Action to Support Practices Implement Research Evidence (ASPIRE): protocol for a cluster-randomised evaluation of adaptable implementation packages targeting 'high impact' clinical practice recommendations in general practice.

PubMed

Willis, Thomas A; Hartley, Suzanne; Glidewell, Liz; Farrin, Amanda J; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Collinson, Michelle; Clamp, Susan; Hunter, Cheryl; Ward, Vicky; Hulme, Claire; Meads, David; Bregantini, Daniele; Carder, Paul; Foy, Robbie

2016-02-29

There are recognised gaps between evidence and practice in general practice, a setting which provides particular challenges for implementation. We earlier screened clinical guideline recommendations to derive a set of 'high impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. We aim to evaluate the effectiveness and cost-effectiveness of a multifaceted, adaptable intervention package to implement four targeted, high impact recommendations in general practice. The research programme Action to Support Practice Implement Research Evidence (ASPIRE) includes a pair of pragmatic cluster-randomised trials which use a balanced incomplete block design. Clusters are general practices in West Yorkshire, United Kingdom (UK), recruited using an 'opt-out' recruitment process. The intervention package adapted to each recommendation includes combinations of audit and feedback, educational outreach visits and computerised prompts with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. In trial 1, practices are randomised to adapted interventions targeting either diabetes control or risky prescribing and those in trial 2 to adapted interventions targeting either blood pressure control in patients at risk of cardiovascular events or anticoagulation in atrial fibrillation. The respective primary endpoints comprise achievement of all recommended target levels of haemoglobin A1c (HbA1c), blood pressure and cholesterol in patients with type 2 diabetes, a composite indicator of risky prescribing, achievement of recommended blood pressure targets for specific patient groups and anticoagulation prescribing in patients with atrial fibrillation. We are also randomising practices to a fifth, non-intervention control group to further assess Hawthorne effects. Outcomes will be assessed using routinely collected data

Geothermal Target Areas in Colorado as Identified by Remote Sensing Techniques

DOE Data Explorer

Khalid Hussein

2012-02-01

This layer contains the areas identified as targets of potential geothermal activity. The Criteria used to identify the target areas include: hot/warm surface exposures modeled from ASTER/Landsat satellite imagery and geological characteristics, alteration mineral commonly associated with hot springs (clays, Si, and FeOx) modeled from ASTER and Landsat data, Colorado Geological Survey (CGS) known thermal hot springs/wells and heat-flow data points, Colorado deep-seated fault zones, weakened basement identified from isostatic gravity data, and Colorado sedimentary and topographic characteristics.

Are national targets the right way to improve infection control practice?

PubMed

Millar, M

2009-12-01

The 'right way to improve infection control practice' should be cost-effective and lead to a fair distribution of infection control resources. Cost-effectiveness is a measure of aggregate 'good', and fairness emphasises similar treatment for individuals under similar circumstances. The UK national meticillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) target encourages National Health Service trusts to prioritise strategies aimed at MRSA BSI prevention. Under resource-limited conditions, the MRSA BSI target inevitably encourages deprioritisation of patients at risk of non-target healthcare-associated infection (HCAI), some of which are associated with an equal or larger burden of adverse outcome. Established healthcare improvement strategies, such as the Plan, Do, Study, Act (PDSA) cycle advocated by the Health Foundation, require the setting of aims (or targets). If we are to improve infection control practice then we need to decide on what to measure, how to measure it, and what the improvement (target) should be. In selecting targets for infection prevention, account should be taken of the contribution of HCAI to adverse health outcomes overall. Human risk compensation behaviour and microbial adaptation may both counteract the overall benefit of infection targets isolated from overall outcomes. Risk taking is part of a healthy healthcare system. We must be careful not to isolate HCAI outcomes from overall outcomes or to isolate 'risk takers' from 'risk controllers'. We must try to limit the scope for human risk compensation and we must watch out for microbial adaptation. Targets should be set locally, taking account of fairness and cost-effectiveness. Locally relevant information is key; positive incentives work best.

Review of Occupational Therapy Intervention Research in the Practice Area of Children and Youth 2009–2013

PubMed Central

Bendixen, Roxanna M.; Huang, Yu Yun; Lim, Yoonjeong

2014-01-01

PURPOSE. We conducted a systematic review examining the extent to which pediatric intervention research recently published in the American Journal of Occupational Therapy reflects occupational therapy’s holistic occupation-based tenets. METHOD. We surveyed 10 systematic reviews and analyzed 38 single effectiveness studies for intervention approach, type, level of environmental targeting, level of occupational task and participation practice, and measures used. RESULTS. Of the 38 single effectiveness studies, 12 (32%) explicitly incorporated both environmental targets of intervention and practice of complex or in vivo occupational tasks, with steady increases during the 2009–2013 time frame. CONCLUSION. In the area of children and youth, occupational therapy is making steady gains in reflecting and demonstrating the effectiveness of the profession’s holistic, occupation-based tenets. Occupational therapy researchers must be mindful to ensure that despite the reductionist nature of intervention research, interventions reflect the profession’s holistic understanding of the interplay between the child, environment, and occupations. PMID:24581415

The positive effect of targeted marketing on an existing uterine fibroid embolization practice.

PubMed

Chrisman, Howard B; Basu, Pat Auveek; Omary, Reed A

2006-03-01

Although uterine fibroid embolization is an effective treatment option for symptomatic women, it is unclear what methods can be used to expand referrals in an already established practice. The authors tested the hypothesis that an advertising strategy focused on a defined target market can expand an existing uterine fibroid embolization practice. A market-driven planning sequence was employed. This included a determination of goals, an examination of current competition, determination of target market based on local environment and previous consumer use, pretest of product sample, and implementation of advertisement. Based on the analysis the authors determined that the target audience was professional black women aged 35 to 45. A specific weekly magazine was selected due to readership demographics. An advertisement was run for 8 consecutive weeks. The authors prospectively tracked patient inquiries, clinic visits, cases performed, and revenues generated for 3 months following the initial advertisement. All patients were seen in a fully staffed, preexisting fibroid clinic located within an urban, university-based academic practice performing 250 uterine fibroid embolizations annually. Ninety calls were received directly related to the advertisement. There were 35 clinic visits, which resulted in 17 uterine fibroid embolizations and 52 total MR imaging procedures. Eighteen patients were not considered candidates based on established protocols. The 17 extra cases performed over 3 months represented a 27% increase in case volume. Total professional cash collections for these cases (including MR imaging) were 58,317 US dollars. The cost of advertising was 8,000 US dollars. As a result of existing infrastructure, no additional costs were necessary. This resulted in a net revenue gain 50,317 US dollars and a nonannualized rate of return of approximately 625%. As Interventional Radiologists look to develop and expand existing practices, traditional marketing tools such as

AN EARLY STAGE IN THE PLANT RECOLONIZATION OF A NUCLEAR TARGET AREA

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

Rickard, W.H.; Shields, L.M.

1963-01-01

Vegetational analyses were conducted three years postdetonation in a nuclear target area in a Grayia spinosa-Lycium andersonii community in Yucca Fiat, Nevada. Annual plants dominated the early stage of recolonization and were quantitatively more abundant in the disturbed areas than in an adjacent undisturbed shrub community. Ment zelia albicaulis and Chaenactis steviodes occurred in both disturbed and undisturbed areas, however; Mentzelia was more abundant in disturbed areas while Chaenactis was more abundant in the undisturbed community. Salsola kali was confined to disturbed areas while Phacelia vallismortae was more often encountered in the undisturbed community. The plant recolonization of a mechanicallymore » disturbed area was quantitatively and qualitatively more like that of the interior zone of the nuclear target area than less disturbed habitats. These data support a conclusion that soil displacement presents a more rigorous habitat for plant recolonization than disturbances created by the wider ranging destructive components of a nuclear detonation. (auth)« less

The effects of figure/ground, perceived area, and target saliency on the luminosity threshold.

PubMed

Bonato, F; Cataliotti, J

2000-02-01

Observers adjusted the luminance of a target region until it began to appear self-luminous, or glowing. In Experiment 1, the target was either a face-shaped region (figure) or a non-face-shaped region (ground) of identical area that appeared to be the face's background. In Experiment 2, the target was a square or a trapezoid of identical area that appeared as a tilted rectangle. In Experiment 3, the target was a square surrounded by square, circular, or diamond-shaped elements. Targets that (1) were perceived as figures, (2) were phenomenally small in area, or (3) did not group well with other elements in the array because of shape appeared self-luminous at significantly lower luminance levels. These results indicate that like lightness perception, the luminosity threshold is influenced by perceptual organization and is not based on low-level retinal processes alone.

Implementation of targeted medication adherence interventions within a community chain pharmacy practice: The Pennsylvania Project.

PubMed

Bacci, Jennifer L; McGrath, Stephanie Harriman; Pringle, Janice L; Maguire, Michelle A; McGivney, Melissa Somma

2014-01-01

To identify facilitators and barriers to implementing targeted medication adherence interventions in community chain pharmacies, and describe adaptations of the targeted intervention and organizational structure within each individual pharmacy practice. Qualitative study. Central and western Pennsylvania from February to April 2012. Rite Aid pharmacists staffed at the 118 Pennsylvania Project intervention sites. Qualitative analysis of pharmacists' perceptions of facilitators and barriers experienced, targeted intervention and organizational structure adaptations implemented, and training and preparation prior to implementation. A total of 15 key informant interviews were conducted from February to April 2012. Ten pharmacists from "early adopter" practices and five pharmacists from "traditionalist" practices were interviewed. Five themes emerged regarding the implementation of targeted interventions, including all pharmacists' need to understand the relationship of patient care programs to their corporation's vision; providing individualized, continual support and mentoring to pharmacists; anticipating barriers before implementation of patient care programs; encouraging active patient engagement; and establishing best practices regarding implementation of patient care services. This qualitative analysis revealed that there are a series of key steps that can be taken before the execution of targeted interventions that may promote successful implementation of medication therapy management in community chain pharmacies.

Identification of clinical target areas in the brainstem of prion‐infected mice

PubMed Central

Mirabile, Ilaria; Jat, Parmjit S.; Brandner, Sebastian

2015-01-01

Aims While prion infection ultimately involves the entire brain, it has long been thought that the abrupt clinical onset and rapid neurological decline in laboratory rodents relates to involvement of specific critical neuroanatomical target areas. The severity and type of clinical signs, together with the rapid progression, suggest the brainstem as a candidate location for such critical areas. In this study we aimed to correlate prion pathology with clinical phenotype in order to identify clinical target areas. Method We conducted a comprehensive survey of brainstem pathology in mice infected with two distinct prion strains, which produce different patterns of pathology, in mice overexpressing prion protein (with accelerated clinical onset) and in mice in which neuronal expression was reduced by gene targeting (which greatly delays clinical onset). Results We identified specific brainstem areas that are affected by prion pathology during the progression of the disease. In the early phase of disease the locus coeruleus, the nucleus of the solitary tract, and the pre‐Bötzinger complex were affected by prion protein deposition. This was followed by involvement of the motor and autonomic centres of the brainstem. Conclusions Neurodegeneration in the locus coeruleus, the nucleus of the solitary tract and the pre‐Bötzinger complex predominated and corresponded to the manifestation of the clinical phenotype. Because of their fundamental role in controlling autonomic function and the overlap with clinical signs in sporadic Creutzfeldt–Jakob disease, we suggest that these nuclei represent key clinical target areas in prion diseases. PMID:25311251

33 CFR 334.120 - Delaware Bay off Milford Neck; naval aircraft bombing target area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Delaware Bay off Milford Neck; naval aircraft bombing target area. 334.120 Section 334.120 Navigation and Navigable Waters CORPS OF....120 Delaware Bay off Milford Neck; naval aircraft bombing target area. (a) The danger zone. A circular...

33 CFR 334.120 - Delaware Bay off Milford Neck; naval aircraft bombing target area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Delaware Bay off Milford Neck; naval aircraft bombing target area. 334.120 Section 334.120 Navigation and Navigable Waters CORPS OF....120 Delaware Bay off Milford Neck; naval aircraft bombing target area. (a) The danger zone. A circular...

Philippine protected areas are not meeting the biodiversity coverage and management effectiveness requirements of Aichi Target 11.

PubMed

Mallari, Neil Aldrin D; Collar, Nigel J; McGowan, Philip J K; Marsden, Stuart J

2016-04-01

Aichi Target 11 of the Convention on Biological Diversity urges, inter alia, that nations protect at least 17 % of their land, and that protection is effective and targets areas of importance for biodiversity. Five years before reporting on Aichi targets is due, we assessed the Philippines' current protected area system for biodiversity coverage, appropriateness of management regimes and capacity to deliver protection. Although protected estate already covers 11 % of the Philippines' land area, 64 % of its key biodiversity areas (KBAs) remain unprotected. Few protected areas have appropriate management and governance infrastructures, funding streams, management plans and capacity, and a serious mismatch exists between protected area land zonation regimes and conservation needs of key species. For the Philippines to meet the biodiversity coverage and management effectiveness elements of Aichi Target 11, protected area and KBA boundaries should be aligned, management systems reformed to pursue biodiversity-led targets and effective management capacity created.

TargetCOPD: a pragmatic randomised controlled trial of targeted case finding for COPD versus routine practice in primary care: protocol.

PubMed

Jordan, Rachel E; Adab, Peymané; Jowett, Sue; Marsh, Jen L; Riley, Richard D; Enocson, Alexandra; Miller, Martin R; Cooper, Brendan G; Turner, Alice M; Ayres, Jon G; Cheng, Kar Keung; Jolly, Kate; Stockley, Robert A; Greenfield, Sheila; Siebert, Stanley; Daley, Amanda; Fitzmaurice, David A

2014-10-04

Many people with clinically significant chronic obstructive pulmonary disease (COPD) remain undiagnosed worldwide. There are a number of small studies which have examined possible methods of case finding through primary care, but no large RCTs that have adequately assessed the most cost-effective approach. In this study, using a cluster randomised controlled trial (RCT) in 56 general practices in the West Midlands, we plan to investigate the effectiveness and cost-effectiveness of a Targeted approach to case finding for COPD compared with routine practice. Using an individual patient RCT nested in the Targeted arm, we plan also to compare the effectiveness and cost-effectiveness of Active case finding using a postal questionnaire (with supplementary opportunistic questionnaires), and Opportunistic-only case finding during routine surgery consultations.All ever-smoking patients aged 40-79 years, without a current diagnosis of COPD and registered with participating practices will be eligible. Patients in the Targeted arm who report positive respiratory symptoms (chronic cough or phlegm, wheeze or dyspnoea) using a brief questionnaire will be invited for further spirometric assessment to ascertain whether they have COPD or not. Post-bronchodilator spirometry will be conducted to ATS standards using an Easy One spirometer by trained research assistants.The primary outcomes will be new cases of COPD and cost per new case identified, comparing targeted case finding with routine care, and two types of targeted case finding (active versus opportunistic). A multilevel logistic regression model will be used to model the probability of detecting a new case of COPD for each treatment arm, with clustering of patients (by practice and household) accounted for using a multi-level structure.A trial-based analysis will be undertaken using costs and outcomes collected during the trial. Secondary outcomes include the feasibility, efficiency, long-term cost-effectiveness, patient and

33 CFR 334.1300 - Blying Sound area, Gulf of Alaska, Alaska; air-to-air gunnery practice area, Alaskan Air Command...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., Alaska; air-to-air gunnery practice area, Alaskan Air Command, U.S. Air Force. 334.1300 Section 334.1300... gunnery practice area, Alaskan Air Command, U.S. Air Force. (a) The danger zone. A rhomboidal area... Air Command, U.S. Air Force, Anchorage, Alaska, or such agencies as he may designate. (Sec. 7, 40 Stat...

33 CFR 334.1300 - Blying Sound area, Gulf of Alaska, Alaska; air-to-air gunnery practice area, Alaskan Air Command...

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Alaska; air-to-air gunnery practice area, Alaskan Air Command, U.S. Air Force. 334.1300 Section 334.1300... gunnery practice area, Alaskan Air Command, U.S. Air Force. (a) The danger zone. A rhomboidal area... Air Command, U.S. Air Force, Anchorage, Alaska, or such agencies as he may designate. (Sec. 7, 40 Stat...

33 CFR 334.1300 - Blying Sound area, Gulf of Alaska, Alaska; air-to-air gunnery practice area, Alaskan Air Command...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., Alaska; air-to-air gunnery practice area, Alaskan Air Command, U.S. Air Force. 334.1300 Section 334.1300... gunnery practice area, Alaskan Air Command, U.S. Air Force. (a) The danger zone. A rhomboidal area... Air Command, U.S. Air Force, Anchorage, Alaska, or such agencies as he may designate. (Sec. 7, 40 Stat...

33 CFR 334.1300 - Blying Sound area, Gulf of Alaska, Alaska; air-to-air gunnery practice area, Alaskan Air Command...

Code of Federal Regulations, 2012 CFR

2012-07-01

..., Alaska; air-to-air gunnery practice area, Alaskan Air Command, U.S. Air Force. 334.1300 Section 334.1300... gunnery practice area, Alaskan Air Command, U.S. Air Force. (a) The danger zone. A rhomboidal area... Air Command, U.S. Air Force, Anchorage, Alaska, or such agencies as he may designate. (Sec. 7, 40 Stat...

33 CFR 334.1300 - Blying Sound area, Gulf of Alaska, Alaska; air-to-air gunnery practice area, Alaskan Air Command...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Alaska; air-to-air gunnery practice area, Alaskan Air Command, U.S. Air Force. 334.1300 Section 334.1300... gunnery practice area, Alaskan Air Command, U.S. Air Force. (a) The danger zone. A rhomboidal area... Air Command, U.S. Air Force, Anchorage, Alaska, or such agencies as he may designate. (Sec. 7, 40 Stat...

Developing a remote practice office.

PubMed

D'Elia, V L

1987-11-01

Remote practice offices (RPOs) offer unique opportunities for hospitals and physicians to increase market share from targeted areas where previously only limited demand existed. This article discusses the benefits and explores the fundamentals of developing a remote practice office.

78 FR 35612 - Agency Information Collection Activities; Comment Request; Targeted Teacher Shortage Areas...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-13

... address the targeted teacher deferment provision of the Higher Education Act of 1965, as amended. The... DEPARTMENT OF EDUCATION [Docket No. ED-2013-ICCD-0076] Agency Information Collection Activities; Comment Request; Targeted Teacher Shortage Areas Nationwide Listing AGENCY: Office of Postsecondary...

Agricultural practice and social change in Berastagi area

NASA Astrophysics Data System (ADS)

Sembiring, Sri Alem Br

2018-03-01

This paper discusses how agricultural practices build social change in the Berastagi highlands. Agricultural products from this area are the vegetable supplier base for Medan City and other surrounding cities. The supply involves a network of trades involving many actors with many interests, as well as generating migration from other areas around and coming from different ethnicities. The migrants’ settlements are concentrated in certain areas of the region around Berastgai. This paper will illustrate the interaction between these aspects to bring about social change in Berastagi. This research uses qualitative method. Primary data were obtained through in-depth interview techniques and participant observation. Secondary data accessed from relevant agencies. This discussion shows how the pattern of social relationships changed due to changes in the goals of agricultural practices that not only oriented local markets but also exports. Competition, secrecy, and money orientation have become part of their planting activities. On the other hand, trade networks also construct them to work together in a particular context. This paper shows that agricultural activities and all things related to it reflect a broader context to see the development of small towns that also affect the development of the surrounding villages.

Decoding Target Distance and Saccade Amplitude from Population Activity in the Macaque Lateral Intraparietal Area (LIP)

PubMed Central

Bremmer, Frank; Kaminiarz, Andre; Klingenhoefer, Steffen; Churan, Jan

2016-01-01

Primates perform saccadic eye movements in order to bring the image of an interesting target onto the fovea. Compared to stationary targets, saccades toward moving targets are computationally more demanding since the oculomotor system must use speed and direction information about the target as well as knowledge about its own processing latency to program an adequate, predictive saccade vector. In monkeys, different brain regions have been implicated in the control of voluntary saccades, among them the lateral intraparietal area (LIP). Here we asked, if activity in area LIP reflects the distance between fovea and saccade target, or the amplitude of an upcoming saccade, or both. We recorded single unit activity in area LIP of two macaque monkeys. First, we determined for each neuron its preferred saccade direction. Then, monkeys performed visually guided saccades along the preferred direction toward either stationary or moving targets in pseudo-randomized order. LIP population activity allowed to decode both, the distance between fovea and saccade target as well as the size of an upcoming saccade. Previous work has shown comparable results for saccade direction (Graf and Andersen, 2014a,b). Hence, LIP population activity allows to predict any two-dimensional saccade vector. Functional equivalents of macaque area LIP have been identified in humans. Accordingly, our results provide further support for the concept of activity from area LIP as neural basis for the control of an oculomotor brain-machine interface. PMID:27630547

[Target chemotherapy of intestinal nematode infection in area with low endemicity].

PubMed

Zhang, Tao; Shen, Yi-ping; Liu, Ying; Yang, Wei-ping; Shao, Jing-ou; Ju, Shao-you; Dong, Kai; Xu, Ju-ling; Jiang, Ji-min

2002-01-01

To evaluate the control measures for intestinal nematodiasis in endemic area with low prevalence and intensity of infection. Target chemotherapy was carried out in high-risk population based on the epidemiological characteristics such as age and clinical findings. Albendazole and mebendazole were administered each 200 mg once daily every year for 3 or 5 years. Saturated brine floatation and Kato-Katz thick smear techniques were used for stool examination to evaluate the efficacy of treatment. Two hundred residents from each of the three investigation villages were selected for target chemotherapy once a year for three years. The prevalence of intestinal nematodes decreased from 6.2% in 1995 to 5.4% in 1996 and 3.2% in 1997, and remained at 2.3% after three years in 2000. One control village where only primary school students were treated once a year for 5 years, the prevalence of Ascaris and Trichuris infection also decreased from 1.4% and 4.2% in 1995 to 0.9% and 1.4% in 2000, respectively. The target chemotherapy on the predisposed population to hookworm infection showed that the prevalence in the population above 41 years old was declined from 19.4% to 10.9%. The target chemotherapy is an economical and effective approach for the control of intestinal nematode infection in endemic area with low prevalence and intensity of infection.

User behaviour, best practice and the risks of non-target exposure associated with anticoagulant rodenticide use.

PubMed

Tosh, David G; Shore, Richard F; Jess, Stephen; Withers, Alan; Bearhop, Stuart; Ian Montgomery, W; McDonald, Robbie A

2011-06-01

Usage of anticoagulant rodenticides (ARs) is an integral component of modern agriculture and is essential for the control of commensal rodent populations. However, the extensive deployment of ARs has led to widespread exposure of a range of non-target predatory birds and mammals to some compounds, in particular the second-generation anticoagulant rodenticides (SGARs). As a result, there has been considerable effort placed into devising voluntary best practice guidelines that increase the efficacy of rodent control and reduce the risk of non-target exposure. Currently, there is limited published information on actual practice amongst users or implementation of best practice. We assessed the behaviour of a typical group of users using an on-farm questionnaire survey. Most baited for rodents every year using SGARs. Most respondents were apparently aware of the risks of non-target exposure and adhered to some of the best practice recommendations but total compliance was rare. Our questionnaire revealed that users of first generation anticoagulant rodenticides rarely protected or checked bait stations, and so took little effort to prevent primary exposure of non-targets. Users almost never searched for and removed poisoned carcasses and many baited for prolonged periods or permanently. These factors are all likely to enhance the likelihood of primary and secondary exposure of non-target species. Copyright © 2010. Published by Elsevier Ltd.

Target Surface Area Effects on Hot Electron Dynamics from High Intensity Laser-Plasma Interactions

DTIC Science & Technology

2016-08-19

New J. Phys. 18 (2016) 063020 doi:10.1088/1367-2630/18/6/063020 PAPER Target surface area effects on hot electron dynamics from high intensity laser ...Science, University ofMichigan, AnnArbor,MI 48109-2099, USA E-mail: czulick@umich.edu Keywords: laser -plasma,mass-limited, fast electrons, sheath...field Abstract Reduced surface area targets were studied using an ultra-high intensity femtosecond laser in order to determine the effect of electron

7 CFR 3402.4 - Food and agricultural sciences areas targeted for National Needs Graduate and Postdoctoral...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Food and agricultural sciences areas targeted for..., AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE FOOD AND AGRICULTURAL SCIENCES NATIONAL NEEDS... sciences areas targeted for National Needs Graduate and Postdoctoral Fellowship Grants Program support...

Retrofitting the Low Impact Development Practices into Developed Urban areas Including Barriers and Potential Solution

NASA Astrophysics Data System (ADS)

Shafique, Muhammad; Kim, Reeho

2017-06-01

Low impact development (LID)/green infrastructure (GI) practices have been identified as the sustainable practices of managing the stormwater in urban areas. Due to the increasing population, most of the cities are more developing which results in the change of natural area into impervious areas (roads, buildings etc.). Moreover, urbanization and climate change are causing many water-related problems and making over cities unsafe and insecure. Under these circumstances, there is a need to introduce new stormwater management practices into developed cities to reduce the adverse impacts of urbanization. For this purpose, retrofitting low impact development practices demands more attention to reduce these water-related problems and trying to make our cities sustainable. In developed areas, there is a little space is available for the retrofitting of LID practices for the stormwater management. Therefore, the selection of an appropriate place to retrofitting LID practices needs more concern. This paper describes the successfully applied retrofitting LID practices around the globe. It also includes the process of applying retrofitting LID practices at the suitable place with the suitable combination. Optimal places for the retrofitting of different LID practices are also mentioned. This paper also highlights the barriers and potential solutions of retrofitting LID practices in urban areas.

Urban-area extraction from polarimetric SAR image using combination of target decomposition and orientation angle

NASA Astrophysics Data System (ADS)

Zou, Bin; Lu, Da; Wu, Zhilu; Qiao, Zhijun G.

2016-05-01

The results of model-based target decomposition are the main features used to discriminate urban and non-urban area in polarimetric synthetic aperture radar (PolSAR) application. Traditional urban-area extraction methods based on modelbased target decomposition usually misclassified ground-trunk structure as urban-area or misclassified rotated urbanarea as forest. This paper introduces another feature named orientation angle to improve urban-area extraction scheme for the accurate mapping in urban by PolSAR image. The proposed method takes randomness of orientation angle into account for restriction of urban area first and, subsequently, implements rotation angle to improve results that oriented urban areas are recognized as double-bounce objects from volume scattering. ESAR L-band PolSAR data of the Oberpfaffenhofen Test Site Area was used to validate the proposed algorithm.

Educational and individual factors associated with positive change in and reaffirmation of medical students' intention to practice in underserved areas.

PubMed

Boscardin, Christy K; Grbic, Douglas; Grumbach, Kevin; O'Sullivan, Patricia

2014-11-01

The projected U.S. physician shortage will disproportionately affect underserved areas. This study examined the impact of medical school educational experiences on positive changes in and reaffirmation of students' intention to practice in underserved areas (practice intention). Medical students (n = 7,361) from 113 U.S. MD-granting medical schools who graduated in 2009-2010 and responded to both the Association of American Medical Colleges' 2006 Matriculating Student Questionnaire and 2010 Graduation Questionnaire were included. Multilevel logistic regression analyses were conducted to determine factors associated with change in and reaffirmation of practice intention. After controlling for individual characteristics, community health field experience (adjusted odds ratio [OR]: 1.36; 95% CI: 1.18, 1.57), learning another language (OR: 1.41; 95% CI: 1.22, 1.63), cultural competence/awareness experience (OR: 1.38; 95% CI: 1.21, 1.58), becoming more aware of perspectives of individuals from different backgrounds (OR: 1.24; 95% CI: 1.04, 1.48), and attending schools with higher social mission scores (OR: 1.66; 95% CI: 1.28, 2.16) were all significantly associated with positive changes in practice intention from matriculation to graduation. Field experience in community health (OR: 1.24; 95% CI: 0.99, 1.53), learning another language (OR: 1.29; 95% CI: 1.01, 1.65), and attending schools with higher social mission scores (OR: 1.62; 95% CI: 1.09, 2.43) were all significantly associated with reaffirmation of practice intention at graduation. Multifaceted factors are associated with practice intention. This study suggests medical schools can play active roles in alleviating the physician shortage in underserved areas through targeted curricular interventions and recruitment.

7 CFR 3402.4 - Food and agricultural sciences areas targeted for National Needs Graduate and Postdoctoral...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Food and agricultural sciences areas targeted for... AGRICULTURE FOOD AND AGRICULTURAL SCIENCES NATIONAL NEEDS GRADUATE AND POSTGRADUATE FELLOWSHIP GRANTS PROGRAM Program Description § 3402.4 Food and agricultural sciences areas targeted for National Needs Graduate and...

7 CFR 3402.4 - Food and agricultural sciences areas targeted for National Needs Graduate and Postdoctoral...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Food and agricultural sciences areas targeted for... AGRICULTURE FOOD AND AGRICULTURAL SCIENCES NATIONAL NEEDS GRADUATE AND POSTGRADUATE FELLOWSHIP GRANTS PROGRAM Program Description § 3402.4 Food and agricultural sciences areas targeted for National Needs Graduate and...

7 CFR 3402.4 - Food and agricultural sciences areas targeted for National Needs Graduate and Postdoctoral...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Food and agricultural sciences areas targeted for... AGRICULTURE FOOD AND AGRICULTURAL SCIENCES NATIONAL NEEDS GRADUATE AND POSTGRADUATE FELLOWSHIP GRANTS PROGRAM Program Description § 3402.4 Food and agricultural sciences areas targeted for National Needs Graduate and...

7 CFR 3402.4 - Food and agricultural sciences areas targeted for National Needs Graduate and Postdoctoral...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Food and agricultural sciences areas targeted for... AGRICULTURE FOOD AND AGRICULTURAL SCIENCES NATIONAL NEEDS GRADUATE AND POSTGRADUATE FELLOWSHIP GRANTS PROGRAM Program Description § 3402.4 Food and agricultural sciences areas targeted for National Needs Graduate and...

Closure Report for Corrective Action Unit 408: Bomblet Target Area Tonopah Test Range (TTR), Nevada, Revision 0

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

Mark Krauss

2010-09-01

(COCs) are present. • If COCs are present, determine their nature and extent, implement appropriate corrective actions, and properly dispose of wastes. Analytes detected during the closure activities were evaluated against final action levels to determine COCs for CAU 408. Assessment of the data indicated COCs are not present at CAS TA-55-002-TAB2; therefore, no corrective action is necessary. No use restrictions are required to be placed on this CAU because the investigation showed no evidence of remaining soil contamination or remaining debris/waste upon completion of all investigation activities. The MEC was successfully removed and dispositioned as planned using current best available technologies. As MEC guidance and general MEC standards acknowledge that MEC response actions cannot determine with 100 percent certainty that all MEC and unexploded ordnance (UXO) are removed, the clean closure of CAU 408 will implement a best management practice of posting UXO hazard warning signs near the seven target areas. The signs will warn future land users of the potential for encountering residual UXO hazards. The DOE, National Nuclear Security Administration Nevada Site Office, provides the following recommendations: • A Notice of Completion to the DOE, National Nuclear Security Administration Nevada Site Office, is requested from the Nevada Division of Environmental Protection for closure of CAU 408. • Corrective Action Unit 408 should be moved from Appendix III to Appendix IV of the Federal Facility Agreement and Consent Order.« less

Current beliefs and practice patterns among urologists regarding prostate magnetic resonance imaging and magnetic resonance-targeted biopsy.

PubMed

Muthigi, Akhil; Sidana, Abhinav; George, Arvin K; Kongnyuy, Michael; Maruf, Mahir; Valayil, Subin; Wood, Bradford J; Pinto, Peter A

2017-01-01

Multiparametric magnetic resonance imaging (MRI) and magnetic resonance (MR) -targeted biopsy have a growing role in the screening and evaluation of prostate cancer. We aim to evaluate the current knowledge, attitude, and practice patterns of urologists regarding this new technique. An anonymous online questionnaire was designed to collect information on urologists' beliefs and use of prostate multiparametric MRI and MR-targeted biopsy. The survey was sent to members of the Society of Urologic Oncology, the Endourological Society, and European Association of Urology. Multivariate logistic regression analysis was performed to determine predictors for use of prostate MRI and MR-targeted biopsy. A total of 302 responses were received (Endourological Society: 175, European Association of Urology: 23, and Society of Urologic Oncology: 104). Most respondents (83.6%) believe MR-targeted biopsy to be moderately to extremely beneficial in the evaluation of prostate cancer. Overall, 85.7% of responders use prostate MRI in their practice, and 63.0% use MR-targeted biopsy. The 2 most common settings for use of MR-targeted biopsy include patients with history of prior negative biopsy result (96.3%) and monitoring patients on active surveillance (72.5%). In those who do not use MR-targeted biopsy, the principal reasons were lack of necessary infrastructure (64.1%) and prohibitive costs (48.1%). On multivariate logistic regression analysis, practice in an academic setting (1.86 [1.02-3.40], P = 0.043) and performing greater than 25 radical prostatectomies per year (2.32 [1.18-4.56], P = 0.015) remained independent predictors for using MR-targeted biopsy. Most respondents of our survey look favorably on use of prostate MRI and MR-targeted biopsy in clinical practice. Over time, reduction in fixed costs and easier access to equipment may lead to further dissemination of this novel and potentially transformative technology. Published by Elsevier Inc.

Targeted interventions of ultra-poor women in rural Rangpur, Bangladesh: do they make a difference to appropriate cooking practices, food habits and sanitation?

PubMed

Yeasmin, Lubna; Akter, Shamima; Shahidul Islam, A M; Mizanur Rahman, Md; Akashi, Hidechika; Jesmin, Subrina

2014-07-01

This study aimed to assess whether teaching good cooking practices, food habits and sanitation to ultra-poor rural women in four rural communities of Rangpur district, Bangladesh, with a high density of extremely poor households, would improve the overall health of the community. The sample size was 200 respondents combined from the target and control areas. In the target area, twelve in-depth interviews and four focus group discussions were undertaken for knowledge dissemination. Descriptive and mixed-model analyses were performed. The results show that washing hands with soap was 1.35 times more likely in the target than the control group (p<0.01). Further, after intervention, there was a significant improvement in hand-washing behaviour: before cutting vegetables, preparing food, feeding a child and eating, and after defecating and cleaning a baby (p<0.05). Also, the target group was more likely to moderately and briefly boil their vegetables and were 19% less likely to use maximum heat when cooking vegetables than the control group (p<0.01). Improved knowledge and skills training of ultra-poor women reduces the loss of nutrients during food preparation and increases their hygiene through hand-washing in every-day life.

Physician Practice Audit Targets Now Become Hospital and Health System Compliance Risks.

PubMed

Hirsch, Ronald L

2015-01-01

In 2013, 22% of the federal budget was spent on Medicare and Medicaid. The Medicare Trust Fund is forecast to be depleted in 2030. More than 12% of Medicare fee-for-service payments in 2014 were made in error. These factors have led Congress to apply more pressure to reduce improper payments. Although hospitals were the initial targets because of their higher reimbursement, recent efforts have shifted to physician billing. Hospitals and health systems continue to acquire physician practices, making them liable for the billing activities of physicians. And for physicians who remain independent, the cost and effort required to respond to audits and denials can be financially devastating, further demonstrating the importance of prevention. This article addresses some of the common audit targets and mistakes made by physicians and provides strategies for physician practices and health systems to respond to and, ultimately, avoid these denials.

33 CFR 334.60 - Cape Cod Bay south of Wellfleet Harbor, Mass.; naval aircraft bombing target area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Harbor, Mass.; naval aircraft bombing target area. 334.60 Section 334.60 Navigation and Navigable Waters... REGULATIONS § 334.60 Cape Cod Bay south of Wellfleet Harbor, Mass.; naval aircraft bombing target area. (a... bombing target hulk James Longstreet in Cape Cod Bay at latitude 41°49′46″, longitude 70°02′54″. (b) The...

33 CFR 334.60 - Cape Cod Bay south of Wellfleet Harbor, Mass.; naval aircraft bombing target area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Harbor, Mass.; naval aircraft bombing target area. 334.60 Section 334.60 Navigation and Navigable Waters... REGULATIONS § 334.60 Cape Cod Bay south of Wellfleet Harbor, Mass.; naval aircraft bombing target area. (a... bombing target hulk James Longstreet in Cape Cod Bay at latitude 41°49′46″, longitude 70°02′54″. (b) The...

Mesophotic depths as refuge areas for fishery-targeted species on coral reefs

NASA Astrophysics Data System (ADS)

Lindfield, Steven J.; Harvey, Euan S.; Halford, Andrew R.; McIlwain, Jennifer L.

2016-03-01

Coral reefs are subjected to unprecedented levels of disturbance with population growth and climate change combining to reduce standing coral cover and stocks of reef fishes. Most of the damage is concentrated in shallow waters (<30 m deep) where humans can comfortably operate and where physical disturbances are most disruptive to marine organisms. Yet coral reefs can extend to depths exceeding 100 m, potentially offering refuge from the threats facing shallower reefs. We deployed baited remote underwater stereo-video systems (stereo-BRUVs) at depths of 10-90 m around the southern Mariana Islands to investigate whether fish species targeted by fishing in the shallows may be accruing benefits from being at depth. We show that biomass, abundance and species richness of fishery-targeted species increased from shallow reef areas to a depth of 60 m, whereas at greater depths, a lack of live coral habitat corresponded to lower numbers of fish. The majority of targeted species were found to have distributions that ranged from shallow depths (10 m) to depths of at least 70 m, emphasising that habitat, not depth, is the limiting factor in their vertical distribution. While the gradient of abundance and biomass versus depth was steepest for predatory species, the first species usually targeted by fishing, we also found that fishery-targeted herbivores prevailed in similar biomass and species richness to 60 m. Compared to shallow marine protected areas, there was clearly greater biomass of fishery-targeted species accrued in mesophotic depths. Particularly some species typically harvested by depth-limited fishing methods (e.g., spearfishing), such as the endangered humphead wrasse Cheilinus undulatus, were found in greater abundance on deeper reefs. We conclude that mesophotic depths provide essential fish habitat and refuge for fishery-targeted species, representing crucial zones for fishery management and research into the resilience of disturbed coral reef ecosystems.

Ground target geolocation based on digital elevation model for airborne wide-area reconnaissance system

NASA Astrophysics Data System (ADS)

Qiao, Chuan; Ding, Yalin; Xu, Yongsen; Xiu, Jihong

2018-01-01

To obtain the geographical position of the ground target accurately, a geolocation algorithm based on the digital elevation model (DEM) is developed for an airborne wide-area reconnaissance system. According to the platform position and attitude information measured by the airborne position and orientation system and the gimbal angles information from the encoder, the line-of-sight pointing vector in the Earth-centered Earth-fixed coordinate frame is solved by the homogeneous coordinate transformation. The target longitude and latitude can be solved with the elliptical Earth model and the global DEM. The influences of the systematic error and measurement error on ground target geolocation calculation accuracy are analyzed by the Monte Carlo method. The simulation results show that this algorithm can improve the geolocation accuracy of ground target in rough terrain area obviously. The geolocation accuracy of moving ground target can be improved by moving average filtering (MAF). The validity of the geolocation algorithm is verified by the flight test in which the plane flies at a geodetic height of 15,000 m and the outer gimbal angle is <47°. The geolocation root mean square error of the target trajectory is <45 and <7 m after MAF.

Resident and user support for urban natural areas restoration practices

Treesearch

Paul H. Gobster; Kristin Floress; Lynne M. Westphal; Cristy A. Watkins; Joanne Vining; Alaka Wali

2016-01-01

Public support is important to the success of natural areas restoration programs. Support can be especially critical in urban settings where stakeholders recreate in or reside near natural areas but may lack familiarity with practices for managing ecological processes. Surveys of on-site recreationists and nearby residents (N= 888) of 11 Chicago metropolitan natural...

Integrated watershed- and farm-scale modeling framework for targeting critical source areas while maintaining farm economic viability.

PubMed

Ghebremichael, Lula T; Veith, Tamie L; Hamlett, James M

2013-01-15

Quantitative risk assessments of pollution and data related to the effectiveness of mitigating best management practices (BMPs) are important aspects of nonpoint source pollution control efforts, particularly those driven by specific water quality objectives and by measurable improvement goals, such as the total maximum daily load (TMDL) requirements. Targeting critical source areas (CSAs) that generate disproportionately high pollutant loads within a watershed is a crucial step in successfully controlling nonpoint source pollution. The importance of watershed simulation models in assisting with the quantitative assessments of CSAs of pollution (relative to their magnitudes and extents) and of the effectiveness of associated BMPs has been well recognized. However, due to the distinct disconnect between the hydrological scale in which these models conduct their evaluation and the farm scale at which feasible BMPs are actually selected and implemented, and due to the difficulty and uncertainty involved in transferring watershed model data to farm fields, there are limited practical applications of these tools in the current nonpoint source pollution control efforts by conservation specialists for delineating CSAs and planning targeting measures. There are also limited approaches developed that can assess impacts of CSA-targeted BMPs on farm productivity and profitability together with the assessment of water quality improvements expected from applying these measures. This study developed a modeling framework that integrates farm economics and environmental aspects (such as identification and mitigation of CSAs) through joint use of watershed- and farm-scale models in a closed feedback loop. The integration of models in a closed feedback loop provides a way for environmental changes to be evaluated with regard to the impact on the practical aspects of farm management and economics, adjusted or reformulated as necessary, and revaluated with respect to effectiveness of

Sources of Principals' Leadership Practices and Areas Training Should Emphasize: Case Finland

ERIC Educational Resources Information Center

Shantal, Kakon Montua Ajua; Halttunen, Leena; Pekka, Kanervio

2014-01-01

Quality educational leadership preparation has positive influences on practices of graduates. In the Finnish decentralized education system, little is yet known about the sources of principals' practices. This research explores the sources of principals' self-assessed leadership practices in Central Finland and identifies areas for more emphasis.…

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. 334.10 Section 334.10 Navigation and Navigable Waters CORPS... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger...

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. 334.10 Section 334.10 Navigation and Navigable Waters CORPS... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger...

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. 334.10 Section 334.10 Navigation and Navigable Waters CORPS... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger...

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. 334.10 Section 334.10 Navigation and Navigable Waters CORPS... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger...

[Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

PubMed

Mehrmann, Lena; Ollenschläger, Günter

2014-01-01

Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care. Copyright © 2013. Published by Elsevier GmbH.

Measuring the extent and effectiveness of protected areas as an indicator for meeting global biodiversity targets

PubMed Central

Chape, S; Harrison, J; Spalding, M; Lysenko, I

2005-01-01

There are now over 100 000 protected areas worldwide, covering over 12% of the Earth's land surface. These areas represent one of the most significant human resource use allocations on the planet. The importance of protected areas is reflected in their widely accepted role as an indicator for global targets and environmental assessments. However, measuring the number and extent of protected areas only provides a unidimensional indicator of political commitment to biodiversity conservation. Data on the geographic location and spatial extent of protected areas will not provide information on a key determinant for meeting global biodiversity targets: ‘effectiveness’ in conserving biodiversity. Although tools are being devised to assess management effectiveness, there is no globally accepted metric. Nevertheless, the numerical, spatial and geographic attributes of protected areas can be further enhanced by investigation of the biodiversity coverage of these protected areas, using species, habitats or biogeographic classifications. This paper reviews the current global extent of protected areas in terms of geopolitical and habitat coverage, and considers their value as a global indicator of conservation action or response. The paper discusses the role of the World Database on Protected Areas and collection and quality control issues, and identifies areas for improvement, including how conservation effectiveness indicators may be included in the database to improve the value of protected areas data as an indicator for meeting global biodiversity targets. PMID:15814356

The control of sequential aiming movements: the influence of practice and manual asymmetries on the one-target advantage.

PubMed

Lavrysen, Ann; Helsen, Werner F; Tremblay, Luc; Elliott, Digby; Adam, Jos J; Feys, Peter; Buekers, Martinus J

2003-04-01

The present experiment was conducted to explore the effect of practice on the one-target advantage in manual aiming, as well as asymmetries in intermanual transfer of training. Reaction and movement times for the first movement were longer in the 2-target than in the 1-target task, regardless of the amount of practice, hand preference and practice hand. When two movements were required, peak velocity was lower and, proportionally, more time was spent after peak velocity. Our kinematic results suggest that the one-target advantage is related to both predefined strategies as well as movement implementation processes during execution. Therefore, an integration of advance planning and on-line explanations for the one-target advantage is suggested. Regarding manual asymmetries, right-handers showed more transfer of training from the left to the right hand than vice versa. Left-handers exhibited a reversed pattern of asymmetric transfer of training to right-handers, but they were more disadvantaged using their non-dominant hand. These latter two findings have implications for models of manual asymmetry and upper limb control.

33 CFR 334.200 - Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Cedar Point; aerial and surface firing range and target area, U.S. Naval Air Station, Patuxent River... Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U.S. Naval Air...) The regulations. (i) Through navigation of surface craft outside the target areas will be permitted at...

Child care hygiene practices of women migrating from rural to urban areas of bangladesh.

PubMed

Begum, Housne Ara; Moneesha, Shanta Shyamolee; Sayem, Amir Mohammad

2013-07-01

Children's hygiene is very important for better health but there is a paucity of studies in this area. This questionnaire study examined the child care hygiene practices of mothers of young children. A total of 354 women from slum areas of Dhaka city, Bangladesh, who migrated from rural to urban areas were selected for this study. The mean score on hygiene practice was 6.21 of 10 items (SD = 2.113). Low (score = 3) and high hygiene practice (score = 7-10) were practiced by 12.4% and 45.8% of participants, respectively. Multivariate regression analysis indicated that independent variables explained 39.9% of variance in hygiene practices. Eight variables have significant effect: participant's education (0.108; P < .05), time spent since marriage to first birth (0.030; P < .05), number of children (-0.105; P < .05), number of antenatal visits (0.319; P < .001), microcredit status (0.214; P < .001), breastfeeding (0.224; P < .001), husband's monthly income (0.146; P < .001), and household economic status (-0.0114; P < .05). The overall hygiene practice indicates the necessity of awareness building initiatives.

Targeting the impact of agri-environmental policy - Future scenarios in two less favoured areas in Portugal.

PubMed

Jones, Nadia; Fleskens, Luuk; Stroosnijder, Leo

2016-10-01

Targeting agri-environmental measures (AEM) improves their effectiveness in the delivery of public goods, provided the necessary coordination with other incentives. In less favoured areas (LFA) measures focusing on the conservation of extensive farming contribute to sustainable land management in these areas. In this paper we investigate the implementation of a possible AEM supporting the improvement of permanent pastures coordinated with the extensive livestock and single farm payments actually in place. Through applying a spatially-explicit mixed integer optimisation model we simulate future land use scenarios for two less favoured areas in Portugal (Centro and Alentejo) considering two policy scenarios: a 'targeted AEM', and a 'non-targeted AEM'. We then compare the results with a 'basic policy' option (reflecting a situation without AEM). This is done with regard to landscape-scale effects on the reduction of fire hazard and erosion risk, as well as effects on farm income. The results show that an AEM for permanent pastures would be more cost-effective for erosion and fire hazard mitigation if implemented within a spatially targeted framework. However when cost-effectiveness is assessed with other indicators (e.g. net farm income and share of grazing livestock) 'non-targeted AEM' implementation delivers the best outcome in Alentejo. In Centro the implementation of an AEM involves important losses of income compared to the 'basic policy'. 'Targeted AEM' tends to favour farms in very marginal conditions, i.e. targeting is demonstrated to perform best in landscapes where spatial heterogeneity is higher. The results also show the risk of farm abandonment in the two studied less favoured areas: in all three scenarios more than 30% of arable land is deemed to be abandoned. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pressure area care: an exploration of Greek nurses' knowledge and practice.

PubMed

Panagiotopoulou, Kalliopi; Kerr, Susan M

2002-11-01

Despite a plethora of information on the prevention of pressure sores, they remain a significant problem in both hospital and community settings. The need to reduce the incidence of pressure sores has been well documented; unfortunately there is little evidence to suggest improvement. The reasons for this lack of improvement have been explored, but the picture remains unclear. While some studies have suggested that nurses have the appropriate knowledge to prevent pressure sores developing (but do not use their knowledge), others suggest that nurses' knowledge of preventive strategies is deficient. In Greece, similarly to the United Kingdom (UK), the incidence of pressure sores is high. There is currently no evidence on Greek nurses' knowledge and practice and therefore no baseline on which to build, in terms of improving practice. The purpose of this study was to explore Greek nurses' knowledge of 'risk factors', 'areas at risk' and 'recommended preventive strategies' in relation to pressure area care. In addition, information was sought on nurses' 'current preventive practice' and any barriers to 'good practice'. The study was exploratory and descriptive, adopting a cross-sectional survey approach. The sample was drawn from the population of nurses working in a military hospital near Athens. The data were collected over a 4-week period in June 2000, using a self-completed questionnaire. Although the knowledge-base of many of the nurses was good in relation to 'risk factors' and 'areas at risk', a significant proportion were unaware that methods such as 'massage' and 'donuts' are no longer recommended. This lack of knowledge influenced practice with these methods commonly being used. In relation to barriers to good practice, a significant proportion of nurses reported that they could not access, read or understand research findings. This has obvious implications for the implementation of evidence-based practice. The results of this study suggest that the knowledge

The area centralis in the chicken retina contains efferent target amacrine cells

PubMed Central

Weller, Cynthia; Lindstrom, Sarah H.; De Grip, Willem J.; Wilson, Martin

2012-01-01

The retinas of birds receive a substantial efferent, or centrifugal, input from a midbrain nucleus. The function of this input is presently unclear but previous work in the pigeon has shown that efferent input is excluded from the area centralis, suggesting that the functions of the area centralis and the efferent system are incompatible. Using an antibody specific to rods, we have identified the area centralis in another species, the chicken, and mapped the distribution of the unique amacrine cells that are the postsynaptic partners of efferent fibers. Efferent target amacrine cells are found within the chicken area centralis and their density is continuous across the border of the area centralis. In contrast to the pigeon retina then, we conclude that the chicken area centralis receives efferent input. We suggest that the difference between the 2 species is attributable to the presence of a fovea within the area centralis of the pigeon and its absence from that of the chicken. PMID:19296862

Large area thermal target board: An improvement to environmental effects and system parameters characterization

NASA Astrophysics Data System (ADS)

Watkins, Wendell R.; Bean, Brent L.; Munding, Peter D.

1994-06-01

Recent field tests have provided excellent opportunities to use a new characterization tool associated with the Mobile Imaging Spectroscopy Laboratory (MISL) of the Battlefield Environment Directorate, formerly the U.S. Army Atmospheric Sciences Laboratory. The MISL large area (1.8 by 1.8 m, uniform temperature, thermal target) was used for characterization and isolation of phenomena which impact target contrast. By viewing the target board from closeup and distant ranges simultaneously with the MISL thermal imagers, the inherent scene content could be calibrated and the degrading effects of atmospheric propagation could be isolated. The target board is equipped with several spatial frequency bar patterns, but only the largest 3.5-cycle full area bar pattern was used for the distant range of 1.6 km. The quantities measured with the target board include the inherent background change, the contrast transmission, and the atmospheric modulation transfer function. The MISL target board has a unique design which makes it lightweight with near perfect transition between the hot and cold portions of the bar pattern. The heated portion of the target is an elongated rectangular even which is tilted back at a 30 deg angle to form a 1.8 by 1.8 m square when viewed from the front. The cold bars we positioned in front of the heated oven surface and can be oriented in either the vertical or horizontal direction. The oven is mounted on a lightweight trailer for one- or two-man positioning. An attached metal and canvas structure is used to shield the entire target from both solar loading and cooling winds. The target board has a thin aluminum sheet front surface which is insulated from the oven's heating structure.

Achieving serum urate targets in gout: an audit in a gout-oriented rheumatology practice.

PubMed

Corbett, Elizabeth J M; Pentony, Peta; McGill, Neil W

2017-07-01

To assess the proportion of patients with gout who achieve target serum urate levels, the drug regime required and the reasons for failing to do so. We reviewed the files of all patients with gout who presented to a gout-oriented rheumatology practice between January 2010 and September 2014. Two hundred and thirty patients agreed to commence urate lowering therapy (ULT); 73% achieved their urate target, including 74% with non-tophaceous gout (target ≤ 0.36 mmol/L) and 71% with tophi (target ≤ 0.30 mmol/L). Of the 62 who failed to reach target, in 61 it was due to non-adherence and in one due to inefficacy. Adherence remains the major challenge to successful long-term gout management. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Community-based oral health promotion practices targeted at children and adolescents in Finland--developing an assessment tool.

PubMed

Blomqvist, Pia; Ojala, Ellinoora; Kettunen, Tarja; Poskiparta, Marita; Kasila, Kirsti

2014-06-01

To develop an assessment tool for evaluating oral health promotion practices and to evaluate community-based oral health promotion practices targeted at children and adolescents with this tool. A theoretical framework about health promotion planning, implementation and evaluation was made on the basis of a literature review. Then, information about Finnish community-based oral health promotion practices (n=12) targeted at children and adolescents was collected using semi-structured interviews. Also, related documents, for example action plans and reports, were collected when available. Next, an assessment tool based on the theoretical framework was developed, and the recorded and transcribed interview data and other documents were evaluated with this tool. The assessment tool proved to be practical: it pointed out the strengths and weaknesses of the practices. The tool revealed strengths in the implementation and deficiencies in the planning and evaluation of oral health promotion practices. One-quarter of the 12 practices assessed could be considered 'good practices'. There is a need to improve the planning and evaluation of oral health promotion practices. The assessment tool developed in this study might be useful for practitioners both in the field of oral health promotion and general health promotion. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Modelling multiple hospital outcomes: the impact of small area and primary care practice variation.

PubMed

Congdon, Peter

2006-11-16

Appropriate management of care--for example, avoiding unnecessary attendances at, or admissions to, hospital emergency units when they could be handled in primary care--is an important part of health strategy. However, some variations in these outcomes could be due to genuine variations in health need. This paper proposes a new method of explaining variations in hospital utilisation across small areas and the general practices (GPs) responsible for patient primary care. By controlling for the influence of true need on such variations, one may identify remaining sources of excess emergency attendances and admissions, both at area and practice level, that may be related to the quality, resourcing or organisation of care. The present paper accordingly develops a methodology that recognises the interplay between population mix factors (health need) and primary care factors (e.g. referral thresholds), that allows for unobserved influences on hospitalisation usage, and that also reflects interdependence between hospital outcomes. A case study considers relativities in attendance and admission rates at a North London hospital involving 149 small areas and 53 GP practices. A fixed effects model shows variations in attendances and admissions are significantly related (positively) to area and practice need, and nursing home patients, and related (negatively) to primary care access and distance of patient homes from the hospital. Modelling the impact of known factors alone is not sufficient to produce a satisfactory fit to the observations, and random effects at area and practice level are needed to improve fit and account for overdispersion. The case study finds variation in attendance and admission rates across areas and practices after controlling for need, and remaining differences between practices may be attributable to referral behaviour unrelated to need, or to staffing, resourcing, and access issues. In managerial terms, the analysis points to the utility of formal

Modelling multiple hospital outcomes: the impact of small area and primary care practice variation

PubMed Central

Congdon, Peter

2006-01-01

Background: Appropriate management of care – for example, avoiding unnecessary attendances at, or admissions to, hospital emergency units when they could be handled in primary care – is an important part of health strategy. However, some variations in these outcomes could be due to genuine variations in health need. This paper proposes a new method of explaining variations in hospital utilisation across small areas and the general practices (GPs) responsible for patient primary care. By controlling for the influence of true need on such variations, one may identify remaining sources of excess emergency attendances and admissions, both at area and practice level, that may be related to the quality, resourcing or organisation of care. The present paper accordingly develops a methodology that recognises the interplay between population mix factors (health need) and primary care factors (e.g. referral thresholds), that allows for unobserved influences on hospitalisation usage, and that also reflects interdependence between hospital outcomes. A case study considers relativities in attendance and admission rates at a North London hospital involving 149 small areas and 53 GP practices. Results: A fixed effects model shows variations in attendances and admissions are significantly related (positively) to area and practice need, and nursing home patients, and related (negatively) to primary care access and distance of patient homes from the hospital. Modelling the impact of known factors alone is not sufficient to produce a satisfactory fit to the observations, and random effects at area and practice level are needed to improve fit and account for overdispersion. Conclusion: The case study finds variation in attendance and admission rates across areas and practices after controlling for need, and remaining differences between practices may be attributable to referral behaviour unrelated to need, or to staffing, resourcing, and access issues. In managerial terms, the

"Green-friendly" best management practices (BMPs) for interstate rest areas.

DOT National Transportation Integrated Search

2011-06-01

This report presents the findings of a research project to study and develop a list of green friendly Best : Management Practices (BMPs) for Illinois interstate rest areas. The objectives of this project are to (1) develop : energy and cost bas...

Statistical methods for identifying and bounding a UXO target area or minefield

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

McKinstry, Craig A.; Pulsipher, Brent A.; Gilbert, Richard O.

2003-09-18

The sampling unit for minefield or UXO area characterization is typically represented by a geographical block or transect swath that lends itself to characterization by geophysical instrumentation such as mobile sensor arrays. New spatially based statistical survey methods and tools, more appropriate for these unique sampling units have been developed and implemented at PNNL (Visual Sample Plan software, ver. 2.0) with support from the US Department of Defense. Though originally developed to support UXO detection and removal efforts, these tools may also be used in current form or adapted to support demining efforts and aid in the development of newmore » sensors and detection technologies by explicitly incorporating both sampling and detection error in performance assessments. These tools may be used to (1) determine transect designs for detecting and bounding target areas of critical size, shape, and density of detectable items of interest with a specified confidence probability, (2) evaluate the probability that target areas of a specified size, shape and density have not been missed by a systematic or meandering transect survey, and (3) support post-removal verification by calculating the number of transects required to achieve a specified confidence probability that no UXO or mines have been missed.« less

Generation of Parametric Equivalent-Area Targets for Design of Low-Boom Supersonic Concepts

NASA Technical Reports Server (NTRS)

Li, Wu; Shields, Elwood

2011-01-01

A tool with an Excel visual interface is developed to generate equivalent-area (A(sub e)) targets that satisfy the volume constraints for a low-boom supersonic configuration. The new parametric Ae target explorer allows users to interactively study the tradeoffs between the aircraft volume constraints and the low-boom characteristics (e.g., loudness) of the ground signature. Moreover, numerical optimization can be used to generate the optimal A(sub e) target for given A(sub e) volume constraints. A case study is used to demonstrate how a generated low-boom Ae target can be matched by a supersonic configuration that includes a fuselage, wing, nacelle, pylon, aft pod, horizontal tail, and vertical tail. The low-boom configuration is verified by sonic-boom analysis with an off-body pressure distribution at three body lengths below the configuration

Mineral target areas in Nevada from geological analysis of LANDSAT-1 imagery

NASA Technical Reports Server (NTRS)

Abdel-Gawad, M.; Tubbesing, L.

1975-01-01

Geological analysis of LANDSAT-1 Scene MSS 1053-17540 suggests that certain known mineral districts in east-central Nevada frequently occur near faults or at faults or lineament intersections and areas of complex deformation and flexures. Seventeen (17) areas of analogous characteristics were identified as favorable targets for mineral exploration. During reconnaissance field trips eleven areas were visited. In three areas evidence was found of mining and/or prospecting not known before the field trips. In four areas favorable structural and alteration features were observed which call for more detailed field studies. In one of the four areas limonitic iron oxide samples were found in the regolith of a brecciated dolomite ridge. This area contains quartz veins, granitic and volcanic rocks and lies near the intersection of two linear fault structures identified in the LANDSAT-1 imagery. Semiquantitative spectroscopic analysis of selected portions of the samples showed abnormal contents of arsenic, molybdenum, copper, lead, zinc, and silver. These limonitic samples found were not in situ and further field studies are required to assess their source and significance.

Embedding Sustainability Instruction across Content Areas: best Classroom Practices from Informal Environmental Education

NASA Astrophysics Data System (ADS)

Clary, R. M.; Walker, R. M.; Wissehr, C.

2017-12-01

Environmental education (EE) facilitates students' scientific and environmental literacy, and addresses content areas including sustainability, ecology, and civic responsibility. However, U.S. science content compartmentalization and EE's interdisciplinary nature historically made it a fragmented curriculum within U.S. schools. To gain a better understanding of effective EE instruction that can be transferred to traditional K-12 classrooms, we researched the interactions between a recognized environmental residential camp and students and teachers from six participating schools using grounded theory methodology. Our research identified the residential learning center's objectives, methods of instruction, and objectives' alignment to the delivered curricula. Data generated included lesson plans, survey responses, and interviews. Students (n = 215) identified wilderness and geology activities as the activities they wanted to experience more; they also identified developing curiosity and a sense of discovery as the most meaningful. Whereas most student-identified meaningful experiences aligned with the center's curricular objectives within the optional units, categories emerged that were not explicitly targeted in the unit activities but were embedded throughout the curriculum in sustainable practices, data collection, and reflections. We propose that embedded activities and implicit instruction can be included across content areas within K-12 classrooms. Teacher modeling and implicit instruction will require minimal classroom time, and facilitate students' scientific and environmental literacy in topics such as sustainability and citizen responsibility.

Do targeted child health promotion services meet the needs of the most disadvantaged? A qualitative study of the views of health visitors working in inner-city and urban areas in England.

PubMed

Condon, Louise

2011-10-01

The aim of this study was to explore health visitors' views on the effects of policy change on the services they offer to preschool children in areas of high health inequalities in England. Child health promotion services are offered throughout the world to maintain and improve children's health. It is not known how the policy shift to a more overtly targeted service, which has occurred in some countries, has affected child health promotion practice in areas of deprivation. An in-depth telephone interview study was conducted between October 2006 and January 2007. All participants (n = 25) were registered health visitors who had taken part in a 2005 National Survey of Child Health Promotion Practice in England and were delivering health promotion services to preschool children in inner-city and urban areas. Despite high levels of need, some children who would have benefited from an enhanced health visiting service were offered only the core programme. Local interpretation of national policy is a key factor in determining the level of service offered, and the extent of targeting. This study illustrates the importance, in any country, of exploring the effects of national policy change from the perspective of practitioners, to identify unintended outcomes. Reductions in the core child health promotion programme can lead to difficulties in monitoring and improving children's health outcomes in areas of deprivation. © 2011 Blackwell Publishing Ltd.

Exploring arising moments and mindfulness in occupational therapists working in diverse clinical practice areas.

PubMed

Reid, Denise; Naseer, Zahid

2012-10-01

An online survey was conducted with 72 Canadian occupational therapists to (1) explore if and how occupational therapists were aware of "arising moments" in clinical practice, which are moments that give rise to emotions, sensations, and thoughts, and (2) to examine therapists' responses to questions related to mindfulness. Participants described arising moments through an open-ended survey question. Framework analysis was used to develop key themes and subthemes. A modified Philadelphia Mindfulness Awareness (PHLMS) subscale with two additional survey questions "understanding of living in the moment and being present, and awareness of mindfulness" (sum = PAM) were used as indicators of mindfulness. There were significant differences in the means of PHLMS mindfulness among therapists working in diverse practice areas (F = 3.63, p = .009). Posthoc analysis revealed that therapists working in mental health had higher mean PHLMS-mindfulness scores than in all other groups. There were no significant differences in PAM mindfulness among the practice areas (ANOVA, F = 2.15, p = .08). However, posthoc tests showed that the participants in the mental health practice area had a significant difference with one group, general physical health. Findings have implications for practice in occupational therapy and education about mindfulness in occupational therapy.

33 CFR 334.200 - Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U...

Code of Federal Regulations, 2010 CFR

2010-07-01

... damage caused by projectiles, bombs, missiles, or Naval or Coast Guard vessels to fishing structures or... and bombs will be dropped at frequent intervals in the target areas. Hooper and Hannibal target areas...

Practical issues of biomarker-assisted targeted therapy in precision medicine and immuno-oncology era.

PubMed

Lee, Dae Ho

2018-01-01

The concept of precision medicine is not new, as multiplex and very sensitive methods, or next-generation sequencing and matched targeted cancer therapies, have come to clinical practice. Substantial progress has been made from the discovery to the development and clinical application of biomarkers and matched targeted therapies. However, there still remain many challenges and issues to be overcome in each step, from acquisition of tumour tissues through validation of biomarkers to the final decision on targeted therapy. This review will briefly touch on these issues, hoping to provide a better understanding and application of targeted therapy in cancer treatment in the era of precision medicine and immuno-oncology. It also helps to understand that the meaning or value of biomarker(s) and matched targeted therapy changes along with expansion of knowledge and advance of methodology, and constant efforts have to be made in evaluating the meaning and clinical value during the development and after the establishment of biomarkers or the approval of matched targeted therapies, which might be more complicated by the advent of new therapeutic agents and new diagnostic methods.

Nursery cultural practices to achieve targets: A case study in western larch irrigation

Treesearch

Anthony S. Davis; Robert F. Keefe

2011-01-01

Nursery cultural practices are used to help growers achieve pre-determined size and physiological targets for seedlings. In that regard, irrigation is used to accelerate or slow growth and as a trigger for changing growth phase. In a case study highlighting the effects of irrigation on seedling development, western larch (Larix occidentalis Nutt.) seedlings were grown...

33 CFR 334.1470 - Caribbean Sea and Vieques Sound, in vicinity of Eastern Vieques; bombing and gunnery target area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Caribbean Sea and Vieques Sound, in vicinity of Eastern Vieques; bombing and gunnery target area. 334.1470 Section 334.1470 Navigation...; bombing and gunnery target area. (a) The danger zone. From Punta Conejo on the south coast of Vieques at...

33 CFR 334.1470 - Caribbean Sea and Vieques Sound, in vicinity of Eastern Vieques; bombing and gunnery target area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Caribbean Sea and Vieques Sound, in vicinity of Eastern Vieques; bombing and gunnery target area. 334.1470 Section 334.1470 Navigation...; bombing and gunnery target area. (a) The danger zone. From Punta Conejo on the south coast of Vieques at...

Dentist shortage: an analysis of dentists, practices, and populations in the underserved areas.

PubMed

Voinea-Griffin, Andreea; Solomon, Eric S

2016-09-01

The objectives of this study are to identify and describe the characteristics of dental underserved geographic areas. Understanding these characteristics is an important step in addressing access to dental care barriers. Dental underserved areas were identified from the Health Resources and Services Administration (HRSA) database and converted to census tracts for analysis. Characteristics of dental underserved geographic areas were compared with areas not designated as underserved. Dental practices included in the Dun & Bradstreet Business information database were geocoded and analyzed according to the underserved designation of their location and census demographic data. Thus, the relationships between dental underserved status, practice, and population characteristics were evaluated. Dental underserved areas are more likely to comprise individuals with lower socio-economic status (income and education levels), higher levels of underrepresented population groups, and have lower population densities than non-underserved areas. The populations living in dental underserved areas are more likely to experience geographic, financial, and educational barriers to dental care. The study identifies the geographic and financial barriers to dental care access. These findings suggest that the likelihood of a market-driven solution to dental underserved geographic areas is low and support public sector interventions to improve the status quo. © 2016 American Association of Public Health Dentistry.

Core areas of practice and associated competencies for nurses working as professional cancer navigators.

PubMed

Cook, Sandra; Fillion, Lise; Fitch, Margaret; Veillette, Anne-Marie; Matheson, Tanya; Aubin, Michèle; de Serres, Marie; Doll, Richard; Rainville, François

2013-01-01

Fillion et al. (2012) recently designed a conceptual framework for professional cancer navigators describing key functions of professional cancer navigation. Building on this framework, this study defines the core areas of practice and associated competencies for professional cancer navigators. The methods used in this study included: literature review, mapping of navigation functions against practice standards and competencies, and validation of this mapping process with professional navigators, their managers and nursing experts and comparison of roles in similar navigation programs. Associated competencies were linked to the three identified core areas of practice, which are: 1) providing information and education, 2) providing emotional and supportive care, and 3) facilitating coordination and continuity of care. Cancer navigators are in a key position to improve patient and family empowerment and continuity of care. This is an important step for advancing the role of oncology nurses in navigator positions and identifying areas for further research.

Targeted case finding for chronic obstructive pulmonary disease versus routine practice in primary care (TargetCOPD): a cluster-randomised controlled trial.

PubMed

Jordan, Rachel E; Adab, Peymané; Sitch, Alice; Enocson, Alexandra; Blissett, Deirdre; Jowett, Sue; Marsh, Jen; Riley, Richard D; Miller, Martin R; Cooper, Brendan G; Turner, Alice M; Jolly, Kate; Ayres, Jon G; Haroon, Shamil; Stockley, Robert; Greenfield, Sheila; Siebert, Stanley; Daley, Amanda J; Cheng, K K; Fitzmaurice, David

2016-09-01

Many individuals with chronic obstructive pulmonary disease (COPD) remain undiagnosed worldwide. Health-care organisations are implementing case-finding programmes without good evidence of which are the most effective and cost-effective approaches. We assessed the effectiveness and cost-effectiveness of two alternative approaches to targeted case finding for COPD compared with routine practice. In this cluster-randomised controlled trial, participating general practices in the West Midlands, UK, were randomly assigned (1:1), via a computer-generated block randomisation sequence, to either a targeted case-finding group or a routine care group. Eligible patients were ever-smokers aged 40-79 years without a previously recorded diagnosis of COPD. Patients in the targeted case-finding group were further randomly assigned (1:1) via their household to receive either a screening questionnaire at the general practitioner (GP) consultation (opportunistic) or a screening questionnaire at the GP consultation plus a mailed questionnaire (active). Respondents reporting relevant respiratory symptoms were invited for post-bronchodilator spirometry. Patients, clinicians, and investigators were not masked to allocation, but group allocation was concealed from the researchers who performed the spirometry assessments. Primary outcomes were the percentage of the eligible population diagnosed with COPD within 1 year (defined as post-bronchodilator forced expiratory volume in 1 s [FEV1] to forced vital capacity [FVC] ratio <0·7 in patients with symptoms or a new diagnosis on their GP record) and cost per new COPD diagnosis. Multiple logistic and Poisson regression were used to estimate effect sizes. Costs were obtained from the trial. This trial is registered with ISRCTN, number ISRCTN14930255. From Aug 10, 2012, to June 22, 2014, 74 818 eligible patients from 54 diverse general practices were randomly assigned and completed the trial. At 1 year, 1278 (4%) cases of COPD were newly

Effectiveness of Practices To Increase Timeliness of Providing Targeted Therapy for Inpatients with Bloodstream Infections: a Laboratory Medicine Best Practices Systematic Review and Meta-analysis

PubMed Central

Buehler, Stephanie S.; Madison, Bereneice; Snyder, Susan R.; Derzon, James H.; Saubolle, Michael A.; Weissfeld, Alice S.; Weinstein, Melvin P.; Liebow, Edward B.; Wolk, Donna M.

2015-01-01

SUMMARY Background. Bloodstream infection (BSI) is a major cause of morbidity and mortality throughout the world. Rapid identification of bloodstream pathogens is a laboratory practice that supports strategies for rapid transition to direct targeted therapy by providing for timely and effective patient care. In fact, the more rapidly that appropriate antimicrobials are prescribed, the lower the mortality for patients with sepsis. Rapid identification methods may have multiple positive impacts on patient outcomes, including reductions in mortality, morbidity, hospital lengths of stay, and antibiotic use. In addition, the strategy can reduce the cost of care for patients with BSIs. Objectives. The purpose of this review is to evaluate the evidence for the effectiveness of three rapid diagnostic practices in decreasing the time to targeted therapy for hospitalized patients with BSIs. The review was performed by applying the Centers for Disease Control and Prevention's (CDC's) Laboratory Medicine Best Practices Initiative (LMBP) systematic review methods for quality improvement (QI) practices and translating the results into evidence-based guidance (R. H. Christenson et al., Clin Chem 57:816–825, 2011, http://dx.doi.org/10.1373/clinchem.2010.157131). Search strategy. A comprehensive literature search was conducted to identify studies with measurable outcomes. A search of three electronic bibliographic databases (PubMed, Embase, and CINAHL), databases containing “gray” literature (unpublished academic, government, or industry evidence not governed by commercial publishing) (CIHI, NIHR, SIGN, and other databases), and the Cochrane database for English-language articles published between 1990 and 2011 was conducted in July 2011. Dates of search. The dates of our search were from 1990 to July 2011. Selection criteria. Animal studies and non-English publications were excluded. The search contained the following medical subject headings: bacteremia; bloodstream

Practical interior tomography with radial Hilbert filtering and a priori knowledge in a small round area.

PubMed

Tang, Shaojie; Yang, Yi; Tang, Xiangyang

2012-01-01

Interior tomography problem can be solved using the so-called differentiated backprojection-projection onto convex sets (DBP-POCS) method, which requires a priori knowledge within a small area interior to the region of interest (ROI) to be imaged. In theory, the small area wherein the a priori knowledge is required can be in any shape, but most of the existing implementations carry out the Hilbert filtering either horizontally or vertically, leading to a vertical or horizontal strip that may be across a large area in the object. In this work, we implement a practical DBP-POCS method with radial Hilbert filtering and thus the small area with the a priori knowledge can be roughly round (e.g., a sinus or ventricles among other anatomic cavities in human or animal body). We also conduct an experimental evaluation to verify the performance of this practical implementation. We specifically re-derive the reconstruction formula in the DBP-POCS fashion with radial Hilbert filtering to assure that only a small round area with the a priori knowledge be needed (namely radial DBP-POCS method henceforth). The performance of the practical DBP-POCS method with radial Hilbert filtering and a priori knowledge in a small round area is evaluated with projection data of the standard and modified Shepp-Logan phantoms simulated by computer, followed by a verification using real projection data acquired by a computed tomography (CT) scanner. The preliminary performance study shows that, if a priori knowledge in a small round area is available, the radial DBP-POCS method can solve the interior tomography problem in a more practical way at high accuracy. In comparison to the implementations of DBP-POCS method demanding the a priori knowledge in horizontal or vertical strip, the radial DBP-POCS method requires the a priori knowledge within a small round area only. Such a relaxed requirement on the availability of a priori knowledge can be readily met in practice, because a variety of small

Best Practices in ELL Instruction

ERIC Educational Resources Information Center

Li, Guofang, Ed.; Edwards, Patricia A., Ed.

2010-01-01

In this work, prominent authorities review the latest research on all aspects of ELL instruction (K-12) and identify what works for today's students and schools. Provided are best-practice guidelines for targeting reading, writing, oral language, vocabulary, content-domain literacies, and other core skill areas; assessing culturally and…

Multiple targets detection method in detection of UWB through-wall radar

NASA Astrophysics Data System (ADS)

Yang, Xiuwei; Yang, Chuanfa; Zhao, Xingwen; Tian, Xianzhong

2017-11-01

In this paper, the problems and difficulties encountered in the detection of multiple moving targets by UWB radar are analyzed. The experimental environment and the penetrating radar system are established. An adaptive threshold method based on local area is proposed to effectively filter out clutter interference The objective of the moving target is analyzed, and the false target is further filtered out by extracting the target feature. Based on the correlation between the targets, the target matching algorithm is proposed to improve the detection accuracy. Finally, the effectiveness of the above method is verified by practical experiment.

Inverse Design of Low-Boom Supersonic Concepts Using Reversed Equivalent-Area Targets

NASA Technical Reports Server (NTRS)

Li, Wu; Rallabhand, Sriam

2011-01-01

A promising path for developing a low-boom configuration is a multifidelity approach that (1) starts from a low-fidelity low-boom design, (2) refines the low-fidelity design with computational fluid dynamics (CFD) equivalent-area (Ae) analysis, and (3) improves the design with sonic-boom analysis by using CFD off-body pressure distributions. The focus of this paper is on the third step of this approach, in which the design is improved with sonic-boom analysis through the use of CFD calculations. A new inverse design process for off-body pressure tailoring is formulated and demonstrated with a low-boom supersonic configuration that was developed by using the mixed-fidelity design method with CFD Ae analysis. The new inverse design process uses the reverse propagation of the pressure distribution (dp/p) from a mid-field location to a near-field location, converts the near-field dp/p into an equivalent-area distribution, generates a low-boom target for the reversed equivalent area (Ae,r) of the configuration, and modifies the configuration to minimize the differences between the configuration s Ae,r and the low-boom target. The new inverse design process is used to modify a supersonic demonstrator concept for a cruise Mach number of 1.6 and a cruise weight of 30,000 lb. The modified configuration has a fully shaped ground signature that has a perceived loudness (PLdB) value of 78.5, while the original configuration has a partially shaped aft signature with a PLdB of 82.3.

33 CFR 334.200 - Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Cedar Point; aerial and surface firing range and target area, U.S. Naval Air Station, Patuxent River... Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U.S. Naval Air Station, Patuxent River, Maryland, danger zones. (a) Aerial firing range—(1) The danger zone. The waters...

33 CFR 334.200 - Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Cedar Point; aerial and surface firing range and target area, U.S. Naval Air Station, Patuxent River... Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U.S. Naval Air Station, Patuxent River, Maryland, danger zones. (a) Aerial firing range—(1) The danger zone. The waters...

33 CFR 334.200 - Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Cedar Point; aerial and surface firing range and target area, U.S. Naval Air Station, Patuxent River... Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U.S. Naval Air Station, Patuxent River, Maryland, danger zones. (a) Aerial firing range—(1) The danger zone. The waters...

Kees: a Practical Ict Solution for Rural Areas

NASA Astrophysics Data System (ADS)

Dai, Xiaoye; Tabirca, Sabin; Lenihan, Eamon

This paper introduces a practical e-learning system, identified as Knowledge Exchange E-learning System (abbr. KEES), for knowledge distribution in rural areas. Particularly, this paper is about providing a virtual teaching and learning environment for small holders in agriculture in those rural areas. E-learning is increasingly influencing the agricultural education (information and knowledge learning) in all forms and the current e-learning in agricultural education appears in informal and formal methods in many developed countries and some developing areas such as Asian Pacific regions. KEES is a solution to provide education services including other services of information distribution and knowledge sharing to local farmers, local institutes or local collection of farmers. The design of KEES is made to meet the needs of knowledge capacity building, experience sharing, skill upgrading, and information exchanging in agriculture for different conditions in rural areas. The system allows the online lecture/training materials to be distributed simultaneously with all multimedia resources through different file formats across different platforms. The teaching/training content can be contextless and broad, allowing for greater participation by more small holders, commercial farmers, extension workers, agriculturists, educators, and other agriculture-related experts. The relative inconsistency in content gives farmers more localised and useful knowledge. The framework of KEES has been designed to be a three-tier architecture logic workflow, which can configure the progressive approach for KEES to pass on and respond to different requests/communications between the client side and the server.

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Gulf of Maine off Seal Island... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger zone. A circular area with a radius of 1.5 nautical miles, having its center just easterly of Seal...

Large-area fabrication of superhydrophobic surfaces for practical applications: an overview

PubMed Central

Xue, Chao-Hua; Jia, Shun-Tian; Zhang, Jing; Ma, Jian-Zhong

2010-01-01

This review summarizes the key topics in the field of large-area fabrication of superhydrophobic surfaces, concentrating on substrates that have been used in commercial applications. Practical approaches to superhydrophobic surface construction and hydrophobization are discussed. Applications of superhydrophobic surfaces are described and future trends in superhydrophobic surfaces are predicted. PMID:27877336

Title VII funding and physician practice in rural or low-income areas.

PubMed

Krist, Alex H; Johnson, Robert E; Callahan, David; Woolf, Steven H; Marsland, David

2005-01-01

Whether Title VII funding enhances physician supply in underserved areas has not clearly been established. To determine the relation between Title VII funding in medical school, residency, or both, and the number of family physicians practicing in rural or low-income communities. A retrospective cross sectional analysis was carried out using the 2000 American Academy of Family Physicians physician database, Title VII funding records, and 1990 U.S. Census data. Included were 9,107 family physicians practicing in 9 nationally representative states in the year 2000. Physicians exposed to Title VII funding through medical school and residency were more likely to have their current practice in low-income communities (11.9% vs 9.9%, P< or =.02) and rural areas (24.5% vs 21.8%, P< or =.02). Physicians were more likely to practice in rural communities if they attended medical schools (24.2% vs 21.4%; P =.009) and residencies (24.0% vs 20.3%; P =.011) after the school or program had at least 5 years of Title VII funding vs before. Similar increases were not observed for practice in low-income communities. In a multivariate analysis, exposure to funding and attending an institution with more years of funding independently increased the odds of practicing in rural or low-income communities. Title VII funding is associated with an increase in the family physician workforce in rural and low-income communities. This effect is temporally related to initiation of funding and independently associated with effect in a multivariate analysis, suggesting a potential causal relationship. Whereas the absolute 2% increase in family physicians in these underserved communities may seem modest, it can represent a substantial increase in access to health care for community members.

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

Measurement of the distribution of radiation in the area surrounding the target mass using optically stimulated luminescence technique.

PubMed

Tanır, A Güneş; Yedek, Hatice; Koç, Kemal; Bölükdemir, M Hicabi

2017-01-01

The scattered doses received by the area surrounding the target that has been subjected to x-rays were investigated. Two experiments were carried out: 1- Al 2 O 3 : C was used as dosimeter and the luminescence counts was measured using both the RisØ TL/OSL system and an ion chamber. 2- BeO aliquots were used and the counts were read using the IBEOX/OSL system. According to the results, the doses absorbed by the area surrounding the target are significantly amount. Copyright © 2016 Elsevier Ltd. All rights reserved.

Achievement of cholesterol targets and prescribing of higher-cost statins: a cross-sectional study in general practice.

PubMed

Fleetcroft, Robert; Schofield, Peter; Duerden, Martin; Ashworth, Mark

2012-12-01

There is conflicting evidence as to whether achievement of cholesterol targets at the population level is dependent on the choice and cost of statin. To investigate the practice-level relationship between cholesterol quality indicators in patients with heart disease, stroke, and diabetes and prescribing of low-cost statins. Correlations and linear regression modelling of retrospective cross-sectional practice-level data with potential explanatory variables in 7909 (96.4%) general practices in England in 2008-2009. Quality indicator data were obtained from the Information Centre and prescribing data from the NHS Business Authority. A 'cholesterol quality indicator' score was constructed by dividing the numbers of patients achieving the target for cholesterol control of ≤5 mmol/l in stroke, diabetes, and heart disease by the numbers on each register. A 'low-cost statin' ratio score was constructed by dividing the numbers of defined daily doses of simvastatin and pravastatin by the total numbers of defined daily doses of statins. Simvastatin accounted for 83.3% (standard deviation [SD] = 15.7%) of low-cost statins prescribed and atorvastatin accounted for 85.7% (SD = 14.8%) of high-cost statins prescribed. The mean cholesterol score was 73.7% (SD = 6.0%). Practices using a higher proportion of the low-cost statins were less successful in achieving cholesterol targets. An increase of 10% in the prescribing of low-cost statins was associated with a decrease of 0.46% in the cholesterol quality indicator score (95% confidence interval = -0.54% to -0.38%, P<0.001). Greater use of low-cost statins was associated with a small reduction in cholesterol control.

Approaches to the implementation of the Water Framework Directive: targeting mitigation measures at critical source areas of diffuse phosphorus in Irish catchments.

PubMed

Doody, D G; Archbold, M; Foy, R H; Flynn, R

2012-01-01

The Water Framework Directive (WFD) has initiated a shift towards a targeted approach to implementation through its focus on river basin districts as management units and the natural ecological characteristics of waterbodies. Due to its role in eutrophication, phosphorus (P) has received considerable attention, resulting in a significant body of research, which now forms the evidence base for the programme of measures (POMs) adopted in WFD River Basin Management Plans (RBMP). Targeting POMs at critical sources areas (CSAs) of P could significantly improve environmental efficiency and cost effectiveness of proposed mitigation strategies. This paper summarises the progress made towards targeting mitigation measures at CSAs in Irish catchments. A review of current research highlights that knowledge related to P export at field scale is relatively comprehensive however; the availability of site-specific data and tools limits widespread identification of CSA at this scale. Increasing complexity of hydrological processes at larger scales limits accurate identification of CSA at catchment scale. Implementation of a tiered approach, using catchment scale tools in conjunction with field-by-field surveys could decrease uncertainty and provide a more practical and cost effective method of delineating CSA in a range of catchments. Despite scientific and practical uncertainties, development of a tiered CSA-based approach to assist in the development of supplementary measures would provide a means of developing catchment-specific and cost-effective programmes of measures for diffuse P. The paper presents a conceptual framework for such an approach, which would have particular relevance for the development of supplementary measures in High Status Waterbodies (HSW). The cost and resources necessary for implementation are justified based on HSWs' value as undisturbed reference condition ecosystems. Copyright © 2011 Elsevier Ltd. All rights reserved.

Changes in Extremely Hot Summers over the Global Land Area under Various Warming Targets.

PubMed

Wang, Lei; Huang, Jianbin; Luo, Yong; Yao, Yao; Zhao, Zongci

2015-01-01

Summer temperature extremes over the global land area were investigated by comparing 26 models of the fifth phase of the Coupled Model Intercomparison Project (CMIP5) with observations from the Goddard Institute for Space Studies (GISS) and the Climate Research Unit (CRU). Monthly data of the observations and models were averaged for each season, and statistics were calculated for individual models before averaging them to obtain ensemble means. The summers with temperature anomalies (relative to 1951-1980) exceeding 3σ (σ is based on the local internal variability) are defined as "extremely hot". The models well reproduced the statistical characteristics evolution, and partly captured the spatial distributions of historical summer temperature extremes. If the global mean temperature increases 2°C relative to the pre-industrial level, "extremely hot" summers are projected to occur over nearly 40% of the land area (multi-model ensemble mean projection). Summers that exceed 5σ warming are projected to occur over approximately 10% of the global land area, which were rarely observed during the reference period. Scenarios reaching warming levels of 3°C to 5°C were also analyzed. After exceeding the 5°C warming target, "extremely hot" summers are projected to occur throughout the entire global land area, and summers that exceed 5σ warming would become common over 70% of the land area. In addition, the areas affected by "extremely hot" summers are expected to rapidly expand by more than 25%/°C as the global mean temperature increases by up to 3°C before slowing to less than 16%/°C as the temperature continues to increase by more than 3°C. The area that experiences summers with warming of 5σ or more above the warming target of 2°C is likely to maintain rapid expansion of greater than 17%/°C. To reduce the impacts and damage from severely hot summers, the global mean temperature increase should remain low.

Changes in Extremely Hot Summers over the Global Land Area under Various Warming Targets

PubMed Central

Wang, Lei; Huang, Jianbin; Luo, Yong; Yao, Yao; Zhao, Zongci

2015-01-01

Summer temperature extremes over the global land area were investigated by comparing 26 models of the fifth phase of the Coupled Model Intercomparison Project (CMIP5) with observations from the Goddard Institute for Space Studies (GISS) and the Climate Research Unit (CRU). Monthly data of the observations and models were averaged for each season, and statistics were calculated for individual models before averaging them to obtain ensemble means. The summers with temperature anomalies (relative to 1951–1980) exceeding 3σ (σ is based on the local internal variability) are defined as “extremely hot”. The models well reproduced the statistical characteristics evolution, and partly captured the spatial distributions of historical summer temperature extremes. If the global mean temperature increases 2°C relative to the pre-industrial level, “extremely hot” summers are projected to occur over nearly 40% of the land area (multi-model ensemble mean projection). Summers that exceed 5σ warming are projected to occur over approximately 10% of the global land area, which were rarely observed during the reference period. Scenarios reaching warming levels of 3°C to 5°C were also analyzed. After exceeding the 5°C warming target, “extremely hot” summers are projected to occur throughout the entire global land area, and summers that exceed 5σ warming would become common over 70% of the land area. In addition, the areas affected by “extremely hot” summers are expected to rapidly expand by more than 25%/°C as the global mean temperature increases by up to 3°C before slowing to less than 16%/°C as the temperature continues to increase by more than 3°C. The area that experiences summers with warming of 5σ or more above the warming target of 2°C is likely to maintain rapid expansion of greater than 17%/°C. To reduce the impacts and damage from severely hot summers, the global mean temperature increase should remain low. PMID:26090931

Understanding Water Storage Practices of Urban Residents of an Endemic Dengue Area in Colombia: Perceptions, Rationale and Socio-Demographic Characteristics.

PubMed

García-Betancourt, Tatiana; Higuera-Mendieta, Diana Rocío; González-Uribe, Catalina; Cortés, Sebastian; Quintero, Juliana

2015-01-01

The main preventive measure against dengue virus transmission is often based on actions to control Ae. Aegypti reproduction by targeting water containers of clean and stagnant water. Household water storage has received special attention in prevention strategies but the evidence about the rationale of this human practice is limited. The objective was to identify and describe water storage practices among residents of an urban area in Colombia (Girardot) and its association with reported perceptions, rationales and socio-demographic characteristics with a mixed methods approach. Knowledge, attitudes and practices and entomological surveys from 1,721 households and 26 semi-structured interviews were conducted among residents of Girardot and technicians of the local vector borne disease program. A multivariate analysis was performed to identify associations between a water storage practice and socio-demographic characteristics, and knowledge, attitudes and practices about dengue and immature forms of the vector, which were then triangulated with qualitative information. Water storage is a cultural practice in Girardot. There are two main reasons for storage: The scarcity concern based on a long history of shortages of water in the region and the perception of high prices in water rates, contrary to what was reported by the local water company. The practice of water storage was associated with being a housewife (Inverse OR: 2.6, 95% CI 1.5 -4.3). The use of stored water depends on the type of container used, while water stored in alberca (Intra household cement basins) is mainly used for domestic cleaning chores, water in plastic containers is used for cooking. It is essential to understand social practices that can increase or reduce the number of breeding sites of Ae. Aegypti. Identification of individuals who store water and the rationale of such storage allow a better understanding of the social dynamics that lead to water accumulation.

Understanding Water Storage Practices of Urban Residents of an Endemic Dengue Area in Colombia: Perceptions, Rationale and Socio-Demographic Characteristics

PubMed Central

González-Uribe, Catalina; Cortés, Sebastian; Quintero, Juliana

2015-01-01

Introduction The main preventive measure against dengue virus transmission is often based on actions to control Ae. Aegypti reproduction by targeting water containers of clean and stagnant water. Household water storage has received special attention in prevention strategies but the evidence about the rationale of this human practice is limited. The objective was to identify and describe water storage practices among residents of an urban area in Colombia (Girardot) and its association with reported perceptions, rationales and socio-demographic characteristics with a mixed methods approach. Methods Knowledge, attitudes and practices and entomological surveys from 1,721 households and 26 semi-structured interviews were conducted among residents of Girardot and technicians of the local vector borne disease program. A multivariate analysis was performed to identify associations between a water storage practice and socio-demographic characteristics, and knowledge, attitudes and practices about dengue and immature forms of the vector, which were then triangulated with qualitative information. Results Water storage is a cultural practice in Girardot. There are two main reasons for storage: The scarcity concern based on a long history of shortages of water in the region and the perception of high prices in water rates, contrary to what was reported by the local water company. The practice of water storage was associated with being a housewife (Inverse OR: 2.6, 95% CI 1.5 -4.3). The use of stored water depends on the type of container used, while water stored in alberca (Intra household cement basins) is mainly used for domestic cleaning chores, water in plastic containers is used for cooking. Conclusions It is essential to understand social practices that can increase or reduce the number of breeding sites of Ae. Aegypti. Identification of individuals who store water and the rationale of such storage allow a better understanding of the social dynamics that lead to water

SEDIMENT HABITAT ASSESSMENT FOR TARGETED NEAR-COASTAL AREAS OF THE GULF OF MEXICO: A SUMMARY

EPA Science Inventory

Lewis, Michael A. In press. Sediment Habitat Assessment for Targeted Near-Coastal Areas of the Gulf of Mexico: A Summary. In: Estuarine Indicators Workshop Proceedings. CRC Press, Boca Raton, FL. 25 p. (ERL,GB 1201).

Sediment chemical and biological quality is summarized ...

Assessing protected area effectiveness using surrounding (buffer) areas environmentally similar to the target area.

PubMed

Mas, Jean-François

2005-06-01

Many studies are based on the assumption that an area and its surrounding (buffer) area present similar environmental conditions and can be compared. For example, in order to assess the effectiveness of a protected area, the land use/cover changes are compared inside the park with its surroundings. However, the heterogeneity in spatial variables can bias this assessment: we have shown that most of the protected areas in Mexico present significant environmental differences between their interior and their surroundings. Therefore, a comparison that aims at assessing the effectiveness of conservation strategies, must be cautioned. In this paper, a simple method which allows the generation of a buffer area that presents similar conditions with respect to a set of environmental variables is presented. The method was used in order to assess the effectiveness of the Calakmul Biosphere Reserve, a protected area located in the south-eastern part of Mexico. The annual rate of deforestation inside the protected area, the standard buffer area (based upon distance from the protected area only) and the similar buffer area (taking into account distance along with some environmental variables) were 0.3, 1.3 and 0.6%, respectively. These results showed that the protected area was effective in preventing land clearing, but that the comparison with the standard buffer area gave an over-optimistic vision of its effectiveness.

Investigation the opinions of the primary science teachers toward practice of teaching and learning activities in science learning area

NASA Astrophysics Data System (ADS)

Chamnanwong, Pornpaka; Thathong, Kongsak

2018-01-01

In preparing a science lesson plan, teachers may deal with numerous difficulties. Having a deep understanding of their problems and their demands is extremely essential for the teachers in preparing themselves for the job. Moreover, it is also crucial for the stakeholders in planning suitable and in-need teachers' professional development programs, in school management, and in teaching aid. This study aimed to investigate the primary school science teachers' opinion toward practice of teaching and learning activities in science learning area. Target group was 292 primary science teachers who teach Grade 4 - 6 students in Khon Kaen Province, Thailand in the academic year of 2014. Data were collected using Questionnaire about Investigation the opinions of the primary science teachers toward practice of teaching and learning activities in science learning area. The questionnaires were consisted of closed questions scored on Likert scale and open-ended questions that invite a sentence response to cover from LS Process Ideas. Research findings were as follow. The primary science teachers' level of opinion toward teaching and learning science subject ranged from 3.19 - 3.93 (mean = 3.43) as "Moderate" level of practice. The primary school science teachers' needs to participate in a training workshop based on LS ranged from 3.66 - 4.22 (mean = 3.90) as "High" level. The result indicated that they were interested in attending a training course under the guidance of the Lesson Study by training on planning of management of science learning to solve teaching problems in science contents with the highest mean score 4.22. Open-ended questions questionnaire showed the needs of the implementation of the lesson plans to be actual classrooms, and supporting for learning Medias, innovations, and equipment for science experimentation.

Targeting as a Mode of Science Communication: Principles, Issues and a Practical Example

NASA Astrophysics Data System (ADS)

Holland, G. J.; Vigh, J. L.

2011-12-01

Today's media landscape contains a rich and diverse range of communications opportunities. New media, such as the internet, blogosphere and social networks, are complementing, supplementing and also replacing the traditional mass media communications through print, radio and television. This diversification certainly contains pitfalls and difficulties as has been demonstrated in the Climategate affair. But there are also real opportunities for utilizing the diversity to provide targeted science communications that are framed in the context of the specific group of interest. That such targeting of audience attitudes and beliefs is an important key to effective science communications has been demonstrated by, for example, Leiserowitz, Maibach et al (2009). This approach does require an understanding of the audience and a careful framing of the message in terms familiar to the targeted group. Here many factors come into play, including: including immediacy, economics, culture, community leaders, emotional framing, and ideological filters. In this talk we shall elaborate on the principles, issues and opportunities. A practical example of working with the religious community on communicating the science of climate change will also be presented. This will include the approach adopted, progress to date and the lessons learnt.

[Evaluation of practices of excisional therapies for CIN: An audit of surgery rooms from Marseilles' area].

PubMed

Einaudi, L; Boubli, L; Carcopino, X

2015-11-01

To evaluate what is the proportion of surgery rooms from Marseilles' area that do perform excisional therapies for CIN without any use of colposcopic guidance. From November 2012 to January 2013, a survey was conducted among all surgery rooms from Marseilles' area practicing excisional therapies for CIN. In addition, answers from gynecologists from Marseilles' area who participated to a national survey that evaluated practices of excisional therapies in France were specifically analyzed. Among the 55 surgery rooms from Marseilles' area practicing excisional therapies, 52 (94.1%) participated to the current survey. A colposcope was available in only 19 (36.5%) surgery rooms and was systematically used for the guidance of excisional therapies in only 4 (21%) of these surgery rooms. Finally, 36 (69.2%) surgery rooms answered performing excisional therapies without any use of colposcopic guidance. Colposcopy was occasionally and systematically used in 12 (23.1%) and 4 (7.7%) surgery rooms, respectively. Among the 116 gynecologists from Marseilles' area who answered to the national survey, 88 (75.9%) answered not using colposcopy when performing excision for CIN. Only 6% answered performing excision systematically under direct colposcopic vision and 18.1% occasionally. No colposcopic guidance is used when performing excision for CIN in the majority of surgery rooms from Marseilles' area. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Best management practices for reducing nutrient loads in a sub-watershed of Chesapeake Bay area

USDA-ARS?s Scientific Manuscript database

Water quality improvement in the Chesapeake Bay is a grave concern. An initiative to reduce the nutrient loads to stream has been undertaken to attain a target total maximum daily load (TMDL) at Chesapeake Bay. A general guideline with a set of best management practices (BMPs) has been in place for ...

Molecular targeted therapy in enteropancreatic neuroendocrine tumors: from biology to clinical practice.

PubMed

Fazio, N; Scarpa, A; Falconi, M

2014-01-01

Advanced enteropancreatic (EP) neuroendocrine tumors (NETs) can be treated with several different therapies, including chemotherapy, biotherapy, and locoregional treatments. Over the last few decades, impressive progress has been made in the biotherapy field. Three main druggable molecular targets have been studied and developed in terms of therapy: somatostatin receptor (sstr), mammalian target of rapamycin (mTOR), and angiogenic factors. In particular, research has moved from the old somatostatin analogs (SSAs), such as octreotide (OCT) and lanreotide (LAN), specifically binding to the sstr-2, to the newer pasireotide (PAS), which presents a wider sstr spectrum. Over the last ten years, several molecular targeted agents (MTAs) have been studied in phase II trials, and very few of them have reached phase III. The mTOR inhibitor everolimus and the multitargeted inhibitor sunitinib have been approved for clinical use by the FDA and EMA in advanced well/moderately-differentiated (WD, MD) progressive pancreatic neuroendocrine tumors (PNETs), on the basis of the positive results of two international large randomized phase III trials vs. placebo. Bevacizumab has been studied in a large US phase III trial vs. interferon (IFN)-alfa2b, and results are pending. In this review, the biological and clinical aspects of MTAs introduced into clinical practice or which are currently in an advanced phase of clinical investigation are addressed.

Does practicing a wide range of joint angle configurations lead to higher flexibility in a manual obstacle-avoidance target-pointing task?

PubMed Central

Bootsma, Reinoud J.; Schoemaker, Marina M.; Otten, Egbert; Mouton, Leonora J.; Bongers, Raoul M.

2017-01-01

Flexibility in motor actions can be defined as variability in the use of degrees of freedom (e.g., joint angles in the arm) over repetitions while keeping performance (e.g., fingertip position) stabilized. We examined whether flexibility can be increased through enlarging the joint angle range during practice in a manual obstacle-avoidance target-pointing task. To establish differences in flexibility we partitioned the variability in joint angles over repetitions in variability within (GEV) and variability outside the solution space (NGEV). More GEV than NGEV reflects flexibility; when the ratio of the GEV and NGEV is higher, flexibility is higher. The pretest and posttest consisted of 30 repetitions of manual pointing to a target while moving over a 10 cm high obstacle. To enlarge the joint angle range during practice participants performed 600 target-pointing movements while moving over obstacles of different heights (5–9 cm, 11–15 cm). The results indicated that practicing movements over obstacles of different heights led participants to use enlarged range of joint angles compared to the range of joint angles used in movements over the 10 cm obstacle in the pretest. However, for each individual obstacle neither joint angle variance nor flexibility were higher during practice. We also did not find more flexibility after practice. In the posttest, joint angle variance was in fact smaller than before practice, primarily in GEV. The potential influences of learning effects and the task used that could underlie the results obtained are discussed. We conclude that with this specific type of practice in this specific task, enlarging the range of joint angles does not lead to more flexibility. PMID:28700695

TRADITIONAL PRACTICES ADOPTED BY JORDANIAN MOTHERS WHEN CARING FOR THEIR INFANTS IN RURAL AREAS

PubMed Central

Al-Sagarat, Ahmad Yahya; Al-Kharabsheh, Amani

2017-01-01

Background: Traditional practices are commonly present within the Jordanian society, especailly those concerned with infant’s care. Some of these practices might be harmful and thus health professioanls are required to substitute these practices with safe and healthy ones. The goal of this study is to determine the traditional practices adopted by Jordanian mothers when caring for their infants in rural areas. Materials and Methods: A descriptive study design using qualitative method was utilized in this study. A Purposive sample of 30 mothers was recruited from four rural regions in outskirts of Amman the capital city of Jordan. Results: Mothers had traditional infant’s care practices pertinent to bathing of babies, including the salting, swaddling, care of the umbilical cord and jaundice. Conclusion: Traditional practices are still common in Jordan; some of these behaviors can cause health risks. While health consequences of some of the traditional practices are still not clear, health professianls, especially nurses, are required to intervene by changing policies and education. PMID:28331910

Multiple and Single Green Area Measurements and Classification Using Phantom Images in Comparison with Derived Experimental Law

NASA Astrophysics Data System (ADS)

Abu-Zaid, N. A. M.

2017-11-01

In many circumstances, it is difficult for humans to reach some areas, due to its topography, personal safety, or security regulations in the country. Governments and persons need to calculate those areas and classify the green parts for reclamation to benefit from it.To solve this problem, this research proposes to use a phantom air plane to capture a digital image for the targeted area, then use a segmentation algorithm to separate the green space and calculate it's area. It was necessary to deal with two problems. The first is the variable elevation at which an image was taken, which leads to a change in the physical area of each pixel. To overcome this problem a fourth degree polynomial was fit to some experimental data. The second problem was the existence of different unconnected pieces of green areas in a single image, but we might be interested only in one of them. To solve this problem, the probability of classifying the targeted area as green was increased, while the probability of other untargeted sections was decreased by the inclusion of parts of it as non-green. A practical law was also devised to measure the target area in the digital image for comparison purposes with practical measurements and the polynomial fit.

Missing marine protected area (MPA) targets: How the push for quantity over quality undermines sustainability and social justice.

PubMed

De Santo, Elizabeth M

2013-07-30

International targets for marine protected areas (MPAs) and networks of MPAs set by the World Summit on Sustainable Development and United Nations Convention on Biological Diversity failed to meet their 2012 deadline and have been extended to 2020. Whilst targets play an important role in building momentum for conservation, they are also responsible for the recent designation of several extremely large no-take MPAs, which pose significant long-term monitoring and enforcement challenges. This paper critically examines the effectiveness of MPA targets, focusing on the underlying risks to achieving Millennium Development Goals posed by the global push for quantity versus quality of MPAs. The observations outlined in this paper have repercussions for international protected area politics with respect to (1) the science-policy interface in environmental decision-making, and (2) social justice concerns in global biodiversity conservation. Copyright © 2013 Elsevier Ltd. All rights reserved.

33 CFR 334.1450 - Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles. 334.1450 Section 334.1450 Navigation and... RESTRICTED AREA REGULATIONS § 334.1450 Atlantic Ocean off north coast of Puerto Rico; practice firing areas...

33 CFR 334.1450 - Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles. 334.1450 Section 334.1450 Navigation and... RESTRICTED AREA REGULATIONS § 334.1450 Atlantic Ocean off north coast of Puerto Rico; practice firing areas...

33 CFR 334.1450 - Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles. 334.1450 Section 334.1450 Navigation and... RESTRICTED AREA REGULATIONS § 334.1450 Atlantic Ocean off north coast of Puerto Rico; practice firing areas...

33 CFR 334.1450 - Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles. 334.1450 Section 334.1450 Navigation and... RESTRICTED AREA REGULATIONS § 334.1450 Atlantic Ocean off north coast of Puerto Rico; practice firing areas...

The Effect of Teaching Practices with Real Life Content in Light and Sound Learning Areas

ERIC Educational Resources Information Center

Yalçin, Sema Altun; Yalçin, Pasa; Akar, M. Said; Sagirli, Meryem Özturan

2017-01-01

In this present study, it was aimed to investigate the effect of teaching practices with real life content in light and sound learning areas. With this purpose, it was intended to determine the contribution of teaching practices with real life content (TPRLC) to the levels of pre-service teachers' skills to associate the light and sound learning…

Health maintenance organization penetration and the practice location choices of new physicians: a study of large metropolitan areas in the United States.

PubMed

Escarce, J J; Polsky, D; Wozniak, G D; Pauly, M V; Kletke, P R

1998-11-01

The rapid growth of health maintenance organizations is reshaping the practice opportunities available to physicians. The practice location decisions of new physicians provide a sensitive bellwether of these changes. This study assessed the effect of health maintenance organization penetration on practice location for physicians completing graduate medical education (GME). Conditional logit regression analysis was used to determine the effect of health maintenance organization penetration on practice location, controlling for other market characteristics. Subjects were physicians who finished GME between 1989 and 1994 and who located in one of the 98 US metropolitan areas with more than 500,000 population. The outcome measure was the particular metropolitan area chosen by each new physician. Early in the study period, new generalists were significantly more likely to locate in metropolitan areas with high health maintenance organization penetration than in low penetration areas, whereas new specialists' practice location choices were not associated with health maintenance organization penetration. The likelihood of choosing a high penetration relative to a low penetration area declined with time, however, for both generalists and specialists. Consequently, by the end of the study period, health maintenance organization penetration had a weak but significant negative effect on practice location for generalists and a strong negative influence on practice location for specialists. New generalists who completed graduate medical education between 1989 and 1994 were more likely than new specialists to locate in market areas with high health maintenance organization penetration; however, the proportions of both generalists and specialists who chose high penetration areas decreased during the study period. This finding may reflect reduced practice opportunities in high penetration areas relative to low penetration areas as health maintenance organizations' systems for

Benchmarking management practices in Australian public healthcare.

PubMed

Agarwal, Renu; Green, Roy; Agarwal, Neeru; Randhawa, Krithika

2016-01-01

The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a "double blind, double scored" methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management - operations, performance monitoring, targets and people management. The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most. This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services. This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of

Impact of target area selection in 125 Iodine seed brachytherapy on locoregional recurrence in patients with non-small cell lung cancer.

PubMed

Yan, Wei-Liang; Lv, Jin-Shuang; Guan, Zhi-Yu; Wang, Li-Yang; Yang, Jing-Kui; Liang, Ji-Xiang

2017-05-01

Computed tomography (CT)-guided percutaneous implantation of 125 Iodine radioactive seeds requires the precise arrangement of seeds by tumor shape. We tested whether selecting target areas, including subclinical areas around tumors, can influence locoregional recurrence in patients with non-small cell lung cancer (NSCLC). We divided 82 patients with NSCLC into two groups. Target areas in group 1 (n = 40) were defined along tumor margins based on lung-window CT. Target areas in group 2 (n = 42) were extended by 0.5 cm in all dimensions outside tumor margins. Preoperative plans for both groups were based on a treatment plan system, which guided 125 I seed implantation. Six months later, patients underwent chest CT to evaluate treatment efficacy (per Response Evaluation Criteria in Solid Tumors version 1). We compared locoregional recurrences between the groups after a year of follow-up. We then used the treatment plan system to extend target areas for group 1 patients by 0.5 cm (defined as group 3 data) and compared these hypothetical group 3 planned seeds with the actual seed numbers used in group 1 patients. All patients successfully underwent implantation; none died during the follow-up period. Recurrence was significantly lower in group 2 than in group 1 ( P  < 0.05). Group 1 patients and group 3 data significantly differed in seed numbers ( P  < 0.01). Our results imply that extending the implantation area for 125 I seeds can decrease recurrence risk by eradicating cancerous lymph-duct blockades within the extended areas. © 2017 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Knowledge and practices related to plague in an endemic area of Uganda.

PubMed

Kugeler, Kiersten J; Apangu, Titus; Forrester, Joseph D; Griffith, Kevin S; Candini, Gordian; Abaru, Janet; Okoth, Jimmy F; Apio, Harriet; Ezama, Geoffrey; Okello, Robert; Brett, Meghan; Mead, Paul

2017-11-01

Plague is a virulent zoonosis reported most commonly from Sub-Saharan Africa. Early treatment with antibiotics is important to prevent mortality. Understanding knowledge gaps and common behaviors informs the development of educational efforts to reduce plague mortality. A multi-stage cluster-sampled survey of 420 households was conducted in the plague-endemic West Nile region of Uganda to assess knowledge of symptoms and causes of plague and health care-seeking practices. Most (84%) respondents were able to correctly describe plague symptoms; approximately 75% linked plague with fleas and dead rats. Most respondents indicated that they would seek health care at a clinic for possible plague; however plague-like symptoms were reportedly common, and in practice, persons sought care for those symptoms at a health clinic infrequently. Persons in the plague-endemic region of Uganda have a high level of understanding of plague, yet topics for targeted educational messages are apparent. Published by Elsevier Ltd.

Promoting Physician Preventive Practices: Needs Assessment for CME in Breast Cancer Detection.

ERIC Educational Resources Information Center

Lane, Dorothy S.; Burg, Mary Ann

1989-01-01

Needs assessment for a continuing medical education (CME) intervention directed at increasing breast cancer screening of women over 50 included a survey of target primary care physicians (n=323) to explore areas of interest for CME in breast care detection and to establish baseline screening practices. A survey of 1,440 women in the target age…

Therapeutic antibodies: market considerations, disease targets and bioprocessing.

PubMed

Elvin, John G; Couston, Ruairidh G; van der Walle, Christopher F

2013-01-02

Antibodies are well established in mainstream clinical practice and present an exciting area for collaborative research and development in industry and academia alike. In this review, we will provide an overview of the current market and an outlook to 2015, focussing on whole antibody molecules while acknowledging the next generation scaffolds containing variable fragments. The market will be discussed in the context of disease targets, particularly in the areas of oncology and immune disorders which generate the greatest revenue by a wide margin. Emerging targets include central nervous system disorders which will also stimulate new delivery strategies. It is becoming increasingly apparent that a better understanding of bioprocessing is required in order to optimize the steps involved in the preparation of a protein prior to formulation. The latter is outside the scope of this review and nor is it our intention to discuss protein delivery and pharmacokinetics. The challenges that lie ahead include the discovery of new disease targets and the development of robust bioprocessing operations. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease.

PubMed

Wolfenden, Luke; Nathan, Nicole K; Sutherland, Rachel; Yoong, Sze Lin; Hodder, Rebecca K; Wyse, Rebecca J; Delaney, Tessa; Grady, Alice; Fielding, Alison; Tzelepis, Flora; Clinton-McHarg, Tara; Parmenter, Benjamin; Butler, Peter; Wiggers, John; Bauman, Adrian; Milat, Andrew; Booth, Debbie; Williams, Christopher M

2017-11-29

consulted with experts in the field to identify other relevant research. 'Implementation' was defined as the use of strategies to adopt and integrate evidence-based health interventions and to change practice patterns within specific settings. We included any trial (randomised or non-randomised) conducted at any scale, with a parallel control group that compared a strategy to implement policies or practices to address diet, physical activity, overweight or obesity, tobacco or alcohol use by school staff to 'no intervention', 'usual' practice or a different implementation strategy. Citation screening, data extraction and assessment of risk of bias was performed by review authors in pairs. Disagreements between review authors were resolved via consensus, or if required, by a third author. Considerable trial heterogeneity precluded meta-analysis. We narratively synthesised trial findings by describing the effect size of the primary outcome measure for policy or practice implementation (or the median of such measures where a single primary outcome was not stated). We included 27 trials, 18 of which were conducted in the USA. Nineteen studies employed randomised controlled trial (RCT) designs. Fifteen trials tested strategies to implement healthy eating policies, practice or programs; six trials tested strategies targeting physical activity policies or practices; and three trials targeted tobacco policies or practices. Three trials targeted a combination of risk factors. None of the included trials sought to increase the implementation of interventions to delay initiation or reduce the consumption of alcohol. All trials examined multi-strategic implementation strategies and no two trials examined the same combinations of implementation strategies. The most common implementation strategies included educational materials, educational outreach and educational meetings. For all outcomes, the overall quality of evidence was very low and the risk of bias was high for the majority of

Underreporting of high-risk water and sanitation practices undermines progress on global targets.

PubMed

Vedachalam, Sridhar; MacDonald, Luke H; Shiferaw, Solomon; Seme, Assefa; Schwab, Kellogg J

2017-01-01

Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly

Underreporting of high-risk water and sanitation practices undermines progress on global targets

PubMed Central

Vedachalam, Sridhar; MacDonald, Luke H.; Shiferaw, Solomon; Seme, Assefa; Schwab, Kellogg J.

2017-01-01

Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly

Marketing Practices of Vapor Store Owners

PubMed Central

Gowin, Mary; Wann, Taylor Franklin

2015-01-01

Objectives. We examined the marketing strategies for local vapor stores in a large metropolitan area in Oklahoma. Methods. Vapor store owners or managers (n = 33) participated in individual interviews regarding marketing practices in 2014. We asked owners about their marketing strategies and the groups they targeted. We transcribed the interviews and analyzed them for themes. Results. Store owners used a variety of marketing strategies to bring new customers to their stores and keep current customers coming back. These marketing strategies showed many parallels to tobacco industry strategies. Most owners engaged in some form of traditional marketing practices (e.g., print media), but only a few used radio or television advertising because of budget constraints. Owners used social media and other forms of electronic communication, pricing discounts and specials, and loyalty programs. Owners also had booths at local events, sponsored community events, and hosted them in their stores. Owners attempted to target different groups of users, such as college students and long-term smokers. Conclusions. Local vapor store marketing practices closely resemble current and former tobacco industry marketing strategies. Surveillance of marketing practices should include local and Web-based strategies. PMID:25880960

Marketing practices of vapor store owners.

PubMed

Cheney, Marshall; Gowin, Mary; Wann, Taylor Franklin

2015-06-01

We examined the marketing strategies for local vapor stores in a large metropolitan area in Oklahoma. Vapor store owners or managers (n = 33) participated in individual interviews regarding marketing practices in 2014. We asked owners about their marketing strategies and the groups they targeted. We transcribed the interviews and analyzed them for themes. Store owners used a variety of marketing strategies to bring new customers to their stores and keep current customers coming back. These marketing strategies showed many parallels to tobacco industry strategies. Most owners engaged in some form of traditional marketing practices (e.g., print media), but only a few used radio or television advertising because of budget constraints. Owners used social media and other forms of electronic communication, pricing discounts and specials, and loyalty programs. Owners also had booths at local events, sponsored community events, and hosted them in their stores. Owners attempted to target different groups of users, such as college students and long-term smokers. Local vapor store marketing practices closely resemble current and former tobacco industry marketing strategies. Surveillance of marketing practices should include local and Web-based strategies.

Transitioning into new clinical areas of practice: An integrative review of the literature.

PubMed

Kinghorn, Grant R; Halcomb, Elizabeth J; Froggatt, Terry; Thomas, Stuart Dm

2017-12-01

To critically synthesise research related to the transition of registered nurses into new areas of clinical practice. Global workforce shortages and rising healthcare demands have encouraged registered nurses to move into new clinical settings. While a body of literature reports on the transition of newly qualified nurses, evidence surrounding the transition of more experienced registered nurses to new clinical areas remains poorly explored. An integrative review was conducted, guided by Whittemore and Knafl (Journal of Advanced Nursing, 52, 2005, 546) framework. An electronic database search was conducted for papers published between 1996-2016. Papers were then subjected to a methodological quality appraisal, with findings synthesised using thematic analysis into core themes. Ten articles met the inclusion criteria. Three themes emerged, namely Support, Professional Development and Emotional Impact. These themes suggest that transitioning nurses experience challenges in adapting to new clinical areas and developing necessary skills. Such challenges prompted various emotional and physical responses. While formal and informal support systems were regarded as valuable by transitioning nurses, they were inconsistent across the new clinical areas. There is some evidence to highlight the initial shock and emotional stress experienced by registered nurses during transition to a new clinical area. However, the influence of formal and informal support systems for such registered nurses is far from conclusive. Further research is needed, to examine registered nurse transition into a variety of clinical areas to inform workforce support, policy and practices. The demand of health care is growing while global shortages of nursing workforce remain. To ensure retention and enhance the transition experience of registered nurses, it is important for nurse leaders, managers and policymakers to understand the transition experience and factors that impact this experience. © 2017

Cost analysis can help a group practice increase revenues.

PubMed

Migliore, Sherry

2002-02-01

Undertaking a cost analysis to determine the cost of providing specific services can help group practices negotiate increased payment and identify areas for cost reduction. An OB/GYN practice in Pennsylvania undertook a cost analysis using the resource-based relative value system. Using data from the cost analysis, the practice was able to negotiate increased payment for some of its services. The practice also was able to target some of its fixed costs for reduction. Another result of the analysis was that the practice was able to focus marketing efforts on some of its most profitable, elective services, thereby increasing revenues. In addition, the practice was able to reduce the provision of unprofitable services.

The Nitrate App: Enhancing nutrient best management practice adoption and targeting via instantaneous, on-farm nitrate data

NASA Astrophysics Data System (ADS)

Rozemeijer, J.; De Geus, D.; Ekkelenkamp, R.

2016-12-01

Sociological surveys suggest that farmers understand that agriculture contributes to nutrient pollution but the same surveys also indicate that in the absence of on-farm nitrate data, farmers assume someone else is causing the problem. This tendency to overestimate our own abilities is common to all of us and often described as "Lake Wobegon Syndrome" after the mythical town where "where all the women are strong, all the men are good-looking, and all the children are above average." We developed the Nitrate App for smartphones to enable farmers and citizens to collect and share nitrate concentration measurements. The app accurately reads and interprets nitrate test strips, directly displays the measured concentration, and gives the option to share the result. The shared results are immediately visualised in the online Delta Data Viewer. Within this viewer, user group specific combinations of background maps, monitoring data, and study area characteristics can be configured. Through the Nitrate App's mapping function project managers can more accurately target conservation practices to areas with the highest nitrate concentrations and loads. Furthermore, we expect that the actual on-farm data helps to overcome the "Lake Wobegon Effect" and will encourage farmers to talk to specialists about the right nutrient best management practices (BMP's) for their farm. After implementing these BMP's, the farmers can keep monitoring to evaluate the reduction in nitrate losses. In this presentation, we explain the Nitrate App technology and present the results of the first field applications in The Netherlands. We expect this free to download app to have wide transferability across watershed projects worldwide focusing on nitrate contamination of groundwater or surface water. Its simple design requires no special equipment outside of the nitrate test strips, a reference card, and a smartphone. The technology is also transferable to other relevant solutes for which test strips

Setting conservation targets for sandy beach ecosystems

NASA Astrophysics Data System (ADS)

Harris, Linda; Nel, Ronel; Holness, Stephen; Sink, Kerry; Schoeman, David

2014-10-01

Representative and adequate reserve networks are key to conserving biodiversity. This begs the question, how much of which features need to be placed in protected areas? Setting specifically-derived conservation targets for most ecosystems is common practice; however, this has never been done for sandy beaches. The aims of this paper, therefore, are to propose a methodology for setting conservation targets for sandy beach ecosystems; and to pilot the proposed method using data describing biodiversity patterns and processes from microtidal beaches in South Africa. First, a classification scheme of valued features of beaches is constructed, including: biodiversity features; unique features; and important processes. Second, methodologies for setting targets for each feature under different data-availability scenarios are described. From this framework, targets are set for features characteristic of microtidal beaches in South Africa, as follows. 1) Targets for dune vegetation types were adopted from a previous assessment, and ranged 19-100%. 2) Targets for beach morphodynamic types (habitats) were set using species-area relationships (SARs). These SARs were derived from species richness data from 142 sampling events around the South African coast (extrapolated to total theoretical species richness estimates using previously-established species-accumulation curve relationships), plotted against the area of the beach (calculated from Google Earth imagery). The species-accumulation factor (z) was 0.22, suggesting a baseline habitat target of 27% is required to protect 75% of the species. This baseline target was modified by heuristic principles, based on habitat rarity and threat status, with final values ranging 27-40%. 3) Species targets were fixed at 20%, modified using heuristic principles based on endemism, threat status, and whether or not beaches play an important role in the species' life history, with targets ranging 20-100%. 4) Targets for processes and 5

Improving access for patients – a practice manager questionnaire

PubMed Central

Meade, James G; Brown, James S

2006-01-01

Background The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting. Methods A four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB) in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire. Results There was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 – 9.80, p = 0.0256) had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006), urban practices (p < 0.001) and those with above average patient list sizes (p < 0.001). Receptionists had not received training in patient appointment management in a quarter of practices. Practices with smaller list sizes were more likely than larger ones to utilise nurses in seeing extra patients (p = 0.007) or to undertake triage procedures (p = 0.062). Conclusion The findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study. PMID:16784530

A Survey of Invasive Catheter Practices in US Burn Centers

DTIC Science & Technology

2012-12-01

exist. The purpose of this study was to define the breadth of current practices and identify areas of practice variation that may be targets for...Centers Robert L . Sheridan, MD,*|| Alice N. Neely, PhD,† Mayra A. Castillo, RN, BS,‡ Heather A. Shankowsky, RN,§ Shawn P. Fagan, MD,*|| Kevin K. Chung, MD...Practices in US Burn Centers 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Sheridan R. L ., Neely A. N., Castillo M. A

Evaluation of the Implementation of Good Handling Practices in Food and Beverage Areas of Hotels.

PubMed

Serafim, A L; Hecktheuer, L H R; Stangarlin-Fiori, L; Medeiros, L B; Martello, L; Machado, C E

2015-11-01

Because of the major international-level events that have recently been held in Brazil, concerns about the sensory and hygienic-sanitary conditions of food have increased. The objective of this study was to evaluate the implementation of good handling practices in food and beverage areas of hotels, with and without outsourced professional intervention. We evaluated 19 food and beverage areas in hotels in Porto Alegre, Rio do Sul, Brazil, using a checklist that was developed by a municipal surveillance team based on existing laws for good handling practices. The evaluation was done by a skilled professional in the food safety area on two occasions, at the beginning of the study (January to May 2013) and at the end (July to November 2014), and the establishments were classified as good, regular, or poor. After the baseline evaluation, an action plan listing the noncompliance found at each location was given to those responsible for the establishments, and a period of 1 year 6 months was stipulated for improvements to be made. In the repeat evaluation, those responsible for the establishments were asked whether they had hired an outsourced professional to assist them in the improvements. The hotels showed improvement during the repeat evaluation, but a significant increase in the percentage of overall adequacy was seen only in the food and beverages areas of the 12 hotels that used the intervention of an outsourced professional. The better percentage of adequacy in establishments with outsourced professional intervention underlines the importance of an external and impartial view of routine activities in the implementation of good handling practices.

The Poughkeepsie Survey. A Report on Employment and Unemployment in a "Target Area" under the Model Cities Program.

ERIC Educational Resources Information Center

Kuper, Irvin, Ed.

Located in the heart of the Mid-Hudson area, Poughkeepsie is in one of the fastest growing regions of New York State, but the city itself has grown very little in the last five decades. The local Model Cities agency has created a target area which includes most of the older part of the city. In July 1967, the population was 35,970. A total of…

A qualitative study of GP, nurse and practice manager views on using targeted case-finding to identify patients with COPD in primary care.

PubMed

Summers, Rachael H; Sharmeen, Taniya; Lippiett, Kate; Gillett, Kate; Astles, Carla; Vu, Linh; Stafford-Watson, Mark; Bruton, Anne; Thomas, Mike; Wilkinson, Tom

2017-08-29

'Finding the missing millions' with chronic obstructive pulmonary disease became part of the Department of Health strategy for England in 2010. Targeted case-finding within primary care is one potential pro-active strategy, but currently little is known about the views of healthcare professionals on this approach. In this study, 36 healthcare professionals (12 GPs, 14 nurses, and 10 practice managers) from 34 UK practices participated in semi-structured telephone interviews about targeted case-finding. Interviews followed an interview guide, were audio-recorded, transcribed verbatim, coded and analysed using 'Framework Approach'. Most of those interviewed practiced opportunistic case-finding. The main perceived barriers to wider case-finding programmes were the resource implications associated with running such programmes and identifying more chronic obstructive pulmonary disease patients. Financial incentives, support from specialist clinicians, and comprehensive guidance were viewed as facilitators. While targeted case-finding is conceptually accepted by primary care staff, scepticism surrounding (1) the value of identifying those with mild disease and (2) the availability of effective targeted case-finding methods, may lead some to favour an opportunistic approach. Key concerns were a lack of unequivocal evidence for the relative benefits vs. disadvantages of diagnosing patients earlier, and resource constraints in an already over-burdened system. Barriers to practical implementation of case-finding studies may be addressed with financial, human and educational resources, such as additional staff to undertake searches and perform spirometry tests, and practical and educational support from specialist teams. SUPPORT NEEDED TO IDENTIFY THOSE UNDIAGNOSED: Additional staff and resources would facilitate targeted searches for patients showing symptoms of early-stage chronic lung disease. Chronic obstructive pulmonary disease (COPD) costs the UK economy billions of

Defining values in place: A practical application for visitor management in protected areas

Treesearch

Gordon Cessford; Mike Edginton

2007-01-01

This paper explores a value specification option to better meet a core information need in protected area management for recreation and conservation. It does not debate the meaning or definition of values, but instead identifies a perspective on values that is aimed at meeting practical conservation management needs. The first part of that perspective involves...

The Roots of Alzheimer's Disease: Are High-Expanding Cortical Areas Preferentially Targeted?†.

PubMed

Fjell, Anders M; Amlien, Inge K; Sneve, Markus H; Grydeland, Håkon; Tamnes, Christian K; Chaplin, Tristan A; Rosa, Marcello G P; Walhovd, Kristine B

2015-09-01

Alzheimer's disease (AD) is regarded a human-specific condition, and it has been suggested that brain regions highly expanded in humans compared with other primates are selectively targeted. We calculated shared and unique variance in the distribution of AD atrophy accounted for by cortical expansion between macaque and human, affiliation to the default mode network (DMN), ontogenetic development and normal aging. Cortical expansion was moderately related to atrophy, but a critical discrepancy was seen in the medial temporo-parietal episodic memory network. Identification of "hotspots" and "coldspots" of expansion across several primate species did not yield compelling evidence for the hypothesis that highly expanded regions are specifically targeted. Controlling for distribution of atrophy in aging substantially attenuated the expansion-AD relationship. A path model showed that all variables explained unique variance in AD atrophy but were generally mediated through aging. This supports a systems-vulnerability model, where critical networks are subject to various negative impacts, aging in particular, rather than being selectively targeted in AD. An alternative approach is suggested, focused on the interplay of the phylogenetically old and preserved medial temporal lobe areas with more highly expanded association cortices governed by different principles of plasticity and stability. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in coastal areas of Karachi

PubMed Central

2014-01-01

Background Migrant populations are at high risk of Human Immuno Deficiency Virus infection (HIV) and Acquired Immunodeficiency Syndrome (AIDS). Studies of HIV/AIDS knowledge, attitudes and practices among fishermen in developing countries have shown gaps in knowledge and fear of contagion with ambivalent attitudes towards HIV/AIDS and inconsistent universal precautions adherence. The aim of this study was to determine the knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in a coastal area of Karachi, Pakistan. Methods Community based cross sectional study was conducted among fishermen in coastal area of Karachi from June to September 2012. A total of 297 adult fishermen were selected by using simple random sampling technique from different sectors of coastal village. Data were collected using a structured validated questionnaire. The frequency distribution of both dependent and independent variables were worked out. Comparisons of knowledge, attitude and practices regarding HIV/AIDS by socio-demographic characteristics were made using logistic regression. Results Out of 297 fishermen, majority had in-appropriate knowledge (93.6%), negative attitude (75.8%) and less adherent sexual practices (91.6%). In univariate analysis, lower education and higher income were significantly associated (OR 2.25, 95% CI, 1.11, 4.55), (OR = 3.04 CI 1.03-9.02, p value 0.04) with negative attitude and un-safe practices towards HIV/AIDS respectively, whereas no significant association of socio-economic characteristics with knowledge, attitude and practices were observed in multivariate analysis. Conclusions This study suggests that fishermen had very poor knowledge, negative attitudes towards HIV and AIDS and had unsafe sexual practices which suggest that they lack the basic understanding of HIV/AIDS infection. Extensive health education campaign should be provided to the vulnerable sections of the society for the control of HIV/AIDS. PMID:24886122

Interprofessional collaborative practice incorporating training for alcohol and drug use screening for healthcare providers in rural areas.

PubMed

Puskar, Kathy; Mitchell, Ann M; Albrecht, Susan A; Frank, Linda R; Kane, Irene; Hagle, Holly; Lindsay, Dawn; Lee, Heeyoung; Fioravanti, Marie; Talcott, Kimberly S

2016-07-01

Interprofessional collaborative practice expands resources in rural and underserved communities. This article explores the impact of an online education programme on the perceptions of healthcare providers about interprofessional care within alcohol and drug use screening for rural residents. Nurses, behavioural health counsellors, and public health professionals participated in an evidence-based practice (screening, brief intervention, and referral to treatment-SBIRT) model that targets individuals who use alcohol and other drugs in a risky manner. SBIRT is recommended by the United States Preventive Services Task Force as a universal, evidence-based screening tool. Online modules, case simulation practice, and interprofessional dialogues are used to deliver practice-based learning experiences. A quasi-experimental method with pre-tests and post-tests was utilised. Results indicate increased perceptions of professional competence, need for cooperation, actual cooperation, and role values pre-to-post training. Implications suggest that online interprofessional education is useful but the added component of professional dialogues regarding patient cases offers promise in promoting collaborative practice.

Attracting qualified physicians to underserved areas. Part 2. Pay physicians more to practice in underserved areas.

PubMed

Weil, T P

1999-01-01

With health networks searching for additional market share and with a projected 30.2 million to be enrolled in Medicaid HMOs by 2000, more health executives will be weighing various strategies of how to attract qualified physicians to practice in poor inner-city and rural areas. Most frequently cited as solutions are supplying more physicians, encouraging more medical school graduates to pursue primary care residencies, and modifying the number of international medical graduates entering U.S. residency programs. Part I of this article, which appeared in the November/December issue of The Physician Executive, reviewed the efficacy of these approaches. The second part explores a more pragmatic option: to simply improve the working conditions and pay substantially more to physicians who practice in "less desirable" locations. Although this idea is consistent with economic principles, drawbacks must be considered, such as: (1) the American taxpayers' reluctance to finance a more costly health care delivery system for the poor; (2) the inherent conceptual difficulties of a capitated Medicaid HMO serving as the linchpin for organizing, financing, and delivering care for the underserved; and, (3) many providers being expected to react in a fairly litigious manner to such an approach.

Colorectal Cancer Screening Practices Among Men and Women in Rural and Nonrural Areas of the United States, 1999

ERIC Educational Resources Information Center

Coughlin, Steven S.; Thompson, Trevor D.

2004-01-01

Previous studies have suggested that men and women in rural areas are less likely than those in urban areas to receive routine cancer screening. Methods: We examined the colorectal cancer screening practices of men (n = 23,565) and women (n = 37,847) aged >50 years living in rural areas and other areas of the United States using data from the…

Study on comprehensive planning of rocky desertification in karst area of Chongqing

NASA Astrophysics Data System (ADS)

Zang, Yajun

2017-11-01

Chongqing is a key area for comprehensive treatment of rocky desertification in karst areas of china. Strengthening the comprehensive management of karst rocky desertification area, for the maintenance of ecological safety of Three Gorges Reservoir area, expanding the karst rocky desertification area people survival and development space, and improving the regional ecological conditions, have important practical significance to the construction of ecological civilization and building a harmonious society. Based on the investigation, analysis and arrangement of the data in the rocky desertification area, the paper puts forward the corresponding measures and phased targets for the treatment of the Rocky Desertification in the karst areas of Chongqing.

Clinical audit of leg ulceration prevalence in a community area: a case study of good practice.

PubMed

Hindley, Jenny

2014-09-01

This article presents the findings of an audit on venous leg ulceration prevalence in a community area as a framework for discussing the concept and importance of audit as a tool to inform practice and as a means to benchmark care against national or international standards. It is hoped that the discussed audit will practically demonstrate how such procedures can be implemented in practice for those who have not yet undertaken it, as well as highlighting the unexpected extra benefits of this type of qualitative data collection that can often unexpectedly inform practice and influence change. Audit can be used to measure, monitor and disseminate evidence-based practice across community localities, facilitating the identification of learning needs and the instigation of clinical change, thereby prioritising patient needs by ensuring safety through the benchmarking of clinical practice.

Shopping list development and use of advertisements' pre-store food-buying practices within different socio-economic status areas in South Africa.

PubMed

Duffett, Rodney Graeme; Foster, Crystal

2017-01-01

The purpose of this paper is to determine whether there is a difference in the development of shopping lists and use of advertisements as pre-store food-buying practices in terms of planned shopping by South African consumers who dwell in different socio-economic status (SES) areas. The paper also considers the influence of shopper and socio-demographic characteristics on pre-store food-buying practices in a developing country. A self-administered questionnaire was used to survey 1 200 consumers in retail stores in low, middle and high SES areas in South Africa. A generalised linear model was employed for the statistical analysis of pre-store food-buying practices within the SES area groups in a developing country. South African consumers that reside in high SES area displayed the largest of shopping list development, while consumers who dwell in low SES areas showed the highest incidence of advertisement usage. Several shopper and socio-demographic characteristics were also found to have an influence on pre-store food-buying practices in different SES areas in South Africa. A qualitative approach would offer a deeper understanding of consumers' pre-store food shopping predispositions as opposed to the quantitative approach, which was adopted for this study. A longitudinal design would also provide a more extensive representation of pre-store food shopping practices over a longer time frame than cross-sectional research. The survey was conducted on Saturdays, whereas consumers who shop during the week may have different shopping and socio-demographic characteristics. Astute food brands, marketers and grocery stores could use the findings of this study to assist with their marketing efforts that they direct at consumers in different SES areas in South Africa and other developing countries. The findings of this study may assist consumers in developing countries, especially those who reside in low SES areas, with food-buying strategies to reduce food costs, make wiser

Strategies to recruit a diverse low-income population to child weight management programs from primary care practices

USDA-ARS?s Scientific Manuscript database

Primary care practices can be used to engage children and families in weight management programs. The Texas Childhood Obesity Research Demonstration (TX CORD) study targeted patients at 12 primary care practices in diverse and low-income areas of Houston, Texas, and Austin, Texas for recruitment to ...

International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma.

PubMed

Lee, Anne W; Ng, Wai Tong; Pan, Jian Ji; Poh, Sharon S; Ahn, Yong Chan; AlHussain, Hussain; Corry, June; Grau, Cai; Grégoire, Vincent; Harrington, Kevin J; Hu, Chao Su; Kwong, Dora L; Langendijk, Johannes A; Le, Quynh Thu; Lee, Nancy Y; Lin, Jin Ching; Lu, Tai Xiang; Mendenhall, William M; O'Sullivan, Brian; Ozyar, Enis; Peters, Lester J; Rosenthal, David I; Soong, Yoke Lim; Tao, Yungan; Yom, Sue S; Wee, Joseph T

2018-01-01

Target delineation in nasopharyngeal carcinoma (NPC) often proves challenging because of the notoriously narrow therapeutic margin. High doses are needed to achieve optimal levels of tumour control, and dosimetric inadequacy remains one of the most important independent factors affecting treatment outcome. A review of the available literature addressing the natural behaviour of NPC and correlation between clinical and pathological aspects of the disease was conducted. Existing international guidelines as well as published protocols specified by clinical trials on contouring of clinical target volumes (CTV) were compared. This information was then summarized into a preliminary draft guideline which was then circulated to international experts in the field for exchange of opinions and subsequent voting on areas with the greatest controversies. Common areas of uncertainty and variation in practices among experts experienced in radiation therapy for NPC were elucidated. Iterative revisions were made based on extensive discussion and final voting on controversial areas by the expert panel, to formulate the recommendations on contouring of CTV based on optimal geometric expansion and anatomical editing for those structures with substantial risk of microscopic infiltration. Through this comprehensive review of available evidence and best practices at major institutions, as well as interactive exchange of vast experience by international experts, this set of consensus guidelines has been developed to provide a practical reference for appropriate contouring to ensure optimal target coverage. However, the final decision on the treatment volumes should be based on full consideration of individual patients' factors and facilities of an individual centre (including the quality of imaging methods and the precision of treatment delivery). Copyright © 2017 Elsevier B.V. All rights reserved.

Pharmacogenomics in diverse practice settings: implementation beyond major metropolitan areas

PubMed Central

Dorfman, Elizabeth H; Trinidad, Susan Brown; Morales, Chelsea T; Howlett, Kevin; Burke, Wylie; Woodahl, Erica L

2015-01-01

Aim The limited formal study of the clinical feasibility of implementing pharmacogenomic tests has thus far focused on providers at large medical centers in urban areas. Our research focuses on small metropolitan, rural and tribal practice settings. Materials & methods We interviewed 17 healthcare providers in western Montana regarding pharmacogenomic testing. Results Participants were optimistic about the potential of pharmacogenomic tests, but noted unique barriers in small and rural settings including cost, adherence, patient acceptability and testing timeframe. Participants in tribal settings identified heightened sensitivity to genetics and need for community leadership approval as additional considerations. Conclusion Implementation differences in small metropolitan, rural and tribal communities may affect pharmacogenomic test adoption and utilization, potentially impacting many patients. PMID:25712186

Factors affecting willingness to practice medicine in underserved areas: a survey of Argentine medical students.

PubMed

Borracci, Raul A; Arribalzaga, Eduardo B; Couto, Juan L; Dvorkin, Mario; Ahuad Guerrero, Rodolfo A; Fernandez, Carmen; Ferreira, Luis N; Cerezo, Leticia

2015-01-01

Previous research has explored the effect of motivations, incentives and working conditions on willingness to accept jobs in rural and remote areas. These studies demonstrated that difficult working conditions, low job satisfaction and remuneration, and poor security, predisposed new medical graduates to select cities instead of rural districts. Since Argentina has a critical shortage of health staff in rural and low-income marginal suburban settings, and limited qualitative and quantitative local research has been done to address this issue, the present study was developed to assess the factors associated with the willingness of medical students to work in low-resource underprivileged areas of the country after graduation. A cross-sectional descriptive design was used with data collected from a self-administered questionnaire and using quantitative analysis methods. A total of 400 eligible second-year medical students were invited to participate in a survey focused on sociodemographic characteristics, incentives and working conditions expected in deprived areas, extrinsic and intrinsic motivations, university medical education and government promotion policies. Twenty-one per cent of medical students showed a strong willingness to work in a deprived area, 57.3% manifested weak willingness and 21.5% unwillingness to work in a low-resource setting. Being female, of older age, not having a university-trained professional parent, previous exposure or service in a poor area, choice of pediatrics as a specialty and strong altruistic motivations were highly associated with the willingness to practice medicine in rural or underprivileged areas. Only 21.5% of respondents considered that medical schools encourage the practice of medicine in poor deprived regions. Likewise, only 6.2% of students considered that national public health authorities suitably stimulate physician distribution in poorer districts. One-third of students expressed high altruistic motivations and

The Exemplary Practices of Professional Development School Principals in the Area of Instructional Leadership

ERIC Educational Resources Information Center

Accardi, Joan

2013-01-01

The success of a Professional Development School (PDS) is dependent upon the PDS principal and her/his ability to negotiate diverse job responsibilities, the most important being an effective instructional leader. Therefore, the issue that was addressed in this study was: What are the exemplary practices of PDS principals in the area of…

Integration of targeted sequencing and NIPT into clinical practice in a Chinese family with maple syrup urine disease.

PubMed

You, Yanqin; Sun, Yan; Li, Xuchao; Li, Yali; Wei, Xiaoming; Chen, Fang; Ge, Huijuan; Lan, Zhangzhang; Zhu, Qian; Tang, Ying; Wang, Shujuan; Gao, Ya; Jiang, Fuman; Song, Jiaping; Shi, Quan; Zhu, Xuan; Mu, Feng; Dong, Wei; Gao, Vince; Jiang, Hui; Yi, Xin; Wang, Wei; Gao, Zhiying

2014-08-01

This article demonstrates a prominent noninvasive prenatal approach to assist the clinical diagnosis of a single-gene disorder disease, maple syrup urine disease, using targeted sequencing knowledge from the affected family. The method reported here combines novel mutant discovery in known genes by targeted massively parallel sequencing with noninvasive prenatal testing. By applying this new strategy, we successfully revealed novel mutations in the gene BCKDHA (Ex2_4dup and c.392A>G) in this Chinese family and developed a prenatal haplotype-assisted approach to noninvasively detect the genotype of the fetus (transmitted from both parents). This is the first report of integration of targeted sequencing and noninvasive prenatal testing into clinical practice. Our study has demonstrated that this massively parallel sequencing-based strategy can potentially be used for single-gene disorder diagnosis in the future.

Targeting the Cerebellum by Noninvasive Neurostimulation: a Review.

PubMed

van Dun, Kim; Bodranghien, Florian; Manto, Mario; Mariën, Peter

2017-06-01

Transcranial magnetic and electric stimulation of the brain are novel and highly promising techniques currently employed in both research and clinical practice. Improving or rehabilitating brain functions by modulating excitability with these noninvasive tools is an exciting new area in neuroscience. Since the cerebellum is closely connected with the cerebral regions subserving motor, associative, and affective functions, the cerebello-thalamo-cortical pathways are an interesting target for these new techniques. Targeting the cerebellum represents a novel way to modulate the excitability of remote cortical regions and their functions. This review brings together the studies that have applied cerebellar stimulation, magnetic and electric, and presents an overview of the current knowledge and unsolved issues. Some recommendations for future research are implemented as well.

Clinical medical education in rural and underserved areas and eventual practice outcomes: A systematic review and meta-analysis.

PubMed

Raymond Guilbault, Ryan William; Vinson, Joseph Alexander

2017-01-01

Undergraduate medical students are enrolled in clinical education programs in rural and underserved urban areas to increase the likelihood that they will eventually practice in those areas and train in a primary care specialty to best serve those patient populations. MEDLINE and Cochrane Library online databases were searched to identify articles that provide a detailed description of the exposure and outcome of interest. A qualitative review of articles reporting outcome data without comparison or control groups was completed using the Medical Education Research Study Quality Instrument (MERSQI). A meta-analysis of articles reporting outcome data with comparison or control groups was completed with statistical and graphical summary estimates. Seven hundred and nine articles were retrieved from the initial search and reviewed based on inclusion and exclusion criteria. Of those, ten articles were identified for qualitative analysis and five articles included control groups and thus were included in the quantitative analysis. Results indicated that medical students with clinical training in underserved areas are almost three times as likely to practice in underserved areas than students who do not train in those areas (relative risk [RR] = 2.94; 95% confidence interval [CI]: 2.17, 4.00). Furthermore, medical students training in underserved areas are about four times as likely to practice primary care in underserved areas than students who do not train in those locations (RR = 4.35; 95% CI: 1.56, 12.10). These estimates may help guide medical school administrators and policymakers to expand underserved clinical training programs to help relieve some of the problems associated with access to medical care among underserved populations.

Community-based clinical education increases motivation of medical students to medicine of remote area: comparison between lecture and practice.

PubMed

Tani, Kenji; Yamaguchi, Harutaka; Tada, Saaya; Kondo, Saki; Tabata, Ryo; Yuasa, Shino; Kawaminami, Shingo; Nakanishi, Yoshinori; Ito, Jun; Shimizu, Nobuhiko; Obata, Fumiaki; Shin, Teruki; Bando, Hiroyasu; Kohno, Mitsuhiro

2014-01-01

In this study, we administered a questionnaire to medical students to evaluate the effect of community-based clinical education on their attitudes to community medicine and medicine in remote area. Questionnaires were given 4 times to all the students from first-year to sixth-year. Of 95 students, 65 students (68.4%) who completed all questionnaires, were used in this study. The intensity of students' attitudes was estimated by using visual analogue scale. The intensity of interest, a sense of fulfillment and passion in medicine of remote area was significantly increased after the community-based practice. On the other hand, the level of understanding in medicine in remote area was increased by the lecture not by the practice. The intensity of desire both to become a generalist and a specialist was significantly increased when the grade went up. Most of sixth-year students desired to have abilities of a generalist and a specialist simultaneously. This study shows that the community-based practice is more meaningful in increasing motivation in medicine in remote area than the lecture, and suggests that it is important to prepare more courses to experience community medicine to increase the number of physicians who desire to work in remote area.

Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas.

PubMed

Agustina, Rina; Sari, Tirta P; Satroamidjojo, Soemilah; Bovee-Oudenhoven, Ingeborg M J; Feskens, Edith J M; Kok, Frans J

2013-10-19

Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian children. A cross-sectional study was conducted among 274 randomly selected children aged 12-59 months in selected low socioeconomic urban areas of East Jakarta. The prevalence of diarrhea was assessed from 7-day records on frequency and consistency of the child's defecation pattern. Food-hygiene practices including mother's and child's hand washing, food preparation, cleanliness of utensils, water source and safe drinking water, habits of buying cooked food, child's bottle feeding hygiene, and housing and environmental condition were collected through home visit interviews and observations by fieldworkers. Thirty-six practices were scored and classified into poor (median and below) and better (above median) food-hygiene practices. Nutritional status of children, defined anthropometrically, was measured through height and weight. Among the individual food-hygiene practices, children living in a house with less dirty sewage had a significantly lower diarrhea prevalence compared to those who did not [adjusted odds ratio (OR) 0.16, 95% confidence interval (CI) = 0.03-0.73]. The overall food-hygiene practice score was not significantly associated with diarrhea in the total group, but it was in children aged < 2 years (adjusted OR 4.55, 95% CI = 1.08-19.1). Overall poor mother's food-hygiene practices did not contribute to the occurrence of diarrhea in Indonesian children. However, among children < 2 years from low socioeconomic urban areas they were associated with more diarrhea.

A trajectory design method via target practice for air-breathing hypersonic vehicle

NASA Astrophysics Data System (ADS)

Kong, Xue; Yang, Ming; Ning, Guodong; Wang, Songyan; Chao, Tao

2017-11-01

There are strong coupling interactions between aerodynamics and scramjet, this kind of aircraft also has multiple restrictions, such as the range and difference of dynamic pressure, airflow, and fuel. On the one hand, we need balance the requirement between maneuverability of vehicle and stabilization of scramjet. On the other hand, we need harmonize the change of altitude and the velocity. By describing aircraft's index system of climbing capability, acceleration capability, the coupling degree in aerospace, this paper further propose a rapid design method which based on target practice. This method aimed for reducing the coupling degree, it depresses the coupling between aircraft and engine in navigation phase, satisfy multiple restriction conditions to leave some control buffer and create good condition for control implementation. According to the simulation, this method could be used for multiple typical fly commissions such as climbing, acceleration or both.

General practice variation in spirometry testing among patients receiving first-time prescriptions for medication targeting obstructive lung disease in Denmark: a population-based observational study

PubMed Central

2013-01-01

Background Spirometry testing is essential to confirm an obstructive lung disease, but studies have reported that a large proportion of patients diagnosed with COPD or asthma have no history of spirometry testing. Also, it has been shown that many patients are prescribed medication for obstructive lung disease without a relevant diagnosis or spirometry test registered. General practice characteristics have been reported to influence diagnosis and management of several chronic diseases. However, these findings are inconsistent, and it is uncertain whether practice characteristics influence spirometry testing among patients receiving medication for obstructive lung disease. The aim of this study was therefore to examine if practice characteristics are associated with spirometry testing among patients receiving first-time prescriptions for medication targeting obstructive lung disease. Methods A national register-based cohort study was performed. All patients over 18 years receiving first-time prescriptions for medication targeting obstructive lung disease in 2008 were identified and detailed patient-specific data on sociodemographic status and spirometry tests were extracted. Information on practice characteristics like number of doctors, number of patients per doctor, training practice status, as well as age and gender of the general practitioners was linked to each medication user. Results Partnership practices had a higher odds ratio (OR) of performing spirometry compared with single-handed practices (OR 1.24, CI 1.09-1.40). We found a significant association between increasing general practitioner age and decreasing spirometry testing. This tendency was most pronounced among partnership practices, where doctors over 65 years had the lowest odds of spirometry testing (OR 0.25, CI 0.10-0.61). Training practice status was significantly associated with spirometry testing among single-handed practices (OR 1.40, CI 1.10-1.79). Conclusion Some of the variation in

Teachers' Beliefs on Foreign Language Teaching Practices in Early Phases of Primary Education: A Case Study

ERIC Educational Resources Information Center

Caner, Mustafa; Subasi, Gonca; Kara, Selma

2010-01-01

The purpose of the study was to examine whether teacher beliefs would play a role in their actual practices while teaching target language in early phases of primary education, principally, in kindergarten and first grades in a state school. As it is a very broad research area, the researchers exclusively analyzed teaching practices and teaching…

High or Low Target Prevalence Increases the Dual-Target Cost in Visual Search

ERIC Educational Resources Information Center

Menneer, Tamaryn; Donnelly, Nick; Godwin, Hayward J.; Cave, Kyle R.

2010-01-01

Previous studies have demonstrated a dual-target cost in visual search. In the current study, the relationship between search for one and search for two targets was investigated to examine the effects of target prevalence and practice. Color-shape conjunction stimuli were used with response time, accuracy and signal detection measures. Performance…

Psychodynamic psychotherapy for complex trauma: targets, focus, applications, and outcomes

PubMed Central

Spermon, Deborah; Darlington, Yvonne; Gibney, Paul

2010-01-01

Complex trauma describes that category of severe, chronic interpersonal trauma usually originating in the formative years of a child. In the adult, this can result in global dissociative difficulties across areas of cognitive, affective, somatic, and behavioral functions. Targeting this field of traumatic pathology, this article reviews the contributions and developments within one broad approach: psychodynamic theory and practice. Brief descriptions of aspects of analytical, Jungian, relational, object relations, and attachment therapeutic approaches are given, along with understandings of pathology and the formulation of therapeutic goals. Major practices within client sessions are canvassed and the issues of researching treatment outcomes are discussed. PMID:22110335

Evaluation of target acquisition difficulty using recognition distance to measure required retinal area

NASA Astrophysics Data System (ADS)

Nilsson, Thomy H.

2001-09-01

The psychophysical method of limits was used to measure the distance at which observers could distinguish military vehicles photographed in natural landscapes. Obtained from the TNO-TM Search_2 dataset, these pictures either were rear-projected 35-mm slides or were presented on a computer monitor. Based on the rationale that more difficult vehicle targets would require more visual pathways for recognition, difficult of acquisition was defined in terms of the relative retinal area required for recognition. Relative retinal area was derived from the inverse square of the recognition distance of a particular vehicle relative to the distance of the vehicle that could be seen furthest away. Results are compared with data on the time required to find the vehicles in these pictures. These comparison indicate recognition distance thresholds can be a suitable means of defining standards for the effectiveness of vital graphic information; and the two methods are complementary with respect to distinguishing different degrees of acquisition difficulty, and together may provide a means to measure the total information processing required for recognition.

A glossary of policy frameworks: the many forms of 'universalism' and policy 'targeting'.

PubMed

Carey, Gemma; Crammond, Brad

2017-03-01

The recognition that certain characteristics (such as poverty, disadvantage or membership of marginalised social or cultural groups) can make individuals more susceptible to illness has reignited interest in how to combine universal programmes and policies with ones targeted at specific groups. However, 'universalism' and 'targeting' are used in different ways for different purposes. In this glossary, we define different types and approaches to universalism and targeting. We anticipate that greater clarity in relation to what is meant by 'universalism' and 'targeting' will lead to a more nuanced debate and practice in this area. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Monitoring Ground Deformation of Subway Area during the Construction Based on the Method of Multi-Temporal Coherent Targets Analysis

NASA Astrophysics Data System (ADS)

Zhang, L.; Wu, J.; Zhao, J.; Yuan, M.

2018-04-01

Multi-temporal coherent targets analysis is a high-precision and high-spatial-resolution monitoring method for urban surface deformation based on Differential Synthetic Aperture Radar (DInSAR), and has been successfully applied to measure land subsidence, landslide and strain accumulation caused by fault movement and so on. In this paper, the multi-temporal coherent targets analysis is used to study the settlement of subway area during the period of subway construction. The eastern extension of Shanghai Metro Line. 2 is taking as an example to study the subway settlement during the construction period. The eastern extension of Shanghai Metro Line. 2 starts from Longyang Road and ends at Pudong airport. Its length is 29.9 kilometers from east to west and it is a key transportation line to the Pudong Airport. 17 PalSAR images during 2007 and 2010 are applied to analyze and invert the settlement of the buildings nearby the subway based on the multi-temporal coherent targets analysis. But there are three significant deformation areas nearby the Line 2 between 2007 and 2010, with maximum subsidence rate up to 30 mm/y in LOS. The settlement near the Longyang Road station and Chuansha Town are both caused by newly construction and city expansion. The deformation of the coastal dikes suffer from heavy settlement and the rate is up to -30 mm/y. In general, the area close to the subway line is relatively stable during the construction period.

Statistical Algorithms for Designing Geophysical Surveys to Detect UXO Target Areas

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

O'Brien, Robert F.; Carlson, Deborah K.; Gilbert, Richard O.

2005-07-29

The U.S. Department of Defense is in the process of assessing and remediating closed, transferred, and transferring military training ranges across the United States. Many of these sites have areas that are known to contain unexploded ordnance (UXO). Other sites or portions of sites are not expected to contain UXO, but some verification of this expectation using geophysical surveys is needed. Many sites are so large that it is often impractical and/or cost prohibitive to perform surveys over 100% of the site. In that case, it is particularly important to be explicit about the performance required of the survey. Thismore » article presents the statistical algorithms developed to support the design of geophysical surveys along transects (swaths) to find target areas (TAs) of anomalous geophysical readings that may indicate the presence of UXO. The algorithms described here determine 1) the spacing between transects that should be used for the surveys to achieve a specified probability of traversing the TA, 2) the probability of both traversing and detecting a TA of anomalous geophysical readings when the spatial density of anomalies within the TA is either uniform (unchanging over space) or has a bivariate normal distribution, and 3) the probability that a TA exists when it was not found by surveying along transects. These algorithms have been implemented in the Visual Sample Plan (VSP) software to develop cost-effective transect survey designs that meet performance objectives.« less

Statistical Algorithms for Designing Geophysical Surveys to Detect UXO Target Areas

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

O'Brien, Robert F.; Carlson, Deborah K.; Gilbert, Richard O.

2005-07-28

The U.S. Department of Defense is in the process of assessing and remediating closed, transferred, and transferring military training ranges across the United States. Many of these sites have areas that are known to contain unexploded ordnance (UXO). Other sites or portions of sites are not expected to contain UXO, but some verification of this expectation using geophysical surveys is needed. Many sites are so large that it is often impractical and/or cost prohibitive to perform surveys over 100% of the site. In such cases, it is particularly important to be explicit about the performance required of the surveys. Thismore » article presents the statistical algorithms developed to support the design of geophysical surveys along transects (swaths) to find target areas (TAs) of anomalous geophysical readings that may indicate the presence of UXO. The algorithms described here determine (1) the spacing between transects that should be used for the surveys to achieve a specified probability of traversing the TA, (2) the probability of both traversing and detecting a TA of anomalous geophysical readings when the spatial density of anomalies within the TA is either uniform (unchanging over space) or has a bivariate normal distribution, and (3) the probability that a TA exists when it was not found by surveying along transects. These algorithms have been implemented in the Visual Sample Plan (VSP) software to develop cost-effective transect survey designs that meet performance objectives.« less

Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas

PubMed Central

2013-01-01

Background Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian children. Methods A cross-sectional study was conducted among 274 randomly selected children aged 12–59 months in selected low socioeconomic urban areas of East Jakarta. The prevalence of diarrhea was assessed from 7-day records on frequency and consistency of the child’s defecation pattern. Food-hygiene practices including mother’s and child’s hand washing, food preparation, cleanliness of utensils, water source and safe drinking water, habits of buying cooked food, child’s bottle feeding hygiene, and housing and environmental condition were collected through home visit interviews and observations by fieldworkers. Thirty-six practices were scored and classified into poor (median and below) and better (above median) food-hygiene practices. Nutritional status of children, defined anthropometrically, was measured through height and weight. Results Among the individual food-hygiene practices, children living in a house with less dirty sewage had a significantly lower diarrhea prevalence compared to those who did not [adjusted odds ratio (OR) 0.16, 95% confidence interval (CI) = 0.03-0.73]. The overall food-hygiene practice score was not significantly associated with diarrhea in the total group, but it was in children aged < 2 years (adjusted OR 4.55, 95% CI = 1.08-19.1). Conclusions Overall poor mother’s food-hygiene practices did not contribute to the occurrence of diarrhea in Indonesian children. However, among children < 2 years from low socioeconomic urban areas they were associated with more diarrhea. PMID:24138899

[Evaluating maternal child care practices in extreme poverty areas in Peru, 2012].

PubMed

Velásquez Hurtado, José Enrique; Solís Alcedo, Lucía; Vigo Valdez, Walter Eduardo; Rosas Aguirre, Angel Martín; Giusti Hundskopf, Paulina; Alfaro Fernandez, Paul; Cabrera Arredondo, Henry

2014-04-01

To evaluate maternal and child care practices in areas with extreme poverty in Peru. Cross-sectional study conducted between August and September 2012; with probabilistic, three-stage stratification by "department" (geographic region) sampling. 540 households were selected that had at least one child younger than 36 months (475 households) and/or a pregnant women (80 households), in rural areas of Cajamarca, Amazonas, Huanuco, Ayacucho, Huancavelica, Apurimac, Cusco, Puno and Ucayali. Regarding the last pregnancy, 69.0% of the mothers reported having had their first prenatal care in the first trimester; 65.3% reported having completed more than six check-ups throughout the pregnancy; 81.1% reported having given birth in a health facility, and only 31.0% chose a method of family planning within 42 days postpartum. With regard to the last child under 3 years old, 64.1% had early mother-infant contact, and 62.8% initiated breastfeeding within one hour of birth. In addition, 89.6% of children under 6 months old exclusively received breastfeeding and 89.1% of children aged 6-8 months old already had received complementary feeding. Fever, diarrhea, vomiting and breathing difficulty were the most mentioned warning signs for seeking care for children. Through this study, a baseline has been established on which a strategy can be designed and implemented to improve best practices for maternal and child care as part of the "Programa de Apoyo" within the Health Sector Reform.

Practice Location Characteristics of Non-Traditional Dental Practices.

PubMed

Solomon, Eric S; Jones, Daniel L

2016-04-01

Current and future dental school graduates are increasingly likely to choose a non-traditional dental practice-a group practice managed by a dental service organization or a corporate practice with employed dentists-for their initial practice experience. In addition, the growth of non-traditional practices, which are located primarily in major urban areas, could accelerate the movement of dentists to those areas and contribute to geographic disparities in the distribution of dental services. To help the profession understand the implications of these developments, the aim of this study was to compare the location characteristics of non-traditional practices and traditional dental practices. After identifying non-traditional practices across the United States, the authors located those practices and traditional dental practices geographically by zip code. Non-traditional dental practices were found to represent about 3.1% of all dental practices, but they had a greater impact on the marketplace with almost twice the average number of staff and annual revenue. Virtually all non-traditional dental practices were located in zip codes that also had a traditional dental practice. Zip codes with non-traditional practices had significant differences from zip codes with only a traditional dental practice: the populations in areas with non-traditional practices had higher income levels and higher education and were slightly younger and proportionally more Hispanic; those practices also had a much higher likelihood of being located in a major metropolitan area. Dental educators and leaders need to understand the impact of these trends in the practice environment in order to both prepare graduates for practice and make decisions about planning for the workforce of the future.

Inquiring into Pre-Service Content Area Teachers' Development of Literacy Practices and Pedagogical Content Knowledge

ERIC Educational Resources Information Center

Mitton Kukner, Jennifer; Murray Orr, Anne

2015-01-01

The focus of this qualitative multi-year case study is on preservice teachers' experiences related to the development of their literacy practices in teaching high school science, math, social studies and other content area courses during their final field placement in a teacher education program. Results indicate tangible indicators of overall…

Comparison of provider and plan-based targeting strategies for disease management.

PubMed

Annis, Ann M; Holtrop, Jodi Summers; Tao, Min; Chang, Hsiu-Ching; Luo, Zhehui

2015-05-01

We aimed to describe and contrast the targeting methods and engagement outcomes for health plan-delivered disease management with those of a provider-delivered care management program. Health plan epidemiologists partnered with university health services researchers to conduct a quasi-experimental, mixed-methods study of a 2-year pilot. We used semi-structured interviews to assess the characteristics of program-targeting strategies, and calculated target and engagement rates from clinical encounter data. Five physician organizations (POs) with 51 participating practices implemented care management. Health plan member lists were sent monthly to the practices to accept patients, and then the practices sent back data reports regarding targeting and engagement in care management. Among patients accepted by the POs, we compared those who were targeted and engaged by POs with those who met health plan targeting criteria. The health plan's targeting process combined claims algorithms and employer group preferences to identify candidates for disease management; on the other hand, several different factors influenced PO practices' targeting approaches, including clinical and personal knowledge of the patients, health assessment information, and availability of disease-relevant programs. Practices targeted a higher percentage of patients for care management than the health plan (38% vs 16%), where only 7% of these patients met the targeting criteria of both. Practices engaged a higher percentage of their targeted patients than the health plan (50% vs 13%). The health plan's claims-driven targeting approach and the clinically based strategies of practices both provide advantages; an optimal model may be to combine the strengths of each approach to maximize benefits in care management.

Practical method for targeted disruption of cilia-related genes by using CRISPR/Cas9-mediated, homology-independent knock-in system.

PubMed

Katoh, Yohei; Michisaka, Saki; Nozaki, Shohei; Funabashi, Teruki; Hirano, Tomoaki; Takei, Ryota; Nakayama, Kazuhisa

2017-04-01

The CRISPR/Cas9 system has revolutionized genome editing in virtually all organisms. Although the CRISPR/Cas9 system enables the targeted cleavage of genomic DNA, its use for gene knock-in remains challenging because levels of homologous recombination activity vary among various cells. In contrast, the efficiency of homology-independent DNA repair is relatively high in most cell types. Therefore the use of a homology-independent repair mechanism is a possible alternative for efficient genome editing. Here we constructed a donor knock-in vector optimized for the CRISPR/Cas9 system and developed a practical system that enables efficient disruption of target genes by exploiting homology-independent repair. Using this practical knock-in system, we successfully disrupted genes encoding proteins involved in ciliary protein trafficking, including IFT88 and IFT20, in hTERT-RPE1 cells, which have low homologous recombination activity. The most critical concern using the CRISPR/Cas9 system is off-target cleavage. To reduce the off-target cleavage frequency and increase the versatility of our knock-in system, we constructed a universal donor vector and an expression vector containing Cas9 with enhanced specificity and tandem sgRNA expression cassettes. We demonstrated that the second version of our system has improved usability. © 2017 Katoh et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Improvement in Diagnosis and Treat-to-Target Management of Hyperuricemia in Gout: Results from the GEMA-2 Transversal Study on Practice.

PubMed

Perez Ruiz, Fernando; Sanchez-Piedra, Carlos A; Sanchez-Costa, Jesus T; Andrés, Mariano; Diaz-Torne, Cesar; Jimenez-Palop, Mercedes; De Miguel, Eugenio; Moragues, Carmen; Sivera, Francisca

2018-06-01

The objective of the study was to evaluate changes regarding main European League Against Rheumatism (EULAR) recommendations on diagnosis and treatment of gout compared to a previous assessment. The GEMA-2 (Gout Evaluation and MAnagement) is a transversal assessment of practice for gout by rheumatologists. Main outcome variables were improvement of the previous GEMA assessment regarding the rate of crystal-proven diagnosis and that reaching therapeutic serum urate target below 6 mg/dl at last visit. Other management variables (prophylaxis, treatment of flares, lifestyle change advice) were also evaluated along with general characteristics. The sample was powered to include at least 483 patients for up to 50% change. Data on management of 506 patients were retrieved from 38 out of 41 rheumatology units that participated in the previous GEMA audit. Crystal-proved diagnosis rate increased from 26% to 32% (31% improvement) and was higher in gout-dedicated practices; ultrasonography contributed to diagnosis in less than 1% of cases. Therapeutic serum urate at last visit improved from 41% to 64% of all patients (66% of patients on urate-lowering medications), in any case over 50% improvement from the previous assessment. The use of any urate-lowering medication available was not prescribed as per label dosing in patients who failed to achieve target serum urate. Clinical inertia to increase doses of either allopurinol or febuxostat was still present in clinical practice. Over 50% improvement in targeting therapeutic serum urate has been observed, but clinical inertia is still present. Diagnosis is still mostly clinically based, ultrasonography not being commonly contributive. Menarini España.

Attainment of Canadian Diabetes Association recommended targets in patients with type 2 diabetes

PubMed Central

McCrate, Farah; Godwin, Marshall; Murphy, Laura

2010-01-01

OBJECTIVE To examine the degree to which targets for diabetes (blood pressure [BP], glycated hemoglobin [HbA1c], and low-density lipoprotein cholesterol [LDL-C]) are achieved in family practices and how these results compare with family physicians’ perceptions of how well targets are being achieved. DESIGN Chart audit and physician survey. SETTING Newfoundland and Labrador. PARTICIPANTS Patients with type 2 diabetes and their family physicians. INTERVENTIONS The charts of 20 patients with type 2 diabetes were randomly chosen from each of 8 family physician practices in St John’s, Nfld, and data were abstracted. All family physicians in the province were surveyed using a modified Dillman method. MAIN OUTCOME MEASURES The most recent HbA1c, LDL-C, and BP measurements listed in each audited chart; surveyed family physicians’ knowledge of the recommended targets for HbA1c, LDL-C, and BP and their estimates of what percentage of their patients were at those recommended targets. RESULTS The chart audit revealed that 20.6% of patients were at the recommended target for BP, 48.1% were at the recommended target for HbA1c, and 17.5% were at the recommended target for LDL-C. When targets were examined collectively, only 2.5% of patients were achieving targets in all 3 areas. The survey found that most family physicians were aware of the recommended targets for BP, LDL-C, and HbA1c. However, their estimates of the percentages of patients in their practices achieving these targets appeared high (59.3% for BP, 58.2% for HbA1c, and 48.4% for LDL-C) compared with the results of the chart audit. CONCLUSION The findings of the chart audit are consistent with other published reports, which have illustrated that a large majority of patients with diabetes fall short of reaching recommended targets for BP, blood glucose, and lipid levels. Although family physicians are knowledgeable about recommended targets, there is a gap between knowledge and clinical outcomes. The reasons for

Optimal implementation of green infrastructure practices to reduce adverse impacts of urban areas on hydrology and water quality

NASA Astrophysics Data System (ADS)

Liu, Y.; Collingsworth, P.; Pijanowski, B. C.; Engel, B.

2016-12-01

Nutrient loading from Maumee River watershed is a significant reason for the harmful algal blooms (HABs) problem in Lake Erie. Although studies have explored strategies to reduce nutrient loading from agricultural areas in the Maumee River watershed, the nutrient loading in urban areas also needs to be reduced. Green infrastructure practices are popular approaches for stormwater management and useful for improving hydrology and water quality. In this study, the Long-Term Hydrologic Impact Assessment-Low Impact Development 2.1 (L-THIA-LID 2.1) model was used to determine how different strategies for implementing green infrastructure practices can be optimized to reduce impacts on hydrology and water quality in an urban watershed in the upper Maumee River system. Community inputs, such as the types of green infrastructure practices of greatest interest and environmental concerns for the community, were also considered during the study. Based on community input, the following environmental concerns were considered: runoff volume, Total Suspended Solids (TSS), Total Phosphorous (TP), Total Kjeldahl Nitrogen (TKN), and Nitrate+Nitrite (NOx); green infrastructure practices of interest included rain barrel, cistern, green roof, permeable patio, porous pavement, grassed swale, bioretention system, grass strip, wetland channel, detention basin, retention pond, and wetland basin. Spatial optimization of green infrastructure practice implementation was conducted to maximize environmental benefits while minimizing the cost of implementation. The green infrastructure practice optimization results can be used by the community to solve hydrology and water quality problems.

Where to Go Next? Identifying Target Areas in the North Atlantic for Future Seafloor Mapping Initiatives

NASA Astrophysics Data System (ADS)

Woelfl, A. C.; Jencks, J.; Johnston, G.; Varner, J. D.; Devey, C. W.

2017-12-01

Human activities are rapidly expanding into the oceans, yet detailed bathymetric maps do not exist for most of the seafloor that would permit governments to formulate sensible usage rules. Changing this situation will require an enormous international mapping effort. To ensure that this effort is directed towards the regions most in need of mapping, we need to know which areas have already been mapped and which areas are potentially most interesting. Despite various mapping efforts in recent years, large parts of the Atlantic still lack detailed bathymetric information. To successfully plan for future mapping efforts to fill these gaps, knowledge of current data coverage is imperative to avoid duplication of effort. While certain datasets are publically available online (e.g. NOAA's NCEI, EMODnet, IHO-DCDB, LDEO's GMRT), many are not. However, with the limited information we do have at hand, the question remains, where should we map next? And what criteria should we take into account? In 2016, a study was taken on as part of the efforts of the International Atlantic Seabed Mapping Working Group (ASMIWG). The ASMIWG, established by the Tri-Partite Galway Statement Implementation Committee, was tasked to develop a cohesive seabed mapping strategy for the Atlantic Ocean. The aim of our study was to develop a reproducible process for identifying and evaluating potential target areas within the North Atlantic that represent suitable sites for future bathymetric surveys. The sites were selected by applying a GIS-based suitability analysis that included specific user group-based parameters of the marine environment. Furthermore, information regarding current data coverage were gathered to take into account in the selection process. The results reveal the suitability of sites within the North Atlantic based on the selected criteria. Three potential target sites should be seen as flexible suggestions for future mapping initiatives rather than a rigid, defined set of areas

[DOPPS estimate of patient life years attributable to modifiable hemodialysis practices in France].

PubMed

Canaud, Bernard; Combe, Christian; Bragg-Gresham, Jennifer L; Eichleay, Margaret A; Pisoni, Ronald L; Port, Friedrich K

2008-07-01

In this study, we used a prevalent cross-sectional sample of French hemodialysis patients from Dialysis Outcomes and Practice Patterns Study (DOPPS) 2 (2002-2004) to determine the percentage of patients whose values failed to meet targets in six different areas of hemodialysis practice (dialysis dose, anemia, serum phosphorus (PO(4)), serum calcium (Ca), serum albumin and catheter use for vascular access). Cox survival models, with adjustments for patient characteristics, were used for these analyses to estimate mortality hazard ratios (HR). Based on the mortality HR, the fraction of patients outside each target and the total HD population in France, we estimated the number of patient life years that could potentially be gained if every chronic, in-center hemodialysis patient in France who is currently outside of the specified target was able to achieve it. The proportion of patients failing to meet one of the six practice targets in France varied from 15% (dialysis dose) to 75% (albumin) while the percentage of patients complying with all six targets was restricted to 1.2%. The relative risk of mortality (RR) associated with being outside these targets varied from 1.12 to 1.46. Based on these two measures the life-years survival was estimated. The projected number of patients and life years potentially gained from adherence to the six targets was estimated close to 10,600 years-patient. In conclusion, this study suggests large opportunities to improve hemodialysis patient care in France still exist. Compliance with two major practice targets, such as albumin and restriction of catheter use will save highly significant life years of hemodialysis patient. Implementing and strict adherence to national and international guidelines should serve as a basic inspiration for continual improvement of hemodialysis patient care.

Practical considerations in emergency management of bleeding in the setting of target-specific oral anticoagulants.

PubMed

Miller, Michael P; Trujillo, Toby C; Nordenholz, Kristen E

2014-04-01

The recent arrival of the target-specific oral anticoagulants (TSOACs) offers potential advantages in the field of anticoagulation. However, there are no rapid and accurate and routinely available laboratory assays to evaluate their contribution to clinical bleeding. With the expanding clinical indications for the TSOACs, and the arrival of newer reversal agents on the market, the emergency clinician will need to be familiar with drug specifics as well as methods for anticoagulation reversal. This review offers a summary of the literature and some practical strategies for the approach to the patient taking TSOACs and the management of bleeding in these cases. Copyright © 2014 Elsevier Inc. All rights reserved.

Community knowledge, attitudes and practices on Yellow fever in South Omo area, Southern Ethiopia.

PubMed

Legesse, Mengistu; Endale, Adugna; Erku, Woldearegay; Tilahun, Getachew; Medhin, Girmay

2018-04-01

Yellow fever (Yf) outbreak was recently reported in South Omo of Southern Ethiopia. This area was also highly affected by Yf outbreak in the 1960s. However, there is no reliable information on the level of community knowledge attitudes and practices about the disease in the area. The objective of the current study was to assess level of community knowledge, attitudes and practices about Yf. Between March and May 2017, a community-based cross-sectional survey was conducted in two districts of the South Omo area. During the survey, 612 randomly selected adults were interviewed about Yf using structured questionnaire. Out of the 612 study participants, 508 (83.0%) reported that they heard about Yf which is locally known as "a disease that causes vomiting blood". Most (90.4%) of the study participants also said that Yf is different from malaria. Two hundred thirteen (41.9%) participants said that Yf can be transmitted from a patient to another person, while only 80 (37.6%) mentioned that the disease is transmitted through mosquitoes bite. Out of 333 (65.7%) study participants who believed that Yf is a preventable disease, 280 (84.1%) mentioned vaccine as a preventive method. The majority believed that the disease is a killer (97.2%) and a newly emerging (69.4%). Among the total of 612 study participants, 221(36.1%) were considered as having a high level of overall knowledge of Yf. Having educational level above 7th grade (AOR = 3.25, 95% CI: 1.39, 7.57, p = 0.006) and being resident of Bena-Tsemay district (AOR = 1.77, 95% CI: 1.12, 2.78, P = 0.014) were significantly associated with having a high level of overall knowledge of Yf. Agro-pastoralism as an occupation compared to farming was associated with having a low level of overall knowledge of Yf (AOR = 0.51, 95% CI, 0.33, 0.79, P = 0.003). The findings indicate that most of the study community members had a low level of overall knowledge of Yf, especially about its cause, mode of transmission and preventive methods

Predicting drug-target interactions using restricted Boltzmann machines.

PubMed

Wang, Yuhao; Zeng, Jianyang

2013-07-01

In silico prediction of drug-target interactions plays an important role toward identifying and developing new uses of existing or abandoned drugs. Network-based approaches have recently become a popular tool for discovering new drug-target interactions (DTIs). Unfortunately, most of these network-based approaches can only predict binary interactions between drugs and targets, and information about different types of interactions has not been well exploited for DTI prediction in previous studies. On the other hand, incorporating additional information about drug-target relationships or drug modes of action can improve prediction of DTIs. Furthermore, the predicted types of DTIs can broaden our understanding about the molecular basis of drug action. We propose a first machine learning approach to integrate multiple types of DTIs and predict unknown drug-target relationships or drug modes of action. We cast the new DTI prediction problem into a two-layer graphical model, called restricted Boltzmann machine, and apply a practical learning algorithm to train our model and make predictions. Tests on two public databases show that our restricted Boltzmann machine model can effectively capture the latent features of a DTI network and achieve excellent performance on predicting different types of DTIs, with the area under precision-recall curve up to 89.6. In addition, we demonstrate that integrating multiple types of DTIs can significantly outperform other predictions either by simply mixing multiple types of interactions without distinction or using only a single interaction type. Further tests show that our approach can infer a high fraction of novel DTIs that has been validated by known experiments in the literature or other databases. These results indicate that our approach can have highly practical relevance to DTI prediction and drug repositioning, and hence advance the drug discovery process. Software and datasets are available on request. Supplementary data are

Practical ways to facilitate ergonomics improvements in occupational health practice.

PubMed

Kogi, Kazutaka

2012-12-01

Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.

LWIR hyperspectral change detection for target acquisition and situation awareness in urban areas

NASA Astrophysics Data System (ADS)

Dekker, Rob J.; Schwering, Piet B. W.; Benoist, Koen W.; Pignatti, Stefano; Santini, Federico; Friman, Ola

2013-05-01

This paper studies change detection of LWIR (Long Wave Infrared) hyperspectral imagery. Goal is to improve target acquisition and situation awareness in urban areas with respect to conventional techniques. Hyperspectral and conventional broadband high-spatial-resolution data were collected during the DUCAS trials in Zeebrugge, Belgium, in June 2011. LWIR data were acquired using the ITRES Thermal Airborne Spectrographic Imager TASI-600 that operates in the spectral range of 8.0-11.5 μm (32 band configuration). Broadband data were acquired using two aeroplanemounted FLIR SC7000 MWIR cameras. Acquisition of the images was around noon. To limit the number of false alarms due to atmospheric changes, the time interval between the images is less than 2 hours. Local co-registration adjustment was applied to compensate for misregistration errors in the order of a few pixels. The targets in the data that will be analysed in this paper are different kinds of vehicles. Change detection algorithms that were applied and evaluated are Euclidean distance, Mahalanobis distance, Chronochrome (CC), Covariance Equalisation (CE), and Hyperbolic Anomalous Change Detection (HACD). Based on Receiver Operating Characteristics (ROC) we conclude that LWIR hyperspectral has an advantage over MWIR broadband change detection. The best hyperspectral detector is HACD because it is most robust to noise. MWIR high spatial-resolution broadband results show that it helps to apply a false alarm reduction strategy based on spatial processing.

Causal evidence for frontal involvement in memory target maintenance by posterior brain areas during distracter interference of visual working memory

PubMed Central

Feredoes, Eva; Heinen, Klaartje; Weiskopf, Nikolaus; Ruff, Christian; Driver, Jon

2011-01-01

Dorsolateral prefrontal cortex (DLPFC) is recruited during visual working memory (WM) when relevant information must be maintained in the presence of distracting information. The mechanism by which DLPFC might ensure successful maintenance of the contents of WM is, however, unclear; it might enhance neural maintenance of memory targets or suppress processing of distracters. To adjudicate between these possibilities, we applied time-locked transcranial magnetic stimulation (TMS) during functional MRI, an approach that permits causal assessment of a stimulated brain region's influence on connected brain regions, and evaluated how this influence may change under different task conditions. Participants performed a visual WM task requiring retention of visual stimuli (faces or houses) across a delay during which visual distracters could be present or absent. When distracters were present, they were always from the opposite stimulus category, so that targets and distracters were represented in distinct posterior cortical areas. We then measured whether DLPFC-TMS, administered in the delay at the time point when distracters could appear, would modulate posterior regions representing memory targets or distracters. We found that DLPFC-TMS influenced posterior areas only when distracters were present and, critically, that this influence consisted of increased activity in regions representing the current memory targets. DLPFC-TMS did not affect regions representing current distracters. These results provide a new line of causal evidence for a top-down DLPFC-based control mechanism that promotes successful maintenance of relevant information in WM in the presence of distraction. PMID:21987824

Speech-language pathologists' practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders.

PubMed

Mcleod, Sharynne; Baker, Elise

2014-01-01

A survey of 231 Australian speech-language pathologists (SLPs) was undertaken to describe practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders (SSD). The participants typically worked in private practice, education, or community health settings and 67.6% had a waiting list for services. For each child, most of the SLPs spent 10-40 min in pre-assessment activities, 30-60 min undertaking face-to-face assessments, and 30-60 min completing paperwork after assessments. During an assessment SLPs typically conducted a parent interview, single-word speech sampling, collected a connected speech sample, and used informal tests. They also determined children's stimulability and estimated intelligibility. With multilingual children, informal assessment procedures and English-only tests were commonly used and SLPs relied on family members or interpreters to assist. Common analysis techniques included determination of phonological processes, substitutions-omissions-distortions-additions (SODA), and phonetic inventory. Participants placed high priority on selecting target sounds that were stimulable, early developing, and in error across all word positions and 60.3% felt very confident or confident selecting an appropriate intervention approach. Eight intervention approaches were frequently used: auditory discrimination, minimal pairs, cued articulation, phonological awareness, traditional articulation therapy, auditory bombardment, Nuffield Centre Dyspraxia Programme, and core vocabulary. Children typically received individual therapy with an SLP in a clinic setting. Parents often observed and participated in sessions and SLPs typically included siblings and grandparents in intervention sessions. Parent training and home programs were more frequently used than the group therapy. Two-thirds kept up-to-date by reading journal articles monthly or every 6 months. There were many similarities with

Physician Professional Satisfaction and Area of Clinical Practice: Evidence from an Integrated Health Care Delivery System.

PubMed

Caloyeras, John P; Kanter, Michael; Ives, Nicole; Kim, Chong Y; Kanzaria, Hemal K; Berry, Sandra H; Brook, Robert H

2016-01-01

For health care reform to succeed, health care systems need a professionally satisfied primary care workforce. Evidence suggests that primary care physicians are less satisfied than those in other medical specialties. To assess three domains of physician satisfaction by area of clinical practice among physicians practicing in an established integrated health system. Cross-sectional online survey of all Southern California Permanente Medical Group (SCPMG) partner and associate physicians (N = 1034) who were primarily providing clinic-based care in 1 of 4 geographically and operationally distinct Kaiser Permanente Southern California Medical Centers. Primary measure was satisfaction with one's day-to-day professional life as a physician. Secondary measures were satisfaction with quality of care and income. Of the 636 physicians responding to the survey (61.5% response rate), on average, 8 in 10 SCPMG physicians reported satisfaction with their day-to-day professional life as a physician. Primary care physicians were only minimally less likely to report being satisfied (difference of 8.2-9.5 percentage points; p < 0.05) than were other physicians. Nearly all physicians (98.2%) were satisfied with the quality of care they are able to provide. Roughly 8 in 10 physicians reported satisfaction with their income. No differences were found between primary care physicians and those in other clinical practice areas regarding satisfaction with quality of care or income. It is possible to create practice settings, such as SCPMG, in which most physicians, including those in primary care, experience high levels of professional satisfaction.

Physician Professional Satisfaction and Area of Clinical Practice: Evidence from an Integrated Health Care Delivery System

PubMed Central

Caloyeras, John P; Kanter, Michael; Ives, Nicole; Kim, Chong Y; Kanzaria, Hemal K; Berry, Sandra H; Brook, Robert H

2016-01-01

Context: For health care reform to succeed, health care systems need a professionally satisfied primary care workforce. Evidence suggests that primary care physicians are less satisfied than those in other medical specialties. Objective: To assess three domains of physician satisfaction by area of clinical practice among physicians practicing in an established integrated health system. Design: Cross-sectional online survey of all Southern California Permanente Medical Group (SCPMG) partner and associate physicians (N = 1034) who were primarily providing clinic-based care in 1 of 4 geographically and operationally distinct Kaiser Permanente Southern California Medical Centers. Main Outcome Measures: Primary measure was satisfaction with one’s day-to-day professional life as a physician. Secondary measures were satisfaction with quality of care and income. Results: Of the 636 physicians responding to the survey (61.5% response rate), on average, 8 in 10 SCPMG physicians reported satisfaction with their day-to-day professional life as a physician. Primary care physicians were only minimally less likely to report being satisfied (difference of 8.2–9.5 percentage points; p < 0.05) than were other physicians. Nearly all physicians (98.2%) were satisfied with the quality of care they are able to provide. Roughly 8 in 10 physicians reported satisfaction with their income. No differences were found between primary care physicians and those in other clinical practice areas regarding satisfaction with quality of care or income. Conclusion: It is possible to create practice settings, such as SCPMG, in which most physicians, including those in primary care, experience high levels of professional satisfaction. PMID:27057819

Beyond cysteine: recent developments in the area of targeted covalent inhibition.

PubMed

Mukherjee, Herschel; Grimster, Neil P

2018-05-29

Over the past decade targeted covalent inhibitors have undergone a renaissance due to the clinical validation and regulatory approval of several small molecule therapeutics that are designed to irreversibly modify their target protein. Invariably, these compounds rely on the serendipitous placement of a cysteine residue proximal to the small molecule binding site; while this strategy has afforded numerous successes, it necessarily limits the number of proteins that can be targeted by this approach. This drawback has led several research groups to develop novel methodologies that target non-cysteine residues for covalent modification. Herein, we survey the current literature of warheads that covalently modify non-cysteine amino acids in proteins. Copyright © 2018 Elsevier Ltd. All rights reserved.

Method of passive ranging from infrared image sequence based on equivalent area

NASA Astrophysics Data System (ADS)

Yang, Weiping; Shen, Zhenkang

2007-11-01

The information of range between missile and targets is important not only to missile controlling component, but also to automatic target recognition, so studying the technique of passive ranging from infrared images has important theoretic and practical meanings. Here we tried to get the range between guided missile and target and help to identify targets or dodge a hit. The issue of distance between missile and target is currently a hot and difficult research content. As all know, infrared imaging detector can not range so that it restricts the functions of the guided information processing system based on infrared images. In order to break through the technical puzzle, we investigated the principle of the infrared imaging, after analysing the imaging geometric relationship between the guided missile and the target, we brought forward the method of passive ranging based on equivalent area and provided mathematical analytic formulas. Validating Experiments demonstrate that the presented method has good effect, the lowest relative error can reach 10% in some circumstances.

Threat Assessment and Targeted Violence at Institutions of Higher Education: Implications for Policy and Practice Including Unique Considerations for Community Colleges

ERIC Educational Resources Information Center

Bennett, Laura; Bates, Michael

2015-01-01

This article provides an overview of the research on targeted violence, including campus violence, and the implications for policy and practice at institutions of higher education. Unique challenges of threat assessment in the community college setting are explored, and an overview of an effective threat assessment policy and team at William…

Higher Education's Influence on the Confessional Practices of Roman Catholic Laity in the Greater Miami Area

ERIC Educational Resources Information Center

Ferrari, Joseph L.

2013-01-01

This qualitative phenomenological study of 20 Roman Catholic laypersons in the Greater Miami area investigated the phenomenon of transformation of confessional practice as a result of the undergraduate educational experience. By searching for meaning in each individual's story, two themes or factors and six sub themes emerged. The themes were…

Effects of the 'Consumer Game' on Learning and Attitudes of Selected Seventh Grade Students in A Target-Area School.

ERIC Educational Resources Information Center

Cohen, Karen C.

The following report describes one teacher's use of the Consumer Game in a class of seventh grade students in a target area school. These students were not highly motivated and displayed poor attitudes toward school, and it was hoped that a game experience might interest them. Despite unusual administrative conditions, the game appears to have…

User friendly tools to target vulnerable areas at watershed scale: evaluation of the soil vulnerability and conductivity claypan indices

USDA-ARS?s Scientific Manuscript database

One finding of the Conservation Effects Assessment Program (CEAP) watershed studies was that Best Management practices (BMPs) were not always installed where most needed: in many watersheds, only a fraction of BMPs were implemented in the most vulnerable areas. While complex computer simulation mode...

Practice Patterns of School-Based Occupational Therapists Targeting Handwriting: A Knowledge-to-Practice Gap

ERIC Educational Resources Information Center

Cramm, Heidi; Egan, Mary

2015-01-01

Poor handwriting is a common reason for referral to school-based occupational therapy. A survey was used to explore the extent to which current practice patterns in Ontario, Canada, align with evidence on effective intervention for handwriting. Knowledge-to-practice gaps were identified related to focus on performance components versus…

Knowledge, Attitudes, and Practices regarding Diarrhea and Cholera following an Oral Cholera Vaccination Campaign in the Solomon Islands

PubMed Central

Burnett, Eleanor; Dalipanda, Tenneth; Ogaoga, Divi; Gaiofa, Jenny; Jilini, Gregory; Halpin, Alison; Dietz, Vance; Date, Kashmira; Mintz, Eric; Hyde, Terri; Wannemuehler, Kathleen; Yen, Catherine

2016-01-01

Background In response to a 2011 cholera outbreak in Papua New Guinea, the Government of the Solomon Islands initiated a cholera prevention program which included cholera disease prevention and treatment messaging, community meetings, and a pre-emptive cholera vaccination campaign targeting 11,000 children aged 1–15 years in selected communities in Choiseul and Western Provinces. Methodology and Principal Findings We conducted a post-vaccination campaign, household-level survey about knowledge, attitudes, and practices regarding diarrhea and cholera in areas targeted and not targeted for cholera vaccination. Respondents in vaccinated areas were more likely to have received cholera education in the previous 6 months (33% v. 9%; p = 0.04), to know signs and symptoms (64% vs. 22%; p = 0.02) and treatment (96% vs. 50%; p = 0.02) of cholera, and to be aware of cholera vaccine (48% vs. 14%; p = 0.02). There were no differences in water, sanitation, and hygiene practices. Conclusions This pre-emptive OCV campaign in a cholera-naïve community provided a unique opportunity to assess household-level knowledge, attitudes, and practices regarding diarrhea, cholera, and water, sanitation, and hygiene (WASH). Our findings suggest that education provided during the vaccination campaign may have reinforced earlier mass messaging about cholera and diarrheal disease in vaccinated communities. PMID:27548678

Knowledge, Attitudes, and Practices regarding Diarrhea and Cholera following an Oral Cholera Vaccination Campaign in the Solomon Islands.

PubMed

Burnett, Eleanor; Dalipanda, Tenneth; Ogaoga, Divi; Gaiofa, Jenny; Jilini, Gregory; Halpin, Alison; Dietz, Vance; Date, Kashmira; Mintz, Eric; Hyde, Terri; Wannemuehler, Kathleen; Yen, Catherine

2016-08-01

In response to a 2011 cholera outbreak in Papua New Guinea, the Government of the Solomon Islands initiated a cholera prevention program which included cholera disease prevention and treatment messaging, community meetings, and a pre-emptive cholera vaccination campaign targeting 11,000 children aged 1-15 years in selected communities in Choiseul and Western Provinces. We conducted a post-vaccination campaign, household-level survey about knowledge, attitudes, and practices regarding diarrhea and cholera in areas targeted and not targeted for cholera vaccination. Respondents in vaccinated areas were more likely to have received cholera education in the previous 6 months (33% v. 9%; p = 0.04), to know signs and symptoms (64% vs. 22%; p = 0.02) and treatment (96% vs. 50%; p = 0.02) of cholera, and to be aware of cholera vaccine (48% vs. 14%; p = 0.02). There were no differences in water, sanitation, and hygiene practices. This pre-emptive OCV campaign in a cholera-naïve community provided a unique opportunity to assess household-level knowledge, attitudes, and practices regarding diarrhea, cholera, and water, sanitation, and hygiene (WASH). Our findings suggest that education provided during the vaccination campaign may have reinforced earlier mass messaging about cholera and diarrheal disease in vaccinated communities.

Continuing professional development and ICT: target practice.

PubMed

Eaton, K A; Reynolds, P A

2008-07-26

Ever-increasing needs and demands by dentists and all other members of the dental team for education and training at all levels - undergraduate, postgraduate and continuing - are straining the resources of existing providers of such education. At the same time, there are ever-increasing opportunities to develop online delivery and the use of a range of information and communication technology (ICT) systems and services further, in all aspects of dental education. This paper reviews recent developments that have led to an increased demand for dental postgraduate programmes and continuing professional development (CPD) courses in the United Kingdom and then discusses how ICT has and will impact on teaching practice. Examples include the use of teaching and learning resources in a virtual learning environment (VLE) and the increasing use of blended learning. The paper then explores the need for both teachers and students to adapt to the new environment to ensure they can benefit to the maximum and that teaching and learning practices are changed accordingly.

Comparison of knowledge, attitude and practices of betelnut users in two socio-economic areas of Karachi.

PubMed

Khan, Muhammad Shahzeb; Bawany, Faizan Imran; Shah, Syed Raza; Hussain, Mehwish; Arshad, Mohammad Hussham; Nisar, Nighat

2013-10-01

To gain an insight on the knowledge, attitude and practices of those who chew betel nut in two different socioeconomic regions of Karachi. The cross-sectional study was conducted in Saddar and Defence areas of Karachi over a five-week period in March-April 2012. Individual interviews following verbal consent were conducted using a pre-coded questionnaire, which was divided into 3 sections to analyse the knowledge, attitude and practices of the chewers. The data was entered and analysed using SPSS v. 16.0. Pearson's chi-square was used as the primary statistical test. A total of 370 subjects, 185 (50%) from each area, comprised the study. Majority of the chewers in Defence had higher educational qualification and income. Most of the participants in both areas acknowledged that betel nut chewing can potentially result in mouth (n = 274; 74.1%) and throat cancers (n = 267; 72.2%). A large part of the sample (n = 299; 80.8%) conceded that betel nut chewing is a bad habit, and almost half the sample was addicted to it (n = 194; 52.4%). Awareness regarding the detrimental effects of betel nut was satisfactory amongst the subjects, but the population was not willing to quit the habit. We recommend a two-pronged approach, offering widespread educational and awareness campaigns to prevent increased consumption of betel nuts, and professional counselling services for those already addicted.

Use of anticoagulant rodenticides in outdoor urban areas: considerations and proposals for the protection of public health and non-target species.

PubMed

Dutto, M; Di Domenico, D; Rubbiani, M

2018-01-01

Rodent control operations represent an important tool for the prevention and management of infestations, in outdoor environments, by synanthropic rodents (Rattus rattus and R. norvegicus), which are a source of economic and environmental damage with significant sanitary implications. Although the use of anticoagulants is safer to humans and pets compared to the use of acute poisoning substances, an intrinsic hazard of the active ingredients exists, i.e. the possible poisoning of non-target organisms (e.g., children, pets and wildlife) following exposure. The risks arising from the use of anticoagulants for rodent control operations in anthropic contexts can therefore only be mitigated by a proper selection of the active ingredient, bait formulation and administration techniques, since an active ingredient with selective action towards non-target species does not currently exist on the market. This document lists practical proposals aimed at reducing the possibility of toxic exposure to anticoagulant rodenticides and mitigate the toxicological risk of human baits and non-target species.

The Neural Mechanisms of Meditative Practices: Novel Approaches for Healthy Aging.

PubMed

Acevedo, Bianca P; Pospos, Sarah; Lavretsky, Helen

2016-01-01

Meditation has been shown to have physical, cognitive, and psychological health benefits that can be used to promote healthy aging. However, the common and specific mechanisms of response remain elusive due to the diverse nature of mind-body practices. In this review, we aim to compare the neural circuits implicated in focused-attention meditative practices that focus on present-moment awareness to those involved in active-type meditative practices (e.g., yoga) that combine movement, including chanting, with breath practices and meditation. Recent meta-analyses and individual studies demonstrated common brain effects for attention-based meditative practices and active-based meditations in areas involved in reward processing and learning, attention and memory, awareness and sensory integration, and self-referential processing and emotional control, while deactivation was seen in the amygdala, an area implicated in emotion processing. Unique effects for mindfulness practices were found in brain regions involved in body awareness, attention, and the integration of emotion and sensory processing. Effects specific to active-based meditations appeared in brain areas involved in self-control, social cognition, language, speech, tactile stimulation, sensorimotor integration, and motor function. This review suggests that mind-body practices can target different brain systems that are involved in the regulation of attention, emotional control, mood, and executive cognition that can be used to treat or prevent mood and cognitive disorders of aging, such as depression and caregiver stress, or serve as "brain fitness" exercise. Benefits may include improving brain functional connectivity in brain systems that generally degenerate with Alzheimer's disease, Parkinson's disease, and other aging-related diseases.

Bolder science needed now for protected areas.

PubMed

Watson, James E M; Darling, Emily S; Venter, Oscar; Maron, Martine; Walston, Joe; Possingham, Hugh P; Dudley, Nigel; Hockings, Marc; Barnes, Megan; Brooks, Thomas M

2016-04-01

Recognizing that protected areas (PAs) are essential for effective biodiversity conservation action, the Convention on Biological Diversity established ambitious PA targets as part of the 2020 Strategic Plan for Biodiversity. Under the strategic goal to "improve the status of biodiversity by safeguarding ecosystems, species, and genetic diversity," Target 11 aims to put 17% of terrestrial and 10% of marine regions under PA status by 2020. Additionally and crucially, these areas are required to be of particular importance for biodiversity and ecosystem services, effectively and equitably managed, ecologically representative, and well-connected and to include "other effective area-based conservation measures" (OECMs). Whereas the area-based targets are explicit and measurable, the lack of guidance for what constitutes important and representative; effective; and OECMs is affecting how nations are implementing the target. There is a real risk that Target 11 may be achieved in terms of area while failing the overall strategic goal for which it is established because the areas are poorly located, inadequately managed, or based on unjustifiable inclusion of OECMs. We argue that the conservation science community can help establish ecologically sensible PA targets to help prioritize important biodiversity areas and achieve ecological representation; identify clear, comparable performance metrics of ecological effectiveness so progress toward these targets can be assessed; and identify metrics and report on the contribution OECMs make toward the target. By providing ecologically sensible targets and new performance metrics for measuring the effectiveness of both PAs and OECMs, the science community can actively ensure that the achievement of the required area in Target 11 is not simply an end in itself but generates genuine benefits for biodiversity. © 2016 Society for Conservation Biology.

Informal mobile learning in nurse education and practice in remote areas--a case study from rural South Africa.

PubMed

Pimmer, Christoph; Brysiewicz, Petra; Linxen, Sebastian; Walters, Fiona; Chipps, Jennifer; Gröhbiel, Urs

2014-11-01

With the proliferation of portable digital technology, mobile learning is becoming increasingly popular in nursing education and practice. Most of the research in this field has been concentrated on small-scale projects in high income countries. Very little is known about the ways in which nurses and midwives use mobile technology in remote and resource poor areas in informal learning contexts in low and middle income countries. To address this gap, this study investigates whether nurses use mobile phones as effective educational tools in marginalized and remote areas, and if so, how and why. In rural South Africa, 16 nurses who attended an advanced midwifery education program, facilitators and clinical managers were interviewed about their use of digital mobile technology for learning. Techniques of qualitative content analysis were used to examine the data. Several rich "organically-grown", learning practices were identified: mobile phone usage facilitated (1) authentic problem solving; (2) reflective practice; (3) emotional support and belongingness; (4) the realization of unpredictable teaching situations; and (5) life-long learning. It is concluded that mobile phones, and the convergence of mobile phones and social media, in particular, change learning environments. In addition, these tools are suitable to connect learners and learning distributed in marginalized areas. Finally, a few suggestions are made about how these insights from informal settings can inform the development of more systematic mobile learning formats. Copyright © 2014 Elsevier Ltd. All rights reserved.

Infant and young child feeding practice among mothers with 0-24 months old children in Slum areas of Bahir Dar City, Ethiopia.

PubMed

Demilew, Yeshalem Mulugeta; Tafere, Tadese Ejigu; Abitew, Dereje Berhanu

2017-01-01

Adequate nutrition during infancy and early childhood is essential to ensure the health, growth and development of children. However, infant feeding practice is suboptimal in Bahir Dar City, Ethiopia. The slum area is a heavily populated urban informal settlement characterized by substandard housing, squalor, with a lack of reliable sanitation services, supply of clean water, reliable electricity, law enforcement and other basic services. Residents of the slum area were poor and less educated. This further compromises infant feeding practice. The aim of this study was to assess infant and young child feeding practice among mothers with 0-24 month old children in the study area. A community based cross-sectional study was conducted among 423 mothers with 0-24 month old children from June 01-30 / 2016. Simple random sampling technique was used to select the respondents. Infant and young child feeding practice was assessed using the fifteen World Health Organisation (WHO) criteria. The prevalence of exclusive breastfeeding practice was 113 (84%). Sixty (15%) mothers gave prelacteal feeds and, 96 (23%) mothers used a bottle to feed their index child. Appropriate complementary feeding practice was only 20 (7%). Thirty nine out of forty mothers introduced complementary food timely, 131 (47%) of mothers gave the minimum meal frequency, and 20 (7%) children took the minimum food diversity and acceptable diet. Independent predictors for complementary feeding practice were having secondary and above education of the mother, receiving postnatal care, possession of radio and giving birth at hospital. In this study infant and young child feeding (IYCF) practice was poor. Therefore, there is a need for strengthening the promotion on IYCF practice during postnatal care and using mass media to giving emphasis for optimal complementary feeding practices, especially for mothers with a lower educational status.

Effects of increasing forest plantation area and management practices on carbon storage and water use in the United States

NASA Astrophysics Data System (ADS)

Chen, G.; Hayes, D. J.; Tian, H.

2013-12-01

Planted forest area in the United States gradually increased during the last half century, and by 2007 accounted for about 20% of the total forest area in the southern United States and about 13% in the entire country. Intensive plantation management activities - such as slash burning, thinning, weed control, fertilization and the use of genetically improved seedlings - are routinely applied during the forest rotation. However, no comprehensive assessments have been made to examine the impacts of this increased forest plantation area and associated management practices on ecosystem function. In this study, we integrated field measurement data and process-based modeling to quantitatively estimate the changes in carbon storage, nitrogen cycling and water use as influenced by forest plantations in the United States from 1925 to 2007. The results indicated that forest plantations and management practices greatly increased forest productivity, vegetation carbon, and wood product carbon storage in the United States, but slightly reduce soil carbon storage at some areas; however, the carbon sink induced by forest plantations was at the expense of more water use as represented by higher evapotranspiration. Stronger nitrogen and water limitations were found for forest plantations as compared to natural or naturally-regenerated forests.

The Effects of Practice-Based Training on Graduate Teaching Assistants’ Classroom Practices

PubMed Central

Becker, Erin A.; Easlon, Erin J.; Potter, Sarah C.; Guzman-Alvarez, Alberto; Spear, Jensen M.; Facciotti, Marc T.; Igo, Michele M.; Singer, Mitchell; Pagliarulo, Christopher

2017-01-01

Evidence-based teaching is a highly complex skill, requiring repeated cycles of deliberate practice and feedback to master. Despite existing well-characterized frameworks for practice-based training in K–12 teacher education, the major principles of these frameworks have not yet been transferred to instructor development in higher educational contexts, including training of graduate teaching assistants (GTAs). We sought to determine whether a practice-based training program could help GTAs learn and use evidence-based teaching methods in their classrooms. We implemented a weekly training program for introductory biology GTAs that included structured drills of techniques selected to enhance student practice, logic development, and accountability and reduce apprehension. These elements were selected based on their previous characterization as dimensions of active learning. GTAs received regular performance feedback based on classroom observations. To quantify use of target techniques and levels of student participation, we collected and coded 160 h of video footage. We investigated the relationship between frequency of GTA implementation of target techniques and student exam scores; however, we observed no significant relationship. Although GTAs adopted and used many of the target techniques with high frequency, techniques that enforced student participation were not stably adopted, and their use was unresponsive to formal feedback. We also found that techniques discussed in training, but not practiced, were not used at quantifiable frequencies, further supporting the importance of practice-based training for influencing instructional practices. PMID:29146664

How to (or not to) … measure performance against the Abuja target for public health expenditure.

PubMed

Witter, Sophie; Jones, Alex; Ensor, Tim

2014-07-01

In 2001, African heads of state committed 'to set a target of allocating at least 15% of our annual budget to the improvement of the health sector'. This target has since been used as a benchmark to hold governments accountable. However, it was never followed by a set of guidelines as to how it should be measured in practice. This article sets out some of the areas of ambiguity and argues for an interpretation which focuses on actual expenditure, rather than budgets (which are theoretical), and which captures areas of spending that are subject to government discretion. These are largely domestic sources, but include budget support, which is externally derived but subject to Ministry of Finance sectoral allocation. Theoretical and practical arguments in favour of this recommendation are recommended using a case study from Sierra Leone. It is recommended that all discretionary spending by government is included in the numerator and denominator when calculating performance against the target, including spending by all ministries on health, social health insurance payments, debt relief funds and budget support. Conversely, all forms of private payment and earmarked aid should be excluded. The authors argue that the target, while an important vehicle for tracking political commitment to the sector, should be assessed intelligently by governments, which have legitimate wider public finance objectives of maximizing overall social returns, and should be complemented by a wider range of indicators, to avoid distortions. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

An Improved Compressive Sensing and Received Signal Strength-Based Target Localization Algorithm with Unknown Target Population for Wireless Local Area Networks.

PubMed

Yan, Jun; Yu, Kegen; Chen, Ruizhi; Chen, Liang

2017-05-30

In this paper a two-phase compressive sensing (CS) and received signal strength (RSS)-based target localization approach is proposed to improve position accuracy by dealing with the unknown target population and the effect of grid dimensions on position error. In the coarse localization phase, by formulating target localization as a sparse signal recovery problem, grids with recovery vector components greater than a threshold are chosen as the candidate target grids. In the fine localization phase, by partitioning each candidate grid, the target position in a grid is iteratively refined by using the minimum residual error rule and the least-squares technique. When all the candidate target grids are iteratively partitioned and the measurement matrix is updated, the recovery vector is re-estimated. Threshold-based detection is employed again to determine the target grids and hence the target population. As a consequence, both the target population and the position estimation accuracy can be significantly improved. Simulation results demonstrate that the proposed approach achieves the best accuracy among all the algorithms compared.

Demographics, training, and practice patterns of practitioners of folk medicine in Taiwan: a survey of the Taipei metropolitan area.

PubMed

Tsai, Pei-Shan; Lee, Pi-Hsia; Wang, Mei-Yeh

2008-12-01

The purpose of this study was to investigate the demographics, training, and practice patterns of folk medicine practitioners, their opinions toward statutory regulation of folk medicine, and the formal education and credentialing for folk medicine providers in the metropolitan Taipei area. A cross-sectional survey design was used. Included in the survey were 200 folk medicine practitioners in Taipei city and 200 folk medicine practitioners in Taipei county. The survey questionnaire consisted of 3 domains including demographics and training; practice patterns; and opinions toward statutory regulation of folk medicine and formal education and credentialing for Tuina, Ba Guan, Gua Sha, and reflexology providers. The response rates ranged from 86.3% to 99.5%. A typical folk medicine provider in the Taipei metropolitan area was a middle-aged man with a high school degree who worked about 50 hours a week. The majority of the providers in the Taipei metropolitan area received their training through apprenticeship. Years of training and experience varied widely among these practitioners. About 80% had received more than one year of training prior to starting their practice. Adult men and women were their major clientele. The major treatment modalities they offered were Tuina, Gua Sha, Ba Guan, reflexology, and meridian massage. The majority of the respondents agreed that practitioners should receive formal education and training and agreed that certifying the qualifications of folk medicine practitioners is necessary. Findings from the present survey provide an understanding of the training and practice patterns of Taiwanese folk medicine practitioners, highlight folk medicine practitioners' needs for formal education and training, and stress the importance of statutory regulation of folk medicine in Taiwan.

San Francisco Bay Area Baseline Trash Loading Summary Results for all counties

EPA Pesticide Factsheets

The San Francisco Bay Area stormwater permit sets trash control guidelines for discharges through the storm drain system. The permit covers Alameda, Contra Costa, Santa Clara, and San Mateo counties and the cities of Vallejo, Fairfield, and Suisun City. By February 2012 the permittees must provide a baseline trash load estimate, a list of trash hotspots targeted for annual cleanup, and an implementation plan for best management practices to meet trash reduction milestones over the next decade. A trash reduction crediting program will be used to account for best management practice effectiveness. The permit establishes goals for trash reduction beginning in 2014 and reaching a zero level by 2022.

Acute oral administration of low doses of methylphenidate targets calretinin neurons in the rat septal area

PubMed Central

García-Avilés, Álvaro; Albert-Gascó, Héctor; Arnal-Vicente, Isabel; Elhajj, Ebtisam; Sanjuan-Arias, Julio; Sanchez-Perez, Ana María; Olucha-Bordonau, Francisco

2015-01-01

Methylphenidate (MPD) is a commonly administered drug to treat children suffering from attention deficit hyperactivity disorder (ADHD). Alterations in septal driven hippocampal theta rhythm may underlie attention deficits observed in these patients. Amongst others, the septo-hippocampal connections have long been acknowledged to be important in preserving hippocampal function. Thus, we wanted to ascertain if MPD administration, which improves attention in patients, could affect septal areas connecting with hippocampus. We used low and orally administered MPD doses (1.3, 2.7 and 5 mg/Kg) to rats what mimics the dosage range in humans. In our model, we observed no effect when using 1.3 mg/Kg MPD; whereas 2.7 and 5 mg/Kg induced a significant increase in c-fos expression specifically in the medial septum (MS), an area intimately connected to the hippocampus. We analyzed dopaminergic areas such as nucleus accumbens and striatum, and found that only 5 mg/Kg induced c-fos levels increase. In these areas tyrosine hydroxylase correlated well with c-fos staining, whereas in the MS the sparse tyrosine hydroxylase fibers did not overlap with c-fos positive neurons. Double immunofluorescence of c-fos with neuronal markers in the septal area revealed that co-localization with choline acethyl transferase, parvalbumin, and calbindin with c-fos did not change with MPD treatment; whereas, calretinin and c-fos double labeled neurons increased after MPD administration. Altogether, these results suggest that low and acute doses of methylphenidate primary target specific populations of caltretinin medial septal neurons. PMID:25852493

Thematic mapping of likely target areas for the occurence of cassiterite in the Serra do Mocambo (GO) granitic massifs using LANDSAT 2 digital imaging

NASA Technical Reports Server (NTRS)

Almeidofilho, R. (Principal Investigator)

1984-01-01

The applicability of LANDSAT/MSS images, enhanced by computer derived techniques, as essential tools in mineral research was investigated and the Serra do Mocambo granitic massif was used as illustration. Given the peculiar factors founded in this area, orbital imagery permitted the delineation of potential target areas of mineralization occurrences, associated to albitized/greisenized types. Follow up prospection for primary tin deposits in this granitic massif should be restricted to the delineated areas which are less than 5% of the total superficial area of the massif.

Fostering resilience among urban youth exposed to violence: a promising area for interdisciplinary research and practice.

PubMed

Jain, Sonia; Cohen, Alison K

2013-12-01

Most studies to date have examined negative effects of exposure to community violence, in line with the deficit-based perspective. However, given that most youth exposed to community violence demonstrate positive adaptation or resilience over time, we suggest a shift in perspective, practices, and policies across systems toward identifying and building individual, family, and community assets and strengths that may more effectively support youth who have been exposed to community violence and related risks into competent, caring, and thriving adults. In this article, we review how resilience has been conceptualized and operationalized within the context of community violence, highlight gaps in literature, and offer directions for future public health research and practice. We illustrate this review with practice-based examples from public health work in the San Francisco Bay Area. Future multidisciplinary longitudinal studies that identify protective processes and successful trajectories and rigorous evaluations of strength-based policies, programs, and protective processes are needed.

Targeted therapies: a nursing perspective.

PubMed

Kay, Polly

2006-02-01

To review the development of targeted therapies and the biology of relevant therapeutic targets. To analyze the relevance of targeted agents as part of current clinical practice. Research articles. Several targeted agents are now available for clinical use. Their mechanisms of action are more specific against tumor cells than traditional cytotoxics. Monotherapy regimens based on targeted agents tend to be better tolerated than chemotherapy, and most combination regimens with targeted agents have proven feasible. Their availability has greatly expanded cancer treatment options, especially for chemorefractory patients. Nurses involved in the care of patients with cancer can benefit from an increased understanding of targeted therapies, including their mechanisms of action, their efficacy profile, as well as prophylaxis and management of adverse events and administration procedures.

Geological structure and ore mineralization of the South Sopchinsky and Gabbro-10 massifs and the Moroshkovoe Lake target, Monchegorsk area, Kola Peninsula, Russia

NASA Astrophysics Data System (ADS)

Pripachkin, Pavel V.; Rundkvist, Tatyana V.; Miroshnikova, Yana A.; Chernyavsky, Alexey V.; Borisenko, Elena S.

2016-12-01

The South Sopchinsky massif (SSM), Gabbro-10 (G-10) massif, and Moroshkovoe Lake (ML) target Monchegorsk area, Kola Peninsula, are located at the junction of the Monchepluton and Monchetundra layered intrusions. The intrusions were studied in detail as they are targets for platinum-group element (PGE) mineralization. The rocks in these targets comprise medium- to coarse-grained mesocratic to leucocratic gabbronorites, medium-grained mesocratic to melanocratic norites and pyroxenites, and various veins mainly comprising norite, plagioclase-amphibole-magnetite rocks, and quartz-magnetite rocks. The veins contain Ni-Cu-PGE mineralization associated with magnetite and chromite. In all targets, the contacts between gabbronorite and norite-pyroxenite are undulating, and the presence of magmatic (intrusive) breccias suggests that these rocks formed through mingling of two distinct magmatic pulses. In places, the gabbronorites clearly crosscut the modal layering of the norites and pyroxenites. Trace element data indicate that the gabbronorites have similar compositions to rocks of the upper part of the Monchetundra intrusion, whereas the norites and pyroxenites resemble rocks from the lower to intermediate stratigraphic levels of the Monchepluton, such as in the Nude-Poaz and Sopcha massifs. Sulfide mineralization in the studied targets principally consists of secondary bornite, millerite, and chalcopyrite. In contrast, the primary sulfide assemblage within the layered sequence of the adjacent Monchepluton is characterized by pentlandite, chalcopyrite, and pyrrhotite. Therefore, the mineralization in the studied targets is interpreted to be of a contact style. We argue that the studied area represents the contact zone between gabbronorites of the Monchetundra intrusion and norites and pyroxenites of the Monchepluton. In addition, the rocks were overprinted by postmagmatic veining and remobilization of contact style sulfide and PGE mineralization.

Locating the optimal internal jugular target site for central venous line placement.

PubMed

Giordano, Chris R; Murtagh, Kevin R; Mills, Jaime; Deitte, Lori A; Rice, Mark J; Tighe, Patrick J

2016-09-01

Historically, the placement of internal jugular central venous lines has been accomplished by using external landmarks to help identify target-rich locations in order to steer clear of dangerous structures. This paradigm is largely being displaced, as ultrasound has become routine practice, raising new considerations regarding target locations and risk mitigation. Most human anatomy texts depict the internal jugular vein as a straight columnar structure that exits the cranial vault the same size that it enters the thoracic cavity. We dispute the notion that the internal jugulars are cylindrical columns that symmetrically descend into the thoracic cavity, and purport that they are asymmetric conical structures. The primary aim of this study was to evaluate 100 consecutive adult chest and neck computed tomography exams that were imaged at an inpatient hospital. We measured the internal jugular on the left and right sides at three different levels to look for differences in size as the internal jugular descends into the thoracic cavity. We revealed that as the internal jugular descends into the thorax, the area of the vessel increases and geometrically resembles a conical structure. We also reconfirmed that the left internal jugular is smaller than the right internal jugular. Understanding that the largest target area for central venous line placement is the lower portion of the right internal jugular vein will help to better target vascular access for central line placement. This is the first study the authors are aware of that depicts the internal jugular as a conical structure as opposed to the commonly depicted symmetrical columnar structure frequently illustrated in anatomy textbooks. This target area does come with additional risk, as the closer you get to the thoracic cavity, the greater the chances for lung injury. Copyright © 2016 Elsevier Inc. All rights reserved.

Interval MULTIMOORA method with target values of attributes based on interval distance and preference degree: biomaterials selection

NASA Astrophysics Data System (ADS)

Hafezalkotob, Arian; Hafezalkotob, Ashkan

2017-06-01

A target-based MADM method covers beneficial and non-beneficial attributes besides target values for some attributes. Such techniques are considered as the comprehensive forms of MADM approaches. Target-based MADM methods can also be used in traditional decision-making problems in which beneficial and non-beneficial attributes only exist. In many practical selection problems, some attributes have given target values. The values of decision matrix and target-based attributes can be provided as intervals in some of such problems. Some target-based decision-making methods have recently been developed; however, a research gap exists in the area of MADM techniques with target-based attributes under uncertainty of information. We extend the MULTIMOORA method for solving practical material selection problems in which material properties and their target values are given as interval numbers. We employ various concepts of interval computations to reduce degeneration of uncertain data. In this regard, we use interval arithmetic and introduce innovative formula for interval distance of interval numbers to create interval target-based normalization technique. Furthermore, we use a pairwise preference matrix based on the concept of degree of preference of interval numbers to calculate the maximum, minimum, and ranking of these numbers. Two decision-making problems regarding biomaterials selection of hip and knee prostheses are discussed. Preference degree-based ranking lists for subordinate parts of the extended MULTIMOORA method are generated by calculating the relative degrees of preference for the arranged assessment values of the biomaterials. The resultant rankings for the problem are compared with the outcomes of other target-based models in the literature.

An iterative and targeted sampling design informed by habitat suitability models for detecting focal plant species over extensive areas.

PubMed

Wang, Ophelia; Zachmann, Luke J; Sesnie, Steven E; Olsson, Aaryn D; Dickson, Brett G

2014-01-01

Prioritizing areas for management of non-native invasive plants is critical, as invasive plants can negatively impact plant community structure. Extensive and multi-jurisdictional inventories are essential to prioritize actions aimed at mitigating the impact of invasions and changes in disturbance regimes. However, previous work devoted little effort to devising sampling methods sufficient to assess the scope of multi-jurisdictional invasion over extensive areas. Here we describe a large-scale sampling design that used species occurrence data, habitat suitability models, and iterative and targeted sampling efforts to sample five species and satisfy two key management objectives: 1) detecting non-native invasive plants across previously unsampled gradients, and 2) characterizing the distribution of non-native invasive plants at landscape to regional scales. Habitat suitability models of five species were based on occurrence records and predictor variables derived from topography, precipitation, and remotely sensed data. We stratified and established field sampling locations according to predicted habitat suitability and phenological, substrate, and logistical constraints. Across previously unvisited areas, we detected at least one of our focal species on 77% of plots. In turn, we used detections from 2011 to improve habitat suitability models and sampling efforts in 2012, as well as additional spatial constraints to increase detections. These modifications resulted in a 96% detection rate at plots. The range of habitat suitability values that identified highly and less suitable habitats and their environmental conditions corresponded to field detections with mixed levels of agreement. Our study demonstrated that an iterative and targeted sampling framework can address sampling bias, reduce time costs, and increase detections. Other studies can extend the sampling framework to develop methods in other ecosystems to provide detection data. The sampling methods

An Iterative and Targeted Sampling Design Informed by Habitat Suitability Models for Detecting Focal Plant Species over Extensive Areas

PubMed Central

Wang, Ophelia; Zachmann, Luke J.; Sesnie, Steven E.; Olsson, Aaryn D.; Dickson, Brett G.

2014-01-01

Prioritizing areas for management of non-native invasive plants is critical, as invasive plants can negatively impact plant community structure. Extensive and multi-jurisdictional inventories are essential to prioritize actions aimed at mitigating the impact of invasions and changes in disturbance regimes. However, previous work devoted little effort to devising sampling methods sufficient to assess the scope of multi-jurisdictional invasion over extensive areas. Here we describe a large-scale sampling design that used species occurrence data, habitat suitability models, and iterative and targeted sampling efforts to sample five species and satisfy two key management objectives: 1) detecting non-native invasive plants across previously unsampled gradients, and 2) characterizing the distribution of non-native invasive plants at landscape to regional scales. Habitat suitability models of five species were based on occurrence records and predictor variables derived from topography, precipitation, and remotely sensed data. We stratified and established field sampling locations according to predicted habitat suitability and phenological, substrate, and logistical constraints. Across previously unvisited areas, we detected at least one of our focal species on 77% of plots. In turn, we used detections from 2011 to improve habitat suitability models and sampling efforts in 2012, as well as additional spatial constraints to increase detections. These modifications resulted in a 96% detection rate at plots. The range of habitat suitability values that identified highly and less suitable habitats and their environmental conditions corresponded to field detections with mixed levels of agreement. Our study demonstrated that an iterative and targeted sampling framework can address sampling bias, reduce time costs, and increase detections. Other studies can extend the sampling framework to develop methods in other ecosystems to provide detection data. The sampling methods

Obstacles to the implementation of the treat-to-target strategy for rheumatoid arthritis in clinical practice in Japan.

PubMed

Kaneko, Yuko; Koike, Takao; Oda, Hiromi; Yamamoto, Kazuhiko; Miyasaka, Nobuyuki; Harigai, Masayoshi; Yamanaka, Hisashi; Ishiguro, Naoki; Tanaka, Yoshiya; Takeuchi, Tsutomu

2015-01-01

To clarify the obstacles preventing the implementation of the treat-to-target (T2T) strategy for rheumatoid arthritis (RA) in clinical practice. A total of 301 rheumatologists in Japan completed a questionnaire. In the first section, participants were indirectly questioned on the implementation of basic components of T2T, and in the second section, participants were directly questioned on their level of agreement and application. Although nearly all participants set treatment targets for the majority of RA patients with moderate to high disease activity, the proportion who set clinical remission as their target was 59%, with only 45% of these using composite measures. The proportion of participants who monitored X-rays and Health Assessment Questionnaires for all their patients was 44% and 14%, respectively. The proportion of participants who did not discuss treatment strategies was 44%, with approximately half of these reasoning that this was due to a proportion of patients having a lack of understanding of the treatment strategy or inability to make decisions. When participants were directly questioned, there was a high level of agreement with the T2T recommendations. Although there was a high level of agreement with the T2T recommendations, major obstacles preventing its full implementation still remain.

Target attribute-based false alarm rejection in small infrared target detection

NASA Astrophysics Data System (ADS)

Kim, Sungho

2012-11-01

Infrared search and track is an important research area in military applications. Although there are a lot of works on small infrared target detection methods, we cannot apply them in real field due to high false alarm rate caused by clutters. This paper presents a novel target attribute extraction and machine learning-based target discrimination method. Eight kinds of target features are extracted and analyzed statistically. Learning-based classifiers such as SVM and Adaboost are developed and compared with conventional classifiers for real infrared images. In addition, the generalization capability is also inspected for various infrared clutters.

Making parks make a difference: poor alignment of policy, planning and management with protected-area impact, and ways forward

PubMed Central

Pressey, Robert L.; Visconti, Piero; Ferraro, Paul J.

2015-01-01

Policy and practice around protected areas are poorly aligned with the basic purpose of protection, which is to make a difference. The difference made by protected areas is their impact, defined in program evaluation as the outcomes arising from protection relative to the counterfactual of no protection or a different form of protection. Although impact evaluation of programs is well established in fields such as medicine, education and development aid, it is rare in nature conservation. We show that the present weak alignment with impact of policy targets and operational objectives for protected areas involves a great risk: targets and objectives can be achieved while making little difference to the conservation of biodiversity. We also review potential ways of increasing the difference made by protected areas, finding a poor evidence base for the use of planning and management ‘levers’ to better achieve impact. We propose a dual strategy for making protected areas more effective in their basic role of saving nature, outlining ways of developing targets and objectives focused on impact while also improving the evidence for effective planning and management. PMID:26460132

Historical and current fire management practices in two wilderness areas in the southwestern United States: The Saguaro Wilderness Area and the Gila-Aldo Leopold Wilderness Complex

Treesearch

Molly E. Hunter; Jose M. Iniguez; Calvin A. Farris

2014-01-01

Fire suppression has been the dominant fire management strategy in the West over the last century. However, managers of the Gila and Aldo Leopold Wilderness Complex in New Mexico and the Saguaro Wilderness Area in Arizona have allowed fire to play a more natural role for decades. This report summarizes the effects of these fire management practices on key resources,...

Market factors and electronic medical record adoption in medical practices.

PubMed

Menachemi, Nir; Mazurenko, Olena; Kazley, Abby Swanson; Diana, Mark L; Ford, Eric W

2012-01-01

Previous studies identified individual or practice factors that influence practice-based physicians' electronic medical record (EMR) adoption. Less is known about the market factors that influence physicians' EMR adoption. The aim of this study was to explore the relationship between environmental market characteristics and physicians' EMR adoption. The Health Tracking Physician Survey 2008 and Area Resource File (2008) were combined and analyzed. Binary logistic regression was used to examine the relationship between three dimensions of the market environment (munificence, dynamism, and complexity) and EMR adoption controlling for several physician and practice characteristics. In a nationally representative sample of 4,720 physicians, measures of market dynamism including increases in unemployment, odds ratio (OR) = 0.95, 95% confidence interval (CI) [0.91, 0.99], or poverty rates, OR = 0.93, 95% CI [0.89, 0.96], were negatively associated with EMR adoption. Health maintenance organization penetration, OR = 3.01, 95% CI [1.49, 6.05], another measure of dynamism, was positively associated with EMR adoption. Physicians practicing in areas with a malpractice crisis, OR = 0.82, 95% CI [0.71, 0.94], representing environmental complexity, had lower EMR adoption rates. Understanding how market factors relate to practice-based physicians' EMR adoption can assist policymakers to better target limited resources as they work to realize the national goal of universal EMR adoption and meaningful use.

Target Practice? Using the Arts for Social Inclusion

ERIC Educational Resources Information Center

Lynch, Heather; Allan, Julie

2007-01-01

Use of creative processes as a tool for social inclusion has gathered momentum in recent years. This article reports the views of education professionals based in Scotland on the use and effects of targeting. While this strategy aims to improve access to those communities considered marginal, it is apparent that some of the effects are detrimental…

The working status of Japanese female physicians by area of practice: cohort analysis of taking leave, returning to work, and changing specialties from 1984 to 2004.

PubMed

Kodama, Tomoko; Koike, Soichi; Matsumoto, Shinya; Ide, Hiroo; Yasunaga, Hideo; Imamura, Tomoaki

2012-05-01

The percentage of females in the physician workforce is increasing in Japan, as in other countries; however, the working status of female physicians has not been sufficiently investigated. Original data were obtained from the National Survey of Physicians (NSP) conducted by the Ministry of Health, Labour and Welfare, Japan, from 1984 to 2004. We examined the trend of female physicians' areas of practice and analyzed their leave, return to work, and change in areas of practice using cohort data. The percentage of female physicians has increased significantly in recent generations, especially in surgery, surgical subareas of practice, and obstetrics and gynecology. A remarkable increase was found in obstetrics and gynecology among women under 29 years old from 15.4 to 66.2%. The total number of female physicians on leave has been higher than the number of female physicians returning since 1998. The average percentage of those who changed their area of practice was high in surgery (20.7%) and low in pediatrics (5.0%) and obstetrics and gynecology (1.7%). A strategic plan is needed for future health policy to plan for the physician workforce, especially for the areas of practice with increasing proportions of young female physicians. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Using Landsat Surface Reflectance Data as a Reference Target for Multiswath Hyperspectral Data Collected Over Mixed Agricultural Rangeland Areas

DOE PAGES

McCann, Cooper; Repasky, Kevin S.; Morin, Mikindra; ...

2017-07-25

Low-cost flight-based hyperspectral imaging systems have the potential to provide important information for ecosystem and environmental studies as well as aide in land management. To realize this potential, methods must be developed to provide large-area surface reflectance data allowing for temporal data sets at the mesoscale. This paper describes a bootstrap method of producing a large-area, radiometrically referenced hyperspectral data set using the Landsat surface reflectance (LaSRC) data product as a reference target. The bootstrap method uses standard hyperspectral processing techniques that are extended to remove uneven illumination conditions between flight passes, allowing for radiometrically self-consistent data after mosaicking. Throughmore » selective spectral and spatial resampling, LaSRC data are used as a radiometric reference target. Advantages of the bootstrap method include the need for minimal site access, no ancillary instrumentation, and automated data processing. Data from two hyperspectral flights over the same managed agricultural and unmanaged range land covering approximately 5.8 km 2 acquired on June 21, 2014 and June 24, 2015 are presented. As a result, data from a flight over agricultural land collected on June 6, 2016 are compared with concurrently collected ground-based reflectance spectra as a means of validation.« less

Using Landsat Surface Reflectance Data as a Reference Target for Multiswath Hyperspectral Data Collected Over Mixed Agricultural Rangeland Areas

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

McCann, Cooper; Repasky, Kevin S.; Morin, Mikindra

Low-cost flight-based hyperspectral imaging systems have the potential to provide important information for ecosystem and environmental studies as well as aide in land management. To realize this potential, methods must be developed to provide large-area surface reflectance data allowing for temporal data sets at the mesoscale. This paper describes a bootstrap method of producing a large-area, radiometrically referenced hyperspectral data set using the Landsat surface reflectance (LaSRC) data product as a reference target. The bootstrap method uses standard hyperspectral processing techniques that are extended to remove uneven illumination conditions between flight passes, allowing for radiometrically self-consistent data after mosaicking. Throughmore » selective spectral and spatial resampling, LaSRC data are used as a radiometric reference target. Advantages of the bootstrap method include the need for minimal site access, no ancillary instrumentation, and automated data processing. Data from two hyperspectral flights over the same managed agricultural and unmanaged range land covering approximately 5.8 km 2 acquired on June 21, 2014 and June 24, 2015 are presented. As a result, data from a flight over agricultural land collected on June 6, 2016 are compared with concurrently collected ground-based reflectance spectra as a means of validation.« less

Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update.

PubMed

Denduluri, Neelima; Chavez-MacGregor, Mariana; Telli, Melinda L; Eisen, Andrea; Graff, Stephanie L; Hassett, Michael J; Holloway, Jamie N; Hurria, Arti; King, Tari A; Lyman, Gary H; Partridge, Ann H; Somerfield, Mark R; Trudeau, Maureen E; Wolff, Antonio C; Giordano, Sharon H

2018-05-22

Purpose To update key recommendations of the ASCO guideline adaptation of the Cancer Care Ontario guideline on the selection of optimal adjuvant chemotherapy regimens for early breast cancer and adjuvant targeted therapy for breast cancer. Methods An Expert Panel conducted targeted systematic literature reviews guided by a signals approach to identify new, potentially practice-changing data that might translate to revised practice recommendations. Results The Expert Panel reviewed phase III trials that evaluated adjuvant capecitabine after completion of standard preoperative anthracycline- and taxane-based combination chemotherapy by patients with early-stage breast cancer HER2-negative breast cancer with residual invasive disease at surgery; the addition of 1 year of adjuvant pertuzumab to combination chemotherapy and trastuzumab for patients with early-stage, HER2-positive breast cancer; and the use of neratinib as extended adjuvant therapy for patients after combination chemotherapy and trastuzumab-based adjuvant therapy with early-stage, HER2-positive breast cancer. Recommendations Patients with early-stage HER2-negative breast cancer with pathologic, invasive residual disease at surgery following standard anthracycline- and taxane-based preoperative therapy may be offered up to six to eight cycles of adjuvant capecitabine. Clinicians may add 1 year of adjuvant pertuzumab to trastuzumab-based combination chemotherapy in patients with high-risk, early-stage, HER2-positive breast cancer. Clinicians may use extended adjuvant therapy with neratinib to follow trastuzumab in patients with early-stage, HER2-positive breast cancer. Neratinib causes substantial diarrhea, and diarrhea prophylaxis must be used. Additional information can be found at www.asco.org/breast-cancer-guidelines .

The virtual practice: using the residents' continuity clinic to teach practice management and systems-based practice.

PubMed

Perez, Jose A; Faust, Cheryl; Kenyon, Angie

2009-09-01

Education in systems-based practice is a required component of all postgraduate medical education programs in the United States. Competency in this area requires that trainees have an understanding of the health care system sufficient to provide optimal care to patients. Most trainees in residency programs have little understanding of the complexities and challenges of present-day practice in the current system of care and consider themselves unprepared to undertake this activity following completion of training. Training in practice management in residency programs has not been emphasized as an important component of systems-based practice. Historically, practice management training in residency programs has been done using a fully didactic model, and residents have expressed a desire to learn this skill by becoming more directly involved in the operations and management of a practice. The patient visit touches many aspects of the health care system, including clinic operations, insurance, quality, and finances. At our institution, we used the residents' continuity clinic practices as a vehicle to provide education in practice management and systems-based practice by creating a curriculum that included the residents' perceived gaps in knowledge regarding going into practice. This is known as the virtual practice. This curriculum is taught using data obtained from residents' practice to illustrate concepts in many areas, including primary practice operations, malpractice insurance, financial benchmarks, and career planning. Resident self-assessed knowledge of these areas increased after participating in the curriculum, and resident testimonials indicate satisfaction with the project. In addition, residents have become engaged and interested in how their effort translates into performance and how they participate in the health care system.

Use of methods for specifying the target difference in randomised controlled trial sample size calculations: Two surveys of trialists' practice.

PubMed

Cook, Jonathan A; Hislop, Jennifer M; Altman, Doug G; Briggs, Andrew H; Fayers, Peter M; Norrie, John D; Ramsay, Craig R; Harvey, Ian M; Vale, Luke D

2014-06-01

Central to the design of a randomised controlled trial (RCT) is a calculation of the number of participants needed. This is typically achieved by specifying a target difference, which enables the trial to identify a difference of a particular magnitude should one exist. Seven methods have been proposed for formally determining what the target difference should be. However, in practice, it may be driven by convenience or some other informal basis. It is unclear how aware the trialist community is of these formal methods or whether they are used. To determine current practice regarding the specification of the target difference by surveying trialists. Two surveys were conducted: (1) Members of the Society for Clinical Trials (SCT): participants were invited to complete an online survey through the society's email distribution list. Respondents were asked about their awareness, use of, and willingness to recommend methods; (2) Leading UK- and Ireland-based trialists: the survey was sent to UK Clinical Research Collaboration registered Clinical Trials Units, Medical Research Council UK Hubs for Trial Methodology Research, and the Research Design Services of the National Institute for Health Research. This survey also included questions about the most recent trial developed by the respondent's group. Survey 1: Of the 1182 members on the SCT membership email distribution list, 180 responses were received (15%). Awareness of methods ranged from 69 (38%) for health economic methods to 162 (90%) for pilot study. Willingness to recommend among those who had used a particular method ranged from 56% for the opinion-seeking method to 89% for the review of evidence-base method. Survey 2: Of the 61 surveys sent out, 34 (56%) responses were received. Awareness of methods ranged from 33 (97%) for the review of evidence-base and pilot methods to 14 (41%) for the distribution method. The highest level of willingness to recommend among users was for the anchor method (87%). Based upon

Evolving Concepts in Posterior Subthalamic Area Deep Brain Stimulation for Treatment of Tremor: Surgical Neuroanatomy and Practical Considerations.

PubMed

Ramirez-Zamora, Adolfo; Smith, Heather; Kumar, Vignessh; Prusik, Julia; Phookan, Sujoy; Pilitsis, Julie G

2016-01-01

Although thalamic deep brain stimulation (DBS) has been established as an effective therapy for refractory tremor in Parkinson's disease and essential tremor, reports investigating the efficacy of posterior subthalamic area (PSA) DBS for severe, debilitating tremors continue to emerge. However, questions regarding the optimal anatomical target, surgical approach, programming paradigms and effectiveness compared to other targets remain. In this report, we aimed to review the current literature to assess different stereotactic techniques, anatomical considerations, adverse effects and stimulation settings in PSA DBS. A comprehensive literature review was performed searching for articles discussing tremors and PSA stimulation. We performed a quantitative analysis comparing different DBS tremor targets. Tremor improvement is consistently documented in most reports with an average reduction in tremor of 79% depending on the specific tremor syndrome. Tremor benefit in patients with multiple sclerosis (MS) tremor was significantly higher than for other stimulation targets. Transient paresthesias, imbalance, dizziness and dysarthria are the most common side effects with PSA DBS. PSA DBS is an effective and safe treatment for tremor control and should be considered in patients with refractory tremors with associated cerebellar or dystonic features, proximal tremors and MS tremor. © 2016 S. Karger AG, Basel.

Diabetes area participation analysis: a review of companies and targets described in the 2008 - 2010 patent literature.

PubMed

Carpino, Philip A; Goodwin, Bryan

2010-12-01

Type 2 diabetes is a chronic disease characterized by the development of insulin resistance, impaired pancreatic β-cell function and, ultimately, hyperglycemia. The disease is highly associated with obesity and it is thought that the inappropriate deposition of lipid in tissues such as liver and muscle contributes to a reduction in insulin sensitivity which, in turn, places a burden on the β-cell to secrete more insulin to achieve normoglycemia. Over an extended period of time, this can result in β-cell failure and diminished glycemic control. When poorly managed, type 2 diabetes increases the risk of developing both microvascular and macrovascular complications, including retinopathy, nephropathy and coronary artery disease. The number of Americans with diabetes has approached 24 million in 2007 and the prevalence of the disease is projected to increase with the sedentary lifestyles and high caloric diets that are common today. First-line treatment for the disease involves lifestyle modifications and, if unsuccessful, pharmacotherapy to control symptoms. Anti-diabetic drugs belonging to several mechanistic classes are available (e.g., insulin secretagogues, insulin sensitizers, insulin mimetics and DPP IV inhibitors); however, many of these drugs lose their effectiveness over time, are not well-tolerated in some patients or may have suboptimal risk:benefit ratios. The search for new anti-diabetic drugs has continued to attract considerable interest from both academia and the pharmaceutical industry. An analysis of 2008 - 2010 patent applications claiming diabetes as an indication has been undertaken. An understanding of: i) the pharmaceutical companies that have filed patent applications in the anti-diabetes area during 2008 - 2010; ii) the different pharmacological targets under investigation and the patent activity around such targets; iii) some of the targets in the research portfolios of selected companies; iv) chemical structures of compounds that modulate

Evidence-based practice in Behçet’s disease: identifying areas of unmet need for 2014

PubMed Central

2014-01-01

Background Behçet’s Disease (BD) is characterized by a relapsing-remitting course, with symptoms of varying severity across almost all organ systems. There is a diverse array of therapeutic options with no universally accepted treatment regime, and it is thus important that clinical practice is evidence-based. We reviewed all currently available literature describing management of BD, and investigated whether evidence-based practice is possible for all disease manifestations, and assessed the range of therapeutic options tested. Methods We conducted an internet search of all literature describing management of BD up to August 2013, including pharmacological and non-pharmacological interventions. We recorded treatment options investigated and disease manifestations reported as primary and secondary study outcomes. Quality of data was assessed according to the Scottish Intercollegiate Guideline Network (SIGN) hierarchy of evidence. Results Whilst there is much literature describing treatment of ocular and mucocutaneous disease, there is little to guide management of rheumatoid, cardiovascular and neurological disease. This broadly reflects the prevalence of disease manifestations of BD, but not the severity. Biologic therapies are the most commonly investigated intervention. The proportion of SIGN-1 graded studies is declining, and there are no SIGN-1 graded studies investigating neurological or gastrointestinal manifestations of BD. Conclusions This is the first study to investigate trends in published literature for management of BD over time. It identifies neurological, cardiovascular and gastro-intestinal disease as particular areas of unmet need and suggests that overall quality of evidence is declining. Future research should be designed to address these areas of insufficiency to facilitate evidence-based practice in BD. PMID:24475935

Disentangling Mathematics Target and Access Skills: Implications for Accommodation Assignment Practices

ERIC Educational Resources Information Center

Ketterlin-Geller, Leanne R.; Jamgochian, Elisa M.; Nelson-Walker, Nancy J.; Geller, Joshua P.

2012-01-01

Appropriate assignment of accommodations is predicated on a clear distinction between target skills and access skills. In this study, we examine the agreement between test developer/researchers' and educators' classification of target and access skills as a possible explanatory mechanism for assigning accommodations. Findings indicate that…

Soil-air greenhouse gas fluxes influenced by farming practices in reservoir drawdown area: A case at the Three Gorges Reservoir in China.

PubMed

Li, Zhe; Zhang, Zengyu; Lin, Chuxue; Chen, Yongbo; Wen, Anbang; Fang, Fang

2016-10-01

The Three Gorges Reservoir (TGR) in China has large water level variations, creating about 393 km(2) of drawdown area seasonally. Farming practices in drawdown area during the low water level period is common in the TGR. Field experiments on soil-air greenhouse gas (GHG) emissions in fallow grassland, peanut field and corn field in reservoir drawdown area at Lijiaba Bay of the Pengxi River, a tributary of the Yangtze River in the TGR were carried out from March through September 2011. Experimental fields in drawdown area had the same land use history. They were adjacent to each other horizontally at a narrow range of elevation i.e. 167-169 m, which assured that they had the same duration of reservoir inundation. Unflooded grassland with the same land-use history was selected as control for study. Results showed that mean value of soil CO2 emissions in drawdown area was 10.38 ± 0.97 mmol m(-2) h(-1). The corresponding CH4 fluxes and N2O fluxes were -8.61 ± 2.15 μmol m(-2) h(-1) and 3.42 ± 0.80 μmol m(-2) h(-1). Significant differences and monthly variations among land uses in treatments of drawdown area and unflooded grassland were evident. These were impacted by the change in soil physiochemical properties which were alerted by reservoir operation and farming. Particularly, N-fertilization in corn field stimulated N2O emissions from March to May. In terms of global warming potentials (GWP), corn field in drawdown area had the maximum GWP mainly due to N-fertilization. Gross GWP in peanut field in drawdown area was about 7% lower than that in fallow grassland. Compared to unflooded grassland, reservoir operation created positive net effect on GHG emissions and GWPs in drawdown area. However, selection of crop species, e.g. peanut, and best practices in farming, e.g. prohibiting N-fertilization, could potentially mitigate GWPs in drawdown area. In the net GHG emissions evaluation in the TGR, farming practices in the drawdown area shall be taken

Infant feeding practices of working mothers in an urban area.

PubMed

Thimmayamma, B V; Vidyavati, M; Belavady, B

1980-12-01

Information on infant feeding practices was collected from 410 educated, working mothers in a urban area. The mean duration for breast feeding was 4.1 months. Early introduction of supplements was the rule. About 61% of mothers used commercial baby foods, though with certain problems. More than 90% of mothers considered breast milk as the best food for infants. About 63% expressed a desire to have more knowledge on their responsibilities and infant care. Working mothers found it difficult to work outside their homes and at the same time care for their infants, because of several problems. They preferred joint families for better child care. The majority of women wanted well-maintained creches, an incease in number and duration of breaks for nursing their infants, and the option of part-time work to help them give proper care to the children. The problems with commercial baby food concerned the proportion of water to powder, which most mothers (62.1%) found too high for the infant to digest. Creche facilities near the place of work were available to 27.8% of mothers. Only 20% used them. 72% of mothers who had no creche facilities used relatives, neighbors, or servants.

Internal Targeting and External Control: Phototriggered Targeting in Nanomedicine.

PubMed

Arrue, Lily; Ratjen, Lars

2017-12-07

The photochemical control of structure and reactivity bears great potential for chemistry, biology, and life sciences. A key feature of photochemistry is the spatiotemporal control over secondary events. Well-established applications of photochemistry in medicine are photodynamic therapy (PDT) and photopharmacology (PP). However, although both are highly localizable through the application of light, they lack cell- and tissue-specificity. The combination of nanomaterial-based drug delivery and targeting has the potential to overcome limitations for many established therapy concepts. Even more privileged seems the merger of nanomedicine and cell-specific targeting (internal targeting) controlled by light (external control), as it can potentially be applied to many different areas of medicine and pharmaceutical research, including the aforementioned PDT and PP. In this review a survey of the interface of photochemistry, medicine and targeted drug delivery is given, especially focusing on phototriggered targeting in nanomedicine. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Contributions of treatment theory and enablement theory to rehabilitation research and practice.

PubMed

Whyte, John

2014-01-01

Scientific theory is crucial to the advancement of clinical research. The breadth of rehabilitation treatment requires that many different theoretical perspectives be incorporated into the design and testing of treatment interventions. In this article, the 2 broad classes of theory relevant to rehabilitation research and practice are defined, and their distinct but complementary contributions to research and clinical practice are explored. These theory classes are referred to as treatment theories (theories about how to effect change in clinical targets) and enablement theories (theories about how changes in a proximal clinical target will influence distal clinical aims). Treatment theories provide the tools for inducing clinical change but do not specify how far reaching the ultimate impact of the change will be. Enablement theories model the impact of changes on other areas of function but provide no insight as to how treatment can create functional change. Treatment theories are more critical in the early stages of treatment development, whereas enablement theories become increasingly relevant in specifying the clinical significance and practical effectiveness of more mature treatments. Understanding the differences in the questions these theory classes address and how to combine their insights is crucial for effective research development and clinical practice. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Statistical Algorithms Accounting for Background Density in the Detection of UXO Target Areas at DoD Munitions Sites

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

Matzke, Brett D.; Wilson, John E.; Hathaway, J.

2008-02-12

Statistically defensible methods are presented for developing geophysical detector sampling plans and analyzing data for munitions response sites where unexploded ordnance (UXO) may exist. Detection methods for identifying areas of elevated anomaly density from background density are shown. Additionally, methods are described which aid in the choice of transect pattern and spacing to assure with degree of confidence that a target area (TA) of specific size, shape, and anomaly density will be identified using the detection methods. Methods for evaluating the sensitivity of designs to variation in certain parameters are also discussed. Methods presented have been incorporated into the Visualmore » Sample Plan (VSP) software (free at http://dqo.pnl.gov/vsp) and demonstrated at multiple sites in the United States. Application examples from actual transect designs and surveys from the previous two years are demonstrated.« less

Knowledge and self-reported practices regarding leptospirosis among adolescent school children in a highly endemic rural area in Sri Lanka.

PubMed

Samarakoon, Yasara M; Gunawardena, Nalika

2013-01-01

Leptospirosis is a zoonotic disease, which has become a major public health threat in Sri Lanka. A majority of patients are farmers in rural endemic areas. The purpose of the present study is to describe the level of knowledge and frequencies of risky practices related to leptospirosis among a sample of rural school adolescents in Galgamuwa, Kurunegala district, a highly endemic area in Sri Lanka. A descriptive cross-sectional study was conducted among 460 adolescents studying in grades 9 and 10 of government schools. Study participants were selected using a multistage cluster sampling technique. A structured, pretested, self-administered questionnaire was used to collect data on sociodemographic characteristics, knowledge on leptospirosis, and frequency of associated risky practices related to leptospirosis. The response rate was 100%. Fifty-two percent of respondents had a 'good' level of knowledge of leptospirosis. In the assessment of practices, 62% were involved in rice paddy cultivation either 'frequently' or 'rarely'. Seventy percent of the fathers and 50% of the mothers of the students were involved in paddy cultivation. Thirteen percent reported that they swam, bathed, or washed in ponds of stagnant water. Of the students involved in paddy cultivation, only 18% said they usually used gloves and boots 'frequently'. Among the 9% of students who handled cattle or buffalo, 61% reported washing their hands and feet after handling the animals. Good level of knowledge was significantly associated with involvement in paddy cultivation among the adolescents (p=0.45), fathers (p<0.001), and mothers (p=0.012). The level of knowledge was not significantly associated with practicing preventive measures for leptospirosis. Although the respondent's overall level of knowledge regarding leptospirosis was satisfactory, the study identified several important gaps in specific areas. Those who were involved or had parents involved in paddy cultivation had better knowledge

First year undergraduate nursing students and nursing mentors: An evaluation of their experience of specialist areas as their hub practice learning environment.

PubMed

McCallum, Jacqueline; Lamont, David; Kerr, Emma-Louise

2016-01-01

Specialist environments have traditionally not been considered as practice learning environments for year one nursing students. Through implementation of the hub and spoke model of practice learning this was implemented across one health board and Higher Education Institution in Scotland. Sixty nine students from specialist and 147 from general areas out of a total population of 467 students (46.2%) and thirteen mentors from specialist and 26 from general areas out of a total 577 mentors (6.7%) completed a questionnaire. The findings support this initiative and suggest in some cases student experiences are more positive in specialist environments. Copyright © 2015 Elsevier Ltd. All rights reserved.

KNOWLEDGE, ATTITUDES AND PRACTICES OF HEPATITIS B AND C AMONG BARBERS OF URBAN AND RURAL AREAS OF RAWALPINDI AND ISLAMABAD.

PubMed

Shah, Hassan Bin Usman; Dar, Mohsin Khalil; Jamil, Anique Ahmad; Atif, Iffat; Ali, Raja Jazib; Sindhu, Ali Shan; Usmani, Abdul Qadir

2015-01-01

Hepatitis B and Hepatitis C are serious global public health problems with a prevalence of 10-15% with majority of the cases seen in the developing countries including Pakistan. It is a blood borne infection transmitted by infected blood and blood products through transfusions, contaminated needles, vertical transmission, unsafe sex and reuse of razors by barbers. The literature search so far did not reveal any study comparing knowledge, attitude and practices of hepatitis B & C in barbers working in Urban and rural areas. A comparative cross sectional survey was carried out among barbers of urban and rural areas of Rawalpindi and Islamabad. A structured close ended questionnaire was filled from total of 202 barbers by non-probability convenience sampling technique. Comparative data analysis was done including variables like age, education, knowledge about hepatitis B & C, mode of transmission, role of the blades and media etc. Knowledge about hepatitis B & C was good in urban areas (92%) as compared to those working in the rural areas (68%). Using new blade for every customer was seen in urban (100%) and rural (93%) area. However barbers knowledge about symptoms of the disease (urban 81% & rural 93%) and vaccination trend of Hepatitis B was low. This study showed a marked difference in the knowledge, attitude and practices of the barbers working in the urban and the rural areas. Main focus should be on launching Health education programs and behaviour change communication campaigns for the barbers. Strict regulatory monitoring must be done against unlicensed street barbers.

The Effects of Practice-Based Training on Graduate Teaching Assistants' Classroom Practices.

PubMed

Becker, Erin A; Easlon, Erin J; Potter, Sarah C; Guzman-Alvarez, Alberto; Spear, Jensen M; Facciotti, Marc T; Igo, Michele M; Singer, Mitchell; Pagliarulo, Christopher

2017-01-01

Evidence-based teaching is a highly complex skill, requiring repeated cycles of deliberate practice and feedback to master. Despite existing well-characterized frameworks for practice-based training in K-12 teacher education, the major principles of these frameworks have not yet been transferred to instructor development in higher educational contexts, including training of graduate teaching assistants (GTAs). We sought to determine whether a practice-based training program could help GTAs learn and use evidence-based teaching methods in their classrooms. We implemented a weekly training program for introductory biology GTAs that included structured drills of techniques selected to enhance student practice, logic development, and accountability and reduce apprehension. These elements were selected based on their previous characterization as dimensions of active learning. GTAs received regular performance feedback based on classroom observations. To quantify use of target techniques and levels of student participation, we collected and coded 160 h of video footage. We investigated the relationship between frequency of GTA implementation of target techniques and student exam scores; however, we observed no significant relationship. Although GTAs adopted and used many of the target techniques with high frequency, techniques that enforced student participation were not stably adopted, and their use was unresponsive to formal feedback. We also found that techniques discussed in training, but not practiced, were not used at quantifiable frequencies, further supporting the importance of practice-based training for influencing instructional practices. © 2017 E. A. Becker et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License

Current practices in the management of adverse events associated with targeted therapies for advanced renal cell carcinoma: a national survey of oncologists.

PubMed

Ruiz, Janelle Nicole; Belum, Viswanath Reddy; Creel, Patricia; Cohn, Allen; Ewer, Michael; Lacouture, Mario E

2014-10-01

Oncologists treating patients with targeted therapies encounter adverse events (AEs) that pose management challenges, lead to dosing inconsistencies, and impact patient quality of life. Oncologists' practices and attitudes in the management of targeted therapy-related AEs in patients with renal cell carcinoma (RCC) are poorly understood. We sought to identify unmet needs associated with AE management and understand oncologists' treatment optimization strategies. A 24-item online survey was administered in August 2012 to 119 US oncologists treating patients with advanced RCC. The survey solicited responses regarding demographics, practice settings, AE management practice patterns and beliefs, treatment barriers, and patient education. Respondents indicated that between 25% and 50% of patients require dose modification/discontinuation because of AEs. The greatest barrier to optimizing treatment for RCC is the unpredictability of patient responses to treatment (43%). Most respondents (78%) discuss AE management with patients, but only a minority of them proactively reach out to patients (46%). Most practitioners (70%) refer patients to nononcology specialists when faced with unfamiliar AEs, although finding interested physicians (43%) and time constraints (40%) were the most commonly cited barriers to consulting with other specialties. Results suggest that many patients require dose modification/discontinuation because of AEs and that nononcologists are a frequently utilized resource to manage these events. There is a need for predictive drug toxicity markers to establish counseling and prevention, along with opportunities for increased education on supportive care techniques to maintain health-related quality of life and consistent dosing. Copyright © 2014 Elsevier Inc. All rights reserved.

"Academic drug-detailing": from project to practice in a Swedish urban area.

PubMed

Lundborg, C S; Hensjö, L O; Gustafsson, L L

1997-01-01

To develop and test the long-term feasibility of an interdisciplinary independent drug information service providing both written and oral drug information to physicians in an urban area of Sweden (> 400,000 inhabitants). A drug information service was developed encouraging a cooperative approach between a department of clinical pharmacology, general practitioners (GPs), pharmacists, and Drug and Therapeutic Committees. Scientifically-based drug information was condensed and interpreted by a team and presented in both written and oral form. In one part of the area, both oral and written information was provided, while in another part of the area, only written information was distributed. Questionnaires and one prescription survey were performed to elucidate the knowledge and attitudes of the GPs regarding drug treatment of one condition (urinary tract infection, UTI, and norfloxacin were used as examples), as well as their opinion of our services. Over a period of 10 years, 75 issues of a drug bulletin (2000 copies) were distributed. Oral producer-independent drug information, provided jointly by a GP and a pharmacist, was given on 16 occasions in each of 30 health centres (150 GPs). Around 80% of the GPs participated in the meetings. Of these GPs, 75% found the service important for their daily work. A majority of the GPs had prescribed the test drug, norfloxacin, not a first-line drug according to local recommendations, 1 year after approval. A significantly lower proportion of prescribers were observed in the area where the GPs had been provided with both written and oral information regarding recommended treatment (including first-line drugs) for uncomplicated cystitis. The approximate cost for this service in 1995 was SEK 0.685 million (USD 0.1 million); the prescribing costs of the 150 GPs were estimated at SEK 255 million per year. This means that the cost of the service per GP is only around 0.3% of normal prescribing costs. Over a period of 10 years the

Cancer Screening Practices among Physicians Serving Chinese Immigrants

PubMed Central

Aragones, Abraham; Trinh-Shevrin, Chau; Gany, Francesca

2012-01-01

Chinese immigrants in the United States are broadly affected by cancer health disparities. We examined the cancer screening attitudes and practices of physicians serving Chinese immigrants in the New York City (NYC) area by mailing a cancer screening survey, based on current guidelines, to a random sample of physicians serving this population. Fifty three physicians (44%) completed the survey. Seventy-two percent reported following the guidelines for breast cancer, 35% for cervical cancer screening, and 45% for all colorectal cancer screening tests. Sixty-eight percent of physicians were satisfied with their current rates of cancer screening with their Chinese immigrant patient population. Physicians serving the Chinese community in NYC follow cancer screening guidelines inadequately. Cancer screening rates in this population could likely be increased by interventions that target physicians and improve awareness of guidelines and recommended best practices. PMID:19202247

From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis.

PubMed

Armstrong, April W; Siegel, Michael P; Bagel, Jerry; Boh, Erin E; Buell, Megan; Cooper, Kevin D; Callis Duffin, Kristina; Eichenfield, Lawrence F; Garg, Amit; Gelfand, Joel M; Gottlieb, Alice B; Koo, John Y M; Korman, Neil J; Krueger, Gerald G; Lebwohl, Mark G; Leonardi, Craig L; Mandelin, Arthur M; Menter, M Alan; Merola, Joseph F; Pariser, David M; Prussick, Ronald B; Ryan, Caitriona; Shah, Kara N; Weinberg, Jeffrey M; Williams, MaryJane O U; Wu, Jashin J; Yamauchi, Paul S; Van Voorhees, Abby S

2017-02-01

An urgent need exists in the United States to establish treatment goals in psoriasis. We aim to establish defined treatment targets toward which clinicians and patients with psoriasis can strive to inform treatment decisions, reduce disease burden, and improve outcomes in practice. The National Psoriasis Foundation conducted a consensus-building study among psoriasis experts using the Delphi method. The process consisted of: (1) literature review, (2) pre-Delphi question selection and input from general dermatologists and patients, and (3) 4 Delphi rounds. A total of 25 psoriasis experts participated in the Delphi process. The most preferred instrument was body surface area (BSA). The most preferred time for evaluating patient response after starting new therapies was at 3 months. The acceptable response at 3 months postinitiation was either BSA 3% or less or BSA improvement 75% or more from baseline. The target response at 3 months postinitiation was BSA 1% or less. During the maintenance period, evaluation every 6 months was most preferred. The target response at every 6 months maintenance evaluation is BSA 1% or less. Although BSA is feasible in practice, it does not encompass health-related quality of life, costs, and risks of side effects. With defined treatment targets, clinicians and patients can regularly evaluate treatment responses and perform benefit-risk assessments of therapeutic options individualized to the patient. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Impact of targeted counseling on reported vaginal hygiene practices and bacterial vaginosis: the HIV Prevention Trials Network 035 study.

PubMed

Kasaro, Margaret P; Husnik, Marla J; Chi, Benjamin H; Reid, Cheri; Magure, Tsitsi; Makanani, Bonus; Tembo, Tchangani; Ramjee, Gita; Maslankowski, Lisa; Rabe, Lorna; Brad Guffey, M

2017-04-01

The objective of this study was to describe the impact of intense counseling to reduce vaginal hygiene practices and its effect on bacterial vaginosis. A secondary data analysis of the HIV Prevention Trials Network 035 study was undertaken, focusing on HIV-negative, nonpregnant women who were at least 18 years old, in seven African sites and one US site. At enrollment and during follow-up quarterly visits, vaginal hygiene practices were determined by face-to-face administration of a behavioral assessment questionnaire. Vaginal hygiene practices were categorized as insertion into the vagina of (1) nothing, (2) water only, and (3) other substances with or without water. Each practice was quantified by frequency and type/combination of inserted substances. At quarterly visits, diagnosis of bacterial vaginosis was made using the Nugent score. Trends for vaginal hygiene practices and bacterial vaginosis were evaluated using generalized estimating equation models. A total of 3087 participants from the HIV Prevention Trials Network 035 study were eligible for this analysis. At enrollment, 1859 (60%) reported recent vaginal hygiene practices. By one year, this figure had decreased to 1019 (33%) with counseling. However, bacterial vaginosis prevalence remained consistent across the study observation period, with 36%-38% of women testing positive for the condition ( p for trend = 0.27). Overall, those who reported douching with water only (AOR = 1.03, 95%CI: 0.94-1.13) and those who reported inserting other substances (AOR= 0.98, 95%CI: 0.88-1.09) in the past quarter were not more likely to have bacterial vaginosis compared to those who reported no insertions. However, in South Africa, an increase in bacterial vaginosis was seen among those who reported inserting other substances (AOR: 1.48, 95%CI: 1.17, 1.88). In conclusion, targeted counseling against vaginal hygiene practices resulted in change in self-reported behavior but did not have an impact on bacterial vaginosis

End-of-life care practices of critical care nurses: A national cross-sectional survey.

PubMed

Ranse, Kristen; Yates, Patsy; Coyer, Fiona

2016-05-01

The critical care context presents important opportunities for nurses to deliver skilled, comprehensive care to patients at the end of life and their families. Limited research has identified the actual end-of-life care practices of critical care nurses. To identify the end-of-life care practices of critical care nurses. A national cross-sectional online survey. The survey was distributed to members of an Australian critical care nursing association and 392 critical care nurses (response rate 25%) completed the survey. Exploratory factor analysis using principal axis factoring with oblique rotation was undertaken on survey responses to identify the domains of end-of-life care practice. Descriptive statistics were calculated for individual survey items. Exploratory factor analysis identified six domains of end-of-life care practice: information sharing, environmental modification, emotional support, patient and family centred decision-making, symptom management and spiritual support. Descriptive statistics identified a high level of engagement in information sharing and environmental modification practices and less frequent engagement in items from the emotional support and symptom management practice areas. The findings of this study identified domains of end-of-life care practice, and critical care nurse engagement in these practices. The findings highlight future training and practice development opportunities, including the need for experiential learning targeting the emotional support practice domain. Further research is needed to enhance knowledge of symptom management practices during the provision of end-of-life care to inform and improve practice in this area. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

A novel algorithm for finding optimal driver nodes to target control complex networks and its applications for drug targets identification.

PubMed

Guo, Wei-Feng; Zhang, Shao-Wu; Shi, Qian-Qian; Zhang, Cheng-Ming; Zeng, Tao; Chen, Luonan

2018-01-19

The advances in target control of complex networks not only can offer new insights into the general control dynamics of complex systems, but also be useful for the practical application in systems biology, such as discovering new therapeutic targets for disease intervention. In many cases, e.g. drug target identification in biological networks, we usually require a target control on a subset of nodes (i.e., disease-associated genes) with minimum cost, and we further expect that more driver nodes consistent with a certain well-selected network nodes (i.e., prior-known drug-target genes). Therefore, motivated by this fact, we pose and address a new and practical problem called as target control problem with objectives-guided optimization (TCO): how could we control the interested variables (or targets) of a system with the optional driver nodes by minimizing the total quantity of drivers and meantime maximizing the quantity of constrained nodes among those drivers. Here, we design an efficient algorithm (TCOA) to find the optional driver nodes for controlling targets in complex networks. We apply our TCOA to several real-world networks, and the results support that our TCOA can identify more precise driver nodes than the existing control-fucus approaches. Furthermore, we have applied TCOA to two bimolecular expert-curate networks. Source code for our TCOA is freely available from http://sysbio.sibcb.ac.cn/cb/chenlab/software.htm or https://github.com/WilfongGuo/guoweifeng . In the previous theoretical research for the full control, there exists an observation and conclusion that the driver nodes tend to be low-degree nodes. However, for target control the biological networks, we find interestingly that the driver nodes tend to be high-degree nodes, which is more consistent with the biological experimental observations. Furthermore, our results supply the novel insights into how we can efficiently target control a complex system, and especially many evidences on the

Best management practices for riparian areas

Treesearch

Michael J. Phillips; Lloyd W. Swift; Charles R. Blinn

2000-01-01

Forest streams, lakes, and other water bodies create unique conditions along their margins that control and influence transfers of energy, nutrients, and sediments between aquatic and terrestrial systems. These riparian areas are among the most critical features of the landscape because they contain a rich diversity of plants and animals and help to maintain water...

Efficient phosphorus management practices in the Everglades Agricultural Area

NASA Astrophysics Data System (ADS)

Bhadha, J. H.; Lang, T. A.; Daroub, S. H.; Alvarez, O.; Tootoonchi, M.; Capasso, J.

2016-12-01

In the 450,000 acres of the Everglades Agricultural Area (EAA) of South Florida, farming practices have long been mindful of phosphorus (P) management as it relates to sufficiency and efficiency of P utilization. Over two decades of P best management practices have resulted in 3001 metric-ton of P load reduction from the EAA to downstream ecosystems. During the summer, more than 50,000 acres of fallow sugarcane land is available for rice production. The net value of growing flooded rice in the EAA as a rotational crop with sugarcane far exceeds its monetary return. Soil conservation, improvement in tilth and P load reduction are only some of the benefits. With no P fertilizer applied, a two-year field trial on flooded rice showed improved outflow P concentrations by up to 40% as a result of particulate setting and plant P uptake. Harvested whole grain rice can effectively remove a significant amount of P from a rice field per growing season. In parts of the EAA where soils are sandy, the application of using locally derived organic amendments as potential P fertilizer has gained interest over the past few years. The use of local agricultural and urban organic residues as amendments in sandy soils of South Florida provide options to enhance soil properties and improve sugarcane yields, while reducing waste and harmful effects of agricultural production on the environment. A lysimeter study conducted to determine the effect of mill ash and three types of biochar (rice hulls, yard waste, horse bedding) on sugarcane yields, soil properties, and drainage water quality in sandy soils showed that mill ash and rice hull biochar increased soil TP, Mehlich 3-P (M3-P), and cation exchange capacity (CEC) compared to the control. TP and M3-P content remained constant after 9 months, CEC showed a significant increase over time with rich hull biochar addition. Future projects include the utilization of aquatic vegetation, such as chara and southern naiad as bio-filters in farm

Characteristics of Japanese medical students associated with their intention for rural practice.

PubMed

Kawamoto, Ryuichi; Uemoto, Asuka; Ninomiya, Daisuke; Hasegawa, Youichi; Ohtsuka, Nobuyuki; Kusunoki, Tomo; Kumagi, Teru; Abe, Masanori

2015-01-01

In Japan, the maldistribution of physicians between urban and rural areas is increasing. It is important to know the practice location expectations of future physicians. The study was designed as a cross-sectional survey. In 2009-2013, students at a medical school in Japan completed a questionnaire containing 50 items with four-point Likert scales. The students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to state their intention to practice in a rural area. The study sample consisted of 368 students (88.2% response rate). Significant variables that were associated with a positively motivated intent for rural practice were 'presence of a role model' (odds ratio (OR), 5.42; 95% confidence interval (CI), 1.58-18.5), 'admission by school recommendation' (OR, 7.68; 95%CI, 2.14-27.6), 'growing up in a rural area' (OR, 6.16; 95%CI, 1.01-37.6), 'general medicine/family medicine as the first career choice' (OR, 5.88; 95%CI, 2.43-14.2), 'interest in the targeted population' (OR, 16.7; 95%CI, 3.97-69.9), 'memorable experience at a class or clinical rotation' (OR, 3.94; 95%CI, 3.73-416), and 'location of their medical school' (OR, 11.4; 95%CI, 2.79-46.2). The present study suggests that medical schools might recruit students with characteristics associated with intention for rural practice.

EXPANDING PRACTICE INTO AREAS. ALIGNED PHILOSOPHICALLY WITH MIDWIFERY.

PubMed

King, Ruth

2016-07-01

The number of midwives practicing in Australia in 1999, were 11,985 and in 2014, 23,862 (Australian Institute of Health & Welfare, 2014 workforce report). Just over 3,000 are registered as a midwife only.

Sustainable Rest Area Design and Operations

DOT National Transportation Integrated Search

2017-10-01

One way in which State Departments of Transportation (DOTs) can modernize their rest areas while reducing operations and maintenance costs is by incorporating sustainable practices into rest area design and operations. Sustainability practices that D...

Balancing the Ecological Function of Residential Stormwater Ponds with Homeowner Landscaping Practices.

PubMed

Monaghan, Paul; Hu, Shangchun; Hansen, Gail; Ott, Emily; Nealis, Charles; Morera, Maria

2016-11-01

Stormwater ponds are installed in urban developments to provide the ecosystem services of flood control and water treatment. In coastal areas, these ponds are connected to watersheds that can drain directly into protected estuaries, making their design, function, and maintenance critical to environmental protection. However, stormwater ponds in residential areas are increasingly managed as aesthetic amenities that add value to real estate rather than as engineered devices with special maintenance requirements. To help extend the life of neighborhood stormwater systems and improve ecosystem services, homeowners should follow best management practices for nutrient management and add shoreline plantings and non-invasive, beneficial aquatic plants to their ponds. This study used focus group and survey research to document the knowledge, behaviors, and attitudes of homeowners living near stormwater ponds in a master-planned community in Florida. The study was designed to use a social marketing research approach to promote Extension best practices. Findings indicate that many residents were aware of the functional components of stormwater systems and respondents' receptivity to best management practices was mediated by age, their attitudes about water quality and whether their home was adjacent to a pond. These findings can be used to target Extension audiences and improve adoption of stormwater pond best management practices for increased protection of water quality.

Balancing the Ecological Function of Residential Stormwater Ponds with Homeowner Landscaping Practices

NASA Astrophysics Data System (ADS)

Monaghan, Paul; Hu, Shangchun; Hansen, Gail; Ott, Emily; Nealis, Charles; Morera, Maria

2016-11-01

Stormwater ponds are installed in urban developments to provide the ecosystem services of flood control and water treatment. In coastal areas, these ponds are connected to watersheds that can drain directly into protected estuaries, making their design, function, and maintenance critical to environmental protection. However, stormwater ponds in residential areas are increasingly managed as aesthetic amenities that add value to real estate rather than as engineered devices with special maintenance requirements. To help extend the life of neighborhood stormwater systems and improve ecosystem services, homeowners should follow best management practices for nutrient management and add shoreline plantings and non-invasive, beneficial aquatic plants to their ponds. This study used focus group and survey research to document the knowledge, behaviors, and attitudes of homeowners living near stormwater ponds in a master-planned community in Florida. The study was designed to use a social marketing research approach to promote Extension best practices. Findings indicate that many residents were aware of the functional components of stormwater systems and respondents' receptivity to best management practices was mediated by age, their attitudes about water quality and whether their home was adjacent to a pond. These findings can be used to target Extension audiences and improve adoption of stormwater pond best management practices for increased protection of water quality.

Making the Invisible of Learning Visible: Pre-Service Teachers Identify Connections between the Use of Literacy Strategies and Their Content Area Assessment Practices

ERIC Educational Resources Information Center

Mitton-Kukner, Jennifer; Orr, Anne Murray

2014-01-01

In this paper we describe four ways secondary pre-service teachers appeared to be developing assessment practices during field experience, after taking a content area literacy course. This paper arises from a multi-year study exploring pre-service and beginning content area teachers' use of literacy strategies in teaching mathematics, science, and…

Does targeting children with hygiene promotion messages work? The effect of handwashing promotion targeted at children, on diarrhoea, soil-transmitted helminth infections and behaviour change, in low- and middle-income countries.

PubMed

Watson, Julie A; Ensink, Jeroen H J; Ramos, Monica; Benelli, Prisca; Holdsworth, Elizabeth; Dreibelbis, Robert; Cumming, Oliver

2017-05-01

To synthesise evidence on the effect of handwashing promotion interventions targeting children, on diarrhoea, soil-transmitted helminth infection and handwashing behaviour, in low- and middle-income country settings. A systematic review of the literature was performed by searching eight databases, and reference lists were hand-searched for additional articles. Studies were reviewed for inclusion according to pre-defined inclusion criteria and the quality of all studies was assessed. Eight studies were included in this review: seven cluster-randomised controlled trials and one cluster non-randomised controlled trial. All eight studies targeted children aged 5-12 attending primary school but were heterogeneous for both the type of intervention and the reported outcomes so results were synthesised qualitatively. None of the studies were of high quality and the large majority were at high risk of bias. The reported effect of child-targeted handwashing interventions on our outcomes of interest varied between studies. Of the different interventions reported, no one approach to promoting handwashing among children appeared most effective. Our review found very few studies that evaluated handwashing interventions targeting children and all had various methodological limitations. It is plausible that interventions which succeed in changing children's handwashing practices will lead to significant health impacts given that much of the attributable disease burden is concentrated in that age group. The current paucity of evidence in this area, however, does not permit any recommendations to be made as to the most effective route to increasing handwashing with soap practice among children in LMIC. © 2017 John Wiley & Sons Ltd.

The stimulus integration area for horizontal vergence.

PubMed

Allison, Robert S; Howard, Ian P; Fang, Xueping

2004-06-01

Over what region of space are horizontal disparities integrated to form the stimulus for vergence? The vergence system might be expected to respond to disparities within a small area of interest to bring them into the range of precise stereoscopic processing. However, the literature suggests that disparities are integrated over a fairly large parafoveal area. We report the results of six experiments designed to explore the spatial characteristics of the stimulus for vergence. Binocular eye movements were recorded using magnetic search coils. Each dichoptic display consisted of a central target stimulus that the subject attempted to fuse, and a competing stimulus with conflicting disparity. In some conditions the target was stationary, providing a fixation stimulus. In other conditions, the disparity of the target changed to provide a vergence-tracking stimulus. The target and competing stimulus were combined in a variety of conditions including those in which (1) a transparent textured-disc target was superimposed on a competing textured background, (2) a textured-disc target filled the centre of a competing annular background, and (3) a small target was presented within the centre of a competing annular background of various inner diameters. In some conditions the target and competing stimulus were separated in stereoscopic depth. The results are consistent with a disparity integration area with a diameter of about 5 degrees. Stimuli beyond this integration area can drive vergence in their own right, but they do not appear to be summed or averaged with a central stimulus to form a combined disparity signal. A competing stimulus had less effect on vergence when separated from the target by a disparity pedestal. As a result, we propose that it may be more useful to think in terms of an integration volume for vergence rather than a two-dimensional retinal integration area.

Target-D: a stratified individually randomized controlled trial of the diamond clinical prediction tool to triage and target treatment for depressive symptoms in general practice: study protocol for a randomized controlled trial.

PubMed

Gunn, Jane; Wachtler, Caroline; Fletcher, Susan; Davidson, Sandra; Mihalopoulos, Cathrine; Palmer, Victoria; Hegarty, Kelsey; Coe, Amy; Murray, Elizabeth; Dowrick, Christopher; Andrews, Gavin; Chondros, Patty

2017-07-20

Depression is a highly prevalent and costly disorder. Effective treatments are available but are not always delivered to the right person at the right time, with both under- and over-treatment a problem. Up to half the patients presenting to general practice report symptoms of depression, but general practitioners have no systematic way of efficiently identifying level of need and allocating treatment accordingly. Therefore, our team developed a new clinical prediction tool (CPT) to assist with this task. The CPT predicts depressive symptom severity in three months' time and based on these scores classifies individuals into three groups (minimal/mild, moderate, severe), then provides a matched treatment recommendation. This study aims to test whether using the CPT reduces depressive symptoms at three months compared with usual care. The Target-D study is an individually randomized controlled trial. Participants will be 1320 general practice patients with depressive symptoms who will be approached in the practice waiting room by a research assistant and invited to complete eligibility screening on an iPad. Eligible patients will provide informed consent and complete the CPT on a purpose-built website. A computer-generated allocation sequence stratified by practice and depressive symptom severity group, will randomly assign participants to intervention (treatment recommendation matched to predicted depressive symptom severity group) or comparison (usual care plus Target-D attention control) arms. Follow-up assessments will be completed online at three and 12 months. The primary outcome is depressive symptom severity at three months. Secondary outcomes include anxiety, mental health self-efficacy, quality of life, and cost-effectiveness. Intention-to-treat analyses will test for differences in outcome means between study arms overall and by depressive symptom severity group. To our knowledge, this is the first depressive symptom stratification tool designed for

Area Studies and Language Teaching: A Practical Approach.

ERIC Educational Resources Information Center

Koch, Karl

A model for integrating second language instruction and business administration education in a college course is proposed. Language instruction is the central element, and area studies (in this example, German area studies) and business studies are bound together by it. The course, in West German industrial relations, would have some German…

Salmonella Knowledge, Attitudes and Practices: A Survey of Backyard Poultry Owners Residing in Seattle, Washington and the Surrounding Metropolitan Area.

PubMed

Kauber, K; Fowler, H; Lipton, B; Meschke, J S; Rabinowitz, P

2017-02-01

with which risky practices are performed during routine animal care. Education and outreach targeting backyard flock owners should aim to improve husbandry and hygiene practices and reduce risk of zoonotic diseases associated with raising poultry in the backyard setting. © 2016 Blackwell Verlag GmbH.

Practice-based learning can improve osteoporosis care.

PubMed

Hess, Brian J; Johnston, Mary M; Iobst, William F; Lipner, Rebecca S

2013-10-01

To examine physician engagement in practice-based learning using a self-evaluation module to assess and improve their care of individuals with or at risk of osteoporosis. Retrospective cohort study. Internal medicine and subspecialty clinics. Eight hundred fifty U.S. physicians with time-limited certification in general internal medicine or a subspecialty. Performance rates on 23 process measures and seven practice system domain scores were obtained from the American Board of Internal Medicine (ABIM) Osteoporosis Practice Improvement Module (PIM), an Internet-based self-assessment module that physicians use to improve performance on one targeted measure. Physicians remeasured performance on their targeted measures by conducting another medical chart review. Variability in performance on measures was found, with observed differences between general internists, geriatricians, and rheumatologists. Some practice system elements were modestly associated with measure performance; the largest association was between providing patient-centered self-care support and documentation of calcium intake and vitamin D estimation and counseling (correlation coefficients from 0.20 to 0.28, Ps < .002). For all practice types, the most commonly selected measure targeted for improvement was documentation of vitamin D level (38% of physicians). On average, physicians reported significant and large increases in performance on measures targeted for improvement. Gaps exist in the quality of osteoporosis care, and physicians can apply practice-based learning using the ABIM PIM to take action to improve the quality of care. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Application of target costing in machining

NASA Astrophysics Data System (ADS)

Gopalakrishnan, Bhaskaran; Kokatnur, Ameet; Gupta, Deepak P.

2004-11-01

In today's intensely competitive and highly volatile business environment, consistent development of low cost and high quality products meeting the functionality requirements is a key to a company's survival. Companies continuously strive to reduce the costs while still producing quality products to stay ahead in the competition. Many companies have turned to target costing to achieve this objective. Target costing is a structured approach to determine the cost at which a proposed product, meeting the quality and functionality requirements, must be produced in order to generate the desired profits. It subtracts the desired profit margin from the company's selling price to establish the manufacturing cost of the product. Extensive literature review revealed that companies in automotive, electronic and process industries have reaped the benefits of target costing. However target costing approach has not been applied in the machining industry, but other techniques based on Geometric Programming, Goal Programming, and Lagrange Multiplier have been proposed for application in this industry. These models follow a forward approach, by first selecting a set of machining parameters, and then determining the machining cost. Hence in this study we have developed an algorithm to apply the concepts of target costing, which is a backward approach that selects the machining parameters based on the required machining costs, and is therefore more suitable for practical applications in process improvement and cost reduction. A target costing model was developed for turning operation and was successfully validated using practical data.

Alternative divertor target concepts for next step fusion devices

NASA Astrophysics Data System (ADS)

Mazul, I. V.

2016-12-01

The operational conditions of a divertor target in the next steps of fusion devices are more severe in comparison with ITER. The current divertor designs and technologies have a limited application concerning these conditions, and so new design concepts/technologies are required. The main reasons which practically prevent the use of the traditional motionless solid divertor target are analyzed. We describe several alternative divertor target concepts in this paper. The comparative analysis of these concepts (including the advantages and the drawbacks) is made and the prospects for their practical implementation are prioritized. The concept of the swept divertor target with a liquid metal interlayer between the moving armour and motionless heat-sink is presented in more detail. The critical issues of this design are listed and outlined, and the possible experiments are presented.

Effects of practice on tip-of-the-tongue states.

PubMed

Smith, S M; Balfour, S P; Brown, J M

1994-03-01

Tip-of-the-tongue (TOT) states were examined in relation to acquisition manipulations, using named imaginary animals (TOTimals) as targets. High levels of TOT states were found in three experiments. In the first experiment an increase in the duration of initial exposure to target material improved recall and recognition, and reduced the number of unrecalled items not in TOT states (NTOTs), but did not affect TOT levels. In Experiment 2 practice at writing target names, as compared with only reading them, improved recall performance and decreased TOT levels, but did not reduce NTOTs. Experiment 3 replicated the finding that writing during practice reduced TOT states, but did not reduce NTOTs, and also found that more frequent practice trials increased recall without affecting TOT levels. The results suggest that practice writing target names prevents TOT states by strengthening otherwise deficient phonological connections in memory, a deficiency that can cause TOT states when visual-to-lexical connections give only partial access to a target in memory. The results also demonstrate the usefulness of the TOTimal technique for testing effects of acquisition variables on TOT experiences.

Schistosomiasis knowledge, attitude, practices, and associated factors among primary school children in the Siphofaneni area in the Lowveld of Swaziland.

PubMed

Maseko, Thokozani S B; Mkhonta, Nkosazana R; Masuku, Sakhile K S; Dlamini, Sabelo V; Fan, Chia-Kwung

2018-02-01

Schistosomiasis, a worldwide concern, has received attention in Swaziland through control programs such as deworming programs, education programs, and school health programs; however, these programs neglect the importance of monitoring and evaluation strategies such as assessing children's knowledge, attitudes and practices (KAPs) and the prevalence of the disease. Children are a high-risk group because of their water contact practices, and need to be informed about schistosomiasis to influence their attitudes and practices. Social and cultural factors are involved in schistosomiasis control because they instill myths and misconceptions about the disease. As a result, children in the community may be comfortable with bad practices. This study aimed to assess the KAPs of schoolchildren on schistosomiasis, and to identify practices that support or hinder the progress of schistosomiasis control. In 2014, a descriptive quantitative cross-sectional survey was conducted through questionnaires among Siphofaneni primary schools, an area hit by schistosomiasis in the Lowveld of Swaziland. A logistic regression model was applied to analyze the data. Moderate knowledge, good attitudes, and fairly good practices were observed in the children. However, practices of certain children were risky and they still had some misconceptions. Knowledge was correlated with practice and with predictors of good and bad practices such as male sex, always urinating in water, and always using river water for domestic practices. This study suggests that empowering children with knowledge and attempting to modify their water contact, and improved human waste disposal practices are necessary for schistosomiasis control. Copyright © 2016. Published by Elsevier B.V.

Genetic risk variants as therapeutic targets for Crohn's disease.

PubMed

Gabbani, Tommaso; Deiana, Simona; Marocchi, Margherita; Annese, Vito

2017-04-01

The pathogenesis of Inflammatory bowel diseases (IBD) is multifactorial, with interactions between genetic and environmental factors. Despite the existence of genetic factors being largely demonstrated by epidemiological data and several genetic studies, only a few findings have been useful in term of disease prediction, disease progression and targeting therapy. Areas covered: This review summarizes the results of genome-wide association studies in Crohn's disease, the role of epigenetics and the recent discovery by genetic studies of new pathogenetic pathways. Furthermore, it focuses on the importance of applying genetic data to clinical practice, and more specifically how to better target therapy and predict potential drug-related toxicity. Expert opinion: Some genetic markers identified in Crohn`s disease have allowed investigators to hypothesize about, and in some cases, prove the usefulness of new specific therapeutic agents. However, the heterogeneity and complexity of this disease has so far limited the daily clinical use of genetic information. Finally, the study of the implications of genetics on therapy, either to predict efficacy or avoid toxicity, is considered still to be in its infancy.

Tobacco Cessation Counselling Practices and Attitude among the Dentist and the Dental Auxiliaries of Urban and Rural Areas of Modinagar, India

PubMed Central

Patthi, Basavaraj; Singh, Khushboo; Jain, Swati; Vashishtha, Vaibhav; Kundu, Hansa; Malhi, Ravneet; Pandita, Venisha

2014-01-01

Background: The increasing use of tobacco among youths warrants the need for dental health professionals to effectively provide tobacco cessation counselling (TCC) in the office and community settings. However, there have been concerns among the dental professionals regarding TCC in dental settings. Aims and Objectives: To assess the attitude of dental professionals including the dentist and dental hygienist towards the TCC and identify the possible barriers towards the implementation of these practices in the rural and urban areas of Modinagar district. Materials and Methods: The present questionnaire based survey was carried among the qualified dentist and dental hygienist from the urban and rural areas of the Modinagar district to attitudes in tobacco cessation, practices in tobacco cessation interventions and related barriers towards implementation. The survey data were analyzed using the SPSS 16 version software package. The descriptive statistics (frequency) was generated for the each question to assess their attitude and practice. Results: The response rate of the questionnaire among the dentist and dental hygienist was 100%. The attitude of the majority of dentist towards the tobacco cessation counselling was positive as compared to the dental hygienist. 69.2% of the dentist were of the view that the dental health professionals should provide TCC as compared to 54.2% among the hygienist. Regarding the practice, only 12.5% and 5.8% of the dentist and dental hygienist had ever used the nicotine replacement therapy in their dental practice. The lack of the knowledge and information regarding TCC was the only perceived barrier among the dentists (51.7%) and dental hygienist (68.3%). Conclusion: Dental professionals must expand their horizon and armamentarium to include TCC strategies inclusive of their regular preventive and therapeutic treatment modalities. Also, the dental institutions should include TCC into the curriculum, but it should not be just

Eye tracking a self-moved target with complex hand-target dynamics

PubMed Central

Landelle, Caroline; Montagnini, Anna; Madelain, Laurent

2016-01-01

Previous work has shown that the ability to track with the eye a moving target is substantially improved when the target is self-moved by the subject's hand compared with when being externally moved. Here, we explored a situation in which the mapping between hand movement and target motion was perturbed by simulating an elastic relationship between the hand and target. Our objective was to determine whether the predictive mechanisms driving eye-hand coordination could be updated to accommodate this complex hand-target dynamics. To fully appreciate the behavioral effects of this perturbation, we compared eye tracking performance when self-moving a target with a rigid mapping (simple) and a spring mapping as well as when the subject tracked target trajectories that he/she had previously generated when using the rigid or spring mapping. Concerning the rigid mapping, our results confirmed that smooth pursuit was more accurate when the target was self-moved than externally moved. In contrast, with the spring mapping, eye tracking had initially similar low spatial accuracy (though shorter temporal lag) in the self versus externally moved conditions. However, within ∼5 min of practice, smooth pursuit improved in the self-moved spring condition, up to a level similar to the self-moved rigid condition. Subsequently, when the mapping unexpectedly switched from spring to rigid, the eye initially followed the expected target trajectory and not the real one, thereby suggesting that subjects used an internal representation of the new hand-target dynamics. Overall, these results emphasize the stunning adaptability of smooth pursuit when self-maneuvering objects with complex dynamics. PMID:27466129

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact.

PubMed

McKenzie, Ellen Nancy

2013-04-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs' perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate practices into their teaching than do non-NBCT teachers.

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact

PubMed Central

McKenzie, Ellen Nancy

2013-01-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs’ perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate practices into their teaching than do non-NBCT teachers. PMID:23626399

Developing Teacher-Researcher Partnerships to Investigate Best Practices: Literacy Learning and Teaching in Content Areas of the Secondary School

ERIC Educational Resources Information Center

McDonald, Trevor; Thornley, Christina; Fitzpatrick, Rosi; Elia, Angie; Stevens, Saria; Teulilo, Gloria; Johnston, Sue; Woock, Sandy; Selbie, Paul; McDonald, Lyn; Pullar, Ken; Pullar, Maree; Low, Helen

2008-01-01

This project aimed to identify a variety of literacy-teaching approaches that could be used in secondary content-area classrooms to improve the achievement of a wide range of students. Specifically, the project aimed to investigate: (1) literacy and the extent to which a focus on improved teacher knowledge and practice would lead to increases in…

The value of best-practice guidelines for OSCEs in a postgraduate program in an Australian remote area setting.

PubMed

Jeffrey, Carol A; Mitchell, Marion L; Henderson, Amanda; Lenthall, Sue; Knight, Sabina; Glover, Pauline; Kelly, Michelle; Nulty, Duncan; Groves, Michele

2014-01-01

Nurses in remote areas of Australia are the primary healthcare professionals, who need to be able to deliver comprehensive and culturally sensitive care to clients, many of whom are Indigenous Australians. Adequate and specific preparation for practice is crucial to the quality of care delivered by remote area nurses (RANs). Objective structured clinical examinations (OSCE) provide an excellent opportunity for student practice in a simulated environment that is safe, authentic, fair and valid when well constructed. Seven integrated best practice guidelines (BPGs), previously developed by project team members to inform OSCEs within educational programs, provided guidance in restructuring the OSCE. This paper provides a detailed analysis of the value of BPGs used in the development, teaching and learning, and evaluation of OSCEs in a rural and remote postgraduate course for RANs. A pre-site visit to the Centre for Remote Health, Alice Springs, Northern Territory, was conducted with modification of the course and previous OSCE according to BPGs. Following delivery of the course and OSCE, evaluations occurred via a mixed method approach. Student surveys (n=15) and focus groups (n=13) and staff interviews (n=5) provided an in-depth analysis of their perceptions of the revised OSCE. Descriptive statistics were used to describe the student sample. The narrative data were transcribed verbatim and analysed using content analysis. Triangulation was achieved with the convergence of the separate data sources focusing on themes and patterns within and between students and tutors. All 15 students and five tutors provided feedback. The majority of student participants had limited experience in working in remote area nursing prior to participation and therefore the opportunities that availed themselves were critical in adequately equipping them with the requisite knowledge, skills and abilities. Three themes emerged from the data: (1) value of common and significant events in OSCE

SuperTarget and Matador: resources for exploring drug-target relationships.

PubMed

Günther, Stefan; Kuhn, Michael; Dunkel, Mathias; Campillos, Monica; Senger, Christian; Petsalaki, Evangelia; Ahmed, Jessica; Urdiales, Eduardo Garcia; Gewiess, Andreas; Jensen, Lars Juhl; Schneider, Reinhard; Skoblo, Roman; Russell, Robert B; Bourne, Philip E; Bork, Peer; Preissner, Robert

2008-01-01

The molecular basis of drug action is often not well understood. This is partly because the very abundant and diverse information generated in the past decades on drugs is hidden in millions of medical articles or textbooks. Therefore, we developed a one-stop data warehouse, SuperTarget that integrates drug-related information about medical indication areas, adverse drug effects, drug metabolization, pathways and Gene Ontology terms of the target proteins. An easy-to-use query interface enables the user to pose complex queries, for example to find drugs that target a certain pathway, interacting drugs that are metabolized by the same cytochrome P450 or drugs that target the same protein but are metabolized by different enzymes. Furthermore, we provide tools for 2D drug screening and sequence comparison of the targets. The database contains more than 2500 target proteins, which are annotated with about 7300 relations to 1500 drugs; the vast majority of entries have pointers to the respective literature source. A subset of these drugs has been annotated with additional binding information and indirect interactions and is available as a separate resource called Matador. SuperTarget and Matador are available at http://insilico.charite.de/supertarget and http://matador.embl.de.

Spatial analysis of ecosystem service relationships to improve targeting of payments for hydrological services

PubMed Central

Manson, Robert H.; Ricketts, Taylor H.; Geissert, Daniel

2018-01-01

Payment for hydrological services (PHS) are popular tools for conserving ecosystems and their water-related services. However, improving the spatial targeting and impacts of PHS, as well as their ability to foster synergies with other ecosystem services (ES), remain challenging. We aimed at using spatial analyses to evaluate the targeting performance of México’s National PHS program in central Veracruz. We quantified the effectiveness of areas targeted for PHS in actually covering areas of high HS provision and social priority during 2003–2013. First, we quantified provisioning and spatial distributions of two target (water yield and soil retention), and one non-target ES (carbon storage) using InVEST. Subsequently, pairwise relationships among ES were quantified by using spatial correlation and overlap analyses. Finally, we evaluated targeting by: (i) prioritizing areas of individual and overlapping ES; (ii) quantifying spatial co-occurrences of these priority areas with those targeted by PHS; (iii) evaluating the extent to which PHS directly contribute to HS delivery; and (iv), testing if PHS targeted areas disproportionately covered areas with high ecological and social priority. We found that modelled priority areas exhibited non-random distributions and distinct spatial patterns. Our results show significant pairwise correlations between all ES suggesting synergistic relationships. However, our analysis showed a significantly lower overlap than expected and thus significant mismatches between PHS targeted areas and all types of priority areas. These findings suggest that the targeting of areas with high HS provisioning and social priority by Mexico’s PHS program could be improved significantly. This study underscores: (1) the importance of using maps of HS provisioning as main targeting criteria in PHS design to channel payments towards areas that require future conservation, and (2) the need for future research that helps balance ecological and

Health Activism Targeting Corporations: A Critical Health Communication Perspective.

PubMed

Zoller, Heather M

2017-02-01

Health activists and health social movements have transformed medical treatment, promoted public health policies, and extended civil rights for people with illness and disability. This essay explores health activism that targets corporate-generated illness and risk in order to understand the unique communicative challenges involved in this area of contention. Arguing for greater critical engagement with policy, the article integrates policy research with social movements, subpolitics, and issue management literature. Drawing from activist discourse and multidisciplinary research, the article describes how a wide array of groups groups build visibility for corporate health effects, create the potential for networking and collaboration, and politicize health by attributing illness to corporate behaviors. The discussion articulates the implications of this activism for health communication theory, research, and practice.

A Review of Health Impact Assessments in the U.S.: Current State-of-Science, Best Practices, and Area for Improvement

EPA Science Inventory

A systematic review was conducted of health impact assessments (HIAs) from the U.S. to obtain a clear picture of how HIAs are being implemented nationally and to identify potential areas for improving the HIA community of practice. The review was focused on HIAs from the four se...

Heart failure—potential new targets for therapy

PubMed Central

Nabeebaccus, Adam; Zheng, Sean; Shah, Ajay M.

2016-01-01

Abstract Introduction/background Heart failure is a major cause of cardiovascular morbidity and mortality. This review covers current heart failure treatment guidelines, emerging therapies that are undergoing clinical trial, and potential new therapeutic targets arising from basic science advances. Sources of data A non-systematic search of MEDLINE was carried out. International guidelines and relevant reviews were searched for additional articles. Areas of agreement Angiotensin-converting enzyme inhibitors and beta-blockers are first line treatments for chronic heart failure with reduced left ventricular function. Areas of controversy Treatment strategies to improve mortality in heart failure with preserved left ventricular function are unclear. Growing points Many novel therapies are being tested for clinical efficacy in heart failure, including those that target natriuretic peptides and myosin activators. A large number of completely novel targets are also emerging from laboratory-based research. Better understanding of pathophysiological mechanisms driving heart failure in different settings (e.g. hypertension, post-myocardial infarction, metabolic dysfunction) may allow for targeted therapies. Areas timely for developing research Therapeutic targets directed towards modifying the extracellular environment, angiogenesis, cell viability, contractile function and microRNA-based therapies. PMID:27365454

The distribution, practice, and attitudes of maternal-fetal medicine specialists.

PubMed

Coustan, D R; Schwartz, R M; Gagnon, D E; VanDorsten, J P

2001-11-01

This study was carried out to determine the distribution of maternal-fetal medicine (MFM) subspecialists and to profile MFM subspecialists' (1) target patient populations, (2) practice organization, (3) workloads, (4) services provided, and (5) job satisfaction. The membership of the Society for Maternal-Fetal Medicine was compared with birth projections for metropolitan statistical areas. A survey was sent to Society for Maternal-Fetal Medicine members. The national supply of MFM subspecialists was 0.34, with individual census regions ranging from 0.22 to 0.52 per thousand births. MFM subspecialists report spending 64% of their time in clinical pursuits, 9% in research, and 12% in administration. They evaluate an average of 512 patients annually and work a 67-hour week (SD, 15.8 hours). Ninety-four percent perform deliveries and 87% perform targeted ultrasound examinations. Overall job satisfaction averages 7.4 on a 10-point scale. The data provide useful bench-marking information for MFM subspecialists exploring options for practice and for health care planners and organizations developing staffing plans. Despite changes in the health care system, MFM subspecialists continue to express a positive attitude toward their work.

The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study.

PubMed

Grant, Suzanne; Huby, Guro; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw; Guthrie, Bruce

2009-03-01

The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact of the new contract and the financial incentives contained within it on professional boundaries in UK general practice. The distribution of clinical and administrative work has changed significantly and there has been a new concentration of authority, with QOF decision making and monitoring being led by an internal QOF team of clinical and managerial staff who make the major practice-level decisions about QOF, monitor progress against targets, and intervene to resolve areas or indicators at risk of missing targets. General practitioners and nurses, however, appear to have accommodated these changes by re-creating long established narratives on professional boundaries and clinical hierarchies. This paper is concerned with the impact of these new arrangements on existing clinical hierarchies.

Synergies and trade-offs in achieving global biodiversity targets.

PubMed

Di Marco, Moreno; Butchart, Stuart H M; Visconti, Piero; Buchanan, Graeme M; Ficetola, Gentile F; Rondinini, Carlo

2016-02-01

After their failure to achieve a significant reduction in the global rate of biodiversity loss by 2010, world governments adopted 20 new ambitious Aichi biodiversity targets to be met by 2020. Efforts to achieve one particular target can contribute to achieving others, but different targets may sometimes require conflicting solutions. Consequently, lack of strategic thinking might result, once again, in a failure to achieve global commitments to biodiversity conservation. We illustrate this dilemma by focusing on Aichi Target 11. This target requires an expansion of terrestrial protected area coverage, which could also contribute to reducing the loss of natural habitats (Target 5), reducing human-induced species decline and extinction (Target 12), and maintaining global carbon stocks (Target 15). We considered the potential impact of expanding protected areas to mitigate global deforestation and the consequences for the distribution of suitable habitat for >10,000 species of forest vertebrates (amphibians, birds, and mammals). We first identified places where deforestation might have the highest impact on remaining forests and then identified places where deforestation might have the highest impact on forest vertebrates (considering aggregate suitable habitat for species). Expanding protected areas toward locations with the highest deforestation rates (Target 5) or the highest potential loss of aggregate species' suitable habitat (Target 12) resulted in partially different protected area network configurations (overlapping with each other by about 73%). Moreover, the latter approach contributed to safeguarding about 30% more global carbon stocks than the former. Further investigation of synergies and trade-offs between targets would shed light on these and other complex interactions, such as the interaction between reducing overexploitation of natural resources (Targets 6, 7), controlling invasive alien species (Target 9), and preventing extinctions of native

33 CFR 334.1450 - Atlantic Ocean off north coast of Puerto Rico; practice firing areas, U.S. Army Forces Antilles.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) The fact that practice firing is to take place over the designated area will be advertised to the public through the usual media for the dissemination of such information. Factual information as to the dates, time, and characteristics of the firing will be advertised in advance of each session of firing...

A survey of reasons why veterinarians leave rural veterinary practice in the United States.

PubMed

Villarroel, Aurora; McDonald, Stephen R; Walker, William L; Kaiser, Lana; Dewell, Reneé D; Dewell, Grant A

2010-04-15

To identify factors associated with veterinarians leaving a career in rural veterinary practice (RVP). Cross-sectional descriptive study. Veterinarians from the United States who no longer worked in RVP. Veterinarians in any area of practice were solicited to participate in an online survey through invitation letters sent to various veterinary associations. Those who indicated that they had left RVP were asked to rank the importance of various potential factors in their decision to leave RVP. 805 responses were obtained from veterinarians who had worked in RVP, of which 246 (30.6%) had left RVP. Most (231/246 [93.9%]) of those who reported leaving RVP had been in practice > 5 years, and 75.2% (185/246) had been in practice > 12 years. Eighty-three (33.7%) who left RVP pursued careers in urban areas, 72 (29.3%) entered academia, and 7 (2.8%) retired. Reasons for leaving RVP ranked by the highest proportions of respondents as being of high importance were emergency duty, time off, salary, practice atmosphere, and family concerns. Women ranked factors such as time off, mentorship, practice atmosphere, conflict with staff, and gender issues as being of high importance more often than men did. Results suggested that the perceived shortage of veterinarians in RVP may be in part influenced by a lack of retention, particularly among experienced veterinarians. Targeted efforts to tackle issues related to emergency duty, time off, salary, practice atmosphere, and family issues could help alleviate the efflux from RVP.

Malaria-related knowledge and prevention practices in four neighbourhoods in and around Mumbai, India: a cross-sectional study.

PubMed

Dhawan, Gaurav; Joseph, Nidhin; Pekow, Penelope S; Rogers, Christine A; Poudel, Krishna C; Bulzacchelli, Maria T

2014-08-07

be tailored according to the knowledge gaps, practices, environments, resources, and preferences in different areas of the city, using the interpersonal and media channels most likely to reach the target audiences. Malaria control efforts involving bed nets should emphasize use of insecticide-treated bed nets.

Simulation of targeted pollutant-mitigation-strategies to reduce nitrate and sediment hotspots in agricultural watershed.

PubMed

Teshager, Awoke Dagnew; Gassman, Philip W; Secchi, Silvia; Schoof, Justin T

2017-12-31

About 50% of U.S. water pollution problems are caused by non-point source (NPS) pollution, primarily sediment and nutrients from agricultural areas, despite the widespread implementation of agricultural Best Management Practices (BMPs). However, the effectiveness of implementation strategies and type of BMPs at watershed scale are still not well understood. In this study, the Soil and Water Assessment Tool (SWAT) ecohydrological model was used to assess the effectiveness of pollutant mitigation strategies in the Raccoon River watershed (RRW) in west-central Iowa, USA. We analyzed fourteen management scenarios based on systematic combinations of five strategies: fertilizer/manure management, changing row-crop land to perennial grass, vegetative filter strips, cover crops and shallower tile drainage systems, specifically aimed at reducing nitrate and total suspended sediment yields from hotspot areas in the RRW. Moreover, we assessed implications of climate change on management practices, and the impacts of management practices on water availability, row crop yield, and total agricultural production. Our results indicate that sufficient reduction of nitrate load may require either implementation of multiple management practices (38.5% with current setup) or conversion of extensive areas into perennial grass (up to 49.7%) to meet and maintain the drinking water standard. However, climate change may undermine the effectiveness of management practices, especially late in the 21st century, cutting the reduction by up to 65% for nitrate and more for sediment loads. Further, though our approach is targeted, it resulted in a slight decrease (~5%) in watershed average crop yield and hence an overall reduction in total crop production, mainly due to the conversion of row-crop lands to perennial grass. Such yield reductions could be quite spatially heterogeneously distributed (0 to 40%). Copyright © 2017 Elsevier B.V. All rights reserved.

Practice management.

PubMed

Althausen, Peter L; Mead, Lisa

2014-07-01

The practicing orthopaedic traumatologist must have a sound knowledge of business fundamentals to be successful in the changing healthcare environment. Practice management encompasses multiple topics including governance, the financial aspects of billing and coding, physician extender management, ancillary service development, information technology, transcription utilization, and marketing. Some of these are universal, but several of these areas may be most applicable to the private practice of medicine. Attention to each component is vital to develop an understanding of the intricacies of practice management.

Fungicides transport in runoff from vineyard plot and catchment: contribution of non-target areas.

PubMed

Lefrancq, Marie; Payraudeau, Sylvain; García Verdú, Antonio Joaquín; Maillard, Elodie; Millet, Maurice; Imfeld, Gwenaël

2014-04-01

Surface runoff and erosion during the course of rainfall events are major processes of pesticides transport from agricultural land to aquatic ecosystem. These processes are generally evaluated either at the plot or the catchment scale. Here, we compared at both scales the transport and partitioning in runoff water of two widely used fungicides, i.e., kresoxim-methyl (KM) and cyazofamid (CY). The objective was to evaluate the relationship between fungicides runoff from the plot and from the vineyard catchment. The results show that seasonal exports for KM and CY at the catchment were larger than those obtained at the plot. This underlines that non-target areas within the catchment largely contribute to the overall load of runoff-associated fungicides. Estimations show that 85 and 62 % of the loads observed for KM and CY at the catchment outlet cannot be explained by the vineyard plots. However, the partitioning of KM and CY between three fractions, i.e., the suspended solids (>0.7 μm) and two dissolved fractions (i.e., between 0.22 and 0.7 µm and <0.22 µm) in runoff water was similar at both scales. KM was predominantly detected below 0.22 μm, whereas CY was mainly detected in the fraction between 0.22 and 0.7 μm. Although KM and CY have similar physicochemical properties and are expected to behave similarly, our results show that their partitioning between two fractions of the dissolved phase differs largely. It is concluded that combined observations of pesticide runoff at both the catchment and the plot scales enable to evaluate the sources areas of pesticide off-site transport.

ACCP white paper: Essential components of a faculty development program for pharmacy practice faculty.

PubMed

Boyce, Eric G; Burkiewicz, Jill S; Haase, Mark R; MacLaughlin, Eric J; Segal, Alissa R; Chung, Eunice P; Chan, Lingtak-Neander; Rospond, Raylene M; Barone, Joseph A; Durst, Stephen W; Wells, Barbara G

2009-01-01

Prospective, ongoing faculty development programs are important in the initial orientation and short- and long-term development of faculty in higher education. Pharmacy practice faculty are likely to benefit from a comprehensive faculty development program due to the complex nature of their positions, incomplete training in select areas, and multiple demands on their time. The need for faculty development programs is supported by the increased need for pharmacy practice faculty due to the increased number of colleges and schools of pharmacy, expanding enrollment in existing colleges and schools, and loss of existing senior faculty to retirement or other opportunities within or outside the academy. This White Paper describes a comprehensive faculty development program that is designed to enhance the satisfaction, retention, and productivity of new and existing pharmacy practice faculty. A comprehensive faculty development program will facilitate growth throughout a faculty member's career in pertinent areas. The structure of such a program includes an orientation program to provide an overview of responsibilities and abilities, a mentoring program to provide one-on-one guidance from a mentor, and a sustained faculty development program to provide targeted development based on individual and career needs. The content areas to be covered in each component include the institution (e.g., culture, structure, roles, responsibilities), student-related activities, teaching abilities, scholarship and research abilities, practice abilities and the practice site, and professional abilities (e.g., leadership, career planning, balancing responsibilities). A general framework for a comprehensive pharmacy practice faculty development program is provided to guide each college, school, department, and division in the design and delivery of a program that meets the needs and desires of the institution and its faculty.

Does Angling Technique Selectively Target Fishes Based on Their Behavioural Type?

PubMed Central

Wilson, Alexander D. M.; Brownscombe, Jacob W.; Sullivan, Brittany; Jain-Schlaepfer, Sofia; Cooke, Steven J.

2015-01-01

Recently, there has been growing recognition that fish harvesting practices can have important impacts on the phenotypic distributions and diversity of natural populations through a phenomenon known as fisheries-induced evolution. Here we experimentally show that two common recreational angling techniques (active crank baits versus passive soft plastics) differentially target wild largemouth bass (Micropterus salmoides) and rock bass (Ambloplites rupestris) based on variation in their behavioural tendencies. Fish were first angled in the wild using both techniques and then brought back to the laboratory and tested for individual-level differences in common estimates of personality (refuge emergence, flight-initiation-distance, latency-to-recapture and with a net, and general activity) in an in-lake experimental arena. We found that different angling techniques appear to selectively target these species based on their boldness (as characterized by refuge emergence, a standard measure of boldness in fishes) but not other assays of personality. We also observed that body size was independently a significant predictor of personality in both species, though this varied between traits and species. Our results suggest a context-dependency for vulnerability to capture relative to behaviour in these fish species. Ascertaining the selective pressures angling practices exert on natural populations is an important area of fisheries research with significant implications for ecology, evolution, and resource management. PMID:26284779

CDTI target selection criteria

NASA Technical Reports Server (NTRS)

Britt, C. L.; Davis, C. M.; Jackson, C. B.; Mcclellan, V. A.

1984-01-01

A Cockpit Display of Traffic Information (CDTI) is a cockpit instrument which provides information to the aircrew on the relative location of aircraft traffic in the vicinity of their aircraft (township). In addition, the CDTI may provide information to assist in navigation and in aircraft control. It is usually anticipated that the CDTI will be integrated with a horizontal situation indicator used for navigational purposes and/or with a weather radar display. In this study, several sets of aircraft traffic data are analyzed to determine statistics on the number of targets that will be displayed on a CDTI using various target selection criteria. Traffic data were obtained from an Atlanta Terminal Area Simulation and from radar tapes recorded at the Atlanta and Miami terminal areas. Results are given in the form of plots showing the average percentage of time (or probability) that an aircraft equipped with a CDTI would observe from 0 to 10 other aircraft on the display for range settings on the CDTI up to 30 n. mi. and using various target discrimination techniques.

Father's involvement and its effect on early breastfeeding practices in Viet Nam.

PubMed

Bich, Tran Huu; Hoa, Dinh Thi Phuong; Ha, Nguyen Thanh; Vui, Le Thi; Nghia, Dang Thi; Målqvist, Mats

2016-10-01

Fathers have an important but often neglected role in the promotion of healthy breastfeeding practices in developing countries. A community-based education intervention was designed to mobilize fathers' support for early breastfeeding. This study aimed to evaluate an education intervention targeting fathers to increase the proportion of early breastfeeding initiation and to reduce prelacteal feeding. Quasi-experimental study design was used to compare intervention and control areas located in two non-adjacent rural districts that shared similar demographic and health service characteristics in northern Viet Nam. Fathers and expectant fathers with pregnant wives from 7 to 30 weeks gestational age were recruited. Fathers in the intervention area received breastfeeding education materials, counselling services at a commune health centre and household visits. They were also invited to participate in a breastfeeding promotion social event. After intervention, early breastfeeding initiation rate was 81.2% in the intervention area and 39.6% in the control area (P < 0.001). Babies in the intervention area were more likely to be breastfed within the first hour after birth [odds ratio (OR) 7.64, 95% confidence interval (CI) 4.81-12.12] and not to receive any prelacteal feeding (OR 4.43, 95% CI 2.88-6.82) compared with those in the control area. Fathers may positively influence the breastfeeding practices of mothers, and as a resource for early childcare, they can be mobilized in programmes aimed at improving the early initiation of breastfeeding. © 2015 John Wiley & Sons Ltd.

Education research: communication skills for neurology residents: structured teaching and reflective practice.

PubMed

Watling, Christopher J; Brown, Judith B

2007-11-27

Despite the importance of communication skills for neurologists, specific training in this area at the residency level is often lacking. This study aimed to enhance learning of these skills and to encourage reflective practice around communication skills. A group of 12 neurology residents participated in a series of six case-based communication skills workshops. Each workshop focused on a particular clinical scenario, including breaking bad news, discussing do-not-resuscitate orders, communicating with "difficult" patients, disclosing medical errors, obtaining informed consent for neurologic tests and procedures, and discussing life-and-death decisions with families of critically ill patients. Residents also kept reflective portfolios in which real examples of these interactions were recorded. The program was well accepted, and residents rated the workshops as effective and relevant to their practice. Analysis of residents' portfolios revealed three themes relevant to patient-physician communication: 1) communication is more successful when adequate time is allowed, 2) the ability to empathize with patients and their families is essential to successful interactions, and 3) the development of specific approaches to challenging scenarios can facilitate effective interactions. The portfolios also demonstrated that residents would engage in reflective practice. Targeting of communication skills training around specific clinical scenarios using neurologic cases was well accepted and was deemed relevant to practice. The use of portfolios may promote lifelong learning in this area.

How may targeted proteomics complement genomic data in breast cancer?

PubMed

Guerin, Mathilde; Gonçalves, Anthony; Toiron, Yves; Baudelet, Emilie; Audebert, Stéphane; Boyer, Jean-Baptiste; Borg, Jean-Paul; Camoin, Luc

2017-01-01

Breast cancer (BC) is the most common female cancer in the world and was recently deconstructed in different molecular entities. Although most of the recent assays to characterize tumors at the molecular level are genomic-based, proteins are the actual executors of cellular functions and represent the vast majority of targets for anticancer drugs. Accumulated data has demonstrated an important level of quantitative and qualitative discrepancies between genomic/transcriptomic alterations and their protein counterparts, mostly related to the large number of post-translational modifications. Areas covered: This review will present novel proteomics technologies such as Reverse Phase Protein Array (RPPA) or mass-spectrometry (MS) based approaches that have emerged and that could progressively replace old-fashioned methods (e.g. immunohistochemistry, ELISA, etc.) to validate proteins as diagnostic, prognostic or predictive biomarkers, and eventually monitor them in the routine practice. Expert commentary: These different targeted proteomic approaches, able to complement genomic data in BC and characterize tumors more precisely, will permit to go through a more personalized treatment for each patient and tumor.

Implications for cancer genetics practice of pro-actively assessing family history in a General Practice cohort in North West London.

PubMed

Kohut, Kelly; D'Mello, Lucia; Bancroft, Elizabeth K; Thomas, Sarah; Young, Mary-Anne; Myhill, Kathryn; Shanley, Susan; Briggs, Brian H J; Newman, Michelle; Saraf, Ifthikhar M; Cox, Penny; Scambler, Sarah; Wagman, Lyndon; Wyndham, Michael T; Eeles, Rosalind A; Ferris, Michelle

2012-03-01

At present cancer genetics referrals are reactive to individuals asking for a referral and providing a family history thereafter. A previous pilot study in a single General Practice (GP) catchment area in North London showed a 1.5-fold increase in breast cancer risk in the Ashkenazi Jewish population compared with the non-Ashkenazi mixed population. The breast cancer incidence was equal in the Ashkenazim in both pre- and postmenopausal groups. We wanted to investigate the effect of proactively seeking family history data from the entire female population of the practice to determine the effect on cancer genetics referral. Objectives To determine the need for cancer genetics intervention for women in a single GP catchment area. (1) to determine the incidence and strength of family history of cancer in women aged over 18 in the practice, (2) to offer cancer genetics advice and determine the uptake of counselling in those with a positive family history, (3) to identify potential BRCA1/BRCA2 gene mutation carriers who can be offered clinical follow up with appropriate translational research studies. Design Population-based cohort study of one General Practice female population. Participants Three hundred and eighty-three women over the age of 18 from one General Practice who responded to a questionnaire about family history of cancer. The whole female adult GP population was the target and the total number sampled was 3,820. Results 10% of patients completed the questionnaire (n = 383). A family history of cancer was present in 338 cases, 95 went on to have genetic counselling or had previously had counselling and 47 were genetically tested. We identified three carriers of an Ashkenazi Jewish founder mutation in BRCA1. Conclusions Response rate to a family history questionnaire such as that used in genetics centres was low (10%) and other approaches will be needed to proactively assess family history. Although the Ashkenazim are present in 39% of the GP catchment

Description of breastfeeding practices among poorer sections in Calcutta Metropolitan Area and its impact on postpartum infecundity.

PubMed

Dihidar, S; Bhattacharya, B N; Mukherjee, K L

2002-09-01

Descriptions of breastfeeding practices among residents in slum areas of Kolkata and the influence of breastfeeding on postpartum amenorrhoea is the focus of this study. Three out of four women initiate breastfeeding after one hour of birth and three out of five women squeeze the first milk from the breast before breastfeeding. Though the median duration of breastfeeding is long, the duration of exclusive breastfeeding is much shorter. Breastfeeding during the first six months has a significant negative influence on the rate of return to menses.

A Real-Time High Performance Computation Architecture for Multiple Moving Target Tracking Based on Wide-Area Motion Imagery via Cloud and Graphic Processing Units

PubMed Central

Liu, Kui; Wei, Sixiao; Chen, Zhijiang; Jia, Bin; Chen, Genshe; Ling, Haibin; Sheaff, Carolyn; Blasch, Erik

2017-01-01

This paper presents the first attempt at combining Cloud with Graphic Processing Units (GPUs) in a complementary manner within the framework of a real-time high performance computation architecture for the application of detecting and tracking multiple moving targets based on Wide Area Motion Imagery (WAMI). More specifically, the GPU and Cloud Moving Target Tracking (GC-MTT) system applied a front-end web based server to perform the interaction with Hadoop and highly parallelized computation functions based on the Compute Unified Device Architecture (CUDA©). The introduced multiple moving target detection and tracking method can be extended to other applications such as pedestrian tracking, group tracking, and Patterns of Life (PoL) analysis. The cloud and GPUs based computing provides an efficient real-time target recognition and tracking approach as compared to methods when the work flow is applied using only central processing units (CPUs). The simultaneous tracking and recognition results demonstrate that a GC-MTT based approach provides drastically improved tracking with low frame rates over realistic conditions. PMID:28208684

A Real-Time High Performance Computation Architecture for Multiple Moving Target Tracking Based on Wide-Area Motion Imagery via Cloud and Graphic Processing Units.

PubMed

Liu, Kui; Wei, Sixiao; Chen, Zhijiang; Jia, Bin; Chen, Genshe; Ling, Haibin; Sheaff, Carolyn; Blasch, Erik

2017-02-12

This paper presents the first attempt at combining Cloud with Graphic Processing Units (GPUs) in a complementary manner within the framework of a real-time high performance computation architecture for the application of detecting and tracking multiple moving targets based on Wide Area Motion Imagery (WAMI). More specifically, the GPU and Cloud Moving Target Tracking (GC-MTT) system applied a front-end web based server to perform the interaction with Hadoop and highly parallelized computation functions based on the Compute Unified Device Architecture (CUDA©). The introduced multiple moving target detection and tracking method can be extended to other applications such as pedestrian tracking, group tracking, and Patterns of Life (PoL) analysis. The cloud and GPUs based computing provides an efficient real-time target recognition and tracking approach as compared to methods when the work flow is applied using only central processing units (CPUs). The simultaneous tracking and recognition results demonstrate that a GC-MTT based approach provides drastically improved tracking with low frame rates over realistic conditions.

Targeted adenoviral vectors

NASA Astrophysics Data System (ADS)

Douglas, Joanne T.

The practical implementation of gene therapy in the clinical setting mandates gene delivery vehicles, or vectors, capable of efficient gene delivery selectively to the target disease cells. The utility of adenoviral vectors for gene therapy is restricted by their dependence on the native adenoviral primary cellular receptor for cell entry. Therefore, a number of strategies have been developed to allow CAR-independent infection of specific cell types, including the use of bispecific conjugates and genetic modifications to the adenoviral capsid proteins, in particular the fibre protein. These targeted adenoviral vectors have demonstrated efficient gene transfer in vitro , correlating with a therapeutic benefit in preclinical animal models. Such vectors are predicted to possess enhanced efficacy in human clinical studies, although anatomical barriers to their use must be circumvented.

Implementing Treat-to-Target Practices for Chronic Pain Through Shared Decision Making: Requisites, Prospects, and Challenges.

PubMed

Falzer, Paul R

2017-02-01

Treat-to-target (T2T) includes a target or goal, standard symptom assessment, and a treatment decision. In specialties that threat chronic pain, T2T is expected to be implemented collaboratively. The ability of patients to participate fully has been questioned, but these concerns have not been demonstrated empirically. The current study examined how patient self-assessed symptom measures and illness beliefs affect their willingness to change their current treatment. A total of 157 patients with rheumatoid arthritis completed a standard "disease activity" (DA) battery consisting of current joint pain, recent pain, daily functioning, and generality disability assessments, along with an illness belief questionnaire and a willingness to change measure. Data were collected at 2-month intervals over a 6-month period. Single and multiple influences on willingness to change were examined using linear mixed models. Willingness is strongly and directly associated with DA scores. Beliefs that were significant as single factors became nonsignificant once DA scores were introduced. The findings established a strong and consistent link between DA scores and willingness, and ruled out the prospect that illness beliefs mediate or moderate this relationship. It was also found that willingness to change is directly related to the number of significant self-reported symptoms. Concerns about the ability of patients to participate in a collaborative implementation of T2T were not substantiated. Future studies can examine the subtle interplay of goals, assessments, and treatment decisions and clarify outstanding issues about the practice of clinical decision making. © 2016 World Institute of Pain.

Responding to Global Shifts: Meta-Practice as a Relevant Social Work Practice Paradigm

ERIC Educational Resources Information Center

Grise-Owens, Erlene; Miller, J. Jay; Owens, Larry W.

2014-01-01

In response to increasing global changes, this article proposes that social work education add meta-practice to traditional micro-, mezzo-, and macro-practice curriculum areas. Drawing on pertinent literature, the authors conceptualize meta-practice as a necessary paradigm shift for competent and relevant social work practice. Further, the authors…

Target analyte quantification by isotope dilution LC-MS/MS directly referring to internal standard concentrations--validation for serum cortisol measurement.

PubMed

Maier, Barbara; Vogeser, Michael

2013-04-01

Isotope dilution LC-MS/MS methods used in the clinical laboratory typically involve multi-point external calibration in each analytical series. Our aim was to test the hypothesis that determination of target analyte concentrations directly derived from the relation of the target analyte peak area to the peak area of a corresponding stable isotope labelled internal standard compound [direct isotope dilution analysis (DIDA)] may be not inferior to conventional external calibration with respect to accuracy and reproducibility. Quality control samples and human serum pools were analysed in a comparative validation protocol for cortisol as an exemplary analyte by LC-MS/MS. Accuracy and reproducibility were compared between quantification either involving a six-point external calibration function, or a result calculation merely based on peak area ratios of unlabelled and labelled analyte. Both quantification approaches resulted in similar accuracy and reproducibility. For specified analytes, reliable analyte quantification directly derived from the ratio of peak areas of labelled and unlabelled analyte without the need for a time consuming multi-point calibration series is possible. This DIDA approach is of considerable practical importance for the application of LC-MS/MS in the clinical laboratory where short turnaround times often have high priority.

Promoting chlamydia screening with posters and leaflets in general practice--a qualitative study.

PubMed

Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

2009-10-12

General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. The NCSP should consider developing a range of more discrete but eye

Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

PubMed Central

Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

2009-01-01

Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP should consider developing

Schools at Work: Targeting Proficiency with Theory to Practice

ERIC Educational Resources Information Center

White-Hood, Marian

2006-01-01

Profound problems in public schools require solutions that are often difficult to implement. Although we, as a society, see the future embodied in the students, our promise to educate them is often not reflected in our practices. A lack of will is evident. The following article explores the notion of "schools at work" and provides…

Impact of medical student origins on the likelihood of ultimately practicing in areas of low vs high socio-economic status.

PubMed

Puddey, Ian B; Playford, Denese E; Mercer, Annette

2017-01-05

Medical schools are in general over-represented by students from high socio-economic status backgrounds. The University of Western Australia Medical School has been progressively widening the participation of students from a broader spectrum of the community both through expanded selection criteria and quota-based approaches for students of rural, indigenous and other socio-educationally disadvantaged backgrounds. We proposed that medical students entering medical school from such backgrounds would ultimately be more likely to practice in areas of increased socio-economic disadvantage. The current practice address of 2829 medical students who commenced practice from 1980 to 2011 was ascertained from the Australian Health Practitioner Regulation Agency (AHPRA) Database. Logistic regression was utilised to determine the predictors of the likelihood of the current practice address being in the lower 8 socio-economic deciles versus the top 2 socio-economic deciles. Those who were categorised in the lower 8 socio-economic deciles at entry to medical school had increased odds of a current practice address in the lower 8 socio-economic deciles 5 or more years after graduation (OR 2.05, 95% CI 1.72, 2.45, P < 0.001). Other positive univariate predictors included age at medical degree completion (for those 25 years or older vs those 24 years or younger OR 1.53, 95% CI 1.27, 1.84, P < 0.001), being female (OR 1.26, 95% CI 1.07, 1.48, P = 0.005) and having a general practice versus specialist qualification (OR 4.16, 95% CI 3.33, 5.19, P < 0.001). Negative predictors included having attended an independent school vs a government school (OR 0.77, 95% CI 0.64, 0.92, P < 0.001) or being originally from overseas vs being born in Oceania (OR 0.80, 95% CI 0.67, 0.96, P = 0.017). After adjustment for potential confounders in multivariate logistic regression, those in the lower 8 socio-economic deciles at entry to medical school still had increased odds of

Mental Disorders, Personality Traits, and Grievance-Fueled Targeted Violence: The Evidence Base and Implications for Research and Practice.

PubMed

Corner, Emily; Gill, Paul; Schouten, Ronald; Farnham, Frank

2018-06-06

This article aims to move away from intuitive appeals that link mental disorder with violence such as terrorism, mass murder, and other targeted violence. The article synthesizes the existing evidence base regarding the relationship between mental disorders and personality traits and (a) attitudinal affinities with violent causes, and (b) a number of violent behaviors (including mass murder and terrorism). The evidence base is mixed and the research focus changed across time: from simple and unempirical assertions of causation to an almost complete rejection of their presence to a finer grained and disaggregated understanding. Empirical research examining mental disorder in crime and violence highlights that the commission of such events is a complex synthesis of psychopathology, personal circumstance, and environment. The article concludes with several suggestions regarding future research and practice.

Screening for important unwarranted variation in clinical practice: a triple-test of processes of care, costs and patient outcomes.

PubMed

Partington, Andrew; Chew, Derek P; Ben-Tovim, David; Horsfall, Matthew; Hakendorf, Paul; Karnon, Jonathan

2017-03-01

Objective Unwarranted variation in clinical practice is a target for quality improvement in health care, but there is no consensus on how to identify such variation or to assess the potential value of initiatives to improve quality in these areas. This study illustrates the use of a triple test, namely the comparative analysis of processes of care, costs and outcomes, to identify and assess the burden of unwarranted variation in clinical practice. Methods Routinely collected hospital and mortality data were linked for patients presenting with symptoms suggestive of acute coronary syndromes at the emergency departments of four public hospitals in South Australia. Multiple regression models analysed variation in re-admissions and mortality at 30 days and 12 months, patient costs and multiple process indicators. Results After casemix adjustment, an outlier hospital with statistically significantly poorer outcomes and higher costs was identified. Key process indicators included admission patterns, use of invasive diagnostic procedures and length of stay. Performance varied according to patients' presenting characteristics and time of presentation. Conclusions The joint analysis of processes, outcomes and costs as alternative measures of performance inform the importance of reducing variation in clinical practice, as well as identifying specific targets for quality improvement along clinical pathways. Such analyses could be undertaken across a wide range of clinical areas to inform the potential value and prioritisation of quality improvement initiatives. What is known about the topic? Variation in clinical practice is a long-standing issue that has been analysed from many different perspectives. It is neither possible nor desirable to address all forms of variation in clinical practice: the focus should be on identifying important unwarranted variation to inform actions to reduce variation and improve quality. What does this paper add? This paper proposes the

Knowledge and practices towards influenza A (H1N1) among adults in three residential areas in Tampin Negeri Sembilan: a cross sectional survey.

PubMed

Zairina, A R; Nooriah, M S; Yunus, A Mohd

2011-08-01

A cross-sectional survey was conducted with the objective to explore a community's knowledge and practices towards prevention of Influenza A (H1N1) in three residential areas in Tampin. Respondents were randomly selected from a list of residences and interviewed face-to-face using a structured questionnaire. A total of 221 respondents (80.9%) were involved with the majority (64.7%) comprising female and who had attained secondary level of education (86.0%). The main source of information was from television/radio. The total score for knowledge questions was 15 and practice questions were 25. A total of 60.2% attained "adequate knowledge" and 52.0% "good practice". Mean (SD) for knowledge score was 11.6 (2.3) and practice was 18.1 (4.1). Ethnicity, education, income and practice score were identified as predictors for knowledge score. Income and knowledge scores were predictors for practice score. There was positive correlation between knowledge and practice scores.

Target detection method by airborne and spaceborne images fusion based on past images

NASA Astrophysics Data System (ADS)

Chen, Shanjing; Kang, Qing; Wang, Zhenggang; Shen, ZhiQiang; Pu, Huan; Han, Hao; Gu, Zhongzheng

2017-11-01

To solve the problem that remote sensing target detection method has low utilization rate of past remote sensing data on target area, and can not recognize camouflage target accurately, a target detection method by airborne and spaceborne images fusion based on past images is proposed in this paper. The target area's past of space remote sensing image is taken as background. The airborne and spaceborne remote sensing data is fused and target feature is extracted by the means of airborne and spaceborne images registration, target change feature extraction, background noise suppression and artificial target feature extraction based on real-time aerial optical remote sensing image. Finally, the support vector machine is used to detect and recognize the target on feature fusion data. The experimental results have established that the proposed method combines the target area change feature of airborne and spaceborne remote sensing images with target detection algorithm, and obtains fine detection and recognition effect on camouflage and non-camouflage targets.

Influence of lateral target size on hot electron production and electromagnetic pulse emission from laser-irradiated metallic targets

NASA Astrophysics Data System (ADS)

Chen, Zi-Yu; Li, Jian-Feng; Yu, Yong; Wang, Jia-Xiang; Li, Xiao-Ya; Peng, Qi-Xian; Zhu, Wen-Jun

2012-11-01

The influences of lateral target size on hot electron production and electromagnetic pulse emission from laser interaction with metallic targets have been investigated. Particle-in-cell simulations at high laser intensities show that the yield of hot electrons tends to increase with lateral target size, because the larger surface area reduces the electrostatic field on the target, owing to its expansion along the target surface. At lower laser intensities and longer time scales, experimental data characterizing electromagnetic pulse emission as a function of lateral target size also show target-size effects. Charge separation and a larger target tending to have a lower target potential have both been observed. The increase in radiation strength and downshift in radiation frequency with increasing lateral target size can be interpreted using a simple model of the electrical capacity of the target.

Knowledge, attitudes and practices (KAP) relating to avian influenza in urban and rural areas of China

PubMed Central

2010-01-01

Background Studies have revealed that visiting poultry markets and direct contact with sick or dead poultry are significant risk factors for H5N1 infection, the practices of which could possibly be influenced by people's knowledge, attitudes and practices (KAPs) associated with avian influenza (AI). To determine the KAPs associated with AI among the Chinese general population, a cross-sectional survey was conducted in China. Methods We used standardized, structured questionnaires distributed in both an urban area (Shenzhen, Guangdong Province; n = 1,826) and a rural area (Xiuning, Anhui Province; n = 2,572) using the probability proportional to size (PPS) sampling technique. Results Approximately three-quarters of participants in both groups requested more information about AI. The preferred source of information for both groups was television. Almost three-quarters of all participants were aware of AI as an infectious disease; the urban group was more aware that it could be transmitted through poultry, that it could be prevented, and was more familiar with the relationship between AI and human infection. The villagers in Xiuning were more concerned than Shenzhen residents about human AI viral infection. Regarding preventative measures, a higher percentage of the urban group used soap for hand washing whereas the rural group preferred water only. Almost half of the participants in both groups had continued to eat poultry after being informed about the disease. Conclusions Our study shows a high degree of awareness of human AI in both urban and rural populations, and could provide scientific support to assist the Chinese government in developing strategies and health-education campaigns to prevent AI infection among the general population. PMID:20170542

Method calibration of the model 13145 infrared target projectors

NASA Astrophysics Data System (ADS)

Huang, Jianxia; Gao, Yuan; Han, Ying

2014-11-01

The SBIR Model 13145 Infrared Target Projectors ( The following abbreviation Evaluation Unit ) used for characterizing the performances of infrared imaging system. Test items: SiTF, MTF, NETD, MRTD, MDTD, NPS. Infrared target projectors includes two area blackbodies, a 12 position target wheel, all reflective collimator. It provide high spatial frequency differential targets, Precision differential targets imaged by infrared imaging system. And by photoelectricity convert on simulate signal or digital signal. Applications software (IR Windows TM 2001) evaluate characterizing the performances of infrared imaging system. With regards to as a whole calibration, first differently calibration for distributed component , According to calibration specification for area blackbody to calibration area blackbody, by means of to amend error factor to calibration of all reflective collimator, radiance calibration of an infrared target projectors using the SR5000 spectral radiometer, and to analyze systematic error. With regards to as parameter of infrared imaging system, need to integrate evaluation method. According to regulation with -GJB2340-1995 General specification for military thermal imaging sets -testing parameters of infrared imaging system, the results compare with results from Optical Calibration Testing Laboratory . As a goal to real calibration performances of the Evaluation Unit.

Rural and remote dental services shortages: filling the gaps through geo-spatial analysis evidence-based targeting.

PubMed

Shiika, Yulia; Kruger, Estie; Tennant, Marc

Australia has a significant mal-distribution of its limited dental workforce. Outside the major capital cities, the distribution of accessible dental care is at best patchy. This study applied geo-spatial analysis technology to locate gaps in dental service accessibility for rural and remote dwelling Australians, in order to test the hypothesis that there are a few key location points in Australia where further dental services could make a significant contribution to ameliorating the immediate shortage crisis. A total of 2,086 dental practices were located in country areas, covering a combined catchment area of 1.84 million square kilometers, based on 50 km catchment zones around each clinic. Geo-spatial analysis technology was used to identify gaps in the accessibility of dental services for rural and remote dwelling Australians. An extraction of data was obtained to analyse the integrated geographically-aligned database. Results: Resolution of the lack of dental practices for 74 townships (of greater than 500 residents) across Australia could potentially address access for 104,000 people. An examination of the socio-economic mix found that the majority of the dental practices (84%) are located in areas classified as less disadvantaged. Output from the study provided a cohesive national map that has identified locations that could have health improvement via the targeting of dental services to that location. The study identified potential location sites for dental clinics, to address the current inequity in accessing dental services in rural and remote Australia.

Bombing Target Identification from Limited Transect Data

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

Roberts, Barry L.; Hathaway, John E.; Pulsipher, Brent A.

2006-08-07

A series of sensor data combined with geostatistical techniques were used to determine likely target areas for a historic military aerial bombing range. Primary data consisted of magnetic anomaly information from limited magnetometer transects across the site. Secondary data included airborne LIDAR, orthophotography, and other general site characterization information. Identification of likely target areas relied primarily upon kriging estimates of magnetic anomaly densities across the site. Secondary information, such as impact crater locations, was used to refine the boundary delineations.

Target Tracking and Interception by Aggressive Honeybees

DTIC Science & Technology

2010-08-01

flat disc) of equal surface area . When aggressive bees are offered a choice between a hemispherical sphere and a flat disc (of equal diameter or...equal surface area ), the bees display a greater frequency of attacks toward the 3-D target when it has the same diameter as the 2-D target, but a...as 107  those carrying pollen on their hind legs. The bees were anesthetized in a refrigerator for 20-108  30 min, after which they were taken out

Orexin–Corticotropin-Releasing Factor Receptor Heteromers in the Ventral Tegmental Area as Targets for Cocaine

PubMed Central

Navarro, Gemma; Quiroz, César; Moreno-Delgado, David; Sierakowiak, Adam; McDowell, Kimberly; Moreno, Estefanía; Rea, William; Cai, Ning-Sheng; Aguinaga, David; Howell, Lesley A.; Hausch, Felix; Cortés, Antonio; Mallol, Josefa; Casadó, Vicent; Lluís, Carme; Canela, Enric I.

2015-01-01

Release of the neuropeptides corticotropin-releasing factor (CRF) and orexin-A in the ventral tegmental area (VTA) play an important role in stress-induced cocaine-seeking behavior. We provide evidence for pharmacologically significant interactions between CRF and orexin-A that depend on oligomerization of CRF1 receptor (CRF1R) and orexin OX1 receptors (OX1R). CRF1R–OX1R heteromers are the conduits of a negative crosstalk between orexin-A and CRF as demonstrated in transfected cells and rat VTA, in which they significantly modulate dendritic dopamine release. The cocaine target σ1 receptor (σ1R) also associates with the CRF1R–OX1R heteromer. Cocaine binding to the σ1R–CRF1R–OX1R complex promotes a long-term disruption of the orexin-A–CRF negative crosstalk. Through this mechanism, cocaine sensitizes VTA cells to the excitatory effects of both CRF and orexin-A, thus providing a mechanism by which stress induces cocaine seeking. PMID:25926444

Orexin-corticotropin-releasing factor receptor heteromers in the ventral tegmental area as targets for cocaine.

PubMed

Navarro, Gemma; Quiroz, César; Moreno-Delgado, David; Sierakowiak, Adam; McDowell, Kimberly; Moreno, Estefanía; Rea, William; Cai, Ning-Sheng; Aguinaga, David; Howell, Lesley A; Hausch, Felix; Cortés, Antonio; Mallol, Josefa; Casadó, Vicent; Lluís, Carme; Canela, Enric I; Ferré, Sergi; McCormick, Peter J

2015-04-29

Release of the neuropeptides corticotropin-releasing factor (CRF) and orexin-A in the ventral tegmental area (VTA) play an important role in stress-induced cocaine-seeking behavior. We provide evidence for pharmacologically significant interactions between CRF and orexin-A that depend on oligomerization of CRF1 receptor (CRF1R) and orexin OX1 receptors (OX1R). CRF1R-OX1R heteromers are the conduits of a negative crosstalk between orexin-A and CRF as demonstrated in transfected cells and rat VTA, in which they significantly modulate dendritic dopamine release. The cocaine target σ1 receptor (σ1R) also associates with the CRF1R-OX1R heteromer. Cocaine binding to the σ1R-CRF1R-OX1R complex promotes a long-term disruption of the orexin-A-CRF negative crosstalk. Through this mechanism, cocaine sensitizes VTA cells to the excitatory effects of both CRF and orexin-A, thus providing a mechanism by which stress induces cocaine seeking. Copyright © 2015 the authors 0270-6474/15/356639-15$15.00/0.

Use of modeling to protect, plan, and manage water resources in catchment areas.

PubMed

Constant, Thibaut; Charrière, Séverine; Lioeddine, Abdejalil; Emsellem, Yves

2016-08-01

The degradation of water resources by diffuse pollution, mainly due to nitrate and pesticides, is an important matter for public health. Restoration of the quality of natural water catchments by focusing on their catchment areas is therefore a national priority in France. To consider catchment areas as homogeneous and to expend an equal effort on the entire area inevitably leads to a waste of time and money, and restorative actions may not be as efficient as intended. The variability of the pedological and geological properties of the area is actually an opportunity to invest effort on smaller areas, simply because every action is not equally efficient on every kind of pedological or geological surface. Using this approach, it is possible to invest in a few selected zones that will be efficient in terms of environmental results. The contributive hydraulic areas (CHA) concept is different from that of the catchment area. Because the transport of most of the mobile and persistent pollutants is primarily driven by water circulation, the concept of the CHA is based on the water pathway from the surface of the soil in the catchment area to the well. The method uses a three-dimensional hydrogeological model of surface and groundwater integrated with a geographic information system called Watermodel. The model calculates the contribution (m(3)/h or %) of each point of the soil to the total flow pumped in a well. Application of this model, partially funded by the Seine Normandy Basin Agency, to the catchment of the Dormelles Well in the Cretaceous chalk aquifer in the Orvanne valley, France (catchment area of 23,000 ha at Dormelles, county 77), shows that 95 % of the water pumped at the Dormelles Well comes from only 26 % of the total surface area of the catchment. Consequently, an action plan to protect the water resource will be targeted at the 93 farmers operating in this source area rather than the total number of farmers (250) across the entire 23,000 ha. Another

Distributed Peer-to-Peer Target Tracking in Wireless Sensor Networks

PubMed Central

Wang, Xue; Wang, Sheng; Bi, Dao-Wei; Ma, Jun-Jie

2007-01-01

Target tracking is usually a challenging application for wireless sensor networks (WSNs) because it is always computation-intensive and requires real-time processing. This paper proposes a practical target tracking system based on the auto regressive moving average (ARMA) model in a distributed peer-to-peer (P2P) signal processing framework. In the proposed framework, wireless sensor nodes act as peers that perform target detection, feature extraction, classification and tracking, whereas target localization requires the collaboration between wireless sensor nodes for improving the accuracy and robustness. For carrying out target tracking under the constraints imposed by the limited capabilities of the wireless sensor nodes, some practically feasible algorithms, such as the ARMA model and the 2-D integer lifting wavelet transform, are adopted in single wireless sensor nodes due to their outstanding performance and light computational burden. Furthermore, a progressive multi-view localization algorithm is proposed in distributed P2P signal processing framework considering the tradeoff between the accuracy and energy consumption. Finally, a real world target tracking experiment is illustrated. Results from experimental implementations have demonstrated that the proposed target tracking system based on a distributed P2P signal processing framework can make efficient use of scarce energy and communication resources and achieve target tracking successfully.

A survey of marketing practices by family practice residency programs.

PubMed

Buckley, R L; Presley, R; Barrigar, R

1995-06-01

The purpose of the study reported in this article was to identify marketing practices that are being utilized by family practice residencies in the United States and to differentiate which strategies were felt to be most useful. A survey questionnaire on marketing strategies was mailed to 361 civilian family practice residencies listed in the 1992 Director of Family Practice Residency Programs. A total of 151 questionnaires were returned for a total response rate of 42.1 percent. The results were summarized using descriptive statistics and Chi-square analysis. Family practice residency programs use a number of different strategies to attract patients. The effectiveness of a given program is dependent on local factors, program strengths and the target population desired. The three most useful marketing strategies reported in the survey were HMO listings, emergency department referrals, and patient referrals. The three least effective strategies were health fairs, sports physicals, and school presentations.

[Association between productivity, list size, patient and practice characteristics in general practice].

PubMed

Olsen, Kim Rose; Sørensen, Torben Højmark; Gyrd-Hansen, Dorte

2010-04-19

Due to shortage of general practitioners, it may be necessary to improve productivity. We assess the association between productivity, list size and patient- and practice characteristics. A regression approach is used to perform productivity analysis based on national register data and survey data for 1,758 practices. Practices are divided into four groups according to list size and productivity. Statistical tests are used to assess differences in patient- and practice characteristics. There is a significant, positive correlation between list size and productivity (p < 0.01). Nevertheless, 19% of the practices have a list size below and a productivity above mean sample values. These practices have relatively demanding patients (older, low socioeconomic status, high use of pharmaceuticals) and they are frequently located in areas with limited access to specialized care and have a low use of assisting personnel. 13% of the practices have a list size above and a productivity below mean sample values. These practices have relatively less demanding patients, are located in areas with good access to specialized care, and have a high use of assisting personnel. Lists and practice characteristics have substantial influence on both productivity and list size. Adjusting list size to external factors seems to be an effective tool to increase productivity in general practice.

Optimal use of EEG recordings to target active brain areas with transcranial electrical stimulation.

PubMed

Dmochowski, Jacek P; Koessler, Laurent; Norcia, Anthony M; Bikson, Marom; Parra, Lucas C

2017-08-15

To demonstrate causal relationships between brain and behavior, investigators would like to guide brain stimulation using measurements of neural activity. Particularly promising in this context are electroencephalography (EEG) and transcranial electrical stimulation (TES), as they are linked by a reciprocity principle which, despite being known for decades, has not led to a formalism for relating EEG recordings to optimal stimulation parameters. Here we derive a closed-form expression for the TES configuration that optimally stimulates (i.e., targets) the sources of recorded EEG, without making assumptions about source location or distribution. We also derive a duality between TES targeting and EEG source localization, and demonstrate that in cases where source localization fails, so does the proposed targeting. Numerical simulations with multiple head models confirm these theoretical predictions and quantify the achieved stimulation in terms of focality and intensity. We show that constraining the stimulation currents automatically selects optimal montages that involve only a few (4-7) electrodes, with only incremental loss in performance when targeting focal activations. The proposed technique allows brain scientists and clinicians to rationally target the sources of observed EEG and thus overcomes a major obstacle to the realization of individualized or closed-loop brain stimulation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Optimal use of EEG recordings to target active brain areas with transcranial electrical stimulation

PubMed Central

Dmochowski, Jacek P.; Koessler, Laurent; Norcia, Anthony M.; Bikson, Marom; Parra, Lucas C.

2018-01-01

To demonstrate causal relationships between brain and behavior, investigators would like to guide brain stimulation using measurements of neural activity. Particularly promising in this context are electroencephalography (EEG) and transcranial electrical stimulation (TES), as they are linked by a reciprocity principle which, despite being known for decades, has not led to a formalism for relating EEG recordings to optimal stimulation parameters. Here we derive a closed-form expression for the TES configuration that optimally stimulates (i.e., targets) the sources of recorded EEG, without making assumptions about source location or distribution. We also derive a duality between TES targeting and EEG source localization, and demonstrate that in cases where source localization fails, so does the proposed targeting. Numerical simulations with multiple head models confirm these theoretical predictions and quantify the achieved stimulation in terms of focality and intensity. We show that constraining the stimulation currents automatically selects optimal montages that involve only a few (4–7) electrodes, with only incremental loss in performance when targeting focal activations. The proposed technique allows brain scientists and clinicians to rationally target the sources of observed EEG and thus overcomes a major obstacle to the realization of individualized or closed-loop brain stimulation. PMID:28578130

Evaluating the Least Cost Selection of Agricultural Management Practices in the Five Mile Creek area of Fort Cobb Watershed, Oklahoma, USA

NASA Astrophysics Data System (ADS)

Rasoulzadeh Gharibdousti, S.; Stoecker, A.; Storm, D.

2017-12-01

One of the main causes of water quality impairment in the United States is human induced Non-Point Source (NPS) pollution through intensive agriculture. The Fort Cobb Reservoir (FCR) watershed located in west-central Oklahoma, United States is a rural agricultural catchment with known issues of NPS pollution including suspended solids, siltation, nutrients, and pesticides. Recently, several Best Management Practices (BMPs) have been implemented in the watershed (such as no-tillage and cropland to grassland conversion) to improve water quality. The objective in this study is to estimate the most cost effective selection and placement of BMPs on farmlands to mitigate soil erosion and the delivery of sediment and nutrient loads to the FCR from Five Mile Creek (FMC) area of the FCR watershed. We employed the Soil and Water Assessment Tool (SWAT) to develop the hydrological model of the study area. The watershed was delineated using the 10 m National Elevation Dataset and divided into 43 sub-basins with an average area of 8 km2. Through a combination of Soil Survey Geographic Database- SSURGO soil data, the US Department of Agriculture crop layer and the slope information, the watershed was further divided into 15,217 hydrologic response units (HRUs). The historical climate pattern in the watershed was represented by two different weather stations. The model was calibrated for the 1991 - 2000 period and validated over the 2001 - 2010 period against the monthly USGS observations of streamflow and suspended sediment concentration recorded at the watershed outlet. Model parametrization resulted in satisfactory values for the R2 (0.64, 0.35) and NS (0.61, 0.34) in calibration period and an excellent model performance (R2 = 0.79, 0.38; NS = 0.75, 0.43) in validation period for streamflow and sediment concentration respectively. We have selected 20 BMPs to estimate their efficacy in terms of water, sediment, and crop yields. Linear Programming (LP) was used to determine the

Mapping for the management of diffuse pollution risks related to agricultural plant protection practices: case of the Etang de l'Or catchment area in France.

PubMed

Mghirbi, Oussama; Bord, Jean-Paul; Le Grusse, Philippe; Mandart, Elisabeth; Fabre, Jacques

2018-03-08

Faced with health, environmental, and socio-economic issues related to the heavy use of pesticides, diffuse phytosanitary pollution becomes a major concern shared by all the field actors. These actors, namely the farmers and territorial managers, have expressed the need to implement decision support tools for the territorial management of diffuse pollution resulting from the plant protection practices and their impacts. To meet these steadily increasing requests, a cartographic analysis approach was implemented based on GIS which allows the spatialization of the diffuse pollution impacts related to plant protection practices on the Etang de l'Or catchment area in the South of France. Risk mapping represents a support-decision tool that enables the different field actors to identify and locate vulnerable areas, so as to determine action plans and agri-environmental measures depending on the context of the natural environment. This work shows that mapping is helpful for managing risks related to the use of pesticides in agriculture by employing indicators of pressure (TFI) and risk on the applicator's health (IRSA) and on the environment (IRTE). These indicators were designed to assess the impact of plant protection practices at various spatial scales (field, farm, etc.). The cartographic analysis of risks related to plant protection practices shows that diffuse pollution is unequally located in the North (known for its abundant garrigues and vineyards) and in the South of the Etang de l'Or catchment area (the Mauguio-Lunel agricultural plain known for its diversified cropping systems). This spatial inequity is essentially related to land use and agricultural production system. Indeed, the agricultural lands cover about 60% of the total catchment area. Consequently, this cartographic analysis helps the territorial actors with the implementation of strategies for managing risks of diffuse pollution related to pesticides use in agriculture, based on environmental and

Optimizing best management practices to control anthropogenic sources of atmospheric phosphorus deposition to inland lakes.

PubMed

Weiss, Lee; Thé, Jesse; Winter, Jennifer; Gharabaghi, Bahram

2018-04-18

Excessive phosphorus loading to inland freshwater lakes around the globe has resulted in nuisance plant growth along the waterfronts, degraded habitat for cold water fisheries, and impaired beaches, marinas and waterfront property. The direct atmospheric deposition of phosphorus can be a significant contributing source to inland lakes. The atmospheric deposition monitoring program for Lake Simcoe, Ontario indicates roughly 20% of the annual total phosphorus load (2010-2014 period) is due to direct atmospheric deposition (both wet and dry deposition) on the lake. This novel study presents a first-time application of the Genetic Algorithm (GA) methodology to optimize the application of best management practices (BMPs) related to agriculture and mobile sources to achieve atmospheric phosphorus reduction targets and restore the ecological health of the lake. The novel methodology takes into account the spatial distribution of the emission sources in the airshed, the complex atmospheric long-range transport and deposition processes, cost and efficiency of the popular management practices and social constraints related to the adoption of BMPs. The optimization scenarios suggest that the optimal overall capital investment of approximately $2M, $4M, and $10M annually can achieve roughly 3, 4 and 5 tonnes reduction in atmospheric P load to the lake, respectively. The exponential trend indicates diminishing returns for the investment beyond roughly $3M per year and that focussing much of this investment in the upwind, nearshore area will significantly impact deposition to the lake. The optimization is based on a combination of the lowest-cost, most-beneficial and socially-acceptable management practices that develops a science-informed promotion of implementation/BMP adoption strategy. The geospatial aspect to the optimization (i.e. proximity and location with respect to the lake) will help land managers to encourage the use of these targeted best practices in areas that

ENSO Predictions in an Intermediate Coupled Model Influenced by Removing Initial Condition Errors in Sensitive Areas: A Target Observation Perspective

NASA Astrophysics Data System (ADS)

Tao, Ling-Jiang; Gao, Chuan; Zhang, Rong-Hua

2018-07-01

Previous studies indicate that ENSO predictions are particularly sensitive to the initial conditions in some key areas (socalled "sensitive areas"). And yet, few studies have quantified improvements in prediction skill in the context of an optimal observing system. In this study, the impact on prediction skill is explored using an intermediate coupled model in which errors in initial conditions formed to make ENSO predictions are removed in certain areas. Based on ideal observing system simulation experiments, the importance of various observational networks on improvement of El Niño prediction skill is examined. The results indicate that the initial states in the central and eastern equatorial Pacific are important to improve El Ni˜no prediction skill effectively. When removing the initial condition errors in the central equatorial Pacific, ENSO prediction errors can be reduced by 25%. Furthermore, combinations of various subregions are considered to demonstrate the efficiency on ENSO prediction skill. Particularly, seasonally varying observational networks are suggested to improve the prediction skill more effectively. For example, in addition to observing in the central equatorial Pacific and its north throughout the year, increasing observations in the eastern equatorial Pacific during April to October is crucially important, which can improve the prediction accuracy by 62%. These results also demonstrate the effectiveness of the conditional nonlinear optimal perturbation approach on detecting sensitive areas for target observations.

Effects of surface area and inflow on the performance of stormwater best management practices with uncertainty analysis.

PubMed

Park, Daeryong; Roesner, Larry A

2013-09-01

The performance of stormwater best management practices (BMPs) is affected by BMP geometric and hydrologic factors. The objective of this study was to investigate the effect of BMP surface area and inflow on BMP performance using the k-C* model with uncertainty analysis. Observed total suspended solids (TSS) from detention basins and retention ponds data sets in the International Stormwater BMP Database were used to build and evaluate the model. Detention basins are regarded as dry ponds because they do not always have water, whereas retention ponds have a permanent pool and are considered wet ponds. In this study, Latin hypercube sampling (LHS) was applied to consider uncertainty in both influent event mean concentration (EMC), C(in), and the areal removal constant, k. The latter was estimated from the hydraulic loading rate, q, through use of a power function relationship. Results show that effluent EMC, C(out), decreased as inflow decreased and as BMP surface area increased in both detention basins and retention ponds. However, the change in C(out), depending on inflow and BMP surface area for detention basins, differed from the change in C(out) for retention ponds. Specifically, C(in) was more dominantly associated with the performance of the k-C* model of detention basins than were BMP surface area and inflow. For retention ponds, however, results suggest that BMP surface area and inflow both influenced changes in C(out) as well as C(in). These results suggest that sensitive factors in the performance of the k-C* model are limited to C(in) for detention basins, whereas BMP surface area, inflow, and C(in) are important for retention ponds.

Protected area management

USGS Publications Warehouse

Fagre, Daniel B.; Prato, Tony; Wang, Yeqiao

2014-01-01

Designated protected areas are diverse in scope and purpose and have expanded from Yellowstone National Park in the United States, the world’s first national park, to 157,897 parks and protected areas distributed globally. Most are publicly owned and serve multiple needs that reflect regional or national cultures. With ever-increasing threats to the integrity of protected areas, managers are turning to flexible management practices such as scenario planning and adaptive management.

Role of Beam Spot Size in Heating Targets at Depth.

PubMed

Ross, E Victor; Childs, James

2015-12-01

Wavelength, fluence and pulse width are primary device parameters for the treatment of skin and hair conditions. Wavelength selection is based on tissue scatter and target chromophores. Pulse width is chosen to optimize target heating. Energy absorbed by a target is determined by fluence and spot size of the light source as well as the depth of the target. We conducted an in vitro skin study and simulations to compare heating of a target at a particular depth versus spot size. Porcine skin and fat tissue were prepared and separated to form a 2mm skin layer above a 1 cm thick fat layer. A 50 μm thermocouple was placed between the layers and centered beneath a 23 x 38 mm treatment window of an 805 nm diode laser device (Vectus, Cynosure, Westford, MA). Apertures provided various incident beam spot sizes and the temperature rise of the thermocouple was measured for a fixed fluence. The 2mm deep target's temperature rise versus treatment area showed two regimes with different positive slopes. The first regime up to approximately 1 cm(2) area has a greater temperature rise versus area than that for the regime greater than 1 cm(2). The slope in the second regime is nonetheless appreciable and provides a fluence reduction factor for skin safety. The same temperature rise in a target at 2 mm depth (typical hair bulb depth in some areas) is realized by increasing the area from 1 to 4 cm(2) while reducing the fluence by half. The role of spot size and in situ beam divergence is an important consideration to determine optimum fluence settings that increase skin safety when treating deeper targets.

The impact of rural-exposure strategies on the intention of dental students and dental graduates to practice in rural areas: a systematic review and meta-analysis

PubMed Central

Suphanchaimat, Rapeepong; Cetthakrikul, Nisachol; Dalliston, Alexander; Putthasri, Weerasak

2016-01-01

Background and objectives The objective of this study was to assess the impact of strategies on the intention of dental students/graduates to practice in rural areas. The strategies included the recruitment of dental students from rural backgrounds and clinical rotations in rural areas during the training of dental students. Materials and methods The study undertook a systematic review and utilized meta-analysis to assess these strategies. International literature published between 2000 and 2015 was retrieved from three main search engines: Medline, Embase, and Scopus. The selected articles were scanned to extract the main content. The impact of the strategies was quantitatively assessed by meta-analysis, using the random-effect model. The pooled effect was reported in terms of odds ratios (ORs) with 95% confidence intervals. Sensitivity and subgroup analyses were performed. Publication bias was assessed by the Funnel plot and Egger’s test. Results Seven of the initially selected 897 articles were included for the full review. The majority of the selected articles had been published in developed countries. The meta-analysis results revealed that the pooled OR of rural exposure on the intention to practice in rural areas was approximately 4.1, statistically significant. Subgroup analysis showed that clinical rotations in rural areas tended to have a slightly greater influence on rural dental practice than recruiting students from rural backgrounds (OR 4.3 versus 4.2). There was weaker evidence of publication bias, which was derived from small-study effects. Conclusion Enrolling students with rural backgrounds and imposing compulsory clinical rotation in rural areas during their study appeared to be effective strategies in tackling the shortage and maldistribution of dentists in rural areas. PMID:27822134

The National Spallation Neutron Source Target Station.

NASA Astrophysics Data System (ADS)

Gabriel, T. A.

1997-05-01

The technologies that are being utilized to design and build a state-of-the-art high powered (>= 1 MW), short pulsed (<= 1 μsec), and reliable spallation neutron source target station are discussed. The protons which directly and indirectly produce the neutrons will be obtained from a 1 GeV proton accelerator composed of an ion gun, rfq, linac, and storage ring. Many scientific and technical disciplines are required to produce a successful target station. These disciplines include engineering, remote handling, neutronics, materials, thermal hydraulics, shock analysis, etc. In the areas of engineering and remote handling special emphasis is being given to rapid and efficient assembly and disassembly of critical parts of the target station. In the neutronics area, emphasis is being given to neutron yield and pulse optimization from the moderators, and heating and activation rates throughout the station. Development of structural materials to withstand aggressive radiation environments and that are compatible with other materials is also an important area. Thermal hydraulics and shock analysis are being closely studied since large amounts of energy are being deposited in small volumes in relatively short time periods (< 1 μsec). These areas will be expanded upon in the paper.

Best practice wound care.

PubMed

O'Brien, Melissa L; Lawton, Joanna E; Conn, Chris R; Ganley, Helen E

2011-04-01

This article describes the barriers, changes and achievements related to implementing one element of a wound care programme being best practice care. With the absence of a coordinated approach to wound care, clinical practice within our Area Health Service (AHS) was diverse, inconsistent and sometimes outdated. This was costly and harmful, leading to overuse of unhelpful care, underuse of effective care and errors in execution. The major aim was to improve the outcomes and quality of life for patients with wound care problems within our community. A collaborative across ten sites/services developed, implemented and evaluated policies and guidelines based on evidence-based bundles of care. Key barriers were local resistance and lack of experience in implementing structural and cultural changes. This was addressed by appointing a wound care programme manager, commissioning of a strategic oversight committee and local wound care committees. The techniques of spread and adoption were used, with early adopters making changes observable and allowing local adaption of guidelines, where appropriate. Deployment and improvement results varied across the sites, ranging from activity but no changes in practice to modest improvement in practice. Evaluating implementation of the leg ulcer guideline as an exemplar, it was demonstrated that there was a statistically significant improvement in overall compliance from 26% to 84%. However, only 7·7% of patients received all interventions to which they were entitled. Compliance with the eight individual interventions of the bundle ranged from 26% to 84%. Generic performance was evaluated against the wound assessment, treatment and evaluation plan with an average compliance of 70%. Early results identified that 20% of wounds were healed within the target of 10 days. As more standardised process are implemented, clinical outcomes should continue to improve and costs decrease. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and

Molecular targets of naturopathy in cancer research: bridge to modern medicine.

PubMed

Ahmad, Aamir; Ginnebaugh, Kevin R; Li, Yiwei; Padhye, Subhash B; Sarkar, Fazlul H

2015-01-06

The relevance of naturopathy (defined as the practice of medicine for the treatment of human diseases with natural agents) in human cancer is beginning to be appreciated, as documented by renewed interest in nutraceutical research, the natural anticancer agents of dietary origin. Because of their pleiotropic effects and the ability to modulate multiple signaling pathways, which is a good attribute of natural agents, nutraceuticals have frequently been demonstrated to re-sensitize drug-resistant cancers. The effectiveness of nutraceuticals can be further enhanced if the tools for the relative assessment of their molecular targets are readily available. Such information can be critical for determining their most effective uses. Here, we discuss the anticancer potential of nutraceuticals and the associated challenges that have interfered with their translational potential as a naturopathic approach for the management of cancers. In the years to come, an efficient screening and assessment of molecular targets will be the key to make rapid progress in the area of drug design and discovery, especially focusing on evidence-based development of naturopathy for the treatment of human malignancies.

Molecular Targets of Naturopathy in Cancer Research: Bridge to Modern Medicine

PubMed Central

Ahmad, Aamir; Ginnebaugh, Kevin R.; Li, Yiwei; Padhye, Subhash B.; Sarkar, Fazlul H.

2015-01-01

The relevance of naturopathy (defined as the practice of medicine for the treatment of human diseases with natural agents) in human cancer is beginning to be appreciated, as documented by renewed interest in nutraceutical research, the natural anticancer agents of dietary origin. Because of their pleiotropic effects and the ability to modulate multiple signaling pathways, which is a good attribute of natural agents, nutraceuticals have frequently been demonstrated to re-sensitize drug-resistant cancers. The effectiveness of nutraceuticals can be further enhanced if the tools for the relative assessment of their molecular targets are readily available. Such information can be critical for determining their most effective uses. Here, we discuss the anticancer potential of nutraceuticals and the associated challenges that have interfered with their translational potential as a naturopathic approach for the management of cancers. In the years to come, an efficient screening and assessment of molecular targets will be the key to make rapid progress in the area of drug design and discovery, especially focusing on evidence-based development of naturopathy for the treatment of human malignancies. PMID:25569626

Catastrophic Declines in Wilderness Areas Undermine Global Environment Targets.

PubMed

Watson, James E M; Shanahan, Danielle F; Di Marco, Moreno; Allan, James; Laurance, William F; Sanderson, Eric W; Mackey, Brendan; Venter, Oscar

2016-11-07

Humans have altered terrestrial ecosystems for millennia [1], yet wilderness areas still remain as vital refugia where natural ecological and evolutionary processes operate with minimal human disturbance [2-4], underpinning key regional- and planetary-scale functions [5, 6]. Despite the myriad values of wilderness areas-as critical strongholds for endangered biodiversity [7], for carbon storage and sequestration [8], for buffering and regulating local climates [9], and for supporting many of the world's most politically and economically marginalized communities [10]-they are almost entirely ignored in multilateral environmental agreements. This is because they are assumed to be relatively free from threatening processes and therefore are not a priority for conservation efforts [11, 12]. Here we challenge this assertion using new comparable maps of global wilderness following methods established in the original "last of the wild" analysis [13] to examine the change in extent since the early 1990s. We demonstrate alarming losses comprising one-tenth (3.3 million km 2 ) of global wilderness areas over the last two decades, particularly in the Amazon (30%) and central Africa (14%). We assess increases in the protection of wilderness over the same time frame and show that these efforts are failing to keep pace with the rate of wilderness loss, which is nearly double the rate of protection. Our findings underscore an immediate need for international policies to recognize the vital values of wilderness and the unprecedented threats they face and to underscore urgent large-scale, multifaceted actions needed to maintain them. Copyright © 2016 Elsevier Ltd. All rights reserved.

Constrained target controllability of complex networks

NASA Astrophysics Data System (ADS)

Guo, Wei-Feng; Zhang, Shao-Wu; Wei, Ze-Gang; Zeng, Tao; Liu, Fei; Zhang, Jingsong; Wu, Fang-Xiang; Chen, Luonan

2017-06-01

It is of great theoretical interest and practical significance to study how to control a system by applying perturbations to only a few driver nodes. Recently, a hot topic of modern network researches is how to determine driver nodes that allow the control of an entire network. However, in practice, to control a complex network, especially a biological network, one may know not only the set of nodes which need to be controlled (i.e. target nodes), but also the set of nodes to which only control signals can be applied (i.e. constrained control nodes). Compared to the general concept of controllability, we introduce the concept of constrained target controllability (CTC) of complex networks, which concerns the ability to drive any state of target nodes to their desirable state by applying control signals to the driver nodes from the set of constrained control nodes. To efficiently investigate the CTC of complex networks, we further design a novel graph-theoretic algorithm called CTCA to estimate the ability of a given network to control targets by choosing driver nodes from the set of constrained control nodes. We extensively evaluate the CTC of numerous real complex networks. The results indicate that biological networks with a higher average degree are easier to control than biological networks with a lower average degree, while electronic networks with a lower average degree are easier to control than web networks with a higher average degree. We also show that our CTCA can more efficiently produce driver nodes for target-controlling the networks than existing state-of-the-art methods. Moreover, we use our CTCA to analyze two expert-curated bio-molecular networks and compare to other state-of-the-art methods. The results illustrate that our CTCA can efficiently identify proven drug targets and new potentials, according to the constrained controllability of those biological networks.

Burning questions for managers: Fuels management practices in riparian areas

Treesearch

Kristen E. Meyer; Kathleen A. Dwire; Patricia A. Champ; Sandra E. Ryan; Gregg M. Riegel; Timothy A. Burton

2012-01-01

Vegetation treatment projects for fuel reduction in riparian areas can pose distinct challenges to resource managers. Riparian areas are protected by administrative regulations, many of which are largely custodial and restrict active management. Like uplands, however, riparian areas have been affected by fire suppression, land use, and multiple types of disturbance....

Drug-targeting methodologies with applications: A review

PubMed Central

Kleinstreuer, Clement; Feng, Yu; Childress, Emily

2014-01-01

Targeted drug delivery to solid tumors is a very active research area, focusing mainly on improved drug formulation and associated best delivery methods/devices. Drug-targeting has the potential to greatly improve drug-delivery efficacy, reduce side effects, and lower the treatment costs. However, the vast majority of drug-targeting studies assume that the drug-particles are already at the target site or at least in its direct vicinity. In this review, drug-delivery methodologies, drug types and drug-delivery devices are discussed with examples in two major application areas: (1) inhaled drug-aerosol delivery into human lung-airways; and (2) intravascular drug-delivery for solid tumor targeting. The major problem addressed is how to deliver efficiently the drug-particles from the entry/infusion point to the target site. So far, most experimental results are based on animal studies. Concerning pulmonary drug delivery, the focus is on the pros and cons of three inhaler types, i.e., pressurized metered dose inhaler, dry powder inhaler and nebulizer, in addition to drug-aerosol formulations. Computational fluid-particle dynamics techniques and the underlying methodology for a smart inhaler system are discussed as well. Concerning intravascular drug-delivery for solid tumor targeting, passive and active targeting are reviewed as well as direct drug-targeting, using optimal delivery of radioactive microspheres to liver tumors as an example. The review concludes with suggestions for future work, considereing both pulmonary drug targeting and direct drug delivery to solid tumors in the vascular system. PMID:25516850

Interventions That Target Criminogenic Needs for Justice-Involved Persons With Serious Mental Illnesses: A Targeted Service Delivery Approach.

PubMed

Wilson, Amy Blank; Farkas, Kathleen; Bonfine, Natalie; Duda-Banwar, Janelle

2018-05-01

This research describes the development of a targeted service delivery approach that tailors the delivery of interventions that target criminogenic needs to the specific learning and treatment needs of justice-involved people with serious mental illnesses (SMIs). This targeted service delivery approach includes five service delivery strategies: repetition and summarizing, amplification, active coaching, low-demand practice, and maximizing participation. Examples of how to apply each strategy in session are provided, as well as recommendations on when to use each strategy during the delivery of interventions that target criminogenic needs. This targeted service delivery approach makes an important contribution to the development of interventions for justice-involved people with SMI by increasing the chances that people with SMI can participate fully in and benefit from these interventions that target criminogenic needs. These developments come at a critical time in the field as the next generation of services for justice-involved people with SMI are being developed.

A multi-criteria targeting approach to neutral grassland conservation.

PubMed

Bayliss, Julian; Helyar, Alice; Lee, John T; Thompson, Stewart

2003-02-01

Resources for creating and managing rare habitats are limited, and a targeting approach aimed at identifying the most viable sites for habitat conservation is therefore desirable. This study developed a multi-criteria targeting approach to site conservation for two rare grassland types, based on a suite of biotic and abiotic factors managed within a Geographical Information System. A number of biotic and abiotic criteria were assessed to evaluate the biodiversity status of grassland sites. Biotic factors included species diversity, species richness and species rarity; and abiotic factors included patch area, position in the ecological unit and the influence of surrounding land use. Each criterion was given equal weighting and a final biodiversity value for each patch was calculated; the patch with the highest cumulative rank score was deemed the patch with the greatest biodiversity. Each site was then examined in relation to agricultural land under the existing management prescriptions of the Upper Thames Tributaries Environmentally Sensitive Area (UTTESA). Sites identified with high biodiversity potential, but currently not included under management prescriptions, were targeted for future inclusion in the ESA scheme. The targeting approach demonstrated how the national Lowland Meadows habitat action plan creation target of 500 ha could be achieved in the UTTESA. The fact that this target figure was so easily attained within this study area highlighted the possible underestimation of national habitat creation targets.

Identifying Educational Practices Supported by Rigorous Evidence: A Guide to the Selection of Evidence-Based Practices

ERIC Educational Resources Information Center

Regional Resource Center Program, 2014

2014-01-01

One component of the recently required State Systemic Improvement Plan (SSIP) for State Departments of Education calls for the selection and implementation of evidence-based practices (EBPs). This report provides six steps to guide the process of selecting evidence based practices (EBP): (1) Begin with the End in Mind--Determine Targeted Outcomes;…

Test of cure, retesting and extragenital testing practices for Chlamydia trachomatis and Neisseria gonorrhoeae among general practitioners in different socioeconomic status areas: A retrospective cohort study, 2011-2016

PubMed Central

van Liere, Geneviève A. F. S.; Cals, Jochen W. L.; Dukers-Muijrers, Nicole H. T. M.

2018-01-01

Background For Chlamydia trachomatis (CT), a test of cure (TOC) within 3–5 weeks is not recommended. International guidelines differ in advising a Neisseria gonorrhoeae (NG) TOC. Retesting CT and NG positives within 3–12 months is recommended in international guidelines. We assessed TOC and retesting practices including extragenital testing in general practitioner (GP) practices located in different socioeconomic status (SES) areas to inform and optimize local test practices. Methods Laboratory data of 48 Dutch GP practices between January 2011 and July 2016 were used. Based on a patient’s first positive CT or NG test, the proportion of TOC (<3 months) and retests (3–12 months) were calculated. Patient- and GP-related factors were assessed using multivariate logistic regression analyses. Results For CT (n = 622), 20% had a TOC and 24% had a retest at the GP practice. GP practices in low SES areas were more likely to perform a CT TOC (OR:1.8;95%CI:1.1–3.1). Younger patients (<25 years) were more likely to have a CT TOC (OR:1.6;95%CI:1.0–2.4). For CT (n = 622), 2.4% had a TOC and 6.1% had a retest at another STI care provider. For NG (n = 73), 25% had a TOC and 15% had a retest at the GP practice. For NG (n = 73), 2.7% had a TOC and 12.3% had a retest at another STI care provider. In only 0.3% of the consultations patients were tested on extragenital sites. Conclusion Almost 20% of the patients returned for a CT TOC, especially at GP practices in low SES areas. For NG, 1 out of 4 patients returned for a TOC. Retesting rates were low for both CT (24%) and NG (15%), (re)infections including extragenital infections may be missed. Efforts are required to focus TOC and increase retesting practices of GPs in order to improve CT/NG control. PMID:29538469

100-F Target Analyte List Development for Soil

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

Ovink, R.

2012-09-18

This report documents the process used to identify source area target analytes in support of the 100-F Area remedial investigation/feasibility study (RI/FS) addendum to the Integrated 100 Area Remedial Investigation/Feasibility Study Work Plan (DOE/RL-2008-46, Rev. 0).

100-K Target Analyte List Development for Soil

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

Ovink, R.

2012-09-18

This report documents the process used to identify source area target analytes in support of the 100-K Area remedial investigation/feasibility study (RI/FS) addendum to the Integrated 100 Area Remedial Investigation/Feasibility Study Work Plan (DOE/RL-2008-46, Rev. 0).

Target Acquisition for Projectile Vision-Based Navigation

DTIC Science & Technology

2014-03-01

Future Work 20 8. References 21 Appendix A. Simulation Results 23 Appendix B. Derivation of Ground Resolution for a Diffraction-Limited Pinhole Camera...results for visual acquisition (left) and target recognition (right). ..........19 Figure B-1. Differential object and image areas for pinhole camera...projectile and target (measured in terms of the angle ) will depend on target heading. In particular, because we have aligned the x axis along the

Utilisation of general practitioner services and achievement of guideline targets by people with diabetes who joined a peer-support program in Victoria, Australia.

PubMed

Rawal, Lal B; Wolfe, Rory; Riddell, Michaela; Dunbar, James A; Li, Hang; Oldenburg, Brian

2015-01-01

This paper describes the use of general practitioner (GP) services and achievement of guideline targets by 285 adults with type 2 diabetes in urban and regional areas of Victoria, Australia. Anthropometric and biomedical measures and responses to a self-administered questionnaire were collected. Findings indicate that almost all participants had visited a GP and had had their hypoglycated haemoglobin (HbA1c) measured in the past 6 months; less than one-third had visited a practice nurse. Fifty per cent achieved a HbA1c target of 7.0%; 40%, a total cholesterol ≤ 4.00 mmol/L; 39%, BP Systolic ≤ 130 mmHg; 51%, BP Diastolic ≤ 80 mmHg; 15%, body mass index ≤ 25 kg/m2; and 34% reported a moderately intense level of physical activity, that is, ≥ 30 min, 5 days a week. However, 39% of individuals achieved at least two targets and 18% achieved at least three of these guideline targets. Regional participants were more likely to report having a management plan and having visited a practice nurse, but they were less likely to have visited other health professionals. Therefore, a more sustained effort that also includes collaborative care approaches is required to improve the management of diabetes in Australia.

Teachers Implementing Entrepreneurship Education: Classroom Practices

ERIC Educational Resources Information Center

Ruskovaara, Elena; Pihkala, Timo

2013-01-01

Purpose: This study aims to highlight the entrepreneurship education practices teachers use in their work. Another target is to analyze how these practices differ based on a number of background factors. Design/methodology/approach: This article presents a quantitative analysis of 521 teachers and other entrepreneurship education actors. The paper…

Factors Affecting Dengue Prevention Practices: Nationwide Survey of the Malaysian Public

PubMed Central

Wong, Li Ping; Shakir, Sharina Mahavera Mohamad; Atefi, Narges; AbuBakar, Sazaly

2015-01-01

Background Efforts to stamp dengue in many dengue endemic countries has met little success. There is a need to re-examine and understand how the public at large view the dengue prevention efforts. This study aimed to examine the demographic factors, theoretical constructs of the Health Belief Model and knowledge about dengue and how these influence the practice of dengue prevention. Methods A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18–60 years. Results The majority (73%) of the Malaysian public had a total dengue prevention score of 51–100 (of a possible score of 1–100). Multivariate analysis suggests significant correlates of higher dengue prevention practices with demographic background, perception of susceptibility to dengue, perceived density of mosquitoes in the neighbourhood and knowledge about dengue. Households of lower income of which the majority (40.7%) were from the rural areas, were associated with the highest odds [OR = 1.33; 95%CI = 1.09–1.67; p = 0.004] of dengue prevention. Dengue prevention practices were also less likely to be undertaken in neighbourhoods where the responders perceived there is no and/or low density of mosquitoes. Dengue prevention practices are also less likely to be practiced by skilled workers [OR = 0.78; 95%CI = 0.63–0.95; p = 0.029] compared to those unemployed. Higher perceived susceptibility to dengue was associated with higher dengue prevention practices and participants with higher dengue knowledge were found to have a higher level of involvement in dengue prevention practices. Conclusion Results from the study suggest that in formulating approaches to contain dengue, strategies should be developed to cultivate dengue prevention practices among urban population and target areas with low density of mosquitoes where public perceived a less likely chance of getting dengue. Dengue prevention campaigns should focus on messages highlighting the risk of contracting

Instructional Supervisory Practices and Teachers' Role Effectiveness in Public Secondary Schools in Calabar South Local Government Area of Cross River State, Nigeria

ERIC Educational Resources Information Center

Sule, Mary Anike; Eyiene, Ameh; Egbai, Mercy E.

2015-01-01

The study investigated the relationship between instructional supervisory practices and teachers' role effectiveness in public secondary schools in Calabar South Local Government Area of Cross River State. Two null hypotheses were formulated to guide the study. Ex-post facto research design was adopted for the study. The population of the study…

Targeting tumor-associated macrophages by anti-tumor Chinese materia medica.

PubMed

Pu, Wei-Ling; Sun, Li-Kang; Gao, Xiu-Mei; Rüegg, Curzio; Cuendet, Muriel; Hottiger, Micheal O; Zhou, Kun; Miao, Lin; Zhang, Yun-Sha; Gebauer, Margaret

2017-10-01

Tumor-associated macrophages (TAMs) play a key role in all stages of tumorigenesis and tumor progression. TAMs secrete different kinds of cytokines, chemokines, and enzymes to affect the progression, metastasis, and resistance to therapy depending on their state of reprogramming. Therapeutic benefit in targeting TAMs suggests that macrophages are attractive targets for cancer treatment. Chinese materia medica (CMM) is an important approach for treating cancer in China and in the Asian region. According to the theory of Chinese medicine (CM) and its practice, some prescriptions of CM regulate the body's internal environment possibly including the remodeling the tumor microenvironment (TME). Here we briefly summarize the pivotal effects of TAMs in shaping the TME and promoting tumorigenesis, invasion, metastasis and immunosuppression. Furthermore, we illustrate the effects and mechanisms of CMM targeting TAMs in antitumor therapy. Finally, we reveal the CMM's dual-regulatory and multi-targeting functions on regulating TAMs, and hopefully, provide the theoretical basis for CMM clinical practice related to cancer therapy.

Occurrence Prospect of HDR and Target Site Selection Study in Southeastern of China

NASA Astrophysics Data System (ADS)

Lin, W.; Gan, H.

2017-12-01

Hot dry rock (HDR) geothermal resource is one of the most important clean energy in future. Site selection a HDR resource is a fundamental work to explore the HDR resources. This paper compiled all the HDR development projects domestic and abroad, and summarized the location of HDR geothermal geological index. After comparing the geological background of HDR in the southeast coastal area of China, Yangjiang Xinzhou in Guangdong province, Leizhou Peninsula area, Lingshui in Hainan province and Huangshadong in Guangzhou were selected from some key potential target area along the southeast coast of China. Deep geothermal field model of the study area is established based on the comprehensive analysis of the target area of deep geothermal geological background and deep thermal anomalies. This paper also compared the hot dry rock resources target locations, and proposed suggestions for the priority exploration target area and exploration scheme.

Burglar Target Selection

PubMed Central

Townsley, Michael; Bernasco, Wim; Ruiter, Stijn; Johnson, Shane D.; White, Gentry; Baum, Scott

2015-01-01

Objectives: This study builds on research undertaken by Bernasco and Nieuwbeerta and explores the generalizability of a theoretically derived offender target selection model in three cross-national study regions. Methods: Taking a discrete spatial choice approach, we estimate the impact of both environment- and offender-level factors on residential burglary placement in the Netherlands, the United Kingdom, and Australia. Combining cleared burglary data from all study regions in a single statistical model, we make statistical comparisons between environments. Results: In all three study regions, the likelihood an offender selects an area for burglary is positively influenced by proximity to their home, the proportion of easily accessible targets, and the total number of targets available. Furthermore, in two of the three study regions, juvenile offenders under the legal driving age are significantly more influenced by target proximity than adult offenders. Post hoc tests indicate the magnitudes of these impacts vary significantly between study regions. Conclusions: While burglary target selection strategies are consistent with opportunity-based explanations of offending, the impact of environmental context is significant. As such, the approach undertaken in combining observations from multiple study regions may aid criminology scholars in assessing the generalizability of observed findings across multiple environments. PMID:25866418

Factor Analysis of Therapist-Identified Treatment Targets in Community-Based Children's Mental Health.

PubMed

Love, Allison R; Okado, Izumi; Orimoto, Trina E; Mueller, Charles W

2018-01-01

The present study used exploratory and confirmatory factor analyses to identify underlying latent factors affecting variation in community therapists' endorsement of treatment targets. As part of a statewide practice management program, therapist completed monthly reports of treatment targets (up to 10 per month) for a sample of youth (n = 790) receiving intensive in-home therapy. Nearly 75 % of youth were diagnosed with multiple co-occurring disorders. Five factors emerged: Disinhibition, Societal Rules Evasion, Social Engagement Deficits, Emotional Distress, and Management of Biodevelopmental Outcomes. Using logistic regression, primary diagnosis predicted therapist selection of Disinhibition and Emotional Distress targets. Client age predicted endorsement of Societal Rules Evasion targets. Practice-to-research implications are discussed.

Target Fishing for Chemical Compounds using Target-Ligand Activity data and Ranking based Methods

PubMed Central

Wale, Nikil; Karypis, George

2009-01-01

In recent years the development of computational techniques that identify all the likely targets for a given chemical compound, also termed as the problem of Target Fishing, has been an active area of research. Identification of likely targets of a chemical compound helps to understand problems such as toxicity, lack of efficacy in humans, and poor physical properties associated with that compound in the early stages of drug discovery. In this paper we present a set of techniques whose goal is to rank or prioritize targets in the context of a given chemical compound such that most targets that this compound may show activity against appear higher in the ranked list. These methods are based on our extensions to the SVM and Ranking Perceptron algorithms for this problem. Our extensive experimental study shows that the methods developed in this work outperform previous approaches by 2% to 60% under different evaluation criterions. PMID:19764745

Targeted Optimization of Quasi-Symmetric Stellarators

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

Hegna, Chris C.; Anderson, D. T.; Talmadge, J. N.

2016-10-06

The proposed research focuses on targeted areas of plasma physics dedicated to improving the stellarator concept. Research was pursued in the technical areas of edge/divertor physics in 3D configurations, magnetic island physics in stellarators, the role of 3D shaping on microinstabilities and turbulent transport and energetic ion confinement in stellarators.

Practice of mechanical ventilation in cardiac arrest patients and effects of targeted temperature management: A substudy of the targeted temperature management trial.

PubMed

Harmon, Matthew B A; van Meenen, David M P; van der Veen, Annelou L I P; Binnekade, Jan M; Dankiewicz, Josef; Ebner, Florian; Nielsen, Niklas; Pelosi, Paolo; Schultz, Marcus J; Horn, Janneke; Friberg, Hans; Juffermans, Nicole P

2018-05-12

Mechanical ventilation practices in patients with cardiac arrest are not well described. Also, the effect of temperature on mechanical ventilation settings is not known. The aims of this study were 1) to describe practice of mechanical ventilation and its relation with outcome 2) to determine effects of different target temperatures strategies (33 °C versus 36 °C) on mechanical ventilation settings. This is a substudy of the TTM-trial in which unconscious survivors of a cardiac arrest due to a cardiac cause were randomized to two TTM strategies, 33 °C (TTM33) and 36 °C (TTM36). Mechanical ventilation data were obtained at three time points: 1) before TTM; 2) at the end of TTM (before rewarming) and 3) after rewarming. Logistic regression was used to determine an association between mechanical ventilation variables and outcome. Repeated-measures mixed modelling was performed to determine the effect of TTM on ventilation settings. Mechanical ventilation data was available for 567 of the 950 TTM patients. Of these, 81% was male with a mean (SD) age of 64 (12) years. At the end of TTM median tidal volume was 7.7 ml/kg predicted body weight (PBW)(6.4-8.7) and 60% of patients were ventilated with a tidal volume ≤ 8 ml/kg PBW. Median PEEP was 7.7cmH 2 O (6.4-8.7) and mean driving pressure was 14.6 cmH 2 O (±4.3). The median FiO 2 fraction was 0.35 (0.30-0.45). Multivariate analysis showed an independent relationship between increased respiratory rate and 28-day mortality. TTM33 resulted in lower end-tidal CO 2 (Pgroup = 0.0003) and higher alveolar dead space fraction (Pgroup = 0.003) compared to TTM36, while PCO 2 levels and respiratory minute volume were similar between groups. In the majority of the cardiac arrest patients, protective ventilation settings are applied, including low tidal volumes and driving pressures. High respiratory rate was associated with mortality. TTM33 results in lower end-tidal CO 2 levels and a higher alveolar dead

Uncovering novel repositioning opportunities using the Open Targets platform.

PubMed

Khaladkar, Mugdha; Koscielny, Gautier; Hasan, Samiul; Agarwal, Pankaj; Dunham, Ian; Rajpal, Deepak; Sanseau, Philippe

2017-12-01

The recently developed Open Targets platform consolidates a wide range of comprehensive evidence associating known and potential drug targets with human diseases. We have harnessed the integrated data from this platform for novel drug repositioning opportunities. Our computational workflow systematically mines data from various evidence categories and presents potential repositioning opportunities for drugs that are marketed or being investigated in ongoing human clinical trials, based on evidence strength on target-disease pairing. We classified these novel target-disease opportunities in several ways: (i) number of independent counts of evidence; (ii) broad therapy area of origin; and (iii) repositioning within or across therapy areas. Finally, we elaborate on one example that was identified by this approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

TARGETING POLYMER THERAPEUTICS TO BONE

PubMed Central

Low, Stewart; Kopeček, Jindřich

2012-01-01

An aging population in the developing world has led to an increase in musculoskeletal diseases such as osteoporosis and bone metastases. Left untreated many bone diseases cause debilitating pain and in the case of cancer, death. Many potential drugs are effective in treating diseases but result in side effects preventing their efficacy in the clinic. Bone, however, provides an unique environment of inorganic solids, which can be exploited in order to effectively target drugs to diseased tissue. By integration of bone targeting moieties to drug-carrying water-soluble polymers, the payload to diseased area can be increased while side effects decreased. The realization of clinically relevant bone targeted polymer therapeutics depends on (1) understanding bone targeting moiety interactions, (2) development of controlled drug delivery systems, as well as (3) understanding drug interactions. The latter makes it possible to develop bone targeted synergistic drug delivery systems. PMID:22316530

Alignment of practice guidelines with targeted-therapy drug funding policies in Ontario.

PubMed

Ramjeesingh, R; Meyer, R M; Brouwers, M; Chen, B E; Booth, C M

2013-02-01

We evaluated clinical practice guideline (cpg) recommendations from Cancer Care Ontario's Program in Evidence-Based Care (pebc) for molecularly targeted systemic treatments (tts) and subsequent funding decisions from the Ontario Ministry of Health and Long-Term Care. We identified pebc cpgs on tt published before June 1, 2010, and extracted information regarding the key evidence cited in support of cpg recommendations and the effect size associated with each tt. Those variables were compared with mohltc funding decisions as of June 2011. From 23 guidelines related to 17 tts, we identified 43 recommendations, among which 38 (88%) endorsed tt use. Among all the recommendations, 38 (88%) were based on published key evidence, with 82% (31 of 38) being supported by meta-analyses or phase iii trials. For the 38 recommendations endorsing tts, funding was approved in 28 (74%; odds ratio related to cpg recommendation: 29.9; p = 0.003). We were unable to demonstrate that recommendations associated with statistically significant improvements in overall survival [os: 14 of 16 (88%) vs. 8 of 14 (57%); p = 0.10] or disease- (dfs) or progression-free survival [pfs: 16 of 21 (76%) vs. 3 of 5 (60%); p = 0.59] were more likely to be funded than those with no significant difference. Moreover, we did not observe significant associations between funding approvals and absolute improvements of 3 months or more in os [6 of 6 (100%) vs. 3 of 6 (50%), p = 0.18] or pfs [6 of 8 (75%) vs. 10 of 12 (83%), p = 1.00]. For use of tts, most recommendations in pebc cpgs are based on meta-analyses or phase iii data, and funding decisions were strongly associated with those recommendations. Our data suggest a trend toward increased rates of funding for therapies with statistically significant improvements in os.

Progress toward a practical laser driven ion source using variable thickness liquid crystal targets

NASA Astrophysics Data System (ADS)

Poole, Patrick; Cochran, Ginevra; Zeil, Karl; Metzkes, Josephine; Obst, Lieselotte; Kluge, Thomas; Schlenvoigt, Hans-Peter; Prencipe, Irene; Cowan, Tom; Schramm, Uli; Schumacher, Douglass

2016-10-01

Ion acceleration from ultra-intense laser interaction has been long investigated in pursuit of requisite energies and spectral distributions for applications like proton cancer therapy. However, the details of ion acceleration mechanisms and their laser intensity scaling are not fully understood, especially the complete role of pulse contrast and target thickness. Additionally, target delivery and alignment at appropriate rates for study and subsequent treatment pose significant challenges. We present results from a campaign on the Draco laser using liquid crystal targets that have on-demand, in-situ thickness tunability over more than three orders of magnitude, enabling rapid data collection due to <1 minute, automatically aligned target formation. Diagnostics include spectral and spatial measurement of ions, electrons, and reflected and transmitted light, all with thickness, laser focus, and pulse contrast variations. In particular we discuss optimal thickness vs. contrast and details of ultra-thin target normal ion acceleration, along with supporting particle-in-cell studies. This work was supported by the DARPA PULSE program through AMRDEC, by the NNSA (DE-NA0001976), by EC Horizon 2020 LASERLAB-EUROPE/LEPP (654148), and by the German Federal Ministry of Education and Research (BMBF, 03Z1O511).

Knowledge, attitudes, beliefs and behaviour intentions for three bowel management practices in intensive care: effects of a targeted protocol implementation for nursing and medical staff.

PubMed

Knowles, Serena; Lam, Lawrence T; McInnes, Elizabeth; Elliott, Doug; Hardy, Jennifer; Middleton, Sandy

2015-01-01

Bowel management protocols have the potential to minimize complications for critically ill patients. Targeted implementation can increase the uptake of protocols by clinicians into practice. The theory of planned behaviour offers a framework in which to investigate clinicians' intention to perform the behaviour of interest. This study aimed to evaluate the effect of implementing a bowel management protocol on intensive care nursing and medical staffs' knowledge, attitude, subjective norms, perceived behavioural control, behaviour intentions, role perceptions and past behaviours in relation to three bowel management practices. A descriptive before and after survey using a self-administered questionnaire sent to nursing and medical staff working within three intensive care units before and after implementation of our bowel management protocol (pre: May - June 2008; post: Feb - May 2009). Participants had significantly higher knowledge scores post-implementation of our protocol (pre mean score 17.6; post mean score 19.3; p = 0.004). Post-implementation there was a significant increase in: self-reported past behaviour (pre mean score 5.38; post mean score 7.11; p = 0.002) and subjective norms scores (pre mean score 3.62; post mean score 4.18; p = 0.016) for bowel assessment; and behaviour intention (pre mean score 5.22; post mean score 5.65; p = 0.048) for administration of enema. This evaluation, informed by the theory of planned behaviour, has provided useful insights into factors that influence clinician intentions to perform evidence-based bowel management practices in intensive care. Addressing factors such as knowledge, attitudes and beliefs can assist in targeting implementation strategies to positively affect clinician behaviour change. Despite an increase in clinicians' knowledge scores, our implementation strategy did not, however, significantly change clinician behaviour intentions for all three bowel management practices. Further research is

Health issues and the practicing radiologist: defining concepts and developing recommendations for leave options and policies.

PubMed

Heilbrun, Marta E; Bender, Claire E; Truong, Hang B; Bluth, Edward I

2013-09-01

Radiologists today are faced with the challenges of maintaining and balancing individual and family health needs and the demands of the workplace. To provide the highest quality and safest care of our patients, a corresponding ethos of support for a healthy workforce is required. There is a paucity of targeted information describing protections for and maintenance of the health of the practicing radiologist, in both private and academic settings. However, a review of existing family and medical leave policies may be helpful to practice leaders and practicing radiologists as a platform for the development of strategic workforce plans. This writing, by members of the ACR Commission on Human Resources, addresses the following areas: (1) medical leave, (2) maternity and/or paternity leave, and (3) disability. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study.

PubMed

Lainez, Nuria; García-Donas, Jesús; Esteban, Emilio; Puente, Javier; Sáez, M Isabel; Gallardo, Enrique; Pinto-Marín, Álvaro; Vázquez-Estévez, Sergio; León, Luis; García-Carbonero, Icíar; Suárez-Rodríguez, Cristina; Molins, Carmen; Climent-Duran, Miguel A; Lázaro-Quintela, Martín; González Del Alba, Aranzazu; Méndez-Vidal, María José; Chirivella, Isabel; Afonso, Francisco J; López-Brea, Marta; Sala-González, Nuria; Domenech, Montserrat; Basterretxea, Laura; Santander-Lobera, Carmen; Gil-Arnáiz, Irene; Fernández, Ovidio; Caballero-Díaz, Cristina; Mellado, Begoña; Marrupe, David; García-Sánchez, José; Sánchez-Escribano, Ricardo; Fernández Parra, Eva; Villa Guzmán, José C; Martínez-Ortega, Esther; Belén González, María; Morán, Marina; Suarez-Paniagua, Beatriz; Lecumberri, María J; Castellano, Daniel

2016-02-22

The impact of such recommendations after their implementation of guidelines has not usually been evaluated. Herein, we assessed the impact and compliance with the Spanish Oncology Genitourinary Group (SOGUG) Guidelines for toxicity management of targeted therapies in metastatic renal cell carcinoma (mRCC) in daily clinical practice. Data on 407 mRCC patients who initiated first-line targeted therapy during the year before and the year after publication and implementation of the SOGUG guideline program were available from 34 Spanish Hospitals. Adherence to SOGUG Guidelines was assessed in every cycle. Adverse event (AE) management was consistent with the Guidelines as a whole for 28.7% out of 966 post-implementation cycles compared with 23.1% out of 892 pre-implementation cycles (p = 0.006). Analysis of adherence by AE in non-compliant cycles showed significant changes in appropriate management of hypertension (33% pre-implementation vs. 44.5% post-implementation cycles; p < 0.0001), diarrhea (74.0% vs. 80.5%; p = 0.011) and dyslipemia (25.0% vs. 44.6%; p < 0.001). Slight but significant improvements in AE management were detected following the implementation of SOGUG recommendations. However, room for improvement in the management of AEs due to targeted agents still remains and could be the focus for further programs in this direction.

Maintenance of antemortem dental records in private dental clinics: Knowledge, attitude, and practice among the practitioners of Mangalore and surrounding areas

PubMed Central

Wadhwani, Surbhi; Shetty, Pushparaja; Sreelatha, S. V.

2017-01-01

Introduction: With time, an increase in the number of crimes, mass disasters, and wars, has led to the identification of the deceased or assailant critical. In such circumstances, antemortem dental records play a crucial role. Materials and Methods: A cross-sectional survey involved 95 dentists practicing in and around Mangalore. The structured questionnaire comprised 24 questions regarding the practice of maintenance of dental records. The questionnaire was given either personally or sent by post. The data obtained was subjected to descriptive analysis. Results: With 87% of the dentists maintaining records, only 31% of them recorded all the details required to be present in a dental record. Of these 18% of them maintained the records for >5 years. Conclusion: The results suggest that most of the practicing dentists in this area either do not maintain or maintain inadequate records, which is alarming. Thus, there is a need to set protocols to increase the awareness for maintaining good dental records. PMID:29263612

Effectiveness of training on infant feeding practices among community influencers in a rural area of west Bengal.

PubMed

Haldar, A; Ray, S; Biswas, R; Biswas, B; Mukherjee, D

2001-01-01

Total 34 Influencers were trained in a subcentre area of South 24-parganas district of West Bengal. Knowledge was imparted to community influencers on infant feeding practices through lecture, group discussion, question-answer session and hand-on-training by trained health workers. Pre-assessment was done before initiation of training. Repeat training was conducted at frequent intervals within a period of 3 months. Mean score of knowledge of influencers during pre-training assessment was 13.3 and improved thereafter-following training to 20.8 (1st assessment), 20.6 (2nd assessment), 23.7 (3rd assessment) and 25.2 (final-assessment). Repeat training had also desired impact.

Vandalism: Take Tempting Targets Out of Washrooms

ERIC Educational Resources Information Center

Nation's Schools, 1973

1973-01-01

Provides practical suggestions from school plant managers who have succeeded in cutting down on washroom vandalism. In addition to doorless stalls, recessed accessories, and limiting space, the article suggests concealed piping, plaster ceilings, and removal of all target items. (EA)

In a rural area of Bangladesh, traditional birth attendant training improved early infant feeding practices: a pragmatic cluster randomized trial.

PubMed

Talukder, Shamim; Farhana, Dina; Vitta, Bineti; Greiner, Ted

2017-01-01

In rural Bangladesh, most births take place at home. There is little evidence regarding the influence of traditional birth attendants (TBAs) or community volunteers (CVs) on early infant feeding practices. We conducted a pragmatic cluster randomized controlled trial in Panchagarh District to examine the effects of training and post-training supervision of TBAs/CVs on early breastfeeding practices. Nine unions were randomized into three groups of three unions. We compared outcomes between mothers in a control group (CG), those living in unions where TBAs/CVs had received a 5-day training in early feeding practices (TG) and those living in unions where TBAs/CVs were both trained and supervised (SG). A total of 1182 mothers of infants aged 0-6 months were interviewed at baseline. After 6 months of intervention, an endline survey was conducted on a different sample of 1148 mothers of infants aged 0-6 months in the same areas. In both intervention areas, TBAs/CVs made regular home visits and attended births whenever possible. Rates of early initiation of breastfeeding, avoidance of prelacteal feeds and exclusive breastfeeding were compared between groups using cluster-controlled mixed model logistic regression. At endline, both intervention groups had significantly higher proportions of mothers who reported early initiation of breastfeeding (CG: 88%, TG: 96%, SG: 96%) and avoidance of prelacteal feeds (CG: 48%, TG: 80%, SG: 88%) compared with the control group; there were no significant differences between the two intervention groups. The endline rates of reported exclusive breastfeeding were not significantly different among groups (CG: 67%, TG: 76%, SG: 83%). © 2016 John Wiley & Sons Ltd.

Method of Simulating Flow-Through Area of a Pressure Regulator

NASA Technical Reports Server (NTRS)

Hass, Neal E. (Inventor); Schallhorn, Paul A. (Inventor)

2011-01-01

The flow-through area of a pressure regulator positioned in a branch of a simulated fluid flow network is generated. A target pressure is defined downstream of the pressure regulator. A projected flow-through area is generated as a non-linear function of (i) target pressure, (ii) flow-through area of the pressure regulator for a current time step and a previous time step, and (iii) pressure at the downstream location for the current time step and previous time step. A simulated flow-through area for the next time step is generated as a sum of (i) flow-through area for the current time step, and (ii) a difference between the projected flow-through area and the flow-through area for the current time step multiplied by a user-defined rate control parameter. These steps are repeated for a sequence of time steps until the pressure at the downstream location is approximately equal to the target pressure.

Experiment research on infrared targets signature in mid and long IR spectral bands

NASA Astrophysics Data System (ADS)

Wang, Chensheng; Hong, Pu; Lei, Bo; Yue, Song; Zhang, Zhijie; Ren, Tingting

2013-09-01

Since the infrared imaging system has played a significant role in the military self-defense system and fire control system, the radiation signature of IR target becomes an important topic in IR imaging application technology. IR target signature can be applied in target identification, especially for small and dim targets, as well as the target IR thermal design. To research and analyze the targets IR signature systematically, a practical and experimental project is processed under different backgrounds and conditions. An infrared radiation acquisition system based on a MWIR cooled thermal imager and a LWIR cooled thermal imager is developed to capture the digital infrared images. Furthermore, some instruments are introduced to provide other parameters. According to the original image data and the related parameters in a certain scene, the IR signature of interested target scene can be calculated. Different background and targets are measured with this approach, and a comparison experiment analysis shall be presented in this paper as an example. This practical experiment has proved the validation of this research work, and it is useful in detection performance evaluation and further target identification research.

Baseline and target values for regional and point PV power forecasts: Toward improved solar forecasting

DOE PAGES

Zhang, Jie; Hodge, Bri -Mathias; Lu, Siyuan; ...

2015-11-10

Accurate solar photovoltaic (PV) power forecasting allows utilities to reliably utilize solar resources on their systems. However, to truly measure the improvements that any new solar forecasting methods provide, it is important to develop a methodology for determining baseline and target values for the accuracy of solar forecasting at different spatial and temporal scales. This paper aims at developing a framework to derive baseline and target values for a suite of generally applicable, value-based, and custom-designed solar forecasting metrics. The work was informed by close collaboration with utility and independent system operator partners. The baseline values are established based onmore » state-of-the-art numerical weather prediction models and persistence models in combination with a radiative transfer model. The target values are determined based on the reduction in the amount of reserves that must be held to accommodate the uncertainty of PV power output. The proposed reserve-based methodology is a reasonable and practical approach that can be used to assess the economic benefits gained from improvements in accuracy of solar forecasting. Lastly, the financial baseline and targets can be translated back to forecasting accuracy metrics and requirements, which will guide research on solar forecasting improvements toward the areas that are most beneficial to power systems operations.« less

Large-area burns with pandrug-resistant Pseudomonas aeruginosa infection and respiratory failure.

PubMed

Ning, Fang-Gang; Zhao, Xiao-Zhuo; Bian, Jing; Zhang, Guo-An

2011-02-01

Infection due to pandrug-resistant Pseudomonas aeruginosa (PDRPA) has become a challenge in clinical practice. The aim of this research was to summarize the treatment of large-area burns (60% - 80%) with PDRPA infection and respiratory failure in our hospital over the last two years, and to explore a feasible treatment protocol for such patients. We retrospectively analyzed the treatment of five patients with large-area burns accompanied by PDRPA infection and respiratory failure transferred to our hospital from burn units in hospitals in other Chinese cities from January 2008 to February 2010. Before PDRPA infection occurred, all five patients had open wounds with large areas of granulation because of the failure of surgery and dissolving of scar tissue; they had also undergone long-term administration of carbapenems. This therapy included ventilatory support, rigorous repair of wounds, and combined antibiotic therapy targeted at drug-resistance mechanisms, including carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors. Four patients recovered from burns and one died after therapy. First, compromised immunity caused by delayed healing of burn wounds in patients with large-area burns and long-term administration of carbapenems may be the important factors in the initiation and progression of PDRPA infection. Second, if targeted at drug-resistance mechanisms, combined antibiotic therapy using carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors could effectively control PDRPA infection. Third, although patients with large-area burns suffered respiratory failure and had high risks from anesthesia and surgery, only aggressive skin grafting with ventilatory support could control the infection and save lives. Patients may not be able to tolerate a long surgical procedure, so the duration of surgery should be minimized, and the frequency of surgery increased.

A strategy for actualization of active targeting nanomedicine practically functioning in a living body.

PubMed

Lee, Kyoung Jin; Shin, Seol Hwa; Lee, Jae Hee; Ju, Eun Jin; Park, Yun-Yong; Hwang, Jung Jin; Suh, Young-Ah; Hong, Seung-Mo; Jang, Se Jin; Lee, Jung Shin; Song, Si Yeol; Jeong, Seong-Yun; Choi, Eun Kyung

2017-10-01

Designing nanocarriers with active targeting has been increasingly emphasized as for an ideal delivery mechanism of anti-cancer therapeutic agents, but the actualization has been constrained by lack of reliable strategy ultimately applicable. Here, we designed and verified a strategy to achieve active targeting nanomedicine that works in a living body, utilizing animal models bearing a patient's tumor tissue and subjected to the same treatments that would be used in the clinic. The concept for this strategy was that a novel peptide probe and its counterpart protein, which responded to a therapy, were identified, and then the inherent ability of the peptide to target the designated tumor protein was used for active targeting in vivo. An initial dose of ionizing radiation was locally delivered to the gastric cancer (GC) tumor of a patient-derived xenograft mouse model, and phage-displayed peptide library was intravenously injected. The peptides tightly bound to the tumor were recovered, and the counterpart protein was subsequently identified. Peptide-conjugated liposomal drug showed dramatically improved therapeutic efficacy and possibility of diagnostic imaging with radiation. These results strongly suggested the potential of our strategy to achieve in vivo functional active targeting and to be applied clinically for human cancer treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Camera calibration: active versus passive targets

NASA Astrophysics Data System (ADS)

Schmalz, Christoph; Forster, Frank; Angelopoulou, Elli

2011-11-01

Traditionally, most camera calibrations rely on a planar target with well-known marks. However, the localization error of the marks in the image is a source of inaccuracy. We propose the use of high-resolution digital displays as active calibration targets to obtain more accurate calibration results for all types of cameras. The display shows a series of coded patterns to generate correspondences between world points and image points. This has several advantages. No special calibration hardware is necessary because suitable displays are practically ubiquitious. The method is fully automatic, and no identification of marks is necessary. For a coding scheme based on phase shifting, the localization accuracy is approximately independent of the camera's focus settings. Most importantly, higher accuracy can be achieved compared to passive targets, such as printed checkerboards. A rigorous evaluation is performed to substantiate this claim. Our active target method is compared to standard calibrations using a checkerboard target. We perform camera, calibrations with different combinations of displays, cameras, and lenses, as well as with simulated images and find markedly lower reprojection errors when using active targets. For example, in a stereo reconstruction task, the accuracy of a system calibrated with an active target is five times better.

Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest

PubMed Central

2012-01-01

Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this first paper we discuss: the target audience(s) for guidelines and their use of guidelines; identifying topics for guidelines; guideline group composition (including consumer involvement) and the processes by which guideline groups function and the important procedural issue of managing conflicts of interest in guideline development. PMID:22762776

Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest.

PubMed

Eccles, Martin P; Grimshaw, Jeremy M; Shekelle, Paul; Schünemann, Holger J; Woolf, Steven

2012-07-04

Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this first paper we discuss: the target audience(s) for guidelines and their use of guidelines; identifying topics for guidelines; guideline group composition (including consumer involvement) and the processes by which guideline groups function and the important procedural issue of managing conflicts of interest in guideline development.

Young Physicians in Rural Areas: The Impact of Service in the National Health Service Corps. Volume 2, Survey of Factors Influencing the Location Decision and Practice Patterns.

ERIC Educational Resources Information Center

Langwell, Kathryn; And Others

A survey of young physicians in rural areas was conducted and information was gathered from other data sources and analyzed for three main purposes: (1) to evaluate the retention of National Health Service Corps (NHSC) alumni in Health Manpower Shortage Areas (HMSAs); (2) to document the distribution of NHSC alumni, Private Practice Option (PPO)…

Critical Source Area Delineation: The representation of hydrology in effective erosion modeling.

NASA Astrophysics Data System (ADS)

Fowler, A.; Boll, J.; Brooks, E. S.; Boylan, R. D.

2017-12-01

Despite decades of conservation and millions of conservation dollars, nonpoint source sediment loading associated with agricultural disturbance continues to be a significant problem in many parts of the world. Local and national conservation organizations are interested in targeting critical source areas for control strategy implementation. Currently, conservation practices are selected and located based on the Revised Universal Soil Loss Equation (RUSLE) hillslope erosion modeling, and the National Resource Conservation Service will soon be transiting to the Watershed Erosion Predict Project (WEPP) model for the same purpose. We present an assessment of critical source areas targeted with RUSLE, WEPP and a regionally validated hydrology model, the Soil Moisture Routing (SMR) model, to compare the location of critical areas for sediment loading and the effectiveness of control strategies. The three models are compared for the Palouse dryland cropping region of the inland northwest, with un-calibrated analyses of the Kamiache watershed using publicly available soils, land-use and long-term simulated climate data. Critical source areas were mapped and the side-by-side comparison exposes the differences in the location and timing of runoff and erosion predictions. RUSLE results appear most sensitive to slope driving processes associated with infiltration excess. SMR captured saturation excess driven runoff events located at the toe slope position, while WEPP was able to capture both infiltration excess and saturation excess processes depending on soil type and management. A methodology is presented for down-scaling basin level screening to the hillslope management scale for local control strategies. Information on the location of runoff and erosion, driven by the runoff mechanism, is critical for effective treatment and conservation.

Factor XI as a target for antithrombotic therapy

PubMed Central

Bane, Charles E.; Gailani, David

2014-01-01

Anticoagulants currently used in clinical practice to treat thromboembolic disorders are effective but increase the risk of severe bleeding because they target proteins that are essential for normal coagulation (hemostasis). Drugs with better safety profiles are required for prevention and treatment of thromboembolic disease. Coagulation factor XIa has emerged as a novel target for safer anticoagulant therapy because of its role in thrombosis and its relatively small contribution to hemostasis. PMID:24886766

Simulation of target interpretation based on infrared image features and psychology principle

NASA Astrophysics Data System (ADS)

Lin, Wei; Chen, Yu-hua; Gao, Hong-sheng; Wang, Zhan-feng; Wang, Ji-jun; Su, Rong-hua; Huang, Yan-ping

2009-07-01

It's an important and complicated process in target interpretation that target features extraction and identification, which effect psychosensorial quantity of interpretation person to target infrared image directly, and decide target viability finally. Using statistical decision theory and psychology principle, designing four psychophysical experiment, the interpretation model of the infrared target is established. The model can get target detection probability by calculating four features similarity degree between target region and background region, which were plotted out on the infrared image. With the verification of a great deal target interpretation in practice, the model can simulate target interpretation and detection process effectively, get the result of target interpretation impersonality, which can provide technique support for target extraction, identification and decision-making.

Transfer of motor learning engages specific neural substrates during motor memory consolidation dependent on the practice structure.

PubMed

Kantak, Shailesh S; Sullivan, Katherine J; Fisher, Beth E; Knowlton, Barbara J; Winstein, Carolee J

2011-01-01

The authors investigated how brain activity during motor-memory consolidation contributes to transfer of learning to novel versions of a motor skill following distinct practice structures. They used 1 Hz repetitive Transcranial Magnetic Stimulation (rTMS) immediately after constant or variable practice of an arm movement skill to interfere with primary motor cortex (M1) or dorsolateral prefrontal cortex (DLPFC). The effect of interference was assessed through skill performance on two transfer targets: one within and one outside the range of practiced movement parameters for the variable practice group. For the control (no rTMS) group, variable practice benefited delayed transfer performance more than constant practice. The rTMS effect on delayed transfer performance differed for the two transfer targets. For the within-range target, rTMS interference had no significant affect on the delayed transfer after either practice structure. However, for the outside-range target, rTMS interference to DLPFC but not M1 attenuated delayed transfer benefit following variable practice. Additionally, for the outside-range target, rTMS interference to M1 but not DLPFC attenuated delayed transfer following constant practice. This suggests that variable practice may promote reliance on DLPFC for memory consolidation associated with outside-range transfer of learning, whereas constant practice may promote reliance on M1 for consolidation and long-term transfer.

Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-07-01

Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are

Policy-into-practice for rheumatoid arthritis: randomized controlled trial and cohort study of e-learning targeting improved physiotherapy management.

PubMed

Fary, Robyn E; Slater, Helen; Chua, Jason; Ranelli, Sonia; Chan, Madelynn; Briggs, Andrew M

2015-07-01

To examine the effectiveness of a physiotherapy-specific, web-based e-learning platform, "RAP-el," in best-practice management of rheumatoid arthritis (RA) using a single-blind, randomized controlled trial (RCT) and prospective cohort study. Australian-registered physiotherapists were electronically randomized into intervention and control groups. The intervention group accessed RAP-eL over 4 weeks. Change in self-reported confidence in knowledge and skills was compared between groups at the end of the RCT using linear regression conditioned for baseline scores by a blinded assessor, using intent-to-treat analysis. Secondary outcomes included physiotherapists' satisfaction with RA management and responses to RA-relevant clinical statements and practice-relevant vignettes. Retention was evaluated in a cohort study 8 weeks after the RCT. Eighty physiotherapists were randomized into the intervention and 79 into the control groups. Fifty-six and 48, respectively, provided baseline data. Significant between-group differences were observed for change in confidence in knowledge (mean difference 8.51; 95% confidence interval [95% CI] 6.29, 10.73; effect size 1.62) and skills (mean difference 7.26; 95% CI 5.1, 9.4; effect size 1.54), with the intervention group performing better. Satisfaction in ability to manage RA, 4 of the 6 clinical statements, and responses to vignettes demonstrated significant improvement in the intervention group. Although 8-week scores showed declines in most outcomes, their clinical significance remains uncertain. RAP-eL can improve self-reported confidence, likely practice behaviors and satisfaction in physiotherapists' ability to manage people with RA, and improve their clinical knowledge in several areas of best-practice RA management in the short term. © 2015, American College of Rheumatology.

A Multi-Year Study of Pre-Service Teachers' Literacy Practices in the Content Areas: Time Epistemologies and Indicators of Stasis and Growth

ERIC Educational Resources Information Center

Mitton-Kükner, Jennifer; Murray Orr, Anne

2018-01-01

This three-year study focuses on 42 pre-service teachers' perspectives on integrating literacy into their content area teaching. Pre-service teachers described time as an influential factor shaping their teaching practices, and, we found, that perceptions of time influenced pre-service teachers' reported ability and willingness to plan for and…

Shape and texture fused recognition of flying targets

NASA Astrophysics Data System (ADS)

Kovács, Levente; Utasi, Ákos; Kovács, Andrea; Szirányi, Tamás

2011-06-01

This paper presents visual detection and recognition of flying targets (e.g. planes, missiles) based on automatically extracted shape and object texture information, for application areas like alerting, recognition and tracking. Targets are extracted based on robust background modeling and a novel contour extraction approach, and object recognition is done by comparisons to shape and texture based query results on a previously gathered real life object dataset. Application areas involve passive defense scenarios, including automatic object detection and tracking with cheap commodity hardware components (CPU, camera and GPS).

Self-assessing target with automatic feedback

DOEpatents

Larkin, Stephen W.; Kramer, Robert L.

2004-03-02

A self assessing target with four quadrants and a method of use thereof. Each quadrant containing possible causes for why shots are going into that particular quadrant rather than the center mass of the target. Each possible cause is followed by a solution intended to help the marksman correct the problem causing the marksman to shoot in that particular area. In addition, the self assessing target contains possible causes for general shooting errors and solutions to the causes of the general shooting error. The automatic feedback with instant suggestions and corrections enables the shooter to improve their marksmanship.

Alternative health practices in ethnically diverse rural areas: a collaborative research project.

PubMed

Vest, G W; Ronnau, J; Lopez, B R; Gonzales, G

1997-05-01

Many alternative health practices are gaining popularity in traditional medical centers throughout the country. However, social workers and allied health professionals are rarely educated in these practices. The collaborative pilot research project discussed in this article involved community health providers and a state university department of social work. The project, conducted in rural health clinics, introduced an approach to skillful, safe, and appropriate use of touch synthesized with an awareness of the breath for giver and receiver to a group of Mexican Americans diagnosed with diabetes and their families. This alternative health practice holds promise for reducing stress, promoting health and well-being, and building relationships and warrants further study.

A qualitative study of medical students in a rural track: views on eventual rural practice.

PubMed

Roseamelia, Carrie; Greenwald, James L; Bush, Tiffany; Pratte, Morgan; Wilcox, Jessica; Morley, Christopher P

2014-04-01

Rural tracks (RTs) exist within medical schools across the United States. These programs often target those students from rural areas and those with primary care career interests, given that these factors are robust predictors of eventual rural practice. However, only 26% to 64% of graduates from RTs enter eventual rural practice. We conducted a qualitative, exploratory study of medical students enrolled in one school's RT, examining their interests in rural training, specialization, and eventual rural practice, via open coding of transcripts from focus groups and in-depth individual interviews, leading to identification of emerging themes. A total of 16 out of 54 eligible first- and second-year preclinical medical students participated in focus group sessions, and a total of seven out of 17 eligible third- and fourth-year medical students participated in individual interviews. Analyses revealed the recognition of a "Rural Identity," typical characteristics, and the importance of "Program Fit" and "Intentions for Practice" that trended toward family medicine specialization and rural practice. However, nuances within the comments reveal incomplete commitment to rural practice. In many cases, student preference for rural practice was driven largely by a disinterest in urban practice. Students with rural and primary care practice interests are often not perfectly committed to rural practice. However, RTs may provide a haven for such students within medical school.

Dust Removal Target on 'Vera Rubin Ridge'

NASA Image and Video Library

2017-11-01

This image from the Mars Hand Lens Imager (MAHLI) camera on NASA's Curiosity Mars rover shows effects of using the rover's wire-bristled Dust Removal Tool (DRT) on a rock target called "Christmas Cove." The tool brushed an area about 2.5 inches (6 centimeters) across on Sept. 16, 2017, during the 1,118th Martian day, or sol of Curiosity's work on Mars. MAHLI took this image later the same sol. Both DRT and MAHLI are on the turret of tools at the end of Curiosity's arm. The site is partway up "Vera Rubin Ridge" on lower Mount Sharp, in an area where reconnaissance imaging with science filters revealed variability in indications of the mineral hematite. Removing dust from part of the Christmas Cove target was part of an experiment to check whether dust is subduing the apparent indications of hematite in some of the area's bedrock. The brushed area's purplish tint in this MAHLI image, accentuated even more when observed with science filters of the rover's Mast Camera, is characteristic of fine-grained hematite. Brushing of this target also exposed details in the fine layering and bright veins within the bedrock of this part of Vera Rubin Ridge. The image is oriented so that sunlight comes from upper left. Layers are lower (older) toward lower right. https://photojournal.jpl.nasa.gov/catalog/PIA22064

House Calls in Private Practice.

ERIC Educational Resources Information Center

Whittington, Ronaele

1985-01-01

Relates the experiences of a social worker in private practice who offered house calls as an ongoing setting for counseling and psychotherapy to individuals and families. Describes advantages and disadvantages, liability, and target populations. (JAC)

Ethnoveterinary plants and practices used for ecto-parasite control in semi-arid smallholder farming areas of Zimbabwe.

PubMed

Nyahangare, Emmanuel Tendai; Mvumi, Brighton Marimanzi; Mutibvu, Tonderai

2015-04-30

The inclusion of traditional plant-based ecto-parasite control methods in primary health care of livestock is increasingly becoming an important intervention for improving livestock productivity in resource-challenged smallholder farming areas. In this study, commonly used plants used for the control of cattle ticks and other pests were identified through a survey in four semi-arid districts of Zimbabwe. A standard structured questionnaire with details of demographics, socioeconomic status of households, livestock parasites, control practices and list of ethnoveterinary plants used was used to interview 233 knowledgeable smallholder farmers in four districts. Focus group discussions with community members further provided insights on how the plants were being used and other issues surrounding ecto-parasite control and indigenous knowledge systems in the study areas. The older generation (>40 years) of the respondents were knowledgeable about ethnoveterinary plants and practices. Overall, 51 plant species were reportedly effective against cattle ticks and other livestock parasites. The most frequently mentioned plants were in descending order, Cissus quadrangularis (30.1%), Lippia javanica (19.6%), Psydrax livida (14.9%) and Aloe sp (14.9%). Most of the plant materials were prepared by crushing and soaking in water and spraying the extract on animals. Despite the knowledge of these useful pesticidal plants, the preferred animal health care for cattle and other highly ranked livestock species is still the use of commercial acaricides. Cattle dipping services were reported sporadic by 48% of the respondents. Traditional knowledge and plants are considered only as an alternative in the absence of conventional synthetic products. Livestock farming communities know of plant species used for livestock ecto-parasite control. The plant species are mostly used to complement commercial products. More work, is required to confirm the acaricidal properties claimed by the

From Reflective Practice to Practical Wisdom: Toward a Post-Foundational Teacher Education

ERIC Educational Resources Information Center

Eryaman, Mustafa Yunus

2007-01-01

The author situates this paper within ongoing debates in related areas such as reflective practice, critical pedagogy, practical wisdom and critical theory. First, the author identifies some of the problems in the present notions of reflective teaching and progressive teacher education. The analyzes and compares the traditional-technical and…

Targeting targeted agents: open issues for clinical trial design.

PubMed

Bria, Emilio; Di Maio, Massimo; Carlini, Paolo; Cuppone, Federica; Giannarelli, Diana; Cognetti, Francesco; Milella, Michele

2009-05-22

Molecularly targeted agents for the treatment of solid tumors had entered the market in the last 5 years, with a great impact upon both the scientific community and the society. Many randomized phase III trials conducted in recent years with new targeted agents, despite previous data coming from preclinical research and from phase II trials were often promising, have produced disappointingly negative results. Some other trials have actually met their primary endpoint, demonstrating a statistically significant result favouring the experimental treatment. Unfortunately, with a few relevant exceptions, this advantage is often small, if not negligible, in absolute terms. The difference between statistical significance and clinical relevance should always be considered when translating clinical trials' results in the practice. The reason why this 'revolution' did not significantly impact on cancer treatment to displace chemotherapy from the patient' bedside is in part due to complicated, and in many cases, unknown, mechanisms of action of such drugs; indeed, the traditional way the clinical investigators were used to test the efficacy of 'older' chemotherapeutics, has become 'out of date' from the methodological perspective. As these drugs should be theoretically tailored upon featured bio-markers expressed by the patients, the clinical trial design should follow new rules based upon stronger hypotheses than those developed so far. Indeed, the early phases of basic and clinical drug development are crucial in the correct process which is able to correctly identify the target (when present). Targeted trial designs can result in easier studies, with less, better selected, and supported by stronger proofs of response evidences, patients, in order to not waste time and resources.

Magnetized Target Fusion Driven by Plasma Liners

NASA Technical Reports Server (NTRS)

Thio, Y. C. Francis; Cassibry, Jason; Eskridge, Richard; Kirkpatrick, Ronald C.; Knapp, Charles E.; Lee, Michael; Martin, Adam; Smith, James; Wu, S. T.; Rodgers, Stephen L. (Technical Monitor)

2001-01-01

For practical applications of magnetized target fusion, standoff drivers to deliver the imploding momentum flux to the target plasma remotely are required. Quasi-spherically converging plasma jets have been proposed as standoff drivers for this purpose. The concept involves the dynamic formation of a quasi-spherical plasma liner by the merging of plasma jets, and the use of the liner so formed to compress a spheromak or a field reversed configuration (FRC). Theoretical analysis and computer modeling of the concept are presented. It is shown that, with the appropriate choice of the flow parameters in the liner and the target, the impact between the liner and the target plasma can be made to be shockless in the liner or to generate at most a very weak shock in the liner. Additional information is contained in the original extended abstract.

Modulation of aryl hydrocarbon receptor target genes in circulating lymphocytes from dairy cows bred in a dioxin-like PCB contaminated area.

PubMed

Girolami, Flavia; Spalenza, Veronica; Carletti, Monica; Sacchi, Paola; Rasero, Roberto; Nebbia, Carlo

2013-04-15

Animal productions (i.e. fish, eggs, milk and dairy products) represent the major source of exposure to dioxins, furans, and dioxin-like (DL) polychlorobiphenyls for humans. The negative effects of these highly toxic and persistent pollutants are mediated by the activation of the aryl hydrocarbon receptor (AHR) that elicits the transcriptional induction of several genes, including those involved in xenobiotic metabolism. Previously we demonstrated the presence and functioning of the AHR signaling pathway in primary cultures of bovine blood lymphocytes. The aim of the present study was to investigate by real time PCR the expression and the inducibility of selected target genes (i.e. AHR, AHR nuclear translocator (ARNT), AHR repressor, CYP1A1 and CYP1B1) in uncultured cells from dairy cows naturally exposed to DL-compounds. The study was carried out on two groups of animals bred in a highly polluted area and characterized by a different degree of contamination, as assessed by bulk milk TEQ values, and a control group reared in an industry free area. Bovine lymphocytes expressed only AHR, ARNT and CYP1B1 genes to a detectable level; moreover, only CYP1B1 expression appeared to be correlated to TEQ values, being higher in the most contaminated group, and decreasing along with animal decontamination. Finally, lymphocytes from exposed cows displayed a lower inducibility of both CYP1A1 and CYP1B1 after the in vitro treatment with a specific AHR ligand. In conclusion, our results indicate that DL-compound contaminated cows may display significant changes in AHR-target gene expression of circulating lymphocytes. Copyright © 2013 Elsevier B.V. All rights reserved.