-down facilities providing test descriptions and result interpretations, or laboratories sending results directly to patients, need evaluation to ensure patient safety is not compromised and the processes fit with ED clinician and laboratory work practices and patient needs. PMID:25739322

  19. Emergency physicians' views of direct notification of laboratory and radiology results to patients using the Internet: a multisite survey.

    PubMed

    Callen, Joanne; Giardina, Traber Davis; Singh, Hardeep; Li, Ling; Paoloni, Richard; Georgiou, Andrew; Runciman, William B; Westbrook, Johanna I

    2015-03-04

    Patients are increasingly using the Internet to communicate with health care providers and access general and personal health information. Missed test results have been identified as a critical safety issue with studies showing up to 75% of tests for emergency department (ED) patients not being followed-up. One strategy that could reduce the likelihood of important results being missed is for ED patients to have direct access to their test results. This could be achieved electronically using a patient portal tied to the hospital's electronic medical record or accessed from the relevant laboratory information system. Patients have expressed interest in accessing test results directly, but there have been no reported studies on emergency physicians' opinions. The aim was to explore emergency physicians' current practices of test result notification and attitudes to direct patient notification of clinically significant abnormal and normal test results. A cross-sectional survey was self-administered by senior emergency physicians (site A: n=50; site B: n=39) at 2 large public metropolitan teaching hospitals in Australia. Outcome measures included current practices for notification of results (timing, methods, and responsibilities) and concerns with direct notification. The response rate was 69% (61/89). More than half of the emergency physicians (54%, 33/61) were uncomfortable with patients receiving direct notification of abnormal test results. A similar proportion (57%, 35/61) was comfortable with direct notification of normal test results. Physicians were more likely to agree with direct notification of normal test results if they believed it would reduce their workload (OR 5.72, 95% CI 1.14-39.76). Main concerns were that patients could be anxious (85%, 52/61), confused (92%, 56/61), and lacking in the necessary expertise to interpret their results (90%, 55/61). Although patients' direct access to test results could serve as a safety net reducing the likelihood of abnormal results being missed, emergency physicians' concerns need further exploration: which results are suitable and the timing and method of direct release to patients. Methods of access, including secure Web-based patient portals with drill-down facilities providing test descriptions and result interpretations, or laboratories sending results directly to patients, need evaluation to ensure patient safety is not compromised and the processes fit with ED clinician and laboratory work practices and patient needs.

  20. 75 FR 63846 - Statement of Organization, Functions and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-18

    ... Preparedness and Continuity of Operations (RA15). Office of the Director (RA1) Provides overall leadership... health care for vulnerable populations worldwide; (3) provides leadership and direction to improve the...; (4) provides leadership and direction in the development of policies on health information technology...

  1. Stakeholders' Responses to CSR Tradeoffs: When Other-Orientation and Trust Trump Material Self-Interest

    PubMed Central

    Bridoux, Flore; Stofberg, Nicole; Den Hartog, Deanne

    2016-01-01

    When investing in corporate social responsibility (CSR), managers may strive for a win-win scenario where all stakeholders end up better off, but they may not always be able to avoid trading off stakeholders' interests. To provide guidance to managers who have to make tradeoffs, this study used a vignette-based experiment to explore stakeholders' intention to associate with a firm (i.e., buy from or become an employee) that trades off CSR directed at the stakeholders' own group (self-directed CSR) and CSR directed at another stakeholder group (other-directed CSR). Results show that stakeholders were not systematically more attracted to a firm that favors their own group over another stakeholder group. Specifically, stakeholders' other-orientation moderated their reaction to tradeoffs: stakeholders higher on other-orientation were willing to forego some material benefits to associate with a firm that treated suppliers in developing countries significantly better than its competitors, whereas stakeholders lower on other-orientation were more attracted to a firm favoring their own stakeholder group. Other-orientation also moderated reactions to tradeoffs involving the environment, although high CSR directed at the environment did not compensate for low self-directed CSR even for stakeholders higher on other-orientation. Second, the vignette study showed that trust mediated the relationship between tradeoffs and stakeholders' reactions. The study contributes first and foremost to the burgeoning literature on CSR tradeoffs and to the multimotive approach to CSR, which claims that other motives can drive stakeholders' reactions to CSR in addition to self-interest. First, it provides further evidence that studying CSR tradeoffs is important to understand both (prospective) employees' and customers' reactions to CSR-related activities. Second, it identifies other-orientation as a motive-related individual difference that explains heterogeneity in stakeholders' reactions to CSR. These findings suggest several avenues for future research for organizational psychologists interested in organizational justice. Third, it investigates trust as a mediating mechanism. Fourth, it reveals differences in stakeholders' reactions depending on which other stakeholder group is involved in the tradeoff. For practice, the findings suggest that tradeoffs are important because they influence which stakeholders are attracted to the firm. PMID:26834657

  2. Stakeholders' Responses to CSR Tradeoffs: When Other-Orientation and Trust Trump Material Self-Interest.

    PubMed

    Bridoux, Flore; Stofberg, Nicole; Den Hartog, Deanne

    2015-01-01

    When investing in corporate social responsibility (CSR), managers may strive for a win-win scenario where all stakeholders end up better off, but they may not always be able to avoid trading off stakeholders' interests. To provide guidance to managers who have to make tradeoffs, this study used a vignette-based experiment to explore stakeholders' intention to associate with a firm (i.e., buy from or become an employee) that trades off CSR directed at the stakeholders' own group (self-directed CSR) and CSR directed at another stakeholder group (other-directed CSR). Results show that stakeholders were not systematically more attracted to a firm that favors their own group over another stakeholder group. Specifically, stakeholders' other-orientation moderated their reaction to tradeoffs: stakeholders higher on other-orientation were willing to forego some material benefits to associate with a firm that treated suppliers in developing countries significantly better than its competitors, whereas stakeholders lower on other-orientation were more attracted to a firm favoring their own stakeholder group. Other-orientation also moderated reactions to tradeoffs involving the environment, although high CSR directed at the environment did not compensate for low self-directed CSR even for stakeholders higher on other-orientation. Second, the vignette study showed that trust mediated the relationship between tradeoffs and stakeholders' reactions. The study contributes first and foremost to the burgeoning literature on CSR tradeoffs and to the multimotive approach to CSR, which claims that other motives can drive stakeholders' reactions to CSR in addition to self-interest. First, it provides further evidence that studying CSR tradeoffs is important to understand both (prospective) employees' and customers' reactions to CSR-related activities. Second, it identifies other-orientation as a motive-related individual difference that explains heterogeneity in stakeholders' reactions to CSR. These findings suggest several avenues for future research for organizational psychologists interested in organizational justice. Third, it investigates trust as a mediating mechanism. Fourth, it reveals differences in stakeholders' reactions depending on which other stakeholder group is involved in the tradeoff. For practice, the findings suggest that tradeoffs are important because they influence which stakeholders are attracted to the firm.

  3. Survivability and Vulnerability Impacts on Mission and Campaign Outcomes: The Role of the AFSAT

    DTIC Science & Technology

    2005-06-23

    suggestions for reducing this burden, to Washington Headquarters Services , Directorate for Information Operations and Reports, 1215 Jefferson Davis...analytic M&S capability investments Oversight AFAC Steering Group provides direction and guidance AFSAA/ SAA – executive agent Subject Matter Expert...operated, DoD sponsored service available to all government and industry users to provide studies, analyses, data gathering, and other operational

  4. Health Care Providers’ Attitudes and Practices Regarding the use of Advance Directives in a Military Health Care Setting

    DTIC Science & Technology

    1998-10-02

    PROVIDERS’ ATTITUDES AND PRACTICES REGARDING THE USE OF ADVANCE DIRECTIVES IN A MILITARY HEALTH CARE SETTING by Bridget L. Larew, Maj, USAF, NC Thesis...entitled: "HEALTH CARE PROVIDER’S ATTITUDES AND PRACTICES REGARDING THE PURPOSE AND USE OF ADVANCE DIRECTIVES IN A MILITARY HEALTH CARE SETTING" beyond...health care, recognized under State law (whether statutory or as recognized by the courts of the State) and relating to the provision of such care

  5. Electron tomography provides a direct link between the Payne effect and the inter-particle spacing of rubber composites

    PubMed Central

    Staniewicz, Lech; Vaudey, Thomas; Degrandcourt, Christophe; Couty, Marc; Gaboriaud, Fabien; Midgley, Paul

    2014-01-01

    Rubber-filler composites are a key component in the manufacture of tyres. The filler provides mechanical reinforcement and additional wear resistance to the rubber, but it in turn introduces non-linear mechanical behaviour to the material which most likely arises from interactions between the filler particles, mediated by the rubber matrix. While various studies have been made on the bulk mechanical properties and of the filler network structure (both imaging and by simulations), there presently does not exist any work directly linking filler particle spacing and mechanical properties. Here we show that using STEM tomography, aided by a machine learning image analysis procedure, to measure silica particle spacings provides a direct link between the inter-particle spacing and the reduction in shear modulus as a function of strain (the Payne effect), measured using dynamic mechanical analysis. Simulations of filler network formation using attractive, repulsive and non-interacting potentials were processed using the same method and compared with the experimental data, with the net result being that an attractive inter-particle potential is the most accurate way of modelling styrene-butadiene rubber-silica composite formation. PMID:25487130

  6. Special Appropriation Act Projects

    EPA Pesticide Factsheets

    EPA is sometimes directed to provide funding to a specific entity for study, purpose, or activity.This information will be of interest to a community or other entity that has been identified in one of EPA's appropriations acts to receive such funding.

  7. Dividends from Technology Applied.

    ERIC Educational Resources Information Center

    Aviation/Space, 1982

    1982-01-01

    National Aeronautics and Space Administration's (NASA) Applications Program employs aerospace science/technology to provide direct public benefit. Topics related to this program discussed include: Landsat, earth crustal study (plate tectonics), search and rescue systems, radiation measurement, upper atmosphere research, space materials processing,…

  8. Cost savings at the end of life. What do the data show?

    PubMed

    Emanuel, E J

    1996-06-26

    Medical care at the end of life consumes 10% to 12% of the total health care budget and 27% of the Medicare budget. Many people claim that increased use of hospice and advance directives and lower use of high-technology interventions for terminally ill patients will produce significant cost savings. However, the studies on cost savings from hospice and advance directives are not definitive. The 3 randomized trials show no savings from these interventions, but either they are too small for confidence in their negative results or their intervention and cost accounting are flawed. The nonrandomized trials of hospice and advance directives show a wide range of savings, from 68% to none. Five methodological issues obscure the assessment of these studies: (1) selection bias in those patients who use hospice and advance directives, (2) the different time frames of assessing the costs, (3) the limited types of medical costs evaluated, (4) the variability of reporting the savings, and (5) the lack of generalizability of the findings to other patient populations. A more definitive study that assessed patients' end-of-life care preferences, use of hospice and advance directives, and direct and indirect costs would be desirable. In the absence of such a study, the existing data suggest that hospice and advance directives can save between 25% and 40% of health care costs during the last month of life, with savings decreasing to 10% to 17% over the last 6 months of life and decreasing further to 0% to 10% over the last 12 months of life. These savings are less than most people anticipate. Nevertheless, they do indicate that hospice and advance directives should be encouraged because they certainly do not cost more and they provide a means for patients to exercise their autonomy over end-of-life decisions.

  9. Barriers to primary care responsiveness to poverty as a risk factor for health.

    PubMed

    Bloch, Gary; Rozmovits, Linda; Giambrone, Broden

    2011-06-29

    Poverty is widely recognized as a major determinant of poor health, and this link has been extensively studied and verified. Despite the strong evidentiary link, little work has been done to determine what primary care health providers can do to address their patients' income as a risk to their health. This qualitative study explores the barriers to primary care responsiveness to poverty as a health issue in a well-resourced jurisdiction with near-universal health care insurance coverage. One to one interviews were conducted with twelve experts on poverty and health in primary care in Ontario, Canada. Participants included family physicians, specialist physicians, nurse practitioners, community workers, advocates, policy experts and researchers. The interviews were analysed for anticipated and emergent themes. This study reveals provider- and patient-centred structural, attitudinal, and knowledge-based barriers to addressing poverty as a risk to health. While many of its findings reinforce previous work in this area, this study's findings point to a number of areas front line primary care providers could target to address their patients' poverty. These include a lack of provider understanding of the lived reality of poverty, leading to a failure to collect adequate data about patients' social circumstances, and to the development of inappropriate care plans. Participants also pointed to prejudicial attitudes among providers, a failure of primary care disciplines to incorporate approaches to poverty as a standard of care, and a lack of knowledge of concrete steps providers can take to address patients' poverty. While this study reinforces, in a well-resourced jurisdiction such as Ontario, the previously reported existence of significant barriers to addressing income as a health issue within primary care, the findings point to the possibility of front line primary care providers taking direct steps to address the health risks posed by poverty. The consistent direction and replicability of these findings point to a refocusing of the research agenda toward an examination of interventions to decrease the health impacts of poverty.

  10. Advantages and Disadvantages of the Patient-Centered Medical Home: A Critical Analysis and Lessons Learned.

    PubMed

    Budgen, Jacqueline; Cantiello, John

    This article provides a detailed examination of the pros and cons associated with patient-centered medical homes (PCMHs). Opinions and findings from those who have studied PCMHs and those who have been directly involved with this type of health care model are outlined. Key lessons from providers are detailed, and critical success factors are highlighted. This synthesized analysis serves to lend evidence to health care managers and providers who are considering implementation of the PCMH model.

  11. Automatic Extraction of Destinations, Origins and Route Parts from Human Generated Route Directions

    NASA Astrophysics Data System (ADS)

    Zhang, Xiao; Mitra, Prasenjit; Klippel, Alexander; Maceachren, Alan

    Researchers from the cognitive and spatial sciences are studying text descriptions of movement patterns in order to examine how humans communicate and understand spatial information. In particular, route directions offer a rich source of information on how cognitive systems conceptualize movement patterns by segmenting them into meaningful parts. Route directions are composed using a plethora of cognitive spatial organization principles: changing levels of granularity, hierarchical organization, incorporation of cognitively and perceptually salient elements, and so forth. Identifying such information in text documents automatically is crucial for enabling machine-understanding of human spatial language. The benefits are: a) creating opportunities for large-scale studies of human linguistic behavior; b) extracting and georeferencing salient entities (landmarks) that are used by human route direction providers; c) developing methods to translate route directions to sketches and maps; and d) enabling queries on large corpora of crawled/analyzed movement data. In this paper, we introduce our approach and implementations that bring us closer to the goal of automatically processing linguistic route directions. We report on research directed at one part of the larger problem, that is, extracting the three most critical parts of route directions and movement patterns in general: origin, destination, and route parts. We use machine-learning based algorithms to extract these parts of routes, including, for example, destination names and types. We prove the effectiveness of our approach in several experiments using hand-tagged corpora.

  12. Self-directed versus traditional classroom training for neonatal resuscitation.

    PubMed

    Weiner, Gary M; Menghini, Karin; Zaichkin, Jeanette; Caid, Ann E; Jacoby, Carrie J; Simon, Wendy M

    2011-04-01

    Neonatal Resuscitation Program instructors spend most of their classroom time giving lectures and demonstrating basic skills. We hypothesized that a self-directed education program could shift acquisition of these skills outside the classroom, shorten the duration of the class, and allow instructors to use their time to facilitate low-fidelity simulation and debriefing. Novice providers were randomly allocated to self-directed education or a traditional class. Self-directed participants received a textbook, instructional video, and portable equipment kit and attended a 90-minute simulation session with an instructor. The traditional class included 6 hours of lectures and instructor-directed skill stations. Outcome measures included resuscitation skill (megacode assessment score), content knowledge, participant satisfaction, and self-confidence. Forty-six subjects completed the study. There was no significant difference between the study groups in either the megacode assessment score (23.8 [traditional] vs 24.5 [self-directed]; P = .46) or fraction that passed the "megacode" (final skills assessment) (56% [traditional] vs 65% [self-directed]; P = .76). There were no significant differences in content knowledge, course satisfaction, or postcourse self-confidence. Content knowledge, years of experience, and self-confidence did not predict resuscitation skill. Self-directed education improves the educational efficiency of the neonatal resuscitation course by shifting the acquisition of cognitive and basic procedural skills outside of the classroom, which allows the instructor to add low-fidelity simulation and debriefing while significantly decreasing the duration of the course.

  13. Effectiveness of a direct-to-consumer written health education program in the reduction of benzodiazepine and sedative-hypnotic use in an elderly population at a single Veterans Affairs medical center

    PubMed Central

    2018-01-01

    Introduction: The use of benzodiazepines and sedative-hypnotics in the elderly is associated with a significant risk of delirium, falls, fractures, cognitive impairment, and motor vehicle accidents. This quality improvement project applies a direct-to-consumer intervention to an elderly veteran population to reduce the use of these medications. Methods: Patients aged 75 and older currently taking a benzodiazepine and/or a sedative-hypnotic were included in the project. Direct-to-consumer education intervention letters were mailed to patients within 30 days of their next appointment. Their providers were emailed a questionnaire after the patient's appointment. Providers were asked if the letter prompted a conversation regarding medication use, whether the provider initiated discussion regarding a taper, and whether a specific taper plan was developed. Medical records were reviewed to determine if a reduction in dose or discontinuation occurred. Results: Fifty-nine direct-to-consumer education letters were mailed to the patients. Follow-up questionnaires were e-mailed to 44 providers, and 27 providers responded. Twenty-two percent of patients had their benzodiazepine and/or sedative hypnotic dose reduced or discontinued after their follow-up appointment. Sixty-seven percent of veterans initiated a conversation with their provider regarding their medication with 74% of providers discussing dose reduction. Fifty-six percent of recipients developed a specific taper plan with their provider. Discussion: The data from this project suggests that direct-to-consumer patient education can reduce the exposure to benzodiazepines and sedative-hypnotics in an elderly veteran population. More data is needed on larger populations to further explore the benefit of direct-to-consumer interventions.

  14. Into Our Hoods: Where Critical Performance Pedagogy Births Resistance

    ERIC Educational Resources Information Center

    Tintiangco-Cubales, Allyson; Daus-Magbual, Arlene; Desai, Maharaj; Sabac, Aldrich; Von Torres, Maynard

    2016-01-01

    This study focuses on Pin@y Educational Partnerships (PEP), an Ethnic Studies educational pipeline that the five authors have been part of. PEP is in direct opposition to neoliberalism by providing an educational experience for youth to positively transform themselves and their communities. As part of PEP's transformative curriculum, we employ…

  15. Learning to Be a Culturally Responsive Teacher through International Study Trips: Transformation or Tourism?

    ERIC Educational Resources Information Center

    Santoro, Ninetta; Major, Jae

    2012-01-01

    Recent rapid changes in the ethnic and cultural make-up of school communities have highlighted the need for teacher education to prepare teachers for culturally diverse contexts. International study trips provide direct experience and interaction with culturally diverse "others" as a way to extend pre-service teachers' understandings of…

  16. An Ecological Analysis of a Preschool Mastery Climate Physical Education Programme

    ERIC Educational Resources Information Center

    Hastie, Peter A.; Rudisill, Mary E.; Boyd, Korey

    2016-01-01

    Background: Previous studies of mastery motivational climates within physical education have reported that providing students with opportunities to become self-directed leads to a number of positive outcomes, including skill attainment and increased perceptions of ability. Nonetheless, within all of these studies, there has been no account of the…

  17. The AFS Volunteer Resources Study: Summary of Findings from Germany Study.

    ERIC Educational Resources Information Center

    Zeutschel, Uli; Hansel, Bettina

    An ongoing debate exists on the issue of volunteering and its political implications in West Germany. Critics of the social welfare system have a direct impact on volunteerism. The ruling coalition aims to limit public spending in the social services sector while the "grassroots" movement emphasizes the danger of state-provided services…

  18. Knowledge of Metabolic Syndrome in Chinese Adults: Implications for Health Education

    ERIC Educational Resources Information Center

    Lo, Sally Wai Sze; Chair, Sek Ying; Lee, Iris Fung Kam

    2016-01-01

    Objective: The objective of this study was to assess knowledge of metabolic syndrome (MS) among Chinese adults and provide directions for designing healthcare promotion schemes for improving MS awareness in the community. Design: The study adopted a cross-sectional design and a convenience sampling method. Method: Chinese adults aged 18-65 years…

  19. Corporate Blended Learning in Portugal: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Marcal, Julia; Caetano, Antonio

    2010-01-01

    The aim of this study is to characterize the current status of blended learning in Portugal, given that b-learning has grown exponentially in the Portuguese market over recent years. 38 organizations (representing 68% of all institutions certified to provide distance training by the Government Labour Office--DGERT-) participated in this study. The…

  20. Dual Credit/Dual Enrollment and Data Driven Policy Implementation

    ERIC Educational Resources Information Center

    Lichtenberger, Eric; Witt, M. Allison; Blankenberger, Bob; Franklin, Doug

    2014-01-01

    The use of dual credit has been expanding rapidly. Dual credit is a college course taken by a high school student for which both college and high school credit is given. Previous studies provided limited quantitative evidence that dual credit/dual enrollment is directly connected to positive student outcomes. In this study, predictive statistics…

  1. ELECTRICAL AND ELECTRONIC INDUSTRIAL CONTROL. D-C MAGNETIC MOTOR CONTROL, UNIT 7, ASSIGNMENTS.

    ERIC Educational Resources Information Center

    SUTTON, MACK C.

    THIS GUIDE IS FOR INDIVIDUAL STUDENT USE IN STUDYING DIRECT CURRENT MAGNETIC MOTOR CONTROL IN ELECTRICAL-ELECTRONIC PROGRAMS. IT WAS DEVELOPED BY AN INSTRUCTIONAL MATERIALS SPECIALIST AND ADVISERS. EACH OF THE 15 ASSIGNMENT SHEETS PROVIDES THE LESSON SUBJECT, PURPOSE, INTRODUCTORY INFORMATION, STUDY REFERENCES, AND PROBLEMS. SOME OF THE LESSONS…

  2. Characterizing Stressors and Modifiable Health Risk Factors among Homeless Smokers: An Exploratory Pilot Study

    ERIC Educational Resources Information Center

    Kendzor, Darla E.; Reitzel, Lorraine R.; Businelle, Michael S.

    2015-01-01

    This pilot study was conducted to explore the associations between stressors related to homelessness and modifiable health risk factors (poor diet, insufficient physical activity, and overweight/obesity) and to provide direction for future research. Participants (N = 57) were homeless adults enrolled in a smoking cessation program. Analyses were…

  3. Leadership, Innovation Climate, and Attitudes toward Evidence-Based Practice during a Statewide Implementation

    ERIC Educational Resources Information Center

    Aarons, Gregory A.; Sommerfeld, David H.

    2012-01-01

    Objective: Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader-member exchange (i.e., the relationship between a supervisor and their direct service providers) on…

  4. The Effect of Student Attributes and Program Characteristics on Doctoral Degree Completion

    ERIC Educational Resources Information Center

    Gittings, Glenn Allen

    2010-01-01

    More than a decade after the state of Kentucky enacted higher education reform that provided specific direction to the University of Kentucky and the University of Louisville, this research study sought to examine the effect of student characteristics and program characteristics on doctoral degree completion. This study attempted to address the…

  5. Aviation Electrician's Mate 3 & 2. Rate Training Manual and Nonresident Career Course.

    ERIC Educational Resources Information Center

    Coyle, John A., Jr.

    This Rate Training Manual and Nonresident Career Course (RTM/NRCC) form a self-study package that will enable Aviation Electrician's (AE) Mates to help themselves fulfill the requirements of their rating. Designed for individual study and not formal classroom instruction, the RTM provides subject matter that relates directly to the occupational…

  6. Literacy Coaching: The Role of Reflective Thought in Teacher Decision Making

    ERIC Educational Resources Information Center

    May, Patricia Jane

    2010-01-01

    Qualitative studies of classroom teachers involved in literacy coaching are crucial to provide direction for future literacy coaching practice and research. Using a grounded theory design, this study examined the experience of four elementary level classroom teachers and one coach as they engaged in a year-long literacy coaching program. Teachers…

  7. Profile of a Museum Registrar: CASE Research Project 7-78.

    ERIC Educational Resources Information Center

    Hoachlander, Marjorie E.

    This book represents the first independent research study directed toward the educational needs and interests of museum registrars to be undertaken by a university in collaboration with a nationally recognized museum. The study's primary objective was to provide data to be used for the development of materials and methods in the training and…

  8. New Directions for the Study of Within-Individual Variability in Development: The Power of "N = 1"

    ERIC Educational Resources Information Center

    Barbot, Baptiste; Perchec, Cyrille

    2015-01-01

    This article provides an introduction to the idiographic approach ("N = 1" research) in developmental psychology and an overview of methodological and statistical techniques employed to address the study of within-individual variability in development. Through a popularization of the idiographic approach and associated statistical…

  9. Emerging Trends, Future Directions. Environmental Scan.

    ERIC Educational Resources Information Center

    Mesa Community Coll., AZ.

    This paper reports on a study funded by Mesa Community College, Chandler-Gilbert Community College, and Rio Salado College in metropolitan Phoenix, Arizona. The aim of the study was to learn more about some of the external factors that are affecting or will affect these institutions. The report provides information in four major areas: (1) State…

  10. It's Not about Me: College Women and Unplanned Pregnancy

    ERIC Educational Resources Information Center

    Hardy, Jayne W.

    2011-01-01

    The purpose of this qualitative study was to explore the experiences of single college women who had an unplanned pregnancy while attending a small private four-year university in the upper midwest. The conceptual framework used to provide direction for this study was social constructivism. A phenomenological approach was used to seek the reality…

  11. The Use of Electronic Mail To Support Off-Campus Student Learning.

    ERIC Educational Resources Information Center

    Doring, Allan

    A key element in the completion of study by off-campus students is support during their learning. The nature of off-campus study renders nearly impossible the face-to-face contact which provides expansion of lecture material, direct answers to problems, guidance on procedures, and immediate responses to learning difficulties. Electronic mail…

  12. Characterization of VOCs Emissions from Industrial Facilities and Natural Gas Production Sites: A Mobile Sensing Approach

    NASA Astrophysics Data System (ADS)

    Zhou, X.; Gu, J.; Trask, B.; Lyon, D. R.; Albertson, J. D.

    2017-12-01

    With the recent expansion of U.S. oil and gas (O&G) production, many studies have focused on the quantification of fugitive methane emissions. However, only a few studies have explored the emissions of volatile organic compounds (VOCs) from O&G production sites that affect human health in adjacent communities, both directly through exposure to toxic chemical compounds and indirectly via formation of ground-level ozone. In this study, we seek to quantify emissions of VOCs from O&G production sites and petrochemical facilities using a mobile sensing approach, with both high-end analyzers and relatively low-cost sensors. A probabilistic source characterization approach is used to estimate emission rates of VOCs, directly taking into account quantitative measure of sensor accuracy. This work will provide data with proper spatiotemporal resolution and coverage, so as to improve the understanding of VOCs emission from O&G production sites, VOCs-exposure of local communities, and explore the feasibility of low-cost sensors for VOCs monitoring. The project will provide an important foundational step to enable large scale studies.

  13. Accuracy of the unified approach in maternally influenced traits - illustrated by a simulation study in the honey bee (Apis mellifera)

    PubMed Central

    2013-01-01

    Background The honey bee is an economically important species. With a rapid decline of the honey bee population, it is necessary to implement an improved genetic evaluation methodology. In this study, we investigated the applicability of the unified approach and its impact on the accuracy of estimation of breeding values for maternally influenced traits on a simulated dataset for the honey bee. Due to the limitation to the number of individuals that can be genotyped in a honey bee population, the unified approach can be an efficient strategy to increase the genetic gain and to provide a more accurate estimation of breeding values. We calculated the accuracy of estimated breeding values for two evaluation approaches, the unified approach and the traditional pedigree based approach. We analyzed the effects of different heritabilities as well as genetic correlation between direct and maternal effects on the accuracy of estimation of direct, maternal and overall breeding values (sum of maternal and direct breeding values). The genetic and reproductive biology of the honey bee was accounted for by taking into consideration characteristics such as colony structure, uncertain paternity, overlapping generations and polyandry. In addition, we used a modified numerator relationship matrix and a realistic genome for the honey bee. Results For all values of heritability and correlation, the accuracy of overall estimated breeding values increased significantly with the unified approach. The increase in accuracy was always higher for the case when there was no correlation as compared to the case where a negative correlation existed between maternal and direct effects. Conclusions Our study shows that the unified approach is a useful methodology for genetic evaluation in honey bees, and can contribute immensely to the improvement of traits of apicultural interest such as resistance to Varroa or production and behavioural traits. In particular, the study is of great interest for cases where negative correlation between maternal and direct effects and uncertain paternity exist, thus, is of relevance for other species as well. The study also provides an important framework for simulating genomic and pedigree datasets that will prove to be helpful for future studies. PMID:23647776

  14. Accuracy of the unified approach in maternally influenced traits--illustrated by a simulation study in the honey bee (Apis mellifera).

    PubMed

    Gupta, Pooja; Reinsch, Norbert; Spötter, Andreas; Conrad, Tim; Bienefeld, Kaspar

    2013-05-06

    The honey bee is an economically important species. With a rapid decline of the honey bee population, it is necessary to implement an improved genetic evaluation methodology. In this study, we investigated the applicability of the unified approach and its impact on the accuracy of estimation of breeding values for maternally influenced traits on a simulated dataset for the honey bee. Due to the limitation to the number of individuals that can be genotyped in a honey bee population, the unified approach can be an efficient strategy to increase the genetic gain and to provide a more accurate estimation of breeding values. We calculated the accuracy of estimated breeding values for two evaluation approaches, the unified approach and the traditional pedigree based approach. We analyzed the effects of different heritabilities as well as genetic correlation between direct and maternal effects on the accuracy of estimation of direct, maternal and overall breeding values (sum of maternal and direct breeding values). The genetic and reproductive biology of the honey bee was accounted for by taking into consideration characteristics such as colony structure, uncertain paternity, overlapping generations and polyandry. In addition, we used a modified numerator relationship matrix and a realistic genome for the honey bee. For all values of heritability and correlation, the accuracy of overall estimated breeding values increased significantly with the unified approach. The increase in accuracy was always higher for the case when there was no correlation as compared to the case where a negative correlation existed between maternal and direct effects. Our study shows that the unified approach is a useful methodology for genetic evaluation in honey bees, and can contribute immensely to the improvement of traits of apicultural interest such as resistance to Varroa or production and behavioural traits. In particular, the study is of great interest for cases where negative correlation between maternal and direct effects and uncertain paternity exist, thus, is of relevance for other species as well. The study also provides an important framework for simulating genomic and pedigree datasets that will prove to be helpful for future studies.

  15. Impact of Maternal Death on Household Economy in Rural China: A Prospective Path Analysis.

    PubMed

    Ye, Fang; Ao, Deng; Feng, Yao; Wang, Lin; Chen, Jie; Huntington, Dale; Wang, Haijun; Wang, Yan

    2015-01-01

    The present study aimed to explore the inter-relationships among maternal death, household economic status after the event, and potential influencing factors. We conducted a prospective cohort study of households that had experienced maternal death (n = 195) and those that experienced childbirth without maternal death (n = 384) in rural China. All the households were interviewed after the event occurred and were followed up 12 months later. Structural equation modeling was used to test the relationship model, utilizing income and expenditure per capita in the following year after the event as the main outcome variables, maternal death as the predictor, and direct costs, the amount of money offset by positive and negative coping strategies, whether the husband remarried, and whether the newborn was alive as the mediators. In the following year after the event, the path analysis revealed a direct effect from maternal death to lower income per capita (standardized coefficient = -0.43, p = 0.041) and to lower expenditure per capita (standardized coefficient = -0.51, p<0.001). A significant indirect effect was found from maternal death to lower income and expenditure per capita mediated by the influencing factors of higher direct costs, less money from positive coping methods, more money from negative coping, and the survival of the newborn. This study analyzed the direct and indirect effects of maternal death on a household economy. The results provided evidence for better understanding the mechanism of how this event affects a household economy and provided a reference for social welfare policies to target the most vulnerable households that have suffered from maternal deaths.

  16. The daily life of patients with dementia: A comparative study between the information provided by the caregiver and direct patient assessment

    PubMed Central

    Bressan, Lucia Aparecida; Vale, Francisco de Assis Carvalho; Speciali, José Geraldo

    2007-01-01

    The functionality concept is very important, as the diagnosis of dementia presupposes the existence of functional impairment. Instruments assessing functional performance present some limitations. In most cases, the assessment is based on the caregiver’s report. Some studies in international literature have evaluated this issue and concluded that a difference exists between the caregiver’s report and direct patient assessment. American and European caregivers tend to underestimate the patient’s functional limitations. However, this issue has hitherto not been investigated in our context. Objective To compare the caregiver’s information with direct assessment of the patient’s performance based on the same functional assessment questionnaire. Methods Seventy-two patients and caregivers were attended by the Occupational Therapy service of the Behavioral Neurology Outpatient Clinic between 1999 and 2001, 25 of whom fulfilled the inclusion criteria: having a confirmed diagnosis of dementia according to the DSM-IV; having attended three or more return appointments, and where the caregiver belonged to the patient’s family nucleus. The remaining subjects were excluded because of non-adherence to treatment or refusal to participate in the study. The Functional Activities Questionnaire by Pfeffer et al., 1982 was applied to patients in a laboratory simulation, while another evaluator interviewed the respective caregivers. The data were analyzed based on the weighted Kappa coefficient, and Wilcoxon test. Results There were significative differences between caregiver’s answers and direct observation of the patient’s performance. The information provided by the caregivers proved unreliable since caregivers underestimated the patient’s functional capacity. PMID:29213403

  17. 47 CFR 52.33 - Recovery of carrier-specific costs directly related to providing long-term number portability.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Recovery of carrier-specific costs directly related to providing long-term number portability. (a... related to providing long-term number portability. 52.33 Section 52.33 Telecommunication FEDERAL... long-term number portability by establishing in tariffs filed with the Federal Communications...

  18. 47 CFR 52.33 - Recovery of carrier-specific costs directly related to providing long-term number portability.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Recovery of carrier-specific costs directly related to providing long-term number portability. (a... related to providing long-term number portability. 52.33 Section 52.33 Telecommunication FEDERAL... long-term number portability by establishing in tariffs filed with the Federal Communications...

  19. 47 CFR 52.33 - Recovery of carrier-specific costs directly related to providing long-term number portability.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Recovery of carrier-specific costs directly related to providing long-term number portability. (a... related to providing long-term number portability. 52.33 Section 52.33 Telecommunication FEDERAL... long-term number portability by establishing in tariffs filed with the Federal Communications...

  20. 47 CFR 52.33 - Recovery of carrier-specific costs directly related to providing long-term number portability.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Recovery of carrier-specific costs directly related to providing long-term number portability. (a... related to providing long-term number portability. 52.33 Section 52.33 Telecommunication FEDERAL... long-term number portability by establishing in tariffs filed with the Federal Communications...

  1. Newer influenza antivirals, biotherapeutics and combinations

    PubMed Central

    Hayden, Frederick G.

    2012-01-01

    Please cite this paper as: Hayden FG. (2012) Newer Influenza Antivirals, Biotherapeutics and Combinations. Influenza and Other Respiratory Viruses 7(Suppl. 1), 63–75. This summary provides an overview of investigational antiviral agents for influenza and of future directions for development of influenza therapeutics. While progress in developing clinically useful antiviral agents for influenza has been generally slow, especially with respect to seriously ill and high‐risk patients, important clinical studies of intravenous neuraminidase inhibitors, antibodies and drug combinations are currently in progress. The current decade offers the promise of developing small molecular weight inhibitors with novel mechanisms of action, including host‐directed therapies, new biotherapeutics and drug combinations, that should provide more effective antiviral therapies and help mitigate the problem of antiviral resistance. Immunomodulatory interventions also offer promise but need to be based on better understanding of influenza pathogenesis, particularly in seriously ill patients. The development of combination interventions, immunomodulators and host‐directed therapies presents unique clinical trial design and regulatory hurdles that remain to be addressed. PMID:23279899

  2. Ionic contrast terahertz near-field imaging of axonal water fluxes

    PubMed Central

    Masson, Jean-Baptiste; Sauviat, Martin-Pierre; Martin, Jean-Louis; Gallot, Guilhem

    2006-01-01

    We demonstrate the direct and noninvasive imaging of functional neurons by ionic contrast terahertz near-field microscopy. This technique provides quantitative measurements of ionic concentrations in both the intracellular and extracellular compartments and opens the way to direct noninvasive imaging of neurons during electrical, toxin, or thermal stresses. Furthermore, neuronal activity results from both a precise control of transient variations in ionic conductances and a much less studied water exchange between the extracellular matrix and the intraaxonal compartment. The developed ionic contrast terahertz microscopy technique associated with a full three-dimensional simulation of the axon-aperture near-field system allows a precise measurement of the axon geometry and therefore the direct visualization of neuron swelling induced by temperature change or neurotoxin poisoning. Water influx as small as 20 fl per μm of axonal length can be measured. This technique should then provide grounds for the development of advanced functional neuroimaging methods based on diffusion anisotropy of water molecules. PMID:16547134

  3. Visual servoing in medical robotics: a survey. Part I: endoscopic and direct vision imaging - techniques and applications.

    PubMed

    Azizian, Mahdi; Khoshnam, Mahta; Najmaei, Nima; Patel, Rajni V

    2014-09-01

    Intra-operative imaging is widely used to provide visual feedback to a clinician when he/she performs a procedure. In visual servoing, surgical instruments and parts of tissue/body are tracked by processing the acquired images. This information is then used within a control loop to manoeuvre a robotic manipulator during a procedure. A comprehensive search of electronic databases was completed for the period 2000-2013 to provide a survey of the visual servoing applications in medical robotics. The focus is on medical applications where image-based tracking is used for closed-loop control of a robotic system. Detailed classification and comparative study of various contributions in visual servoing using endoscopic or direct visual images are presented and summarized in tables and diagrams. The main challenges in using visual servoing for medical robotic applications are identified and potential future directions are suggested. 'Supervised automation of medical robotics' is found to be a major trend in this field. Copyright © 2013 John Wiley & Sons, Ltd.

  4. LIM Protein Ajuba associates with the RPA complex through direct cell cycle-dependent interaction with the RPA70 subunit.

    PubMed

    Fowler, Sandy; Maguin, Pascal; Kalan, Sampada; Loayza, Diego

    2018-06-22

    DNA damage response pathways are essential for genome stability and cell survival. Specifically, the ATR kinase is activated by DNA replication stress. An early event in this activation is the recruitment and phosphorylation of RPA, a single stranded DNA binding complex composed of three subunits, RPA70, RPA32 and RPA14. We have previously shown that the LIM protein Ajuba associates with RPA, and that depletion of Ajuba leads to potent activation of ATR. In this study, we provide evidence that the Ajuba-RPA interaction occurs through direct protein contact with RPA70, and that their association is cell cycle-regulated and is reduced upon DNA replication stress. We propose a model in which Ajuba negatively regulates the ATR pathway by directly interacting with RPA70, thereby preventing inappropriate ATR activation. Our results provide a framework to further our understanding of the mechanism of ATR regulation in human cells in the context of cellular transformation.

  5. Demographics of cleft care providers in Africa and reported experience in training and practice: direct analysis of continent-based practitioners.

    PubMed

    Adetayo, Oluwaseun A; Martin, Mark C

    2012-05-01

    To elucidate the impact of several geographic, cultural, and socioeconomic variables on cleft care delivery in Africa, and to investigate the current status of cleft care delivery in Africa. Survey of practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP). The annual PACCLIP conference in Ibadan, Nigeria, West Africa, February 2007. To provide an analysis of the demographics and training experience of cleft care providers in Africa by collating information directly from the continent-based practitioners. Plastic surgeons and oral and maxillofacial surgeons provide the majority of cleft care. Most of the participants reported availability of formal training programs in their respective countries. The predominant practice settings were university and government-based. During training, half of the providers had encountered up to 30 cleft cases, and a quarter had managed more than 100 cases. Representation of visiting surgeons were equally distributed between African and non-African countries. This study provides initial and detailed analysis crucial to understanding the underlying framework of cleft care composition teams, demographics of providers, and training and practice experience. This awareness will further enable North American and other non-African plastic surgeons to effectively partner with African cleft care providers to have a further reaching impact in the region.

  6. Emerging directions in the study of the ecology and evolution of plant-animal mutualistic networks: a review.

    PubMed

    Gu, Hao; Goodale, Eben; Chen, Jin

    2015-03-18

    The study of mutualistic plant and animal networks is an emerging field of ecological research. We reviewed progress in this field over the past 30 years. While earlier studies mostly focused on network structure, stability, and biodiversity maintenance, recent studies have investigated the conservation implications of mutualistic networks, specifically the influence of invasive species and how networks respond to habitat loss. Current research has also focused on evolutionary questions including phylogenetic signal in networks, impact of networks on the coevolution of interacting partners, and network influences on the evolution of interacting species. We outline some directions for future research, particularly the evolution of specialization in mutualistic networks, and provide concrete recommendations for environmental managers.

  7. A Bayesian Approach to the Paleomagnetic Conglomerate Test

    NASA Astrophysics Data System (ADS)

    Heslop, David; Roberts, Andrew P.

    2018-02-01

    The conglomerate test has served the paleomagnetic community for over 60 years as a means to detect remagnetizations. The test states that if a suite of clasts within a bed have uniformly random paleomagnetic directions, then the conglomerate cannot have experienced a pervasive event that remagnetized the clasts in the same direction. The current form of the conglomerate test is based on null hypothesis testing, which results in a binary "pass" (uniformly random directions) or "fail" (nonrandom directions) outcome. We have recast the conglomerate test in a Bayesian framework with the aim of providing more information concerning the level of support a given data set provides for a hypothesis of uniformly random paleomagnetic directions. Using this approach, we place the conglomerate test in a fully probabilistic framework that allows for inconclusive results when insufficient information is available to draw firm conclusions concerning the randomness or nonrandomness of directions. With our method, sample sets larger than those typically employed in paleomagnetism may be required to achieve strong support for a hypothesis of random directions. Given the potentially detrimental effect of unrecognized remagnetizations on paleomagnetic reconstructions, it is important to provide a means to draw statistically robust data-driven inferences. Our Bayesian analysis provides a means to do this for the conglomerate test.

  8. A Review of Research on Impulsive Loading of Marine Composites

    NASA Astrophysics Data System (ADS)

    Porfiri, Maurizio; Gupta, Nikhil

    Impulsive loading conditions, such as those produced by blast waves, are being increasingly recognized as relevant in marine applications. Significant research efforts are directed towards understanding the impulsive loading response of traditional naval materials, such as aluminum and steel, and advanced composites, such as laminates and sandwich structures. Several analytical studies are directed towards establishing predictive models for structural response and failure of marine structures under blast loading. In addition, experimental research efforts are focused on characterizing structural response to blast loading. The aim of this review is to provide a general overview of the state of the art on analytical and experimental studies in this field that can serve as a guideline for future research directions. Reported studies cover the Office of Naval Research-Solid Mechanics Program sponsored research along with other worldwide research efforts of relevance to marine applications. These studies have contributed to developing a fundamental knowledge of the mechanics of advanced materials subjected to impulsive loading, which is of interest to all Department of Defense branches.

  9. Mathematical interpretation of Brownian motor model: Limit cycles and directed transport phenomena

    NASA Astrophysics Data System (ADS)

    Yang, Jianqiang; Ma, Hong; Zhong, Suchuang

    2018-03-01

    In this article, we first suggest that the attractor of Brownian motor model is one of the reasons for the directed transport phenomenon of Brownian particle. We take the classical Smoluchowski-Feynman (SF) ratchet model as an example to investigate the relationship between limit cycles and directed transport phenomenon of the Brownian particle. We study the existence and variation rule of limit cycles of SF ratchet model at changing parameters through mathematical methods. The influences of these parameters on the directed transport phenomenon of a Brownian particle are then analyzed through numerical simulations. Reasonable mathematical explanations for the directed transport phenomenon of Brownian particle in SF ratchet model are also formulated on the basis of the existence and variation rule of the limit cycles and numerical simulations. These mathematical explanations provide a theoretical basis for applying these theories in physics, biology, chemistry, and engineering.

  10. The Development of a Novel High Throughput Computational Tool for Studying Individual and Collective Cellular Migration

    PubMed Central

    Chapnick, Douglas A.; Jacobsen, Jeremy; Liu, Xuedong

    2013-01-01

    Understanding how cells migrate individually and collectively during development and cancer metastasis can be significantly aided by a computation tool to accurately measure not only cellular migration speed, but also migration direction and changes in migration direction in a temporal and spatial manner. We have developed such a tool for cell migration researchers, named Pathfinder, which is capable of simultaneously measuring the migration speed, migration direction, and changes in migration directions of thousands of cells both instantaneously and over long periods of time from fluorescence microscopy data. Additionally, we demonstrate how the Pathfinder software can be used to quantify collective cell migration. The novel capability of the Pathfinder software to measure the changes in migration direction of large populations of cells in a spatiotemporal manner will aid cellular migration research by providing a robust method for determining the mechanisms of cellular guidance during individual and collective cell migration. PMID:24386097

  11. Direct profiling of environmental microbial populations by thermal dissociation analysis of native rRNAs hybridized to oligonucleotide microarrays

    NASA Technical Reports Server (NTRS)

    El Fantroussi, Said; Urakawa, Hidetoshi; Bernhard, Anne E.; Kelly, John J.; Noble, Peter A.; Smidt, H.; Yershov, G. M.; Stahl, David A.

    2003-01-01

    Oligonucleotide microarrays were used to profile directly extracted rRNA from environmental microbial populations without PCR amplification. In our initial inspection of two distinct estuarine study sites, the hybridization patterns were reproducible and varied between estuarine sediments of differing salinities. The determination of a thermal dissociation curve (i.e., melting profile) for each probe-target duplex provided information on hybridization specificity, which is essential for confirming adequate discrimination between target and nontarget sequences.

  12. Response of cat inferior colliculus neurons to binaural beat stimuli: possible mechanisms for sound localization.

    PubMed

    Kuwada, S; Yin, T C; Wickesberg, R E

    1979-11-02

    The interaural phase sensitivity of neurons was studied through the use of binaural beat stimuli. The response of most cells was phase-locked to the beat frequency, which provides a possible neural correlate to the human sensation of binaural beats. In addition, this stimulus allowed the direction and rate of interaural phase change to be varied. Some neurons in our sample responded selectively to manipulations of these two variables, which suggests a sensitivity to direction or speed of movement.

  13. Dynamic Kinetic Asymmetric Transformations of β-Stereogenic-α-Keto Esters via Direct Aldolization

    PubMed Central

    Corbett, Michael T.; Johnson, Jeffrey S.

    2014-01-01

    Dynamic kinetic asymmetric transformations (DyKAT) of racemic β-bromo-α-keto esters via direct aldolization of nitromethane and acetone provide access to fully substituted α-glycolic acid derivatives bearing a β-stereocenter. The aldol adducts are obtained in excellent yield with high relative and absolute stereocontrol under mild reaction conditions. Mechanistic studies determined that the reactions proceed through a facile catalyst-mediated racemization of the β-bromo-α-keto esters under a DyKAT Type I manifold. PMID:24222195

  14. Innovation Incubator: LiquidCool Solutions Technical Evaluation. Laboratory Study and Demonstration Results of a Directed-Flow, Liquid Submerged Server for High-Efficiency Data Centers

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

    Kozubal, Eric J

    LiquidCool Solutions (LCS) has developed liquid submerged server (LSS) technology that changes the way computer electronics are cooled. The technology provides an option to cool electronics by the direct contact flow of dielectric fluid (coolant) into a sealed enclosure housing all the electronics of a single server. The intimate dielectric fluid contact with electronics improves the effectiveness of heat removal from the electronics.

  15. Direct β-Alkylation of Aldehydes via Photoredox Organocatalysis

    PubMed Central

    2015-01-01

    Direct β-alkylation of saturated aldehydes has been accomplished by synergistically combining photoredox catalysis and organocatalysis. Photon-induced enamine oxidation provides an activated β-enaminyl radical intermediate, which readily combines with a wide range of Michael acceptors to produce β-alkyl aldehydes in a highly efficient manner. Furthermore, this redox-neutral, atom-economical C–H functionalization protocol can be achieved both inter- and intramolecularly. Mechanistic studies by various spectroscopic methods suggest that a reductive quenching pathway is operable. PMID:24754456

  16. Evaluation of the lubricating effect of magnesium stearate and glyceryl behenate solid lipid nanoparticles in a direct compression process.

    PubMed

    Martínez-Acevedo, Lizbeth; Zambrano-Zaragoza, María de la Luz; Vidal-Romero, Gustavo; Mendoza-Elvira, Susana; Quintanar-Guerrero, David

    2018-05-02

    The aim of this study was to develop solid lipid nanoparticles (SLN) and introduce them into a direct compression process to evaluate their lubricant properties. The study consisted of preparing glyceryl behenate SLN (Compritol® 888 ATO) by hot dispersion, and magnesium stearate SLN by a novel nanoprecipitation/ion exchange method. The ejection force was measured for nanosystems and raw materials in a formulation typically used for direct compression. The smallest particle sizes obtained were 456 nm for Compritol® 888 ATO and 330 nm for magnesium stearate. Results show that the NPs used as lubricants in a direct compression model formulation provided efficient lubrication by maintaining the lubricating properties of the system, thereby decreasing the amount of lubricant used compared to the raw material. The lubricating effect showed an increase of 15-30% for magnesium stearate and Compritol® 888 ATO, compared to the raw material at concentrations above 2%. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. The Scharff-technique: eliciting intelligence from human sources.

    PubMed

    Oleszkiewicz, Simon; Granhag, Pär Anders; Montecinos, Sebastian Cancino

    2014-10-01

    This study is on how to elicit intelligence from human sources. We compared the efficacy of two human intelligence gathering techniques: the Scharff-technique (conceptualized as four different tactics) and the Direct Approach (a combination of open and direct questions). Participants (N = 60) were asked to take on the role of "sources" and were given information about a planned terrorist attack. They were to reveal part of this information in an upcoming interview. Critically, the participants were instructed to strike a balance between not revealing too much or too little information. As predicted, the participants revealed significantly more, and more precise, new information when interviewed with the Scharff-technique (vs. the Direct Approach). Furthermore, and as predicted, the participants in the Scharff condition underestimated how much new information they revealed whereas the participants in the Direct Approach overestimated how much new information they revealed. The study provides rather strong support for the Scharff-technique as an effective human intelligence gathering technique. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  18. Construction and direct electrochemistry of orientation controlled laccase electrode.

    PubMed

    Li, Ying; Zhang, Jiwei; Huang, Xirong; Wang, Tianhong

    2014-03-28

    A laccase has multiple redox centres. Chemisorption of laccases on a gold electrode through a polypeptide tag introduced at the protein surface provides an isotropic orientation of laccases on the Au surface, which allows the orientation dependent study of the direct electrochemistry of laccase. In this paper, using genetic engineering technology, two forms of recombinant laccase which has Cys-6×His tag at the N or C terminus were generated. Via the Au-S linkage, the recombinant laccase was assembled orientationally on gold electrode. A direct electron transfer and a bioelectrocatalytic activity toward oxygen reduction were observed on the two orientation controlled laccase electrodes, but their electrochemical behaviors were found to be quite different. The orientation of laccase on the gold electrode affects both the electron transfer pathway and the electron transfer efficiency of O2 reduction. The present study is helpful not only to the in-depth understanding of the direct electrochemistry of laccase, but also to the development of laccase-based biofuel cells. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Direct and Indirect Peer Socialization of Adolescent Nonsuicidal Self-Injury

    PubMed Central

    Giletta, Matteo; Burk, William J.; Scholte, Ron H. J.; Engels, Rutger C. M. E.; Prinstein, Mitchell J.

    2015-01-01

    This study examined direct and indirect forms of peer socialization of non-suicidal self-injury (NSSI) in adolescent friendship networks. Data were collected among 348 adolescents (55% females; Mage = 15.02 years; SD = 0.53) at 4 assessment waves. Stochastic actor-based models revealed no evidence for direct socialization of NSSI: adolescents whose friends reported higher NSSI did not increase their NSSI over time. However, indirect forms of socialization were found. After controlling for direct socialization and selection effects, friends’ depressive symptoms predicted changes in male and female adolescents’ NSSI and friends’ impulsivity predicted changes in male adolescents’ NSSI. Findings highlight the importance of extending peer influence research beyond the classical “modeling” paradigm by providing evidence that peers may indirectly socialize adolescents’ NSSI. PMID:26412955

  20. Three-dimensional reconstruction from multiple reflected views within a realist painting: an application to Scott Fraser's "Three way vanitas"

    NASA Astrophysics Data System (ADS)

    Smith, Brandon M.; Stork, David G.; Zhang, Li

    2009-01-01

    The problem of reconstructing a three-dimensional scene from single or multiple views has been thoroughly studied in the computer vision literature, and recently has been applied to problems in the history of art. Criminisi pioneered the application of single-view metrology to reconstructing the fictive spaces in Renaissance paintings, such as the vault in Masaccio's Trinità and the plaza in Piero della Francesca's Flagellazione. While the vast majority of realist paintings provide but a single view, some provide multiple views, through mirrors depicted within their tableaus. The contemporary American realist Scott Fraser's Three way vanitas is a highly realistic still-life containing three mirrors; each mirror provides a new view of the objects in the tableau. We applied multiple-view reconstruction methods to the direct image and the images reflected by these mirrors to reconstruct the three-dimensional tableau. Our methods estimate virtual viewpoints for each view using the geometric constraints provided by the direct view of the mirror frames, along with the reflected images themselves. Moreover, our methods automatically discover inconsistencies between the different views, including ones that might elude careful scrutiny by eye, for example the fact that the height of the water in the glass differs between the direct view and that in the mirror at the right. We believe our work provides the first application of multiple-view reconstruction to a single painting and will have application to other paintings and questions in the history of art.

  1. Combined measurement of directional Raman scattering and surface-plasmon-polariton cone from adsorbates on smooth planar gold surfaces

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

    Nyamekye, Charles K. A.; Weibel, Stephen C.; Bobbitt, Jonathan M.

    Directional-surface-plasmon-coupled Raman scattering (directional RS) has the combined benefits of surface plasmon resonance and Raman spectroscopy, and provides the ability to measure adsorption and monolayer-sensitive chemical information. Directional RS is performed by optically coupling a 50-nm gold film to a Weierstrass prism in the Kretschmann configuration and scanning the angle of the incident laser under total internal reflection. The collected parameters on the prism side of the interface include a full surface-plasmon-polariton cone and the full Raman signal radiating from the cone as a function of incident angle. An instrument for performing directional RS and a quantitative study of themore » instrumental parameters are herein reported. To test the sensitivity and quantify the instrument parameters, self-assembled monolayers and 10 to 100-nm polymer films are studied. The signals are found to be well-modeled by two calculated angle-dependent parameters: three-dimensional finite-difference time-domain calculations of the electric field generated in the sample layer and projected to the far-field, and Fresnel calculations of the reflected light intensity. This is the first report of the quantitative study of the full surface-plasmon-polariton cone intensity, cone diameter, and directional Raman signal as a function of incident angle. We propose that directional RS is a viable alternative to surface plasmon resonance when added chemical information is beneficial.« less

  2. Combined measurement of directional Raman scattering and surface-plasmon-polariton cone from adsorbates on smooth planar gold surfaces

    DOE PAGES

    Nyamekye, Charles K. A.; Weibel, Stephen C.; Bobbitt, Jonathan M.; ...

    2017-09-15

    Directional-surface-plasmon-coupled Raman scattering (directional RS) has the combined benefits of surface plasmon resonance and Raman spectroscopy, and provides the ability to measure adsorption and monolayer-sensitive chemical information. Directional RS is performed by optically coupling a 50-nm gold film to a Weierstrass prism in the Kretschmann configuration and scanning the angle of the incident laser under total internal reflection. The collected parameters on the prism side of the interface include a full surface-plasmon-polariton cone and the full Raman signal radiating from the cone as a function of incident angle. An instrument for performing directional RS and a quantitative study of themore » instrumental parameters are herein reported. To test the sensitivity and quantify the instrument parameters, self-assembled monolayers and 10 to 100-nm polymer films are studied. The signals are found to be well-modeled by two calculated angle-dependent parameters: three-dimensional finite-difference time-domain calculations of the electric field generated in the sample layer and projected to the far-field, and Fresnel calculations of the reflected light intensity. This is the first report of the quantitative study of the full surface-plasmon-polariton cone intensity, cone diameter, and directional Raman signal as a function of incident angle. We propose that directional RS is a viable alternative to surface plasmon resonance when added chemical information is beneficial.« less

  3. Direct and extended intergenerational contact and young people's attitudes towards older adults.

    PubMed

    Drury, Lisbeth; Hutchison, Paul; Abrams, Dominic

    2016-09-01

    Research suggests that positive intergenerational contact can improve young people's attitudes towards older adults. However, today's age-segregated society may not provide ample opportunities for positive contact between younger and older adults to occur on a regular basis. In three studies, we investigated whether the positive attitudinal outcomes associated with direct contact might also stem from a more indirect form of intergenerational relationship: extended contact. In Study 1 (N = 70), extended contact was associated with more positive attitudes towards older adults even when controlling for direct intergenerational contact (contact frequency and contact quality). In Study 2 (N = 110), the positive effects of direct and extended contact on young people's age-related attitudes were mediated by reductions in intergroup anxiety and ageing anxiety. The mediational effects of intergroup anxiety were replicated in Study 3 (N = 95) and ingroup norms additionally emerged as a mediator of the positive effects of extended contact on young people's attitudes towards older adults. Discussion focuses on the implications for strategies aimed at tackling ageism. ©2016 The Authors. British Journal of Social Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

  4. The Inelastic Instrument suite at the SNS

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

    Granroth, Garrett E; Abernathy, Douglas L; Ehlers, Georg

    2008-01-01

    Abstract The instruments in the extensive suite of spectrometers at the SNS are in various stages of installation and commissioning. The Back Scattering Spectrometer (BASIS) is installed and is in commissioning. It's near backscattering analyzer crystals provide the 3 eV resolution as expected. BASIS will enter the user program in the fall of 2007. The ARCS wide angular-range thermal to epithermal neutron spectrometer will come on line in the fall of 2007 followed shortly by the Cold Neutron Chopper Spectrometer. These two direct geometry instruments provide moderate resolution and the ability to trade resolution for flux. In addition both instrumentsmore » have detector coverage out to 140o to provide a large Q range. The SEQUOIA spectrometer, complete in 2008, is the direct geometry instrument that will provide fine resolution in the thermal to epithermal range. The Spin-Echo spectrometer, to be completed on a similar time scale, will provide the finest energy resolution worldwide. The HYSPEC spectrometer, available no later than 2011, will provide polarized capabilities and optimized flux in the thermal energy range. Finally, the Vision chemical spectrometer will use crystal analyzers to study energy transfers into the epithermal range« less

  5. Numerical study on the selective excitation of Helmholtz-Gauss beams in end-pumped solid-state digital lasers with the control of the laser gain transverse position provided by off-axis end pumping

    NASA Astrophysics Data System (ADS)

    Tsai, Ko-Fan; Chu, Shu-Chun

    2018-03-01

    This study proposes a complete and unified method for selective excitation of any specified nearly nondiffracting Helmholtz-Gauss (HzG) beam in end-pumped solid-state digital lasers. Four types of the HzG beams: cosine-Gauss beams, Bessel-Gauss beams, Mathieu-Gauss beams, and, in particular, parabolic-Gauss beams are successfully demonstrated to be generated with the proposed methods. To the best of the authors’ knowledge, parabolic-Gauss beams have not yet been directly generated from any kind of laser system. The numerical results of this study show that one can successfully achieve any lasing HzG beams directly from the solid-state digital lasers with only added control of the laser gain transverse position provided by off-axis end pumping. This study also presents a practical digital laser set-up for easily manipulating off-axis pumping in order to achieve the control of the laser gain transverse gain position in digital lasers. The reported results in this study provide advancement of digital lasers in dynamically generating nondiffracting beams. The control of the digital laser cavity gain position creates the possibility of achieving real-time selection of more laser modes in digital lasers, and it is worth further investigation in the future.

  6. Direct Loans: A Simple, Convenient, Flexible Way To Finance Your Education.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC. Student Financial Assistance.

    This pamphlet provides basic facts about the U.S. Department of Education's Direct Loan Program for students. These loans include Federal Direct Stafford/Ford Loans, Federal Direct Unsubsidized Stafford/Ford Loans, Direct PLUS Loans, and Direct Consolidation Loans. The pamphlet's sections are: (1) "The Direct Loan Program: What Is It?";…

  7. The Role of Industrial Parks in Mitigating Greenhouse Gas Emissions from China.

    PubMed

    Guo, Yang; Tian, Jinping; Zang, Na; Gao, Yang; Chen, Lujun

    2018-06-14

    This study uncovered the direct and indirect energy-related GHG emissions of 213 Chinese national-level industrial parks, providing 11% of China's GDP, from a life-cycle perspective. Direct emissions are sourced from fuel combustion, and indirect emissions are embodied in energy production. The results indicated that in 2015, the direct and indirect GHG emissions of the parks were 1042 and 181 million tonne CO2 eq., respectively, totally accounting for 11% of national GHG emissions. The total energy consumption of the parks accounted for 10% of national energy consumption. Coal constituted 74% of total energy consumption in these parks. Baseline and low-carbon scenarios are established for 2030, and five GHG mitigation measures targeting energy consumption are modeled. The GHG mitigation potential for these parks in 2030 is quantified as 116 million tonne, equivalent to 9.5% of the parks' total emission in 2015. The measures that increase the share of natural gas consumption, reduce the GHG emission factor of electricity grid, and improve the average efficiency of industrial coal-fired boilers, will totally contribute 94% and 98% in direct and indirect GHG emissions reductions, respectively. These findings will provide a solid foundation for the low-carbon development of Chinese industrial parks.

  8. Comparison of ionospheric plasma drifts obtained by different techniques

    NASA Astrophysics Data System (ADS)

    Kouba, Daniel; Arikan, Feza; Arikan, Orhan; Toker, Cenk; Mosna, Zbysek; Gok, Gokhan; Rejfek, Lubos; Ari, Gizem

    2016-07-01

    Ionospheric observatory in Pruhonice (Czech Republic, 50N, 14.9E) provides regular ionospheric sounding using Digisonde DPS-4D. The paper is focused on F-region vertical drift data. Vertical component of the drift velocity vector can be estimated by several methods. Digisonde DPS-4D allows sounding in drift mode with direct output represented by drift velocity vector. The Digisonde located in Pruhonice provides direct drift measurement routinely once per 15 minutes. However, also other different techniques can be found in the literature, for example the indirect estimation based on the temporal evolution of measured ionospheric characteristics is often used for calculation of the vertical drift component. The vertical velocity is thus estimated according to the change of characteristics scaled from the classical quarter-hour ionograms. In present paper direct drift measurement is compared with technique based on measuring of the virtual height at fixed frequency from the F-layer trace on ionogram, technique based on variation of h`F and hmF. This comparison shows possibility of using different methods for calculating vertical drift velocity and their relationship to the direct measurement used by Digisonde. This study is supported by the Joint TUBITAK 114E092 and AS CR 14/001 projects.

  9. Usability Studies in Virtual and Traditional Computer Aided Design Environments for Fault Identification

    DTIC Science & Technology

    2017-08-08

    Usability Studies In Virtual And Traditional Computer Aided Design Environments For Fault Identification Dr. Syed Adeel Ahmed, Xavier University...virtual environment with wand interfaces compared directly with a workstation non-stereoscopic traditional CAD interface with keyboard and mouse. In...the differences in interaction when compared with traditional human computer interfaces. This paper provides analysis via usability study methods

  10. Official Study Guide for the Certified Park and Recreation Professional. Fourth Edition

    ERIC Educational Resources Information Center

    Mulvaney, Michael A.; Hurd, Amy R.

    2013-01-01

    The "Official Study Guide for the CPRP Examination" provides up-to-date information in this new edition to assist the park and recreation professional in preparing for the CPRP examination. The study guide serves as an excellent source of information for any individual who works directly or indirectly in the field of park and recreation services.

  11. The Missouri Career Development and Teacher Excellence Plan: An Initial Study of Missouri's Career Ladder Program. A Technical Report.

    ERIC Educational Resources Information Center

    Schofer, Richard C.; And Others

    The Missouri Plan provides for direct participation of teachers in the planning, development, and implementation of the district career ladder plan. This study analyzed the appropriateness of the Missouri teacher incentive plan. In particular, the study sought to determine why districts did or did not choose to implement career ladder programs;…

  12. The Convoy Model: Explaining Social Relations From a Multidisciplinary Perspective

    PubMed Central

    Antonucci, Toni C.

    2014-01-01

    Purpose of the Study: Social relations are a key aspect of aging and the life course. In this paper, we trace the scientific origins of the study of social relations, focusing in particular on research grounded in the convoy model. Design and Methods: We first briefly review and critique influential historical studies to illustrate how the scientific study of social relations developed. Next, we highlight early and current findings grounded in the convoy model that have provided key insights into theory, method, policy, and practice in the study of aging. Results: Early social relations research, while influential, lacked the combined approach of theoretical grounding and methodological rigor. Nevertheless, previous research findings, especially from anthropology, suggested the importance of social relations in the achievement of positive outcomes. Considering both life span and life course perspectives and grounded in a multidisciplinary perspective, the convoy model was developed to unify and consolidate scattered evidence while at the same time directing future empirical and applied research. Early findings are summarized, current evidence presented, and future directions projected. Implications: The convoy model has provided a useful framework in the study of aging, especially for understanding predictors and consequences of social relations across the life course. PMID:24142914

  13. Human's Capability to Discriminate Spatial Forces at the Big Toe.

    PubMed

    Hagengruber, Annette; Höppner, Hannes; Vogel, Jörn

    2018-01-01

    A key factor for reliable object manipulation is the tactile information provided by the skin of our hands. As this sensory information is so essential in our daily life it should also be provided during teleoperation of robotic devices or in the control of myoelectric prostheses. It is well-known that feeding back the tactile information to the user can lead to a more natural and intuitive control of robotic devices. However, in some applications it is difficult to use the hands as natural feedback channels since they may already be overloaded with other tasks or, e.g., in case of hand prostheses not accessible at all. Many alternatives for tactile feedback to the human hand have already been investigated. In particular, one approach shows that humans can integrate uni-directional (normal) force feedback at the toe into their sensorimotor-control loop. Extending this work, we investigate the human's capability to discriminate spatial forces at the bare front side of their toe. A state-of-the-art haptic feedback device was used to apply forces with three different amplitudes-2 N, 5 N, and 8 N-to subjects' right big toes. During the experiments, different force stimuli were presented, i.e., direction of the applied force was changed, such that tangential components occured. In total the four directions up (distal), down (proximal), left (medial), and right (lateral) were tested. The proportion of the tangential force was varied corresponding to a directional change of 5° to 25° with respect to the normal force. Given these force stimuli, the subjects' task was to identify the direction of the force change. We found the amplitude of the force as well as the proportion of tangential forces to have a significant influence on the success rate. Furthermore, the direction right showed a significantly different successrate from all other directions. The stimuli with a force amplitude of 8 N achieved success rates over 89% in all directions. The results of the user study provide evidence that the subjects were able to discriminate spatial forces at their toe within defined force amplitudes and tangential proportion.

  14. Human's Capability to Discriminate Spatial Forces at the Big Toe

    PubMed Central

    Hagengruber, Annette; Höppner, Hannes; Vogel, Jörn

    2018-01-01

    A key factor for reliable object manipulation is the tactile information provided by the skin of our hands. As this sensory information is so essential in our daily life it should also be provided during teleoperation of robotic devices or in the control of myoelectric prostheses. It is well-known that feeding back the tactile information to the user can lead to a more natural and intuitive control of robotic devices. However, in some applications it is difficult to use the hands as natural feedback channels since they may already be overloaded with other tasks or, e.g., in case of hand prostheses not accessible at all. Many alternatives for tactile feedback to the human hand have already been investigated. In particular, one approach shows that humans can integrate uni-directional (normal) force feedback at the toe into their sensorimotor-control loop. Extending this work, we investigate the human's capability to discriminate spatial forces at the bare front side of their toe. A state-of-the-art haptic feedback device was used to apply forces with three different amplitudes—2 N, 5 N, and 8 N—to subjects' right big toes. During the experiments, different force stimuli were presented, i.e., direction of the applied force was changed, such that tangential components occured. In total the four directions up (distal), down (proximal), left (medial), and right (lateral) were tested. The proportion of the tangential force was varied corresponding to a directional change of 5° to 25° with respect to the normal force. Given these force stimuli, the subjects' task was to identify the direction of the force change. We found the amplitude of the force as well as the proportion of tangential forces to have a significant influence on the success rate. Furthermore, the direction right showed a significantly different successrate from all other directions. The stimuli with a force amplitude of 8 N achieved success rates over 89% in all directions. The results of the user study provide evidence that the subjects were able to discriminate spatial forces at their toe within defined force amplitudes and tangential proportion. PMID:29692718

  15. Radial arm strike rail

    DOEpatents

    McKeown, Mark H.; Beason, Steven C.

    1991-01-01

    The radial arm strike rail assembly is a system for measurement of bearings, directions, and stereophotography for geologic mapping, particularly where magnetic compasses are not appropriate. The radial arm, pivoting around a shaft axis, provides a reference direction determination for geologic mapping and bearing or direction determination. The centerable and levelable pedestal provide a base for the radial arm strike rail and the telescoping camera pedestal. The telescoping feature of the radial arm strike rail allows positioning the end of the rail for strike direction or bearing measurement with a goniometer.

  16. Method for measuring surface shear stress magnitude and direction using liquid crystal coatings

    NASA Technical Reports Server (NTRS)

    Reda, Daniel C. (Inventor)

    1995-01-01

    A method is provided for determining surface shear magnitude and direction at every point on a surface. The surface is covered with a shear stress sensitive liquid crystal coating and illuminated by white light from a normal direction. A video camera is positioned at an oblique angle above the surface to observe the color of the liquid crystal at that angle. The shear magnitude and direction are derived from the color information. A method of calibrating the device is also provided.

  17. Assessing the Impact of Urbanization on Direct Runoff Using Improved Composite CN Method in a Large Urban Area.

    PubMed

    Li, Chunlin; Liu, Miao; Hu, Yuanman; Shi, Tuo; Zong, Min; Walter, M Todd

    2018-04-17

    Urbanization is one of the most widespread anthropogenic activities, which brings a range of physical and biochemical changes to hydrological system and processes. Increasing direct runoff caused by land use change has become a major challenge for urban ecological security. Reliable prediction of the quantity and rate of surface runoff is an inherently difficult and time-consuming task for large ungauged urban areas. In this study, we combined Geographic Information System and remote sensing technology with an improved Soil Conservation Service curve number model to evaluate the effects of land use change on direct runoff volume of the four-ring area in Shenyang, China, and analyzed trends of direct runoff at different scales. Through analyzing trends of direct runoff from 1984 to 2015 at different scales, we explored how urbanization and other potential factors affect direct runoff changes. Total direct runoff volume increased over time, and trends varied from the inner urban area to suburban area. Zones 1 and 2 had a tendency toward decreasing direct runoff volume and risks, while Zones 3 and 4 showed gradual increases at both regional and pixel scales. The most important influence on direct runoff change was urban surface change caused by urbanization. This study presents a framework for identifying hotspots of runoff increase, which can provide important guidance to urban managers in future green infrastructure planning, in the hopes of improving the security of urban water ecological patterns.

  18. Assessing the Impact of Urbanization on Direct Runoff Using Improved Composite CN Method in a Large Urban Area

    PubMed Central

    Li, Chunlin; Liu, Miao; Hu, Yuanman; Shi, Tuo; Zong, Min; Walter, M. Todd

    2018-01-01

    Urbanization is one of the most widespread anthropogenic activities, which brings a range of physical and biochemical changes to hydrological system and processes. Increasing direct runoff caused by land use change has become a major challenge for urban ecological security. Reliable prediction of the quantity and rate of surface runoff is an inherently difficult and time-consuming task for large ungauged urban areas. In this study, we combined Geographic Information System and remote sensing technology with an improved Soil Conservation Service curve number model to evaluate the effects of land use change on direct runoff volume of the four-ring area in Shenyang, China, and analyzed trends of direct runoff at different scales. Through analyzing trends of direct runoff from 1984 to 2015 at different scales, we explored how urbanization and other potential factors affect direct runoff changes. Total direct runoff volume increased over time, and trends varied from the inner urban area to suburban area. Zones 1 and 2 had a tendency toward decreasing direct runoff volume and risks, while Zones 3 and 4 showed gradual increases at both regional and pixel scales. The most important influence on direct runoff change was urban surface change caused by urbanization. This study presents a framework for identifying hotspots of runoff increase, which can provide important guidance to urban managers in future green infrastructure planning, in the hopes of improving the security of urban water ecological patterns. PMID:29673182

  19. Direct enzymatic bioelectrocatalysis: differentiating between myth and reality

    PubMed Central

    2017-01-01

    Enzymatic bioelectrocatalysis is being increasingly exploited to better understand oxidoreductase enzymes, to develop minimalistic yet specific biosensor platforms, and to develop alternative energy conversion devices and bioelectrosynthetic devices for the production of energy and/or important chemical commodities. In some cases, these enzymes are able to electronically communicate with an appropriately designed electrode surface without the requirement of an electron mediator to shuttle electrons between the enzyme and electrode. This phenomenon has been termed direct electron transfer or direct bioelectrocatalysis. While many thorough studies have extensively investigated this fascinating feat, it is sometimes difficult to differentiate desirable enzymatic bioelectrocatalysis from electrocatalysis deriving from inactivated enzyme that may have also released its catalytic cofactor. This article will review direct bioelectrocatalysis of several oxidoreductases, with an emphasis on experiments that provide support for direct bioelectrocatalysis versus denatured enzyme or dissociated cofactor. Finally, this review will conclude with a series of proposed control experiments that could be adopted to discern successful direct electronic communication of an enzyme from its denatured counterpart. PMID:28637918

  20. [Comparison of noise characteristics of direct and indirect conversion flat panel detectors].

    PubMed

    Murai, Masami; Kishimoto, Kenji; Tanaka, Katsuhisa; Oota, Kenji; Ienaga, Akinori

    2010-11-20

    Flat-panel detector (FPD) digital radiography systems have direct and indirect conversion systems, and the 2 conversion systems provide different imaging performances. We measured some imaging performances [input-output characteristic, presampled modulation transfer function (presampled MTF), noise power spectrum (NPS)] of direct and indirect FPD systems. Moreover, some image samples of the NPSs were visually evaluated by the pair comparison method. As a result, the presampled MTF of the direct FPD system was substantially higher than that of the indirect FPD system. The NPS of the direct FPD system had a high value for all spatial frequencies. In contrast, the NPS of the indirect FPD system had a lower value as the frequency became higher. The results of visual evaluations showed the same tendency as that found for NPSs. We elucidated the cause of the difference in NPSs in a simulation study, and we determined that the cause of the difference in the noise components of the direct and indirect FPD systems was closely related to the presampled MTF.

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