Towards a rigorous framework for studying 2-player continuous games.

PubMed

Shutters, Shade T

2013-03-21

The use of 2-player strategic games is one of the most common frameworks for studying the evolution of economic and social behavior. Games are typically played between two players, each given two choices that lie at the extremes of possible behavior (e.g. completely cooperate or completely defect). Recently there has been much interest in studying the outcome of games in which players may choose a strategy from the continuous interval between extremes, requiring the set of two possible choices be replaced by a single continuous equation. This has led to confusion and even errors in the classification of the game being played. The issue is described here specifically in relation to the continuous prisoners dilemma and the continuous snowdrift game. A case study is then presented demonstrating the misclassification that can result from the extension of discrete games into continuous space. The paper ends with a call for a more rigorous and clear framework for working with continuous games. Copyright © 2013 Elsevier Ltd. All rights reserved.

45 CFR 1801.30 - Continuation into graduate study.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 1801.30 Public Welfare Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM Graduate Study § 1801.30 Continuation into graduate study. (a... Foundation does not conduct a competition for graduate scholarships and does not add new Truman Scholars at...

45 CFR 1801.30 - Continuation into graduate study.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 1801.30 Public Welfare Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM Graduate Study § 1801.30 Continuation into graduate study. (a... Foundation does not conduct a competition for graduate scholarships and does not add new Truman Scholars at...

45 CFR 1801.30 - Continuation into graduate study.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 1801.30 Public Welfare Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM Graduate Study § 1801.30 Continuation into graduate study. (a... Foundation does not conduct a competition for graduate scholarships and does not add new Truman Scholars at...

Nurse Continuity and Hospital-Acquired Pressure Ulcers: A Comparative Analysis Using an Electronic Health Record "Big Data" Set.

PubMed

Stifter, Janet; Yao, Yingwei; Lodhi, Muhammad Kamran; Lopez, Karen Dunn; Khokhar, Ashfaq; Wilkie, Diana J; Keenan, Gail M

2015-01-01

Little research demonstrating the association between nurse continuity and patient outcomes exists despite an intuitive belief that continuity makes a difference in care outcomes. The aim of this study was to examine the association of nurse continuity with the prevention of hospital-acquired pressure ulcers (HAPU). A secondary use of data from the Hands on Automated Nursing Data System (HANDS) was performed for this comparative study. The HANDS is a nursing plan of care data set containing 42,403 episodes documented by 787 nurses, on nine units, in four hospitals and includes nurse staffing and patient characteristics. The HANDS data set resides in a "big data" relational database consisting of 89 tables and 747 columns of data. Via data mining, we created an analytic data set of 840 care episodes, 210 with and 630 without HAPUs, matched by nursing unit, patient age, and patient characteristics. Logistic regression analysis determined the association of nurse continuity and additional nurse-staffing variables on HAPU occurrence. Poor nurse continuity (unit mean continuity index = .21-.42 [1.0 = optimal continuity]) was noted on all nine study units. Nutrition, mobility, perfusion, hydration, and skin problems on admission, as well as patient age, were associated with HAPUs (p < .001). Controlling for patient characteristics, nurse continuity, and the interactions between nurse continuity and other nurse-staffing variables were not significantly associated with HAPU development. Patient characteristics including nutrition, mobility, and perfusion were associated with HAPUs, but nurse continuity was not. We demonstrated a high level of variation in the degree of continuity between patient episodes in the HANDS data, showing that it offers rich potential for future study of nurse continuity and its effect on patient outcomes.

A Process Evaluation of Project Developmental Continuity, Interim Report VI: Recommendations for Continuing the Impact Study.

ERIC Educational Resources Information Center

Granville, Arthur; And Others

This interim report re-examines data on instrument suitability, comparability of groups, and adequacy of sample size in Year III of the process evaluation of Project Developmental Continuity (PDC) and offers preliminary recommendations concerning the feasibility of continuing the impact study. PDC is a Head Start demonstration program aimed at…

A Process Evaluation of Project Developmental Continuity. Interim Report VI: Executive Summary. Recommendations for Continuing the Impact Study.

ERIC Educational Resources Information Center

Granville, Arthur C.; Love, John M.

This brief report summarizes the analysis and conclusions presented in detail in Interim Report VI regarding the feasibility of conducting a longitudinal study of Project Developmental Continuity (PDC). This project is a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and…

Marketing Continuing Education: A Study of Price Strategies. Occasional Papers in Continuing Education, No. 11.

ERIC Educational Resources Information Center

Lamoureux, Marvin E.

The objective of the study conducted at the Centre for Continuing Education (CCE) at the University of British Columbia was to determine that threshold pricing not only existed for continuing education courses, but also was applicable to an administrative decision-making structure. The first part of the three-part investigation analyzed consumer…

The Challenge of Continuation: Schools' Continuation of the Respect Program

ERIC Educational Resources Information Center

Ertesvag, Sigrun K.; Roland, Pal; Vaaland, Grete Sorensen; Storksen, Svein; Veland, Jarmund

2010-01-01

The Respect program is a whole school approach to prevent and reduce problem behavior. The purpose of this study was to investigate which conditions in schools helped them to continue the program successfully after the end of the 1-year implementation period. The study also looked at the actual continuation after the program end. Especially, we…

Studying Implementation within a Continuous Continuous-Improvement Process: What Happens When We Design with Adaptations in Mind?

ERIC Educational Resources Information Center

Tichnor-Wagner, Ariel; Allen, Danielle; Socol, Allison Rose; Cohen-Vogel, Lora; Rutledge, Stacey A.; Xing, Qi W.

2018-01-01

Background/Context: This study examines the implementation of an academic and social-emotional learning innovation called Personalization for Academic and Social-Emotional Learning, or PASL. The innovation was designed, tested, and implemented using a continuous continuous-improvement model. The model emphasized a top-and-bottom process in which…

Quality Assurance in In-House Continuing Training. Case Studies from Europe.

ERIC Educational Resources Information Center

Severing, Eckart; Stahl, Thomas

Nine European Community Member States (Belgium, Germany, France, Greece, Ireland, Luxembourg, Portugal, Spain, and United Kingdom) conducted national studies that involved case studies of quality assurance in continuing education. Analysis of findings indicated that many firms regarded continuing training as a central instrument for achieving…

Future self-continuity is associated with improved health and increases exercise behavior.

PubMed

Rutchick, Abraham M; Slepian, Michael L; Reyes, Monica O; Pleskus, Lindsay N; Hershfield, Hal E

2018-03-01

To the extent that people feel more continuity between their present and future selves, they are more likely to make decisions with the future self in mind. The current studies examined future self-continuity in the context of health. In Study 1, people reported the extent to which they felt similar and connected to their future self; people with more present-future continuity reported having better subjective health across a variety of measures. In Study 2, people were randomly assigned to write a letter to themselves either three months or 20 years into the future; people for whom continuity with the distant future self was enhanced exercised more in the days following the writing task. These findings suggest that future self-continuity promotes adaptive long-term health behavior, suggesting the promise of interventions enhancing future self-continuity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Ferris Educational Mission: A Continuing Study by the Ferris Educational Planning Committee, Part II: Continuing Education.

ERIC Educational Resources Information Center

Ferris State Coll., Big Rapids, MI.

This document, the second of a two-part study, focuses on the area of continuing and adult education at Ferris State College (FSC), Michigan. An overview of the status of adult and continuing education and recommendations are provided by the schools of allied health, business, general education, education, pharmacy, technical and applied arts, and…

An Examination of Different Motivational Orientations That Drive Graduate Students to Continue/Complete Their Education in the U.S.

ERIC Educational Resources Information Center

Karayigit, Cebrail

2017-01-01

Different types and levels of motivation can play an important role for graduate students to continue their studies. The current research study was one of the few studies that examined if domestic and international graduate students differ on their level of different motivational orientations to continue their education. This study employs a…

Predictors of relational continuity in primary care: patient, provider and practice factors

PubMed Central

2013-01-01

Background Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. Methods This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient’s perspective. Results Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Conclusions Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that physicians and policy makers need to consider the fact that ‘bigger is not always necessarily better’. PMID:23725212

Predictors of relational continuity in primary care: patient, provider and practice factors.

PubMed

Kristjansson, Elizabeth; Hogg, William; Dahrouge, Simone; Tuna, Meltem; Mayo-Bruinsma, Liesha; Gebremichael, Goshu

2013-05-31

Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient's perspective. Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that physicians and policy makers need to consider the fact that 'bigger is not always necessarily better'.

Why Students Withdraw or Continue Their Educational Careers: A Closer Look at Differences in Study Approaches and Personal Reasons

ERIC Educational Resources Information Center

Van Bragt, Cyrille A. C.; Bakx, Anouke W. E. A.; Teune, Peter J.; Bergen, Theo C. M.; Croon, Marcel A.

2011-01-01

The central goal of this study is to gain insight into students' study approach, their personal reasons and the relations between them regarding students who continue or withdraw from the educational system within one year. Results of our questionnaire study show that students who continue their educational careers show higher scores on a…

Explaining Electronic Learning Management Systems (ELMS) Continued Usage Intentions among Facilitators in Higher Education Institutions (HEIs) in Tanzania

ERIC Educational Resources Information Center

Muries, Bruckse; Masele, Juma James

2017-01-01

This study sought to explain ELMS continued usage intentions among HEIs in Tanzania. The study was guided by main research question, "What explains ELMS continued usage intentions among facilitators in HEIs in Tanzania?" The study used descriptive cross sectional design administered to 264 respondents drawn from five universities…

Applying andragogy in nursing continuing education.

PubMed

Nielsen, B B

1989-01-01

Andragogy, a philosophical orientation for adult education, receives little attention in the nursing continuing education literature. Yet, the tenets of andragogy form the organizing framework for programming. This article defines andragogy and provides selected results of a research study designed to test andragogical concepts in long-term oncology nursing continuing education programs. The results of the study suggest a new way of viewing the goals of nursing continuing education activities.

Kernel-Smoothing Estimation of Item Characteristic Functions for Continuous Personality Items: An Empirical Comparison with the Linear and the Continuous-Response Models

ERIC Educational Resources Information Center

Ferrando, Pere J.

2004-01-01

This study used kernel-smoothing procedures to estimate the item characteristic functions (ICFs) of a set of continuous personality items. The nonparametric ICFs were compared with the ICFs estimated (a) by the linear model and (b) by Samejima's continuous-response model. The study was based on a conditioned approach and used an error-in-variables…

Assessing the Needs of Adults for Continuing Education: A Model.

ERIC Educational Resources Information Center

Moore, Donald E., Jr.

1980-01-01

Reviews the needs assessment studies described in this journal issue. Concludes that (1) lessons from completed needs assessments can help continuing education practitioners plan and conduct future studies, and (2) a rational, need-reduction, decision-making approach can improve continuing education programs. (CT)

Continuous Manufacturing of Recombinant Therapeutic Proteins: Upstream and Downstream Technologies.

PubMed

Patil, Rohan; Walther, Jason

2017-03-07

Continuous biomanufacturing of recombinant therapeutic proteins offers several potential advantages over conventional batch processing, including reduced cost of goods, more flexible and responsive manufacturing facilities, and improved and consistent product quality. Although continuous approaches to various upstream and downstream unit operations have been considered and studied for decades, in recent years interest and application have accelerated. Researchers have achieved increasingly higher levels of process intensification, and have also begun to integrate different continuous unit operations into larger, holistically continuous processes. This review first discusses approaches for continuous cell culture, with a focus on perfusion-enabling cell separation technologies including gravitational, centrifugal, and acoustic settling, as well as filtration-based techniques. We follow with a review of various continuous downstream unit operations, covering categories such as clarification, chromatography, formulation, and viral inactivation and filtration. The review ends by summarizing case studies of integrated and continuous processing as reported in the literature.

A Process Evaluation of Project Developmental Continuity. Interim Report II, Part A: Program Case Studies. Volume 2.

ERIC Educational Resources Information Center

Spencer, Lynn, Ed.

These 7 case studies are part of a series of documents on the evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and primary school experiences. Each case study reviews the planning year at a PDC demonstration site in one…

A Process Evaluation of Project Developmental Continuity. Interim Report II, Part A: Program Case Studies. Volume I.

ERIC Educational Resources Information Center

Spencer, Lynn, Ed.

These 8 case studies are part of a series of documents on the evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and primary school experiences. Each case study reviews the planning year at a PDC demonstration site in one…

[Continuity and non-continuity from child- to adulthood in psychiatric clinical studies].

PubMed

Kuwabara, Hitoshi; Kawakubo, Yuki; Kano, Yukiko

2014-01-01

It is difficult to conceive of the development of the brain as a single process, especially when we think about continuity and non-continuity from child- to adulthood. Non-continuity may be present when the brain is developing normally or consistently, or during aging, and development may vary across behavioral, structural, functional, and regional units. Clinical studies that consider the developmental process of change as natural and expected may better incorporate the potential variety and non-continuity than clinical studies that do not consider the process of change. It is likely that these complications are exacerbated because the timing of changes appears to vary across units. If we can identify the critical points of plasticity, temporally appropriate interventions can be developed. A focus on the developmental process of changes in the brain may lead to more rational and effective intervention strategies.

Patients' attitudes and experiences of relational continuity in semi-urban general practices in Oman.

PubMed

Al-Azri, Mohammed; Al-Ramadhani, Ruqaiya; Al-Rawahi, Nada; Al-Shafee, Kawther; Al-Hinai, Mustafa; Al-Maniri, Abdullah

2014-06-01

Relational continuity is a cornerstone of primary care. In developing countries, however, little research has been conducted to determine the perception and experiences of patients in view of relational continuity in primary care. To study the role of relational continuity in primary care settings and its effect on patients' perceptions and experiences. A questionnaire-based survey was conducted at eight primary care health centres (PCHCs) in Al-Seeb province, Muscat, the capital city of Oman. All Omani patients aged 18 years and above attending their PCHCs during the study period were invited to participate in the study. From a total of 1300 patients invited, 958 Omani patients agreed to participate in the study (response rate = 74%). More than half of the patients (61%) expressed the preference of consulting the same primary care physician (PCP) to whom they were accustomed. This increased to 69% if the patients had psychosocial problems and to 71% if the patients had chronic medical conditions. A significant proportion of the respondents (72%) felt comfortable and relaxed when consulting the same PCP and 67% expressed an interest in maintaining continuity with the same PCP. The general perspective held by the majority of the studied patients (61%) indicated that relational continuity improved both the patients' medical conditions (51%) and the quality of services (61%). In actuality, however, only 18% experienced relational continuity in their PCHCs. The preference for relational continuity was significantly increased among patients who identified a favourite PCP (P = 0.029) and among educated patients (P = 0.023). Although it is relatively difficult to consult with the same PCP, the majority of Omani patients have experienced several benefits from relational continuity within the context of patient-physician relationship. The preference for relational continuity was highly expressed by patients with chronic or psychosocial problems, patients who were educated and those who identified a named PCP. In view of these findings, the basis of relational continuity if progressed, a great effort is needed to develop and implement strategies to promote relational continuity in primary health care in Oman. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Continuous Classroom Assessment at Primary Level

ERIC Educational Resources Information Center

Ali, Imtiaz; Shah, Syed Manzoor Hussein; Gujjar, Aijaz Ahmed

2014-01-01

This study was designed to analyze the continuous classroom assessment at primary level in Pakistan. Findings of the study revealed that the students' achievement of single class teacher in the subject of English, General science, Urdu and mathematics were almost on average and rubric observation during continuous classroom assessment ranked…

Life Course and Intergenerational Continuity of Intimate Partner Aggression and Physical Injury: A 20-Year Study.

PubMed

Knight, Kelly E; Menard, Scott; Simmons, Sara B; Bouffard, Leana A; Orsi, Rebecca

2016-01-01

The objective of this study is to examine continuity of intimate partner aggression (IPA), which is defined as repeated annual involvement in IPA, across respondents' life course and into the next generation, where it may emerge among adult children. A national, longitudinal, and multigenerational sample of 1,401 individuals and their adult children is analyzed. Annual data on IPA severity and physical injury were collected by the National Youth Survey Family Study across a 20-year period from 1984 to 2004. Three hypotheses and biological sex differences are tested and effect sizes are estimated. First, findings reveal evidence for life course continuity (IPA is a strong predictor of subsequent IPA), but the overall trend decreases over time. Second, intergenerational continuity is documented (parents' IPA predicts adult children's IPA), but the effect is stronger for female than for male adult children. Third, results from combined and separate, more restrictive, measures of victimization and perpetration are nearly identical except in the intergenerational analyses. Fourth, evidence for continuity is not found when assessing physical injury alone. Together, these findings imply that some but not all forms of IPA are common, continuous, and intergenerational. Life course continuity appears stronger than intergenerational continuity.

The use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry.

PubMed

Sadeghi, M; Nilsson, K F; Larzon, T; Pirouzram, A; Toivola, A; Skoog, P; Idoguchi, K; Kon, Y; Ishida, T; Matsumara, Y; Matsumoto, J; Reva, V; Maszkowski, M; Bersztel, A; Caragounis, E; Falkenberg, M; Handolin, L; Kessel, B; Hebron, D; Coccolini, F; Ansaloni, L; Madurska, M J; Morrison, J J; Hörer, T M

2017-08-11

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. REBOA practicing centers were invited to join this online register, which was established in September 2014. REBOA cases were reported, both retrospective and prospective. Demographics, injury patterns, hemodynamic variables, REBOA-specific data, complications and 30-days mortality were reported. Ninety-six cases from 6 different countries were reported between 2011 and 2016. Mean age was 52 ± 22 years and 88% of the cases were blunt trauma with a median injury severity score (ISS) of 41 (IQR 29-50). In the majority of the cases, Zone I REBOA was used. Median systolic blood pressure before balloon inflation was 60 mmHg (IQR 40-80), which increased to 100 mmHg (IQR 80-128) after inflation. Continuous occlusion was applied in 52% of the patients, and 48% received non-continuous occlusion. Occlusion time longer than 60 min was reported as 38 and 14% in the non-continuous and continuous groups, respectively. Complications, such as extremity compartment syndrome (n = 3), were only noted in the continuous occlusion group. The 30-day mortality for non-continuous REBOA was 48%, and 64% for continuous occlusion. This observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.

Mixture Factor Analysis for Approximating a Nonnormally Distributed Continuous Latent Factor with Continuous and Dichotomous Observed Variables

ERIC Educational Resources Information Center

Wall, Melanie M.; Guo, Jia; Amemiya, Yasuo

2012-01-01

Mixture factor analysis is examined as a means of flexibly estimating nonnormally distributed continuous latent factors in the presence of both continuous and dichotomous observed variables. A simulation study compares mixture factor analysis with normal maximum likelihood (ML) latent factor modeling. Different results emerge for continuous versus…

Switch to maraviroc with darunavir/r, both QD, in patients with suppressed HIV-1 was well tolerated but virologically inferior to standard antiretroviral therapy: 48-week results of a randomized trial

PubMed Central

Gagliardini, Roberta; Meini, Genny; Sterrantino, Gaetana; Colangeli, Vincenzo; Re, Maria Carla; Latini, Alessandra; Colafigli, Manuela; Vignale, Francesca; Rusconi, Stefano; Micheli, Valeria; Di Biagio, Antonio; Orofino, Giancarlo; Ghisetti, Valeria; Fantauzzi, Alessandra; Vullo, Vincenzo; Grima, Pierfrancesco; Francisci, Daniela; Mastroianni, Claudio; Antinori, Andrea; Trezzi, Michele; Lisi, Lucia; Navarra, Pierluigi; Canovari, Benedetta; D’Arminio Monforte, Antonella; Lamonica, Silvia; D’Avino, Alessandro; Zazzi, Maurizio; Di Giambenedetto, Simona; De Luca, Andrea

2017-01-01

Objectives Primary study outcome was absence of treatment failure (virological failure, VF, or treatment interruption) per protocol at week 48. Methods Patients on 3-drug ART with stable HIV-1 RNA <50 copies/mL and CCR5-tropic virus were randomized 1:1 to maraviroc with darunavir/ritonavir qd (study arm) or continue current ART (continuation arm). Results In June 2015, 115 patients were evaluable for the primary outcome (56 study, 59 continuation arm). The study was discontinued due to excess of VF in the study arm (7 cases, 12.5%, vs 0 in the continuation arm, p = 0.005). The proportion free of treatment failure was 73.2% in the study and 59.3% in the continuation arm. Two participants in the study and 10 in the continuation arm discontinued therapy due to adverse events (p = 0.030). At VF, no emergent drug resistance was detected. Co-receptor tropism switched to non-R5 in one patient. Patients with VF reported lower adherence and had lower plasma drug levels. Femoral bone mineral density was significantly improved in the study arm. Conclusion Switching to maraviroc with darunavir/ritonavir qd in virologically suppressed patients was associated with improved tolerability but was virologically inferior to 3-drug therapy. PMID:29161288

Using Electronic Health Record (EHR) “Big Data” to Examine the Influence of Nurse Continuity on a Hospital-Acquired Never Event

PubMed Central

STIFTER, Janet; YAO, Yingwei; LODHI, Muhammad Kamran; LOPEZ, Karen Dunn; KHOKHAR, Ashfaq; WILKIE, Diana J.; KEENAN, Gail M.

2015-01-01

Background There is little research demonstrating the influence of nurse continuity on patient outcomes despite an intuitive belief that continuity of care makes a difference in care outcomes. Objective To examine the influence of nurse continuity (the number of consecutive care days by the same/consistent RN[s]) on the prevention of hospital-acquired pressure ulcers (HAPU). Method A secondary use of data from the Hands on Automated Nursing Data System (HANDS) was performed for this comparative study. The HANDS is a nursing plan of care (POC) “big data” database containing 42,403 episodes documented by 787 nurses, on 9 units, in four hospitals and includes nurse staffing and patient characteristics. Via data mining, we created an analytic dataset of 840 care episodes, 210 with and 630 without HAPUs, matched by nursing unit, patient age, and patient characteristics. Logistic regression analysis determined the influence of nurse continuity and additional nurse-staffing variables on the presence of HAPUs. Results Poor nurse continuity (Continuity Index=.21-.42 [1.0=optimal continuity]) was noted on all nine study units. Nutrition, mobility, perfusion, hydration, and skin problems on admission as well as patient age were associated with HAPUs (p<.001). Controlling for patient characteristics, nurse continuity and the interactions between nurse continuity and other nurse-staffing variables were not significantly associated with HAPU development. Discussion Patient characteristics including nutrition, mobility, and perfusion were associated with HAPUs, but nurse continuity was not. One study implication is that to reduce the incidence of HAPUs the most effective resource utilization might be in the continued development of best practices to address patient characteristics that lead to pressure ulcer vulnerability rather than a focus on nurse staffing. PMID:26325278

Comparing Measures of Voice Quality from Sustained Phonation and Continuous Speech

ERIC Educational Resources Information Center

Gerratt, Bruce R.; Kreiman, Jody; Garellek, Marc

2016-01-01

Purpose: The question of what type of utterance--a sustained vowel or continuous speech--is best for voice quality analysis has been extensively studied but with equivocal results. This study examines whether previously reported differences derive from the articulatory and prosodic factors occurring in continuous speech versus sustained phonation.…

Using Perfusion fMRI to Measure Continuous Changes in Neural Activity with Learning

ERIC Educational Resources Information Center

Olson, Ingrid R.; Rao, Hengyi; Moore, Katherine Sledge; Wang, Jiongjiong; Detre, John A.; Aguirre, Geoffrey K.

2006-01-01

In this study, we examine the suitability of a relatively new imaging technique, "arterial spin labeled perfusion imaging," for the study of continuous, gradual changes in neural activity. Unlike BOLD imaging, the perfusion signal is stable over long time-scales, allowing for accurate assessment of continuous performance. In addition, perfusion…

The Role and Impact of Continuing Education on Rural Revitalization: A Case Study

ERIC Educational Resources Information Center

Miller, Marilyn

2008-01-01

This article presents the findings of a study that explored the role and impact of continuing education on rural revitalization. A community development approach, academic expertise, and a university's resources were used to assist the citizens of Montmartre, Saskatchewan, to establish Centre 48, an arts and continuing education centre. Courses…

Kinematic Effects of Nickel-Titanium Instruments with Reciprocating or Continuous Rotation Motion: A Systematic Review of In Vitro Studies.

PubMed

Ahn, So-Yeon; Kim, Hyeon-Cheol; Kim, Euiseong

2016-07-01

This review aimed to compare the kinematic effect of nickel-titanium instruments with reciprocating and continuous rotation motion for cyclic fatigue resistance, shaping ability, apical debris extrusion, and dentinal defects or cracks. Articles were selected for inclusion in this review if they fulfilled all of the following criteria: described in vitro studies performed on either extracted human teeth or an artificial canal model, assessed both reciprocating and rotary instruments, compared reciprocating files and rotary files for the kinematics of files, and evaluated reciprocating and rotary files regarding the aim of this study. The electronic search was undertaken in MEDLINE, Cochrane database, and manual searches, including journals, reference lists, and other reviews. Twelve studies were chosen for cyclic fatigue, 19 studies for shaping ability, 14 studies for apical debris extrusion, and 13 studies for dentinal defects or cracks. Most of the studies showed that reciprocating motion had a higher resistance to cyclic fatigue. Nine studies from the shaping studies reported less canal transportation by using the reciprocating motion than the continuous rotation. The reciprocating instruments tended to extrude more dentin debris than the continuous rotating instruments, but many of the studies showed conflicting results. In addition, 2 studies from the defects or cracks studies claimed the reciprocating motion produced more dentinal defects than the continuous rotating motion. Instruments with reciprocating motion seemed to have better resistance to cyclic fatigue with less canal transportation tendency than the instruments with continuous rotating motion. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The relationship between maternal depression and smoking cessation during pregnancy--a cross-sectional study of pregnant women from 15 European countries.

PubMed

Smedberg, Janne; Lupattelli, Angela; Mårdby, Ann-Charlotte; Øverland, Simon; Nordeng, Hedvig

2015-02-01

Epidemiologic studies have reported an association between depression and continuing smoking during pregnancy. However, differences in study design and methodology challenge study comparability. The purpose of this study was to examine the relationship between maternal depression and continuing smoking among pregnant European women while adjusting for maternal characteristics. This multinational, web-based study evaluated pregnant women in 15 European countries recruited from October 2011 to February 2012. Data on depression status, smoking habits, maternal socio-demographic characteristics, and life-style factors were collected via an anonymous online questionnaire. Associations were estimated with logistic regression. Of 4,295 women included, 1,481 (34.5 %) reported smoking before pregnancy, and 391 (26.4 %) continued smoking during pregnancy whereof 127 (32.5 %) were depressed. The association between depression and continuing smoking during pregnancy were uniform across the European countries (OR 2.02, 95 % CI 1.50-2.71), with about twice the prevalence of continuing smoking among the depressed. There was a strong relationship between continuing smoking in pregnancy and low education level (OR 4.46, 95 % CI 2.72-7.32), which coincided with risky pregnancy behavior such as failure to attend pregnancy/birth preparation courses (OR 1.80, 95 % CI 1.19-2.72) and follow recommended use of folic acid (OR 1.81, 95 % CI 1.23-2.65). Women who perceived the risk for the fetus of continued smoking during pregnancy as higher were the least likely to continue smoking during pregnancy (OR 0.72, 95 % CI 0.68-0.77). This underlines the clustering of risk in some pregnant women, and the results should guide antenatal care of depressed women struggling to quit smoking during pregnancy.

Evidence for the Continuous Latent Structure of Mania in the Epidemiologic Catchment Area from Multiple Latent Structure and Construct Validation Methodologies

PubMed Central

Prisciandaro, James J.; Roberts, John E.

2011-01-01

Background Although psychiatric diagnostic systems have conceptualized mania as a discrete phenomenon, appropriate latent structure investigations testing this conceptualization are lacking. In contrast to these diagnostic systems, several influential theories of mania have suggested a continuous conceptualization. The present study examined whether mania has a continuous or discrete latent structure using a comprehensive approach including taxometric, information-theoretic latent distribution modeling (ITLDM), and predictive validity methodologies in the Epidemiologic Catchment Area (ECA) study. Methods Eight dichotomous manic symptom items were submitted to a variety of latent structural analyses; including factor analyses, taxometric procedures, and ITLDM; in 10,105 ECA community participants. Additionally, a variety of continuous and discrete models of mania were compared in terms of their relative abilities to predict outcomes (i.e., health service utilization, internalizing and externalizing disorders, and suicidal behavior). Results Taxometric and ITLDM analyses consistently supported a continuous conceptualization of mania. In ITLDM analyses, a continuous model of mania demonstrated 6:52:1 odds over the best fitting latent class model of mania. Factor analyses suggested that the continuous structure of mania was best represented by a single latent factor. Predictive validity analyses demonstrated a consistent superior ability of continuous models of mania relative to discrete models. Conclusions The present study provided three independent lines of support for a continuous conceptualization of mania. The implications of a continuous model of mania are discussed. PMID:20507671

Skeletal and Clinical Effects of Exoskeletal Assisted - Gait

DTIC Science & Technology

2016-10-01

assisted gait and derive estimates of loads applied to the bones. The research team continues to recruit study volunteers . 15. SUBJECT TERMS biomechanical...subjects. As we submit this annual report, we continue to actively schedule study volunteers for screening in order to reach the target sample size for... volunteers and apply the biomechanical models developed so far to the datasets that will be collected from study volunteers . We anticipate continuing to

Factors Affecting Resident Satisfaction in Continuity Clinic-a Systematic Review.

PubMed

Stepczynski, J; Holt, S R; Ellman, M S; Tobin, D; Doolittle, Benjamin R

2018-05-07

In recent years, with an increasing emphasis on time spent in ambulatory training, educators have focused attention on improving the residents' experience in continuity clinic. The authors sought to review the factors associated with physician trainee satisfaction with outpatient ambulatory training. A systematic literature review was conducted for all English language articles published between January 1980 and December 2016 in relevant databases, including Medline (medicine), CINAHL (nursing), PSYCHinfo (psychology), and the Cochrane Central Register of Controlled Clinical Trials. Search terms included internship and residency, satisfaction, quality of life, continuity of care, ambulatory care, and medical education. We included studies that directly addressed resident satisfaction in the ambulatory setting through interventions that we considered reproducible. Three hundred fifty-seven studies were reviewed; 346 studies were removed based on exclusion criteria with 11 papers included in the final review. Seven studies emphasized aspects of organizational structure such as block schedules, working in teams, and impact on resident-patient continuity (continuity between resident provider and patient as viewed from the provider's perspective). Four studies emphasized the importance of a dedicated faculty for satisfaction. The heterogeneity of the studies precluded aggregate analysis. Clinic structures that limit inpatient and outpatient conflict and enhance continuity, along with a dedicated outpatient faculty, are associated with greater resident satisfaction. Implications for further research are discussed.

Usability, Quality, Value and E-Learning Continuance Decisions

ERIC Educational Resources Information Center

Chiu, Chao-Min; Hsu, Meng-Hsiang; Sun, Szu-Yuan; Lin, Tung-Ching; Sun, Pei-Chen

2005-01-01

Previous research suggests that an eventual information technology (IT) success depend on both its initial adoption (acceptance) and subsequent continued usage (continuance). Expectancy disconfirmation theory (EDT) has been successfully used to predict users' intention to continue using information technologies. This study proposed a decomposed…

Representing Numbers as Continued Fractions and an N-Spire. tns Document to Do Some Basic Continued Fraction Arithmetic

ERIC Educational Resources Information Center

Leinbach, L. Carl

2015-01-01

This paper illustrates a TI N-Spire .tns file created by the author for generating continued fraction representations of real numbers and doing arithmetic with them. The continued fraction representation provides an alternative to the decimal representation. The .tns file can be used as tool for studying continued fractions and their properties as…

Simulation-Based Prediction of Equivalent Continuous Noises during Construction Processes

PubMed Central

Zhang, Hong; Pei, Yun

2016-01-01

Quantitative prediction of construction noise is crucial to evaluate construction plans to help make decisions to address noise levels. Considering limitations of existing methods for measuring or predicting the construction noise and particularly the equivalent continuous noise level over a period of time, this paper presents a discrete-event simulation method for predicting the construction noise in terms of equivalent continuous level. The noise-calculating models regarding synchronization, propagation and equivalent continuous level are presented. The simulation framework for modeling the noise-affected factors and calculating the equivalent continuous noise by incorporating the noise-calculating models into simulation strategy is proposed. An application study is presented to demonstrate and justify the proposed simulation method in predicting the equivalent continuous noise during construction. The study contributes to provision of a simulation methodology to quantitatively predict the equivalent continuous noise of construction by considering the relevant uncertainties, dynamics and interactions. PMID:27529266

Simulation-Based Prediction of Equivalent Continuous Noises during Construction Processes.

PubMed

Zhang, Hong; Pei, Yun

2016-08-12

Quantitative prediction of construction noise is crucial to evaluate construction plans to help make decisions to address noise levels. Considering limitations of existing methods for measuring or predicting the construction noise and particularly the equivalent continuous noise level over a period of time, this paper presents a discrete-event simulation method for predicting the construction noise in terms of equivalent continuous level. The noise-calculating models regarding synchronization, propagation and equivalent continuous level are presented. The simulation framework for modeling the noise-affected factors and calculating the equivalent continuous noise by incorporating the noise-calculating models into simulation strategy is proposed. An application study is presented to demonstrate and justify the proposed simulation method in predicting the equivalent continuous noise during construction. The study contributes to provision of a simulation methodology to quantitatively predict the equivalent continuous noise of construction by considering the relevant uncertainties, dynamics and interactions.

The Facilitators and Barriers to Nurses’ Participation in Continuing Education Programs: A Mixed Method Explanatory Sequential Study

PubMed Central

Shahhosseini, Zohreh; Hamzehgardeshi, Zeinab

2015-01-01

Background: Since several factors affect nurses’ participation in Continuing Education, and that nurses’ Continuing Education affects patients’ and community health status, it is essential to know facilitators and barriers of participation in Continuing Education programs and plan accordingly. This mixed approach study aimed to investigate the facilitators and barriers of nurses’ participation, to explore nurses’ perception of the most common facilitators and barriers. Methods: An explanatory sequential mixed methods design with follow up explanations variant were used, and it involved collecting quantitative data (361 nurses) first and then explaining the quantitative results with in-depth interviews during a qualitative study. Results: The results showed that the mean score of facilitators to nurses’ participation in Continuing Education was significantly higher than the mean score of barriers (61.99±10.85 versus 51.17±12.83; p<0.001, t=12.23). The highest mean score of facilitators of nurses’ participation in Continuing Education was related to “Update my knowledge”. By reviewing the handwritings in qualitative phase, two main levels of updating information and professional skills were extracted as the most common facilitators and lack of support as the most common barrier to nurses’ participation in continuing education program. Conclusion: According to important role Continuing Education on professional skills, nurse managers should facilitate the nurse’ participation in the Continues Education. PMID:25948439

The facilitators and barriers to nurses' participation in continuing education programs: a mixed method explanatory sequential study.

PubMed

Shahhosseini, Zohreh; Hamzehgardeshi, Zeinab

2014-11-30

Since several factors affect nurses' participation in Continuing Education, and that nurses' Continuing Education affects patients' and community health status, it is essential to know facilitators and barriers of participation in Continuing Education programs and plan accordingly. This mixed approach study aimed to investigate the facilitators and barriers of nurses' participation, to explore nurses' perception of the most common facilitators and barriers. An explanatory sequential mixed methods design with follow up explanations variant were used, and it involved collecting quantitative data (361 nurses) first and then explaining the quantitative results with in-depth interviews during a qualitative study. The results showed that the mean score of facilitators to nurses' participation in Continuing Education was significantly higher than the mean score of barriers (61.99 ± 10.85 versus 51.17 ± 12.83; p<0.001, t=12.23). The highest mean score of facilitators of nurses' participation in Continuing Education was related to "Update my knowledge". By reviewing the handwritings in qualitative phase, two main levels of updating information and professional skills were extracted as the most common facilitators and lack of support as the most common barrier to nurses' participation in continuing education program. According to important role Continuing Education on professional skills, nurse managers should facilitate the nurse' participation in the Continues Education.

Continuous sweep versus discrete step protocols for studying effects of wearable robot assistance magnitude.

PubMed

Malcolm, Philippe; Rossi, Denise Martineli; Siviy, Christopher; Lee, Sangjun; Quinlivan, Brendan Thomas; Grimmer, Martin; Walsh, Conor J

2017-07-12

Different groups developed wearable robots for walking assistance, but there is still a need for methods to quickly tune actuation parameters for each robot and population or sometimes even for individual users. Protocols where parameters are held constant for multiple minutes have traditionally been used for evaluating responses to parameter changes such as metabolic rate or walking symmetry. However, these discrete protocols are time-consuming. Recently, protocols have been proposed where a parameter is changed in a continuous way. The aim of the present study was to compare effects of continuously varying assistance magnitude with a soft exosuit against discrete step conditions. Seven participants walked on a treadmill wearing a soft exosuit that assists plantarflexion and hip flexion. In Continuous-up, peak exosuit ankle moment linearly increased from approximately 0 to 38% of biological moment over 10 min. Continuous-down was the opposite. In Discrete, participants underwent five periods of 5 min with steady peak moment levels distributed over the same range as Continuous-up and Continuous-down. We calculated metabolic rate for the entire Continuous-up and Continuous-down conditions and the last 2 min of each Discrete force level. We compared kinematics, kinetics and metabolic rate between conditions by curve fitting versus peak moment. Reduction in metabolic rate compared to Powered-off was smaller in Continuous-up than in Continuous-down at most peak moment levels, due to physiological dynamics causing metabolic measurements in Continuous-up and Continuous-down to lag behind the values expected during steady-state testing. When evaluating the average slope of metabolic reduction over the entire peak moment range there was no significant difference between Continuous-down and Discrete. Attempting to correct the lag in metabolics by taking the average of Continuous-up and Continuous-down removed all significant differences versus Discrete. For kinematic and kinetic parameters, there were no differences between all conditions. The finding that there were no differences in biomechanical parameters between all conditions suggests that biomechanical parameters can be recorded with the shortest protocol condition (i.e. single Continuous directions). The shorter time and higher resolution data of continuous sweep protocols hold promise for the future study of human interaction with wearable robots.

Randomized, multicenter study: on-demand versus continuous maintenance treatment with esomeprazole in patients with non-erosive gastroesophageal reflux disease.

PubMed

Bayerdörffer, Ekkehard; Bigard, Marc-Andre; Weiss, Werner; Mearin, Fermín; Rodrigo, Luis; Dominguez Muñoz, Juan Enrique; Grundling, Hennie; Persson, Tore; Svedberg, Lars-Erik; Keeling, Nanna; Eklund, Stefan

2016-04-14

Most patients with gastroesophageal reflux disease experience symptomatic relapse after stopping acid-suppressive medication. The aim of this study was to compare willingness to continue treatment with esomeprazole on-demand versus continuous maintenance therapy for symptom control in patients with non-erosive reflux disease (NERD) after 6 months. This multicenter, open-label, randomized, parallel-group study enrolled adults with NERD who were heartburn-free after 4 weeks' treatment with esomeprazole 20 mg daily. Patients received esomeprazole 20 mg daily continuously or on-demand for 6 months. The primary variable was discontinuation due to unsatisfactory treatment. On-demand treatment was considered non-inferior if the upper limit of the one-sided 95 % confidence interval (CI) for the difference between treatments was <10 %. Of 877 patients enrolled, 598 were randomized to maintenance treatment (continuous: n = 297; on-demand: n = 301). Discontinuation due to unsatisfactory treatment was 6.3 % for on-demand and 9.8 % for continuous treatment (difference -3.5 % [90 % CI: -7.1 %, 0.2 %]). In total, 82.1 and 86.2 % of patients taking on-demand and continuous therapy, respectively, were satisfied with the treatment of heartburn and regurgitation symptoms, a secondary variable (P = NS). Mean study drug consumption was 0.41 and 0.91 tablets/day, respectively. Overall, 5 % of the on-demand group developed reflux esophagitis versus none in the continuous group (P < 0.0001). The Gastrointestinal Symptom Rating Scale Reflux dimension was also improved for continuous versus on-demand treatment. Esomeprazole was well tolerated. In terms of willingness to continue treatment, on-demand treatment with esomeprazole 20 mg was non-inferior to continuous maintenance treatment and reduced medication usage in patients with NERD who had achieved symptom control with initial esomeprazole treatment. ClinicalTrials.gov identifier (NCT number): NCT02670642 ; Date of registration: December 2015.

Persistence motives in irrational decisions to complete a boring task.

PubMed

Halkjelsvik, Torleif; Rise, Jostein

2015-01-01

We explored a novel task paradigm where participants from the online work marketplace Amazon Mechanical Turk were given the choice to quit or continue an unfinished boring task for identical economic rewards. In Studies 1a and 1b, about half the participants chose to continue (corresponding to an average of 55 and 35 cents in foregone earnings). Participants' self-reported reasons for continuing involved various types of persistence motives, reflecting a desire to persist or complete per se. Studies 2, 3a, 3b, and 3c ruled out the possibility that people continued because they enjoyed the task or believed there were additional rewards for continuing. Study 4 showed that the choice to quit/continue was associated with the manner in which the choice was presented (persistence test vs. decision-making test) and individual differences in dispositional persistence motives. The present data indicate that motivational forces independent of the focal reward may affect intertemporal decisions. © 2014 by the Society for Personality and Social Psychology, Inc.

EMR continuance usage intention of healthcare professionals.

PubMed

Sayyah Gilani, Mina; Iranmanesh, Mohammad; Nikbin, Davoud; Zailani, Suhaiza

2017-03-01

Electronic medical records (EMRs) have been proven to be effective tools for improving the safety and quality of healthcare despite their relatively low usage rate in hospitals. The long-term development by EMRs depends on the continued use of healthcare professionals. In this study, technology continuance theory (TCT) was used to evaluate the short-term and long-term continuance acceptance of EMRs among healthcare professionals. Data were gathered by surveying 195 medical professionals in Iran. The data were analyzed using the partial least squares (PLS) technique. The analysis showed that the TCT provided a deep understanding of user continuance intention toward EMRs. In addition, the findings illustrated that the determinants of continuance intention vary between short-term and long-term users. The theoretical and practical implications of the study are discussed.

Patients' experiences of continuity in the care of type 2 diabetes: a focus group study in primary care

PubMed Central

Alazri, Mohammed H; Neal, Richard D; Heywood, Phil; Leese, Brenda

2006-01-01

Background Continuity of care is fundamental to general practice and type 2 diabetes is a common chronic disease with major health and social impacts. Nevertheless continuity, as experienced by patients with type 2 diabetes, remains a neglected area. Aim To explore perceptions and experiences of continuity of care in general practice from the perspectives of patients with type 2 diabetes, focusing on the advantages and disadvantages of different types of continuity. Design of study Focus groups with patients. Setting Seven practices with different organisational structures in Leeds, UK. Method Seventy-nine patients with type 2 diabetes were recruited. Focus group interviews were conducted with 79 patients with type 2 diabetes from seven practices in Leeds, UK. Results Patients experienced three different types of continuity: relational (or longitudinal) continuity, cross-boundary (or team) continuity, and continuity of information. Patients' perceptions of continuity were influenced by several factors including a personal relationship between themselves and their healthcare professional, their own beliefs and behaviours, presence of diabetes, and the systems and structures of general practices. Patients identified the advantages and disadvantages of two types of continuity. Relational or longitudinal continuity was important in providing psychosocial care, but with a risk of misdiagnosis. The advantages of cross-boundary or team continuity were to provide physical care, whereas the main disadvantages were the absence of personal care and patient confusion. Conclusion Perceptions of continuity by patients with type 2 diabetes were influenced by several factors; they perceived several advantages and disadvantages associated with different types of continuity. Patients might expect certain healthcare benefits by following certain types of continuity. PMID:16834874

Cognitive insensitivity and cognitive impulsivity as mediators of bullying continuity: Extending the psychological inertia construct to bullying behavior.

PubMed

Walters, Glenn D; Espelage, Dorothy L

2018-06-21

Psychological inertia, the process by which social-cognitive variables help maintain behavioral patterns over time, has been found to explain crime continuity. The present study sought to determine whether psychological inertia can also be used to explain continuity in bullying behavior. A group of 1,161 youth (567 male) from the Illinois Study of Bullying and Sexual Violence were surveyed 3 times over a period of 1 year in an effort to determine which of two dimensions of precriminal cognition-cognitive insensitivity (callous, self-serving) or cognitive impulsivity (reckless, emotional)-mediated the past bullying-future bullying relationship. Consistent with research on crime continuity, cognitive impulsivity mediated bullying continuity, but cognitive insensitivity did not. Congruent with research on psychological inertia and crime continuity, the main reason why cognitive insensitivity did not mediate bullying continuity was that prior bullying behavior failed to predict subsequent cognitive insensitivity. In addition to providing support for a 2-dimensional (insensitivity, impulsivity) model of bullying development, these results suggest that 1 way bullying behavior can be managed is by challenging and reducing cognitive impulsivity, which in the current study was found to be a major contributor to bullying continuity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A Process Evaluation of Project Developmental Continuity. Interim Report IV, Volume 2: Development of the Implementation and Cost Studies.

ERIC Educational Resources Information Center

Smith, Allen G.; And Others

This interim report describes the development of program implementation and cost studies for Year II of the process evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and primary school experiences. Specific areas focused…

Comparison of Continuing Bonds Reported by Parents and Siblings after a Child's Death from Cancer

ERIC Educational Resources Information Center

Foster, Terrah L.; Gilmer, Mary Jo; Davies, Betty; Dietrich, Mary S.; Barrera, Maru; Fairclough, Diane L.; Vannatta, Kathryn; Gerhardt, Cynthia A.

2011-01-01

Few studies have distinguished similarities and differences between continuing bonds as they appear in various bereaved populations, particularly parent versus sibling cohorts following a child's death. This mixed-method study compared how parents and siblings experienced continuing bonds in 40 families who lost a child to cancer. Thirty-six…

On s*g-continuous Functions on Topological Spaces

NASA Astrophysics Data System (ADS)

Khan, M.; Hussain, Murad

2010-11-01

The aim of this paper is to introduce and study the concept of s*g-continuous and s*g-closed functions. We investigate their relation with already existing notions. We also introduce s*g-irresolute function and investigate its relation with s*g-continuous function. When the s*g-closed sets are preserved, is also studied. In the end, we define and study the notions of s*g-compactness and s*g-connectedness.

Continuing Education in the Health Professions. A Review of the Literature: 1960-1970.

ERIC Educational Resources Information Center

Nakamoto, June; Verner, Coolie

A review is made of the literature on continuing education in the health professions. After an overview of the study, six chapters cover continuing education in medicine -- physical composition and distribution, participation in continuing education, organization and administration, instructional processes, evaluation, and summary and conclusions.…

Continuing Educators' Attitudes toward Professional Program Delivery.

ERIC Educational Resources Information Center

Blakely, Thomas J.

A study examined the beliefs that the deans/directors of continuing education had about the delivery of professional education programs through continuing education. Data were collected through a mailed questionnaire sent to 60 deans and directors of continuing education departments/divisions of universities and colleges that are members of Region…

CONTINUOUS AND SEMI-CONTINUOUS METHODS FOR PM MASS AND COMPOSITION

EPA Science Inventory

This article is a review of the status of continuous and semi-continuous methods for PM mass and composition based on results from EPA's PM Supersites Program and related studies. It summarizes recommendations suggested by Solomon and Sioutas (2006 submitted to the J. Air and Wa...

Sustaining Lesson Study: Resources and Factors that Support and Constrain Mathematics Teachers' Ability to Continue After the Grant Ends

NASA Astrophysics Data System (ADS)

Druken, Bridget Kinsella

Lesson study, a teacher-led vehicle for inquiring into teacher practice through creating, enacting, and reflecting on collaboratively designed research lessons, has been shown to improve mathematics teacher practice in the United States, such as improving knowledge about mathematics, changing teacher practice, and developing communities of teachers. Though it has been described as a sustainable form of professional development, little research exists on what might support teachers in continuing to engage in lesson study after a grant ends. This qualitative and multi-case study investigates the sustainability of lesson study as mathematics teachers engage in a district scale-up lesson study professional experience after participating in a three-year California Mathematics Science Partnership (CaMSP) grant to improve algebraic instruction. To do so, I first provide a description of material (e.g. curricular materials and time), human (attending district trainings and interacting with mathematics coaches), and social (qualities like trust, shared values, common goals, and expectations developed through relationships with others) resources present in the context of two school districts as reported by participants. I then describe practices of lesson study reported to have continued. I also report on teachers' conceptions of what it means to engage in lesson study. I conclude by describing how these results suggest factors that supported and constrained teachers' in continuing lesson study. To accomplish this work, I used qualitative methods of grounded theory informed by a modified sustainability framework on interview, survey, and case study data about teachers, principals, and Teachers on Special Assignment (TOSAs). Four cases were selected to show the varying levels of lesson study practices that continued past the conclusion of the grant. Analyses reveal varying levels of integration, linkage, and synergy among both formally and informally arranged groups of teachers. High levels of integration and linkage among groups of teachers supported them in sustaining lesson study practices. Groups of teachers with low levels of integration but with linked individuals sustained some level of practices, whereas teachers with low levels of integration and linkage constrained them in continuing lesson study at their site. Additionally, teachers' visions of lesson study and its uses shaped the types of activities teachers engaged, with well-developed conceptions of lesson study supporting and limited visions constraining the ability to attract or align resources to continue lesson study practices. Principals' support, teacher autonomy, and cultures of collaboration or isolation were also factors that either supported or constrained teachers' ability to continue lesson study. These analyses provide practical implications on how to support mathematics teachers in continuing lesson study, and theoretical contributions on developing the construct of sustainability within mathematics education research.

Patients' assessments of the continuity of primary care in Finland: a 15-year follow-up questionnaire survey.

PubMed

Raivio, Risto; Holmberg-Marttila, Doris; Mattila, Kari J

2014-10-01

Continuity of care is an essential aspect of quality in general practice. This study is the first systematic follow-up of Finnish primary care patients' assessments with regard to personal continuity of care. To ascertain whether patient-reported longitudinal personal continuity of care is related to patient characteristics and their consultation experiences, and how this had changed over the study period. A 15-year follow-up questionnaire survey that took place at Tampere University Hospital catchment area, Finland. The survey was conducted among patients attending health centres in the Tampere University Hospital catchment area from 1998 until 2013. From a sample of 363 464 patients, a total of 157 549 responded. The responses of patients who had visited a doctor during the survey weeks (n = 97 468) were analysed. Continuity of care was assessed by asking the question: 'When visiting the health centre, do you usually see the same doctor?'; patients could answer 'yes' or 'no'. Approximately half of the responders had met the same doctor when visiting the healthcare centre. Personal continuity of care decreased by 15 percentage points (from 66% to 51%) during the study years. The sense of continuity was linked to several patients' experiences of the consultation. The most prominent factor contributing to the sense of continuity of care was having a doctor who was specifically appointed (odds ratio 7.28, 95% confidence interval = 6.65 to 7.96). Continuity of care was proven to enhance the experienced quality of primary care. Patients felt that continuity of care was best realised when they could consult a doctor who had been specifically appointed to them. Despite efforts of the authorities, over the past 15 years patient-reported continuity of care has declined in Finland. © British Journal of General Practice 2014.

Women's experiences of continuous fetal monitoring - a mixed-methods systematic review.

PubMed

Crawford, Alexandra; Hayes, Dexter; Johnstone, Edward D; Heazell, Alexander E P

2017-12-01

Antepartum stillbirth is often preceded by detectable signs of fetal compromise, including changes in fetal heart rate and movement. It is hypothesized that continuous fetal monitoring could detect these signs more accurately and objectively than current forms of fetal monitoring and allow for timely intervention. This systematic review aimed to explore available evidence on women's experiences of continuous fetal monitoring to investigate its acceptability before clinical implementation and to inform clinical studies. Systematic searching of four electronic databases (Embase, PsycINFO, MEDLINE and CINAHL), using key terms defined by initial scoping searches, identified a total of 35 studies. Following title and abstract screening by two independent researchers, five studies met the inclusion criteria. Studies were not excluded based on language, methodology or quality assessment. An integrative methodology was used to synthesize qualitative and quantitative data together. Forms of continuous fetal monitoring used included Monica AN24 monitors (n = 4) and phonocardiography (n = 1). Four main themes were identified: practical limitations of the device, negative emotions, positive perceptions, and device implementation. Continuous fetal monitoring was reported to have high levels of participant satisfaction and was preferred by women to intermittent cardiotocography. This review suggests that continuous fetal monitoring is accepted by women. However, it has also highlighted both the paucity and heterogeneity of current studies and suggests that further research should be conducted into women's experiences of continuous fetal monitoring before such devices can be used clinically. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Nurse educators' perceived challenges in mandatory continuing nursing education.

PubMed

Xiao, L D

2006-09-01

This paper reports a study that leads to understanding challenges facing nurse educators implementing mandatory continuing nursing education in The People's Republic of China. Mandatory continuing nursing education was instituted to maintain and develop registered nurses' competence in the context of healthcare reform in China in 1996. However, there is an increasing complaint of credit-focused and teacher-centred learning in Chinese literature. Despite an increasing appeal to improve the learning situation, little consensus has been reached. By examining nurse educators' perceived challenges and their coping strategies in implementing mandatory continuing nursing education, this study illuminates the possibilities for reform in mandatory continuing nursing education. Data were collected through in-depth interactive dialogues between the researcher and five nurse educators in five healthcare organizations in China, utilizing Gadamer's philosophical hermeneutics. Three themes were found in this study described as finding a way to support nurses' competence within a constrained situation, reconciling credit requirements and representing all stakeholders' interests. A tension between the mandatory continuing nursing education policy and the context of implementing the policy can contribute to credit-focused and teacher-centred learning. Regular policy review and educational support for nurse educators are crucial aspects to improve mandatory continuing nursing education.

The role of nursing team continuity in the treatment of very-low-birth-weight infants: findings from a pilot study.

PubMed

Miedaner, Felix; Allendorf, Antje; Kuntz, Ludwig; Woopen, Christiane; Roth, Bernhard

2016-05-01

To assess the association between nursing team continuity and quality of care. Research on nurse staffing and its effect on quality of care is investigated to different degrees. However, very few studies have observed whether the continuous deployment of nursing staff is associated with quality of care. This study was conducted in two university neonatal intensive care units (NICUs). We matched nurse schedule data for the NICUs with nursing-sensitive patient outcomes and quality of care, as perceived by parents. We used analysis of variance to analyse differences in nursing team continuity between NICUs and regression analyses to identify associations with the outcome measures. There were considerable differences between units in terms of team continuity of nursing staff. Positive associations were found between team continuity and a higher rate of non-invasive respiratory support as well as parents' perceptions of how well they knew their nurse. The findings show remarkable differences in staff assignment in the different NICUs. In addition to appropriate staffing levels, scheduling nursing teams continuously would appear to play a role in influencing treatment quality. This paper emphasises the importance of carefully considered staff scheduling decisions. © 2015 John Wiley & Sons Ltd.

Safety of continuing aspirin therapy during spinal surgery: A systematic review and meta-analysis.

PubMed

Zhang, Chenggui; Wang, Guodong; Liu, Xiaoyang; Li, Yang; Sun, Jianmin

2017-11-01

Questions whether to continue or discontinue aspirin administration in the perioperative period of spinal surgery has not been systematically evaluated. The present systematic review is carried out to assess the impact of continuing aspirin administration on the bleeding and cardiovascular events in perispinal surgery period. Studies were retrieved through MEDLINE, EMBASE, and Springer Link Databases (search terms, aspirin, continue or discontinue, and spinal fusion), bibliographies of the articles retrieved, and the authors' reference files. We included studies that enrolled patients who underwent spinal surgery who were anticoagulated with aspirin alone and that reported bleeding or cardiovascular events as an outcome. Study quality was assessed using a validated form. 95% confidence interval (95% CI) was pooled to give summary estimates of bleeding and cardiovascular risk. We identified 4 studies assessing bleeding risk associated with aspirin continuation or cardiovascular risk with aspirin discontinuation during spinal surgery. The continuation of aspirin will not increase the risk of blood loss during the spinal surgery (95% CI, -111.72 to -0.59; P = .05). Also, there was no observed increase in the operative time (95% CI, -33.29 to -3.89; P = .01) and postoperative blood transfusion (95% CI, 0.00-0.27; P = .05). But as for the cardiovascular risk without aspirin continuation and mean hospital length of stay with aspirin continuation, we did not get enough samples to make an accurate decision about their relations with aspirin. Patients undergoing spinal surgery with continued aspirin administration do not have an increased risk for bleeding. In addition, there is no observed increase in the operation time and postoperative blood transfusion.

Recovery in bipolar depression: Post-hoc analysis of a placebo-controlled lurasidone trial followed by a long-term continuation study.

PubMed

Loebel, Antony; Siu, Cynthia; Rajagopalan, Krithika; Pikalov, Andrei; Cucchiaro, Josephine; Ketter, Terence A

2015-11-01

In this post-hoc analysis, rates of remission and recovery were evaluated in patients with bipolar depression treated with lurasidone. Outpatients meeting DSM-IV-TR criteria for bipolar I depression, were randomized to 6 weeks of once-daily, double-blind treatment with lurasidone 20-60mg, lurasidone 80-120mg or placebo, followed by a 6-month, open-label, flexible-dose, lurasidone continuation study. Recovery was defined as meeting criteria for combined symptomatic remission (Montgomery-Asberg Depression Rating Scale total score ≤12) and functional remission (all Sheehan Disability Scale domain scores ≤3) sustained for at least 3 months in the 6-month continuation study. A significantly higher proportion of lurasidone-treated patients met criteria for combined symptomatic remission and functional remission (33.3%, 91/273) compared to the placebo group (21.0%, 30/143, p<0.05, NNT=9) at the 6-week study endpoint. In the 6-month continuation study, the proportion of lurasidone-treated patients achieving sustained recovery was 60.7% (85/140) and 44.9% (31/69), for patients who continued lurasidone treatment and who switched from placebo to lurasidone, respectively. The definition of recovery used has not been previously validated and the analysis was post hoc. Lack of a control group in the continuation study limits data interpretation. Recovery in patients with bipolar depression was assessed based on rates of combined symptomatic and functional remission sustained over time. A majority of patients initially treated with lurasidone in the acute phase achieved recovery status in the continuation study. Treatment with lurasidone (vs. placebo) earlier in the course of the bipolar depressive episode increased the likelihood of subsequent recovery. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Women's experiences of continuous support during childbirth: a meta-synthesis.

PubMed

Lunda, Petronellah; Minnie, Catharina Susanna; Benadé, Petronella

2018-05-15

Despite the known benefits of continuous support during childbirth, the practice is still not routinely implemented in all maternity settings and women's views and experiences might not be considered. The purpose of the study was to integrate individual studies' findings related to women's experiences of continuous support during childbirth in order to expand the understanding of the phenomenon. The review question was: What were the views and experiences of women regarding continuous support during childbirth as reported in studies that adopted qualitative or mixed research methods (with a qualitative component) using semi-structured, in-depth or focus group interviews or case studies? A detailed search was executed on electronic data bases: EBSCOhost: Medline, CINAHL, PsychINFO, SocINDEX, OAlster, Scopus, SciELO, Science Direct, PubMED and Google Scholar, using a predetermined search strategy. Reference lists of included studies were analysed to identify possible studies that were missing from electronic data bases. Pre-determined inclusion and exclusion criteria were applied during the selection of eligible sources. After critical appraisal, a total of 12 studies were included for data-extraction and meta-synthesis. Two themes were identified, namely the roles and attributes of the support persons and the type of support provided. Women's perceptions about continuous support during childbirth were influenced by the characteristics and attributes of the support person as well as the types of supportive care rendered. Women preferred someone with whom they were familiar and comfortable. Continuous support during childbirth was valued by most women. Their perceptions were influenced by the type of support person: a health professional or a lay support person. Health care institutions should include continuous support during childbirth in their policies and guidelines.

Pemetrexed Continuation Maintenance in Patients with Nonsquamous Non-small Cell Lung Cancer: Review of Two East Asian Trials in Reference to PARAMOUNT

PubMed Central

Yang, James Chin-Hsin; Ahn, Myung-Ju; Nakagawa, Kazuhiko; Tamura, Tomohide; Barraclough, Helen; Enatsu, Sotaro; Cheng, Rebecca; Orlando, Mauro

2015-01-01

Purpose A recent phase III study (PARAMOUNT) demonstrated that pemetrexed continuation maintenance therapy is a new treatment paradigm for advanced nonsquamous non-small cell lung cancer (NSCLC). The majority of patients enrolled in PARAMOUNT were Caucasian (94%). We reviewed efficacy and safety data from two clinical trials, which enrolled East Asian (EA) patients, to supplement data from PARAMOUNT on pemetrexed continuation maintenance therapy in patients with nonsquamous NSCLC. Materials and Methods Study S110 was a phase II, multicenter, randomized, controlled, open-label trial in never-smoker, chemonaïve, EA patients (n=31) with locally advanced or metastatic nonsquamous NSCLC (n=27). Study JMII was a multicenter, open-label, single-arm, post-marketing, clinical trial in Japanese patients (n=109) with advanced nonsquamous NSCLC. PARAMOUNT was a multicenter, randomized, double-blind, placebo-controlled trial in patients with advanced nonsquamous NSCLC. Results In EA patients with nonsquamous NSCLC, the median progression-free survival (PFS) for pemetrexed continuation maintenance therapy was 4.04 months (95% confidence interval [CI], 3.22 to 5.29 months) in study S110 and 3.9 months (95% CI, 3.2 to 5.2 months) in study JMII. The median PFS for pemetrexed continuation maintenance therapy in PARAMOUNT was 4.1 months (95% CI, 3.2 to 4.6 months). Pemetrexed continuation maintenance therapy in EA patients in studies S110 and JMII did not lead to any unexpected safety events, and was consistent with PARAMOUNT’s safety profile. Conclusion The efficacy and safety data in the EA trials were similar to those in PARAMOUNT despite differences in patient populations and study designs. These data represent consistent evidence for pemetrexed continuation maintenance therapy in EA patients with advanced nonsquamous NSCLC. PMID:25410761

Pemetrexed Continuation Maintenance in Patients with Nonsquamous Non-small Cell Lung Cancer: Review of Two East Asian Trials in Reference to PARAMOUNT.

PubMed

Yang, James Chin-Hsin; Ahn, Myung-Ju; Nakagawa, Kazuhiko; Tamura, Tomohide; Barraclough, Helen; Enatsu, Sotaro; Cheng, Rebecca; Orlando, Mauro

2015-07-01

A recent phase III study (PARAMOUNT) demonstrated that pemetrexed continuation maintenance therapy is a new treatment paradigm for advanced nonsquamous non-small cell lung cancer (NSCLC). The majority of patients enrolled in PARAMOUNT were Caucasian (94%). We reviewed efficacy and safety data from two clinical trials, which enrolled East Asian (EA) patients, to supplement data from PARAMOUNT on pemetrexed continuation maintenance therapy in patients with nonsquamous NSCLC. Study S110 was a phase II, multicenter, randomized, controlled, open-label trial in never-smoker, chemonaïve, EA patients (n=31) with locally advanced or metastatic nonsquamous NSCLC (n=27). Study JMII was a multicenter, open-label, single-arm, post-marketing, clinical trial in Japanese patients (n=109) with advanced nonsquamous NSCLC. PARAMOUNT was a multicenter, randomized, double-blind, placebo-controlled trial in patients with advanced nonsquamous NSCLC. In EA patients with nonsquamous NSCLC, the median progression-free survival (PFS) for pemetrexed continuation maintenance therapy was 4.04 months (95% confidence interval [CI], 3.22 to 5.29 months) in study S110 and 3.9 months (95% CI, 3.2 to 5.2 months) in study JMII. The median PFS for pemetrexed continuation maintenance therapy in PARAMOUNT was 4.1 months (95% CI, 3.2 to 4.6 months). Pemetrexed continuation maintenance therapy in EA patients in studies S110 and JMII did not lead to any unexpected safety events, and was consistent with PARAMOUNT's safety profile. The efficacy and safety data in the EA trials were similar to those in PARAMOUNT despite differences in patient populations and study designs. These data represent consistent evidence for pemetrexed continuation maintenance therapy in EA patients with advanced nonsquamous NSCLC.

Improving critical thinking and clinical reasoning with a continuing education course.

PubMed

Cruz, Dina Monteiro; Pimenta, Cibele Mattos; Lunney, Margaret

2009-03-01

Continuing education courses related to critical thinking and clinical reasoning are needed to improve the accuracy of diagnosis. This study evaluated a 4-day, 16-hour continuing education course conducted in Brazil.Thirty-nine nurses completed a pretest and a posttest consisting of two written case studies designed to measure the accuracy of nurses' diagnoses. There were significant differences in accuracy from pretest to posttest for case 1 (p = .008) and case 2 (p = .042) and overall (p = .001). Continuing education courses should be implemented to improve the accuracy of nurses' diagnoses.

A Process Evaluation of Project Developmental Continuity. Interim Report IV, Volume I: Pilot Year Impact Study--Instrument Characteristics and Attrition Trends.

ERIC Educational Resources Information Center

Granville, Arthur C.; And Others

This interim report of a pilot year impact study on evaluation methodology is part of a series of documents on the evaluation of Project Developmental Continuity, a Head Start demonstration program aimed at promoting educational and developmental continuity between children's Head Start and primary school experiences. This report deals with…

Research on the Relation the Characteristics of the Faculty and the Commitment to Continuous Improvement of Motivations and Student Study Processes

ERIC Educational Resources Information Center

Chen, Kun-Dang; Chen, Ping-Kuo

2017-01-01

This study focused on China's higher education system and explored if personality traits were a mediator of the relationship between motivational mechanisms and continuous improvement, and further explored if leadership change was a moderator of the relationship between personality traits and continuous improvement of the motivations and student…

A STUDY OF CONTINUING EDUCATION NEEDS OF SELECTED PROFESSIONAL GROUPS AND UNIVERSITY EXTENSION CONTRACT PROGRAMS IN WYOMING.

ERIC Educational Resources Information Center

NICHOLAS, ROBERT A.

THIS STUDY AIMED TO DEVELOP PRINCIPLES FOR A MODEL PROGRAM OF CONTINUING EDUCATION FOR THE PROFESSIONS AT THE UNIVERSITY OF WYOMING. THE AUTHOR REVIEWED THE LITERATURE ON THE GROWTH OF THE PROFESSIONS AND ON CONTINUING EDUCATION IN THE PROFESSIONS GENERALLY, WITH SPECIAL REFERENCE TO ARCHITECTURE, DENTISTRY, LAW, MEDICINE, AND PHARMACY. FROM THIS…

Higher Education and Employment: The Changing Relationship. Recent Developments in Continuing Professional Education. Country Study: Japan.

ERIC Educational Resources Information Center

Kaneko, Motohisa

This report, one of a series of country studies on higher education and employment, particularly in continuing professional education, looks at recent developments in Japan. The first of five sections defines the scope of continuing professional education in the context of Japanese economy and society, and sets forth a theoretical framework for…

Almost All Start but Who Continue? A Longitudinal Study of Youth Participation in Swedish Club Sports

ERIC Educational Resources Information Center

Jakobsson, Britta Thedin; Lundvall, Suzanne; Redelius, Karin; Engstrom, Lars-Magnus

2012-01-01

Many young people in Sweden stop participating in club sports during their teens, but some continue. Drawing on a longitudinal study, the aim of this article is to highlight some of the characteristics of teenagers who continue with club sports and to discuss the relation between club-sport participation and social and cultural conditions, with…

Research study on IPS digital controller design

NASA Technical Reports Server (NTRS)

Kuo, B. C.; Folkerts, C.

1976-01-01

The performance is investigated of the simplified continuous-data model of the Instrument Pointing System (IPS). Although the ultimate objective is to study the digital model of the system, knowledge on the performance of the continuous-data model is important in the sense that the characteristics of the digital system should approach those of the continuous-data system as the sampling period approaches zero.

Comparing continuous and dichotomous scoring of the balanced inventory of desirable responding.

PubMed

Stöber, Joachim; Dette, Dorothea E; Musch, Jochen

2002-04-01

The Balanced Inventory of Desirable Responding (BIDR; Paulhus, 1994) is a widely used instrument to measure the 2 components of social desirability: self-deceptive enhancement and impression management. With respect to scoring of the BIDR, Paulhus (1994) authorized 2 methods, namely continuous scoring (all answers on the continuous answer scale are counted) and dichotomous scoring (only extreme answers are counted). In this article, we report 3 studies with student samples, and continuous and dichotomous scoring of BIDR subscales are compared with respect to reliability, convergent validity, sensitivity to instructional variations, and correlations with personality. Across studies, the scores from continuous scoring (continuous scores) showed higher Cronbach's alphas than those from dichotomous scoring (dichotomous scores). Moreover, continuous scores showed higher convergent correlations with other measures of social desirability and more consistent effects with self-presentation instructions (fake-good vs. fake-bad instructions). Finally, continuous self-deceptive enhancement scores showed higher correlations with those traits of the Five-factor model for which substantial correlations were expected (i.e., Neuroticism, Extraversion, and Conscientiousness). Consequently, these findings indicate that continuous scoring may be preferable to dichotomous scoring when assessing socially desirable responding with the BIDR.

High statistical heterogeneity is more frequent in meta-analysis of continuous than binary outcomes.

PubMed

Alba, Ana C; Alexander, Paul E; Chang, Joanne; MacIsaac, John; DeFry, Samantha; Guyatt, Gordon H

2016-02-01

We compared the distribution of heterogeneity in meta-analyses of binary and continuous outcomes. We searched citations in MEDLINE and Cochrane databases for meta-analyses of randomized trials published in 2012 that reported a measure of heterogeneity of either binary or continuous outcomes. Two reviewers independently performed eligibility screening and data abstraction. We evaluated the distribution of I(2) in meta-analyses of binary and continuous outcomes and explored hypotheses explaining the difference in distributions. After full-text screening, we selected 671 meta-analyses evaluating 557 binary and 352 continuous outcomes. Heterogeneity as assessed by I(2) proved higher in continuous than in binary outcomes: the proportion of continuous and binary outcomes reporting an I(2) of 0% was 34% vs. 52%, respectively, and reporting an I(2) of 60-100% was 39% vs. 14%. In continuous but not binary outcomes, I(2) increased with larger number of studies included in a meta-analysis. Increased precision and sample size do not explain the larger I(2) found in meta-analyses of continuous outcomes with a larger number of studies. Meta-analyses evaluating continuous outcomes showed substantially higher I(2) than meta-analyses of binary outcomes. Results suggest differing standards for interpreting I(2) in continuous vs. binary outcomes may be appropriate. Copyright © 2016 Elsevier Inc. All rights reserved.

A Comparative Study of Definitions on Limit and Continuity of Functions

ERIC Educational Resources Information Center

Shipman, Barbara A.

2012-01-01

Differences in definitions of limit and continuity of functions as treated in courses on calculus and in rigorous undergraduate analysis yield contradictory outcomes and unexpected language. There are results about limits in calculus that are false by the definitions of analysis, functions not continuous by one definition and continuous by…

Teacher Perspectives on the Practice of Continuity of Care

ERIC Educational Resources Information Center

Longstreth, Sascha; Garrity, Sarah; Ritblatt, Shulamit N.; Olson, Kelsey; Virgilio, Ashley; Dinh, Hilary; Padamada, Shane

2016-01-01

This study aims to address gaps in the literature on continuity of care through focus group interviews with teachers at public early care and education programs in San Diego County, California, USA. To better understand various perspectives on continuity of care, focus groups were conducted at programs that currently practice continuity of care,…

An action research study; cultural differences impact how manufacturing organizations receive continuous improvement

NASA Astrophysics Data System (ADS)

Kattman, Braden R.

National culture and organizational culture impact how continuous improvement methods are received, implemented and deployed by suppliers. Previous research emphasized the dominance of national culture over organizational culture. The countries studied included Poland, Mexico, China, Taiwan, South Korea, Estonia, India, Canada, the United States, the United Kingdom, and Japan. The research found that Canada was most receptive to continuous improvement, with China being the least receptive. The study found that organizational culture was more influential than national culture. Isomorphism and benchmarking is driving continuous-improvement language and methods to be more universally known within business. Business and management practices are taking precedence in driving change within organizations.

Performance studies of continuously reinforced concrete pavement : pavements without transverse steel.

DOT National Transportation Integrated Search

1972-01-01

The status of studies of the three continuously reinforced pavement projects near Charlottesville is reported. Of particular interest in these studies are the effects of the elimination of transverse reinforcing steel, the changing characteristics of...

Behavior of stabled horses provided continuous or intermittent access to drinking water.

PubMed

McDonnell, S M; Freeman, D A; Cymbaluk, N F; Schott, H C; Hinchcliff, K; Kyle, B

1999-11-01

To compare quantitative measures and clinical assessments of behavior as an indication of psychologic well-being of stabled horses provided drinking water continuously or via 1 of 3 intermittent delivery systems. 22 Quarter Horse (QH) or QH-crossbred mares and 17 Belgian or Belgian-crossbred mares (study 1) and 24 QH or QH-crossbred mares and 18 Belgian or Belgian-crossbred mares (study 2). Stabled horses were provided water continuously or via 1 of 3 intermittent water delivery systems in 2 study periods during a 2-year period. Continuous 24-hour videotaped samples were used to compare quantitative measures and clinical assessments of behavior among groups provided water by the various water delivery systems. All horses had clinically normal behavior. Significant differences in well being were not detected among groups provided water by the various delivery systems. Various continuous and intermittent water delivery systems can provide adequately for the psychologic well-being of stabled horses.

Continuous-Infusion Antipseudomonal Beta-Lactam Therapy in Patients With Cystic Fibrosis

PubMed Central

Prescott, William A.; Gentile, Allison E.; Nagel, Jerod L.; Pettit, Rebecca S.

2011-01-01

Objective: We sought to evaluate the pharmacokinetics, efficacy, safety, stability, pharmacoeconomics, and quality-of-life effects of continuous-infusion antipseudomonal beta-lactam therapy in patients with cystic fibrosis (CF). Data Sources: Literature retrieval was accessed through Medline (from 1950 to December 2010) using the following terms: cystic fibrosis; beta-lactams or piperacillin or ticarcillin or cefepime or ceftazidime or doripenem or meropenem or imipenem/cilastin or aztreonam; continuous infusion or constant infusion; drug stability; economics, pharmaceutical; and quality of life. In addition, reference citations from identified publications were reviewed. Study Selection and Data Extraction: We evaluated all articles in English identified from the data sources. Data Synthesis: Patients with CF often harbor colonies of multidrug-resistant organisms, increasing the risk of suboptimal dosing and failure to meet the time above the minimum inhibitory concentration (T > MIC) pharmacodynamic targets. The pharmacokinetics of continuous-infusion antipseudomonal beta-lactam therapy in CF maintains serum concentrations above the MIC of susceptible strains and is more likely than intermittent infusion to achieve optimal T > MIC targets for some intermediate and resistant strains of Pseudomonas aeruginosa. Three noncomparative and four comparative studies have assessed the efficacy and safety of continuous-infusion antipseudomonal beta-lactam therapy during CF pulmonary exacerbations. Ceftazidime, the most extensively studied antibiotic for continuous infusion in CF, has been shown to improve forced expiratory volume in 1 second (FEV1), to improve forced vital capacity (FVC), and to extend the time between pulmonary exacerbations. Continuous-infusion cefepime has been studied in a small number of patients, and a trend toward improved pulmonary function has been observed. Continuous-infusion antipseudomonal beta-lactam therapy appears to be well tolerated, although most of the data pertain to ceftazidime. Because continuous infusion may necessitate that patients wear a portable pump in close proximity to the body, the stability of the antibiotic at body temperature must be considered. Several beta-lactams have good stability at body temperature (piperacillin/tazobactam, ticarcillin/clavulanate, and aztreonam) or acceptable if the medication cartridge is changed twice daily (cefepime and doripenem), whereas other beta-lactams have acceptable 24-hour stability only at lower temperatures (cefepime, ceftazidime, doripenem, and meropenem). Although no pharmacoeconomic studies have evaluated the cost–benefit of continuous infusion versus intermittent infusion in patients with CF, the potential medication cost reduction appears to be considerable. There is little information regarding the impact of continuous infusion on quality of life in patients with CF. Conclusion: Efficacy and safety studies suggest that ceftazidime, administered as a continuous infusion for the treatment of CF pulmonary exacerbations, is safe and effective; has the potential to reduce the costs of treatment; and is preferred to intermittent infusion among patients treated at home. Continuous-infusion ceftazidime may therefore be an alternative to traditional dosing on a case-by-case basis, such as for patients with multidrug-resistant isolates of P. aeruginosa. Treatment with continuous-infusion ceftazidime at home may be considered in such a case, assuming resources and support equivalent to the hospital setting can be ensured. Additional studies assessing the safety and efficacy of other antipseudomonal beta-lactams, when administered as a continuous infusion, during CF pulmonary exacerbations are needed. PMID:22346306

Family medicine patients who use retail clinics have lower continuity of care.

PubMed

Rohrer, James E; Angstman, Kurt B; Garrison, Gregory M; Maxson, Julie A; Furst, Joseph W

2013-04-01

The purpose of this study was to compare continuity of care for family medicine patients using retail medicine clinics to continuity for patients not using retail clinics. Retail medicine clinics have become popular in some markets. However, their impact on continuity of care has not been studied. Electronic medical records of adult primary care patients seen in a large group practice in Minnesota in 2011 were analyzed for this study. Two randomly chosen groups of patients were selected (N = 400): those using 1 of 3 retail walk-in clinics staffed by nurse practitioners in addition to standard office care and a comparison group that only used standard office care. Continuity was measured as the percentage of visits that involved the primary care provider. We also compared patients who made zero visits to their primary care providers with those who made some visits to their primary care providers. Continuity of care was lower for patients who used retail clinics than for patients who did not use retail clinics (0.17 vs 0.44, mean difference 0.27). The percentage of patients who made zero visits to their primary care providers was 54.5 for users of retail clinics versus 31.0 for those who did not use retail clinics. Continuity of care should be monitored as retail medicine continues to expand.

Dimensions of integration, continuity and longitudinality in clinical clerkships.

PubMed

Ellaway, Rachel H; Graves, Lisa; Cummings, Beth-Ann

2016-09-01

Over the past few decades, longitudinal integrated clerkships (LICs) have been proposed to address many perceived short-coming of traditional block clerkships. This growing interest in LICs has raised broader questions regarding the role of integration, continuity and longitudinality in medical education. A study with complementary theoretical and empirical dimensions was conducted to derive a more precise way of defining these three underlying concepts within the design of medical education curricula. The theoretical dimension involved a thematic review of the literature on integration, continuity and longitudinality in medical education. The empirical dimension surveyed all 17 Canadian medical schools on how they have operationalised integration, continuity and longitudinality in their undergraduate programmes. The two dimensions were iteratively synthesised to explore the meaning and expression of integration, continuity and longitudinality in medical education curriculum design. Integration, continuity and longitudinality were expressed in many ways and forms, including: integration of clinical disciplines, combined horizontal integration and vertical integration, and programme-level integration. Types of continuity included: continuity of patients, continuity of teaching, continuity of location and peer continuity. Longitudinality focused on connected or repeating episodes of training or on connecting activities, such as encounter logging across educational episodes. Twelve of the 17 schools were running an LIC of some kind, although only one school had a mandatory LIC experience. An ordinal scale of uses of integration, continuity and longitudinality during clerkships was developed, and new definitions of these concepts in the clerkship context were generated. Different clerkship designs embodied different forms and levels of integration, continuity and longitudinality. A dichotomous view of LICs and rotation-based clerkships was found not to represent current practices in Canada, which instead tended to fall along a continuum of integration, continuity and longitudinality. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Prognosis and Continuity of Child Mental Health Problems from Preschool to Primary School: Results of a Four-Year Longitudinal Study

ERIC Educational Resources Information Center

Beyer, Thomas; Postert, Christian; Muller, Jorg M.; Furniss, Tilman

2012-01-01

In a four-year longitudinal study, changes in and continuity of behavioral and emotional problems were examined in 814 subjects from kindergarten to primary school. Mental health problems were assessed by means of the Child Behavior Checklist (CBCL). The distribution of the CBCL broadband groups revealed a high level of continuity of internalizing…

Investigation of continuous effect modifiers in a meta-analysis on higher versus lower PEEP in patients requiring mechanical ventilation--protocol of the ICEM study.

PubMed

Kasenda, Benjamin; Sauerbrei, Willi; Royston, Patrick; Briel, Matthias

2014-05-20

Categorizing an inherently continuous predictor in prognostic analyses raises several critical methodological issues: dependence of the statistical significance on the number and position of the chosen cut-point(s), loss of statistical power, and faulty interpretation of the results if a non-linear association is incorrectly assumed to be linear. This also applies to a therapeutic context where investigators of randomized clinical trials (RCTs) are interested in interactions between treatment assignment and one or more continuous predictors. Our goal is to apply the multivariable fractional polynomial interaction (MFPI) approach to investigate interactions between continuous patient baseline variables and the allocated treatment in an individual patient data meta-analysis of three RCTs (N = 2,299) from the intensive care field. For each study, MFPI will provide a continuous treatment effect function. Functions from each of the three studies will be averaged by a novel meta-analysis approach for functions. We will plot treatment effect functions separately for each study and also the averaged function. The averaged function with a related confidence interval will provide a suitable basis to assess whether a continuous patient characteristic modifies the treatment comparison and may be relevant for clinical decision-making. The compared interventions will be a higher or lower positive end-expiratory pressure (PEEP) ventilation strategy in patients requiring mechanical ventilation. The continuous baseline variables body mass index, PaO2/FiO2, respiratory compliance, and oxygenation index will be the investigated potential effect modifiers. Clinical outcomes for this analysis will be in-hospital mortality, time to death, time to unassisted breathing, and pneumothorax. This project will be the first meta-analysis to combine continuous treatment effect functions derived by the MFPI procedure separately in each of several RCTs. Such an approach requires individual patient data (IPD). They are available from an earlier IPD meta-analysis using different methods for analysis. This new analysis strategy allows assessing whether treatment effects interact with continuous baseline patient characteristics and avoids categorization-based subgroup analyses. These interaction analyses of the present study will be exploratory in nature. However, they may help to foster future research using the MFPI approach to improve interaction analyses of continuous predictors in RCTs and IPD meta-analyses. This study is registered in PROSPERO (CRD42012003129).

A Study of Continuing Education for Selected Occupations Licensed by the State of California.

ERIC Educational Resources Information Center

California Univ., Berkeley. Office of the Statewide Dean.

This paper provides, for the state of California: (1) a review of state licensing and continuing education requirements; (2) a brief discussion of trends in legislation along with arguments over the effectiveness of mandatory continuing education; (3) a listing of occupations and their continuing education requirements; (4) a listing of state…

Identifying Principal and Teacher Descriptions of the Continuation High School Teacher's "Special Fitness to Perform"

ERIC Educational Resources Information Center

Vargas, Nestor Albert

2013-01-01

The objective of this study was to generate principal and teacher descriptions of what constitutes a teacher's "special fitness to perform" in a public urban continuation high school with a concentration of at-risk students. The sample included 6 continuation principals and 15 continuation teachers from a large urban school district in…

Continuing Education of Nurses in Lebanon: Evaluation and Unmet Needs

ERIC Educational Resources Information Center

Salameh, Pascale R.; Barbour, Bernadette

2006-01-01

In the nursing profession it is necessary for a nurse to engage in continuing education to keep up to date. In Lebanon efforts to establish such continuing education are being made. However, a cross-sectional study conducted on a representative sample of 254 nurses found that 60 per cent attend an insufficient number of continuing education…

A Study of Innovation: ERD Takes Pollution Prevention to a New Level

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

Southmayd, A.

1999-01-20

ERD approaches its mission with a vision of continuously exceeding customer needs and expectations and continuously improving. It's this vision of continuous improvement that drives the ERD pollution prevention program towards innovation.

The impact of continuous versus intermittent vital signs monitoring in hospitals: A systematic review and narrative synthesis.

PubMed

Downey, C L; Chapman, S; Randell, R; Brown, J M; Jayne, D G

2018-08-01

Continuous vital signs monitoring on general hospital wards may allow earlier detection of patient deterioration and improve patient outcomes. This systematic review will assess if continuous monitoring is practical outside of the critical care setting, and whether it confers any clinical benefit to patients. MEDLINE ® , MEDLINE ® In-Process, EMBASE, CINAHL and The Cochrane Library were searched for articles that evaluated the clinical or non-clinical outcomes of continuous vital signs monitoring in adults outside of the critical care setting. The protocol was registered with PROSPERO (CRD42017058098). Twenty-four studies met the inclusion criteria and reported outcomes on a total of 40,274 patients and 59 ward staff in nine countries. The majority of studies showed benefits in terms of critical care use and length of hospital stay. Larger studies were more likely to demonstrate clinical benefit, particularly critical care use and length of hospital stay. Three studies showed cost-effectiveness. Barriers to implementation included nursing and patient satisfaction and the burden of false alerts. Continuous vital signs monitoring outside the critical care setting is feasible and may provide a benefit in terms of improved patient outcomes and cost efficiency. Large, well-controlled studies in high-risk populations are required to evaluate the clinical benefit of continuous monitoring systems. Copyright © 2018 Elsevier Ltd. All rights reserved.

Differential results integrated with continuous and discrete gravity measurements between nearby stations

NASA Astrophysics Data System (ADS)

Xu, Weimin; Chen, Shi; Lu, Hongyan

2016-04-01

Integrated gravity is an efficient way in studying spatial and temporal characteristics of the dynamics and tectonics. Differential measurements based on the continuous and discrete gravity observations shows highly competitive in terms of both efficiency and precision with single result. The differential continuous gravity variation between the nearby stations, which is based on the observation of Scintrex g-Phone relative gravimeters in every single station. It is combined with the repeated mobile relative measurements or absolute results to study the regional integrated gravity changes. Firstly we preprocess the continuous records by Tsoft software, and calculate the theoretical earth tides and ocean tides by "MT80TW" program through high precision tidal parameters from "WPARICET". The atmospheric loading effects and complex drift are strictly considered in the procedure. Through above steps we get the continuous gravity in every station and we can calculate the continuous gravity variation between nearby stations, which is called the differential continuous gravity changes. Then the differential results between related stations is calculated based on the repeated gravity measurements, which are carried out once or twice every year surrounding the gravity stations. Hence we get the discrete gravity results between the nearby stations. Finally, the continuous and discrete gravity results are combined in the same related stations, including the absolute gravity results if necessary, to get the regional integrated gravity changes. This differential gravity results is more accurate and effective in dynamical monitoring, regional hydrologic effects studying, tectonic activity and other geodynamical researches. The time-frequency characteristics of continuous gravity results are discussed to insure the accuracy and efficiency in the procedure.

Delivering Continuing Education to the Pharmacist: Correspondence Course versus Computer-Assisted Instruction.

ERIC Educational Resources Information Center

Knoll, K. Richard; And Others

1988-01-01

A study of the effectiveness of two teaching methods, correspondence study and computer-assisted instruction, for professional continuing education in pharmacokinetics found that both were effective methods. (AUTHOR/MSE)

"I had a good time when I was young": Interpreting descriptions of continuity among older people.

PubMed

Breheny, Mary; Griffiths, Zoë

2017-04-01

Messages describing how best to age are prominent in gerontological theory, research and the media. These prescriptions for ageing may foster positive experiences in later life; however, they may also obscure the social and situated nature of expectations for ageing well. Continuity Theory proposes ageing well is achieved through continuity of activity and stability of relationships and identity over the life course. Continuity seems adaptive, yet prioritising continuity may not match the expectations, desires and realities of older people. To understand continuity among older people, the present study used interpretative phenomenological analysis (IPA) to analyse transcripts from eleven participants over the age of 79 years. Continuity was important for older people in this study, who described a range of practices that supported internal and external continuity. Participants acknowledged both positive and negative changes in roles and obligations as they aged which impacted on continuity of identity. Continuity of identity was linked both to being 'just like always' and 'just like everyone else'. Examining these accounts shows how they are tied to expectations that older people should both maintain earlier patterns of behaviour while also negotiating changing social expectations for behaviour that are linked to age. These tensions point to the balance between physical, environmental and interpersonal change and the negotiation of social expectations which together structure possibilities for ageing well. Copyright © 2017 Elsevier Inc. All rights reserved.

Continuing education for primary health care nurse practitioners in Ontario, Canada.

PubMed

Baxter, Pamela; DiCenso, Alba; Donald, Faith; Martin-Misener, Ruth; Opsteen, Joanne; Chambers, Tracey

2013-04-01

The Council of Ontario University Programs in Nursing offers a nine-university, consortium-based primary health care nurse practitioner education program and on-line continuing education courses for primary health care nurse practitioners. Our study sought to determine the continuing education needs of primary health care nurse practitioners across Ontario, how best to meet these needs, and the barriers they face in completing continuing education. Surveys were completed by 83 (40%) of 209 learners who had participated in continuing education offered by the Council of Ontario University Programs in Nursing between 2004 and 2007. While 83% (n=50) of nurse practitioners surveyed indicated that continuing education was extremely important to them, they also identified barriers to engaging in continuing education offerings including; time intensity of the courses, difficulty taking time off work, family obligations, finances and fatigue. The most common reason for withdrawal from a continuing education offering was the difficulty of balancing work and study demands. Continuing education opportunities are important to Ontario primary health care nurse practitioners, and on-line continuing education offerings have been well received, but in order to be taken up by their target audience they must be relevant, readily accessible, flexible, affordable and offered over brief, intense periods of time using technology that is easy to use and Internet sites that are easily navigated. Copyright © 2012 Elsevier Ltd. All rights reserved.

Predicting declines in perceived relationship continuity using practice deprivation scores: a longitudinal study in primary care.

PubMed

Levene, Louis S; Baker, Richard; Walker, Nicola; Williams, Christopher; Wilson, Andrew; Bankart, John

2018-06-01

Increased relationship continuity in primary care is associated with better health outcomes, greater patient satisfaction, and fewer hospital admissions. Greater socioeconomic deprivation is associated with lower levels of continuity, as well as poorer health outcomes. To investigate whether deprivation scores predicted variations in the decline over time of patient-perceived relationship continuity of care, after adjustment for practice organisational and population factors. An observational study in 6243 primary care practices with more than one GP, in England, using a longitudinal multilevel linear model, 2012-2017 inclusive. Patient-perceived relationship continuity was calculated using two questions from the GP Patient Survey. The effect of deprivation on the linear slope of continuity over time was modelled, adjusting for nine confounding variables (practice population and organisational factors). Clustering of measurements within general practices was adjusted for by using a random intercepts and random slopes model. Descriptive statistics and univariable analyses were also undertaken. Relationship continuity declined by 27.5% between 2012 and 2017, and at all deprivation levels. Deprivation scores from 2012 did not predict variations in the decline of relationship continuity at practice level, after accounting for the effects of organisational and population confounding variables, which themselves did not predict, or weakly predicted with very small effect sizes, the decline of continuity. Cross-sectionally, continuity and deprivation were negatively correlated within each year. The decline in relationship continuity of care has been marked and widespread. Measures to maximise continuity will need to be feasible for individual practices with diverse population and organisational characteristics. © British Journal of General Practice 2018.

Protein and calorie prescription for children and young adults receiving continuous renal replacement therapy: a report from the Prospective Pediatric Continuous Renal Replacement Therapy Registry Group.

PubMed

Zappitelli, Michael; Goldstein, Stuart L; Symons, Jordan M; Somers, Michael J G; Baum, Michelle A; Brophy, Patrick D; Blowey, Douglas; Fortenberry, James D; Chua, Annabelle N; Flores, Francisco X; Benfield, Mark R; Alexander, Steven R; Askenazi, David; Hackbarth, Richard; Bunchman, Timothy E

2008-12-01

Few published reports describe nutrition provision for critically ill children and young adults with acute kidney injury receiving continuous renal replacement therapy. The goals of this study were to describe feeding practices in pediatric continuous renal replacement therapy and to evaluate factors associated with over- and under-prescription of protein and calories. Retrospective database study. Multicenter study in pediatric critical care units. Patients with acute kidney injury (estimated glomerular filtration rate < 75 mL/min/1.73 m at continuous renal replacement therapy initiation) enrolled in the Prospective Pediatric Continuous Renal Replacement Therapy Registry. None. Nutrition variables: initial and maximal protein (g/kg/day) and caloric (kcal/kg/day) prescription and predicted resting energy expenditure (kcal/kg/day). We determined factors predicting initial and maximal protein and caloric prescription by multivariate analysis. One hundred ninety-five patients (median [interquartile range] age = 8.1 [12.8] yrs, 56.9% men) were studied. Mean protein and caloric prescriptions at continuous renal replacement therapy initiation were 1.3 +/- 1.5 g/kg/day (median, 1.0; range, 0-10) and 37 +/- 27 kcal/kg/day (median, 32; range, 0-107). Mean maximal protein and caloric prescriptions during continuous renal replacement therapy were 2.0 +/- 1.5 g/kg/day (median, 1.7; range, 0-12) and 48 +/- 32 kcal/kg/day (median, 43; range, 0-117). Thirty-four percent of patients were initially prescribed < 1 g/kg/day protein; 23% never attained > 1 g/kg/day protein prescription. By continuous renal replacement therapy day 5, median protein prescribed was > 2 g/kg/day. Protein prescription practices differed substantially between medical centers with 5 of 10 centers achieving maximal protein prescription of > 2 g/kg/day in > or = 40% of patients. Caloric prescription exceeded predicted resting energy expenditure by 30%-100%. Factors independently associated with maximal protein and caloric prescription while on continuous renal replacement therapy were younger age, initial protein and caloric prescription and number of continuous renal replacement therapy treatment days (p < 0.05). Protein prescription in pediatric continuous renal replacement therapy may be inadequate. Inter-center variation exists with respect to nutrition prescription. Feeding practice standardization and research in pediatric acute kidney injury nutrition are essential to begin providing evidence-based feeding recommendations.

Intellectual and Emotional Development and School Adjustment in Preterm Children at 6 and 7 Years of Age. Continuation of a Follow-Up Study.

ERIC Educational Resources Information Center

Grigoroiu-Serbanescu, Maria

1984-01-01

Continues a previous five-year follow-up of preterm and full-term children by studying the continuity in their intellectual and emotional development. Prematurity was predictive for school adjustment at ages six and seven only when regression was performed on the preterm group, but failed to be predictive when mixed groups of preterm and full-term…

Continuous care and patients' basic needs during weaning from mechanical ventilation: A qualitative study.

PubMed

Khalafi, Ali; Elahi, Nasrin; Ahmadi, Fazlollah

2016-12-01

Mechanical ventilation is associated with a number of risks and complications. Thus, rapid and safe weaning from mechanical ventilation is of great importance. Weaning is a complex and challenging process, requiring continuous care and knowledge of the patient. The aim of the present study was to describe the continuous care process during weaning as well as to analyse the facilitators and obstacles to the weaning process from start to finish from the perspective of intensive care unit (ICU) staff, particularly nurses. Twenty-two ICU staff members, including nurses and physicians, and three patients hospitalised in the ICU were enrolled in this qualitative study. Semi-structured interviews were used for data collection and the transcripts were analysed using qualitative content analysis. 'Continuous care' was found to be the patients' basic need during weaning from mechanical ventilation. Uninterrupted, stable, comprehensive and dynamic care and monitoring with immediate response to all physiological and psychological changes were features of continuous care. The three main themes identified by this study were time spent with the patient, comprehensive supervision and maintenance of the quality of care during shifts. Continuous and constant care should be provided during the weaning process. Such care will help to provide health care staff with a deeper understanding of the patient and his or her continuous changes, leading to a timely and favourable response during weaning. To achieve this goal, skill, communication and organisational changes are essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cryotherapy Treatment After Unicompartmental and Total Knee Arthroplasty: A Review.

PubMed

Chughtai, Morad; Sodhi, Nipun; Jawad, Michael; Newman, Jared M; Khlopas, Anton; Bhave, Anil; Mont, Michael A

2017-12-01

Cryotherapy is widely utilized to enhance recovery after knee surgeries. However, the outcome parameters often vary between studies. Therefore, the purpose of this review is to compare (1) no cryotherapy vs cryotherapy; (2) cold pack cryotherapy vs continuous flow device cryotherapy; (3) various protocols of application of these cryotherapy methods; and (4) cost-benefit analysis in patients who had unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). A search for "knee" and "cryotherapy" using PubMed, EBSCO Host, and SCOPUS was performed, yielding 187 initial reports. After selecting for RCTs relevant to our study, 16 studies were included. Of the 8 studies that compared the immediate postoperative outcomes between patients who did and did not receive cryotherapy, 5 studies favored cryotherapy (2 cold packs and 3 continuous cold flow devices). Of the 6 studies comparing the use of cold packs and continuous cold flow devices in patients who underwent UKA or TKA, 3 favor the use of continuous flow devices. There was no difference in pain, postoperative opioid consumption, or drain output between 2 different temperature settings of continuous cold flow device. The optimal device to use may be one that offers continuous circulating cold flow, as there were more studies demonstrating better outcomes. In addition, the pain relieving effects of cryotherapy may help minimize pain medication use, such as with opioids, which are associated with numerous potential side effects as well as dependence and addiction. Meta-analysis on the most recent RCTs should be performed next. Copyright © 2017 Elsevier Inc. All rights reserved.

Lumbar muscle structure and function in chronic versus recurrent low back pain: a cross-sectional study.

PubMed

Goubert, Dorien; De Pauw, Robby; Meeus, Mira; Willems, Tine; Cagnie, Barbara; Schouppe, Stijn; Van Oosterwijck, Jessica; Dhondt, Evy; Danneels, Lieven

2017-09-01

Heterogeneity exists within the low back pain (LBP) population. Some patients recover after every pain episode, whereas others suffer daily from LBP complaints. Until now, studies rarely make a distinction between recurrent low back pain (RLBP) and chronic low back pain (CLBP), although both are characterized by a different clinical picture. Clinical experiences also indicate that heterogeneity exists within the CLBP population. Muscle degeneration, like atrophy, fat infiltration, alterations in muscle fiber type, and altered muscle activity, compromises proper biomechanics and motion of the spinal units in LBP patients. The amount of alterations in muscle structure and muscle function of the paraspinal muscles might be related to the recurrence or chronicity of LBP. The aim of this experimental study is to evaluate differences in muscle structure (cross-sectional area and lean muscle fat index) and muscle activity of the multifidus (MF) and erector spinae (ES) during trunk extension, in patients with RLBP, non-continuous CLBP, and continuous CLBP. This cross-sectional study took place in the university hospital of Ghent, Belgium. Muscle structure characteristics and muscle activity were assessed by magnetic resonance imaging (MRI). Fifty-five adults with non-specific LBP (24 RLBP in remission, 15 non-continuous CLBP, 16 continuous CLBP) participated in this study. Total cross-sectional area, muscle cross-sectional area, fat cross-sectional area, lean muscle fat index, T2-rest and T2-shift were assessed. A T1-weighted Dixon MRI scan was used to evaluate spinal muscle cross-sectional area and fat infiltration in the lumbar MF and ES. Muscle functional MRI was used to evaluate the muscle activity of the lumbar MF and ES during a lumbar extension exercise. Before and after the exercise, a pain assessment was performed. This study was supported by grants from the Special Research Fund of Ghent University (DEF12/AOP/022) without potential conflict of interest-associated biases in the text of the paper. Fat cross-sectional area and lean muscle fat index were significantly higher in MF and ES in continuous CLBP compared with non-continuous CLBP and RLBP (p<.05). No differencesbetween groups were found for total cross-sectional area and muscle cross-sectional area in MF or ES (p>.05). Also, no significant differences between groups for T2-rest were established. T2-shift, however, was significantly lower in MF and ES in RLBP compared with, respectively, non-continuous CLBP and continuous CLBP (p<.05). These results indicate a higher amount of fat infiltration in the lumbar muscles, in the absence of clear atrophy, in continuous CLBP compared with RLBP. A lower metabolic activity of the lumbar muscles was seen in RLBP replicating a relative lower intensity in contractions performed by the lumbar muscles in RLBP compared with non-continuous and continuous CLBP. In conclusion, RLBP differs from continuous CLBP for both muscle structure and muscle function, whereas non-continuous CLBP seems comparable with RLBP for lumbar muscle structure and with continuous CLBP for lumbar muscle function. These results underline the differences in muscle structure and muscle function between different LBP populations. Copyright © 2017 Elsevier Inc. All rights reserved.

Continuing Education of Health Personnel as a Factor in Career Development. Report on a WHO Working Group. EURO Reports and Studies: 6.

ERIC Educational Resources Information Center

World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

A World Health Organization (WHO) working group discussed continuing education and career development of health care personnel at a meeting in Budapest, October 31-November 2, 1978. Group members defined continuing education, analyzed its methods and organization in various countries, and explored the relationship of continuing education to career…

An understanding of nurse educators' leadership behaviors in implementing mandatory continuing nursing education in China.

PubMed

Xiao, Lily Dongxia

2008-09-01

Mandatory continuing nursing education is viewed as one way to develop registered nurses' continuing competencies. However, as has been argued internationally, it can also create a paradox in terms of learning to meet study requirements. Such paradox has been discussing in China since the implementation of mandatory continuing nursing education in 1996. Nurse educators, who develop continuing nursing education programs, appear to respond to the paradox differently associated with their leadership styles. This article reports a qualitative study aiming to gain an understanding of nurse educators' leadership behaviors in implementing mandatory continuing nursing education in China. Gadamer's philosophical hermeneutics underpins in-depth interviews with five nurse educators and data interpretation. Two categories of nurse educators, described as proactive educator and reactive educator, were identified and compared with two types of leadership styles described as transformational leader and transactional leader in the literature of educational leadership and continuing professional development. Proactive educators shared core attributors of transformational leaders and were able to relieve the paradox in mandatory continuing nursing education. Reactive educators however showed some attributors of transactional leaders and might escalate the paradox. Findings suggest further research in relation to the preparation of nurse educators.

A Roadmap for the Implementation of Continued Process Verification.

PubMed

Boyer, Marcus; Gampfer, Joerg; Zamamiri, Abdel; Payne, Robin

2016-01-01

In 2014, the members of the BioPhorum Operations Group (BPOG) produced a 100-page continued process verification case study, entitled "Continued Process Verification: An Industry Position Paper with Example Protocol". This case study captures the thought processes involved in creating a continued process verification plan for a new product in response to the U.S. Food and Drug Administration's guidance on the subject introduced in 2011. In so doing, it provided the specific example of a plan developed for a new molecular antibody product based on the "A MAb Case Study" that preceded it in 2009.This document provides a roadmap that draws on the content of the continued process verification case study to provide a step-by-step guide in a more accessible form, with reference to a process map of the product life cycle. It could be used as a basis for continued process verification implementation in a number of different scenarios: For a single product and process;For a single site;To assist in the sharing of data monitoring responsibilities among sites;To assist in establishing data monitoring agreements between a customer company and a contract manufacturing organization. The U.S. Food and Drug Administration issued guidance on the management of manufacturing processes designed to improve quality and control of drug products. This involved increased focus on regular monitoring of manufacturing processes, reporting of the results, and the taking of opportunities to improve. The guidance and practice associated with it is known as continued process verification This paper summarizes good practice in responding to continued process verification guidance, gathered from subject matter experts in the biopharmaceutical industry. © PDA, Inc. 2016.

Factors associated with a continuous regular analgesic use - a population-based study of more than 45,000 Danish women and men 18-45 years of age.

PubMed

Hargreave, Marie; Andersen, Tina Veje; Nielsen, Ann; Munk, Christian; Liaw, Kai-Li; Kjaer, Susanne K

2010-01-01

Widespread use of and serious adverse effects associated with use of analgesics accentuates the need to consider factors related to analgesic use. The objective of this study was to describe continuous regular analgesics use and examine factors associated with a continuous regular analgesic use. The study was based on data from two surveys and included a random sample of women and men aged 18-45 years from the general Danish population. Information on analgesics use, self-rated health, demographic and lifestyle factors was collected using a self-administered questionnaire. A total of 28,000 women and 33 000 men were invited to participate and 22,199 women (response-rate 81.4%) and 23,080 men (response-rate 71.0%), respectively, were included in the study. Data were analyzed using multivariate logistic regression. We found that 27% of the women and 18% of the men reported a regular monthly use of at least seven analgesic tablets during the last year (continuous regular analgesics use). Besides poor self-rated health we found in both sexes that increasing age, poor self-rated fitness, and smoking were related to a continuous regular analgesics use. Nulliparity, low level of education, overweight/obesity, binge drinking, and abstinence were associated with a continuous regular analgesics use for women, while underweight and marital/cohabiting status were associated with a continuous regular analgesics use only for men. Regular monthly analgesic use during the last year was generally prevalent. Besides self-rated health, several socio-demographic and lifestyle factors were associated with a continuous regular analgesic use, although with some gender differences.

Patient–doctor continuity and diagnosis of cancer: electronic medical records study in general practice

PubMed Central

Ridd, Matthew J; Ferreira, Diana L Santos; Montgomery, Alan A; Salisbury, Chris; Hamilton, William

2015-01-01

Background Continuity of care may affect the diagnostic process in cancer but there is little research. Aim To estimate associations between patient–doctor continuity and time to diagnosis and referral of three common cancers. Design and setting Retrospective cohort study in general practices in England. Method This study used data from the General Practice Research Database for patients aged ≥40 years with a diagnosis of breast, colorectal, or lung cancer. Relevant cancer symptoms or signs were identified up to 12 months before diagnosis. Patient–doctor continuity (fraction-of-care index adjusted for number of consultations) was calculated up to 24 months before diagnosis. Time ratios (TRs) were estimated using accelerated failure time regression models. Results Patient–doctor continuity in the 24 months before diagnosis was associated with a slightly later diagnosis of colorectal (time ratio [TR] 1.01, 95% confidence interval [CI] =1.01 to 1.02) but not breast (TR = 1.00, 0.99 to 1.01) or lung cancer (TR = 1.00, 0.99 to 1.00). Secondary analyses suggested that for colorectal and lung cancer, continuity of doctor before the index consultation was associated with a later diagnosis but continuity after the index consultation was associated with an earlier diagnosis, with no such effects for breast cancer. For all three cancers, most of the delay to diagnosis occurred after referral. Conclusion Any effect for patient–doctor continuity appears to be small. Future studies should compare investigations, referrals, and diagnoses in patients with and without cancer who present with possible cancer symptoms or signs; and focus on ‘difficult to diagnose’ types of cancer. PMID:25918335

A quantitative method for optimized placement of continuous air monitors.

PubMed

Whicker, Jeffrey J; Rodgers, John C; Moxley, John S

2003-11-01

Alarming continuous air monitors (CAMs) are a critical component for worker protection in facilities that handle large amounts of hazardous materials. In nuclear facilities, continuous air monitors alarm when levels of airborne radioactive materials exceed alarm thresholds, thus prompting workers to exit the room to reduce inhalation exposures. To maintain a high level of worker protection, continuous air monitors are required to detect radioactive aerosol clouds quickly and with good sensitivity. This requires that there are sufficient numbers of continuous air monitors in a room and that they are well positioned. Yet there are no published methodologies to quantitatively determine the optimal number and placement of continuous air monitors in a room. The goal of this study was to develop and test an approach to quantitatively determine optimal number and placement of continuous air monitors in a room. The method we have developed uses tracer aerosol releases (to simulate accidental releases) and the measurement of the temporal and spatial aspects of the dispersion of the tracer aerosol through the room. The aerosol dispersion data is then analyzed to optimize continuous air monitor utilization based on simulated worker exposure. This method was tested in a room within a Department of Energy operated plutonium facility at the Savannah River Site in South Carolina, U.S. Results from this study show that the value of quantitative airflow and aerosol dispersion studies is significant and that worker protection can be significantly improved while balancing the costs associated with CAM programs.

Molasses supplementation of grazing dairy cows: summary of case study, continuous culture fermenter trials, and controlled research farm study

USDA-ARS?s Scientific Manuscript database

This fact sheet summarizes the results of a three-tiered research approach (case study, two continuous culture fermenter studies, and a controlled research farm study) to evaluate molasses as an alternative supplement source for grazing dairy cows. A two-year case study of a New York organic dairy f...

[Continuous subcutaneous infusion of opioids in cancer patients].

PubMed

Galamba, J M; Olsen, A K; Crawford, M E; Sjøgren, P

1995-07-17

This review article describes pharmacokinetics, pharmaco-dynamics, side effects and the practical use of continuous subcutaneous infusion of opioids in cancer patients with pain. Clinical studies have shown that the analgesic effects of continuous subcutaneous infusion of morphine are comparable to continuous intravenous morphine, and that the treatment modality is associated with a low frequency of side-effects and complications. Continuous subcutaneous infusions of morphine are therefore recommended as the treatment of choice for cancer patients with pain, when oral analgesic treatment is no longer possible.

Online Continuing Professional Education: An Evaluative Case Study

ERIC Educational Resources Information Center

Pullen, Darren L.

2005-01-01

An evaluation study, assessing the pedagogical and instructional design (e-pedagogy) effectiveness of online continuing professional education (CPE) courses offered by a large Australasian CPE provider to health care professionals (HCPs). The study used a naturalistic theory approach in conjunction with a multilevel evaluation to examine the…

Understanding the mediating effects of relationship quality on technology acceptance: an empirical study of e-appointment system.

PubMed

Chen, Shih-Chih; Liu, Shih-Chi; Li, Shing-Han; Yen, David C

2013-12-01

This study extends the Technology Acceptance Model (TAM) by incorporating relationship quality as a mediator to construct a comprehensive framework for understanding the influence on continuance intention in the hospital e-appointment system. A survey of 334 Taiwanese citizens who were contacted via phone or the Internet and Structural Equation Modeling (SEM) is used for path analysis and hypothesis tests. The study shows that perceived ease of use (PEOU) and perceived usefulness (PU) have significant influence on continuance intention through the mediation of relationship quality, consisting of satisfaction and trust. The direct impact of relationship quality on continuance intention is also significant. The analytical results reveal that the relationship between the hospital, patients and e-appointment users can be improved via enhancing the continued usage of e-appointment. This paper also proposes a general model to synthesize the essence of PEOU, PU, and relationship quality for explaining users' continuous intention of e-appointment.

Can integrated health services delivery have an impact on hypertension management? A cross-sectional study in two cities of China.

PubMed

Li, Haitao; Sun, Ying; Qian, Dongfu

2016-11-30

Policy makers require information regarding performance of different primary care delivery models in managing hypertension, which can be helpful for better hypertension management. This study aims to compare continuity of care among hypertensive patients between Direct Management (DM) Model of community health centers (CHCs) in Wuhan and Loose Collaboration (LC) Model in Nanjing. A cross-sectional questionnaire survey was conducted. Four CHCs in each city were randomly selected as study settings. 386 patients in Nanjing and 396 in Wuhan completed face-to-face interview surveys and were included in the final analysis. The relational continuity and coordination continuity (including both information continuity and management continuity) were measured and analyzed. Binary or multinomial logistic regression models were used for comparison between the two cities. Participants from Nanjing had better relational continuity with primary care providers as compared with those from Wuhan, including more likely to be familiar with a CHC physician (OR = 2.762; 95%CI: 1.878 to 4.061), taken care of by the same CHC physician (OR = 1.846; 95%CI: 1.262 to 2.700), and known well by a CHC physician (OR = 1.762; 95%CI: 1.206 to 2.572). Multinomial logistic regression analyses showed there were significant differences between the two cities in reported frequency of communications between hospital and CHC physicians (P = 0.001), whether hospital and CHC physicians gave same treatment suggestions (P = 0.016), as well as how treatment strategy was formulated (P < 0.001). Participants in Wuhan were less likely than those in Nanjing to consider there was continuum regarding health services provided by hospital and CHC physicians (OR = 3.932; 95%CI: 2.394 to 6.459). Our study shows that continuity of care is better for LC Model in Nanjing than DM Model in Wuhan. Our study suggests there is room for improvement regarding relational and information continuity in both cities.

A Continuous Variation Study of Heats of Neutralization.

ERIC Educational Resources Information Center

Mahoney, Dennis W.; And Others

1981-01-01

Suggests that students study heats of neutralization of a 1 M solution of an unknown acid by 1 M solution of a strong base using the method continuous variation. Reviews results using several common acids. (SK)

Theoretical and Empirical Comparisons between Two Models for Continuous Item Responses.

ERIC Educational Resources Information Center

Ferrando, Pere J.

2002-01-01

Analyzed the relations between two continuous response models intended for typical response items: the linear congeneric model and Samejima's continuous response model (CRM). Illustrated the relations described using an empirical example and assessed the relations through a simulation study. (SLD)

Learning and Context: Connections in Continuing Professional Education.

ERIC Educational Resources Information Center

Daley, Barbara J.

A qualitative interpretivist study analyzed interrelationships among professional practice, knowledge gained in continuing professional education (CPE) programs, and context of employment. Eighty semi-structured, tape-recorded interviews were conducted with social workers, lawyers, adult educators, and nurses who had attended continuing education…

Dimensionality and consequences of employee commitment to supervisors: a two-study examination.

PubMed

Landry, Guylaine; Panaccio, Alexandra; Vandenberghe, Christian

2010-01-01

Research on the 3-component model of organizational commitment--affective, normative, and continuance--has suggested that continuance commitment comprises 2 subcomponents, perceived lack of alternatives and sacrifice (e.g., S. J. Jaros, 1997; G. W. McGee & R. C. Ford, 1987). The authors aimed to extend that research in the context of employees' commitment to their immediate supervisors. Through two studies, they examined the validity and consequences of a 4-factor model of commitment to supervisors including affective, normative, continuance-alternatives, and continuance-sacrifice components. Study 1 (N = 317) revealed that the 4 components of commitment to supervisors were distinguishable from the corresponding components of organizational commitment. Study 2 (N = 240) further showed that the 4 components of commitment to supervisors differentially related to intention to leave the supervisor, supervisor-directed negative affect and emotional exhaustion. The authors discuss the implications of these findings for the management of employee commitment in organizations.

Continuous traumatic stress as a mental and physical health challenge: Case studies from South Africa.

PubMed

Kaminer, Debra; Eagle, Gillian; Crawford-Browne, Sarah

2018-07-01

This article discusses the condition of continuous traumatic stress as common on the African continent and in other international settings characterised by very high levels of ongoing violence and threat of community, political or war-related origin. Through consideration of three case studies from South Africa, contexts of continuous traumatic stress are described, and the mental health and physical health effects of living in such contexts are elaborated. Cautions are raised about attempting to transpose existing posttraumatic stress models onto individuals exposed to situations of continuous traumatic stress, and guidelines for optimal interventions with such cases are proposed.

Continuing Education Activities of the University of British Columbia, 1982-1983. A Report to the President, the Senate, and the Board of Governors.

ERIC Educational Resources Information Center

British Columbia Univ., Vancouver.

Continuing education activities of the University of British Columbia for the 1982-1983 academic year are reported. Information is provided on: extra-sessional credit programs, guided independent study, the Centre for Continuing Education, the Division of Continuing Education in the Health Sciences, professional programs of the Faculty of Commerce…

Unlocking information for coordination of care in Australia: a qualitative study of information continuity in four primary health care models

PubMed Central

2013-01-01

Background Coordination of care is considered a key component of patient-centered health care systems, but is rarely defined or operationalised in health care policy. Continuity, an aspect of coordination, is the patient’s experience of care over time, and is often described in terms of three dimensions: information, relational and management continuity. With the current health policy focus on both the use of information technology and care coordination, this study aimed to 1) explore how information continuity supports coordination and 2) investigate conditions required to support information continuity. Methods Four diverse Australian primary health care initiatives were purposively selected for inclusion in the study. Each has improved coordination as an aim or fundamental principle. Each organization was asked to identify practitioners, managers and decision makers who could provide insight into the use of information for care coordination to participate in the study. Using in-depth semi-structured interviews, we explored four questions covering the scope and use of information, the influence of governance, data ownership and confidentiality and the influence of financial incentives and quality improvement on information continuity and coordination. Data were thematically analyzed using NVivo 8. Results The overall picture that emerged across all four cases was that whilst accessibility and continuity of information underpin effective care, they are not sufficient for coordination of care for complex conditions. Shared information reduced unnecessary repetition and provided health professionals with the opportunity to access records of care from other providers, but participants described their role in coordination in terms of the active involvement of a person in care rather than the passive availability of information. Complex issues regarding data ownership and confidentiality often hampered information sharing. Successful coordination in each case was associated with responsiveness to local rather than system level factors. Conclusions The availability of information is not sufficient to ensure continuity for the patient or coordination from the systems perspective. Policy directed at information continuity must give consideration to the broader ‘fit’ with management and relational continuity and provide a broad base that allows for local responsiveness in order for coordination of care to be achieved. PMID:23497291

Unlocking information for coordination of care in Australia: a qualitative study of information continuity in four primary health care models.

PubMed

Banfield, Michelle; Gardner, Karen; McRae, Ian; Gillespie, James; Wells, Robert; Yen, Laurann

2013-03-13

Coordination of care is considered a key component of patient-centered health care systems, but is rarely defined or operationalised in health care policy. Continuity, an aspect of coordination, is the patient's experience of care over time, and is often described in terms of three dimensions: information, relational and management continuity. With the current health policy focus on both the use of information technology and care coordination, this study aimed to 1) explore how information continuity supports coordination and 2) investigate conditions required to support information continuity. Four diverse Australian primary health care initiatives were purposively selected for inclusion in the study. Each has improved coordination as an aim or fundamental principle. Each organization was asked to identify practitioners, managers and decision makers who could provide insight into the use of information for care coordination to participate in the study. Using in-depth semi-structured interviews, we explored four questions covering the scope and use of information, the influence of governance, data ownership and confidentiality and the influence of financial incentives and quality improvement on information continuity and coordination. Data were thematically analyzed using NVivo 8. The overall picture that emerged across all four cases was that whilst accessibility and continuity of information underpin effective care, they are not sufficient for coordination of care for complex conditions. Shared information reduced unnecessary repetition and provided health professionals with the opportunity to access records of care from other providers, but participants described their role in coordination in terms of the active involvement of a person in care rather than the passive availability of information. Complex issues regarding data ownership and confidentiality often hampered information sharing. Successful coordination in each case was associated with responsiveness to local rather than system level factors. The availability of information is not sufficient to ensure continuity for the patient or coordination from the systems perspective. Policy directed at information continuity must give consideration to the broader 'fit' with management and relational continuity and provide a broad base that allows for local responsiveness in order for coordination of care to be achieved.

Strengthening healthcare delivery in Haiti through nursing continuing education.

PubMed

Clark, M; Julmisse, M; Marcelin, N; Merry, L; Tuck, J; Gagnon, A J

2015-03-01

The aim of this paper was to (1) highlight nursing continuing education as a key initiative for strengthening healthcare delivery in low-resource settings, and (2) provide an example of a nursing continuing education programme in Haiti. Haiti and other low-resource settings face extreme challenges including severe shortages of healthcare workers, high rates of nurse out-migration and variations in nurse competency at entry-to-practice. Nursing continuing education has the potential to address these challenges and improve healthcare delivery through enhanced nurse performance and retention; however, it is underutilized in low-resource settings. A case study is presented from the Hôpital Universitaire de Mirebalais in Mirebalais, Haiti of a new nursing continuing education programme called the Beyond Expert Program. The case study highlights eight key dimensions of nursing continuing education in low-resource settings: (1) involving local stakeholders in planning process, (2) targeting programme to nurse participant level and area of care, (3) basing course content on local context, (4) including diverse range of nursing topics, (5) using participatory teaching methods, (6) addressing resource constraints in time and scheduling, (7) evaluating and monitoring outcomes, and (8) establishing partnerships. The case study provides guidance for others wishing to develop programmes in similar settings. Creating a nursing continuing education programme in a low-resource setting is possible when there is commitment and engagement for nursing continuing education at all levels of the organization. Our report suggests a need for policy-makers in resource-limited settings to make greater investments in nursing continuing education as a focus of human resources for health, as it is an important strategy for promoting nurse retention, building the knowledge and skill of the existing nursing workforce, and raising the image of nursing in low-resource settings. © 2015 International Council of Nurses.

Integrated continuous processing of proteins expressed as inclusion bodies: GCSF as a case study.

PubMed

Kateja, Nikhil; Agarwal, Harshit; Hebbi, Vishwanath; Rathore, Anurag S

2017-07-01

Affordability of biopharmaceuticals continues to be a challenge, particularly in developing economies. This has fuelled advancements in manufacturing that can offer higher productivity and better economics without sacrificing product quality in the form of an integrated continuous manufacturing platform. While platform processes for monoclonal antibodies have existed for more than a decade, development of an integrated continuous manufacturing process for bacterial proteins has received relatively scant attention. In this study, we propose an end-to-end integrated continuous downstream process (from inclusion bodies to unformulated drug substance) for a therapeutic protein expressed in Escherichia coli as inclusion body. The final process consisted of a continuous refolding in a coiled flow inverter reactor directly coupled to a three-column periodic counter-current chromatography for capture of the product followed by a three-column con-current chromatography for polishing. The continuous bioprocessing train was run uninterrupted for 26 h to demonstrate its capability and the resulting output was analyzed for the various critical quality attributes, namely product purity (>99%), high molecular weight impurities (<0.5%), host cell proteins (<100 ppm), and host cell DNA (<10 ppb). All attributes were found to be consistent over the period of operation. The developed assembly offers smaller facility footprint, higher productivity, fewer hold steps, and significantly higher equipment and resin utilization. The complexities of process integration in the context of continuous processing have been highlighted. We hope that the study presented here will promote development of highly efficient, universal, end-to-end, fully continuous platforms for manufacturing of biotherapeutics. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 33:998-1009, 2017. © 2016 American Institute of Chemical Engineers.

Dynamic Succession of Soil Bacterial Community during Continuous Cropping of Peanut (Arachis hypogaea L.)

PubMed Central

Chen, Mingna; Li, Xiao; Yang, Qingli; Chi, Xiaoyuan; Pan, Lijuan; Chen, Na; Yang, Zhen; Wang, Tong; Wang, Mian; Yu, Shanlin

2014-01-01

Plant health and soil fertility are affected by plant–microbial interactions in soils. Peanut is an important oil crop worldwide and shows considerable adaptability, but growth and yield are negatively affected by continuous cropping. In this study, 16S rRNA gene clone library analyses were used to study the succession of soil bacterial communities under continuous peanut cultivation. Six libraries were constructed for peanut over three continuous cropping cycles and during its seedling and pod-maturing growth stages. Cluster analyses indicated that soil bacterial assemblages obtained from the same peanut cropping cycle were similar, regardless of growth period. The diversity of bacterial sequences identified in each growth stage library of the three peanut cropping cycles was high and these sequences were affiliated with 21 bacterial groups. Eight phyla: Acidobacteria, Actinobacteria, Bacteroidetes, Chloroflexi, Gemmatimonadetes, Planctomycetes, Proteobacteria and Verrucomicrobia were dominant. The related bacterial phylotypes dynamic changed during continuous cropping progress of peanut. This study demonstrated that the bacterial populations especially the beneficial populations were positively selected. The simplification of the beneficial microbial communities such as the phylotypes of Alteromonadales, Burkholderiales, Flavobacteriales, Pseudomonadales, Rhizobiales and Rhodospirillales could be important factors contributing to the decline in peanut yield under continuous cropping. The microbial phylotypes that did not successively changed with continuous cropping, such as populations related to Rhizobiales and Rhodospirillales, could potentially resist stress due to continuous cropping and deserve attention. In addition, some phylotypes, such as Acidobacteriales, Chromatiales and Gemmatimonadales, showed a contrary tendency, their abundance or diversity increased with continuous peanut cropping progress. Some bacterial phylotypes including Acidobacteriales, Burkholderiales, Bdellovibrionales, and so on, also were affected by plant age. PMID:25010658

[Continuous insulin therapy versus multiple insulin injections in the management of type 1 diabetes: a longitutinal study].

PubMed

Ribeiro, Maria Estela Bellini; Del Roio Liberatore Junior, Raphael; Custodio, Rodrigo; Martinelli Junior, Carlos Eduardo

2016-01-01

To compare multiple doses of insulin and continuous insulin infusion therapy as treatment for type 1 diabetes melito. 40 patients with type 1 diabetes melito (21 female) with ages between 10 and 20 years (mean=14.2) and mean duration of diabetes of 7 years used multiple doses of insulin for at least 6 months and after that, continuous insulin infusion therapy for at least 6 months. Each one of the patients has used multiple doses of insulin and continuous insulin infusion therapy. For analysis of HbA1c, mean glycated hemoglobin levels (mHbA1c) were obtained during each treatment period (multiple doses of insulin and continuous insulin infusion therapy period). Although mHbA1c levels were lower during continuous insulin infusion therapy the difference was not statistically significant. During multiple doses of insulin, 14.2% had mHbA1c values below 7.5% vs. 35.71% while on continuous insulin infusion therapy; demonstrating better glycemic control with the use of continuous insulin infusion therapy. During multiple doses of insulin, 15-40 patients have severe hypoglycemic events versus 5-40 continuous insulin infusion therapy. No episodes of ketoacidosis events were recorded. This is the first study with this design comparing multiple doses of insulin and continuous insulin infusion therapy in Brazil showing no significant difference in HbA1c; hypoglycemic events were less frequent during continuous insulin infusion therapy than during multiple doses of insulin and the percentage of patients who achieved a HbA1c less than 7.5% was greater during continuous insulin infusion therapy than multiple doses of insulin therapy. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

"Faces" and Complexities of Continuing Higher Education Units: A Postmodern Approach

ERIC Educational Resources Information Center

Stephenson, Sandria S.

2010-01-01

This study examines the dynamics of continuing higher education units within the sociopolitical context of higher education institutions. A qualitative approach to data collection and analysis was the study's design, while the theoretical frame was a postmodern, symbolic, theoretical approach to organizational studies. Results show that continuing…

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

Sackl, S., E-mail: stephanie.sackl@unileoben.ac.at

The continuous heat treatment of high speed steels reduces the process times from several hours to a few minutes. The resulting cost savings as well as lower decarburisation and distortion make the continuous heat treatment favourable over an isothermal heat treatment. However, the microstructure-property relationship during continuous heat treatments is far from being well understood. In order to identify the key microstructural features for the future optimisation of continuous heat treatments of high speed steels this study compares a current industrial continuous and an isothermal heat treatment of steel HS 6-5-2 by means of light optical microscopy, scanning electron microscopy,more » X-ray diffraction, atom probe tomography, and red hardness. After continuous hardening the content of primary carbides is higher and the amount of retained austenite is lower compared to isothermal hardening. Due to the reduced time for dissolution of primary carbides a lower content of alloying elements is present in the martensitic matrix for subsequent tempering. Therefore, the chemical composition of the secondary hardening carbides after tempering is different for a continuous heat treatment. Although the difference in chemistry is quite pronounced, the deterioration of the hardness at elevated temperatures, which strongly influences the performance characteristics of the finished parts, is not altered. - Highlights: •We studied the continuous and isothermal heat treatment of the steel HS 6-5-2. •The amount of primary carbides is higher in a continuously heat treated steel. •The chemistry of secondary hardening carbides changes during tempering. •Continuously heat treated steels exhibit the same performance characteristics.« less

Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative.

PubMed

Francis, Maureen D; Wieland, Mark L; Drake, Sean; Gwisdalla, Keri Lyn; Julian, Katherine A; Nabors, Christopher; Pereira, Anne; Rosenblum, Michael; Smith, Amy; Sweet, David; Thomas, Kris; Varney, Andrew; Warm, Eric; Wininger, David; Francis, Mark L

2015-03-01

Many internal medicine (IM) programs have reorganized their resident continuity clinics to improve trainees' ambulatory experience. Downstream effects on continuity of care and other clinical and educational metrics are unclear. This multi-institutional, cross-sectional study included 713 IM residents from 12 programs. Continuity was measured using the usual provider of care method (UPC) and the continuity for physician method (PHY). Three clinic models (traditional, block, and combination) were compared using analysis of covariance. Multivariable linear regression analysis was used to analyze the effect of practice metrics and clinic model on continuity. UPC, reflecting continuity from the patient perspective, was significantly different, and was highest in the block model, midrange in combination model, and lowest in the traditional model programs. PHY, reflecting continuity from the perspective of the resident provider, was significantly lower in the block model than in combination and traditional programs. Panel size, ambulatory workload, utilization, number of clinics attended in the study period, and clinic model together accounted for 62% of the variation found in UPC and 26% of the variation found in PHY. Clinic model appeared to have a significant effect on continuity measured from both the patient and resident perspectives. Continuity requires balance between provider availability and demand for services. Optimizing this balance to maximize resident education, and the health of the population served, will require consideration of relevant local factors and priorities in addition to the clinic model.

Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative

PubMed Central

Francis, Maureen D.; Wieland, Mark L.; Drake, Sean; Gwisdalla, Keri Lyn; Julian, Katherine A.; Nabors, Christopher; Pereira, Anne; Rosenblum, Michael; Smith, Amy; Sweet, David; Thomas, Kris; Varney, Andrew; Warm, Eric; Wininger, David; Francis, Mark L.

2015-01-01

Background Many internal medicine (IM) programs have reorganized their resident continuity clinics to improve trainees' ambulatory experience. Downstream effects on continuity of care and other clinical and educational metrics are unclear. Methods This multi-institutional, cross-sectional study included 713 IM residents from 12 programs. Continuity was measured using the usual provider of care method (UPC) and the continuity for physician method (PHY). Three clinic models (traditional, block, and combination) were compared using analysis of covariance. Multivariable linear regression analysis was used to analyze the effect of practice metrics and clinic model on continuity. Results UPC, reflecting continuity from the patient perspective, was significantly different, and was highest in the block model, midrange in combination model, and lowest in the traditional model programs. PHY, reflecting continuity from the perspective of the resident provider, was significantly lower in the block model than in combination and traditional programs. Panel size, ambulatory workload, utilization, number of clinics attended in the study period, and clinic model together accounted for 62% of the variation found in UPC and 26% of the variation found in PHY. Conclusions Clinic model appeared to have a significant effect on continuity measured from both the patient and resident perspectives. Continuity requires balance between provider availability and demand for services. Optimizing this balance to maximize resident education, and the health of the population served, will require consideration of relevant local factors and priorities in addition to the clinic model. PMID:26217420

A Review of Evaluations of Effectiveness in Continuing Dental Education.

ERIC Educational Resources Information Center

Bader, James D.

1987-01-01

The literature evaluating the effectiveness of continuing education in dentistry is reviewed critically. Levels of effectiveness of continuing dental education reported by the studies has tended to be low, and no distinctions in effectiveness can be made among different educational methods. (CH)

Continuities in Antisocial Behavior and Parenting across Three Generations

ERIC Educational Resources Information Center

Smith, Carolyn A.; Farrington, David P.

2004-01-01

Background: Accumulating evidence indicates that there are intergenerational continuities in antisocial behavior, and that parenting patterns play a role in these continuities. Very few studies, however, enable assessment across two generations of children at comparable ages, employing independent reporters and comparable measurements. The present…

The presence of field geologists in Mars-like terrain

NASA Technical Reports Server (NTRS)

Mcgreevy, Michael W.

1992-01-01

Methods of ethnographic observation and analysis have been coupled with object-oriented analysis and design concepts to begin the development of a clear path from observations in the field to the design of virtual presence systems. The existence of redundancies in field geology and presence allowed for the application of methods for understanding complex systems. As a result of this study, some of these redundancies have been characterized. Those described are all classes of continuity relations, including the continuities of continuous existence, context-constituent continuities, and state-process continuities. The discussion of each includes statements of general relationships, logical consequences of these, and hypothetical situations in which the relationships would apply. These are meant to aid in the development of a theory of presence. The discussion also includes design considerations, providing guidance for the design of virtual planetary exploration systems and other virtual presence systems. Converging evidence regarding continuity in presence is found in the nature of psychological dissociation. Specific methodological refinements should enhance ecological validity in subsequent field studies, which are in progress.

Continuing Education Preferences, Facilitators, and Barriers for Nursing Home Nurses.

PubMed

Dyck, Mary J; Kim, Myoung Jin

2018-01-01

The purpose of the study was to determine the continuing education needs for nursing home nurses in rural central Illinois and to determine any potential facilitators or barriers to obtaining continuing education. Data were collected using the Educational Needs Assessment questionnaire. Descriptive statistics were computed to examine continuing education preferences, facilitators, and barriers among nursing home nurses. Independent samples t tests were used to compare preferences between administrative and staff nurses. The sample included 317 nurses from 34 facilities. The five top needs were related to clinical problems. Administrative nurses had greater needs for professional issues, managerial skills, and quality improvement than staff nurses. Barriers included rural settings, need for vacation time for programs, and inadequate staffing. Continuing education needs of nursing home nurses in Illinois are similar to previous studies conducted in Arizona and North Carolina. Continuing education barriers were mostly organizational, rather than personal. J Contin Nurs Educ. 2018;49(1):26-33. Copyright 2018, SLACK Incorporated.

Interview Schedule for Studying Why Adults Learn.

ERIC Educational Resources Information Center

Tough, Allen

Designed for use in a 1968 study of why adults learn, this interview schedule contains situation-description and question sheets for use by the interviewer and subject for examining thirteen reasons why adults begin and why they continue a learning project. (The study, "Why Adults Learn: A Study of the Major Reasons for Beginning and Continuing a…

Teaching a "Critical Accessibility Case Study": Developing Disability Studies Curricula for the Technical Communication Classroom

ERIC Educational Resources Information Center

Browning, Ella R.; Cagle, Lauren E.

2017-01-01

As technical communication (TC) instructors, it is vital that we continue reimagining our curricula as the field itself is continually reimagined in light of new technologies, genres, workplace practices, and theories--theories such as those from disability studies scholarship. Here, the authors offer an approach to including disability studies in…

Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review.

PubMed

Zorbas, Konstantinos A; Economopoulos, Konstantinos P; Vlahos, Nikos F

2015-07-01

Recurrence of endometriosis after conservative surgery has been observed in 40-50 % of patients within the first 5 years. A variety of regimens such as combined oral contraceptives, GnRH agonists, danazol, and progestins have been used postoperatively to reduce recurrence rates. Oral contraceptives (oCP) have been used either in a cyclic or in a continuous (no pill-free interval) fashion. The purpose of this article was to summarize the existing evidence on the efficacy and patient compliance for the use of oCP in a continuous versus cyclic fashion following conservative surgery for endometriosis. A systematic search of Medline identified four eligible studies. Studies were considered eligible, if they have evaluated oCP therapy, either in a cyclic or continuous regimen, after conservative surgery for endometriosis. Specifically, studies (1) reporting on women with endometriosis who were treated postoperatively with both continuous oCP and cyclic oCP, (2) written in English, (3) with minimum 6 months duration of medical treatment, and (4) with minimum 12 months duration of follow-up were considered eligible for our systematic review. Outcome measures of these eligible studies were tabulated and then analyzed cumulatively. A purely descriptive approach was adopted concerning all variables. Postoperative use of continuous oCP was associated with a reduction in the recurrence rate of dysmenorrhea, delay in the presentation of dysmenorrhea, reduction in nonspecific pelvic pain, and reduction in the recurrence rate for endometrioma. Use of oCP in a continuous fashion following conservative surgery for endometriosis is more beneficial to cyclic use.

Do nurses wish to continue working for the UK National Health Service? A comparative study of three generations of nurses.

PubMed

Robson, Andrew; Robson, Fiona

2015-01-01

To identify the combination of variables that explain nurses' continuation intention in the UK National Health Service. This alternative arena has permitted the replication of a private sector Australian study. This study provides understanding about the issues that affect nurse retention in a sector where employee attrition is a key challenge, further exacerbated by an ageing workforce. A quantitative study based on a self-completion survey questionnaire completed in 2010. Nurses employed in two UK National Health Service Foundation Trusts were surveyed and assessed using seven work-related constructs and various demographics including age generation. Through correlation, multiple regression and stepwise regression analysis, the potential combined effect of various explanatory variables on continuation intention was assessed, across the entire nursing cohort and in three age-generation groups. Three variables act in combination to explain continuation intention: work-family conflict, work attachment and importance of work to the individual. This combination of significant explanatory variables was consistent across the three generations of nursing employee. Work attachment was identified as the strongest marginal predictor of continuation intention. Work orientation has a greater impact on continuation intention compared with employer-directed interventions such as leader-member exchange, teamwork and autonomy. UK nurses are homogeneous across the three age-generations regarding explanation of continuation intention, with the significant explanatory measures being recognizably narrower in their focus and more greatly concentrated on the individual. This suggests that differentiated approaches to retention should perhaps not be pursued in this sectoral context. © 2014 John Wiley & Sons Ltd.

[Ultrastructural changes of myelinated fibers in the brain in continuous and attack-like paranoid schizophrenia].

PubMed

Uranova, N A; Kolomeets, N S; Vikhreva, O V; Zimina, I S; Rakhmanova, V I; Orlovskaya, D D

Previously the authors have reported the ultrastructural pathology of myelinated fibers (MF) in the brain in schizophrenia. The aim of the present study was to compare the effect of disease course on ultrastructural changes of MF. Postmortem electron microscopic morphometric study of MF was performed in the prefrontal cortex, caudate nucleus and hippocampus in 19 cases of paranoid schizophrenia. Fourteen cases of continuous schizophrenia, 5 cases of attack-like schizophrenia and 25 normal matched control cases were studied. The proportion (percentage) of pathological MF was estimated in the prefrontal cortex, layer 5, CA3 area of hippocampus, pyramidal layer, and in the head of the caudate nucleus. The percentage of MF having axonal atrophy and swelling of periaxonal oligodendrocyte process was significantly higher in both continuous and attack-like schizophrenia in all brain structures studied as compared to the control group. In the hippocampus and caudate nucleus, this parameter was increased significantly in attack-like schizophrenia as compared to continuous schizophrenia. In the prefrontal cortex. The percentage of the pathological MF having signs of deformation and destruction of myelin sheaths increased significantly only in continuous schizophrenia as compared to the control group. MF pathology is similar in attack-like and continuous paranoid schizophrenia but differ by the degree of severity of pathological MF. Abnormalities in MF contribute to the disconnectivity between the prefrontal cortex, caudate nucleus and hippocampus.

Effects of High-Intensity Interval Training on Aerobic Capacity in Cardiac Patients: A Systematic Review with Meta-Analysis

PubMed Central

Xie, Bin; Yan, Xianfeng

2017-01-01

Purpose. The aim of this study was to compare the effects of high-intensity interval training (INTERVAL) and moderate-intensity continuous training (CONTINUOUS) on aerobic capacity in cardiac patients. Methods. A meta-analysis identified by searching the PubMed, Cochrane Library, EMBASE, and Web of Science databases from inception through December 2016 compared the effects of INTERVAL and CONTINUOUS among cardiac patients. Results. Twenty-one studies involving 736 participants with cardiac diseases were included. Compared with CONTINUOUS, INTERVAL was associated with greater improvement in peak VO2 (mean difference 1.76 mL/kg/min, 95% confidence interval 1.06 to 2.46 mL/kg/min, p < 0.001) and VO2 at AT (mean difference 0.90 mL/kg/min, 95% confidence interval 0.0 to 1.72 mL/kg/min, p = 0.03). No significant difference between the INTERVAL and CONTINUOUS groups was observed in terms of peak heart rate, peak minute ventilation, VE/VCO2 slope and respiratory exchange ratio, body mass, systolic or diastolic blood pressure, triglyceride or low- or high-density lipoprotein cholesterol level, flow-mediated dilation, or left ventricular ejection fraction. Conclusions. This study showed that INTERVAL improves aerobic capacity more effectively than does CONTINUOUS in cardiac patients. Further studies with larger samples are needed to confirm our observations. PMID:28386556

Continuing pregnancy after mifepristone and "reversal" of first-trimester medical abortion: a systematic review.

PubMed

Grossman, Daniel; White, Kari; Harris, Lisa; Reeves, Matthew; Blumenthal, Paul D; Winikoff, Beverly; Grimes, David A

2015-09-01

We conducted a systematic review of the literature on the effectiveness of medical abortion "reversal" treatment. Since the usual care for women seeking to continue pregnancies after ingesting mifepristone is expectant management with fetal surveillance, we also performed a systematic review of continuing pregnancy after mifepristone alone. We searched PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus and the Cochrane Library for articles published through March 2015 reporting the proportion of pregnancies continuing after treatment with either mifepristone alone or after an additional treatment following mifepristone aimed at reversing its effect. From 1115 articles retrieved, 1 study met inclusion criteria for abortion reversal, and 13 studies met criteria for continuing pregnancy after mifepristone alone. The one report of abortion reversal was a case series of 7 patients receiving varying doses of progesterone in oil intramuscularly or micronized progesterone orally or vaginally; 1 patient was lost to follow-up. The study was of poor quality and lacked clear information on patient selection. Four of six women continued the pregnancy to term [67%, 95% confidence interval (CI) 30-90%]. Assuming the lost patient aborted resulted in a continuing pregnancy proportion of 57% (95% CI 25-84%). The proportion of pregnancies continuing 1-2 weeks after mifepristone alone varied from 8% (95% CI 3-22%) to 46% (95% CI 37-56%). Continuing pregnancy was more common with lower mifepristone doses and advanced gestational age. In the rare case that a woman changes her mind after starting medical abortion, evidence is insufficient to determine whether treatment with progesterone after mifepristone results in a higher proportion of continuing pregnancies compared to expectant management. Legislation requiring physicians to inform patients about abortion reversal transforms an unproven therapy into law and represents legislative interference in the patient-physician relationship. Copyright © 2015 Elsevier Inc. All rights reserved.

Falls-Related Drug Use and Risk of Falls Among Older Adults: A Study in a US Medicare Population.

PubMed

Musich, Shirley; Wang, Shaohung S; Ruiz, Joann; Hawkins, Kevin; Wicker, Ellen

2017-07-01

Approximately one-third of community-dwelling older adults fall each year, and approximately 10% have falls requiring medical services. Among other factors, research studies have linked certain medications with an increased risk of falls. The aim of this study was to examine the risk of falls relative to use patterns among new and continuing falls-related drug (FRD) users. A 10% random sample, insured in AARP ® Medicare Supplement and AARP Medicare Part D Rx plans, was utilized to define new and continuing FRD users. New users had a 12-month pre-period without FRD use, whereas continuing users had at least one FRD in the pre-period. Both groups had 12-month follow-up after initiating or continuing FRD use. Characteristics associated with the risk of falls for new and continuing users were determined using multivariate logistic regression models. Among insureds, 44% used at least one of the FRD classes. Of these, 29% were new users (N = 35,340) and 71% were continuing users (N = 121,488). Fall rates for the two subgroups were similar at 7 and 8%, respectively. Characteristics associated with the risk of falls were previous injurious fall, use of two or more classes of FRDs, older age, poorer health, and being female. New users were at higher risk than continuing users. New users of FRDs were at highest risk of falls, and continuing users were at increased risk, especially with higher numbers of FRD classes. Both groups could benefit from falls awareness and prevention programs.

Patient-reported care coordination: associations with primary care continuity and specialty care use.

PubMed

Liss, David T; Chubak, Jessica; Anderson, Melissa L; Saunders, Kathleen W; Tuzzio, Leah; Reid, Robert J

2011-01-01

Care coordination is increasingly recognized as a necessary element of high-quality, patient-centered care. This study investigated (1) the association between care coordination and continuity of primary care, and (2) differences in this association by level of specialty care use. We conducted a cross-sectional study of Medicare enrollees with select chronic conditions in an integrated health care delivery system in Washington State. We collected survey information on patient experiences and automated health care utilization data for 1 year preceding survey completion. Coordination was defined by the coordination measure from the short form of the Ambulatory Care Experiences Survey (ACES). Continuity was measured by primary care visit concentration. Patients who had 10 or more specialty care visits were classified as high users. Linear regression was used to estimate the association between coordination and continuity, controlling for potential confounders and clustering within clinicians. We used a continuity-by-specialty interaction term to determine whether the continuity-coordination association was modified by high specialty care use. Among low specialty care users, an increase of 1 standard deviation (SD) in continuity was associated with an increase of 2.71 in the ACES coordination scale (P <.001). In high specialty care users, we observed no association between continuity and reported coordination (P= .77). High use of specialty care may strain the ability of primary care clinicians to coordinate care effectively. Future studies should investigate care coordination interventions that allow for appropriate specialty care referrals without diminishing the ability of primary care physicians to manage overall patient care.

The relationship between group size, intoxication and continuing to drink after bar attendance.

PubMed

Reed, Mark B; Clapp, John D; Martell, Brandi; Hidalgo-Sotelo, Alexandra

2013-11-01

The present study was undertaken to explore multilevel determinants of planning to continue to drink alcohol after leaving public drinking events. We assessed whether individual-level factors, group-related factors, or event-level bar characteristics were associated with post-bar drinking. We recruited a total of 642 participants from 30 participating bars in urban Southern California. Groups who arrived to patron a bar were interviewed upon their entrance and exit. Given data nesting, we employed a multilevel modeling approach to data analysis. More than one-third (40%) of our sample reported the intention to continue drinking as they exited the bar. Results of our multilevel model indicated eight individual-level variables significantly associated with intending to continue to drink. Time of night moderated the relationship between BrAC change and intentions to continue to drink. Although none of the group factors were significant in our model, a significant cross-level interaction between BrAC change and number of group members indicated the effect of intoxication on planning to continue to drink increases as group members increase. At the bar level, the presence of temporary bars and server offers of non-alcoholic drinks significantly decreased intentions to continue to drink. Given the large percentage of participants who reported the intention to continue drinking after exiting a bar, this study draws attention to the fact that field studies of drinking behavior may assess drinking mid-event rather than at the end of a drinking event. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Soil Eukaryotic Microorganism Succession as Affected by Continuous Cropping of Peanut - Pathogenic and Beneficial Fungi were Selected

PubMed Central

Chen, Mingna; Li, Xiao; Yang, Qingli; Chi, Xiaoyuan; Pan, Lijuan; Chen, Na; Yang, Zhen; Wang, Tong; Wang, Mian; Yu, Shanlin

2012-01-01

Peanut is an important oil crop worldwide and shows considerable adaptability but growth and yield are negatively affected by continuous cropping. Soil micro-organisms are efficient bio-indicators of soil quality and plant health and are critical to the sustainability of soil-based ecosystem function and to successful plant growth. In this study, 18S rRNA gene clone library analyses were employed to study the succession progress of soil eukaryotic micro-organisms under continuous peanut cultivation. Eight libraries were constructed for peanut over three continuous cropping cycles and its representative growth stages. Cluster analyses indicated that soil micro-eukaryotic assemblages obtained from the same peanut cropping cycle were similar, regardless of growth period. Six eukaryotic groups were found and fungi predominated in all libraries. The fungal populations showed significant dynamic change and overall diversity increased over time under continuous peanut cropping. The abundance and/or diversity of clones affiliated with Eurotiales, Hypocreales, Glomerales, Orbiliales, Mucorales and Tremellales showed an increasing trend with continuous cropping but clones affiliated with Agaricales, Cantharellales, Pezizales and Pyxidiophorales decreased in abundance and/or diversity over time. The current data, along with data from previous studies, demonstrated that the soil microbial community was affected by continuous cropping, in particular, the pathogenic and beneficial fungi that were positively selected over time, which is commonplace in agro-ecosystems. The trend towards an increase in fungal pathogens and simplification of the beneficial fungal community could be important factors contributing to the decline in peanut growth and yield over many years of continuous cropping. PMID:22808226

Patient attitudes towards remote continuous vital signs monitoring on general surgery wards: An interview study.

PubMed

Downey, C L; Brown, J M; Jayne, D G; Randell, R

2018-06-01

Vital signs monitoring is used to identify deteriorating patients in hospital. The most common tool for vital signs monitoring is an early warning score, although emerging technologies allow for remote, continuous patient monitoring. A number of reviews have examined the impact of continuous monitoring on patient outcomes, but little is known about the patient experience. This study aims to discover what patients think of monitoring in hospital, with a particular emphasis on intermittent early warning scores versus remote continuous monitoring, in order to inform future implementations of continuous monitoring technology. Semi-structured interviews were undertaken with 12 surgical inpatients as part of a study testing a remote continuous monitoring device. All patients were monitored with both an early warning score and the new device. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Patients can see the value in remote, continuous monitoring, particularly overnight. However, patients appreciate the face-to-face aspect of early warning score monitoring as it allows for reassurance, social interaction, and gives them further opportunity to ask questions about their medical care. Early warning score systems are widely used to facilitate detection of the deteriorating patient. Continuous monitoring technologies may provide added reassurance. However, patients value personal contact with their healthcare professionals and remote monitoring should not replace this. We suggest that remote monitoring is best introduced in a phased manner, and initially as an adjunct to usual care, with careful consideration of the patient experience throughout. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparative effect of interval and continuous training programs on serum uric acid in management of hypertension: a randomized controlled trial.

PubMed

Lamina, Sikiru

2011-03-01

The purpose of the study was to investigate the effect of interval and continuous training program on blood pressure and serum uric acid (SUA) levels in subjects with hypertension. Three hundred and fifty-seven male patients with mild to moderate systolic blood pressure (SBP) between 140 and 179 and diastolic blood pressure (DBP) between 90 and 109 mm Hg essential hypertension were age-matched and grouped into interval, continuous, and control groups. The interval (work:rest ratio of 1:1) and continuous groups were involved in an 8-week interval and continuous training program of 45-60 minutes, at intensities of 60-79% of heart rate maximum, whereas the control group remained sedentary during this period. SBP, DBP, maximum oxygen uptake (VO2max) and SUA concentration were assessed. One-way analysis of variance and Scheffe and Pearson correlation tests were used in data analysis. Findings of the study revealed significant effect of exercise training program on VO2max, SBP, DBP, and SUA. However, there was no significant difference between the interval and continuous groups. Changes in VO2max negatively correlated with changes in SUA (r = -0.220) at p < 0.05. It was concluded that both moderate-intensity interval and continuous training programs are effective and neither seems superior to the other in the nonpharmacological management of hypertension and may prevent cardiovascular events through the downregulation of SUA in hypertension. Findings of the study support the recommendations of moderate-intensity interval and continuous training programs as adjuncts for nonpharmacological management of essential hypertension.

Planning for Project Continuation.

ERIC Educational Resources Information Center

Berry, Grant, Jr.

Designed to help colleges plan for the successful continuation of educational improvement projects beyond the end of their original funding period, this report presents a case study of Pennsylvania College of Technology's (PCT's) efforts to ensure the continuation of a Title III faculty development program. After describing the the Title III…

Continuous Evaluation Of In-Service Highway Safety Feature Performance

DOT National Transportation Integrated Search

2002-09-01

This report documents the research effort, findings, conclusions, and recommendations of a study to develop a program for the continuous in-service evaluation of highway safety features. The study consisted of two phases and eight tasks. An in-servic...

The incidence of Crohn's disease in Cardiff over the last 75 years: an update for 1996-2005.

PubMed

Gunesh, S; Thomas, G A O; Williams, G T; Roberts, A; Hawthorne, A B

2008-02-01

The incidence of Crohn's disease rose rapidly in industralized countries over the past 50 years, but it is unclear whether the incidence is still rising or has reached a plateau. To update the long-term incidence study of Crohn's disease in Cardiff for 1996-2005, to investigate whether incidence is still rising and to study changes in disease characteristics over time. Crohn's cases identified by retrospective analysis of hospital records as in previous studies in Cardiff. Two hundred and twelve cases were identified. Corrected incidence for this decade was 66 x 10(6) per year (95% confidence interval: 58-76), showing a continuing rise compared to previous decades. The proportion with colonic disease at presentation continues to rise (43%) with a corresponding fall in those with terminal ileal disease. There remains a strong female preponderance (F:M 1.6:1) as in previous studies. The incidence in children under age 16 continues to rise, and the median age at diagnosis has fallen slightly. Crohn's disease incidence continues to rise slowly in Cardiff with a continuing increase in those presenting with colonic disease, which is now the commonest disease pattern.

An overview of four studies of a continuous oral contraceptive (levonorgestrel 90 mcg/ethinyl estradiol 20 mcg) on premenstrual dysphoric disorder and premenstrual syndrome.

PubMed

Freeman, Ellen W; Halbreich, Uriel; Grubb, Gary S; Rapkin, Andrea J; Skouby, Sven O; Smith, Lynne; Mirkin, Sebastian; Constantine, Ginger D

2012-05-01

This article presents an overview of four studies that evaluated a continuous oral contraceptive (OC) containing levonorgestrel (90 mcg) and ethinyl estradiol (20 mcg; LNG/EE) for managing premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS). Three randomized, double-blind, placebo-controlled trials and one open-label, single-treatment substudy examined mean changes from baseline in the Daily Record of Severity of Problems (DRSP) or Penn Daily Symptom Rating (DSR). Improvements from baseline in mean DRSP and DSR scores were observed, but results were not consistent among the studies. Mean percent improvement of premenstrual symptoms ranged from 30% to 59% in controlled trials and 56% to 81% in an open-label substudy. A large placebo effect was also observed in the placebo-controlled studies. Continuous LNG/EE yielded a favorable safety profile. These data, although not consistent, indicate that continuous LNG/EE may reduce the symptoms of PMDD and PMS, providing an option for women who are appropriate candidates for a continuous OC as a contraceptive, the approved indication for this medication. Copyright © 2012 Elsevier Inc. All rights reserved.

Development of a Competency Framework for Quality Improvement in Family Medicine: A Qualitative Study

ERIC Educational Resources Information Center

Czabanowska, Katarzyna; Klemenc-Ketis, Zalika; Potter, Amanda; Rochfort, Andree; Tomasik, Tomasz; Csiszar, Judit; Van den Bussche, Piet

2012-01-01

Objective: The aim of this study was to develop a comprehensive framework of quality improvement competencies for use in continuing professional development (CPD) and continuing medical education (CME) for European general practice/family medicine physicians (GPs/FDs). Methods: The study was carried out in three phases: literature review,…

Continuing Education for Texas: Special Studies of Non-Traditional Approaches to Education.

ERIC Educational Resources Information Center

Neidhart, Anthony C., Ed.

The report presents 13 studies, undertaken by Texas institutions of higher learning, responding to educational needs for improved delivery systems of higher education services to adults, and adult continuing education programs. The individual studies are: The Urban University and the Learning Society (J. E. Champagne, R. Hopper, B. Leaman); The…

Research Areas in Adult and Continuing Education

ERIC Educational Resources Information Center

Zawacki-Richter, Olaf; Röbken, Heinke; Ehrenspeck-Kolasa, Yvonne; von Ossietzky, Carl

2014-01-01

This study builds upon a Delphi study carried out by Zawacki-Richter (2009) which posited a validated classification of research areas in the special area of distance education. We now replicate the study for the broader field of adult and continuing education (ACE). The aims of this paper are: firstly, to develop a categorisation of research…

Beginning a Higher Trajectory: Grade 11 Study. State Teachers of the Year Compare Former and New State Assessments

ERIC Educational Resources Information Center

McClellan, Catherine; Joe, Jilliam; Bassett, Katherine

2017-01-01

This study continues the work that National Network of State Teachers of the Year (NNSTOY) and its partners, Clowder Consulting and Education-Counsel, began with their "Right Trajectory" study (see ED581172), released in 2015, and continued in their "Still the Right Trajectory" study (see ED581173) released in early 2017. In…

Impact of Commercial Support on Continuing Pharmacy Education

ERIC Educational Resources Information Center

Smith, Jayne L.; Cervero, Ronald M.; Valentine, Thomas

2006-01-01

Introduction: There is a serious debate over the involvement of the pharmaceutical industry in continuing education. Policies that govern the planning of continuing education for pharmacists center on the potential conflict of interest when there is commercial support for programs. The purpose of this study was to investigate the impact of…

Factors Affecting Teachers' Continuation of Technology Use in Teaching

ERIC Educational Resources Information Center

Kafyulilo, Ayoub; Fisser, Petra; Voogt, Joke

2016-01-01

This study was conducted to investigate the continuation of technology use in science and mathematics teaching of the teachers who attended a professional development program between 2010 and 2012. Continuation of technology use was hypothesized to be affected by the professional development program and by personal, institutional, and…

Perceived Value of University-Based Continuing Education Leadership Development Programs for Administrators

ERIC Educational Resources Information Center

Stone, Geri L.; Major, Claire H.

2014-01-01

This quantitative study, which involved development of a Value Creation Survey, examined the perceived value of leadership development programs (LDPs) provided by continuing higher education for administrators in colleges and universities. Participants were administrators at Association for Continuing Higher Education (ACHE) member institutions.…

Developing a Marketing Strategy for Adult and Continuing Education.

ERIC Educational Resources Information Center

Further Education Unit, London (England).

The project described in this report aimed to develop an effective and affordable educational marketing strategy in one local British continuing education provider, as a case study for adult and continuing education nationally. Methods employed were as follows: a marketing consultant visited education centers; business and community directories…

Constructivism Pedagogy Drives Redevelopment of CAD Course: A Case Study

ERIC Educational Resources Information Center

Clemons, Stephanie A.

2006-01-01

Teacher and student roles continue to change as computers continue to influence the design curriculum (Kaplan, 1997). Educators and administrators continue to grapple with the best ways to teach, implement, and maintain current technology. Few technology teachers would argue that computers, software, and hardware found in technology laboratories…

The Tactile Continuity Illusion

ERIC Educational Resources Information Center

Kitagawa, Norimichi; Igarashi, Yuka; Kashino, Makio

2009-01-01

We can perceive the continuity of an object or event by integrating spatially/temporally discrete sensory inputs. The mechanism underlying this perception of continuity has intrigued many researchers and has been well documented in both the visual and auditory modalities. The present study shows for the first time to our knowledge that an illusion…

Personality and Psychopathology in Flemish Referred Children: Five Perspectives of Continuity

ERIC Educational Resources Information Center

De Bolle, Marleen; De Clercq, Barbara; Van Leeuwen, Karla; Decuyper, Mieke; Rosseel, Yves; De Fruyt, Filip

2009-01-01

The present study investigates five types of continuity of personality and internalizing and externalizing problems (i.e., structural, differential, mean-level, individual-level and ipsative continuity) in a sample of referred children and adolescents (N = 114) with a broad variety of psychological problems. Mothers were administered a child…

Development of Proportional Reasoning: Where Young Children Go Wrong

PubMed Central

Boyer, Ty W.; Levine, Susan C.; Huttenlocher, Janellen

2008-01-01

Previous studies have found that children have difficulty solving proportional reasoning problems involving discrete units until 10- to 12-years of age, but can solve parallel problems involving continuous quantities by 6-years of age. The present studies examine where children go wrong in processing proportions that involve discrete quantities. A computerized proportional equivalence choice task was administered to kindergartners through fourth-graders in Study 1, and to first- and third-graders in Study 2. Both studies involved four between-subjects conditions that were formed by pairing continuous and discrete target proportions with continuous and discrete choice alternatives. In Study 1, target and choice alternatives were presented simultaneously and in Study 2 target and choice alternatives were presented sequentially. In both studies, children performed significantly worse when both the target and choice alternatives were represented with discrete quantities than when either or both of the proportions involved continuous quantities. Taken together, these findings indicate that children go astray on proportional reasoning problems involving discrete units only when a numerical match is possible, suggesting that their difficulty is due to an overextension of numerical equivalence concepts to proportional equivalence problems. PMID:18793078

Comparing Measures of Voice Quality From Sustained Phonation and Continuous Speech.

PubMed

Gerratt, Bruce R; Kreiman, Jody; Garellek, Marc

2016-10-01

The question of what type of utterance-a sustained vowel or continuous speech-is best for voice quality analysis has been extensively studied but with equivocal results. This study examines whether previously reported differences derive from the articulatory and prosodic factors occurring in continuous speech versus sustained phonation. Speakers with voice disorders sustained vowels and read sentences. Vowel samples were excerpted from the steadiest portion of each vowel in the sentences. In addition to sustained and excerpted vowels, a 3rd set of stimuli was created by shortening sustained vowel productions to match the duration of vowels excerpted from continuous speech. Acoustic measures were made on the stimuli, and listeners judged the severity of vocal quality deviation. Sustained vowels and those extracted from continuous speech contain essentially the same acoustic and perceptual information about vocal quality deviation. Perceived and/or measured differences between continuous speech and sustained vowels derive largely from voice source variability across segmental and prosodic contexts and not from variations in vocal fold vibration in the quasisteady portion of the vowels. Approaches to voice quality assessment by using continuous speech samples average across utterances and may not adequately quantify the variability they are intended to assess.

EFL Teachers' Perceptions of Continuing Professional Development: A Case of Iranian High School Teachers (La percepción de docentes de inglés como lengua extranjera acerca del desarrollo profesional continuado: el caso de profesores iraníes de bachillerato)

ERIC Educational Resources Information Center

Alibakhshi, Goudarz; Dehvari, Najibeh

2015-01-01

English, particularly regarding a foreign language teachers' professional development, has been studied in depth. However, it is not known how Iranian English as a foreign language teachers perceive continuing professional development. This study explored the perceptions of Iranian English as a foreign language teachers of continuing professional…

34 CFR 686.25 - Correspondence study.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Correspondence study. 686.25 Section 686.25 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH...

34 CFR 691.66 - Correspondence study.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 4 2012-07-01 2012-07-01 false Correspondence study. 691.66 Section 691.66 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS GRANT (ACG) AND NATIONAL SCIENCE AND MATHEMATICS...

34 CFR 691.66 - Correspondence study.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 4 2014-07-01 2014-07-01 false Correspondence study. 691.66 Section 691.66 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS GRANT (ACG) AND NATIONAL SCIENCE AND MATHEMATICS...

34 CFR 691.66 - Correspondence study.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 4 2013-07-01 2013-07-01 false Correspondence study. 691.66 Section 691.66 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS GRANT (ACG) AND NATIONAL SCIENCE AND MATHEMATICS...

Stem Cell Therapy to Improve Burn Wound Healing

DTIC Science & Technology

2017-03-01

Aim(s) • Perform Phase 1 Trial of Allogeneic MSCs in Burns • Perform Phase 2 Trial of Allogeneic MSCs in Burns • Collect Tissue Repository for...for safety/dose studies CY15 Goal – Continue Phase 1 and, Start Tissue Repository  Continue donors recruitment, screening and Bone Marrow Aspiration...1 Trial and Collect Tissue Repository  Continue donors recruitment, screening and Bone Marrow Aspiration as needed.  Continue patients screening

Spherical harmonics and rigged Hilbert spaces

NASA Astrophysics Data System (ADS)

Celeghini, E.; Gadella, M.; del Olmo, M. A.

2018-05-01

This paper is devoted to study discrete and continuous bases for spaces supporting representations of SO(3) and SO(3, 2) where the spherical harmonics are involved. We show how discrete and continuous bases coexist on appropriate choices of rigged Hilbert spaces. We prove the continuity of relevant operators and the operators in the algebras spanned by them using appropriate topologies on our spaces. Finally, we discuss the properties of the functionals that form the continuous basis.

Five-centimeter diameter ion thruster development

NASA Technical Reports Server (NTRS)

Weigand, A. J.

1972-01-01

All system components were tested for endurance and steady state and cyclic operation. The following results were obtained: acceleration system (electrostatic type), 3100 hours continuous running; acceleration system (translation type), 2026 hours continuous running; cathode-isolator-vaporizer assembly, 5000 hours continuous operation and 190 restart cycles with 1750 hours operation; mercury expulsion system, 5000 hours continuous running; and neutralizer, 5100 hours continuous operation. The results of component optimization studies such as neutralizer position, neutralizer keeper hole, and screen grid geometry are included. Extensive mapping of the magnet field within and immediately outside the thruster are shown. A technique of electroplating the molybdenum accelerator grid with copper to study erosion patterns is described. Results of tests being conducted to more fully understand the operation of the hollow cathode are also given. This type of 5-cm thruster will be space tested on the Communication Technology Satellite in 1975.

A Longitudinal Analysis of Site of Death: The Effects of Continuous Enrollment in Medicare Advantage Versus Conventional Medicare.

PubMed

Chen, Elizabeth Edmiston; Miller, Edward Alan

2017-09-01

This study assessed the odds of dying in hospital associated with enrollment in Medicare Advantage (M-A) versus conventional Medicare Fee-for-Service (M-FFS). Data were derived from the 2008 and 2010 waves of the Health and Retirement Study ( n = 1,030). The sample consisted of elderly Medicare beneficiaries who died in 2008-2010 (34% died in hospital, and 66% died at home, in long-term senior care, a hospice facility, or other setting). Logistic regression estimated the odds of dying in hospital for those continuously enrolled in M-A from 2008 until death compared to those continuously enrolled in M-FFS and those switching between the two plans. Results indicate that decedents continuously enrolled in M-A had 43% lower odds of dying in hospital compared to those continuously enrolled in M-FFS. Financial incentives in M-A contracts may reduce the odds of dying in hospital.

RFID Continuance Usage Intention in Health Care Industry.

PubMed

Iranmanesh, Mohammad; Zailani, Suhaiza; Nikbin, Davoud

Radio-frequency identification (RFID) has been proved to be an effective tool both for improving operational efficiency and for gaining competitive advantage in the health care industry despite its relatively low-usage rate in hospitals. The sustained use of RFID by health care professionals will promote its development in the long term. This study evaluates the acceptance continuance of RFID among health care professionals through technology continuance theory (TCT). Data were collected from 178 medical professionals in Malaysia and were then analyzed using the partial least squares technique. The analysis showed that the TCT model provided not only a thorough understanding of the continuance behavior of health care professionals toward RFID but also the attitudes, satisfaction, and perceived usefulness of professionals toward it. The results of this study are expected to assist policy makers and managers in the health care industry in implementing the RFID technology in hospitals by understanding the determinants of continuance of RFID usage intention.

Social identity continuity and mental health among Syrian refugees in Turkey.

PubMed

Smeekes, Anouk; Verkuyten, Maykel; Çelebi, Elif; Acartürk, Ceren; Onkun, Samed

2017-10-01

Building upon social psychological work on social identity and mental health, this study among Syrian refugees in Turkey examined the importance of multiple group memberships and identity continuity for mental health and well-being. A survey study was conducted among the very difficult to reach population of Syrian refugees (N = 361). With path analysis in AMOS the associations were examined between multiple group memberships, social identity continuity and mental health and psychological well-being. Indicate that belonging to multiple groups before migration was related to a higher likelihood of having preserved group memberships after migration (i.e., sense of social identity continuity), which, in turn, predicted greater life satisfaction and lower levels of depression. Multiple group membership, however, was also directly related to higher depression. Findings are discussed in relation to the importance of multiple group membership and feelings of identity continuity for refugees.

Kinetic Study of Acetone-Butanol-Ethanol Fermentation in Continuous Culture

PubMed Central

Buehler, Edward A.; Mesbah, Ali

2016-01-01

Acetone-butanol-ethanol (ABE) fermentation by clostridia has shown promise for industrial-scale production of biobutanol. However, the continuous ABE fermentation suffers from low product yield, titer, and productivity. Systems analysis of the continuous ABE fermentation will offer insights into its metabolic pathway as well as into optimal fermentation design and operation. For the ABE fermentation in continuous Clostridium acetobutylicum culture, this paper presents a kinetic model that includes the effects of key metabolic intermediates and enzymes as well as culture pH, product inhibition, and glucose inhibition. The kinetic model is used for elucidating the behavior of the ABE fermentation under the conditions that are most relevant to continuous cultures. To this end, dynamic sensitivity analysis is performed to systematically investigate the effects of culture conditions, reaction kinetics, and enzymes on the dynamics of the ABE production pathway. The analysis provides guidance for future metabolic engineering and fermentation optimization studies. PMID:27486663

Continuous hydroponic wheat production using a recirculating system

NASA Technical Reports Server (NTRS)

Mackowiak, C. L.; Owens, L. P.; Hinkle, C. R.; Prince, R. P.

1989-01-01

Continuous crop production, where plants of various ages are growing simultaneously in a single recirculating nutrient solution, is a possible alternative to batch production in a Controlled Ecological Life Support System. A study was conducted at John F. Kennedy Space Center where 8 trays (0.24 sq m per tray) of Triticum aestivum L. Yecora Rojo were grown simultaneously in a growth chamber at 23 C, 65 percent relative humidity, 1000 ppm CO2, continuous light, with a continuous flow, thin film nutrient delivery system. The same modified Hoagland nutrient solution was recirculated through the plant trays from an 80 L reservoir throughout the study. It was maintained by periodic addition of water and nutrients based on chemical analyses of the solution. The study was conducted for 216 days, during which 24 trays of wheat were consecutively planted (one every 9 days), 16 of which were grown to maturity and harvested. The remaining 8 trays were harvested on day 216. Grain yields averaged 520 g m(exp -2), and had an average edible biomass of 32 percent. Consecutive yields were unaffected by nutrient solution age. It was concluded that continual wheat production will work in this system over an extended period of time. Certain micronutrient deficiencies and toxicities posed problems and must be addressed in future continuous production systems.

Understanding E-Book Continuance Intention: Empirical Evidence from E-Book Users in a Developing Country.

PubMed

Maduku, Daniel K

2017-01-01

The book publishing industry is going through radical transformations that are driven by recent developments in information systems (IS). E-books are merely one of these developments. Notwithstanding the projections in the growth of e-book use, producers of these products contend with the issue of building user retention and loyalty through continued use. Extending the technology acceptance model (TAM), this study examined the impact of factors of perceived usefulness, perceived ease of use, social influence, and facilitating conditions on e-book continuance intention among users. The subjects of this study were 317 students from five higher institutions of learning in South Africa. Empirical testing of the research model was carried out using structural equation modeling. The results indicate that 42 percent of the variance in e-book users' continuance intention is explained by perceived usefulness, perceived ease of use, and social influence. Interestingly, facilitating conditions have an influence, although indirectly, through perceived usefulness, perceived ease of use, and social influence. The study not only contributes to the existing IS literature by extending the TAM to explain continuance intention in the e-book IS domain in a developing country but also makes recommendations to practitioners who attempt to foster continuous use of this technology.

Effects of Aerobic Exercise Training on Psychosocial Status and Serum Uric Acid in Men with Essential Hypertension: A Randomized Controlled Trial

PubMed Central

Lamina, S; Okoye, GC

2012-01-01

Background: Chronic psychosocial stress and serum uric acid (SUA) level have been implicated in the etiology and cardiovascular events risk factors in hypertension. Studies have reported significant benefit of exercise in the overall management of hypertension. However, studies on the effect of exercise on psychosocial stress and SUA in the management of hypertension seem scanty. Aim: The aim of this study was to determine the effect of continuous training program on SUA and psychosocial status of black African (Nigerian) population with hypertension. Subjects and Methods: Age-matched randomized controlled trial was used; subjects with diagnosis of hypertension attending the hypertensive clinic of Murtala Muhammed Specialist Hospital (MMSH), Kano, Nigeria form the population for the study. Two hundred and seventeen subjects with mild to moderate (systolic blood pressure (SBP) between 140 and180 and diastolic blood pressure (DBP) between 90 and 109 mmHg) essential hypertension were grouped into continuous (112) and control groups (105). The continuous group involved in an 8 weeks continuous training (60%-79% HR max) of between 45 and 60 min, 3 times per week, while the controls group remain sedentary. SBP, DBP, SUA, VO2 max and psychosocial status were assessed. Student t-test and Pearson correlation test were used in data analysis. Results: The study revealed significant beneficial effect of continuous training programs on VO2 max, SBP, DBP, SUA, and psychosocial status (P < 0.05). Psychosocial status and SUA was significantly and positively and negatively correlated respectively with VO2 max at P < 0.01. Conclusions: This study concludes and supports the recommendations of moderate intensity (continuous) training program in blood pressure reduction, SUA and psychosocial stress management in hypertension. PMID:23439606

Evaluation of a continuous regimen of levonorgestrel/ethinyl estradiol: phase 3 study results.

PubMed

Archer, David F; Jensen, Jeffrey T; Johnson, Julia V; Borisute, Hannah; Grubb, Gary S; Constantine, Ginger D

2006-12-01

This study was conducted to evaluate the safety and efficacy of a continuous daily regimen of levonorgestrel (LNG) 90 microg/ethinyl estradiol (EE) 20 microg (continuous LNG/EE). Healthy women aged 18-49 years with regular menstrual cycles for 3 months enrolled in this single-treatment open-label study and took one pill of LNG 90 microg/EE 20 microg daily for 12 months. For the 2134 subjects enrolled, the Pearl Index method failure was 1.26, and user failure was 0.34. While on Pill Pack 13, 58.7% of subjects reported amenorrhea and 79.0% reported absence of bleeding. Overall, the number of bleeding and spotting days per pill pack declined progressively. Adverse events and discontinuations were comparable to those reported for cyclic oral contraceptive (OC) regimens, except for higher rates in those related to uterine bleeding. Continuous LNG/EE demonstrated a good safety profile and efficacy similar to cyclic OCs. The regimen continuously inhibited menses, increased the incidence of amenorrhea over time and, except for a subset of women, decreased the number of bleeding and spotting days.

Bayesian inference for joint modelling of longitudinal continuous, binary and ordinal events.

PubMed

Li, Qiuju; Pan, Jianxin; Belcher, John

2016-12-01

In medical studies, repeated measurements of continuous, binary and ordinal outcomes are routinely collected from the same patient. Instead of modelling each outcome separately, in this study we propose to jointly model the trivariate longitudinal responses, so as to take account of the inherent association between the different outcomes and thus improve statistical inferences. This work is motivated by a large cohort study in the North West of England, involving trivariate responses from each patient: Body Mass Index, Depression (Yes/No) ascertained with cut-off score not less than 8 at the Hospital Anxiety and Depression Scale, and Pain Interference generated from the Medical Outcomes Study 36-item short-form health survey with values returned on an ordinal scale 1-5. There are some well-established methods for combined continuous and binary, or even continuous and ordinal responses, but little work was done on the joint analysis of continuous, binary and ordinal responses. We propose conditional joint random-effects models, which take into account the inherent association between the continuous, binary and ordinal outcomes. Bayesian analysis methods are used to make statistical inferences. Simulation studies show that, by jointly modelling the trivariate outcomes, standard deviations of the estimates of parameters in the models are smaller and much more stable, leading to more efficient parameter estimates and reliable statistical inferences. In the real data analysis, the proposed joint analysis yields a much smaller deviance information criterion value than the separate analysis, and shows other good statistical properties too. © The Author(s) 2014.

How to use case studies: continuity cases vs. one-shot cases.

PubMed

Reeves, P N

1992-01-01

Cases are a widely used instructional technique in health services administration education. This article discusses the merits of using cases in graduate education and identifies two types of cases, one-shot cases and continuity cases. The continuity case has many advantages for professional education. In particular it requires the students to recognize and cope with the interactions among decisions. Continuity cases are good vehicles both for instruction and for evaluation of students' competence. The supply of good continuity cases, however, is very limited. Consequently, despite the advantages of this type of case, instructors must consider using a blend of continuity and one-shot cases. Suggestions for the mix of cases within a curriculum are presented.

Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review.

PubMed

Coventry, Tracey H; Maslin-Prothero, Sian E; Smith, Gilly

2015-12-01

To identify the best evidence on the impact of healthcare organizations' supply of nurses and nursing workload on the continuing professional development opportunities of Registered Nurses in the acute care hospital. To maintain registration and professional competence nurses are expected to participate in continuing professional development. One challenge of recruitment and retention is the Registered Nurse's ability to participate in continuing professional development opportunities. The integrative review method was used to present Registered Nurses perspectives on this area of professional concern. The review was conducted for the period of 2001-February 2015. Keywords were: nurs*, continuing professional development, continuing education, professional development, supply, shortage, staffing, workload, nurse: patient ratio, barrier and deterrent. The integrative review used a structured approach for literature search and data evaluation, analysis and presentation. Eleven international studies met the inclusion criteria. Nurses are reluctant or prevented from leaving clinical settings to attend continuing professional development due to lack of relief cover, obtaining paid or unpaid study leave, use of personal time to undertake mandatory training and organizational culture and leadership issues constraining the implementation of learning to benefit patients. Culture, leadership and workload issues impact nurses' ability to attend continuing professional development. The consequences affect competence to practice, the provision of safe, quality patient care, maintenance of professional registration, job satisfaction, recruitment and retention. Organizational leadership plays an important role in supporting attendance at continuing professional development as an investment for the future. © 2015 John Wiley & Sons Ltd.

Cultural continuity, traditional Indigenous language, and diabetes in Alberta First Nations: a mixed methods study.

PubMed

Oster, Richard T; Grier, Angela; Lightning, Rick; Mayan, Maria J; Toth, Ellen L

2014-10-19

We used an exploratory sequential mixed methods approach to study the association between cultural continuity, self-determination, and diabetes prevalence in First Nations in Alberta, Canada. We conducted a qualitative description where we interviewed 10 Cree and Blackfoot leaders (members of Chief and Council) from across the province to understand cultural continuity, self-determination, and their relationship to health and diabetes, in the Alberta First Nations context. Based on the qualitative findings, we then conducted a cross-sectional analysis using provincial administrative data and publically available data for 31 First Nations communities to quantitatively examine any relationship between cultural continuity and diabetes prevalence. Cultural continuity, or "being who we are", is foundational to health in successful First Nations. Self-determination, or "being a self-sufficient Nation", stems from cultural continuity and is seriously compromised in today's Alberta Cree and Blackfoot Nations. Unfortunately, First Nations are in a continuous struggle with government policy. The intergenerational effects of colonization continue to impact the culture, which undermines the sense of self-determination, and contributes to diabetes and ill health. Crude diabetes prevalence varied dramatically among First Nations with values as low as 1.2% and as high as 18.3%. Those First Nations that appeared to have more cultural continuity (measured by traditional Indigenous language knowledge) had significantly lower diabetes prevalence after adjustment for socio-economic factors (p =0.007). First Nations that have been better able to preserve their culture may be relatively protected from diabetes.

Therapeutic effect of continuous exercise training program on serum creatinine concentration in men with hypertension: a randomized controlled trial.

PubMed

Sikiru, L; Okoye, G C

2014-09-01

Creatinine (Cr) has been implicated as an independent predictor of hypertension and exercise has been reported as adjunct therapy for hypertension. The purpose of the present study was to investigate the effect of continuous training programme on blood pressure and serum creatinine concentration in black African subjects with hypertension. Three hundred and fifty seven male patients with mild to moderate (systolic blood pressure [SBP] between 140-180 & diastolic blood pressure [DBP] between 90-109 mmHg) essential hypertension were age matched and randomly grouped into continuous & control groups. The continuous group involved in an 8 weeks continuous training (60-79% HR reserve) of between 45 minutes to 60 minutes, 3 times per week, while the control group remain sedentary. SBP, DBP, VO2max, serum Cr, body mass index (BMI), waist hip ratio (WHR) and percent (%) body fat. Analysis of covariance (ANCOVA) and Pearson correlation tests were used in data analysis. Findings of the study revealed significant decreased effects of continuous training programme on SBP, DBP, Cr, BMI, WHR, % body fat and significant increase in VO2max at p< 0.05. Serum Cr is significantly and negatively correlated with SBP (-.335), DBP (.194), BMI (.268), WHR (-.258) and % body fat (-.190) at p<0.05. The present study demonstrated a rationale bases for the adjunct therapeutic role of moderate intensity continuous exercise training as a multi-therapy in the down regulation of blood pressure, serum Cr, body size and body fat in hypertension.

Reasons for continuing or discontinuing olanzapine in the treatment of schizophrenia from the perspectives of patients and clinicians

PubMed Central

Chen, Jian; Ascher-Svanum, Haya; Nyhuis, Allen W; Case, Michael G; Phillips, Glenn A; Schuh, Kory J; Hoffmann, Vicki Poole

2011-01-01

Background The aim of this study was to assess the reasons for discontinuing or continuing olanzapine in patients with schizophrenia, from the perspectives of the patients and their clinicians. Methods The Reasons for Antipsychotic Discontinuation/Continuation (RAD) is a pair of questionnaires assessing these reasons from the perspectives of patients and their clinicians. Outpatients with schizophrenia (n = 199) who were not acutely ill participated in a 22-week open-label study of olanzapine from November 2006 to September 2008. Reasons for continuing or discontinuing olanzapine (on a five-point scale), along with the single most important reason and the top primary reasons, were identified. Concordance between reasons given by patients and clinicians was assessed. Results The top primary reasons for continuing olanzapine were patients’ perceptions of improvement, improvement of positive symptoms, and improved functioning. The study discontinuation rate was low (30.2%), and only a subset of patients who discontinued reported reasons for medication discontinuation. The top primary reasons for discontinuing olanzapine were insufficient improvement or worsening of positive symptoms, adverse events, and insufficient improvement or worsening of negative symptoms. Ratings given by patients and clinicians were highly concordant. Conclusion The main reason for continuing or discontinuing olanzapine appears to be medication efficacy, especially for positive symptoms. Reasons for medication discontinuation differ somewhat from reasons for continuation, with a high level of concordance between patient and clinician responses. PMID:22114469

Trends in Continuous Deep Sedation until Death between 2007 and 2013: A Repeated Nationwide Survey

PubMed Central

Cohen, Joachim; Rietjens, Judith

2016-01-01

Background Continuous deep sedation until death is a highly debated medical practice, particularly regarding its potential to hasten death and its proper use in end-of-life care. A thorough analysis of important trends in this practice is needed to identify potentially problematic developments. This study aims to examine trends in the prevalence and practice characteristics of continuous deep sedation until death in Flanders, Belgium between 2007 and 2013, and to study variation on physicians’ degree of palliative training. Methods Population-based death certificate study in 2007 and 2013 in Flanders, Belgium. Reporting physicians received questionnaires about medical practices preceding the patient’s death. Patient characteristics, clinical characteristics (drugs used, duration, artificial nutrition/hydration, intention and consent), and palliative care training of attending physician were recorded. We posed the following question regarding continuous deep sedation: ‘Was the patient continuously and deeply sedated or kept in a coma until death by the use of one or more drugs’. Results After the initial rise of continuous deep sedation to 14.5% in 2007 (95%CI 13.1%-15.9%), its use decreased to 12.0% in 2013 (95%CI 10.9%-13.2%). Compared with 2007, in 2013 opioids were less often used as sole drug and the decision to use continuous deep sedation was more often preceded by patient request. Compared to non-experts, palliative care experts more often used benzodiazepines and less often opioids, withheld artificial nutrition/hydration more often and performed sedation more often after a request from or with the consent of the patient or family. Conclusion Worldwide, this study is the first to show a decrease in the prevalence of continuous deep sedation. Despite positive changes in performance and decision-making towards more compliance with due care requirements, there is still room for improvement in the use of recommended drugs and in the involvement of patients and relatives in the decision-making process. PMID:27337064

A continuous optimization approach for inferring parameters in mathematical models of regulatory networks.

PubMed

Deng, Zhimin; Tian, Tianhai

2014-07-29

The advances of systems biology have raised a large number of sophisticated mathematical models for describing the dynamic property of complex biological systems. One of the major steps in developing mathematical models is to estimate unknown parameters of the model based on experimentally measured quantities. However, experimental conditions limit the amount of data that is available for mathematical modelling. The number of unknown parameters in mathematical models may be larger than the number of observation data. The imbalance between the number of experimental data and number of unknown parameters makes reverse-engineering problems particularly challenging. To address the issue of inadequate experimental data, we propose a continuous optimization approach for making reliable inference of model parameters. This approach first uses a spline interpolation to generate continuous functions of system dynamics as well as the first and second order derivatives of continuous functions. The expanded dataset is the basis to infer unknown model parameters using various continuous optimization criteria, including the error of simulation only, error of both simulation and the first derivative, or error of simulation as well as the first and second derivatives. We use three case studies to demonstrate the accuracy and reliability of the proposed new approach. Compared with the corresponding discrete criteria using experimental data at the measurement time points only, numerical results of the ERK kinase activation module show that the continuous absolute-error criteria using both function and high order derivatives generate estimates with better accuracy. This result is also supported by the second and third case studies for the G1/S transition network and the MAP kinase pathway, respectively. This suggests that the continuous absolute-error criteria lead to more accurate estimates than the corresponding discrete criteria. We also study the robustness property of these three models to examine the reliability of estimates. Simulation results show that the models with estimated parameters using continuous fitness functions have better robustness properties than those using the corresponding discrete fitness functions. The inference studies and robustness analysis suggest that the proposed continuous optimization criteria are effective and robust for estimating unknown parameters in mathematical models.

Continuing Engineering Studies Series; Monograph No. 3.

ERIC Educational Resources Information Center

American Society for Engineering Education, Washington, DC.

Interest in continuing engineering studies has been growing within the American Society for Engineering Education as well as among educational institutions, industrial organizations, professional association, and governmental agencies. Feeling a national need for uniformity, in 1968 the National Planning Conference authorized a National Task Force…

Continuation of copper and levonorgestrel intrauterine devices: a retrospective cohort study

PubMed Central

Phillips, Sharon J.; Hofler, Lisa G.; Modest, Anna M.; Harvey, Lara F. B.; Wu, Lily H.; Hacker, Michele R.

2018-01-01

Background Studies conflict on whether the duration of use of the copper intrauterine device is longer than that of the levonorgestrel intra-uterine device, and whether women who continue using intrauterine devices differ from those who discontinue. Objective We sought to assess continuation rates and performance of levonorgestrel intrauterine devices compared with copper intrauterine devices over a 5-year period. Study Design We performed a retrospective cohort study of 1164 individuals who underwent intrauterine device placement at an urban academic medical center. The analysis focused on a comparison of continuation rates between those using levonorgestrel intrauterine device and copper intrauterine device, factors associated with discontinuation, and intrauterine device performance. We assessed the differences in continuation at discrete time points, pregnancy, and expulsion rates using χ2 tests and calculated hazard ratios using a multivariable Cox model. Results Of 1164 women who underwent contraceptive intrauterine device insertion, 956 had follow-up data available. At 2 years, 64.9% of levonorgestrel intrauterine device users continued their device, compared with 57.7% of copper intrauterine device users (P = .11). At 4 years, continuation rates were 45.1% for levonorgestrel intrauterine device and 32.6% for copper intrauterine device (P < .01), and at 5 years continuation rates were 28.1% for levonorgestrel intrauterine device and 23.8% for copper intrauterine device (P = .33). Black race, primiparity, and age were positively associated with discontinuation; education was not. The hazard ratio for discontinuation of levonorgestrel intrauterine device compared with copper intrauterine device >4 years was 0.71 (95% confidence interval, 0.55–0.93) and >5 years was 0.82 (95% confidence interval, 0.64–1.05) after adjusting for race, age, parity, and education. Copper intrauterine device users were more likely to experience expulsion (10.2% copper intrauterine device vs 4.9% levonorgestrel intrauterine device, P < .01) over the study period and to become pregnant in the first year of use (1.6% copper intrauterine device vs 0.1% levonorgestrel intrauterine device, P < .01). Conclusion We found a difference in continuation rates between levonorgestrel and copper intrauterine device users at 4 years but not at 5 years. Copper intrauterine device users were more likely to experience expulsion and pregnancy. PMID:28315664

Long-Term Continuous Ambulatory ECG Monitors and External Cardiac Loop Recorders for Cardiac Arrhythmia: A Health Technology Assessment

PubMed Central

Kabali, Conrad; Xie, Xuanqian; Higgins, Caroline

2017-01-01

Background Ambulatory electrocardiography (ECG) monitors are often used to detect cardiac arrhythmia. For patients with symptoms, an external cardiac loop recorder will often be recommended. The improved recording capacity of newer Holter monitors and similar devices, collectively known as longterm continuous ambulatory ECG monitors, suggests that they will perform just as well as, or better than, external loop recorders. This health technology assessment aimed to evaluate the effectiveness, cost-effectiveness, and budget impact of longterm continuous ECG monitors compared with external loop recorders in detecting symptoms of cardiac arrhythmia. Methods Based on our systematic search for studies published up to January 15, 2016, we did not identify any studies directly comparing the clinical effectiveness of longterm continuous ECG monitors and external loop recorders. Therefore, we conducted an indirect comparison, using a 24-hour Holter monitor as a common comparator. We used a meta-regression model to control for bias due to variation in device-wearing time and baseline syncope rate across studies. We conducted a similar systematic search for cost-utility and cost-effectiveness studies comparing the two types of devices; none were found. Finally, we used historical claims data (2006–2014) to estimate the future 5-year budget impact in Ontario, Canada, of continued public funding for both types of longterm ambulatory ECG monitors. Results Our clinical literature search yielded 7,815 non-duplicate citations, of which 12 cohort studies were eligible for indirect comparison. Seven studies assessed the effectiveness of longterm continuous monitors and five assessed external loop recorders. Both types of devices were more effective than a 24-hour Holter monitor, and we found no substantial difference between them in their ability to detect symptoms (risk difference 0.01; 95% confidence interval −0.18, 0.20). Using GRADE for network meta-analysis, we evaluated the quality of the evidence as low. Our budget impact analysis showed that use of the longterm continuous monitors has grown steadily in Ontario since they became publicly funded in 2006, particularly since 2011 when monitors that can record for 14 days or longer became funded, and the use of external cardiac loop recorders has correspondingly declined. The analysis suggests that, with these trends, continued public funding of both types of longterm ambulatory ECG testing will result in additional costs ranging from $130,000 to $370,000 per year over the next 5 years. Conclusions Although both longterm continuous ambulatory ECG monitors and external cardiac loop recorders were more effective than a 24-hour Holter monitor in detecting symptoms of cardiac arrhythmia, we found no evidence to suggest that these two devices differ in effectiveness. Assuming that the use of longterm continuous monitors will continue to increase in the next 5 years, the public health care system in Ontario can expect to see added costs of $130,000 to $370,000 per year. PMID:28194254

Predicting Workplace Transfer of Learning: A Study of Adult Learners Enrolled in a Continuing Professional Education Training Program

ERIC Educational Resources Information Center

Nafukho, Fredrick Muyia; Alfred, Mary; Chakraborty, Misha; Johnson, Michelle; Cherrstrom, Catherine A.

2017-01-01

Purpose: The primary purpose of this study was to predict transfer of learning to workplace among adult learners enrolled in a continuing professional education (CPE) training program, specifically training courses offered through face-to-face, blended and online instruction formats. The study examined the predictive capacity of trainee…

A Pilot Study of the Challenges and Prospects of Continuous Assessment Implementation in Nigeria

ERIC Educational Resources Information Center

Owolabi, Henry O.; Onuka, Adams O. U.

2010-01-01

This study obtained basic information from teachers and students on the challenges and prospects of implementing continuous assessment (CA) in the Nigerian school system. Secondary Schools in Ilorin, the capital city of Kwara State, located in the central region of Nigeria were sampled for use in the study. It employed survey research design…

Using Online Student Polling for Continuous Improvement Planning

ERIC Educational Resources Information Center

Wingate, Julius Jason

2010-01-01

This study examines the use of Internet polling at schools to gain student input for the improvement of learning conditions to assist in the continuous improvement planning. The study consists of 2006 respondents and three different schools containing the middle school child. The grades included in the study were 5, 6, 7, and 8. Although two…

The Role of Cultural Context in Continuing Vocational Training: A Study on Auto Repairmen in Turkey

ERIC Educational Resources Information Center

Akbas, Oktay

2011-01-01

This study analysed how auto repairmen working in micro-enterprises undertake continuing vocational training in relation to cultural context. The study was conducted in Kirikkale, a city in central Anatolia in Turkey. To this end, the descriptive research technique of structured interview was used. Interviews with 33 auto repairmen were recorded…

A Correlational Study of Self-Directed Learning Readiness and Learning Activity Preference for Continuing Medical Education among Family Physicians

ERIC Educational Resources Information Center

Barrett, Theresa J.

2014-01-01

This quantitative, nonexperimental, correlational study sought to determine whether a relationship exists between family physicians' levels of self-directed learning readiness (SDLR) and their preferences for continuing medical education (CME) activities. The study also sought to determine whether years in clinical practice or size of clinical…

A continuous mass-rearing technique for the southern pine beetle (Coleoptera: Scolytidae)

Treesearch

J. Robert Bridges; John C. Moser

1983-01-01

Studying the southern pine beetle (SPB), Dendroctonus frontalis zimmermann, during endemic periods is difficult because beetle-infested trees are often hard to locate. This is especially true during the winter months. Studies that require a continuous supply of beetles are often jeopardized by a lack of beetles. During our studies of the...

[Application of biotope mapping model integrated with vegetation cover continuity attributes in urban biodiversity conservation].

PubMed

Gao, Tian; Qiu, Ling; Chen, Cun-gen

2010-09-01

Based on the biotope classification system with vegetation structure as the framework, a modified biotope mapping model integrated with vegetation cover continuity attributes was developed, and applied to the study of the greenbelts in Helsingborg in southern Sweden. An evaluation of the vegetation cover continuity in the greenbelts was carried out by the comparisons of the vascular plant species richness in long- and short-continuity forests, based on the identification of woodland continuity by using ancient woodland indicator species (AWIS). In the test greenbelts, long-continuity woodlands had more AWIS. Among the forests where the dominant trees were more than 30-year-old, the long-continuity ones had a higher biodiversity of vascular plants, compared with the short-continuity ones with the similar vegetation structure. The modified biotope mapping model integrated with the continuity features of vegetation cover could be an important tool in investigating urban biodiversity, and provide corresponding strategies for future urban biodiversity conservation.

Diversity of rhizosphere soil arbuscular mycorrhizal fungi in various soybean cultivars under different continuous cropping regimes.

PubMed

Jie, Weiguang; Liu, Xiaorui; Cai, Baiyan

2013-01-01

Recent studies have shown that continuous cropping in soybean causes substantial changes to the microbial community in rhizosphere soil. In this study, we investigated the effects of continuous cropping for various time periods on the diversity of rhizosphere soil arbuscular mycorrhizal (AM) fungi in various soybean cultivars at the branching stage. The soybean cultivars Heinong 37 (an intermediate cultivar), Heinong 44 (a high-fat cultivar) and Heinong 48 (a high-protein cultivar) were seeded in a field and continuously cropped for two or three years. We analyzed the diversity of rhizosphere soil AM fungi of these soybean plants at the branching stage using morphological and denaturing gradient gel electrophoresis (DGGE) techniques. The clustering analysis of unweighted pair-group method with arithmetic averages (UPGMA) was then used to investigate the AM fungal community shifts. The results showed that increasing the number of years of continuous cropping can improve the colonization rate of AM fungi in different soybean cultivars at the branching stage. The dominant AM fungi in the experimental fields were Funneliformismosseae and Glomus spp. The number of years of continuous cropping and the soybean cultivar both had obvious effects on the diversity of AM fungi, which was consistent with the results of colonization rate analysis. This study establishes a basis for screening dominant AM fungi of soybean. In addition, the results of this study may be useful for the development of AM fungal inoculants.

Diversity of Rhizosphere Soil Arbuscular Mycorrhizal Fungi in Various Soybean Cultivars under Different Continuous Cropping Regimes

PubMed Central

Jie, Weiguang; Liu, Xiaorui; Cai, Baiyan

2013-01-01

Recent studies have shown that continuous cropping in soybean causes substantial changes to the microbial community in rhizosphere soil. In this study, we investigated the effects of continuous cropping for various time periods on the diversity of rhizosphere soil arbuscular mycorrhizal (AM) fungi in various soybean cultivars at the branching stage. The soybean cultivars Heinong 37 (an intermediate cultivar), Heinong 44 (a high-fat cultivar) and Heinong 48 (a high-protein cultivar) were seeded in a field and continuously cropped for two or three years. We analyzed the diversity of rhizosphere soil AM fungi of these soybean plants at the branching stage using morphological and denaturing gradient gel electrophoresis (DGGE) techniques. The clustering analysis of unweighted pair-group method with arithmetic averages (UPGMA) was then used to investigate the AM fungal community shifts. The results showed that increasing the number of years of continuous cropping can improve the colonization rate of AM fungi in different soybean cultivars at the branching stage. The dominant AM fungi in the experimental fields were Funneliformismosseae and Glomus spp. The number of years of continuous cropping and the soybean cultivar both had obvious effects on the diversity of AM fungi, which was consistent with the results of colonization rate analysis. This study establishes a basis for screening dominant AM fungi of soybean. In addition, the results of this study may be useful for the development of AM fungal inoculants. PMID:23977368

Use of technology to support information needs for continuity of operations planning in public health: a systematic review.

PubMed

Reeder, Blaine; Turner, Anne; Demiris, George

2010-01-01

Continuity of operations planning focuses on an organization's ability to deliver essential services before, during and after an emergency. Public health leaders must make decisions based on information from many sources and their information needs are often facilitated or hindered by technology. The aim of this study is to provide a systematic review of studies of technology projects that address public health continuity of operations planning information needs and to discuss patterns, themes, and challenges to inform the design of public health continuity of operations information systems. To return a comprehensive results set in an under-explored area, we searched broadly in the Medline and EBSCOHost bibliographic databases using terms from prior work in public health emergency management and continuity of operations planning in other domains. In addition, we manually searched the citation lists of publications included for review. A total of 320 publications were reviewed. Twenty studies were identified for inclusion (twelve risk assessment decision support tools, six network and communications-enabled decision support tools, one training tool and one dedicated video-conferencing tool). Levels of implementation for information systems in the included studies range from proposed frameworks to operational systems. There is a general lack of documented efforts in the scientific literature for technology projects about public health continuity of operations planning. Available information about operational information systems suggest inclusion of public health practitioners in the design process as a factor in system success.

Unscheduled bleeding with continuous oral contraceptive pills: a comparison of progestin dose.

PubMed

Kaneshiro, Bliss; Edelman, Alison; Carlson, Nichole E; Nichols, Mark; Jensen, Jeffrey

2012-07-01

Although the use of continuous oral contraceptive pills (OCPs) eliminates scheduled uterine bleeding, unscheduled bleeding is common. The objective of this study was to determine whether progestin dose influences bleeding with use of continuous OCPs. This was a secondary data analysis of two other studies of continuous OCPs. Women were eligible if they were switching from a cyclic hormonal contraceptive to a continuous OCP. Women took a 20-mcg ethinyl estradiol (EE)/100-mcg levonorgestrel (LNG) pill or a 20-mcg EE/90-mcg LNG pill for 112 days. The number of bleeding/spotting days was compared between groups using a t test. Sample size was adequate to detect a difference of 8 days of bleeding/spotting over the 112 day study period (β=0.80, α=0.05). Sixty-six subjects were enrolled, 33 in each group. There were no differences in baseline characteristic, missed OCPs or side effects. There were no differences in the mean number of bleeding/spotting days in the first 84 days of the study (90 mcg LNG mean 20.8 (SE 3.6) days versus 100 mcg LNG 17.8 (SE 2.3) days, p=.48), nor was there a difference in the time to amenorrhea (p=.35). Our results do not support the use of one LNG dose over another to decrease the amount of unscheduled bleeding women experience when initiating a continuous OCP. Copyright © 2012 Elsevier Inc. All rights reserved.

Risk of aspirin continuation in spinal surgery: a systematic review and meta-analysis.

PubMed

Goes, Rik; Muskens, Ivo S; Smith, Timothy R; Mekary, Rania A; Broekman, Marike L D; Moojen, Wouter A

2017-12-01

Aspirin is typically discontinued in spinal surgery because of increased risk of hemorrhagic complications. The risk of perioperative continuation of aspirin in neurosurgery needed to be evaluated. This study aimed to evaluate all available evidence about continuation of aspirin and to compare peri- and postoperative blood loss and complication rates between patients that continued aspirin and those who discontinued aspirin perioperatively in spinal surgery. Systematic review and meta-analysis were carried out. A meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies comparing aspirin continuation with discontinuation were included. Studies using a combination of anticlotting agents or non-spinal procedures were excluded. Operative outcomes (blood loss and operative length) and different complications (surgical site infection [SSI]), stroke, myocardial infarction within 30 days postoperatively) were extracted. Overall prevalence and means were calculated for the reported outcomes in fixed-effects models with heterogeneity (I-squared [I 2 ]) and effect modification (P-interaction) assessment. Out of 1,339 studies, three case series were included in the meta-analysis. No significant differences in mean operating time were seen between the aspirin-continuing group (mean=201.8 minutes, 95% confidence interval [CI]=193.3; 210.3; I 2 =95.4%; 170 patients) and the aspirin-discontinuing group (mean=178.4 minutes, 95% CI=119.1; 237.6; I 2 =93.5%; 200 patients); (P-interaction=0.78). No significant differences in mean perioperative blood loss were seen between the aspirin-continuing group (mean=553.9 milliliters, 95% CI=468.0; 639.9; I 2 =83.4%; 170 patients) and the aspirin-discontinuing group (mean=538.7 milliliters, 95% CI=427.6; 649.8; I 2 =985.5%; 200 patients); (P-interaction=0.96). Similar non-significant differences between the two groups were found for cardiac events, stroke, and surgical site infections. This meta-analysis showed an absence of significant differences in perioperative complications between aspirin continuation and discontinuation. Because of the paucity of included studies, further well-designed prospective trials are imperative to demonstrate potential benefit and safety. Copyright © 2017 Elsevier Inc. All rights reserved.

Risky drinking patterns are being continued into pregnancy: a prospective cohort study.

PubMed

Anderson, Amy E; Hure, Alexis J; Forder, Peta M; Powers, Jennifer; Kay-Lambkin, Frances J; Loxton, Deborah J

2014-01-01

Risky patterns of alcohol use prior to pregnancy increase the risk of alcohol-exposed pregnancies and subsequent adverse outcomes. It is important to understand how consumption changes once women become pregnant. The aim of this study was to describe the characteristics of women that partake in risky drinking patterns before pregnancy and to examine how these patterns change once they become pregnant. A sample of 1577 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health were included if they first reported being pregnant in 2000, 2003, 2006, 2009 and reported risky drinking patterns prior to that pregnancy. Multinomial logistic regression was used to determine which risky drinking patterns were most likely to continue into pregnancy. When reporting risky drinking patterns prior to pregnancy only 6% of women reported weekly drinking only, whereas 46% reported binge drinking only and 48% reported both. Women in both binge categories were more likely to have experienced financial stress, not been partnered, smoked, used drugs, been nulliparous, experienced a violent relationship, and were less educated. Most women (46%) continued these risky drinking patterns into pregnancy, with 40% reducing these behaviors, and 14% completely ceasing alcohol consumption. Once pregnant, women who binged only prior to pregnancy were more likely to continue (55%) rather than reduce drinking (29%). Of the combined drinking group 61% continued to binge and 47% continued weekly drinking. Compared with the combined drinking group, binge only drinkers prior to pregnancy were less likely to reduce rather than continue their drinking once pregnant (OR = 0.37, 95% CI  =  0.29, 0.47). Over a third of women continued risky drinking into pregnancy, especially binge drinking, suggesting a need to address alcohol consumption prior to pregnancy.

Continuing and ceasing leisure activities in later life: a longitudinal study.

PubMed

Strain, Laurel A; Grabusic, Carmen C; Searle, Mark S; Dunn, Nicole J

2002-04-01

This study examined changes in leisure activities of older adults over an 8-year period, and associated sociodemographic and health characteristics. Data were from a longitudinal study conducted in Winnipeg, Manitoba, Canada; 380 respondents were interviewed in-person in both 1985 and 1993. Changes in ten specific activities and the overall number of activities continued were examined. Theater/movies/spectator sports and travel were the activities least likely to be continued over the 8-year period; watching television and reading were most likely to be continued. Characteristics significantly related to changes in activities were age, gender, education, and self-rated health in 1985 as well as changes in marital status, self-rated health, and functional ability between 1985 and 1993, although no consistent pattern emerged. Leisure education is discussed as a means of introducing modifications to enhance older adults' participation in desired activities. Directions for future research are highlighted.

Research in Secondary English, 1912-2011: Historical Continuities and Discontinuities in the NCTE Imprint

ERIC Educational Resources Information Center

Brass, Jory; Burns, Leslie David

2011-01-01

This study identified historical continuities and discontinuities across a century of secondary research published in "English Journal" (1912-1966) and "Research in the Teaching of English" (1967-2011). It highlights considerable methodological continuity across six decades of "English Journal" and some shifts in research emphases that tended to…

Developmental Trajectories of Childhood Anxiety: Identifying Continuity and Change in Anxious Emotion

ERIC Educational Resources Information Center

Weems, Carl F.

2008-01-01

This paper outlines a way for thinking about continuity and change in childhood anxiety symptoms. Considerations for a model of continuity and change in anxious emotion are discussed first. Then, a perspective which may resolve inconsistencies across studies on the stability of childhood anxiety problems overtime is presented. The perspective…

Overcoming the Discontinuity of Patriotic Education and Moral Development by Means of Regional Culture

ERIC Educational Resources Information Center

Tikhonova, Anna U.

2016-01-01

The paper analyzes studies on continuing education, explains the concept of "continuity of patriotic education and moral development by means of regional culture", determines the uniqueness of regional culture as the core of patriotic education and moral development, and characterizes the model of continuity of patriotic education and…

First-Time-Users' Impressions of Continuing Education Using the Internet

ERIC Educational Resources Information Center

Conte, Nelly

2012-01-01

Purpose: The paper's aim is to describe the first experiences of, opinions and attitudes toward, continuing education using the internet of a group of Puerto Rican pharmacists after an online course. Design/methodology/approach: This is a descriptive study using a focus group of practicing pharmacists who participated in continuing education using…

A Comparison of Two Methods of Needs Assessment: Implications for Continuing Professional Education.

ERIC Educational Resources Information Center

Igarashi, Michiko; Suveges, Linda; Moss, Gwenna

2002-01-01

A study of 113 Canadian pharmacists attending continuing education on asthma compared two methods of needs assessment: perceived needs and knowledge-based needs. Scores indicated no relationship between the two kinds of needs. Needs assessment in continuing professional education thus should recognize and address the limitations of self-perceived…

Mediators of Telephone-Based Continuing Care for Alcohol and Cocaine Dependence

ERIC Educational Resources Information Center

Mensinger, Janell Lynn; Lynch, Kevin G.; Tenhave, Thomas R.; McKay, James R.

2007-01-01

A previous randomized trial with 224 alcohol and/or cocaine addicts who had completed an initial phase of treatment indicated that 12 weeks of telephone-based continuing care yielded higher abstinence rates over 24 months than did group counseling continuing care. The current study examined mediators of this treatment effect. Results suggested…

Using Dentistry as a Case Study to Examine Continuing Education and Its Impact on Practice

ERIC Educational Resources Information Center

Bullock, Alison; Firmstone, Vickie; Frame, John; Thomas, Hywel

2010-01-01

Continuing education is a defining characteristic of work in the professions. Yet the approach various professional groups take to continuing professional development (CPD) differs widely in terms of regulatory frameworks and requirements, modes of delivery and funding. Importantly, little is understood about how CPD impacts on practice. This…

Noncredit Continuing Education: Who Does what for Whom...and Why?

ERIC Educational Resources Information Center

Long, Norma R.

1988-01-01

A case study illustrates the need to examine criteria used to select noncredit continuing education offerings. In this case, the physics faculty protested that the offering "Fundamentals of Astrology" was inappropriate as a university noncredit course. A survey of 77 continuing education divisions revealed how course offering choices are made. (CH)

Online Learning Experiences of New versus Continuing Learners: A Large-Scale Replication Study

ERIC Educational Resources Information Center

Li, Nai; Marsh, Vicky; Rienties, Bart; Whitelock, Denise

2017-01-01

A vast body of research has indicated the importance of distinguishing new vs. continuing students' learning experiences in blended and online environments. Continuing learners may have developed learning and coping mechanisms for "surviving" in such learning environments, while new learners might still need to adjust their learning…

Community College Graduates' Perceptions of Adult Learning Instructional Practices Employed in Continuing Education Programs

ERIC Educational Resources Information Center

Hinkson, Chandris Christina

2010-01-01

The purpose of this mixed methods study was to examine continuing education students' perceptions of adult education instructional practices at an urban community college. The continuing education students recently graduated from programs of law enforcement, truck driving, and health occupations. Perception analysis was based on the six principles…

The Correlates and Influences of Career-Related Continuous Learning: Implications for Management Professionals

ERIC Educational Resources Information Center

Kuznia, Kevin D.; Kerno, Steven J., Jr.; Gilley, Ann

2010-01-01

Management personnel are increasingly aware that career success depends on the ability to continuously learn and adapt to the environment. However, scant attention has been paid to how learning activities contribute to managerial success. This study examines the degree to which involvement in career-related continuous learning affects managerial…

Competence by Simulation: The Expert Nurse Continuing Education Experience Utilizing Simulation

ERIC Educational Resources Information Center

Underwood, Douglas W.

2013-01-01

Registered nurses practice in an environment that involves complex healthcare issues requiring continuous learning and evaluation of cognitive and technical skills to ensure safe and quality patient care. The purpose of this basic qualitative study was to gain a better understanding of the continuing educational needs of the expert nurse. This…

Optimization and Quantization in Gradient Symbol Systems: A Framework for Integrating the Continuous and the Discrete in Cognition

ERIC Educational Resources Information Center

Smolensky, Paul; Goldrick, Matthew; Mathis, Donald

2014-01-01

Mental representations have continuous as well as discrete, combinatorial properties. For example, while predominantly discrete, phonological representations also vary continuously; this is reflected by gradient effects in instrumental studies of speech production. Can an integrated theoretical framework address both aspects of structure? The…

Continuous Partial Attention as a Problematic Technology Use: A Case of Educators

ERIC Educational Resources Information Center

Firat, Mehmet

2013-01-01

Continuous Partial Attention is a current concept open to research which, besides multitasking, intensely occupies the agenda of education, communication and cognitive psychology. The purpose of the present study was to determine educators' continuous partial attention. In line with this purpose, the research data were collected from 109 educators…

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

ERIC Educational Resources Information Center

Aventur, Francois; Campo, Christian; Moebus, Martine

1999-01-01

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

Exploring the Moderating Role of Perceived Flexibility Advantages in Mobile Learning Continuance Intention (MLCI)

ERIC Educational Resources Information Center

Huang, Rui-Ting; Hsiao, Chia-Hua; Tang, Tzy-Wen; Lien, Tsung-Cheng

2014-01-01

The primary purpose of this study was to explore the key factors that could affect mobile learning continuance intention (MLCI), and examine the moderating effect of perceived flexibility advantages (PFA) on the relationship between key mobile learning elements and continuance intention. Five hundred undergraduate students who had previously…

Continuing Education: Bridging the Information Gap. Research Publication 76-1.

ERIC Educational Resources Information Center

State Univ. of New York, Ithaca. Cornell Inst. for Research and Development in Occupational Education.

As part of a statewide effort to contribute necessary information for the improvement of planning, administration, and delivery of continuing education services, the central region studies were an attempt to discover more about adult learning interests, the needs for continuing education services, and the present delivery system in an 11-county…

Palestinian Continuing Education under Occupation:Images of Distress and Possibilities for Hope

ERIC Educational Resources Information Center

Davidson, Howard

2010-01-01

This study examines how aspects of a militarily enforced occupation have influenced continuing education at Palestinian universities. It focuses on three influences: the impact of the politics of occupation on the history of continuing education; the effect of travel restriction, violence, and a damaged economy on participation; and the influence…

The Relationship between Continuing Education and Perceived Competence, Professional Support, and Professional Value among Clinical Psychologists

ERIC Educational Resources Information Center

Bradley, Stacy; Drapeau, Martin; DeStefano, Jack

2012-01-01

Introduction: Continuing education is one of the means by which professionals maintain and increase their level of competence. However, the relationship between continuing education and the professional's sense of personal competence and other practice-related variables remains unclear. This study examined practicing psychologists' continuing…

Exploratory Study for Continuous-time Parameter Estimation of Ankle Dynamics

NASA Technical Reports Server (NTRS)

Kukreja, Sunil L.; Boyle, Richard D.

2014-01-01

Recently, a parallel pathway model to describe ankle dynamics was proposed. This model provides a relationship between ankle angle and net ankle torque as the sum of a linear and nonlinear contribution. A technique to identify parameters of this model in discrete-time has been developed. However, these parameters are a nonlinear combination of the continuous-time physiology, making insight into the underlying physiology impossible. The stable and accurate estimation of continuous-time parameters is critical for accurate disease modeling, clinical diagnosis, robotic control strategies, development of optimal exercise protocols for longterm space exploration, sports medicine, etc. This paper explores the development of a system identification technique to estimate the continuous-time parameters of ankle dynamics. The effectiveness of this approach is assessed via simulation of a continuous-time model of ankle dynamics with typical parameters found in clinical studies. The results show that although this technique improves estimates, it does not provide robust estimates of continuous-time parameters of ankle dynamics. Due to this we conclude that alternative modeling strategies and more advanced estimation techniques be considered for future work.

Manifestation of Hyperandrogenism in the Continuous Light Exposure-Induced PCOS Rat Model

PubMed Central

Kang, Xuezhi; Jia, Lina; Shen, Xueyong

2015-01-01

Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder, and its pathogenesis has yet to be completely clarified. A fully convincing animal model has not been established for PCOS. In earlier studies, researchers have shown that the exposure of rats to continuous light can induce PCOS; nevertheless, hyperandrogenism, a key characteristic observed in human PCOS, has not been reported previously. In the present study, we found that (1) body weights decreased in female rats in a continuous light environment with both ovarian and uterine augmentation; (2) the estrous cycle in rats under continuous light environment was disordered, and polycystic ovary-like changes occurred, accompanied with fur loss and lethargy; and (3) serum testosterone levels in rats in a continuous light environment significantly increased. Our data suggest that continuous light can lead to the occurrence of PCOS in female rats without the need for drugs; this is a reasonable PCOS animal model that is more consistent with the natural disease state in humans; and poor sleep habits or negligence of sleep hygiene may be an important lifestyle factor in pathogenesis of PCOS. PMID:26064969

Reasons for starting and continuing to volunteer for hospice.

PubMed

Planalp, Sally; Trost, Melanie

2009-01-01

The purpose of this study was to find out from hospice volunteers how they first heard of opportunities to volunteer, what motivated them to volunteer when they first began, and why they continue. A total of 351 volunteers from 3 states in the western United States participated in a questionnaire study. Three open-ended questions addressed how they heard of hospice, why they started, and why they continued. Their intentions to continue were also measured on rating scales. Responses to the open-ended questions were coded with acceptable intercoder reliability. Findings were that volunteers heard of opportunities through hospice and health care contacts, personal contacts, print and electronic sources, and other nonhospice organizations. They began volunteering primarily to be of service and because of a personal experience with the death of someone to whom they were close. Most volunteers chose to continue because they found it personally rewarding, helpful to others, or both, but many reported that they continue because of the quality of their own hospice organization and its staff. Demographic influences were noted but were generally small.

Continuing education for staff in long-term care facilities: corporate philosophies and approaches.

PubMed

Ross, M M; Carswell, A; Dalziel, W B; Aminzadeh, F

2001-01-01

The purpose of this study was to determine corporate philosophies of continuing education and approaches to meeting the learning needs of staff who strive to provide for the increasingly challenging care requirements of seniors who reside in long-term care facilities. In-depth interviews lasting approximately 1 hour were conducted with key informants at the administrative level from nine long-term care facilities. Content analysis revealed a commitment to continuing education for staff. While recognizing the importance of organizational responsibility for continuing education, administrators placed emphasis on the individual responsibility of staff. Learning needs were identified as affective, managerial, and physical in nature. Challenges to providing continuing education programs were derived from a general lack of fiscal and human resources. A variety of measures was suggested as important to supporting the continuing learning of staff. Implications of this study point to the need for long-term care facilities to incorporate into their strategic plans measures of ensuring continuing education as a basis for the ongoing competence and development of staff. In addition, there is a need for collaboration between long-term care facilities and other institutions of a long-term care, acute care, and educational nature in the development of strategies to operationalize a philosophy of continuing learning as a basis for the provision of optimal care to residents.

Proposing a New Conceptual Model and an Exemplar Measure Using Health Information: Technology to Examine the Impact of Relational Nurse Continuity on Hospital-Acquired Pressure Ulcers

PubMed Central

STIFTER, Janet; YAO, Yingwei; LOPEZ, Karen Dunn; KHOKHAR, Ashfaq; WILKIE, Diana J.; KEENAN, Gail M.

2015-01-01

The influence of the staffing variable nurse continuity on patient outcomes has been rarely studied and with inconclusive results. Multiple definitions and an absence of systematic methods for measuring the influence of continuity have resulted in its exclusion from nurse-staffing studies and conceptual models. We present a new conceptual model and an innovative use of health information technology to measure nurse continuity and to demonstrate the potential for bringing the results of big data science back to the bedside. Understanding the power of big data to address critical clinical issues may foster a new direction for nursing administration theory development. PMID:26244480

Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium.

PubMed

Raus, Kasper; Brown, Jayne; Seale, Clive; Rietjens, Judith A C; Janssens, Rien; Bruinsma, Sophie; Mortier, Freddy; Payne, Sheila; Sterckx, Sigrid

2014-02-20

Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress. This study is an international qualitative interview study involving interviews with physicians, nurses, and relatives of deceased patients in the UK, The Netherlands and Belgium (the UNBIASED study) about a case of continuous sedation at the end of life they were recently involved in. All interviews were transcribed verbatim and analysed by staying close to the data using open coding. Next, codes were combined into larger themes and categories of codes resulting in a four point scheme that captured all of the data. Finally, our findings were compared with others and explored in relation to theories in ethics and sociology. The participants' responses can be captured as different dimensions of 'closeness', i.e. the degree to which one feels connected or 'close' to a certain decision or event. We distinguished four types of 'closeness', namely emotional, physical, decisional, and causal. Using these four dimensions of 'closeness' it became possible to describe how physicians, nurses, and relatives experience their involvement in cases of continuous sedation until death. More specifically, it shined a light on the everyday moral reasoning employed by care providers and relatives in the context of continuous sedation, and how this affected the emotional impact of being involved in sedation, as well as the perception of their own moral responsibility. Findings from this study demonstrate that various factors are reported to influence the degree of closeness to continuous sedation (and thus the extent to which carers feel morally responsible), and that some of these factors help care providers and relatives to distinguish continuous sedation from euthanasia.

Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium

PubMed Central

2014-01-01

Background Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress. Methods This study is an international qualitative interview study involving interviews with physicians, nurses, and relatives of deceased patients in the UK, The Netherlands and Belgium (the UNBIASED study) about a case of continuous sedation at the end of life they were recently involved in. All interviews were transcribed verbatim and analysed by staying close to the data using open coding. Next, codes were combined into larger themes and categories of codes resulting in a four point scheme that captured all of the data. Finally, our findings were compared with others and explored in relation to theories in ethics and sociology. Results The participants’ responses can be captured as different dimensions of ‘closeness’, i.e. the degree to which one feels connected or ‘close’ to a certain decision or event. We distinguished four types of ‘closeness’, namely emotional, physical, decisional, and causal. Using these four dimensions of ‘closeness’ it became possible to describe how physicians, nurses, and relatives experience their involvement in cases of continuous sedation until death. More specifically, it shined a light on the everyday moral reasoning employed by care providers and relatives in the context of continuous sedation, and how this affected the emotional impact of being involved in sedation, as well as the perception of their own moral responsibility. Conclusion Findings from this study demonstrate that various factors are reported to influence the degree of closeness to continuous sedation (and thus the extent to which carers feel morally responsible), and that some of these factors help care providers and relatives to distinguish continuous sedation from euthanasia. PMID:24555871

40 CFR 792.10 - Applicability to studies performed under grants and contracts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Applicability to studies performed under grants and contracts. 792.10 Section 792.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS General...

Social Work Continuing Education: A Statewide Case Study

ERIC Educational Resources Information Center

Gianino, Mark; Ruth, Betty J.; Miyake Geron, Scott

2016-01-01

This article presents findings from a 2013 qualitative study of social work continuing education (CE) in Massachusetts. Eleven focus groups were conducted with 75 participants from key stakeholder groups: practitioners, educators, licensing board members, and agency administrators. Although positive perspectives surfaced--such as diversity of CE…

40 CFR 792.33 - Study director.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Study director. 792.33 Section 792.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED... protocol, including any change, is approved as provided by § 792.120 and is followed. (b) All experimental...

Clausal Continuations in Japanese

ERIC Educational Resources Information Center

Krekoski, Ross

2012-01-01

Recent studies illustrate cases of turn continuations that are not necessarily criterially dependent on clausal syntax (Couper-Kuhlen & Ono, 2007; Ford, Fox, & Thompson, 2002), advancing a more multidimensional construal of turn expansions, in general, which, as Auer (2007) put it, "is not a syntactic issue alone" (p. 651). This study further…

Clinical, biochemical, and hygiene assessment of stabled horses provided continuous or intermittent access to drinking water.

PubMed

Freeman, D A; Cymbaluk, N F; Schott, H C; Hinchcliff, K; McDonnell, S M; Kyle, B

1999-11-01

To compare health, hydration status, and management of stabled pregnant mares provided drinking water continuously or via 1 of 3 intermittent delivery systems. 22 Quarter Horse (QH) or QH-crossbred mares and 18 Belgian or Belgian-crossbred mares (study 1); 24 QH or QH-crossbred mares and 18 Belgian or Belgian-crossbred mares (study 2). Stabled horses were provided water continuously or via 1 of 3 intermittent water delivery systems in 2 study periods during a 2-year period. Body temperature, attitude, appetite, water intake, and urine output were recorded daily. Hygiene of each horse and the stable were assessed weekly. Clinical and biochemical measures of hydration were determined 3 times during each study. Clinical measures of hydration included skin turgor, gum moisture, capillary refill time, and fecal consistency. Biochemical measures of hydration included PCV, plasma total protein concentration, serum osmolality, plasma vasopressin concentration, urine specific gravity, and urine osmolality. All horses remained healthy. Stable hygiene was worse when horses had continuous access to water. Clinical and biochemical measures of hydration did not differ among water delivery systems. Various continuous and intermittent water delivery systems provided adequate amounts of water to stabled horses to maintain health and hydration status. Providing intermittent access to water may be preferable on the basis of stable hygiene.

Parental preference and perspectives on continuous pulse oximetry in infants and children with bronchiolitis

PubMed Central

Hendaus, Mohamed A; Nassar, Suzan; Leghrouz, Bassil A; Alhammadi, Ahmed H; Alamri, Mohammed

2018-01-01

Objective The purpose of the study was to investigate parental preference of continuous pulse oximetry in infants and children with bronchiolitis. Materials and methods A cross-sectional prospective study was conducted at Hamad Medical Corporation in Qatar. Parents of infants and children <24 months old and hospitalized with bronchiolitis were offered an interview survey. Results A total of 132 questionnaires were completed (response rate 100%). Approximately 90% of participants were 20–40 years of age, and 85% were females. The mean age of children was 7.2±5.8 months. Approximately eight in ten parents supported the idea of continuous pulse oximetry in children with bronchiolitis. Almost 43% of parents believed that continuous pulse-oximetry monitoring would delay their children’s hospital discharge. Interestingly, approximately 85% of caregivers agreed that continuous pulse oximetry had a good impact on their children’s health. In addition, around one in two of the participants stated that good bedside examinations can obviate the need for continuous pulse oximetry. Furthermore, 80% of parents believed that continuous pulse-oximetry monitoring would give the health-care provider a good sense of security regarding the child’s health. Finally, being a male parent was associated with significantly increased risk of reporting unnecessary fatigue, attributed to the sound of continuous pulse oximetry (P=0.031). Conclusion Continuous pulse-oximetry monitoring in children with bronchiolitis was perceived as reassuring for parents. Involving parents in decision-making is considered essential in the better management of children with bronchiolitis or any other disease. The first step to decrease continuous pulse oximetry will require provider education and change as well. Furthermore, we recommend proper counseling for parents, emphasizing that medical technology is not always essential, but is a complementary mode of managing a disease. PMID:29662305

Multidisciplinary Prerounding Meeting as a Continuous Quality Improvement Tool: Leveraging to Reduce Continuous Benzodiazepine Use at an Academic Medical Center.

PubMed

Flannery, Alexander H; Thompson Bastin, Melissa L; Montgomery-Yates, Ashley; Hook, Corrine; Cassity, Evan; Eaton, Phillip M; Morris, Peter E

2018-01-01

Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period. A morning multidisciplinary prerounding meeting was implemented to report on metrics required to establish a dashboard for MICU care for the previous 24 hours. Fellows and nurse practitioners on respective teams reported on key quality metrics and other important data related to patient census. Continuous benzodiazepines were tracked daily as the number of patients per team who had orders for a continuous benzodiazepine infusion. The aim of this report is to describe the development of the morning multidisciplinary prerounding meeting and its impact on continuous benzodiazepine use, along with associated clinical outcomes. The median number of patients prescribed a continuous benzodiazepine daily decreased over this time period and demonstrated a sustained reduction at 1 year. Furthermore, sedation scores improved, corresponding to a reduction in median duration of mechanical ventilation. The effectiveness of this intervention was mapped post hoc to conceptual models used in implementation science. A brief multidisciplinary meeting to review select data points prior to morning rounds establishes mechanisms for continuous quality improvement and may serve as a mediating factor for successful implementation when initiating and monitoring practice change in the ICU.

Acclimatization Study for Biohydrogen Production from Palm Oil Mill Effluent (POME) in Continuous-flow System

NASA Astrophysics Data System (ADS)

Idris, N.; Lutpi, N. A.; Wong, Y. S.; Tengku Izhar, T. N.

2018-03-01

This research aims to study the acclimatization phase for biohydrogen production from palm oil mill effluent (POME) by adapting the microorganism to the new environment in continuous-flow system of thermophilic bioreactor. The thermophilic fermentation was continuously loaded with 0.4 L/day of raw POME for 35 days to acclimatize the microorganism until a steady state of biohydrogen production was obtained. The significance effect of acclimatization phase on parameter such as pH, microbial growth, chemical oxygen demand (COD), and alkalinity were also studied besides the production of biogas. This study had found that the thermophilic bioreactor reach its steady state with 1960 mL/d of biogas produced, which consist of 894 ppm of hydrogen composition.

Continuity of the sequential product of sequential quantum effect algebras

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

Lei, Qiang, E-mail: leiqiang@hit.edu.cn; Su, Xiaochao, E-mail: hitswh@163.com; Wu, Junde, E-mail: wjd@zju.edu.cn

In order to study quantum measurement theory, sequential product defined by A∘B = A{sup 1/2}BA{sup 1/2} for any two quantum effects A, B has been introduced. Physically motivated conditions ask the sequential product to be continuous with respect to the strong operator topology. In this paper, we study the continuity problems of the sequential product A∘B = A{sup 1/2}BA{sup 1/2} with respect to other important topologies, such as norm topology, weak operator topology, order topology, and interval topology.

Assessing the relationship between technology readiness and continuance intention in an E-appointment system: relationship quality as a mediator.

PubMed

Chen, Shih-Chih; Jong, Din; Lai, Min-Tsai

2014-09-01

Numerous types of self-service technologies have prevailed due to innovations in network and information technology. To hospitals, patient intentions to continue to use the e-appointment system are crucial. Previous investigations discussed only the relationships between the technology readiness of users and their continuance intentions, and ignored the most important mediator, relationship quality. This study explored the relationships among technology readiness, relationship quality, and continuance intention. The research results demonstrated that both optimism and innovativeness significantly and positively influenced continuance intention through the mediating effect of relationship quality. However, discomfort and insecurity hid not significantly influence relationship quality or continuance intention. Finally, theoretical contributions, managerial implications and future research directions were discussed.

One Continuous Auditing Practice in China: Data-oriented Online Auditing(DOOA)

NASA Astrophysics Data System (ADS)

Chen, Wei; Zhang, Jin-Cheng; Jiang, Yu-Quan

Application of information technologies (IT) in the field of audit is worth studying. Continuous auditing (CA) is an active research domain in computer-assisted audit field. In this paper, the concept of continuous auditing is analyzed firstly. Then, based on analysis on research literatures of continuous auditing, technique realization methods are classified into embedded mode and separate mode. According to the condition of implementing online auditing in China, data-oriented online auditing (DOOA) used in China is also one of separate mode of continuous auditing. And the principle of DOOA is analyzed. Furthermore, the advantages and disadvantages of DOOA are also discussed. Finally, advices to implement DOOA in China are given, and the future research topics related to continuous auditing are also discussed.

Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system: Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system

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

Stickel, Jonathan J.; Adhikari, Birendra; Sievers, David A.

Converting abundant lignocellulosic biomass to sugars as fungible precursors to fuels and chemicals has the potential to diversify the supply chain for those products, but further process improvements are needed to achieve economic viability. In the current work, process intensification of the key enzymatic hydrolysis unit operation is demonstrated by means of a membrane reactor system that was operated continuously. Lignocellulosic biomass (pretreated corn stover) and buffered enzyme solution were fed to a continuously stirred-tank reactor, and clarified sugar solution was withdrawn via a commercial tubular ultrafiltration membrane. The membrane permeance decline and membrane cleaning efficacy were studied and didmore » not vary significantly when increasing fraction insoluble solids (FIS) from 2.5% to 5%. Continuous enzymatic hydrolysis was successfully operated for more than 80 h. A model for the reactor system was able to predict dynamic behavior that was in reasonable agreement with experimental results. The modeled technical performance of anticipated commercial batch and continuous enzymatic hydrolysis processes were compared and showed that continuous operation would provide at least twice the volumetric productivity for the conditions studied. Further improvements are anticipated by better membrane selection and by increasing FIS.« less

Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system: Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system

DOE PAGES

Stickel, Jonathan J.; Adhikari, Birendra; Sievers, David A.; ...

2018-02-21

Converting abundant lignocellulosic biomass to sugars as fungible precursors to fuels and chemicals has the potential to diversify the supply chain for those products, but further process improvements are needed to achieve economic viability. In the current work, process intensification of the key enzymatic hydrolysis unit operation is demonstrated by means of a membrane reactor system that was operated continuously. Lignocellulosic biomass (pretreated corn stover) and buffered enzyme solution were fed to a continuously stirred-tank reactor, and clarified sugar solution was withdrawn via a commercial tubular ultrafiltration membrane. The membrane permeance decline and membrane cleaning efficacy were studied and didmore » not vary significantly when increasing fraction insoluble solids (FIS) from 2.5% to 5%. Continuous enzymatic hydrolysis was successfully operated for more than 80 h. A model for the reactor system was able to predict dynamic behavior that was in reasonable agreement with experimental results. The modeled technical performance of anticipated commercial batch and continuous enzymatic hydrolysis processes were compared and showed that continuous operation would provide at least twice the volumetric productivity for the conditions studied. Further improvements are anticipated by better membrane selection and by increasing FIS.« less

Continuity, Comorbidity and Longitudinal Associations between Depression and Antisocial Behaviour in Middle Adolescence: A 2-Year Prospective Follow-Up Study

ERIC Educational Resources Information Center

Ritakallio, Minna; Koivisto, Anna-Maija; von der Pahlen, Bettina; Pelkonen, Mirjami; Marttunen, Mauri; Kaltiala-Heino, Riittakerttu

2008-01-01

The study investigated continuity, comorbidity and longitudinal associations between depression Beck depression inventory (RBDI) and antisocial behaviour Youth self-report (YSR) in middle adolescence. Data were used from a community sample of 2070 adolescents who participated in a 2-year prospective follow-up study. The results indicate that both…

Planning and Instruction and the Social Studies Curriculum: A Discourse on Design and Delivery Systems.

ERIC Educational Resources Information Center

Peters, Richard

A model for Continuous-Integrated-Sequential (C/I/S) curricula for social studies education is presented. The design advocated involves ensuring continuity of instruction from grades K-12, an integration of social studies disciplines, and a sequential process of refining and reinforcing concept and skills from grade-to-grade along the K-12…

Adaptive Capacity in the Pacific Region: A Study of Continuous Professional Development for In-Service Teachers in Kiribati

ERIC Educational Resources Information Center

Martin, Tess; Thomson, Ian

2018-01-01

This study of I-Kiribati secondary school teachers used a project-based approach to investigate the notions of school-based and collaborative learning as a suitable model for in-service teacher continuous professional development (CPD). The design and methodology adopted by the study framed the argument that since collaborative behavior is…

A Model of Continuing Professional Competency Development by Using ICT (Study at Senior High School Teachers Padangsidimpuan, North Sumatera)

ERIC Educational Resources Information Center

Hasibuan, Sarmadan

2013-01-01

In order to solve the weakness of current status of high school teachers' professional competency in Padangsidimpuan the researcher purposed this study to implement A Model of Continuing Professional Competency Development by using Information Communication Technology (ICT). This study was conducted by using a Research and Development (R&D).…

Organisation and Management of Continuing Higher Education: Findings of a Comparative Study in Six Countries from a German Perspective

ERIC Educational Resources Information Center

Knust, Michaela; Zawacki-Richter, Olaf; Hanft, Anke

2008-01-01

An international comparison study investigated the organisation and management of continuing higher education (CHE) in Germany, Finland, France, the United Kingdom, Austria and the United States of America. CHE is compared on the system level (boundaries between traditional study programmes and CHE, linking of CHE and vocational training,…

Teachers' Perception and Implementation of Continuous Assessment Practices in Secondary Schools in Ekiti-State, Nigeria

ERIC Educational Resources Information Center

Modup, Ale Veronica; Sunday, Omirin Michael

2015-01-01

This study examined the practices and implementation of continuous assessment in Ekiti State Secondary Schools with special interest in Ado Local Government. The population for the study was the whole number of teachers in Ekiti State secondary school and the sample for the study was 160 secondary school teachers who were randomly selected from…

Experience Differences and Continuance Intention of Blog Sharing

ERIC Educational Resources Information Center

Lu, Hsi-Peng; Lee, Ming-Ren

2012-01-01

Although many studies focus on information sharing in communities and organisations, little research has been carried out on the antecedents of continuance intention of blog sharing. This study focuses on amateur blogs, which are the major customers for blog service providers (BSPs). The purposes are to investigate the antecedents of continuous…

A Critique of Two Studies Considering the Continuing Professional Education of Accountants.

ERIC Educational Resources Information Center

Holt, Margaret; And Others

1992-01-01

Synthesis of 2 studies--1 of 429 accountant participants in continuing education (CE) and 1 of CE accounting courses taught by practitioners and academics--found that (1) academicians were rated slightly higher than practitioners and (2) assessments of learning indicate proficiency rather than competence in practice. (SK)

A Case Study of Leadership Transition: Continuity and Change

ERIC Educational Resources Information Center

Cocklin, Barry; Wilkinson, Jane

2011-01-01

Few studies of school leadership succession document the processes of continuity and change, especially within situations where there has been a strong tradition of tenure of principal, within a "quality" school. This article examines how a new principal with a commitment towards notions of Learning Community Schools, "quality" teaching and…

Factors Influencing Continuing Professional Development: A Delphi Study among Nursing Experts

ERIC Educational Resources Information Center

Brekelmans, Gerard; Poell, Rob F.; van Wijk, Kees

2013-01-01

Purpose: The aim of this paper is to present an inventory of expert opinions on the factors that influence the participation of registered nurses in continuing professional development (CPD) activities. Design/methodology/approach: A Delphi study was conducted among 38 Dutch experts (nursing employers, managers, education institutions, and…

34 CFR 691.6 - Duration of student eligibility-undergraduate course of study.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 4 2014-07-01 2014-07-01 false Duration of student eligibility-undergraduate course of study. 691.6 Section 691.6 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS...

34 CFR 691.6 - Duration of student eligibility-undergraduate course of study.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 4 2012-07-01 2012-07-01 false Duration of student eligibility-undergraduate course of study. 691.6 Section 691.6 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS...

34 CFR 691.6 - Duration of student eligibility-undergraduate course of study.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Duration of student eligibility-undergraduate course of study. 691.6 Section 691.6 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS...

34 CFR 691.6 - Duration of student eligibility-undergraduate course of study.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 4 2013-07-01 2013-07-01 false Duration of student eligibility-undergraduate course of study. 691.6 Section 691.6 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS...

Classroom Strategies and Behaviors Facilitating Continued Scholastic Growth

ERIC Educational Resources Information Center

Scott-Moore, Charlotte; Mitchell, Ronald

2017-01-01

The researchers conducted a qualitative study involving two rural public school districts in Tennessee. The purpose of this study was to discover classroom strategies and behaviors that enable regular classroom teachers to facilitate continued scholastic growth of fourth and fifth grade students who had experienced notable academic gains in their…

40 CFR 792.10 - Applicability to studies performed under grants and contracts.

Code of Federal Regulations, 2011 CFR

2011-07-01

... AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS General... person utilizes the services of a consulting laboratory, contractor, or grantee to perform all or a part of a study to which this part applies, it shall notify the consulting laboratory, contractor, or...

Behavior analytic approaches to problem behavior in intellectual disabilities.

PubMed

Hagopian, Louis P; Gregory, Meagan K

2016-03-01

The purpose of the current review is to summarize recent behavior analytic research on problem behavior in individuals with intellectual disabilities. We have focused our review on studies published from 2013 to 2015, but also included earlier studies that were relevant. Behavior analytic research on problem behavior continues to focus on the use and refinement of functional behavioral assessment procedures and function-based interventions. During the review period, a number of studies reported on procedures aimed at making functional analysis procedures more time efficient. Behavioral interventions continue to evolve, and there were several larger scale clinical studies reporting on multiple individuals. There was increased attention on the part of behavioral researchers to develop statistical methods for analysis of within subject data and continued efforts to aggregate findings across studies through evaluative reviews and meta-analyses. Findings support continued utility of functional analysis for guiding individualized interventions and for classifying problem behavior. Modifications designed to make functional analysis more efficient relative to the standard method of functional analysis were reported; however, these require further validation. Larger scale studies on behavioral assessment and treatment procedures provided additional empirical support for effectiveness of these approaches and their sustainability outside controlled clinical settings.

Perceptions of registered nurses in four state health insititutions on continuing formal education.

PubMed

Richards, L; Potgieter, E

2010-06-01

This study investigated registered nurses in four selected state health institutions' perceptions with regard to continuing formal education. The relevance of continuing formal education is being emphasised globally by the increasing quest for quality assurance and quality management systems within an ethos of continuous improvement. According to Tlholoe (2006:5), it is important to be committed to continual learning, as people's knowledge become less relevant because skills gained early in a career are insufficient to avoid costly mistakes made through ignorance. Continuing formal education in nursing is a key element to the maintenance of quality in health care delivery. The study described: registered nurses' views on continuing formal education. Registered nurses' perceived barriers to continuing formal education. A quantitative descriptive survey design was chosen using a questionnaire for data collection. The sample consisted of 40 registered nurses working at four state health institutions in the Western Cape Province, South Africa. Convenience sampling was selected to include registered nurses who were on duty on the days during which the researcher visited the health institutions to distribute the questionnaires. The questionnaire contained mainly closed-ended and a few open-ended questions. Content validity of the instrument was ensured by doing a thorough literature review before construction of items and a pretest. Reliability was established by the pretest and providing the same information to all respondents before completion of the questionnaires. The ethical considerations of informed consent, anonymity and confidentiality were adhered to and consent to conduct the study was obtained from relevant authorities. Descriptive statistics, based on calculations using the Microsoft (MS) Excel (for Windows 2000) programme, were used to summarise and describe the research results. The research results indicated that most registered nurses perceive continuing formal education as beneficial to their personal and professional growth and that it could lead towards improving the quality of patient/client care, but barriers exist which prevent or deter them from undertaking continuing formal education programmes. The main structural barriers included lack of funding and lack of coherent staff development planning and physical barriers including job and family responsibilities.

Patient Experienced Continuity of Care in the Psychiatric Healthcare System—A Study Including Immigrants, Refugees and Ethnic Danes

PubMed Central

Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne; Krasnik, Allan; Norredam, Marie

2014-01-01

Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups. PMID:25233017

Measuring Several Aspects of Attention in One Test: The Factor Structure of Conners's Continuous Performance Test

ERIC Educational Resources Information Center

Egeland, Jens; Kovalik-Gran, Iwona

2010-01-01

Objective: Continuous performance tests are known to typically measure sustained attention but usually also yield parameters that potentially measure other subprocesses of attention. The aim of the present study was to test the factor structure of the Conners's Continuous Performance Test (CCPT) in a heterogeneous clinical sample consisting of…

The Practice of Continuous Assessment in Primary Schools: The Case of Chagni, Ethiopia

ERIC Educational Resources Information Center

Abejehu, Sintayehu Belay

2016-01-01

Continuous assessment is part and parcel of instructional process that has to be taken as a key tool in educational quality assurance endeavor. Thus, this article examined the actual practice of continuous assessment in primary schools of Chagni City Administration, Ethiopia. To address this purpose the study employed descriptive survey design.…

A Comparative Study on the Practice of Continuous Assessment between Addis Ababa and Unity Universities

ERIC Educational Resources Information Center

Zeleke, Aytaged Sisay

2013-01-01

This paper aims to explore the practice of continuous assessment at Unity University College and Addis Ababa University. It has also investigated constraints instructors say they have been facing in implementing continuous assessment. Students' attitudes about the practice of this assessment mode towards their course achievements were explored.…

Research in Adult and Continuing Education: Master of Adult and Continuing Education Program.

ERIC Educational Resources Information Center

Washington State Univ., Pullman. Coll. of Education.

The document presents an annotated bibliography of Master's degree theses in Adult and Continuing Education, Washington State University, 1974-76. Abstracts for the following 12 theses are presented: (1) Agrarian Reform in Chile: A Case Study; (2) An Analysis of the Activities and the Needs of the Senior Citizens in Garfield, Washington and the…

A Road Travelled Too Far?: A Case Study of the Restructuring of University Adult and Continuing Education.

ERIC Educational Resources Information Center

Findsen, Brian

2001-01-01

Describes the restructuring of the Centre for Continuing Education and the University of Auckland within the context of political ideology, developments in New Zealand universities, and the historical role of adult and continuing education. Concludes that strategic neglect enabled external forces to drive policy and practice toward neoliberal…

Continuity in Primary School Children's Eating Problems and the Influence of Parental Feeding Strategies

ERIC Educational Resources Information Center

Matton, Annelies; Goossens, Lien; Braet, Caroline; Van Durme, Kim

2013-01-01

Eating problems are highly prevalent and seem to show continuity in children. Nevertheless, the effect of different maternal and paternal feeding practices on changes in these problems is not fully understood yet. This study examines short-term continuity in primary school children's overeating, loss of control (over eating), restraint and…

Antecedents of Continued Usage Intentions of Web-Based Learning Management System in Tanzania

ERIC Educational Resources Information Center

Lwoga, Edda Tandi; Komba, Mercy

2015-01-01

Purpose: The purpose of this paper is to examine factors that predict students' continued usage intention of web-based learning management systems (LMS) in Tanzania, with a specific focus on the School of Business of Mzumbe University. Specifically, the study investigated major predictors of actual usage and continued usage intentions of…

2001 Industry Studies: Financial Services

DTIC Science & Technology

2001-01-01

financial services firms are also positioning to compete here and abroad with international firms. Advances in information technology continue to provide...future. A veritable revolution is taking place within the financial services industry. Globalization, information technology and continuing... technological infrastructure that must be protected. Industry vulnerabilities will continue to increase as use of the Internet , e-commerce, and e-banking become

Continuing Professional Development in Context: Teachers' Continuing Professional Development Culture in Germany and Sweden

ERIC Educational Resources Information Center

Wermke, Wieland

2011-01-01

This article investigates the continuing professional development (CPD) culture of teachers, and asks how it is influenced by properties of the school system. It reports the results of a questionnaire study with 418 secondary teachers from Sweden and Germany. The results show highly significant differences between Swedish and German teachers'…

Users' Continuance Intention of Virtual Learning Community Services: The Moderating Role of Usage Experience

ERIC Educational Resources Information Center

Zhang, Min; Liu, Yupei; Yan, Weiwei; Zhang, Yan

2017-01-01

Users' continuance intention plays a significant role in the process of information system (IS) service, especially virtual learning community (VLC) services. Following the IS success model and IS post-acceptance model, this study explores the determinants of users' intention to continue using VLCs' service from the perspective of quality,…

Understanding the Quality Factors That Influence the Continuance Intention of Students toward Participation in MOOCs

ERIC Educational Resources Information Center

Yang, Ming; Shao, Zhen; Liu, Qian; Liu, Chuiyi

2017-01-01

The massive open online course (MOOC) is emerging as the new paradigm for modern education. The success of MOOCs depends on learners' continued usage. Drawing upon the information systems success model (IS success model) and technology acceptance model, a theoretical model for studying learners' continuance intentions toward participation in MOOCs…

Alteration of Influencing Factors of E-Learning Continued Intention for Different Degrees of Online Participation

ERIC Educational Resources Information Center

Chang, Chi-Cheng; Liang, Chaoyun; Shu, Kuen-Ming; Chiu, Yi-Chun

2015-01-01

The purpose of the present study was to investigate the variation of influencing factors of e-learning continuance intention for different degrees of participation and to examine moderating effects of degrees of participation on influencing factors of e-learning continuance intention. Participants included 670 learners from an adult professional…

A Qualitative Phenomenological Study of Students' Perceptions of Classroom Practices and the Affect on Engagement

ERIC Educational Resources Information Center

Baum-Leaman, Rebekah

2013-01-01

Although teachers continue to implement an array of best practices, learners identified as unsuccessful according to criteria may lack engagement to succeed in the current curriculum activities. Even as teachers continue to apply best practices in the classroom, data does not support continued improvement of student engagement and achievement of…

Cognitive Factors in Predicting Continued Use of Information Systems with Technology Adoption Models

ERIC Educational Resources Information Center

Huang, Chi-Cheng

2017-01-01

Introduction: The ultimate viability of an information system is dependent on individuals' continued use of the information system. In this study, we use the technology acceptance model and the theory of interpersonal behaviour to predict continued use of information systems. Method: We established a Web questionnaire on the mySurvey Website and…

Conceptions of Environment in a Continuing Education Course for Science Teachers in Brazil

ERIC Educational Resources Information Center

dos Santos Matos, Mauricio; Barbosa, Paulo; Coelho-Matos, Myrna Elisa Chagas

2012-01-01

Studies focusing on environmental education and continuing education of science teachers play an important role in the science education area. This research analyzed conceptions of environment in a continuing education course for science teachers developed at the University of Sao Paulo, Brazil. The analysis of the material was made using a…

Business Continuity Management Plan

DTIC Science & Technology

2014-12-01

organization ( Shaw , 2004). Navy Supply Systems Command (NAVSUP) does not have a framework that can help develop a business continuity management (BCM...cites two case studies that demonstrate how an organization mitigated issues during catastrophic events that led to disruptions to their business ...www.uschamber.com/sites/default/files/legacy/ issues /defense/files/guideli nesbc.pdf Comprehensive Emergency Management Associates. (2006). Business continuity

Nigerian Primary Schools' Compliance with Nigeria National Policy on Education: An Evaluation of Continuous Assessment Practices.

ERIC Educational Resources Information Center

Ali, Anthony; Akubue, Augustine

1988-01-01

A study involving 1,800 teachers and 180 headmasters assessed the nature and scope of activities and problems associated with implementing federally mandated continuous educational assessment activities at the primary school level in Nigeria. Findings indicate that continuous assessment is preferred to the narrower one-shot evaluation. (TJH)

Continuity, but at what cost? The impact of telemonitoring COPD on continuities of care: a qualitative study.

PubMed

Fairbrother, Peter; Pinnock, Hilary; Hanley, Janet; McCloughan, Lucy; Sheikh, Aziz; Pagliari, Claudia; McKinstry, Brian

2012-09-01

Continuity of care is widely regarded as an important marker of quality in the management of patients with long-term conditions. New services that integrate telemonitoring into care pathways have potential to change aspects of continuity in both positive and negative ways. A telemonitoring service for patients with chronic obstructive pulmonary disease (COPD) was introduced in Lothian, Scotland, in 2009. A qualitative study, nested within the TELESCOT COPD randomised control trial, was undertaken to explore the views of patients and professionals on telemonitoring. The perceived impact of telemonitoring on continuity of care was investigated as part of the research. Semi-structured interviews were undertaken with 38 patients (47% male, mean age 67.5 years). A maximum variation sample in relation to age, sex, socio-economic background, disease severity, and compliance with telemonitoring was recruited. Thirty-two stakeholders (healthcare professionals and managers) were interviewed. Transcribed coded data were analysed thematically using the framework approach. Interpretation was supported by multidisciplinary discussion. Patients and healthcare professionals considered that relationship-based continuity of care was important in the delivery of telemonitoring services. Managers placed emphasis on improved continuity of clinical management as a means of reducing healthcare costs. However, professionals described many operational challenges arising from the 'bolting-on' of telemonitoring provision to existing usual care provision which, they considered, resulted in the proliferation of additional managerial discontinuities. Managers and healthcare professionals face major challenges in meeting demands for both relationship continuity and continuity of clinical management in the development of telemonitoring services.

Comparison of a continuous temperature-controlled cryotherapy device to a simple icing regimen following outpatient knee arthroscopy.

PubMed

Woolf, Shane K; Barfield, William R; Merrill, Keith D; McBryde, Angus M

2008-01-01

This prospective, randomized study compared postoperative pain control with use of a continuous temperature-controlled cryotherapy system versus a traditional ice therapy regimen following outpatient knee arthroscopy. Patients with unilateral knee pathology scheduled for outpatient arthroscopic surgery were included. Patients with major ligament reconstructions were excluded. A specific cold therapy regimen was begun postoperatively and continued for 2 weeks as adjunctive management of postoperative pain. Preoperative and postoperative pain intensity, pain type, functionality, and sleep quality were assessed. Patients were randomly assigned to either an ice or a continuous cryotherapy group. Follow-up questionnaires were completed on 5 postoperative days. Data were analyzed using a chi-square test with a level of significance at P < 0.05. Fifty-three patients completed the study. Pain intensity was similar between groups throughout the course of the study. Among patients who reported experiencing night pain, 36% of those in the continuous cryotherapy group were able to sleep soundly with minimal awakening through postoperative day 2 versus 5.9% among the ice therapy group (P = 0.04). No significant differences existed between groups regarding functional ability, and no differences were noted on other follow-up days. These findings support use of continuous temperature-controlled cold therapy devices for nighttime pain control and improved quality of life in the early period following routine knee arthroscopy.

The Comparison of Relationship Beliefs and Couples Burnout in women who apply for Divorce and Women Who Want to Continue their Marital Life

PubMed Central

Adibrad, Nastaran; Sedgh poor, Bahram Saleh

2010-01-01

Objective The aim of this study was to examine the comparison of relationship beliefs and couples burnout in women who apply for divorce and women who want to continue their marital life. Method for this study, 50 women who referred to judicial centers and 50 women who claimed they wanted to continue their marital life were randomly selected. Participants were asked to complete the relationship beliefs inventory and marital burnout questionnaires. In this study, descriptive statistical methods such as standard deviation, mean, t- students for independent groups, correlation, multi-variable regression and independent group's correlation difference test were used. Results The comparison between the relationship beliefs of the 2 groups (those wanting to divorce and women wanting to continue their marital life) was significantly different (p<0/1). In addition, the comparison of marital burnout was significantly different in the 2 groups (p<0/1). Discussion Women who were about to divorce were significantly different from those who wanted to continue their marital relationship in the general measure of the relationship beliefs and factors of “believing that disagreement is destructive and their partners can not change their undesirable behaviors”. In other words, women who were applying for divorce had more unreasonable thoughts and burnout compared to those who wanted to continue their marital life. PMID:22952488

[The path of continuity of care between hospital and territory in patients with severe brain injury. The expectations of caregivers and professionals].

PubMed

Feiroli, Raffaele; Bolzani, Monica; Cornelli, Maria Cristina; Ghirardi, Lida; Guizzardi, Loris; Onesti, Roberta; Dovani, Antonella; Davolo, Andrea; Artioli, Giovanna; Mancini, Tiziana

2013-01-01

The present study analyses how continuity of care is perceived by health professionals and GRACER (Gravi Cerebrolesioni Acquisite Emilia Romagna) patients' caregivers, in order to investigate where the gap between expectations and reality is more heavily felt and which dimension of the continuity of care is the most important both for health professionals and GRACER patients' caregivers. The study has been developed following the Gap Analysis theoretical model. A questionnaire, based on ServQual model, was used to collect data about the three dimensions of the construct of continuity of care related to information, management and relation, declined along the lines of expectations and perception of reality. The questionnaire was administered to health professionals and caregivers of GRACER patients (12-36 months after the event) inside 4 healthcare institutes in Emilia Romagna. The PAI (Piano Assistenziale Individuale) approach was the methodology applied in these 4 sites. To both groups the relational continuity was the most important dimension, followed at a long distance by the informational and the management ones. It has also been noted that to professionals reality is always worse than expectations, with the exception of only two items in the dimension of management continuity. To caregivers reality is worse than expectations in some items in the dimensions of information and management The study has shown that the relational dimension of continuity of care should be more investigated, as confirmed by literature. More research is needed about the professionals' dissatisfaction generated by the negative balance between expectations and perception of reality.

A comparison of continuous video-EEG monitoring and 30-minute EEG in an ICU.

PubMed

Khan, Omar I; Azevedo, Christina J; Hartshorn, Alendia L; Montanye, Justin T; Gonzalez, Juan C; Natola, Mark A; Surgenor, Stephen D; Morse, Richard P; Nordgren, Richard E; Bujarski, Krzysztof A; Holmes, Gregory L; Jobst, Barbara C; Scott, Rod C; Thadani, Vijay M

2014-12-01

To determine whether there is added benefit in detecting electrographic abnormalities from 16-24 hours of continuous video-EEG in adult medical/surgical ICU patients, compared to a 30-minute EEG. This was a prospectively enroled non-randomized study of 130 consecutive ICU patients for whom EEG was requested. For 117 patients, a 30-minute EEG was requested for altered mental state and/or suspected seizures; 83 patients continued with continuous video-EEG for 16-24 hours and 34 patients had only the 30-minute EEG. For 13 patients with prior seizures, continuous video-EEG was requested and was carried out for 16-24 hours. We gathered EEG data prospectively, and reviewed the medical records retrospectively to assess the impact of continuous video-EEG. A total of 83 continuous video-EEG recordings were performed for 16-24 hours beyond 30 minutes of routine EEG. All were slow, and 34% showed epileptiform findings in the first 30 minutes, including 2% with seizures. Over 16-24 hours, 14% developed new or additional epileptiform abnormalities, including 6% with seizures. In 8%, treatment was changed based on continuous video-EEG. Among the 34 EEGs limited to 30 minutes, almost all were slow and 18% showed epileptiform activity, including 3% with seizures. Among the 13 patients with known seizures, continuous video-EEG was slow in all and 69% had epileptiform abnormalities in the first 30 minutes, including 31% with seizures. An additional 8% developed epileptiform abnormalities over 16-24 hours. In 46%, treatment was changed based on continuous video-EEG. This study indicates that if continuous video-EEG is not available, a 30-minute EEG in the ICU has a substantial diagnostic yield and will lead to the detection of the majority of epileptiform abnormalities. In a small percentage of patients, continuous video-EEG will lead to the detection of additional epileptiform abnormalities. In a sub-population, with a history of seizures prior to the initiation of EEG recording, the benefits of continuous video-EEG in monitoring seizure activity and influencing treatment may be greater.

Provider connectedness and communication patterns: extending continuity of care in the context of the circle of care

PubMed Central

2013-01-01

Background Continuity is an important aspect of quality of care, especially for complex patients in the community. We explored provider perceptions of continuity through a system’s lens. The circle of care was used as the system. Methods Soft systems methodology was used to understand and improve continuity for end of life patients in two communities. Participants: Physicians, nurses, pharmacists in two communities in British Columbia, involved in end of life care. Two debates/discussion groups were completed after the interviews and initial analysis to confirm findings. Interview recordings were qualitatively analyzed to extract components and enablers of continuity. Results 32 provider interviews were completed. Findings from this study support the three types of continuity described by Haggerty and Reid (information, management, and relationship continuity). This work extends their model by adding features of the circle of care that influence and enable continuity: Provider Connectedness the sense of knowing and trust between providers who share care of a patient; a set of ten communication patterns that are used to support continuity across the circle of care; and environmental factors outside the circle that can indirectly influence continuity. Conclusions We present an extended model of continuity of care. The components in the model can support health planners consider how health care is organized to promote continuity and by researchers when considering future continuity research. PMID:23941179

Psychosocial factors underlying the mother's decision to continue exclusive breastfeeding for 6 months: an elicitation study.

PubMed

Bai, Y K; Middlestadt, S E; Joanne Peng, C-Y; Fly, A D

2009-04-01

Despite numerous benefits of exclusive breastfeeding (EBF) for infants and mothers, a significant decrease in the EBF rate in the USA at six months compared to the rate at birth suggests that reasons for initiation and continuation of EBF may differ. The purpose of this qualitative study was to explore psychosocial factors underlying the continued EBF behaviour for six months, in order to identify salient belief structures according to the theory of planned behaviour. Participants were recruited from central Indiana in the USA. They were asked to respond to an open-ended questionnaire designed to elicit positive/negative consequences, approving/disapproving social referents, and easy/difficult circumstances in continuing EBF for six months. Responses were translated into behavioural, normative, and control beliefs of the theory. Findings suggest that respondents (1) value emotional and health benefits of continued EBF for six months; (2) feel the approval from family and friends but disapproval from the society; (3) view health professional's position as positive and negative. Breastfeeding educators can more likely improve the EBF duration by addressing these salient beliefs. Identified beliefs provide a basis for the development of a quantitative instrument to further study the EBF behaviour.

Lubricant based determination of design space for continuously manufactured high dose paracetamol tablets.

PubMed

Taipale-Kovalainen, Krista; Karttunen, Anssi-Pekka; Ketolainen, Jarkko; Korhonen, Ossi

2018-03-30

The objective of this study was to devise robust and stable continuous manufacturing process settings, by exploring the design space after an investigation of the lubrication-based parameters influencing the continuous direct compression tableting of high dose paracetamol tablets. Experimental design was used to generate a structured study plan which involved 19 runs. The formulation variables studied were the type of lubricant (magnesium stearate or stearic acid) and its concentration (0.5, 1.0 and 1.5%). Process variables were total production feed rate (5, 10.5 and 16kg/h), mixer speed rpm (500, 850 and 1200rpm), and mixer inlet port for lubricant (A or B). The continuous direct compression tableting line consisted of loss-in-weight feeders, a continuous mixer and a tablet press. The Quality Target Product Profile (QTPP) was defined for the final product, as the flowability of powder blends (2.5s), tablet strength (147N), dissolution in 2.5min (90%) and ejection force (425N). A design space was identified which fulfilled all the requirements of QTPP. The type and concentration of lubricant exerted the greatest influence on the design space. For example, stearic acid increased the tablet strength. Interestingly, the studied process parameters had only a very minor effect on the quality of the final product and the design space. It is concluded that the continuous direct compression tableting process itself is insensitive and can cope with changes in lubrication, whereas formulation parameters exert a major influence on the end product quality. Copyright © 2017 Elsevier B.V. All rights reserved.

The Importance of and the Complexities Associated With Measuring Continuity of Care During Resident Training: Possible Solutions Do Exist.

PubMed

Carney, Patricia A; Conry, Colleen M; Mitchell, Karen B; Ericson, Annie; Dickinson, W Perry; Martin, James C; Carek, Peter J; Douglass, Alan B; Eiff, M Patrice

2016-04-01

Evolutions in care delivery toward the patient-centered medical home have influenced important aspects of care continuity. Primary responsibility for a panel of continuity patients is a foundational requirement in family medicine residencies. In this paper we characterize challenges in measuring continuity of care in residency training in this new era of primary care. We synthesized the literature and analyzed information from key informant interviews and group discussions with residency faculty and staff to identify the challenges and possible solutions for measuring continuity of care during family medicine training. We specifically focused on measuring interpersonal continuity at the patient level, resident level, and health care team level. Challenges identified in accurately measuring interpersonal continuity of care during residency training include: (1) variability in empanelment approaches for all patients, (2) scheduling complexity in different types of visits, (3) variability in ability to attain continuity counts at the level of the resident, and (4) shifting make-up of health care teams, especially in residency training. Possible solutions for each challenge are presented. Philosophical issues related to continuity are discussed, including whether true continuity can be achieved during residency training and whether qualitative rather than quantitative measures of continuity are better suited to residencies. Measuring continuity of care in residency training is challenging but possible, though improvements in precision and assessment of the comprehensive nature of the relationships are needed. Definitions of continuity during training and the role continuity measurement plays in residency need further study.

[Application of continuous mixing technology in ethanol precipitation process of Salvia miltiorrhiza by using micromixer].

PubMed

Gong, Xing-Chu; Shen, Ji-Chen; Qu, Hai-Bin

2016-12-01

Continuous pharmaceutical manufacturing is one of the development directions in international pharmaceutical technology. In this study, a continuous mixing technology of ethanol and concentrated extract in the ethanol precipitation of Salvia miltiorrhiza was realized by using a membrane dispersion method. The effects of ethanol flowrate, concentrated extract flowrate, and flowrate ratio on ethanol precipitation results were investigated. With the increase of the flowrates of ethanol and concentrated extract, retention rate of active phenolic acids components was increased, and the total solid removal rate was decreased. The purity of active components in supernatants was mainly affected by the ratio of ethanol flowrate and concentrated extract flowrate. The mixing efficiency of adding ethanol under continuous flow mixing mode in this study was comparable to that of industrial ethanol precipitation. Continuous adding ethanol by using a membrane dispersion mixer is a promising technology with many advantages such as easy enlargement, large production per unit volume, and easy control. Copyright© by the Chinese Pharmaceutical Association.

Mourning Dove nesting habitat and nest success in Central Missouri

USGS Publications Warehouse

Drobney, R.D.; Schulz, J.H.; Sheriff, S.L.; Fuemmeler, W.J.

1998-01-01

Previous Mourning Dove (Zenaida macroura) nesting studies conducted in areas containing a mixture of edge and continuous habitats have focused on edge habitats. Consequently, little is known about the potential contribution of continuous habitats to dove production. In this study we evaluated the relative importance of these two extensive habitat types by monitoring the habitat use and nest success of 59 radio-marked doves during 1990-1991 in central Missouri. Of 83 nests initiated by our marked sample, most (81.9%) were located in edge habitats. Although continuous habitats were selected less as nest sites, the proportion of successful nests did not differ significantly from that in edge habitats. Our data indicate that continuous habitats should not be considered marginal nesting habitat. If the intensity of use and nest success that we observed are representative regionally or nationally, continuous habitats could contribute substantially to annual Mourning Dove production because of the high availability of these habitats throughout much of the Mourning Dove breeding range.

Droplet microfluidics with a nanoemulsion continuous phase.

PubMed

Gu, Tonghan; Yeap, Eunice W Q; Somasundar, Ambika; Chen, Ran; Hatton, T Alan; Khan, Saif A

2016-07-05

We present the first study of a novel, generalizable method that uses a water-in-oil nanoemulsion as the continuous phase to generate uniform aqueous micro-droplets in a capillary-based microfluidic system. We first study the droplet generation mechanism in this system and compare it to the more conventional case where a simple oil/solvent (with surfactant) is used as the continuous phase. Next, we present two versatile methods - adding demulsifying chemicals and heat treatment - to allow active online chemical interaction between the continuous and dispersed phases. These methods allow each generated micro-droplet to act as a well-mixed micro-reactor with walls that are 'permeable' to the nanoemulsion droplets and their contents. Finally, we demonstrate an application of this system in the fabrication of uniform hydrogel (alginate) micro-beads with control over particle properties such as size and swelling. Our work expands the toolbox of droplet-based microfluidics, enabling new opportunities and applications involving active colloidal continuous phases carrying chemical payloads, both in advanced materials synthesis and droplet-based screening and diagnostic methods.

Factors in Maintaining a Stable Patient-Physician Relationship among Individuals with Schizophrenia.

PubMed

Huang, Hsin-Hui; Chen, Chuan-Yu; Tsay, Jen-Huoy; Chou, Yiing-Jenq; Huang, Nicole

2017-07-01

This study aimed to determine whether adequate continuity of care (COC) existed among individuals with schizophrenia, and what the associated determinants were. The National Health Insurance Research Database of Taiwan was used to identify individuals with newly diagnosed schizophrenia from 2000 to 2009. Two outcome indicators were first derived to conduct the continuity assessment based on the usual provider continuity (UPC) index and the continuity of care index (COCI). The average scores of the UPC and COCI were 0.78 and 0.67, respectively. Patients who have been hospitalized, with lower income, and unemployed had significantly poorer continuity of care. In addition, patients were cared for by higher caseload physicians, treated at mental health specialty institutions, and at hospital outpatient settings also experienced significantly poorer continuity. Patients cared for by middle-aged physicians, psychiatrists, and treated at private institutions had significantly better continuity of mental health care.

Educational differences in continuing or restarting drinking in early and late pregnancy: role of psychological and physical problems.

PubMed

Pfinder, Manuela; Kunst, Anton E; Feldmann, Reinhold; van Eijsden, Manon; Vrijkotte, Tanja G M

2014-01-01

Many women continue drinking alcohol during pregnancy. This study aimed to describe educational differences in continued drinking in early and late pregnancy and to examine the contribution of psychological and physical factors to the explanation of educational differences. We examined 4,885 women enrolled in the Amsterdam Born Children and their Development study. Information on alcohol intake during pregnancy was based on self-reports at the 16th week of gestation and at 3 months postpartum. Only women who reported alcohol intake before pregnancy were included. Explanatory factors were alcohol intake before pregnancy, psychological problems, and physical problems. The risk of continued drinking in early pregnancy was increased in higher educated women (odds ratio [OR] = 1.41, 95% CI [1.25, 1.60]); in addition, in late pregnancy, higher educated women had an increased risk of restarting (OR = 1.67, 95% CI [1.37, 2.04]) and continuing drinking (OR = 1.77, 95% CI [1.36, 2.30]). The intensity of alcohol intake before pregnancy and all physical and psychological problems together explained 17.1% and 8.8% of the educational differences in continued drinking in early pregnancy, respectively. Higher educated women are more likely to continue drinking during pregnancy. The intensity of alcohol intake before pregnancy and physical and psychological problems contributed to the explanation of continued drinking. However, other factors may play a greater role, such as cultural factors and social norms.

Patients’ experiences with continuity of cancer care in Canada

PubMed Central

Easley, Julie; Miedema, Baukje; Carroll, June C.; O’Brien, Mary Ann; Manca, Donna P.; Grunfeld, Eva

2016-01-01

Abstract Objective To explore patient perspectives on and experiences with the coordination and continuity of cancer care. Design Qualitative study using semistructured telephone interviews. Setting Canada. Participants Thirty-eight breast and colorectal cancer survivors 1 to 4 years after diagnosis. Methods Using a constructivist grounded theory approach, semistructured telephone interviews were conducted with the participants. The interviews were digitally recorded, transcribed verbatim, and proofread. Transcripts were reviewed to create a focused coding scheme that was used to develop categories for participants’ experiences. Main findings Although this study focused on the continuity of cancer care, patients described their experiences with cancer care in general, concentrating predominantly on their relationships with individual health care providers (HCPs). Based on patients’ experiences, several themes were identified as the core components of providing good continuity and well coordinated care. The most important overarching theme was communication, which overlapped with 4 other themes: patient-HCP relationships, the role of HCPs, lack of access to care, and timely and tailored information. Conclusion Patients believed that good communication between HCPs and patients was key to improving the overall continuity of cancer care. Continuity of care is an important theoretical concept in cancer care, but it is not easily recognized by patients. They perceive the cancer care continuum and continuity of care as cancer care in general, which is typically framed by the individual relationships with their HCPs. Future research and interventions need to focus on finding and testing ways to improve communication to enhance continuity of cancer care. PMID:27737982

The Role of Continuous Education Programs Organized by Saudi Universities in Literacy--A Case Study of King Saud University

ERIC Educational Resources Information Center

Al Rawaf, Haya Saad Abdulla; Fattah, Azza Khalil Abdel; Megeid, Fadia Yousif Abdel; Nazmy, Rania Mohammed Aziz; Alarifi, Sarah Nasser; Al Sulaihm, Hind Sulaiman

2017-01-01

This study aims at highlighting the role of Continuous Education Programs at the Saudi Universities in Religious, Social, and Health Literacy; King Saud University was taken as an example. To achieve the goals of the study two questionnaires were distributed among two samples from King Saud University; (101) of students, and (9) of continuous…

Funding Continuing Training in Small and Medium-Sized Enterprises: Discussion and Case Studies from across the EU. CEDEFOP Panorama Series.

ERIC Educational Resources Information Center

Pukkinen, Tommi; Romijn, Clemens; Elson-Rogers, Sarah

There are three main parts to this report of a study that used case studies to showcase the different approaches used to encourage more continuing training within small and medium-sized enterprises (SMEs) across the European Union (EU). Section 1 discusses the importance of funding training in SMEs and highlights the various types of funding…

The Relationship between Employer Endorsement of Continuing Education and Training and Work and Study Performance: A Hong Kong Case Study

ERIC Educational Resources Information Center

Hung, Humphry; Wong, Yiu Hing

2007-01-01

Based on psychological contract theory and expectancy disconfirmation theory, we posit that if employers support their staff by endorsing their continuing education and training, these employees will in turn be more satisfied and will perform better not only in their studies but also in their jobs. We also propose that such an endorsement will…

Spread prediction model of continuous steel tube based on BP neural network

NASA Astrophysics Data System (ADS)

Zhai, Jian-wei; Yu, Hui; Zou, Hai-bei; Wang, San-zhong; Liu, Li-gang

2017-07-01

According to the geometric pass of roll and technological parameters of three-roller continuous mandrel rolling mill in a factory, a finite element model is established to simulate the continuous rolling process of seamless steel tube, and the reliability of finite element model is verified by comparing with the simulation results and actual results of rolling force, wall thickness and outer diameter of the tube. The effect of roller reduction, roller rotation speed and blooming temperature on the spread rule is studied. Based on BP(Back Propagation) neural network technology, a spread prediction model of continuous rolling tube is established for training wall thickness coefficient and spread coefficient of the continuous rolling tube, and the rapid and accurate prediction of continuous rolling tube size is realized.

Country, Sex, and Parent Occupational Status: Moderators of the Continuity of Aggression from Childhood to Adulthood

PubMed Central

Kokko, Katja; Simonton, Sharon; Dubow, Eric; Lansford, Jennifer E.; Olson, Sheryl L.; Huesmann, L. Rowell; Boxer, Paul; Pulkkinen, Lea; Bates, John E.; Dodge, Kenneth A.; Pettit, Gregory S.

2015-01-01

Using data from two American and one Finnish long-term longitudinal studies, we examined continuity of general aggression from age 8 to physical aggression in early adulthood (age 21–30) and whether continuity of aggression differed by country, sex, and parent occupational status. In all samples, childhood aggression was assessed via peer nominations and early adulthood aggression via self-reports. Multi-group structural equation models revealed significant continuity in aggression in the American samples but not in the Finnish sample. These relations did not differ by sex but did differ by parent occupational status: whereas there was no significant continuity among American children from professional family-of-origin backgrounds, there was significant continuity among American children from non-professional backgrounds. PMID:24990543

Ensuring IT service continuity in the face of increasing threats.

PubMed

Nair, Vishwanath

2014-01-01

How is IT service continuity related to business continuity management? Is it just a glorified disaster recovery procedure? Will IT service continuity help increase the assurance of IT services from the business owner to the customer? This paper is an attempt at answering these and many such questions. It is presented as a case study of IT service continuity management implementation at Emirates Group IT, Dubai. It takes the reader through the need for the process as felt by the business, through the learning acquired during implementation, to the practices deployed for managing the process on an ongoing basis. It provides a detailed view of the kind of pitfalls that could be encountered during implementation of the IT service continuity management process in a large-scale enterprise.

Motivational Factors in Continuing Education an Academic Achievement of Adult Learners

ERIC Educational Resources Information Center

Lee, Pei Ling; Pang, Vincent

2013-01-01

Purpose: The purpose of this study is to examine the relationship between motivational factors in continuing education and academic achievement of adult learners. The study is conducted due to a lack of research pertaining to academic achievement among adult learners particularly in Malaysia. Methodology: A random sample of 150 part-time adult…

Why Organizations Continue to Create Patient Information Leaflets with Readability and Usability Problems: An Exploratory Study

ERIC Educational Resources Information Center

Gal, Iddo; Prigat, Ayelet

2005-01-01

Readability and usability problems with patient information leaflets continue to be reported despite long-standing recognition of their existence and the availability of guidelines for developing health education materials. This exploratory study examined possible causes for such problems, based on interviews with professionals who developed…

Effects of Career-Related Continuous Learning: A Case Study

ERIC Educational Resources Information Center

Rowold, Jens; Hochholdinger, Sabine; Schilling, Jan

2008-01-01

Purpose: Although proposed from theory, the assumption that career-related continuous learning (CRCL) has a positive impact on subsequent job performance has not been tested empirically. The present study aims to close this gap in the literature. A model is derived from theory that predicts a positive impact of CRCL, learning climate, and initial…

The Study Club as a Continuing Education Format for Training in Implant Dentistry.

ERIC Educational Resources Information Center

Rubenstein, Jeffrey E.; Corbett, Suzanne M.

1996-01-01

A study club for continuing education in dental implant techniques at the University of Washington is described and evaluated. Training included didactic and patient treatment components. In two sessions of the program, 17 participating restorative dentists and oral surgeons completed treatment on 12 patients. Practitioners found this…

Financing Techniques and Stadium Subsidies in the United States

ERIC Educational Resources Information Center

Weiner, Ross D.

2004-01-01

This paper recognizes the numerous studies that have demonstrated that building stadiums for professional sports team is not a viable strategy for urban development. Despite these studies, however, subsidies continue to be offered to builders of stadiums. Why do these subsidies continue? This paper explores the four main drivers of stadium…

Case Study: Online Continuing Education for New Librarians

ERIC Educational Resources Information Center

Hendrix, Beth R.; McKeal, Alyse E.

2017-01-01

Continuing education is vital for new librarians to gain skills and knowledge beyond library school. Professional development offered free in an online environment is often the best option for staying current on the issues and trends necessary for young librarians to grow and flourish. This paper presents a case study of an online professional…

Using Formative Student Feedback: A Continuous Quality Improvement Approach for Online Course Development

ERIC Educational Resources Information Center

Bloxham, Kristy Taylor

2010-01-01

The objective of this study was to examine the use of frequent, anonymous student course surveys as a tool in supporting continuous quality improvement (CQI) principles in online instruction. The study used a qualitative, multiple-case design involving four separate online courses. Analysis methods included pattern matching/explanation building,…

Recollection and Familiarity in Recognition Memory: Evidence from ROC Curves

ERIC Educational Resources Information Center

Heathcote, Andrew; Raymond, Frances; Dunn, John

2006-01-01

Does recognition memory rely on discrete recollection, continuous evidence, or both? Is continuous evidence sensitive to only the recency and duration of study (familiarity), or is it also sensitive to details of the study episode? Dual process theories assume recognition is based on recollection and familiarity, with only recollection providing…

Volunteerism as Purpose: Examining the Long-Term Predictors of Continued Community Engagement

ERIC Educational Resources Information Center

Barber, Carolyn; Mueller, Conrad T.; Ogata, Sachiko

2013-01-01

This study frames continued long-term participation in community engagement activities as indicative of a sense of "purpose" as defined by Damon, Menon, and Cotton Bronk (2003). Using data from US-based National Longitudinal Study of Adolescent Health, we examined factors that predict whether students participating in civic engagement…

ACCOUNTING FOR THE ENDOGENEITY OF HEALTH AND ENVIRONMENTAL TOBACCO SMOKE EXPOSURE IN CHILDREN: AN APPLICATION TO CONTINUOUS LUNG FUNCTION

EPA Science Inventory

The goal of this study is to estimate an unbiased exposure effect of environmental tobacco smoke (ETS) exposure on children's continuous lung function. A majority of the evidence from health studies suggests that ETS exposure in early life contributes significantly to childhood ...

Distinguishing Continuous and Discrete Approaches to Multilevel Mixture IRT Models: A Model Comparison Perspective

ERIC Educational Resources Information Center

Zhu, Xiaoshu

2013-01-01

The current study introduced a general modeling framework, multilevel mixture IRT (MMIRT) which detects and describes characteristics of population heterogeneity, while accommodating the hierarchical data structure. In addition to introducing both continuous and discrete approaches to MMIRT, the main focus of the current study was to distinguish…

USE OF A CONTINUOUS NEPHELOMETER TO MEASURE PERSONAL EXPOSURE TO PARTICLES DURING THE U.S. EPA BALTIMORE AND FRESNO PANEL STUDIES

EPA Science Inventory

In population exposure studies, personal exposure to particulate matter (PM) is typically measured as a 12- to 24-hour integrated mass concentration. To better understand short-term variation in personal PM exposure, continuous (one-minute averaging time) nephelometers were wo...

Relationships and Dropping Out: The Voice of At-Risk Youth

ERIC Educational Resources Information Center

Henry, Robert Thomas

2009-01-01

The practice of retaining students in grade has been studied, researched, discussed, criticized and yet it continues. Dropping out of school prior to graduation has been studied, researched, discussed, written about and continues to be practiced by our youth. Policymakers are often provided quantitative data to consider as they explore, evaluate,…

Continued Use of a Chinese Online Portal: An Empirical Study

ERIC Educational Resources Information Center

Shih, Hung-Pin

2008-01-01

The evolution of the internet has made online portals a popular means of surfing the internet. In internet commerce, understanding the post-adoption behaviour of users of online portals can help enterprises to attract new users and retain existing customers. For predicting continued use intentions, this empirical study focused on applying and…

Developing Specifications for Waste Glass, Municipal Waste Combustor Ash and Waste Tires as Highway Fill Materials (Continuation): Final Report. Volume 2. Waste Glass.

DOT National Transportation Integrated Search

1995-04-01

A two year study was conducted as a continuation project for the Florida Department of Transportation (FDOT) to evaluate Municipal Waste Combustor (MWD) ash, Waste Glass, and Waste Tires for use as general highway fill. Initial studies conducted at F...

Digital Textbooks: A Study of Factors Affecting College Student Adoption

ERIC Educational Resources Information Center

Barajas-Murphy, Noreen

2017-01-01

Purpose: The purpose of this quantitative research study was to examine the factors that influence students' intentions to continue to use digital texts. Specifically, the purpose was to investigate what impact the external factors of instructor modeling and instructor expectation to use had on the intention to continue to use digital textbooks as…

Developing Specifications for Waste Glass, Municipal Waste Combustor Ash and Waste Tires as Highway Fill Materials (Continuation). Final Report. Volume 3. Waste Tires.

DOT National Transportation Integrated Search

1995-04-01

A two year study was conducted as a continuation project for the Florida Department of Transportation (FDOT) to evaluate Municipal Waste Combustor (MWC) ash, Waste Glass, and Waste Tires for use as general highway fill. Initial studies conducted at F...

The Influence of Motivational Orientations on Academic Achievement among Working Adults in Continuing Education

ERIC Educational Resources Information Center

Lee, Pei-Ling; Pang, Vincent

2014-01-01

This paper reports on a study of five motivational orientations in continuing education among working adults. The influence of motivational orientations on their academic achievement was identified. The study involved 159 working adults who enrolled into part-time programs in an Open University in Sabah. Boshier's Education Participation Scale…

Uses, funding, and availability of continuous streamflow data in Montana

USGS Publications Warehouse

Shields, R.R.; White, M.K.

1984-01-01

This report documents the results of a study of the uses, funding, and availability of continuous streamflow data collected and published by the U.S. Geological Survey in Montana. Data uses and funding sources are identified for the 218 continuous streamflow gages currently (1984) being operated. These stations are supported by 18 different funding sources at a budget for the 1984 water year of $1,065,000. The streamflow-gaging program in Montana has evolved through the years as Federal, State, and local needs for surface-water data have increased. Continuous streamflow records for periods ranging from less than 1 year to more than 90 years have been collected. This report describes phase 1 of a cost-effectiveness study of the streamflow-gaging program in Montana. Evaluation of the program indicates that numerous agencies use the data for studies involving regional hydrology, hydrologic systems, and planning and design. They also use the data for operations of existing hydroelectric and irrigation dams, forecasting flood and seasonal flows, water-quality monitoring, research studies for fish habitat, and other uses such as recreational management. (USGS)

Progress on the New York State Observatory: a new 12-meter astronomical telescope

NASA Astrophysics Data System (ADS)

Sebring, T.; O'Dea, C.; Baum, S.; Teran, J.; Loewen, N.; Stutzki, C.; Egerman, R.; Bonomi, G.

2014-07-01

Over the past two years, the New York Astronomical Corporation (NYAC), the business arm of the Astronomical Society of New York (ASNY), has continued planning and technical studies toward construction of a 12-meter class optical telescope for the use of all New York universities and research institutions. Four significant technical studies have been performed investigating design opportunities for the facility, the dome, the telescope optics, and the telescope mount. The studies were funded by NYAC and performed by companies who have provided these subsystems for large astronomical telescopes in the past. In each case, innovative and cost effective approaches were identified, developed, analyzed, and initial cost estimates developed. As a group, the studies show promise that this telescope could be built at historically low prices. As the project continues forward, NYAC intends to broaden the collaboration, pursue funding, to continue to develop the telescope and instrument designs, and to further define the scientific mission. The vision of a historically large telescope dedicated to all New York institutions continues to grow and find new adherents.

Intermittent versus Continuous Physiotherapy in Children with Cerebral Palsy

ERIC Educational Resources Information Center

Christiansen, Annette Sandahl; Lange, Christa

2008-01-01

The aim of this study was to compare the effect of the delivery of the same amount of intermittent versus continuous physiotherapy given to children with cerebral palsy (CP). This was organized either in an intermittent regime four times a week for 4 weeks alternating with a 6-week treatment pause, or a continuous once or twice a week regime, both…

A Process Evaluation of Project Developmental Continuity. Interim Report III, Executive Summary: Preliminary Recommendations for the Study of Child Impact.

ERIC Educational Resources Information Center

Granville, Arthur C.; And Others

This executive summary presents the major findings of Interim Report III, which reports preliminary evaluation of Project Developmental Continuity (PDC). A Head Start demonstration program, PDC is aimed at promoting greater educational and developmental continuity as children make the transition from preschool to school. The report addresses three…

A Process Evaluation of Project Developmental Continuity: Final Report of the PDC Feasibility Study, 1974-1977.

ERIC Educational Resources Information Center

Love, John M.; And Others

This is the final report of the 3-year feasibility phase of a projected 7-year longitudinal evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and primary school experiences. Chapter I gives an overview of the PDC program…

Survey of Students and Non-Students about Continuing Education Market Place. Volume XXIV, Number 16.

ERIC Educational Resources Information Center

Lucas, John A.; And Others

To evaluate the outreach and marketing efforts for its non-credit offerings, William Rainey Harper College in Illinois conducted a study of recent continuing education students in spring 1996. First, a random sample of 200 former students who had enrolled in continuing education courses in the past 5 years was surveyed, receiving 57 completed…

Specific Instructions Are Important for Continuous Bimanual Drumming in Adults with Down Syndrome

ERIC Educational Resources Information Center

Ringenbach, Shannon D.; Allen, Heather; Chung, Susan; Jung, Michelle L.

2006-01-01

The present study examined continuous and discrete bimanual drumming in response to different instructions in 10 adults with Down syndrome, 10 mental age-matched and 10 chronological age-matched groups. For continuous drumming, participants hit two drums with both hands at the same time following verbal (e.g., "up" and "down"), visual (e.g., video…

A Study of Reasons for Participation in Continuing Professional Education in the U.S. Nuclear Power Industry

ERIC Educational Resources Information Center

McCamey, Randy B.

2003-01-01

The need for workers in the U.S. nuclear power industry to continually update their knowledge, skills, and abilities is critical to the safe and reliable operation of the country's nuclear power facilities. To improve their skills, knowledge, and abilities, many professionals in the nuclear power industry participate in continuing professional…

The Effectiveness of the Continuation Task on Second Language Learning of English Articles

ERIC Educational Resources Information Center

Jiang, Lin

2015-01-01

This article aims to uncover how alignment in the continuation task affects second language (L2) learning of English articles. Two classes of 47 Chinese students participated in the study which employed a pretest-treatment-posttest research design and lasted for a period of 20 weeks. One class received the continuation task treatment, during which…

Continuity and Discontinuity of Depressed Mood from Late Adolescence to Young Adulthood: The Mediating and Stabilizing Roles of Young Adults' Socioeconomic Attainment

ERIC Educational Resources Information Center

Wickrama, K. A. S.; Conger, Rand D.; Lorenz, Federick O.; Martin, Monica

2012-01-01

Using prospective, longitudinal data from 467 youth over a 13-year period (late adolescence and young adulthood), the present study investigates three research questions: (1) to what extent do elevations in depressed mood continue (homotypic continuity) from adolescence to young adulthood, (2) to what extent do young adults' socioeconomic…

A cross-sectional study of facilitators and barriers of Iranian nurses' participation in continuing education programs.

PubMed

Hamzehgardeshi, Zeinab; Shahhosseini, Zohreh

2013-12-27

Continuing education is one of the modern strategies to maintain and elevate knowledge and professional skills of nurses which in turn elevate the health status of society. Since several factors affect nurses' participation in continuing education, it's essential to know promoters and obstacles in this issue and plan accordingly. In this cross-sectional study, 361 Iranian nurses who were recruited by convenience sampling method completed an anonymous, self-administered questionnaire from October 2012 to April 2013. Topics covered the participants' attitudes towards facilitators and barriers of their participation in continuing education. Mean and standard deviation of participants ' age were 37.14±7.58 years and 93.94% were female. The maximum score of facilitators and barriers to nurses' participation in continuing education were related to "Update my knowledge" and "Work commitments" respectively. The results showed among Iranian nurses, the mean score of personal and structural barriers was significantly higher than the mean score of interpersonal ones (F=2122.66, p<0.001). Results highlight policy makers and nursing managers' role on improving the accessibility to provided continuing education programs by enforcement of facilitators and reducing barriers focusing on the personal and structural barriers.

Effects of continuous midwifery labour support for women with severe fear of childbirth.

PubMed

Sydsjö, Gunilla; Blomberg, Marie; Palmquist, Sofie; Angerbjörn, Louise; Bladh, Marie; Josefsson, Ann

2015-05-15

Continuous support by a midwife during childbirth has shown positive effects on the duration of active labour, use of pain relief and frequency of caesarean section (CS) in women without fear of childbirth (FOC). We have evaluated how continuous support by a specially assigned midwife during childbirth affects birth outcome and the subjective experience of women with severe FOC. A case-control pilot study with an index group of 14 women with severe FOC and a reference group of 28 women without FOC giving birth. In this study the index group received continuous support during childbirth. The women with severe FOC more often had an induction of labour. The parous women with severe FOC had a shorter duration of active labour compared to the parous reference women (p = 0.047). There was no difference in caesarean section frequency between the two groups. Women with severe FOC experienced a very high anxiety level during childbirth (OR = 20.000, 95% CI: 3.036-131.731). Women with severe FOC might benefit from continuous support by a midwife during childbirth. Midwives should acknowledge the importance of continuous support in order to enhance the experience of childbirth in women with severe FOC.

Continuing medical education for general practitioners: a practice format

PubMed Central

VanNieuwenborg, Lena; Goossens, Martine; De Lepeleire, Jan; Schoenmakers, Birgitte

2016-01-01

Introduction Our current knowledge-based society and the many actualisations within the medical profession require a great responsibility of physicians to continuously develop and refine their skills. In this article, we reflect on some recent findings in the field of continuing education for professional doctors (continuing medical education, CME). Second, we describe the development of a CME from the Academic Center for General Practice (ACHG) of the KU Leuven. Methods First, we performed a literature study and we used unpublished data of a need assessment performed (2013) in a selected group of general practitioners. Second, we describe the development of a proposal to establish a CME programme for general practitioners. Results CME should go beyond the sheer acquisition of knowledge, and also seek changes in practice, attitudes and behaviours of physicians. The continuing education offerings are subject to the goals of the organising institution, but even more to the needs and desires of the end user. Conclusions Integrated education is crucial to meet the conditions for efficient and effective continuing education. The ACHG KU Leuven decided to offer a postgraduate programme consisting of a combination of teaching methods: online courses (self-study), contact courses (traditional method) and a materials database. PMID:26850504

Relapse prevention after index electroconvulsive therapy in treatment-resistant depression

PubMed Central

Youssef, Nagy A.; McCall, W. Vaughn

2015-01-01

Background One-third of patients who suffer from depression are resistant to conventional treatments. An acute course of electroconvulsive therapy (ECT) can lead to remission of depressive symptoms in a substantial portion of the treatment-resistant patients. However, prevention of relapse with depressive symptoms after the index course of ECT can be challenging. We review pertinent studies on the topic and analyze the best strategies to avoid relapse and recurrence of depressive symptoms. Methods We performed a systematic literature review of PubMed through April 2014 for clinical trials published in English to determine if continuation ECT, continuation medication, continuation psychotherapy, or combinations of these are the best strategy to avoid relapse and recurrence of depressive symptoms after an acute course of ECT. Clinical trials comparing ≥2 of the above strategies were included in the review. Results Although there are few rigorous randomized clinical trials in this area, most studies suggest that combined continuation ECT (C-ECT) and continuation pharmacotherapy are the most effective strategy in relapse prevention. Conclusions C-ECT and continuation pharmacotherapy may be more effective than either alone for preventing relapse. However, more definitive randomized clinical trials are needed. PMID:25401716

Continuation of copper and levonorgestrel intrauterine devices: a retrospective cohort study.

PubMed

Phillips, Sharon J; Hofler, Lisa G; Modest, Anna M; Harvey, Lara F B; Wu, Lily H; Hacker, Michele R

2017-07-01

Studies conflict on whether the duration of use of the copper intrauterine device is longer than that of the levonorgestrel intrauterine device, and whether women who continue using intrauterine devices differ from those who discontinue. We sought to assess continuation rates and performance of levonorgestrel intrauterine devices compared with copper intrauterine devices over a 5-year period. We performed a retrospective cohort study of 1164 individuals who underwent intrauterine device placement at an urban academic medical center. The analysis focused on a comparison of continuation rates between those using levonorgestrel intrauterine device and copper intrauterine device, factors associated with discontinuation, and intrauterine device performance. We assessed the differences in continuation at discrete time points, pregnancy, and expulsion rates using χ 2 tests and calculated hazard ratios using a multivariable Cox model. Of 1164 women who underwent contraceptive intrauterine device insertion, 956 had follow-up data available. At 2 years, 64.9% of levonorgestrel intrauterine device users continued their device, compared with 57.7% of copper intrauterine device users (P = .11). At 4 years, continuation rates were 45.1% for levonorgestrel intrauterine device and 32.6% for copper intrauterine device (P < .01), and at 5 years continuation rates were 28.1% for levonorgestrel intrauterine device and 23.8% for copper intrauterine device (P = .33). Black race, primiparity, and age were positively associated with discontinuation; education was not. The hazard ratio for discontinuation of levonorgestrel intrauterine device compared with copper intrauterine device >4 years was 0.71 (95% confidence interval, 0.55-0.93) and >5 years was 0.82 (95% confidence interval, 0.64-1.05) after adjusting for race, age, parity, and education. Copper intrauterine device users were more likely to experience expulsion (10.2% copper intrauterine device vs 4.9% levonorgestrel intrauterine device, P < .01) over the study period and to become pregnant in the first year of use (1.6% copper intrauterine device vs 0.1% levonorgestrel intrauterine device, P < .01). We found a difference in continuation rates between levonorgestrel and copper intrauterine device users at 4 years but not at 5 years. Copper intrauterine device users were more likely to experience expulsion and pregnancy. Copyright © 2017 Elsevier Inc. All rights reserved.

Continuous- and discrete-time stimulus sequences for high stimulus rate paradigm in evoked potential studies.

PubMed

Wang, Tao; Huang, Jiang-hua; Lin, Lin; Zhan, Chang'an A

2013-01-01

To obtain reliable transient auditory evoked potentials (AEPs) from EEGs recorded using high stimulus rate (HSR) paradigm, it is critical to design the stimulus sequences of appropriate frequency properties. Traditionally, the individual stimulus events in a stimulus sequence occur only at discrete time points dependent on the sampling frequency of the recording system and the duration of stimulus sequence. This dependency likely causes the implementation of suboptimal stimulus sequences, sacrificing the reliability of resulting AEPs. In this paper, we explicate the use of continuous-time stimulus sequence for HSR paradigm, which is independent of the discrete electroencephalogram (EEG) recording system. We employ simulation studies to examine the applicability of the continuous-time stimulus sequences and the impacts of sampling frequency on AEPs in traditional studies using discrete-time design. Results from these studies show that the continuous-time sequences can offer better frequency properties and improve the reliability of recovered AEPs. Furthermore, we find that the errors in the recovered AEPs depend critically on the sampling frequencies of experimental systems, and their relationship can be fitted using a reciprocal function. As such, our study contributes to the literature by demonstrating the applicability and advantages of continuous-time stimulus sequences for HSR paradigm and by revealing the relationship between the reliability of AEPs and sampling frequencies of the experimental systems when discrete-time stimulus sequences are used in traditional manner for the HSR paradigm.

Continuation of superpave projects monitoring.

DOT National Transportation Integrated Search

2011-07-01

This study involved the continuous monitoring of material properties and field performance of : twelve Superpave project sections in Florida for the establishment of reasonable and effective mixture : design guidelines and criteria, the identificatio...

A systematic review on clinical benefits of continuous administration of beta-lactam antibiotics.

PubMed

Roberts, Jason A; Webb, Steven; Paterson, David; Ho, Kwok M; Lipman, Jeffrey

2009-06-01

The clinical benefits of extended infusion or continuous infusion of beta-lactam antibiotics remain controversial. We systematically reviewed the literature to determine whether any clinical benefits exist for administration of beta-lactam antibiotics by extended or continuous infusion. PubMed (January 1950 to November 2007), EMBASE (1966 to November 2007), and the Cochrane Controlled Trial Register were searched (updated November 2007). Randomized controlled trials (RCTs) were meta-analyzed, and observational studies were described by two unblinded reviewers. A total of 846 patients from eligible prospective randomized controlled studies were included in the meta-analysis. Two observational studies were deemed appropriate for description. A meta-analysis of prospective RCTs was undertaken using Review Manager. Among a total of 59 potentially relevant studies, 14 RCTs involving a total of 846 patients from nine countries were deemed appropriate for meta-analysis. The use of continuous infusion of a beta-lactam antibiotic was not associated with an improvement in clinical cure (n = 755 patients; odds ratio: 1.04, 95% confidence interval: 0.74-1.46, p = 0.83, I = 0%) or mortality (n = 541 patients; odds ratio: 1.00, 95% confidence interval: 0.48-2.06, p = 1.00, I = 14.8%). All RCTs except one used a higher antibiotic dose in the bolus administration group. Two observational studies, not pooled because they did not meet the a priori criteria for meta-analysis, showed that beta-lactam administration by extended or continuous infusion was associated with an improvement in clinical cure. The difference in the results between the meta-analysis results and the observational studies could be explained by the bias created by a higher dose of antibiotic in the bolus group in the RCTs and because many of the RCTs only recruited patients with a low acuity of illness. The limited data available suggest that continuous infusion of beta-lactam antibiotics leads to the same clinical results as higher dosed bolus administration in hospitalized patients.

Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams.

PubMed

Premji, Shahirose S; Chessell, Lorraine

2011-11-09

Milk feedings can be given via nasogastric tube either intermittently, typically over 10 to 20 minutes every two or three hours, or continuously, using an infusion pump. Although theoretical benefits and risks of each method have been proposed, effects on clinically important outcomes remain uncertain. To examine the evidence regarding the effectiveness of continuous versus intermittent bolus nasogastric milk feeding in premature infants less than 1500 grams. Searches were performed of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2011), MEDLINE, CINAHL and HealthSTAR up to July 2011. Randomised and quasi-randomised clinical trials comparing continuous versus intermittent bolus nasogastric milk feeding in premature infants less than 1500 grams. Two review authors independently assessed all trials for relevance and methodologic quality. The standard methods of the Cochrane Neonatal Review Group were used to extract data. Overall, the seven included trials, involving 511 infants, found no differences in time to achieve full enteral feeds between feeding methods (weighted mean difference (WMD) 2 days; 95% CI -0.3 to 3.9) . In the subgroup analysis of those studies comparing continuous nasogastric versus intermittent bolus nasogastric milk feedings the findings remained unchanged (WMD 2 days, 95% CI -0.4 to 4.1). There was no significant difference in somatic growth and incidence of NEC between feeding methods irrespective of tube placement. One study noted a trend toward more apneas during the study period in infants fed by the continuous tube feeding method compared to those fed by intermittent feedings delivered predominantly by orogastric tube placements [mean difference (MD) 14.0 apneas during study period; 95% CI -0.2 to 28.2]. In subgroup analysis based on weight groups, one study suggested that infants less than 1000 grams and 1000 to 1250 grams birth weight gained weight faster when fed by the continuous nasogastric tube feeding method compared to intermittent nasogastric tube feeding method (MD 2.0 g/day; 95% CI 0.5 to 3.5; MD 2.0 g/day; 95% CI 0.2 to 3.8, respectively). A trend toward earlier discharge for infants less than 1000 grams birth weight fed by the continuous tube feeding method compared to intermittent nasogastric tube feeding method (MD -11 days; 95% CI -21.8 to -0.2). Small sample sizes, methodologic limitations, inconsistencies in controlling variables that may affect outcomes, and conflicting results of the studies to date make it difficult to make universal recommendations regarding the best tube feeding method for premature infants less than 1500 grams. The clinical benefits and risks of continuous versus intermittent nasogastric tube milk feeding cannot be reliably discerned from the limited information available from randomised trials to date.

Continuous biohydrogen production from waste bread by anaerobic sludge.

PubMed

Han, Wei; Huang, Jingang; Zhao, Hongting; Li, Yongfeng

2016-07-01

In this study, continuous biohydrogen production from waste bread by anaerobic sludge was performed. The waste bread was first hydrolyzed by the crude enzymes which were generated by Aspergillus awamori and Aspergillus oryzae via solid-state fermentation. It was observed that 49.78g/L glucose and 284.12mg/L free amino nitrogen could be produced with waste bread mass ratio of 15% (w/v). The waste bread hydrolysate was then used for biohydrogen production by anaerobic sludge in a continuous stirred tank reactor (CSTR). The optimal hydrogen production rate of 7.4L/(Ld) was achieved at chemical oxygen demand (COD) of 6000mg/L. According to the results obtained from this study, 1g waste bread could generate 0.332g glucose which could be further utilized to produce 109.5mL hydrogen. This is the first study which reports continuous biohydrogen production from waste bread by anaerobic sludge. Copyright © 2016 Elsevier Ltd. All rights reserved.

How does cognitive dissonance influence the sunk cost effect?

PubMed

Chung, Shao-Hsi; Cheng, Kuo-Chih

2018-01-01

The sunk cost effect is the scenario when individuals are willing to continue to invest capital in a failing project. The purpose of this study was to explain such irrational behavior by exploring how sunk costs affect individuals' willingness to continue investing in an unfavorable project and to understand the role of cognitive dissonance on the sunk cost effect. This study used an experimental questionnaire survey on managers of firms listed on the Taiwan Stock Exchange and Over-The-Counter. The empirical results show that cognitive dissonance does not mediate the relationship between sunk costs and willingness to continue an unfavorable investment project. However, cognitive dissonance has a moderating effect, and only when the level of cognitive dissonance is high does the sunk cost have significantly positive impacts on willingness to continue on with an unfavorable investment. This study offers psychological mechanisms to explain the sunk cost effect based on the theory of cognitive dissonance, and it also provides some recommendations for corporate management.

How does cognitive dissonance influence the sunk cost effect?

PubMed Central

Chung, Shao-Hsi; Cheng, Kuo-Chih

2018-01-01

Background The sunk cost effect is the scenario when individuals are willing to continue to invest capital in a failing project. The purpose of this study was to explain such irrational behavior by exploring how sunk costs affect individuals’ willingness to continue investing in an unfavorable project and to understand the role of cognitive dissonance on the sunk cost effect. Methods This study used an experimental questionnaire survey on managers of firms listed on the Taiwan Stock Exchange and Over-The-Counter. Results The empirical results show that cognitive dissonance does not mediate the relationship between sunk costs and willingness to continue an unfavorable investment project. However, cognitive dissonance has a moderating effect, and only when the level of cognitive dissonance is high does the sunk cost have significantly positive impacts on willingness to continue on with an unfavorable investment. Conclusion This study offers psychological mechanisms to explain the sunk cost effect based on the theory of cognitive dissonance, and it also provides some recommendations for corporate management. PMID:29535561

Continuous high-frequency activity in mesial temporal lobe structures

PubMed Central

Mari, Francesco; Zelmann, Rina; Andrade-Valenca, Luciana; Dubeau, Francois; Gotman, Jean

2013-01-01

Summary Purpose Many recent studies have reported the importance of high-frequency oscillations (HFOs) in the intracerebral electroencephalography (EEG) of patients with epilepsy. These HFOs have been defined as events that stand out from the background. We have noticed that this background often consists itself of high-frequency rhythmic activity. The purpose of this study is to perform a first evaluation of the characteristics of high-frequency continuous or semicontinuous background activity. Methods Because the continuous high-frequency pattern was noted mainly in mesial temporal structures, we reviewed the EEG studies from these structures in 24 unselected patients with electrodes implanted in these regions. Sections of background away from interictal spikes were marked visually during periods of slow-wave sleep and wakefulness. They were then high-passed filtered at 80 Hz and categorized as having high-frequency rhythmic activity in one of three patterns: continuous/semicontinuous, irregular, sporadic. Wavelet entropy, which measures the degree of rhythmicity of a signal, was calculated for the marked background sections. Key Findings Ninety-six bipolar channels were analyzed. The continuous/semicontinuous pattern was found frequently (29/96 channels during wake and 34/96 during sleep). The different patterns were consistent between sleep and wakefulness. The continuous/semicontinuous pattern was found significantly more often in the hippocampus than in the parahippocampal gyrus and was rarely found in the amygdala. The types of pattern were not influenced by whether a channel was within the seizure-onset zone, or whether it was a lesional channel. The continuous/semicontinuous pattern was associated with a higher frequency of spikes and with high rates of ripples and fast ripples. Significance It appears that high-frequency activity (above 80 Hz) does not appear only in the form of brief paroxysmal events but also in the form of continuous rhythmic activity or very long bursts. In this study limited to mesial temporal structures, we found a clear anatomic preference for the hippocampus. Although associated with spikes and with distinct HFOs, this pattern was not clearly associated with the seizure-onset zone. Future studies will need to evaluate systematically the presence of this pattern, as it may have a pathophysiologic significance and it will also have an important influence on the very definition of HFOs. PMID:22416973

Childhood bereavement: The role of the surviving parent and the continuing bond with the deceased.

PubMed

Karydi, Evangelia

2018-08-01

This study investigated the relationship between the role of the surviving parent in the child's grieving process, the continuing bond with the deceased parent and biopsychosocial functioning and active grief in adulthood. A survey of 135 adults, parentally bereaved in childhood, indicated that the surviving parent's role in facilitating the grieving process promoted a positive continuing bond with the deceased in childhood as well as general functioning in adulthood. The continuing bond with the deceased had a weak association with both better general functioning and relational active grief.

Pseudomaster equation for the no-count process in a continuous photodetection

NASA Technical Reports Server (NTRS)

Lee, Ching-Tsung

1994-01-01

The detection of cavity radiation with the detector placed outside the cavity is studied. Each leaked photon has a certain probability of propagating away without being detected. It is viewed as a continuous quantum measurement in which the density matrix is continuously revised according to the readout of the detector. The concept of pseudomaster equation for the no-count process is introduced; its solution leads to the discovery of the superoperator for the same process. It has the potential to become the key equation for continuous measurement process.

Cost effectiveness of the stream-gaging program in Louisiana

USGS Publications Warehouse

Herbert, R.A.; Carlson, D.D.

1985-01-01

This report documents the results of a study of the cost effectiveness of the stream-gaging program in Louisiana. Data uses and funding sources were identified for the 68 continuous-record stream gages currently (1984) in operation with a budget of $408,700. Three stream gages have uses specific to a short-term study with no need for continued data collection beyond the study. The remaining 65 stations should be maintained in the program for the foreseeable future. In addition to the current operation of continuous-record stations, a number of wells, flood-profile gages, crest-stage gages, and stage stations, are serviced on the continuous-record station routes; thus, increasing the current budget to $423,000. The average standard error of estimate for data collected at the stations is 34.6%. Standard errors computed in this study are one measure of streamflow errors, and can be used as guidelines in comparing the effectiveness of alternative networks. By using the routes and number of measurements prescribed by the ' Traveling Hydrographer Program, ' the standard error could be reduced to 31.5% with the current budget of $423,000. If the gaging resources are redistributed, the 34.6% overall level of accuracy at the 68 continuous-record sites and the servicing of the additional wells or gages could be maintained with a budget of approximately $410,000. (USGS)

The anxiety of Taiwanese women with or without continuity treatment after previous in vitro fertilisation failure.

PubMed

Su, Tsann-Juu; Tzeng, Ya-Ling; Kuo, Pi-Chao

2011-08-01

To compare the anxiety levels of Taiwanese women who continued with in vitro fertilisation treatment and those who discontinued treatment post-in vitro fertilisation failure. In vitro fertilisation is perceived as the last resort of infertility treatment. The impact of unsuccessful in vitro fertilisation treatment on psychological function has been documented; however, research comparing the levels of anxiety of women who cease and those who continue in vitro fertilisation post-failure is scant. A cross-sectional comparative study design was used. Fifty-eight women in whom in vitro fertilisation had failed within the previous year were recruited to this study from a medical centre in northern Taiwan; 34 women continued treatment and 24 discontinued treatment. The State-Trait Anxiety Inventory was used to assess their levels of anxiety. Women in the group who continued treatment exhibited higher state and trait anxiety (TA) than women in the group who discontinued treatment (p < 0·005). The number and frequency of in vitro fertilisation cycles were significantly higher in the group who continued treatment than in those who did not. A strong positive correlation between state and TA (r = 0·8, p < 0·01) existed in both groups. Both groups exhibited considerable levels of anxiety; however, the women who continued in vitro fertilisation treatment had higher levels of anxiety than those who discontinued treatment. The level of anxiety of women who decide to continue in vitro fertilisation treatment should be assessed as early as possible and counselling services provided to women who experience in vitro fertilisation failure should concentrate more on relieving psychological distress. One year after discontinuing treatment, some women still experience considerable anxiety; therefore, the care and assistance provided to these women need to be continually evaluated. © 2011 Blackwell Publishing Ltd.

Terbinafine in the treatment of dermatophyte toenail onychomycosis: a meta-analysis of efficacy for continuous and intermittent regimens.

PubMed

Gupta, A K; Paquet, M; Simpson, F; Tavakkol, A

2013-03-01

To compare mycological and complete cures of terbinafine continuous and intermittent regimens in the treatment of toenail onychomycosis. The PubMed database was searched using the terms "terbinafine", "onychomycosis", "continuous" and "pulse(d)" or "intermittent". The inclusion criteria were head-to-head comparison of terbinafine pulse and continuous regimens for dermatophyte toenail infections. Risk ratios were calculated for intention-to-treat and evaluable patient analyses, when possible. Pooled estimates for total and subgroup analyses were calculated using a random effect model, Mantel-Haenszel method and their probabilities were calculated with z-statistics. Nine studies from eight publications were included. Two continuous regimens and four intermittent regimens were investigated. A pooled risk ratio of 0.87 was obtained for intention-to-treat (95% CI: 0.79-0.96, P = 0.004, n = 6) and evaluable patient (95% CI: 0.80-0.96, P = 0.003, n = 8) analyses of mycological cure, favouring continuous terbinafine. For complete cure, pooled risk ratios of 0.97 (95% CI: 0.77-1.23, P = 0.82, n = 7) for intention-to-treat and 0.93 (95% CI: 0.76-1.13, P = 0.44, n = 9) for evaluable patient analyses showed equality of the two regimens. The pulse regimen that demonstrated consistently comparable results to the continuous terbinafine regimen was two pulses of terbinafine 250 mg/day for 4 weeks on/4 weeks off. Meta-analysis of published studies of toenail onychomycosis showed that a continuous terbinafine regimen is generally significantly superior to a pulsed terbinafine regimen for mycological cure. In contrast, some pulse terbinafine regimens were as effective as continuous terbinafine regimens for complete cure. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Continuing education requirements among State Occupational Therapy Regulatory Boards in the United States of America.

PubMed

Hall, Savannah R; Crifasi, Kristen A; Marinelli, Christina M; Yuen, Hon K

2016-01-01

The purpose of this study is to compare and contrast the contents of each state's occupational therapy (OT) regulatory board requirements regarding licensees' acquisition of continuing education units in the United States of America. Data related to continuing education requirements from each OT regulatory board of all 50 states and the District of Columbia in the United States were reviewed and categorized by two reviewers. Analysis was conducted based on the categorization of the continuing education requirements and activities required, allowed, and not allowed/not mentioned for continuing education units. Findings revealed non-uniformity and inconsistency of continuing education requirements for licensure renewal between OT regulatory boards and was coupled with lack of specific criteria for various continuing education activities. Continuing education requirements were not tailored to meet the needs of individual licensee's current and anticipated professional role and job responsibilities, with a negative bias towards presentation and publication allowed for continuing education units. Few boards mandated continuing education topics on ethics related to OT practice within each renewal cycle. OT regulatory boards should move towards unifying the reporting format of continuing education requirements across all states to reduce ambiguity and to ensure licensees are equipped to provide ethical and competent practice. Efforts could be made to enact continuing education requirements specific to the primary role of a particular licensee. Finally, assigning the amount of continuing education credits to be awarded for different activities should be based on research evidence rather than arbitrary determination.

Continuation of superpave projects monitoring.

DOT National Transportation Integrated Search

2011-07-01

This study involved the continuous monitoring of material properties and field performance of twelve Superpave project sections in Florida for the establishment of reasonable and effective mixture design guidelines and criteria, the identification an...

Prevention of hypophosphatemia after burn injury with a protocol for continuous, preemptive repletion.

PubMed

Kahn, Steven A; Bell, Derek E; Stassen, Nicole A; Lentz, Christopher W

2015-01-01

Severe burn injury has been shown to result in hypophosphatemia. Hypophosphatemia can cause cardiac, hematologic, immunologic, and neuromuscular dysfunction. This study compares serum phosphate levels and outcomes in patients who were administered a continuous, preemptive phosphate repletion protocol vs those who only received phosphate supplementation after they developed hypophosphatemia. Records of patients with greater than 19% TBSA burn admitted to the intensive care unit from 2006 to 2010 were reviewed. Patients were divided into two groups: historical controls who received responsive repletion when serum phosphate levels were less than 2.5 mg/dl (2006-2008) and the experimental group that received 30 mmol intravenous every 6 hours starting at approximately 24 hours after injury as long as serum phosphate levels were less than 4 mg/dl (2008-2010). Patients with chronic kidney disease or acute kidney injury were excluded. Data collected included age, weight, burn size, age, all serum phosphate levels, and total amount of phosphate administered. Differences in groups were compared with Mann-Whitney U test and Fisher's exact test. A total of 30 patients were included in the study, 20 in the responsive repletion group and 10 in the continuous repletion group. No significant difference was detected in age, sex, burn size, or full thickness burn size between groups. The continuous group had a statistically lower percentage of hypophosphatemic lab values compared with the responsive group, 13 ± 14% vs 45 ± 21% (P < .0001). No difference was found in percent of observations reflecting hyperphosphatemia (median of 2% in each group, P = .7). Four patients in the continuous group suffered cardiac and/or infectious complications compared with 16 in the responsive group (P = .04). Continuous, pre-emptive repletion of phosphate prevents hypophosphatemia after severe burn injury when compared with responsive repletion in historical controls. The protocol resulted in less hypophosphatemia without increasing the risk of hyperphosphatemia. This study also suggests that continuous repletion may result in fewer complications, but this needs to be confirmed in larger, prospective studies.

Advantages of continuous genotype values over genotype classes for GWAS in higher polyploids: a comparative study in hexaploid chrysanthemum.

PubMed

Grandke, Fabian; Singh, Priyanka; Heuven, Henri C M; de Haan, Jorn R; Metzler, Dirk

2016-08-24

Association studies are an essential part of modern plant breeding, but are limited for polyploid crops. The increased number of possible genotype classes complicates the differentiation between them. Available methods are limited with respect to the ploidy level or data producing technologies. While genotype classification is an established noise reduction step in diploids, it gains complexity with increasing ploidy levels. Eventually, the errors produced by misclassifications exceed the benefits of genotype classes. Alternatively, continuous genotype values can be used for association analysis in higher polyploids. We associated continuous genotypes to three different traits and compared the results to the output of the genotype caller SuperMASSA. Linear, Bayesian and partial least squares regression were applied, to determine if the use of continuous genotypes is limited to a specific method. A disease, a flowering and a growth trait with h (2) of 0.51, 0.78 and 0.91 were associated with a hexaploid chrysanthemum genotypes. The data set consisted of 55,825 probes and 228 samples. We were able to detect associating probes using continuous genotypes for multiple traits, using different regression methods. The identified probe sets were overlapping, but not identical between the methods. Baysian regression was the most restrictive method, resulting in ten probes for one trait and none for the others. Linear and partial least squares regression led to numerous associating probes. Association based on genotype classes resulted in similar values, but missed several significant probes. A simulation study was used to successfully validate the number of associating markers. Association of various phenotypic traits with continuous genotypes is successful with both uni- and multivariate regression methods. Genotype calling does not improve the association and shows no advantages in this study. Instead, use of continuous genotypes simplifies the analysis, saves computational time and results more potential markers.

Development of internalizing problems from adolescence to emerging adulthood: Accounting for heterotypic continuity with vertical scaling.

PubMed

Petersen, Isaac T; Lindhiem, Oliver; LeBeau, Brandon; Bates, John E; Pettit, Gregory S; Lansford, Jennifer E; Dodge, Kenneth A

2018-03-01

Manifestations of internalizing problems, such as specific symptoms of anxiety and depression, can change across development, even if individuals show strong continuity in rank-order levels of internalizing problems. This illustrates the concept of heterotypic continuity, and raises the question of whether common measures might be construct-valid for one age but not another. This study examines mean-level changes in internalizing problems across a long span of development at the same time as accounting for heterotypic continuity by using age-appropriate, changing measures. Internalizing problems from age 14-24 were studied longitudinally in a community sample (N = 585), using Achenbach's Youth Self-Report (YSR) and Young Adult Self-Report (YASR). Heterotypic continuity was evaluated with an item response theory (IRT) approach to vertical scaling, linking different measures over time to be on the same scale, as well as with a Thurstone scaling approach. With vertical scaling, internalizing problems peaked in mid-to-late adolescence and showed a group-level decrease from adolescence to early adulthood, a change that would not have been seen with the approach of using only age-common items. Individuals' trajectories were sometimes different than would have been seen with the common-items approach. Findings support the importance of considering heterotypic continuity when examining development and vertical scaling to account for heterotypic continuity with changing measures. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Continuous-time quantum random walks require discrete space

NASA Astrophysics Data System (ADS)

Manouchehri, K.; Wang, J. B.

2007-11-01

Quantum random walks are shown to have non-intuitive dynamics which makes them an attractive area of study for devising quantum algorithms for long-standing open problems as well as those arising in the field of quantum computing. In the case of continuous-time quantum random walks, such peculiar dynamics can arise from simple evolution operators closely resembling the quantum free-wave propagator. We investigate the divergence of quantum walk dynamics from the free-wave evolution and show that, in order for continuous-time quantum walks to display their characteristic propagation, the state space must be discrete. This behavior rules out many continuous quantum systems as possible candidates for implementing continuous-time quantum random walks.

Hypergeometric continuation of divergent perturbation series: II. Comparison with Shanks transformation and Padé approximation

NASA Astrophysics Data System (ADS)

Sanders, Sören; Holthaus, Martin

2017-11-01

We explore in detail how analytic continuation of divergent perturbation series by generalized hypergeometric functions is achieved in practice. Using the example of strong-coupling perturbation series provided by the two-dimensional Bose-Hubbard model, we compare hypergeometric continuation to Shanks and Padé techniques, and demonstrate that the former yields a powerful, efficient and reliable alternative for computing the phase diagram of the Mott insulator-to-superfluid transition. In contrast to Shanks transformations and Padé approximations, hypergeometric continuation also allows us to determine the exponents which characterize the divergence of correlation functions at the transition points. Therefore, hypergeometric continuation constitutes a promising tool for the study of quantum phase transitions.

Validation of the replica trick for simple models

NASA Astrophysics Data System (ADS)

Shinzato, Takashi

2018-04-01

We discuss the replica analytic continuation using several simple models in order to prove mathematically the validity of the replica analysis, which is used in a wide range of fields related to large-scale complex systems. While replica analysis consists of two analytical techniques—the replica trick (or replica analytic continuation) and the thermodynamical limit (and/or order parameter expansion)—we focus our study on replica analytic continuation, which is the mathematical basis of the replica trick. We apply replica analysis to solve a variety of analytical models, and examine the properties of replica analytic continuation. Based on the positive results for these models we propose that replica analytic continuation is a robust procedure in replica analysis.

Comparison of the Effects of Intermittent Boluses to Simple Continuous Infusion on Patients' Global Perceived Effect in Intrathecal Therapy for Pain: A Randomized Double-Blind Crossover Study.

PubMed

Eldabe, Sam; Duarte, Rui V; Madzinga, Grace; Batterham, Alan M; Brookes, Morag E; Gulve, Ashish P; Perruchoud, Christophe; Raphael, Jon H; Lorenzana, David; Buchser, Eric

2017-05-01

Intrathecal drug delivery (ITDD) is commonly used for intractable pain management. A paucity of good-quality studies in chronic noncancer patients and concerns over increased dosages have focused interest on different modes of administration. The aim of this international multicenter randomized double-blind crossover trial was to compare the efficacy of the same daily dose of drugs administered by intermittent boluses vs simple continuous infusion. Eligible patients implanted with a programmable ITDD device were randomized to receive two weeks of either intermittent boluses or a simple continuous flow in period 1, followed by a crossover to the alternative mode of administration. The primary outcome measure was the Patients' Global Impression of Change (PGIC) scale. The mean proportion of positive responders (at least "minimally improved") was 38.4% in the continuous condition vs 37.3% in the bolus (difference in proportions = 1.1%, 95% confidence interval [CI] = -21.8-24.0%, P  = 0.93). The mean PGIC in the continuous condition was 3.8 vs 3.9 in the bolus (mean difference = -0.1, -0.6-0.4, P  = 0.72). Exploratory analyses revealed a tendency for the mean proportion of positive responders to be higher at low vs high flow rates for both bolus and continuous administrations. Two patients were withdrawn from the study due to adverse events during the bolus phase, both with symptoms of increased pain, and one patient with additional symptoms of numbness and urinary retention. The mean PGIC and proportion of positive responders was not substantially different after intermittent bolus vs continuous administration. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Pharmacokinetics and Pharmacodynamics of Piperacillin-Tazobactam in 42 Patients Treated with Concomitant CRRT

PubMed Central

Bauer, Seth R.; Salem, Charbel; Connor, Michael J.; Groszek, Joseph; Taylor, Maria E.; Wei, Peilin; Tolwani, Ashita J.

2012-01-01

Summary Background and objectives Current recommendations for piperacillin-tazobactam dosing in patients receiving continuous renal replacement therapy originate from studies with relatively few patients and lower continuous renal replacement therapy doses than commonly used today. This study measured the pharmacokinetic and pharmacodynamic characteristics of piperacillin-tazobactam in patients treated with continuous renal replacement therapy using contemporary equipment and prescriptions. Design, setting, participants, & measurements A multicenter prospective observational study in the intensive care units of two academic medical centers was performed, enrolling patients with AKI or ESRD receiving piperacillin-tazobactam while being treated with continuous renal replacement therapy. Pregnant women, children, and patients with end stage liver disease were excluded from enrollment. Plasma and continuous renal replacement therapy effluent samples were analyzed for piperacillin and tazobactam levels using HPLC. Pharmacokinetic and pharmacodynamic parameters were calculated using standard equations. Multivariate analyses were used to examine the association of patient and continuous renal replacement therapy characteristics with piperacillin pharmacokinetic parameters. Results Forty-two of fifty-five subjects enrolled had complete sampling. Volume of distribution (median=0.38 L/kg, intraquartile range=0.20 L/kg) and elimination rate constants (median=0.104 h−1, intraquartile range=0.052 h−1) were highly variable, and clinical parameters could explain only a small fraction of the large variability in pharmacokinetic parameters. Probability of target attainment for piperacillin was 83% for total drug but only 77% when the unbound fraction was considered. Conclusions There is significant patient to patient variability in pharmacokinetic/pharmacodynamic parameters in patients receiving continuous renal replacement therapy. Many patients did not achieve pharmacodynamic targets, suggesting that therapeutic drug monitoring might optimize therapy. PMID:22282479

Il problema della scelta e della continuita della lingua straniera nella scuola dell'obbligo (Problems of Choice and Continuity of a Foreign Language in Elementary and Junior High School).

ERIC Educational Resources Information Center

Gotti, Maurizio

1987-01-01

Discusses two current problems with foreign language study in Italy: (1) Students are frequently unable to study English, the most popular language, because of a lack of qualified English teachers; and (2) Students sometimes cannot continue studying in junior high school the language they began in elementary school. (CFM)

An Analysis of Factor Extraction Strategies: A Comparison of the Relative Strengths of Principal Axis, Ordinary Least Squares, and Maximum Likelihood in Research Contexts That Include Both Categorical and Continuous Variables

ERIC Educational Resources Information Center

Coughlin, Kevin B.

2013-01-01

This study is intended to provide researchers with empirically derived guidelines for conducting factor analytic studies in research contexts that include dichotomous and continuous levels of measurement. This study is based on the hypotheses that ordinary least squares (OLS) factor analysis will yield more accurate parameter estimates than…

Pharmacy claims data versus patient self-report to measure contraceptive method continuation.

PubMed

Triebwasser, Jourdan E; Higgins, Stephanie; Secura, Gina M; Zhao, Qiuhong; Peipert, Jeffrey F

2015-07-01

To compare self-reported 12-month continuation of oral contraceptive pills (OCPs), patch, and ring versus continuation by pharmacy claims data. Women in the Contraceptive CHOICE Project who chose OCPs, the patch, or the ring as their initial method were included. Continuation was assessed by periodic telephone survey and by obtaining prescription claims data. Continuation was defined as no gap of more than 30 days. Kaplan-Meier survival functions were used to estimate continuation rates and cumulative unintended pregnancy rates. Kappa statistic assessed the level of agreement between self-report and claims data. We analyzed 1510 women who initiated use by 3 months and provided information on discontinuation. Of OCP users, 59% continued their method at 12 months by self-report versus 38% by pharmacy claims. Patch and ring users had self-reported/pharmacy continuation of 45%/28% and 57%/37%, respectively. Kappa coefficients and their 95% confidence intervals between the two measurements were 0.46 (0.40, 0.52), 0.54 (0.39, 0.68), and 0.54 (0.47, 0.61) for OCP, patch, and ring, respectively. Among women who self-reported continuation, unintended pregnancy rates were 0.4% in those who continued by pharmacy claims versus 4.9% in those who discontinued according to claims data. Contraceptive continuation rates differ by self-report versus pharmacy claims with women overestimating their continuation by self-report. This article directly compares contraception continuation rates by self-report and by pharmacy claims data. The study suggests that previously reported continuation rates from survey data overestimate specific method use. Copyright © 2015 Elsevier Inc. All rights reserved.

Associations of work and health-related characteristics with intention to continue working after the age of 65 years.

PubMed

ten Have, Margreet; van Dorsselaer, Saskia; de Graaf, Ron

2015-02-01

This study examines the association of work and health-related characteristics with the intention to continue working after the age of 65 years. Data were from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative population survey, including 1854 employees aged 45-64 years; 29.0% reported the intention to continue working after 65 years. Lower education, more adverse psychosocial working conditions and any physical disorder were negatively associated with this intention. Mental disorders were not associated. These findings highlight the importance of favourable working conditions and good physical health in relation to employees' intention to continue working after 65 years. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Predicting continuance-findings from a longitudinal study of older adults using an eHealth newsletter.

PubMed

Forquer, Heather A; Christensen, John L; Tan, Andy S L

2014-01-01

While eHealth technologies are promisingly efficient and widespread, theoretical frameworks capable of predicting long-term use, termed continuance, are lacking. Attempts to extend prominent information technology (IT) theories to the area of eHealth have been limited by small sample sizes, cross-sectional designs, self-reported as opposed to actual use measures, and a focus on technology adoption rather than continuance. To address these gaps in the literature, this analysis includes empirical evidence of actual use of an eHealth technology over the course of one year. This large (n = 4,570) longitudinal study focuses on older adults, a population with many health needs and among whom eHealth use may be particularly important. With three measurement points over the course of a year, this study examined the effects of utilitarian and hedonic beliefs on the continued use of an eHealth newsletter using constructs from IT adoption and continuance theories. Additional analyses compared the relative strength of intentions compared to earlier use in predicting later use. Usage intention was strongly predicted by both hedonic beliefs and utilitarian beliefs. In addition, utilitarian beliefs had both direct effects on intention and indirect effects, mediated by hedonic beliefs. While intention predicted subsequent use, earlier use was a significantly stronger predictor of use than intention. These findings make a theoretical contribution to an emerging literature by shedding light on the complex interplay of reasoned action and automaticity in the context of eHealth continuance.

A new device for administration of continuous positive airway pressure in preterm infants: comparison with a standard nasal CPAP continuous positive airway pressure system.

PubMed

Trevisanuto, Daniele; Grazzina, Nicoletta; Doglioni, Nicoletta; Ferrarese, Paola; Marzari, Francesco; Zanardo, Vincenzo

2005-06-01

We compared the effectiveness of a new continuous positive airway pressure (CPAP) device (neonatal helmet CPAP) with a conventional nasal CPAP system in preterm neonates needing continuous distending pressure. Randomized, physiological, cross-over study in a tertiary referral, neonatal intensive care unit in a university teaching hospital. Twenty very low birth weight infants with a postnatal age greater than 24 h who were receiving nasal CPAP for apnea and/or mild respiratory distress were enrolled. CPAP delivered by neonatal helmet CPAP and nasal CPAP in random order for two subsequent 90-min periods. Were continuously measured the Neonatal Infant Pain Scale (NIPS) score, oxygen requirements, respiratory rate, heart rate, oxygen saturation, transcutaneous PO(2) (tcPO(2)) and PCO(2) (tcPCO(2)), blood pressure, and desaturations. NIPS scores were significantly lower when the infants were on the neonatal helmet CPAP than when they were on nasal CPAP (0.26+/-0.07 vs. 0.63+/-0.12). The other studied parameters did not differ between the two CPAP modes. The number of desaturations was reduced during the neonatal helmet CPAP treatment (18 vs. 32), although this difference was not significant. In this short-term physiological study the neonatal helmet CPAP appears to be as good as the golden standard for managing preterm infants needing continuous distending pressure, with enhanced tolerability. Further evaluation in a randomized clinical trial is needed to confirm these findings.

A randomized controlled trial of subantimicrobial-dose doxycycline to prevent unscheduled bleeding with continuous oral contraceptive pill use☆

PubMed Central

Kaneshiro, Bliss; Edelman, Alison; Carlson, Nichole E.; Nichols, Mark; Forbes, Marci Messerle; Jensen, Jeffrey

2016-01-01

Background Unscheduled bleeding is the main side effect of continuous oral contraceptive pills (OCPs) and has been correlated with the up-regulation of matrix metalloprotineases (MMPs). The study objective was to determine if prophylactic administration of doxycycline (an MMP inhibitor at low subantimicrobial doses) would prevent unscheduled bleeding during the initiation of a continuous OCP. Study Design Subjects using cyclic hormonal contraceptives (combined OCPs, patch or ring) without unscheduled bleeding were switched to continuous OCPs (20 mcg ethinyl estradiol/100 mcg levonorgestrel). They were randomized to receive daily doxycycline [sustained-release subantimicrobial dose (40 mg daily)] or placebo for the first 84 days and then observed for an additional 28 days on the continuous OCP alone. The number of bleeding/spotting days and the time in days it took to achieve amenorrhea were compared using a t test. Results Sixty-five subjects were randomized. Although the use of doxycycline did not significantly decrease the number of mean bleeding/spotting days in the first 84 days of the study [doxycycline 14.75 (SE 2.30), placebo 17.78 (2.31), p=.36], women who received doxycycline had a significantly earlier onset of amenorrhea [mean last day of bleeding/spotting doxycycline 61.7 (7.7), placebo 85.2 (6.7), p=.03]. Conclusion The coadministration of subantimicrobial-dose doxycycline during initiation of continuous OCPs results in a significant reduction in the length of time needed to achieve amenorrhea. PMID:22067758

Teachers in Continuation High Schools--Attributes of New Teachers and Veteran Teachers in Urban Continuation High Schools

ERIC Educational Resources Information Center

Obiamalu, Reginald

2013-01-01

The purpose of study was to examine the attributes of teachers of urban continuation high schools in Los Angeles Unified School District. The research questions were: 1. What are the attributes of veteran teachers and new teachers as prepared to teach at-risk students in alternative high schools? and 2. How do alternative high school teachers…

The Moderating Role of Self-Regulated Learning in Job Characteristics and Attitudes towards Web-Based Continuing Learning in the Airlines Workplace

ERIC Educational Resources Information Center

Lin, Xiao-fan; Liang, Jyh-Chong; Tsai, Chin-Chung; Hu, Qintai

2018-01-01

With the increasing importance of adult and continuing education, the present study aimed to examine the factors that influence continuing web-based learning at work. Three questionnaires were utilised to investigate the association of the job characteristics from Karasek et al.'s (1998) job demand-control-support model and the self-regulated…

Continuity or Discontinuity? Scientific Governance in the Pre-History of the 1977 Law of Higher Education and Research in Sweden

ERIC Educational Resources Information Center

Bragesjo, Fredrik; Elzinga, Aant; Kasperowski, Dick

2012-01-01

The objective of this paper is to balance two major conceptual tendencies in science policy studies, continuity and discontinuity theory. While the latter argue for fundamental and distinct changes in science policy in the late 20th century, continuity theorists show how changes do occur but not as abrupt and fundamental as discontinuity theorists…

The Mediating Roles of Internal Context Variables in the Relationship between Distributed Leadership Perceptions and Continuous Change Behaviours of Public School Teachers

ERIC Educational Resources Information Center

Kondakci, Yasar; Zayim, Merve; Beycioglu, Kadir; Sincar, Mehmet; Ugurlu, Celal T

2016-01-01

This study aims at building a theoretical base for continuous change in education and using this base to test the mediating roles of two key contextual variables, knowledge sharing and trust, in the relationship between the distributed leadership perceptions and continuous change behaviours of teachers. Data were collected from 687 public school…

Survey of Interest for Continuing Education among Registered Nurses in the Northwest Suburbs. Volume XVII, No. 8.

ERIC Educational Resources Information Center

Wisner, Patricia; And Others

In 1988, a study was conducted at William Rainey Harper College (WRHC) to assess the needs of registered nurses in the college's service district for continuing education courses, seminars, and workshops. A survey was mailed to 6,228 registered nurses to determine their awareness of and/or past participation in WRHC's continuing education program,…

COBI (COntinuous hyperosmolar therapy for traumatic Brain-Injured patients) trial protocol: a multicentre randomised open-label trial with blinded adjudication of primary outcome.

PubMed

Roquilly, Antoine; Lasocki, Sigismond; Moyer, Jean Denis; Huet, Olivier; Perrigault, Pierre François; Dahyot-Fizelier, Claire; Seguin, Philippe; Sharshar, Tarek; Geeraerts, Thomas; Remerand, Francis; Feuillet, Fanny; Asehnoune, Karim

2017-09-24

Traumatic brain injury (TBI) is a major cause of death and severe prolonged disability. Intracranial hypertension (ICH) is a critical risk factor of bad outcomes after TBI. Continuous infusion of hyperosmolar therapy has been proposed for the prevention and the treatment of ICH. Whether an early administration of continuous hyperosmolar therapy improves long-term outcomes of patients with TBI is uncertain. The aim of the COBI study (number clinicaltrial.gov 03143751, pre-results stage) is to assess the efficiency and the safety of continuous hyperosmolar therapy in patients with TBI. The COBI (COntinuous hyperosmolar therapy in traumatic Brain-Injured patients) trial is a multicentre, randomised, controlled, open-label, two-arms study with blinded adjudication of primary outcome. Three hundred and seventy patients hospitalised in intensive care unit with a TBI (Glasgow Coma Scale ≤12 and abnormal brain CT scan) are randomised in the first 24 hours following trauma to standard care or continuous hyperosmolar therapy (20% NaCl) plus standard care. Continuous hyperosmolar therapy is maintained for at least 48 hours in the treatment group and continued for as long as is necessary to prevent ICH. The primary outcome is the score on the Extended Glasgow Outcome Scale at 6 months. The treatment effect is estimated with ordinal logistic regression adjusted for prespecified prognostic factors and expressed as a common OR. The COBI trial protocol has been approved by the ethics committee of Paris Ile de France VIII and will be carried out according to the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals. The COBI trial is the first randomised controlled trial powered to investigate whether continuous hyperosmolar therapy in patients with TBI improve long-term recovery. Trial registration number is NCT03143751. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Relational continuity with primary and secondary care doctors: a qualitative study of perceptions of users of the Catalan national health system.

PubMed

Waibel, Sina; Vargas, Ingrid; Coderch, Jordi; Vázquez, María-Luisa

2018-04-10

In the current context of increasingly fragmented healthcare systems where patients are seen by multiple doctors in different settings, patients' relational continuity with one doctor is regaining relevance; however little is known about relational continuity with specialists. The aim of this study is to explore perceptions of relational continuity with primary care and secondary care doctors, its influencing factors and consequences from the viewpoint of users of the Catalan national health system (Spain). We conducted a descriptive-interpretative qualitative study using a two-stage theoretical sample; (i) contexts: three healthcare areas in the Catalan national health system with differing characteristics; (ii) informants: users 18 years or older attended to at both care levels. Sample size (n = 49) was reached by saturation. Data were collected by individual semi-structured interviews, which were audio recorded and transcribed. A thematic content analysis was carried out segmenting data by study area, and leaving room for new categories to emerge from the data. Patients across the areas studied generally experienced consistency of primary care doctors (PCD), alongside some inconsistency of specialists. Consistency of specialists did not seem to be relevant to some patients when their clinical information was shared and used. Patients who experienced consistency and frequent visits with the same PCD or specialist described and valued having established an ongoing relationship characterised by personal trust and mutual accumulated knowledge. Identified consequences were diverse and included, for example, facilitated diagnosis or improved patient-doctor communication. The ascription to a PCD, a health system-related factor, facilitated relational continuity with the PCD, whereas organizational factors (for instance, the size of the primary care centre) favoured consistency of PCD and specialists. Doctor-related factors (for example, high technical competence or commitment to patient care) particulary fostered the development of an ongoing relationship. Consistency of doctors differs depending on the care level as does the relevance attributed to it. Most influencing factors can be applied to both care levels and might be addressed by healthcare managers to foster relational continuity. More research is needed to fully understand the relevance patients assign to relational continuity with specialists.

Knowledge and Attitude of Secondary School Teachers towards Continuous Assessment Practices in Esan Central Senatorial District of Edo State

ERIC Educational Resources Information Center

Alufohai, P. J.; Akinlosotu, T. N.

2016-01-01

The study investigated knowledge and attitude of secondary school teachers towards continuous assessment (CA) practices in Edo Central Senatorial District, Nigeria. The study was undertaken to determine the influence of gender, age, years of experience and area of educational specialization on teachers' attitude towards CA practices in secondary…

Sharing, Trading, Stealing: Exploring the Role of Peers in Shaping Foods Available at Lunchtime

ERIC Educational Resources Information Center

Sutter, Carolyn; Nishina, Adrienne; Scherr, Rachel E.; Zidenberg-Cherr, Sheri; Ontai, Lenna L.

2016-01-01

Childhood obesity continues to be a major concern in the United States, warranting a comprehensive approach. However, the majority of research studies continue to neglect the influence of peers on dietary behaviors. The present descriptive study aimed to provide information about the ways peers directly shape dietary choices via food exchanges…

LABORATORY AND FIELD EVALUATION OF INSTRUMENTATION FOR THE SEMI-CONTINUOUS DETERMINATION OF PARTICULATE NITRATE (AND OTHER WATER-SOLUBLE PARTICULATE COMPOUNDS)

EPA Science Inventory

Studies conducted at the EPA facility in Research Triangle Park, NC and at a field study in Southern California have demonstrated the capability for the semi-continuous determination of particulate nitrate (and other water soluble ionic species). Two instruments, a R&P 8400N par...

Using Reflective Learning to Improve the Impact of Continuing Education in the Context of Work Rehabilitation

ERIC Educational Resources Information Center

Vachon, Brigitte; Durand, Marie-Jose; LeBlanc, Jeannette

2010-01-01

Reflective learning has been described as a promising approach for ameliorating the impact of continuing education (CE) programs. However, there are still very few studies that have investigated how occupational therapists use reflection to improve the integration of CE program content in their decision-making processes. The study objectives were…

Continuing Professional Development - Why Bother? Perceptions and Motivations of Teachers in Ireland

ERIC Educational Resources Information Center

McMillan, Dorothy J.; McConnell, Barbara; O'Sullivan, Helen

2016-01-01

In a larger study carried out by O'Sullivan "et al." to explore the perceptions and experiences of teachers in the Republic of Ireland and Northern Ireland who were engaged in continuing professional development (CPD), one of the significant findings to emerge was the key role of teacher motivation. The current study therefore focuses on…

University Continuing Education as Teamwork--Three Case Studies

ERIC Educational Resources Information Center

Sandberg, Håkan

2004-01-01

Previous work has identified a lack of focused research in the field of team working in university continuing education (UCE). However, teamwork could be seen as self-evident in UCE, in part because UCE is of interest to employees, employers, universities and society. The aim of this study is to "describe" teamwork in UCE at three…

Continuous Flash Suppression: Stimulus Fractionation rather than Integration.

PubMed

Moors, Pieter; Hesselmann, Guido; Wagemans, Johan; van Ee, Raymond

2017-10-01

Recent studies using continuous flash suppression suggest that invisible stimuli are processed as integrated, semantic entities. We challenge the viability of this account, given recent findings on the neural basis of interocular suppression and replication failures of high-profile CFS studies. We conclude that CFS reveals stimulus fractionation in visual cortex. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of Continuous Assessment on Learning Outcomes on Two Chemical Engineering Courses: Case Study

ERIC Educational Resources Information Center

Tuunila, R.; Pulkkinen, M.

2015-01-01

In this paper, the effect of continuous assessment on the learning outcomes of two chemical engineering courses is studied over a several-year period. Average grades and passing percentages of courses after the final examination are reported and also student feedback on the courses is collected. The results indicate significantly better learning…

Prompting Children to Reason Proportionally: Processing Discrete Units as Continuous Amounts

ERIC Educational Resources Information Center

Boyer, Ty W.; Levine, Susan C.

2015-01-01

Recent studies reveal that children can solve proportional reasoning problems presented with continuous amounts that enable intuitive strategies by around 6 years of age but have difficulties with problems presented with discrete units that tend to elicit explicit count-and-match strategies until at least 10 years of age. The current study tests…

A Descriptive Study of Mandatory Continuing Professional Education in an Emerging Field: A Prospectus on the Counseling Profession. Executive Summary.

ERIC Educational Resources Information Center

Sattem, Linda Lee

A study analyzed the continuing professional education (CPE) requirements, practices, policies, evaluation measures, and perception of impact on practice and participants in the counseling profession. Research was conducted in 22 states with at least 5 years experience with their counselor licensing legislation requiring CPE. Other states were…

Continuity in Literacy Achievements from Kindergarten to First Grade: A Longitudinal Study of Arabic-Speaking Children

ERIC Educational Resources Information Center

Hassunah Arafat, Safieh; Korat, Ofra; Aram, Dorit; Saiegh-Haddad, Elinor

2017-01-01

The study addressed the question of continuity in literacy achievements from kindergarten to first grade among Arabic-speaking children in Israel. We examined (1) how age and family socio-economic status (SES) predict children's literacy skills in kindergarten and (2) how age, SES, and early literacy skills in kindergarten predict literacy…

Recruiting and Retaining African American Students for Gifted Education and Accelerated Programs in Middle School: A Qualitative Case Study

ERIC Educational Resources Information Center

Roberson, Ivory S.

2017-01-01

Recruiting and retaining African American students in middle school gifted education continues to be challenging in American schools. African American students continue to be underrepresented in middle school gifted education and accelerated programs, even when they qualify to be gifted education participants. The case study that follows focuses…

LABORATORY AND FIELD EVALUATION OF INSTRUMENTATION FOR THE SEMI-CONTINUOUS DETERMINATION OF PARTICULATE NITRATE (AND OTHER WATER-SOLUBLE PARTICULATE COMPONENTS)

EPA Science Inventory

Studies conducted at the EPA facility in Research Triangle Park, NC and at a field study in Southern California have demonstrated the capability for the semi-continuous determination of particulate nitrate (and other water soluble ionic species). Two instruments, a R&P 8400N pa...

Effects of Continuing Professional Development on Group Work Practices in Scottish Primary Schools

ERIC Educational Resources Information Center

Thurston, A.; Christie, D.; Howe, C. J.; Tolmie, A.; Topping, K. J.

2008-01-01

The present study investigated the effects of a continuing professional development (CPD) initiative that provided collaborative group work skills training for primary school teachers. The study collected data from 24 primary school classrooms in different schools in a variety of urban and rural settings. The sample was composed of 332 pupils,…

Alcohol and the College Freshman: "Binge" Drinking and Associated Problems. A Report.

ERIC Educational Resources Information Center

Wechsler, Henry; Isaac, Nancy

This study concerning the continued heavy drinking rate among Massachusetts college students sought to: (1) determine the specific changes in college drinking since a similar study on the topic was done in 1977; (2) determine the types of problems experienced by heavy drinkers; and (3) search for factors which might account for the continuation of…

Developing Specifications for Waste Glass, Municipal Waste Combustor Ash and Waste Tires as Highway Fill Materials (Continuation): Final Report. Volume 1. Municipal Waste Combustor Ash.

DOT National Transportation Integrated Search

1995-04-01

A two year study was conducted as a continuation project for the Florida Department of Transportation (FDOT) to evlauate Municipal Waste Combustor (MWC) ash, Waste Glass, and Waste Tires for use as general highway fill. Initial studies conducted at F...

The Implementations and Challenges of Continuous Assessment in Public Universities of Eastern Ethiopia

ERIC Educational Resources Information Center

Abera, Gemechu; Kedir, Muhammed; Beyabeyin, Maeregu

2017-01-01

The study was aimed to investigate the implementations and challenges of continuous assessment in selected Public Universities of Eastern Ethiopia. Descriptive survey research design was employed to carry out this study because it is used to describe the characteristics of a given population in a systematic and accurate fashion. Stratified random…

Teachers' Continuing Professional Development as Correlates of Sustainable Universal Basic Education in Bayelsa State, Nigeria

ERIC Educational Resources Information Center

Iyunade, Olufunmilayo T.

2017-01-01

The study examined the correlates of teachers' continuing professional development on universal basic education in Bayelsa State, Nigeria. Using descriptive survey, a sample of 500 teachers was randomly selected from twenty (20) Basic Junior Secondary Schools and Primary Schools used for the study. The instrument used for data collection was a…

Assessment of forest fragmentation in southern New England using remote sensing and geographic information systems technology

USGS Publications Warehouse

Vogelmann, James E.

1995-01-01

Spatial patterns and rates of forest fragmentation were assessed using digital remote sensing data for a region in southern New England that included 157 townships in southern New Hampshire and northeastern Massachusetts. The study area has undergone marked population increases over the last several decades. Following classification of 1973 and 1988 Landsat Multispectral Scanner data into forest and nonforest classes, data were incorporated into a geographic information system. The natural logarithms of forest area to perimeter ratios, referred to as the forest continuity index, were used to assess patterns and trends of forest fragmentation across the region Forest continuity index values were extracted from each township for both data sets and compared with population data. Forest continuity index values were found to decrease with increasing population density until about 200 persons per square kilometer, after which the relationship stabilized. With slight population increases at low densities forest continuity index values declined sharply, implying abrupt increases in forest fragmentation. Results from the study indicated good negative correlations (r2 values of 0.81 and 0.77) between the Multispectral Scanner-derived forest continuity index and natural logs of township population density. Socioeconomic indicators such as affluence and commuting patterns did not appear to correlate well with forest fragmentation estimates. Decreases in forest continuity index values occurred throughout much of the study region between 1973 and 1988, suggesting that forest fragmentation is occurring over large regions within the eastern United States. It is technologically feasible to assess patterns and rates of forest fragmentation across much larger areas than analyzed in this study; such analyses would provide useful overviews enabling objective assessment of the magnitude of forest fragmentation.

Cost Effectiveness of Implantable Cardiac Monitor-Guided Intermittent Anticoagulation for Atrial Fibrillation: An Analysis of the REACT.COM Pilot Study.

PubMed

Steinhaus, Daniel A; Zimetbaum, Peter J; Passman, Rod S; Leong-Sit, Peter; Reynolds, Matthew R

2016-08-30

Anticoagulation guidelines for patients with atrial fibrillation (AF) disregard AF burden. A strategy of targeted anticoagulation with novel oral anticoagulants (NOACs) based on continuous rhythm assessment with an implantable cardiac monitor (ICM) has recently been explored. We evaluated the potential cost-effectiveness of this strategy versus projected outcomes with continuous anticoagulation. We developed a Markov model using data from the Rhythm Evaluation for AntiCoagulaTion With COntinuous Monitoring (REACT.COM) pilot study (N = 59) and prior NOAC trials to calculate the costs and quality-adjusted life years (QALYs) associated with ICM-guided intermittent anticoagulation for AF versus standard care during a 3-year time horizon. Health state utilities were estimated from the pilot study population using the SF-12. Costs were based on current Medicare reimbursement. Over 14 ± 4 months of follow-up, 18 of 59 patients had 35 AF episodes. The ICM-guided strategy resulted in a 94% reduction in anticoagulant use relative to continuous treatment. There were no strokes, 3 (5.1%) TIAs, 2 major bleeding events (on aspirin) and 3 minor bleeding events with the ICM-guided strategy. The projected total 3-year costs were $12,535 for the ICM-guided strategy versus $13,340 for continuous anticoagulation. Projected QALYs were 2.45 for both groups. Based on a pilot study, a strategy of ICM-guided anticoagulation with NOACs may be cost-saving relative to expected outcomes with continuous anticoagulation, with similar quality-adjusted survival. This strategy could be attractive from a health economic perspective if shown to be safe and effective in a rigorous clinical trial. © 2016 Wiley Periodicals, Inc.

Cost Effectiveness of Implantable Cardiac Monitor-Guided Intermittent Anticoagulation for Atrial Fibrillation: An Analysis of the REACT.COM Pilot Study

PubMed Central

Steinhaus, Daniel A; Zimetbaum, Peter J; Passman, Rod S; Leong-Sit, Peter; Reynolds, Matthew R.

2016-01-01

Introduction Anticoagulation guidelines for patients with atrial fibrillation (AF) disregard AF burden. A strategy of targeted anticoagulation with novel oral anticoagulants (NOACs) based on continuous rhythm assessment with an implantable cardiac monitor (ICM) has recently been explored. We evaluated the potential cost-effectiveness of this strategy versus projected outcomes with continuous anticoagulation. Methods and Results We developed a Markov model using data from the Rhythm Evaluation for AntiCoagulaTion With COntinuous Monitoring (REACT.COM) pilot study (N=59) and prior NOAC trials to calculate the costs and quality-adjusted life years (QALYs) associated with ICM-guided intermittent anticoagulation for AF vs. standard care over a 3-year time horizon. Health state utilities were estimated from the pilot study population using the SF-12. Costs were based on current Medicare reimbursement. Over 14±4 months of follow-up 18 of 59 patients had 35 AF episodes. The ICM-guided strategy resulted in a 94% reduction in anticoagulant use relative to continuous treatment. There were no strokes, 3 (5.1%) TIAs, 2 major bleeding events (on aspirin) and 3 minor bleeding events with the ICM-guided strategy. The projected total 3-year costs were $12,535 for the ICM-guided strategy vs. $13,340 for continuous anticoagulation. Projected QALYs were 2.45 for both groups. Conclusion Based on a pilot study, a strategy of ICM-guided anticoagulation with NOACs may be cost-saving relative to expected outcomes with continuous anticoagulation, with similar quality-adjusted survival. This strategy could be attractive from a health economic perspective if shown to be safe and effective in a rigorous clinical trial. PMID:27571718

Continuous decline in mortality from coronary heart disease in Japan despite a continuous and marked rise in total cholesterol: Japanese experience after the Seven Countries Study.

PubMed

Sekikawa, Akira; Miyamoto, Yoshihiro; Miura, Katsuyuki; Nishimura, Kunihiro; Willcox, Bradley J; Masaki, Kamal H; Rodriguez, Beatriz; Tracy, Russell P; Okamura, Tomonori; Kuller, Lewis H

2015-10-01

The Seven Countries Study in the 1960s showed very low mortality from coronary heart disease (CHD) in Japan, which was attributed to very low levels of total cholesterol. Studies of migrant Japanese to the USA in the 1970s documented increase in CHD rates, thus CHD mortality in Japan was expected to increase as their lifestyle became Westernized, yet CHD mortality has continued to decline since 1970. This study describes trends in CHD mortality and its risk factors since 1980 in Japan, contrasting those in other selected developed countries. We selected Australia, Canada, France, Japan, Spain, Sweden, the UK and the USA. CHD mortality between 1980 and 2007 was obtained from WHO Statistical Information System. National data on traditional risk factors during the same period were obtained from literature and national surveys. Age-adjusted CHD mortality continuously declined between 1980 and 2007 in all these countries. The decline was accompanied by a constant fall in total cholesterol except Japan where total cholesterol continuously rose. In the birth cohort of individuals currently aged 50-69 years, levels of total cholesterol have been higher in Japan than in the USA, yet CHD mortality in Japan remained the lowest: >67% lower in men and > 75% lower in women compared with the USA. The direction and magnitude of changes in other risk factors were generally similar between Japan and the other countries. Decline in CHD mortality despite a continuous rise in total cholesterol is unique. The observation may suggest some protective factors unique to Japanese. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Effectiveness of Anti-Dementia Drugs in Extremely Severe Alzheimer's Disease: A 12-Week, Multicenter, Randomized, Single-Blind Study.

PubMed

Hong, Yun Jeong; Choi, Seong Hye; Jeong, Jee Hyang; Park, Kyung Won; Na, Hae Ri

2018-01-01

There is insufficient evidence to guide decisions concerning how long anti-dementia drug (ADD) regimens should be maintained in severe Alzheimer's disease (AD). We investigated whether patients with extremely severe AD who were already receiving donepezil or memantine benefited from continuing treatment. In this randomized and rater-blinded trial, 65 AD patients with a Mini-Mental State Examination score from 0 to 5 and a score of 6c or worse on Functional Assessment Staging were randomly assigned to an ADD-continuation group (N = 30) or an ADD-discontinuation group (N = 35). The current use of donepezil or memantine was maintained for 12 weeks in the ADD-continuation group and was discontinued after baseline in the ADD-discontinuation group. Efficacy measures were obtained at baseline and 12 weeks. The primary efficacy variable was the change from baseline to the end of the study in Baylor Profound Mental State Examination (BPMSE) scores. The change in the BPMSE from baseline to the end of the study in the ADD-continuation group (a 0.4-point improvement) was not equivalent to that in the ADD-discontinuation group (a 0.5-point decline), as determined by two one-sided tests of equivalence. Study withdrawals due to adverse events (11.4% versus 6.7%) were more frequent in the ADD-discontinuation group than in the ADD-continuation group. Continued treatment with donepezil or memantine seems unequal and might be superior to withdrawal of the drugs in terms of the effects on global cognition in patients with extremely severe AD. Current Controlled Trials number: KCT0000874 (CRIS).

A continuous glucose monitoring and problem-solving intervention to change physical activity behavior in women with type 2 diabetes: a pilot study.

PubMed

Allen, Nancy; Whittemore, Robin; Melkus, Gail

2011-11-01

Diabetes technology has the potential to provide useful data for theory-based behavioral counseling. The aims of this study are to evaluate the feasibility, acceptability, and preliminary efficacy of a continuous glucose monitoring and problem-solving counseling intervention to change physical activity (PA) behavior in women with type 2 diabetes. Women (n=29) with type 2 diabetes were randomly assigned to one of two treatment conditions: continuous glucose counseling and problem-solving skills or continuous glucose monitoring counseling and general diabetes education. Feasibility data were obtained on intervention dose, implementation, and satisfaction. Preliminary efficacy data were collected at baseline and 12 weeks on the following measures: PA amount and intensity, diet, problem-solving skills, self-efficacy for PA, depression, hemogoloin A1c, weight, and blood pressure. Demographic and implementation variables were described using frequency distributions and summary statistics. Satisfaction data were analyzed using Wilcoxon rank. Differences between groups were analyzed using linear mixed-modeling. Women were mostly white/non-Latina with a mean age of 53 years, a 6.5-year history of diabetes, and suboptimal glycemic control. Continuous glucose monitoring plus problem-solving group participants had significantly greater problem-solving skills and had greater, although not statistically significant, dietary adherence, moderate activity minutes, weight loss, and higher intervention satisfaction pre- to post-intervention than did participants in the continuous glucose monitoring plus education group. A continuous glucose monitoring plus problem-solving intervention was feasible and acceptable, and participants had greater problem-solving skills than continuous glucose monitoring plus education group participants.

Discontinuities between maternity and child and family health services: health professional’s perceptions

PubMed Central

2014-01-01

Background Continuity in the context of healthcare refers to the perception of the client that care has been connected and coherent over time. For over a decade professionals providing maternity and child and family health (CFH) services in Australia and internationally have emphasised the importance of continuity of care for women, families and children. However, continuity across maternity and CFH services remains elusive. Continuity is defined and implemented in different ways, resulting in fragmentation of care particularly at points of transition from one service or professional to another. This paper examines the concept of continuity across the maternity and CFH service continuum from the perspectives of midwifery, CFH nursing, general practitioner (GP) and practice nurse (PN) professional leaders. Methods Data were collected as part of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (CHoRUS study). Representatives from the four participating professional groups were consulted via discussion groups, focus groups and e-conversations, which were recorded and transcribed. In total, 132 professionals participated, including 45 midwives, 60 CFH nurses, 15 general practitioners and 12 practice nurses. Transcripts were analysed using a thematic approach. Results ‘Continuity’ was used and applied differently within and across groups. Aspects of care most valued by professionals included continuity preferably characterised by the development of a relationship with the family (relational continuity) and good communication (informational continuity). When considering managerial continuity we found professionals’ were most concerned with co-ordination of care within their own service, rather than focusing on the co-ordination between services. Conclusion These findings add new perspectives to understanding continuity within the maternity and CFH services continuum of care. All health professionals consulted were committed to a smooth journey for families along the continuum. Commitment to collaboration is required if service gaps are to be addressed particularly at the point of transition of care between services which was found to be particularly problematic. PMID:24387686

Effects of long-term continuous cropping on soil nematode community and soil condition associated with replant problem in strawberry habitat.

PubMed

Li, Xingyue; Lewis, Edwin E; Liu, Qizhi; Li, Heqin; Bai, Chunqi; Wang, Yuzhu

2016-08-10

Continuous cropping changes soil physiochemical parameters, enzymes and microorganism communities, causing "replant problem" in strawberry cultivation. We hypothesized that soil nematode community would reflect the changes in soil conditions caused by long-term continuous cropping, in ways that are consistent and predictable. To test this hypothesis, we studied the soil nematode communities and several soil parameters, including the concentration of soil phenolic acids, organic matter and nitrogen levels, in strawberry greenhouse under continuous-cropping for five different durations. Soil pH significantly decreased, and four phenolic acids, i.e., p-hydroxybenzoic acid, ferulic acid, cinnamic acid and p-coumaric acid, accumulated with time under continuous cropping. The four phenolic acids were highly toxic to Acrobeloides spp., the eudominant genus in non-continuous cropping, causing it to reduce to a resident genus after seven-years of continuous cropping. Decreased nematode diversity indicated loss of ecosystem stability and sustainability because of continuous-cropping practice. Moreover, the dominant decomposition pathway was altered from bacterial to fungal under continuous cropping. Our results suggest that along with the continuous-cropping time in strawberry habitat, the soil food web is disturbed, and the available plant nutrition as well as the general health of the soil deteriorates; these changes can be indicated by soil nematode community.

Orodispersible films: Product transfer from lab-scale to continuous manufacturing.

PubMed

Thabet, Yasmin; Breitkreutz, Joerg

2018-01-15

Orodispersible films have been described as new beneficial dosage forms for special patient populations. Due to various production settings, different requirements on film formulations are required for non- continuous and continuous manufacturing. In this study, a continuous coating machine was qualified in regards of the process conditions for film compositions and their effects on the formed films. To investigate differences between both manufacturing processes, various film formulations of hydrochlorothiazide and hydroxypropylcellulose (HPC) or hydroxypropylmethycellulose (HPMC) as film formers were produced and the resulting films were characterized. The qualification of the continuously operating coating machine reveals no uniform heat distribution during drying. Coating solutions for continuous manufacturing should provide at least a dynamic viscosity of 1 Pa*s (wet film thickness of 500 μm, velocity of 15.9 cm/min). HPC films contain higher residuals of ethanol or acetone in bench-scale than in continuous production mode. Continuous production lead to lower drug content of the films. All continuously produced films disintegrate within less than 30 s. There are observed significant effects of the production process on the film characteristics. When transferring film manufacturing from lab-scale to continuous mode, film compositions, processing conditions and suitable characterization methods have to be carefully selected and adopted. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of long-term continuous cropping on soil nematode community and soil condition associated with replant problem in strawberry habitat

NASA Astrophysics Data System (ADS)

Li, Xingyue; Lewis, Edwin E.; Liu, Qizhi; Li, Heqin; Bai, Chunqi; Wang, Yuzhu

2016-08-01

Continuous cropping changes soil physiochemical parameters, enzymes and microorganism communities, causing “replant problem” in strawberry cultivation. We hypothesized that soil nematode community would reflect the changes in soil conditions caused by long-term continuous cropping, in ways that are consistent and predictable. To test this hypothesis, we studied the soil nematode communities and several soil parameters, including the concentration of soil phenolic acids, organic matter and nitrogen levels, in strawberry greenhouse under continuous-cropping for five different durations. Soil pH significantly decreased, and four phenolic acids, i.e., p-hydroxybenzoic acid, ferulic acid, cinnamic acid and p-coumaric acid, accumulated with time under continuous cropping. The four phenolic acids were highly toxic to Acrobeloides spp., the eudominant genus in non-continuous cropping, causing it to reduce to a resident genus after seven-years of continuous cropping. Decreased nematode diversity indicated loss of ecosystem stability and sustainability because of continuous-cropping practice. Moreover, the dominant decomposition pathway was altered from bacterial to fungal under continuous cropping. Our results suggest that along with the continuous-cropping time in strawberry habitat, the soil food web is disturbed, and the available plant nutrition as well as the general health of the soil deteriorates; these changes can be indicated by soil nematode community.

Midwife-led continuity models versus other models of care for childbearing women.

PubMed

Sandall, Jane; Soltani, Hora; Gates, Simon; Shennan, Andrew; Devane, Declan

2016-04-28

Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. To compare midwife-led continuity models of care with other models of care for childbearing women and their infants. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (25 January 2016) and reference lists of retrieved studies. All published and unpublished trials in which pregnant women are randomly allocated to midwife-led continuity models of care or other models of care during pregnancy and birth. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach. We included 15 trials involving 17,674 women. We assessed the quality of the trial evidence for all primary outcomes (i.e. regional analgesia (epidural/spinal), caesarean birth, instrumental vaginal birth (forceps/vacuum), spontaneous vaginal birth, intact perineum, preterm birth (less than 37 weeks) and all fetal loss before and after 24 weeks plus neonatal death using the GRADE methodology: all primary outcomes were graded as of high quality.For the primary outcomes, women who had midwife-led continuity models of care were less likely to experience regional analgesia (average risk ratio (RR) 0.85, 95% confidence interval (CI) 0.78 to 0.92; participants = 17,674; studies = 14; high quality), instrumental vaginal birth (average RR 0.90, 95% CI 0.83 to 0.97; participants = 17,501; studies = 13; high quality), preterm birth less than 37 weeks (average RR 0.76, 95% CI 0.64 to 0.91; participants = 13,238; studies = eight; high quality) and less all fetal loss before and after 24 weeks plus neonatal death (average RR 0.84, 95% CI 0.71 to 0.99; participants = 17,561; studies = 13; high quality evidence). Women who had midwife-led continuity models of care were more likely to experience spontaneous vaginal birth (average RR 1.05, 95% CI 1.03 to 1.07; participants = 16,687; studies = 12; high quality). There were no differences between groups for caesarean births or intact perineum.For the secondary outcomes, women who had midwife-led continuity models of care were less likely to experience amniotomy (average RR 0.80, 95% CI 0.66 to 0.98; participants = 3253; studies = four), episiotomy (average RR 0.84, 95% CI 0.77 to 0.92; participants = 17,674; studies = 14) and fetal loss less than 24 weeks and neonatal death (average RR 0.81, 95% CI 0.67 to 0.98; participants = 15,645; studies = 11). Women who had midwife-led continuity models of care were more likely to experience no intrapartum analgesia/anaesthesia (average RR 1.21, 95% CI 1.06 to 1.37; participants = 10,499; studies = seven), have a longer mean length of labour (hours) (mean difference (MD) 0.50, 95% CI 0.27 to 0.74; participants = 3328; studies = three) and more likely to be attended at birth by a known midwife (average RR 7.04, 95% CI 4.48 to 11.08; participants = 6917; studies = seven). There were no differences between groups for fetal loss equal to/after 24 weeks and neonatal death, induction of labour, antenatal hospitalisation, antepartum haemorrhage, augmentation/artificial oxytocin during labour, opiate analgesia, perineal laceration requiring suturing, postpartum haemorrhage, breastfeeding initiation, low birthweight infant, five-minute Apgar score less than or equal to seven, neonatal convulsions, admission of infant to special care or neonatal intensive care unit(s) or in mean length of neonatal hospital stay (days).Due to a lack of consistency in measuring women's satisfaction and assessing the cost of various maternity models, these outcomes were reported narratively. The majority of included studies reported a higher rate of maternal satisfaction in midwife-led continuity models of care. Similarly, there was a trend towards a cost-saving effect for midwife-led continuity care compared to other care models. This review suggests that women who received midwife-led continuity models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable adverse outcomes for women or their infants than women who received other models of care.Further research is needed to explore findings of fewer preterm births and fewer fetal deaths less than 24 weeks, and all fetal loss/neonatal death associated with midwife-led continuity models of care.

Midwife-led continuity models versus other models of care for childbearing women.

PubMed

Sandall, Jane; Soltani, Hora; Gates, Simon; Shennan, Andrew; Devane, Declan

2015-09-15

Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. To compare midwife-led continuity models of care with other models of care for childbearing women and their infants. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies. All published and unpublished trials in which pregnant women are randomly allocated to midwife-led continuity models of care or other models of care during pregnancy and birth. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included 15 trials involving 17,674 women. We assessed the quality of the trial evidence for all primary outcomes (i.e., regional analgesia (epidural/spinal), caesarean birth, instrumental vaginal birth (forceps/vacuum), spontaneous vaginal birth, intact perineum, preterm birth (less than 37 weeks) and overall fetal loss and neonatal death (fetal loss was assessed by gestation using 24 weeks as the cut-off for viability in many countries) using the GRADE methodology: All primary outcomes were graded as of high quality.For the primary outcomes, women who had midwife-led continuity models of care were less likely to experience regional analgesia (average risk ratio (RR) 0.85, 95% confidence interval (CI) 0.78 to 0.92; participants = 17,674; studies = 14; high quality), instrumental vaginal birth (average RR 0.90, 95% CI 0.83 to 0.97; participants = 17,501; studies = 13; high quality), preterm birth less than 37 weeks (average RR 0.76, 95% CI 0.64 to 0.91; participants = 13,238; studies = 8; high quality) and less overall fetal/neonatal death (average RR 0.84, 95% CI 0.71 to 0.99; participants = 17,561; studies = 13; high quality evidence). Women who had midwife-led continuity models of care were more likely to experience spontaneous vaginal birth (average RR 1.05, 95% CI 1.03 to 1.07; participants = 16,687; studies = 12; high quality). There were no differences between groups for caesarean births or intact perineum.For the secondary outcomes, women who had midwife-led continuity models of care were less likely to experience amniotomy (average RR 0.80, 95% CI 0.66 to 0.98; participants = 3253; studies = 4), episiotomy (average RR 0.84, 95% CI 0.77 to 0.92; participants = 17,674; studies = 14) and fetal loss/neonatal death before 24 weeks (average RR 0.81, 95% CI 0.67 to 0.98; participants = 15,645; studies = 11). Women who had midwife-led continuity models of care were more likely to experience no intrapartum analgesia/anaesthesia (average RR 1.21, 95% CI 1.06 to 1.37; participants = 10,499; studies = 7), have a longer mean length of labour (hours) (mean difference (MD) 0.50, 95% CI 0.27 to 0.74; participants = 3328; studies = 3) and more likely to be attended at birth by a known midwife (average RR 7.04, 95% CI 4.48 to 11.08; participants = 6917; studies = 7). There were no differences between groups for fetal loss or neonatal death more than or equal to 24 weeks, induction of labour, antenatal hospitalisation, antepartum haemorrhage, augmentation/artificial oxytocin during labour, opiate analgesia, perineal laceration requiring suturing, postpartum haemorrhage, breastfeeding initiation, low birthweight infant, five-minute Apgar score less than or equal to seven, neonatal convulsions, admission of infant to special care or neonatal intensive care unit(s) or in mean length of neonatal hospital stay (days).Due to a lack of consistency in measuring women's satisfaction and assessing the cost of various maternity models, these outcomes were reported narratively. The majority of included studies reported a higher rate of maternal satisfaction in midwife-led continuity models of care. Similarly, there was a trend towards a cost-saving effect for midwife-led continuity care compared to other care models. This review suggests that women who received midwife-led continuity models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable adverse outcomes for women or their infants than women who received other models of care.Further research is needed to explore findings of fewer preterm births and fewer fetal deaths less than 24 weeks, and overall fetal loss/neonatal death associated with midwife-led continuity models of care.

Is the comprehension of idiomatic sentences indeed impaired in paranoid Schizophrenia? A window into semantic processing deficits

PubMed Central

Pesciarelli, Francesca; Gamberoni, Tania; Ferlazzo, Fabio; Lo Russo, Leo; Pedrazzi, Francesca; Melati, Ermanno; Cacciari, Cristina

2014-01-01

Schizophrenia patients have been reported to be more impaired in comprehending non-literal than literal language since early studies on proverbs. Preference for literal rather than figurative interpretations continues to be documented. The main aim of this study was to establish whether patients are indeed able to use combinatorial semantic processing to comprehend literal sentences and both combinatorial analysis, and retrieval of pre-stored meanings to comprehend idiomatic sentences. The study employed a sentence continuation task in which subjects were asked to decide whether a target word was a sensible continuation of a previous sentence fragment to investigate idiomatic and literal sentence comprehension in patients with paranoid schizophrenia. Patients and healthy controls were faster in accepting sensible continuations than in rejecting non-sensible ones in both literal and idiomatic sentences. Patients were as accurate as controls in comprehending literal and idiomatic sentences, but they were overall slower than controls in all conditions. Once the contribution of cognitive covariates was partialled out, the response times (RTs) to sensible idiomatic continuations of patients did not significantly differ from those of controls. This suggests that the state of residual schizophrenia did not contribute to slower processing of sensible idioms above and beyond the cognitive deficits that are typically associated with schizophrenia. PMID:25346676

Quality in rehabilitation after a working age person has sustained a fracture: partnership contributes to continuity.

PubMed

Lindahl, Marianne; Hvalsoe, Berit; Poulsen, Jeppe Rosengaard; Langberg, Henning

2013-01-01

Research in quality of rehabilitation has mostly concerned patients with chronic diseases, but the aim of the present study was to investigate what constitutes good quality in rehabilitation after a person has sustained a fracture at working age, from both patients' and therapists' perspectives. Seven patients with bone fracture, aged 32-60 years, and 23 occupational therapists and physiotherapists from hospitals, municipalities and private practices in Denmark. Qualitative study with in-depth semi-structured interviews. Data were analyzed according to grounded theory method. Partnership was a central theme that was constituted by continuity of rehabilitation and therapists' use of a patient-centred approach. Patients' experiences of continuity of rehabilitation was supported, not only by organizational factors, but depended also on values constituting the patient-centred approach. Therapists used their professional network to refine the transition process from hospital into the community, but there was no co-operation between departments in the municipalities about patients' return to work. The study suggests that patients with acute injuries need partnership, respect, and understanding through the rehabilitation course. Personal relations were important for continuity of rehabilitation (i.e. that organizational quality depended more on therapists' efforts to promote continuity for the patient than organizational tools).

Map of assessed continuous (unconventional) oil resources in the United States, 2014

USGS Publications Warehouse

,; Biewick, Laura R. H.

2015-01-01

The U.S. Geological Survey (USGS) conducts quantitative assessments of potential oil and gas resources of the onshore United States and associated coastal State waters. Since 2000, the USGS has completed assessments of continuous (unconventional) resources in the United States based on geologic studies and analysis of well-production data and has compiled digital maps of the assessment units classified into four categories: shale gas, tight gas, coalbed gas, and shale oil or tight oil (continuous oil). This is the fourth digital map product in a series of USGS unconventional oil and gas resource maps; its focus being shale-oil or tight-oil (continuous-oil) assessments. The map plate included in this report can be printed in hardcopy form or downloaded in a Geographic Information System (GIS) data package, which includes an ArcGIS ArcMap document (.mxd), geodatabase (.gdb), and a published map file (.pmf). Supporting geologic studies of total petroleum systems and assessment units, as well as studies of the methodology used in the assessment of continuous-oil resources in the United States, are listed with hyperlinks in table 1. Assessment results and geologic reports are available at the USGS websitehttp://energy.usgs.gov/OilGas/AssessmentsData/NationalOilGasAssessment.aspx.

The Impact of Continuity Editing in Narrative Film on Event Segmentation

PubMed Central

Magliano, Joseph P.; Zacks, Jeffrey M.

2011-01-01

Filmmakers use continuity editing to engender a sense of situational continuity or discontinuity at editing boundaries. The goal of this study was to assess the impact of continuity editing on how people perceive the structure of events in a narrative film and to identify brain networks that are associated with the processing of different types of continuity editing boundaries. Participants viewed a commercially produced film and segmented it into meaningful events while brain activity was recorded with functional MRI. We identified three degrees of continuity that can occur at editing locations: edits that are continuous in space, time, and action; edits that are discontinuous in space or time but continuous in action; and edits that are discontinuous in action as well as space or time. Discontinuities in action had the biggest impact on behavioral event segmentation and discontinuities in space and time had minor effects. Edits were associated with large transient increases in early visual areas. Spatial-temporal changes and action changes produced strikingly different patterns of transient change, and provided evidence that specialized mechanisms in higher-order perceptual processing regions are engaged to maintain continuity of action in the face of spatiotemporal discontinuities. These results suggest that commercial film editing is shaped to support the comprehension of meaningful events that bridge breaks in low-level visual continuity, and even breaks in continuity of spatial and temporal location. PMID:21972849

Developing Continuing Professional Education in the Health and Medical Professions through Collaboration

ERIC Educational Resources Information Center

Tisdell, Elizabeth J.; Wojnar, Margaret; Sinz, Elizabeth

2016-01-01

This chapter focuses on how to negotiate power and interest among multiple stakeholders to develop continuing professional education programs as graduate study for those in the health and medical professions.

Analysing the external supply chain risk driver competitiveness: a risk mitigation framework and business continuity plan.

PubMed

Blos, Mauricio F; Wee, Hui-Ming; Yang, Joshua

2010-11-01

Innovation challenges for handling supply chain risks have become one of the most important drivers in business competitiveness and differentiation. This study analyses competitiveness at the external supply chain level as a driver of risks and provides a framework for mitigating these risks. The mitigation framework, also called the supply chain continuity framework, provides insight into six stages of the business continuity planning (BCP) process life cycle (risk mitigation management, business impact analysis, supply continuity strategy development, supply continuity plan development, supply continuity plan testing and supply continuity plan maintenance), together with the operational constructs: customer service, inventory management, flexibility, time to market, ordering cycle time and quality. The purpose of the BCP process life cycle and operational constructs working together is to emphasise the way in which a supply chain can deal with disruption risks and, consequently, bring competitive advantage. Future research will consider the new risk scenarios and analyse the consequences to promote the improvement of supply chain resilience.

Exploring family physicians' reasons to continue or discontinue providing intrapartum care: Qualitative descriptive study.

PubMed

Dove, Marion; Dogba, Maman Joyce; Rodríguez, Charo

2017-08-01

To examine the reasons why family physicians continue or discontinue providing intrapartum care in their clinical practice. Qualitative descriptive study. Two hospitals located in a multicultural area of Montreal, Que, in November 2011 to June 2012. Sixteen family physicians who were current or former providers of obstetric care. Data were collected using semistructured qualitative interviews. Thematic analysis was used to analyze the interview transcripts. Three overarching themes that help create understanding of why family doctors continue to provide obstetric care were identified: their attraction, often initiated by role models early in their careers, to practising complete continuity of care and accompanying patients in a special moment in their lives; the personal, family, and organizational pressures experienced while pursuing a family medicine career that includes obstetrics; and their ongoing reflection about continuing to practise obstetrics. The practice of obstetrics was very attractive to family physician participants whether they provided intrapartum care or decided to stop. More professional support and incentives might help keep family doctors practising obstetrics. Copyright© the College of Family Physicians of Canada.

Natural Length Scales Shape Liquid Phase Continuity in Unsaturated Flows

NASA Astrophysics Data System (ADS)

Assouline, S.; Lehmann, P. G.; Or, D.

2015-12-01

Unsaturated flows supporting soil evaporation and internal drainage play an important role in various hydrologic and climatic processes manifested at a wide range of scales. We study inherent natural length scales that govern these flow processes and constrain the spatial range of their representation by continuum models. These inherent length scales reflect interactions between intrinsic porous medium properties that affect liquid phase continuity, and the interplay among forces that drive and resist unsaturated flow. We have defined an intrinsic length scale for hydraulic continuity based on pore size distribution that controls soil evaporation dynamics (i.e., stage 1 to stage 2 transition). This simple metric may be used to delineate upper bounds for regional evaporative losses or the depth of soil-atmosphere interactions (in the absence of plants). A similar length scale governs the dynamics of internal redistribution towards attainment of field capacity, again through its effect on hydraulic continuity in the draining porous medium. The study provides a framework for guiding numerical and mathematical models for capillary flows across different scales considering the necessary conditions for coexistence of stationarity (REV), hydraulic continuity and intrinsic capillary gradients.

Design and Validation of In-Source Atmospheric Pressure Photoionization Hydrogen/Deuterium Exchange Mass Spectrometry with Continuous Feeding of D2O.

PubMed

Acter, Thamina; Lee, Seulgidaun; Cho, Eunji; Jung, Maeng-Joon; Kim, Sunghwan

2018-01-01

In this study, continuous in-source hydrogen/deuterium exchange (HDX) atmospheric pressure photoionization (APPI) mass spectrometry (MS) with continuous feeding of D 2 O was developed and validated. D 2 O was continuously fed using a capillary line placed on the center of a metal plate positioned between the UV lamp and nebulizer. The proposed system overcomes the limitations of previously reported APPI HDX-MS approaches where deuterated solvents were premixed with sample solutions before ionization. This is particularly important for APPI because solvent composition can greatly influence ionization efficiency as well as the solubility of analytes. The experimental parameters for APPI HDX-MS with continuous feeding of D 2 O were optimized, and the optimized conditions were applied for the analysis of nitrogen-, oxygen-, and sulfur-containing compounds. The developed method was also applied for the analysis of the polar fraction of a petroleum sample. Thus, the data presented in this study clearly show that the proposed HDX approach can serve as an effective analytical tool for the structural analysis of complex mixtures. Graphical abstract ᅟ.

[Successful management of neurosurgical procedures with continuous infusion of recombinant factor IX in a child with hemophilia B].

PubMed

Yamamoto, Mariko; Nakadate, Hisaya; Iguchi, Umefumi; Masuda, Hiroshi; Sakai, Hirokazu; Ishiguro, Akira

2013-03-01

This report describes the successful management of neurosurgical procedures with continuous infusion of recombinant factor IX (rFIX). A 1-year-old boy with severe hemophilia B was administered prophylactic therapy with rFIX after intracranial bleeding. We found the enlargement of an arachnoid cyst in a follow-up CT scan. He underwent marsupialization of the cyst under the continuous infusion of rFIX. FIX levels were examined in our hospital and the rFIX infusion rate was adjusted in an attempt to keep FIX levels above 90% intraoperatively, and 70% until his 7th post-operative day. We studied the pharmacokinetic profile of rFIX and found a half-time of 25 hours and mean in vivo recovery of 0.69 IU/dl/IU/kg. Reconstituted rFIX also retained at least 95% activity after 72 hours at room temperature. This is the first report of the perioperative management of a child undergoing a neurosurgical procedure under the continuous infusion of rFIX in Japan. Further studies are required before the routine use of this product for continuous infusion.

Developmental trajectories of marital happiness in continuously married individuals: a group-based modeling approach.

PubMed

Anderson, Jared R; Van Ryzin, Mark J; Doherty, William J

2010-10-01

Most contemporary studies of change in marital quality over time have used growth curve modeling to describe continuously declining mean curves. However, there is some evidence that different trajectories of marital quality exist for different subpopulations. Group-based trajectory modeling provides the opportunity to conduct an empirical investigation of the variance in marital quality trajectories. We applied this method to analyze data from continuously married individuals from the Marital Instability over the Life Course Study (N = 706). Instead of a single continuously declining trajectory of marital happiness, we found 5 distinct trajectories. Nearly two thirds of participants reported high and stable levels of happiness over time, and the other one third showed either a pattern of continuous low happiness, low happiness that subsequently declined, or a curvilinear pattern of high happiness, decline, and recovery. Marital problems, time spent in shared activities, and (to a lesser degree) economic hardship were able to distinguish trajectory group membership. Our results suggest that marital happiness may have multiple distinct trajectories across reasonably diverse populations. Implications for theory, research, and practice are discussed.

Migratory-stage sea lamprey Petromyzon marinus stop responding to conspecific damage-released alarm cues after 4 h of continuous exposure in laboratory conditions

USGS Publications Warehouse

Imre, Istvan; Di Rocco, Richard T.; McClure, Haley; Johnson, Nicholas; Brown, Grant E.

2016-01-01

This study investigated the length of avoidance response of migratory-stage sea lamprey Petromyzon marinus exposed continuously to conspecific damage-released alarm cues for varying lengths of time in laboratory stream channels. Ten replicate groups of P. marinus, separated by sex, were exposed to either deionized water control or to P. marinus extract for 0, 2 or 4 h continuously. Petromyzon marinus maintained their avoidance response to the conspecific damage-released alarm cue after continuous exposure to the alarm cue for 0 and 2 h but not 4 h. Beyond being one of the first studies in regards to sensory–olfactory adaptation–acclimation of fishes to alarm cues of any kind, these results have important implications for use of conspecific alarm cues in P. marinus control. For example, continuous application of conspecific alarm cue during the day, when P. marinus are inactive and hiding, may result in sensory adaptation to the odour by nightfall when they migrate upstream.

Using Visual Methods to Understand Physical Activity Maintenance following Cardiac Rehabilitation

PubMed Central

Hardcastle, Sarah J.

2015-01-01

Few studies have explored the factors associated with long-term maintenance of exercise following cardiac rehabilitation. The present study used auto-photography and interviews to explore the factors that influence motivation and continued participation in physical activity among post cardiac rehabilitation patients. Twenty-three semi-structured interviews were conducted alongside participant-selected photographs or drawings with participants that had continued participation in physical activity for at least two years following the cardiac rehabilitation programme. Participants were recruited from circuit training classes in East Sussex in the UK. Thematic content analysis revealed seven main themes: fear of death and ill health avoidance, critical incidents, overcoming aging, social influences, being able to enjoy life, provision of routine and structure, enjoyment and psychological well-being. Fear of death, illness avoidance, overcoming aging, and being able to enjoy life were powerful motives for continued participation in exercise. The social nature of the exercise class was also identified as a key facilitator of continued participation. Group-based exercise suited those that continued exercise participation post cardiac rehabilitation and fostered adherence. PMID:26381147

The perspectives of clinical staff and bereaved informal care-givers on the use of continuous sedation until death for cancer patients: The study protocol of the UNBIASED study

PubMed Central

2011-01-01

Background A significant minority of dying people experience refractory symptoms or extreme distress unresponsive to conventional therapies. In such circumstances, sedation may be used to decrease or remove consciousness until death occurs. This practice is described in a variety of ways, including: 'palliative sedation', 'terminal sedation', 'continuous deep sedation until death', 'proportionate sedation' or 'palliative sedation to unconsciousness'. Surveys show large unexplained variation in incidence of sedation at the end of life across countries and care settings and there are ethical concerns about the use, intentions, risks and significance of the practice in palliative care. There are also questions about how to explain international variation in the use of the practice. This protocol relates to the UNBIASED study (UK Netherlands Belgium International Sedation Study), which comprises three linked studies with separate funding sources in the UK, Belgium and the Netherlands. The aims of the study are to explore decision-making surrounding the application of continuous sedation until death in contemporary clinical practice, and to understand the experiences of clinical staff and decedents' informal care-givers of the use of continuous sedation until death and their perceptions of its contribution to the dying process. The UNBIASED study is part of the European Association for Palliative Care Research Network. Methods/Design To realize the study aims, a two-phase study has been designed. The study settings include: the domestic home, hospital and expert palliative care sites. Phase 1 consists of: a) focus groups with health care staff and bereaved informal care-givers; and b) a preliminary case notes review to study the range of sedation therapy provided at the end of life to cancer patients who died within a 12 week period. Phase 2 employs qualitative methods to develop 30 patient-centred case studies in each country. These involve interviews with staff and informal care-givers closely involved in the care of cancer patients who received continuous sedation until death. Discussion To our knowledge, this is one of the few studies which seek to take a qualitative perspective on clinical decision making surrounding the use of continuous sedation until death and the only one which includes the perspectives of nurses, physicians, as well as bereaved informal care-givers. It has several potential strengths, weaknesses, opportunities and threats associated with the specific design of the study, as well as with the sensitive nature of the topic and the different frameworks for ethical review in the participating countries. PMID:21375747

Comparison of Continuous Femoral Nerve Block with and Without Combined Sciatic Nerve Block after Total Hip Arthroplasty: A Prospective Randomized Study.

PubMed

Nishio, Shoji; Fukunishi, Shigeo; Fukui, Tomokazu; Fujihara, Yuki; Okahisa, Shohei; Takeda, Yu; Yoshiya, Shinichi

2017-06-23

In association with the growing interests in pain management, several modalities to control postoperative pain have been proposed and examined for the efficacy in the recent studies. Various modes of peripheral nerve block have been proposed and the effectiveness and safety have been examined for each of those techniques. We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after total hip arthroplasty (THA) procedure. In this study, we compared the effectiveness and safety of continuous femoral nerve block with and without sciatic nerve blockade on pain control after THA. Forty patients scheduled for THA were included in the study and randomly divided into 2 groups. Postoperative analgesic measure was continuous femoral nerve block alone, while the identical regimen of continuous femoral nerve block was combined with sciatic nerve block. The amount of postoperative pain was evaluated in the immediate postoperative period, 6 hours, and 12 hours after surgery. Moreover, postoperative complications as well as requirement of supplemental analgesics during the initial 12 hours after surgery were reviewed in the patient record. The obtained study results showed that the supplemental sciatic nerve blockade provided no significant effect on arrival at the postoperative recovery room, while the NRS pain score was significantly reduced by the combined application of sciatic nerve blockade at 6 and 12 hours after surgery. In the investigation of postoperative analgesiarelated complications, no major complication was encountered without significant difference in complication rate between the groups.

Conversion to IUI versus continuance with IVF in low responder patients: A systematic review.

PubMed

Fujii, Dennis T; Quesnell, Jodi L; Heitmann, Ryan J

2018-06-01

Poor response to ovarian hyper-stimulation can be difficult to predict prior to stimulation even when factoring in patient age and ovarian reserve testing. When faced with the situation of poor response, patients and providers have the difficult decision to proceed with oocyte retrieval, convert to intrauterine insemination (IUI), or cancel the cycle. Although this is not an uncommon scenario, there is little data available to assist with the counseling of these patients. We performed a systematic review of published studies comparing clinical pregnancy and live births between those patients continuing with in-vitro fertilization (IVF) and those converting to IUI. PubMed and Ovid were searched for all retrospective and randomized studies using the Keywords 'in-vitro fertilization', 'intrauterine insemination', 'poor responders', 'clinical pregnancy' and 'live birth rates'. A total of seven retrospective studies and one randomized control trial were reviewed. When evaluating poor responders as a group, six studies reported higher overall clinical pregnancy rates and five studies reported overall increased live birth rates with continuance of IVF. When stratified by the number of follicles produced, continuance of IVF demonstrated higher clinical pregnancy and live birth rates with ≥ 2 follicles. When only one follicle developed there were no significant differences in clinical pregnancy or live birth rates between the two groups. In patients undergoing IVF with ≤4 follicles, continuance with IVF may lead to higher clinical pregnancy and live birth compared to conversion to IUI except in patients with monofollicular development, although additional randomized controlled trials are needed to confirm these findings. Published by Elsevier B.V.

The juxtaposition of ageing and nursing: the challenges and enablers of continuing to work in the latter stages of a nursing career.

PubMed

Clendon, Jill; Walker, Léonie

2016-05-01

To identify why some nurses cope well with continuing to work as they age and others struggle. There is a need to understand better the challenges older nurses face and how they manage them. Secondary analysis of existing data. Data collected in two separate studies were analysed. The first study (2012) was an online, anonymous survey that collected free text (qualitative) and categorical data (n = 3273, 57·6% response rate). The second (2014) was an explorative, descriptive study that collected data through focus groups and interviews (n = 46). Qualitative data from both studies were analysed using David Thomas' () general inductive approach. Research Ethics Committee approval was gained for the 2012 and 2014 studies. Data were categorised in two themes: the challenges of ageing and nursing; and factors that enable nurses to continue to practice. Physical challenges, fatigue, guilt, ageism and demands to complete continuing education were considered challenges. Maintaining personal fitness, self care, flexible working and a strong belief in their ability to contribute to the profession were present in older nurses who continued to practice. While older nurses face growing physical and cognitive challenges as they age, they demonstrate strong resilience in the face of these challenges. It is recommended nurses seek support from their workplaces early to address challenges. Organisations must address ageism in the workplace and provide practical interventions such as supporting changes to work hours, shifting nurses to less physical roles and providing career planning to support resilience in older workers. © 2016 John Wiley & Sons Ltd.

Studies and Training in Continuing Education; A Directory of Residential Continuing Education Centers in the United States, Canada, and Abroad, 1967-68.

ERIC Educational Resources Information Center

Chicago Univ., IL.

This directory is a descriptive list of residential continuing education centers in the United States, Canada, and abroad which were known to be operating in 1968. They are distributed as follows: 117 in 37 states and the District of Columbia; 33 in Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Quebic, and Saskatchewan; one each in…

Is participation in research as an investigator an effective form of continuing medical education?

PubMed Central

Huas, D; Wallace, P

2000-01-01

Continuing medical education and research are a daily necessity for general practitioners (GPs). This study investigated the possibility that participation in research is an effective form of continuing medical education. Although there was an indication that some modification of GPs' knowledge and skills had occurred, it was not possible to conclude that this was entirely due to participation in research. PMID:11224971

Culture and Continuing Bonds: A Prospective Comparison of Bereavement in the United States and the People's Republic of China

ERIC Educational Resources Information Center

Lalande, Kathleen M.; Bonanno, George A.

2006-01-01

There has been an increased interest and debate regarding the adaptiveness of continuing bonds with the deceased. The authors used data from a cross-cultural study of 61 participants from the United States (US) and 58 participants from the People's Republic of China (PRC) who completed measures of continuing bonds and adjustment at 4 and 18 months…

Investigating repeatable ionospheric features during large space storms and superstorms

DTIC Science & Technology

2014-08-25

operated under continuous disturbance dynamo electric field effects. Thus, this storm offered the opportunity to study the impact of eastward PPEF on the...daytime Equatorial Ionization Anomaly (EIA) while the disturbance dynamo continued. The 25 September 1998 great storm (Dst = -220 nT) was a unique...as the prompt penetration electric field (PPEF) developed and operated under continuous disturbance dynamo electric field (DDEF) effects. Thus, this

Wireless Instrumentation Use on Launch Vehicles

NASA Technical Reports Server (NTRS)

Sherman, Aaron

2010-01-01

This slide presentation reviews the results of a study on the use of wireless instrumentation and sensors on future launch vehicles. The use of wireless technologies would if feasible would allow for fewer wires, and allow for more flexibility. However, it was generally concluded that wireless solutions are not currently ready to replace wired technologies for launch vehicles. The recommendations of the study were to continue to use wired sensors as the primary choice for vehicle instrumentation, and to continue to assess needs and use wireless instrumentation where appropriate. The future work includes support efforts for wireless technologies, and continue to monitor the development of wireless solutions.

Continuing Care in High Schools: A Descriptive Study of Recovery High School Programs

PubMed Central

Finch, Andrew J.; Moberg, D. Paul; Krupp, Amanda Lawton

2014-01-01

Data from 17 recovery high schools suggest programs are dynamic and vary in enrollment, fiscal stability, governance, staffing, and organizational structure. Schools struggle with enrollment, funding, lack of primary treatment accessibility, academic rigor, and institutional support. Still, for adolescents having received treatment for substance abuse, recovery schools appear to successfully function as continuing care providers reinforcing and sustaining therapeutic benefits gained from treatment. Small size and therapeutic programming allow for a potentially broader continuum of services than currently exists in most of the schools. Recovery schools thus provide a useful design for continuing care warranting further study and policy support. PMID:24591808

Extubation success in premature infants with respiratory distress syndrome treated with bi-level nasal continuous positive airway pressure versus nasal intermittent positive pressure ventilation.

PubMed

Thomas, Patricia E; LeFlore, Judy

2013-01-01

Infants born prematurely with respiratory distress syndrome are at high risk for complications from mechanical ventilation. Strategies are needed to minimize their days on the ventilator. The purpose of this study was to compare extubation success rates in infants treated with 2 different types of continuous positive airway pressure devices. A retrospective cohort study design was used. Data were retrieved from electronic medical records for patients in a large, metropolitan, level III neonatal intensive care unit. A sample of 194 premature infants with respiratory distress syndrome was selected, 124 of whom were treated with nasal intermittent positive pressure ventilation and 70 with bi-level variable flow nasal continuous positive airway pressure (bi-level nasal continuous positive airway pressure). Infants in both groups had high extubation success rates (79% of nasal intermittent positive pressure ventilation group and 77% of bi-level nasal continuous positive airway pressure group). Although infants in the bi-level nasal continuous positive airway pressure group were extubated sooner, there was no difference in duration of oxygen therapy between the 2 groups. Promoting early extubation and extubation success is a vital strategy to reduce complications of mechanical ventilation that adversely affect premature infants with respiratory distress syndrome.

Auditory training of speech recognition with interrupted and continuous noise maskers by children with hearing impairment

PubMed Central

Sullivan, Jessica R.; Thibodeau, Linda M.; Assmann, Peter F.

2013-01-01

Previous studies have indicated that individuals with normal hearing (NH) experience a perceptual advantage for speech recognition in interrupted noise compared to continuous noise. In contrast, adults with hearing impairment (HI) and younger children with NH receive a minimal benefit. The objective of this investigation was to assess whether auditory training in interrupted noise would improve speech recognition in noise for children with HI and perhaps enhance their utilization of glimpsing skills. A partially-repeated measures design was used to evaluate the effectiveness of seven 1-h sessions of auditory training in interrupted and continuous noise. Speech recognition scores in interrupted and continuous noise were obtained from pre-, post-, and 3 months post-training from 24 children with moderate-to-severe hearing loss. Children who participated in auditory training in interrupted noise demonstrated a significantly greater improvement in speech recognition compared to those who trained in continuous noise. Those who trained in interrupted noise demonstrated similar improvements in both noise conditions while those who trained in continuous noise only showed modest improvements in the interrupted noise condition. This study presents direct evidence that auditory training in interrupted noise can be beneficial in improving speech recognition in noise for children with HI. PMID:23297921

Phase I study of afatinib combined with nintedanib in patients with advanced solid tumours.

PubMed

Bahleda, Rastislav; Hollebecque, Antoine; Varga, Andrea; Gazzah, Anas; Massard, Christophe; Deutsch, Eric; Amellal, Nadia; Farace, Françoise; Ould-Kaci, Mahmoud; Roux, Flavien; Marzin, Kristell; Soria, Jean-Charles

2015-11-17

This Phase I study evaluated continuous- and intermittent-dosing (every other week) of afatinib plus nintedanib in patients with advanced solid tumours. In the dose-escalation phase (n=45), maximum tolerated doses (MTDs) were determined for continuous/intermittent afatinib 10, 20, 30 or 40 mg once daily plus continuous nintedanib 150 or 200 mg twice daily. Secondary objectives included safety and efficacy. Clinical activity of continuous afatinib plus nintedanib at the MTD was further evaluated in an expansion phase (n=25). The most frequent dose-limiting toxicities were diarrhoea (11%) and transaminase elevations (7%). Maximum tolerated doses were afatinib 30 mg continuously plus nintedanib 150 mg, and afatinib 40 mg intermittently plus nintedanib 150 mg. Treatment-related adverse events (mostly Grade⩽3) included diarrhoea (98%), asthenia (64%), nausea (62%) and vomiting (60%). In the dose-escalation phase, two patients had partial responses (PRs) and 27 (60%) had stable disease (SD). In the expansion phase, one complete response and three PRs were observed (all non-small cell lung cancer), with SD in 13 (52%) patients. No pharmacokinetic interactions were observed. MTDs of continuous or intermittent afatinib plus nintedanib demonstrated a manageable safety profile with proactive management of diarrhoea. Antitumour activity was observed in patients with solid tumours.

Ergodic Transition in a Simple Model of the Continuous Double Auction

PubMed Central

Radivojević, Tijana; Anselmi, Jonatha; Scalas, Enrico

2014-01-01

We study a phenomenological model for the continuous double auction, whose aggregate order process is equivalent to two independent queues. The continuous double auction defines a continuous-time random walk for trade prices. The conditions for ergodicity of the auction are derived and, as a consequence, three possible regimes in the behavior of prices and logarithmic returns are observed. In the ergodic regime, prices are unstable and one can observe a heteroskedastic behavior in the logarithmic returns. On the contrary, non-ergodicity triggers stability of prices, even if two different regimes can be seen. PMID:24558377

Ergodic transition in a simple model of the continuous double auction.

PubMed

Radivojević, Tijana; Anselmi, Jonatha; Scalas, Enrico

2014-01-01

We study a phenomenological model for the continuous double auction, whose aggregate order process is equivalent to two independent M/M/1 queues. The continuous double auction defines a continuous-time random walk for trade prices. The conditions for ergodicity of the auction are derived and, as a consequence, three possible regimes in the behavior of prices and logarithmic returns are observed. In the ergodic regime, prices are unstable and one can observe a heteroskedastic behavior in the logarithmic returns. On the contrary, non-ergodicity triggers stability of prices, even if two different regimes can be seen.

The Perceived Value of University-Based, Continuing Education Leadership Development Programs for Administrators in Higher Education: An Intangibles Model of Value Creation

ERIC Educational Resources Information Center

Stone, Geraldine Louise

2012-01-01

This study examined the perceived value of leadership development programs (LDPs) provided by continuing education for administrators in colleges and universities. Included in this study were questions about the perceived value of non-credit, credit, and blended (credit and non-credit) programs at the individual, institutional, and higher…

The syndrome of `continuous muscle-fibre activity' cured: further studies

PubMed Central

Isaacs, Hyam; Heffron, J. J. A.

1974-01-01

Two cases suffering from the syndrome of `continuous muscle-fibre activity' have been followed-up for 14 years. These patients have gradually gone into remission and no longer require therapy. The results of recent histology, histochemistry, and electronmicroscopy, as well as sural nerve biopsy studies, are presented. The sarcoplasmic reticulum calcium binding activity and ATPase activity are normal. Images PMID:4281819

Studying Fast Reactions: Construction and Use of a Low-Cost Continuous-Flow Instrument

ERIC Educational Resources Information Center

Bisson, Patrick J.; Whitten, James E.

2006-01-01

The construction and use of a low-cost continuous-flow instrument for measuring the kinetics of fast reaction which include the use of an light emitting diode light source, a photodiode-on-a-chip detector, and a position sensor is demonstrated. The instrument is suitable for the physical chemistry laboratory and could be used to study the kinetics…

Transition into and out of Special Education Services by Young Australian School Children between 2006 and 2010

ERIC Educational Resources Information Center

Dempsey, Ian

2014-01-01

The extent to which school students continue to receive special education services over time is largely unknown because longitudinal studies are rare in this area. The present study examined a large Australian longitudinal database to track the status of children who received special education support in 2006 and whether they continued to access…

Exploring Factors Affecting Students' Continued Wiki Use for Individual and Collaborative Learning: An Extended UTAUT Perspective

ERIC Educational Resources Information Center

Yueh, Hsiu-Ping; Huang, Jo-Yi; Chang, Chueh

2015-01-01

The purpose of this study was to investigate what factors affect students' adaptation and continued use of a Wiki system for collaborative writing tasks through an extension of the Unified Theory of Acceptance and Use of Technology (UTAUT). This study was conducted in a general education course in a university in northern Taiwan. Data were…

Long-Term Safety and Adverse Events of Risperidone in Children, Adolescents, and Adults with Pervasive Developmental Disorders

ERIC Educational Resources Information Center

Hellings, Jessica A.; Cardona, Alicia M.; Schroeder, Stephen R.

2010-01-01

The objective of this study was to examine long-term adverse events of risperidone in 19 children, adolescents, and adults with Pervasive Developmental Disorders and intellectual disability, continuing risperidone for a mean of 186.5 weeks, following a 46-week risperidone study. Nineteen individuals continued long-term follow-up after our…

Bridging the Gap: A Longitudinal Study of the Relationship between Pedagogical Continuity and Early Chinese Literacy Acquisition

ERIC Educational Resources Information Center

Li, Hui; Rao, Nirmala; Tse, Shek Kam

2011-01-01

This longitudinal study examined the relationship between pedagogical continuity in literacy education and early literacy development by comparing Chinese children in Hong Kong and Shenzhen. Stratified random sampling was used to select 24 preschool and Primary 1 classes in four communities catering to middle-class families in each city. The 24…

Protective Factors Interrupting the Continuity from School Bullying to Later Internalizing and Externalizing Problems: A Systematic Review of Prospective Longitudinal Studies

ERIC Educational Resources Information Center

Ttofi, Maria M.; Bowes, Lucy; Farrington, David P.; Lösel, Friedrich

2014-01-01

A systematic review is presented, based on prospective longitudinal studies, on protective factors that interrupt the continuity from bullying perpetration at school to externalizing problem behaviors later in life; and from bullying victimization to later internalizing problems. Some common factors were established, which seem to interrupt the…

A Multiple Regression Analysis of Factors Concerning Superintendent Longevity and Continuity Relative to Student Achievement

ERIC Educational Resources Information Center

Plotts, Timothy

2011-01-01

The purpose of this quantitative study was to examine the relationship between the length of superintendent tenure, longevity, and continuity relative to student achievement as evidenced by the 2008-2009 3rd Grade New Jersey Assessment of Skills and Knowledge (NJASK) in language arts. Achievement in the study was defined as those students who…

Student Perspectives on International Education: An Examination into the Decline of Japanese Studying Abroad

ERIC Educational Resources Information Center

Lassegard, James P.

2013-01-01

The number of students going abroad for study purposes continues to grow exponentially, even despite the global economic downturns of recent years. One exception is Japan, where the number of students going overseas has continued to decline since the mid-2000s. This paper first explores various explanations for the persistent decline in Japanese…

Design study of a continuously variable roller cone traction CVT for electric vehicles

NASA Technical Reports Server (NTRS)

Mccoin, D. K.; Walker, R. D.

1980-01-01

Continuously variable ratio transmissions (CVT) featuring cone and roller traction elements and computerized controls are studied. The CVT meets or exceeds all requirements set forth in the design criteria. Further, a scalability analysis indicates the basic concept is applicable to lower and higher power units, with upward scaling for increased power being more readily accomplished.

Unpacking the "Value Added" Impact of Continuing Professional Education: A Multi-Method Case Study Approach.

ERIC Educational Resources Information Center

Smith, Jo; Topping, Annie

2001-01-01

A study of 14 nurses who completed a children's neuroscience course found evidence of improved knowledge and increased ability to care for neurology patients. Although the direct impact of continuing education on patient care is difficult to assess, participants' assessment of their learning and its potential to affect patient care is a valid…

Continuous Practice-Based Research on the Use of Standardized Patients: Experience from Shanghai Medical College of Fudan University

ERIC Educational Resources Information Center

Zeng, Yong; Wu, Yan; Lai, Yanni; Lu, Yingqing; Zou, Hejian; Feng, Xueshan

2014-01-01

In the past ten years, the objective structured clinical examination (OSCE) project team of the Shanghai Medical College of Fudan University has continuously conducted further study on the development and maintenance of standardized patients and their application in teaching. The team carried out a series of randomized controlled studies on the…

Continuous control systems for non-contact ECG

NASA Astrophysics Data System (ADS)

Kodkin, Vladimir L.; Yakovleva, Galina V.; Smirnov, Alexey S.

2017-03-01

South Ural State University is still conducting the research work dedicated to innovations in biomedicine. Development of system for continuous control and diagnosis of the functional state in large groups of people is based on studies of non-contact ECG recording reported by the authors at the SPIE conference in 2016. The next stage of studies has been performed this year.

Toward continuous glucose monitoring with planar modified biosensors and microdialysis. Study of temperature, oxygen dependence and in vivo experiment.

PubMed

Ricci, Francesco; Caprio, Felice; Poscia, Alessandro; Valgimigli, Francesco; Messeri, Dimitri; Lepori, Elena; Dall'Oglio, Giorgio; Palleschi, Giuseppe; Moscone, Danila

2007-04-15

Glucose biosensors based on the use of planar screen-printed electrodes modified with an electrochemical mediator and with glucose oxidase have been optimised for their application in the continuous glucose monitoring in diabetic patients. A full study of their operative stability and temperature dependence has been accomplished, thus giving useful information for in vivo applications. The effect of dissolved oxygen concentration in the working solution was also studied in order to evaluate its effect on the linearity of the sensors. Glucose monitoring performed with serum samples was performed to evaluate the effect of matrix components on operative stability and demonstrated an efficient behaviour for 72 h of continuous monitoring. Finally, these studies led to a sensor capable of detecting glucose at concentrations as low as 0.04 mM and with a good linearity up to 2.0 mM (at 37 degrees C) with an operative stability of ca. 72 h, thus demonstrating the possible application of these sensors for continuous glucose monitoring in conjunction with a microdialysis probe. Moreover, preliminary in vivo experiments for ca. 20 h have demonstrated the feasibility of this system.

Internal Architecture of Meteorite Impact Crater at Bukit Bunuh, Lenggong – Perak, Malaysia Inferred from Upward Continuation of Magnetic Field Intensity Data

NASA Astrophysics Data System (ADS)

Muhammad, S. B.; Saad, R.; Saidin, M.; Yusoh, R.; Sabrian, T. A.; Samuel, Y. M.

2018-04-01

2–D upward continuation of magnetic field data acquired at Bukit Bunuh, Lenggong – Perak, Malaysia, with the objective to ascertain the impact crater and possible rebounds, has be carried out and interpreted in this study. Ground magnetic survey was conducted first as regional study in the entire area followed by a detailed study at the suspected crater region. Data from both studies were compiled, corrected and separated (regional – residual). The residual magnetic data ranged between -272 and +134.2 nT. 2–D upward continuation at various planes of observation was carried out on the gridded residual magnetic field data after coordinates were converted (from degrees to meters) to understate anomalies due to shallow features. The planes were at 250 m, 500 m and 750 m above the ground level. The continuation at 500 m revealed a low magnetic region, believed to be an impact crater, which is now filled with sediments, surrounded by a high magnetic shallow bedrock. Other high magnetic key features interpreted as rebounds (R) also remained after filtering out the ambiguous anomalies.

Web-based continuing medical education. (II): Evaluation study of computer-mediated continuing medical education.

PubMed

Curran, V R; Hoekman, T; Gulliver, W; Landells, I; Hatcher, L

2000-01-01

Over the years, various distance learning technologies and methods have been applied to the continuing medical education needs of rural and remote physicians. They have included audio teleconferencing, slow scan imaging, correspondence study, and compressed videoconferencing. The recent emergence and growth of Internet, World Wide Web (Web), and compact disk read-only-memory (CD-ROM) technologies have introduced new opportunities for providing continuing education to the rural medical practitioner. This evaluation study assessed the instructional effectiveness of a hybrid computer-mediated courseware delivery system on dermatologic office procedures. A hybrid delivery system merges Web documents, multimedia, computer-mediated communications, and CD-ROMs to enable self-paced instruction and collaborative learning. Using a modified pretest to post-test control group study design, several evaluative criteria (participant reaction, learning achievement, self-reported performance change, and instructional transactions) were assessed by various qualitative and quantitative data collection methods. This evaluation revealed that a hybrid computer-mediated courseware system was an effective means for increasing knowledge (p < .05) and improving self-reported competency (p < .05) in dermatologic office procedures, and that participants were very satisfied with the self-paced instruction and use of asynchronous computer conferencing for collaborative information sharing among colleagues.

Factors associated with the effectiveness of continuing education in long-term care.

PubMed

Stolee, Paul; Esbaugh, Jacquelin; Aylward, Sandra; Cathers, Tamzin; Harvey, David P; Hillier, Loretta M; Keat, Nancy; Feightner, John W

2005-06-01

This article examines factors within the long-term-care work environment that impact the effectiveness of continuing education. In Study 1, focus group interviews were conducted with staff and management from urban and rural long-term-care facilities in southwestern Ontario to identify their perceptions of the workplace factors that affect transfer of learning into practice. Thirty-five people were interviewed across six focus groups. In Study 2, a Delphi technique was used to refine our list of factors. Consensus was achieved in two survey rounds involving 30 and 27 participants, respectively. Management support was identified as the most important factor impacting the effectiveness of continuing education. Other factors included resources (staff, funding, space) and the need for ongoing expert support. Organizational support is necessary for continuing education programs to be effective and ongoing expert support is needed to enable and reinforce learning.

Continuous Metabolic Monitoring Based on Multi-Analyte Biomarkers to Predict Exhaustion

PubMed Central

Kastellorizios, Michail; Burgess, Diane J.

2015-01-01

This work introduces the concept of multi-analyte biomarkers for continuous metabolic monitoring. The importance of using more than one marker lies in the ability to obtain a holistic understanding of the metabolism. This is showcased for the detection and prediction of exhaustion during intense physical exercise. The findings presented here indicate that when glucose and lactate changes over time are combined into multi-analyte biomarkers, their monitoring trends are more sensitive in the subcutaneous tissue, an implantation-friendly peripheral tissue, compared to the blood. This unexpected observation was confirmed in normal as well as type 1 diabetic rats. This study was designed to be of direct value to continuous monitoring biosensor research, where single analytes are typically monitored. These findings can be implemented in new multi-analyte continuous monitoring technologies for more accurate insulin dosing, as well as for exhaustion prediction studies based on objective data rather than the subject’s perception. PMID:26028477

Continuous metabolic monitoring based on multi-analyte biomarkers to predict exhaustion.

PubMed

Kastellorizios, Michail; Burgess, Diane J

2015-06-01

This work introduces the concept of multi-analyte biomarkers for continuous metabolic monitoring. The importance of using more than one marker lies in the ability to obtain a holistic understanding of the metabolism. This is showcased for the detection and prediction of exhaustion during intense physical exercise. The findings presented here indicate that when glucose and lactate changes over time are combined into multi-analyte biomarkers, their monitoring trends are more sensitive in the subcutaneous tissue, an implantation-friendly peripheral tissue, compared to the blood. This unexpected observation was confirmed in normal as well as type 1 diabetic rats. This study was designed to be of direct value to continuous monitoring biosensor research, where single analytes are typically monitored. These findings can be implemented in new multi-analyte continuous monitoring technologies for more accurate insulin dosing, as well as for exhaustion prediction studies based on objective data rather than the subject's perception.

Study of continuous precipitation of ADU for the implantation in the pilot installation at the Atomic Energy Institute, Brazil. Estudo de precipitacao continua de DUA para a implantacao na instalacao piloto CEQ-IEA (in Portuguese)

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

Araujo, Jose Adroalado de

1974-05-15

The paper deals with the ammonium diuranate continuous precipitation with a high chemical purity degree from uranyl nitrate solutions, using 1.2 and 2.4 ammonium hydroxide solutions and gaseous NH{sub 3} as a precipitating agent. The precipitations were carried out in a continuous procedure with one and two stages. The variables studied were the NH[sub 4}OH solutions concentration, ADU precipitation curve, the flow rate of reactants, the temperature of the precipitation, pH of the suspended ADU, and ammonium diuranate filtrability. The experimental work performed and the data obtained permitted the design of a chemical reactor for the continuous nuclear grade ADUmore » precipitation at the Chemical Engineering Department of the Atomic Energy Institute of Sao Paulo.« less

Effect of a continuous regimen of contraceptive combination of ethinylestradiol and drospirenone on lipid, carbohydrate and coagulation profiles.

PubMed

Machado, Rogério Bonassi; de Melo, Nilson Roberto; Maia, Hugo; Cruz, Achilles Machado

2010-02-01

The objective of this study was to evaluate the effects of a contraceptive pill containing ethinylestradiol (30 mcg) and drospirenone (3 mg) in a continuous regimen on lipid, carbohydrate and coagulation parameters. This open, prospective, randomized study included 78 participants (mean age 27.8 years) who were randomized into two groups to use the pill continuously for 168 days or for six 28-day cycles with a 7-day hormone-free interval between cycles. Markers of lipid, carbohydrate and coagulation profiles were measured prior to initiation and after the 6 months of pill use. No statistically significant differences were found between the two contraceptive regimens with respect to carbohydrate or lipid profiles or in the parameters related to coagulation. The contraceptive combination of ethinylestradiol and drospirenone used in a continuous regimen was associated with metabolic alterations similar to those found during the traditional cyclic regimen of oral contraceptive use.

Continuity equation for probability as a requirement of inference over paths

NASA Astrophysics Data System (ADS)

González, Diego; Díaz, Daniela; Davis, Sergio

2016-09-01

Local conservation of probability, expressed as the continuity equation, is a central feature of non-equilibrium Statistical Mechanics. In the existing literature, the continuity equation is always motivated by heuristic arguments with no derivation from first principles. In this work we show that the continuity equation is a logical consequence of the laws of probability and the application of the formalism of inference over paths for dynamical systems. That is, the simple postulate that a system moves continuously through time following paths implies the continuity equation. The translation between the language of dynamical paths to the usual representation in terms of probability densities of states is performed by means of an identity derived from Bayes' theorem. The formalism presented here is valid independently of the nature of the system studied: it is applicable to physical systems and also to more abstract dynamics such as financial indicators, population dynamics in ecology among others.

Steep Delay Discounting and Addictive Behavior: A Meta-Analysis of Continuous Associations

PubMed Central

Amlung, Michael; Vedelago, Lana; Acker, John; Balodis, Iris; MacKillop, James

2016-01-01

Aims To synthesize continuous associations between delayed reward discounting (DRD) and both addiction severity and quantity-frequency (QF); to examine moderators of these relationships; and to investigate publication bias. Methods Meta-analysis of published studies examining continuous associations between DRD and addictive behaviors. Published, peer-reviewed studies on addictive behaviors (alcohol, tobacco, cannabis, stimulants, opiates, and gambling) were identified via PubMed, MEDLINE, and PsycInfo. Studies were restricted to DRD measures of monetary gains. Random effects meta-analysis was conducted using Pearson’s r as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger’s tests, meta-regression of publication year and effect size, and imputation of missing studies. Results The primary meta-analysis revealed a small magnitude effect size that was highly significant (r = 0.14, p < 10−14). Significantly larger effect sizes were observed for studies examining severity compared with QF (p = 0.01), but not between the type of addictive behavior (p = 0.30) or DRD assessment (p = 0.90). Indices of publication bias suggested a modest impact of unpublished findings. Conclusions Delayed reward discounting is robustly associated with continuous measures of addiction severity and quantity-frequency. This relation is generally robust across type of addictive behavior and delayed reward discounting assessment modality. PMID:27450931

Determinants of the administration of continuous palliative sedation: a systematic review.

PubMed

van Deijck, Rogier H P D; Hasselaar, Jeroen G J; Verhagen, Stans C A H H V M; Vissers, Kris C P; Koopmans, Raymond T C M

2013-12-01

Little is known about the determining factors related to the administration of continuous palliative sedation. Knowledge of these determinants may assist physicians in identifying patients who are at high risk of developing refractory symptoms, enable physicians to inform patients, and optimize close monitoring. The aim of this systematic review was to identify determinants of the administration of continuous palliative sedation. A systematic review of PubMed, EMBASE, and CINAHL was performed to identify English, Dutch, and German language papers published from January 1990 through April 2011. Inclusion was based on the following criteria: patient-based research on continuous palliative sedation, studies investigating determinants of palliative sedation and/or comparison between sedated and nonsedated cohorts, and studies using multivariate analyses and of fair to good or good methodological quality. In total, eight papers were reviewed. The following nine factors were found to be associated with the administration of continuous palliative sedation: younger age, male sex, having cancer, feelings of hopelessness, dying in a hospital, living in a Dutch speaking community setting, very nonreligious or extremely nonreligious physicians, physicians working in "other hospital" specialties, and physicians in favor of assisted death. Given the variation in study designs and the limitations of the included studies, the outcomes should be interpreted carefully. Further research is needed, particularly regarding factors that can be influenced and that may alter the course of a patient's symptoms and the patient's eventual need for palliative sedation.

A high temperature drop-tube and packed-bed solar reactor for continuous biomass gasification

NASA Astrophysics Data System (ADS)

Bellouard, Quentin; Abanades, Stéphane; Rodat, Sylvain; Dupassieux, Nathalie

2017-06-01

Biomass gasification is an attractive process to produce high-value syngas. Utilization of concentrated solar energy as the heat source for driving reactions increases the energy conversion efficiency, saves biomass resource, and eliminates the needs for gas cleaning and separation. A high-temperature tubular solar reactor combining drop tube and packed bed concepts was used for continuous solar-driven gasification of biomass. This 1 kW reactor was experimentally tested with biomass feeding under real solar irradiation conditions at the focus of a 2 m-diameter parabolic solar concentrator. Experiments were conducted at temperatures ranging from 1000°C to 1400°C using wood composed of a mix of pine and spruce (bark included) as biomass feedstock. The aim of this study was to demonstrate the feasibility of syngas production in this reactor concept and to prove the reliability of continuous biomass gasification processing using solar energy. The study first consisted of a parametric study of the gasification conditions to obtain an optimal gas yield. The influence of temperature and oxidizing agent (H2O or CO2) on the product gas composition was investigated. The study then focused on solar gasification during continuous biomass particle injection for demonstrating the feasibility of a continuous process. Regarding the energy conversion efficiency of the lab scale reactor, energy upgrade factor of 1.21 and solar-to-fuel thermochemical efficiency up to 28% were achieved using wood heated up to 1400°C.

A comparative parametric study of a catalytic plate methane reformer coated with segmented and continuous layers of combustion catalyst for hydrogen production

NASA Astrophysics Data System (ADS)

Mundhwa, Mayur; Parmar, Rajesh D.; Thurgood, Christopher P.

2017-03-01

A parametric comparison study is carried out between segmented and conventional continuous layer configurations of the coated combustion-catalyst to investigate their influence on the performance of methane steam reforming (MSR) for hydrogen production in a catalytic plate reactor (CPR). MSR is simulated on one side of a thin plate over a continuous layer of nickel-alumina catalyst by implementing an experimentally validated surface microkinetic model. Required thermal energy for the MSR reaction is supplied by simulating catalytic methane combustion (CMC) on the opposite side of the plate over segmented and continuous layer of a platinum-alumina catalyst by implementing power law rate model. The simulation results of both coating configurations of the combustion-catalyst are compared using the following parameters: (1) co-flow and counter-flow modes between CMC and MSR, (2) gas hourly space velocity and (3) reforming-catalyst thickness. The study explains why CPR designed with the segmented combustion-catalyst and co-flow mode shows superior performance not only in terms of high hydrogen production but also in terms of minimizing the maximum reactor plate temperature and thermal hot-spots. The study shows that the segmented coating requires 7% to 8% less combustion-side feed flow and 70% less combustion-catalyst to produce the required flow of hydrogen (29.80 mol/h) on the reforming-side to feed a 1 kW fuel-cell compared to the conventional continuous coating of the combustion-catalyst.

Discontinuity of cortical gradients reflects sensory impairment

PubMed Central

Saadon-Grosman, Noam; Tal, Zohar; Itshayek, Eyal; Amedi, Amir; Arzy, Shahar

2015-01-01

Topographic maps and their continuity constitute a fundamental principle of brain organization. In the somatosensory system, whole-body sensory impairment may be reflected either in cortical signal reduction or disorganization of the somatotopic map, such as disturbed continuity. Here we investigated the role of continuity in pathological states. We studied whole-body cortical representations in response to continuous sensory stimulation under functional MRI (fMRI) in two unique patient populations—patients with cervical sensory Brown-Séquard syndrome (injury to one side of the spinal cord) and patients before and after surgical repair of cervical disk protrusion—enabling us to compare whole-body representations in the same study subjects. We quantified the spatial gradient of cortical activation and evaluated the divergence from a continuous pattern. Gradient continuity was found to be disturbed at the primary somatosensory cortex (S1) and the supplementary motor area (SMA), in both patient populations: contralateral to the disturbed body side in the Brown-Séquard group and before repair in the surgical group, which was further improved after intervention. Results corresponding to the nondisturbed body side and after surgical repair were comparable with control subjects. No difference was found in the fMRI signal power between the different conditions in the two groups, as well as with respect to control subjects. These results suggest that decreased sensation in our patients is related to gradient discontinuity rather than signal reduction. Gradient continuity may be crucial for somatotopic and other topographical organization, and its disruption may characterize pathological processing. PMID:26655739

Do social functioning and symptoms improve with continuation antidepressant treatment of persistent depressive disorder? An observational study.

PubMed

Hellerstein, David J; Hunnicutt-Ferguson, Kallio; Stewart, Jonathan W; McGrath, Patrick J; Keller, Samantha; Peterson, Bradley S; Chen, Ying

2017-03-01

To determine efficacy of continued treatment with the serotonin norepinephrine reuptake inhibitor duloxetine on symptom reduction and functional improvement in outpatients with dysthymia. Fifty outpatients with DSM-IV-TR diagnosed dysthymia who had participated in a 10 week double-blind, placebo-controlled study of duloxetine received open treatment for three months. Nineteen duloxetine responders continued duloxetine, 24 patients initially treated with placebo started open duloxetine treatment, and 7 duloxetine non-responders were treated with desvenlafaxine or bupropion, selected by clinician choice. Patients continuing duloxetine maintained symptom improvement, 84% meeting response and 63% remission criteria at week 22. Patients initially treated with placebo showed similarly high levels of response (83%) and remission (62%) at week 22, and most duloxetine non-responders subsequently responded to other antidepressants. Duloxetine-continuation patients improved modestly between weeks 10 and 22 on measures of social and cognitive functioning and temperament. Despite this improvement concurrently across several functional domains, 66.7% of patients continuing duloxetine remained in the impaired range of functioning according to the Social Adjustment Scale (SAS). Continued duloxetine treatment appears to be effective in maintaining symptom response in dysthymic disorder, and has positive effects on social functioning. However, the majority of patients do not show normalization of functioning, even when controlling for remission status. Additional treatments should be considered to target residual impairments in social functioning in mood remitted patients with persistent depressive disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

Lymphoid cell kinetics under continuous low dose-rate gamma irradiation: A comparison study

NASA Technical Reports Server (NTRS)

Foster, B. R.

1975-01-01

A comparison study was conducted of the effects of continuous low dose-rate gamma irradiation on cell population kinetics of lymphoid tissue (white pulp) of the mouse spleen with findings as they relate to the mouse thymus. Experimental techniques employed included autoradiography and specific labeling with tritiated thymidine (TdR-(h-3)). The problem studied involved the mechanism of cell proliferation of lymphoid tissue of the mouse spleen and thymus under the stress of continuous irradiation at a dose rate of 10 roentgens (R) per day for 105 days (15 weeks). The aim was to determine whether or not a steady state or near-steady state of cell population could be established for this period of time, and what compensatory mechanisms of cell population were involved.

Coaches’ Preferences for Continuing Coaching Education in South Africa

PubMed Central

Coopoo, Yoga; Morris-Eyton, Heather

2016-01-01

Abstract The purpose of this study was to examine coaches’ preferences for continuing coaching education. The sample consisted of 122 male and 102 female coaches from the Gauteng Province of South Africa who were purposively recruited to participate in this study. The results of this study showed that the coaches wanted to learn more about motivational techniques, advanced instructional drills, advanced first aid, goal setting, character building and conditioning drills. The results further indicated that sport coaches would be more likely to continue their coaching education if they had a desire to coach at a high level, if topics were relevant and if courses were in line with league requirements and were available online. The practical implications of the findings for the development of coaching education programmes in South Africa were discussed. PMID:28149360

An acceptability and safety study of the Duet cervical barrier and gel delivery system in Zimbabwe.

PubMed

Montgomery, Elizabeth T; Woodsong, Cynthia; Musara, Petina; Cheng, Helen; Chipato, Tsungai; Moench, Thomas R; Spielberg, Freya; van der Straten, Ariane

2010-08-05

Adherence problems with coitally dependent, female-initiated HIV prevention methods have contributed to several trials' failure to establish efficacy. Continuous use of a cervical barrier with once-daily cleaning and immediate reinsertion may simplify use for women and improve adherence. We assessed the acceptability and safety of precoital and continuous use of the Duet, a cervical barrier and gel delivery system, in Zimbabwean women. Using a two-arm crossover design with a parallel observation group, we randomized 103 women in a 2:2:1 ratio: (1) to use the Duet continuously for 14 days, followed by a minimum of seven days of washout and then 14 days of precoital use; (2) to use the same Duet regimens in reverse order; or (3) for observation only. Women were aged 18 to 40 years; half were recruited from a pool of previous diaphragm study participants and the other half from the general community. Acceptability and adherence were assessed through an interviewer-administered questionnaire at each of two follow-up visits. Safety was monitored through pelvic speculum exams and report of adverse events. The proportion of women who reported consistent Duet use during sex was virtually identical during continuous and precoital regimens (88.6% vs. 88.9%). Partner refusal was the most common reason cited for non-use during sex in both use regimens. Not having the device handy was the most common reason cited for non-daily use (in the continuous regimen). Most women were "very comfortable" using it continuously (86.3%) and inserting it precoitally (92.8%). The most favoured Duet attribute was that it did not interfere with "natural" sex (55%). The least favoured Duet attribute was the concern that it might come out during sex (71.3%). No serious adverse events were reported during the study; 57 participants reported 90 adverse events classified as mild or moderate. There were no statistically significant differences in: (1) the proportion of women reporting adverse events; (2) the severity of events among those using the Duet and observational controls; or (3) event severity reported during each regimen use period. In this study, the Duet was found to be acceptable and safe when inserted precoitally or used continuously for 14 days. Assignment to use of the Duet continuously did not increase adherence to the Duet during sex. Future HIV prevention trials should evaluate use of the Duet (precoitally and continuously) with promising microbicide candidates.

An acceptability and safety study of the Duet® cervical barrier and gel delivery system in Zimbabwe

PubMed Central

2010-01-01

Background Adherence problems with coitally dependent, female-initiated HIV prevention methods have contributed to several trials' failure to establish efficacy. Continuous use of a cervical barrier with once-daily cleaning and immediate reinsertion may simplify use for women and improve adherence. We assessed the acceptability and safety of precoital and continuous use of the Duet®, a cervical barrier and gel delivery system, in Zimbabwean women. Methods Using a two-arm crossover design with a parallel observation group, we randomized 103 women in a 2:2:1 ratio: (1) to use the Duet continuously for 14 days, followed by a minimum of seven days of washout and then 14 days of precoital use; (2) to use the same Duet regimens in reverse order; or (3) for observation only. Women were aged 18 to 40 years; half were recruited from a pool of previous diaphragm study participants and the other half from the general community. Acceptability and adherence were assessed through an interviewer-administered questionnaire at each of two follow-up visits. Safety was monitored through pelvic speculum exams and report of adverse events. Results The proportion of women who reported consistent Duet use during sex was virtually identical during continuous and precoital regimens (88.6% vs. 88.9%). Partner refusal was the most common reason cited for non-use during sex in both use regimens. Not having the device handy was the most common reason cited for non-daily use (in the continuous regimen). Most women were "very comfortable" using it continuously (86.3%) and inserting it precoitally (92.8%). The most favoured Duet attribute was that it did not interfere with "natural" sex (55%). The least favoured Duet attribute was the concern that it might come out during sex (71.3%). No serious adverse events were reported during the study; 57 participants reported 90 adverse events classified as mild or moderate. There were no statistically significant differences in: (1) the proportion of women reporting adverse events; (2) the severity of events among those using the Duet and observational controls; or (3) event severity reported during each regimen use period. Conclusions In this study, the Duet was found to be acceptable and safe when inserted precoitally or used continuously for 14 days. Assignment to use of the Duet continuously did not increase adherence to the Duet during sex. Future HIV prevention trials should evaluate use of the Duet (precoitally and continuously) with promising microbicide candidates. PMID:20687954

The forgotten majority: unfinished business in cardiovascular risk reduction.

PubMed

Libby, Peter

2005-10-04

Despite meaningful progress in the identification of risk factors and the development of highly effective clinical tools, deaths from cardiovascular disease continue to increase worldwide. Sparked by an obesity epidemic, the metabolic syndrome and the rising incidence of type 2 diabetes have led to an upsurge of cardiovascular risk. Although pharmacologic treatments with the statin class of drugs have reduced cholesterol levels and lowered mortality rates, several large controlled clinical trials, including the Scandinavian Simvastatin Survival Study, the Cholesterol and Recurrent Events trial, the Air Force/Texas Coronary Atherosclerosis Prevention studies, and Long-term Intervention with Pravastatin in Ischemic Disease study, have indicated that cardiovascular events continue to occur in two thirds of all patients. Follow-up studies, such as the Heart Protection Study and the Pravastatin or Atorvastatin Evaluation and Infection Therapy/Thrombolysis In Myocardial Infarction-22 trials, reinforced these earlier results. Although therapy with gemfibrozil, a fibric acid derivative, showed reduced occurrence of cardiovascular events in the Helsinki Heart Study and the Veterans Affairs HDL Intervention Trial, results of other studies, e.g., the Bezafibrate Intervention Program and the Diabetes Atherosclerosis Intervention study, showed less encouraging results. Although lifestyle modifications, such as improved diet and increased exercise levels, benefit general health and the metabolic syndrome and insulin resistance in particular, most people continue to resist changes in their daily routines. Thus, physicians must continue to educate their patients regarding an optimal balance of drug therapy and personal behavior.

The Continuity of Care Experience in Australian midwifery education-What have we achieved?

PubMed

Tierney, Olivia; Sweet, Linda; Houston, Don; Ebert, Lyn

2017-06-01

The Continuity of Care Experience is a mandated workplace based component of midwifery education in Australia. Since its inclusion in midwifery clinical education, the pedagogical approaches used across Australia have varied. The purpose of this integrative review is to determine the outcomes of the Continuity of Care Experience as an educational model. A search for relevant research literature was undertaken in 2015 using a range of databases and by examining relevant bibliographies. Articles published in English, which provided information about the outcomes of Continuity of Care Experiences for midwifery education were included. A total of 20 studies were selected. The included studies were primarily exploratory and descriptive. Studies reported the value that both students and women place on the relationship they developed. This relationship resulted in opportunities that enhanced student learning by providing a context in which clinical practice learning was optimized. Challenges identified included managing time and workload pressures for students in relation to the CCE, inconsistencies in academic use of the experience, and variations in how the healthcare system influences the continuity experience. No research was found that reports on the educational model in terms of defining learning objectives and assessment of outcomes. This represents an important omission in mandating this clinical practice model in midwifery curricula without sufficient guidance to unify and maximize learning for students. Research is required to explore the educational intent and assessment methods of the Continuity of Care Experience as an educational model. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

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

Fernandez-Gutierrez, Sulmer, E-mail: sulmer.a.fernandez.gutierrez@intel.com; Browning, Jim; Lin, Ming-Chieh

Phase-control of a magnetron is studied via simulation using a combination of a continuous current source and a modulated current source. The addressable, modulated current source is turned ON and OFF at the magnetron operating frequency in order to control the electron injection and the spoke phase. Prior simulation work using a 2D model of a Rising Sun magnetron showed that the use of 100% modulated current controlled the magnetron phase and allowed for dynamic phase control. In this work, the minimum fraction of modulated current source needed to achieve a phase control is studied. The current fractions (modulated versusmore » continuous) were varied from 10% modulated current to 100% modulated current to study the effects on phase control. Dynamic phase-control, stability, and start up time of the device were studied for all these cases showing that with 10% modulated current and 90% continuous current, a phase shift of 180° can be achieved demonstrating dynamic phase control.« less

Use and Availability of Continuous Streamflow Records in Tennessee

DTIC Science & Technology

1988-01-01

which are operated for a water budget study of Reelfoot Lake and two stations for a base flow-groundwater study at the Department of Energy’s Oak...continuous lake stage; (3) 5 flood hydrograph; (4) 75 low-flow partial-record; (5) 84 crest-stage partial-record; and (6) 6 flood-profile partial...operated for planning or design purposes. There is one gage at each of three water-supply studies, five stations are used in a lake sedimentation

Growth and tuberization of potato (Solanum tuberosum L.) under continuous light

NASA Technical Reports Server (NTRS)

Wheeler, R. M.; Tibbitts, T. W.

1986-01-01

The growth and tuberization of potatoes (Solanum tuberosum L.) maintained for 6 weeks under four different regimes of continuous irradiance were compared to plants given 12 hours light and 12 hours dark. Treatments included: (a) continuous photosynthetic photon flux of 200 micromoles per square meter per second cool-white fluorescent (CWF); (b) continuous 400 micromoles per square meter per second CWF; (c) 12 hours 400 micromoles per square meter per second CWF plus 12 hours dim CWF at 5 micromoles per square meter per second; (d) 12 hours [400] micromoles per square meter per second CWF plus 12 hours dim incandescent (INC) at 5 micromoles per square meter per second and a control treatment of 12 hours light at 400 micromoles per square meter per second CWF and 12 hours dark. The study included five cultivars ranging from early- to late-season types: 'Norland,' 'Superior,''Norchip,' 'Russet Burbank,' and 'Kennebec,' Tuber development progressed well under continuous irradiation at 400 micromoles per square meter per second and under 12 hours irradiance and 12 hours dark, while tuber development was suppressed in all other light treatments. Continuous irradiation at 200 or 400 micromoles per square meter per second resulted in severe stunting and leaf malformation on 'Superior' and 'Kennebec' plants, but little or no injury and vigorous shoot growth in the other cultivars. No injury or stunting were apparent under 12-dim light or 12-dark treatments. Plants given 12 hours dim INC showed significantly greater stem elongation but less total biomass than plants in other treatments. The continuous light encouraged shoot growth over tuber growth but this trend was overridden by providing a high irradiance level. The variation among cultivars for tolerance to continuous lighting indicates that potato may be a useful species for photoinhibition studies.

The experiences of new graduate midwives working in midwifery continuity of care models in Australia.

PubMed

Cummins, Allison M; Denney-Wilson, E; Homer, C S E

2015-04-01

midwifery continuity of care has been shown to be beneficial to women through reducing interventions and other maternal and neonatal morbidity. In Australia, numerous government reports recognise the importance of midwifery models of care that provide continuity. Given the benefits, midwives, including new graduate midwives, should have the opportunity to work in these models of care. Historically, new graduates have been required to have a number of years׳ experience before they are able to work in these models of care although a small number have been able to move into these models as new graduates. to explore the experiences of the new graduate midwives who have worked in midwifery continuity of care, in particular, the support they received; and, to establish the facilitators and barriers to the expansion of new graduate positions in midwifery continuity of care models. a qualitative descriptive study was undertaken framed by the concept of continuity of care. the new graduate midwives valued the relationship with the women and with the group of midwives they worked alongside. The ability to develop trusting relationships, consolidate skills and knowledge, be supported by the group and finally feeling prepared to work in midwifery continuity of care from their degree were all sub-themes. All of these factors led to the participants feeling as though they were 'becoming a real midwife'. this is the first study to demonstrate that new graduate midwives value working in midwifery continuity of care - they felt well prepared to work in this way from their degree and were supported by midwives they worked alongside. The participants reported having more confidence to practice when they have a relationship with the woman, as occurs in these models. Copyright © 2015 Elsevier Ltd. All rights reserved.

Growth and Tuberization of Potato (Solanum tuberosum L.) under Continuous Light 1

PubMed Central

Wheeler, Raymond M.; Tibbitts, Theodore W.

1986-01-01

The growth and tuberization of potatoes (Solanum tuberosum L.) maintained for 6 weeks under four different regimes of continuous irradiance were compared to plants given 12 hours light and 12 hours dark. Treatments included: (a) continuous photosynthetic photon flux of 200 micromoles per square meter per second cool-white fluorescent (CWF); (b) continuous 400 micromoles per square meter per second CWF; (c) 12 hours 400 micromoles per square meter per second CWF plus 12 hours dim CWF at 5 micromoles per square meter per second; (d) 12 hours micromoles per square meter per second CWF plus 12 hours dim incandescent (INC) at 5 micromoles per square meter per second and a control treatment of 12 hours light at 400 micromoles per square meter per second CWF and 12 hours dark. The study included five cultivars ranging from early- to late-season types: `Norland,' `Superior,' `Norchip,' `Russet Burbank,' and `Kennebec.' Tuber development progressed well under continuous irradiation at 400 micromoles per square meter per second and under 12 hours irradiance and 12 hours dark, while tuber development was suppressed in all other light treatments. Continuous irradiation at 200 or 400 micromoles per square meter per second resulted in severe stunting and leaf malformation on `Superior' and `Kennebec' plants, but little or no injury and vigorous shoot growth in the other cultivars. No injury or stunting were apparent under 12-dim light or 12-dark treatments. Plants given 12 hours dim INC showed significantly greater stem elongation but less total biomass than plants in other treatments. The continuous light encouraged shoot growth over tuber growth but this trend was overridden by providing a high irradiance level. The variation among cultivars for tolerance to continuous lighting indicates that potato may be a useful species for photoinhibition studies. PMID:11539039

Understanding How Clinician-Patient Relationships and Relational Continuity of Care Affect Recovery from Serious Mental Illness: STARS Study Results

PubMed Central

Green, Carla A.; Polen, Michael R.; Janoff, Shannon L.; Castleton, David K.; Wisdom, Jennifer P.; Vuckovic, Nancy; Perrin, Nancy A.; Paulson, Robert I.; Oken, Stuart L.

2008-01-01

Objective Recommendations for improving care include increased patient-clinician collaboration, patient empowerment, and greater relational continuity of care. All rely upon good clinician-patient relationships, yet little is known about how relational continuity and clinician-patient relationships interact, or their effects on recovery from mental illness. Methods Individuals (92 women, 85 men) with schizophrenia, schizoaffective disorder, affective psychosis, or bipolar disorder participated in this observational study. Participants completed in-depth interviews detailing personal and mental health histories. Questionnaires included quality of life and recovery assessments and were linked to records of services used. Qualitative analyses yielded a hypothesized model of the effects of relational continuity and clinician-patient relationships on recovery and quality of life, tested using covariance structure modeling. Results Qualitative data showed that positive, trusting relationships with clinicians, developed over time, aid recovery. When “fit” with clinicians was good, long-term relational continuity of care allowed development of close, collaborative relationships, fostered good illness and medication management, and supported patient-directed decisions. Most valued were competent, caring, trustworthy, and trusting clinicians who treated clinical encounters “like friendships,” increasing willingness to seek help and continue care when treatments were not effective and supporting “normal” rather than “mentally ill” identities. Statistical models showed positive relationships between recovery-oriented patient-driven care and satisfaction with clinicians, medication satisfaction, and recovery. Relational continuity indirectly affected quality of life via satisfaction with clinicians; medication satisfaction was associated with fewer symptoms; fewer symptoms were associated with recovery and better quality of life. Conclusions Strong clinician-patient relationships, relational continuity, and a caring, collaborative approach facilitate recovery from mental illness and improved quality of life. PMID:18614445

Understanding how clinician-patient relationships and relational continuity of care affect recovery from serious mental illness: STARS study results.

PubMed

Green, Carla A; Polen, Michael R; Janoff, Shannon L; Castleton, David K; Wisdom, Jennifer P; Vuckovic, Nancy; Perrin, Nancy A; Paulson, Robert I; Oken, Stuart L

2008-01-01

Recommendations for improving care include increased patient-clinician collaboration, patient empowerment, and greater relational continuity of care. All rely upon good clinician-patient relationships, yet little is known about how relational continuity and clinician-patient relationships interact, or their effects on recovery from mental illness. Individuals (92 women, 85 men) with schizophrenia, schizoaffective disorder, affective psychosis, or bipolar disorder participated in this observational study. Participants completed in-depth interviews detailing personal and mental health histories. Questionnaires included quality of life and recovery assessments and were linked to records of services used. Qualitative analyses yielded a hypothesized model of the effects of relational continuity and clinician-patient relationships on recovery and quality of life, tested using covariance structure modeling. Qualitative data showed that positive, trusting relationships with clinicians, developed over time, aid recovery. When "fit" with clinicians was good, long-term relational continuity of care allowed development of close, collaborative relationships, fostered good illness and medication management, and supported patient-directed decisions. Most valued were competent, caring, trustworthy, and trusting clinicians who treated clinical encounters "like friendships," increasing willingness to seek help and continue care when treatments were not effective and supporting "normal" rather than "mentally ill" identities. Statistical models showed positive relationships between recovery-oriented patient-driven care and satisfaction with clinicians, medication satisfaction, and recovery. Relational continuity indirectly affected quality of life via satisfaction with clinicians; medication satisfaction was associated with fewer symptoms; fewer symptoms were associated with recovery and better quality of life. Strong clinician-patient relationships, relational continuity, and a caring, collaborative approach facilitate recovery from mental illness and improved quality of life.

Chinese midwives' experience of providing continuity of care to labouring women.

PubMed

Gu, Chunyi; Zhang, Zheng; Ding, Yan

2011-04-01

to explore and describe Chinese midwives' experience of providing one-to-one continuity of care to labouring women. a qualitative study using a phenomenological approach. Data were collected using open-ended, tape-recorded interviews. The analysis of the transcribed texts included searching for themes sorted into clusters for a final expression of the essential structure of the phenomenon. Obstetrics and gynaecology hospital of Fudan University, Shanghai, China. 12 midwives, providing one-to-one continuity of care to labouring women. two main categories were identified: (1) midwives' feelings on providing continuity of care, and (2) impact of on-call system on midwives providing continuity of care. Key themes emerged from each main category: (1) 'playing important roles in labour care', 'gaining a sense of self-achievement', 'falling into exhaustion and frustration' and 'coping with caring work'; and (2) 'on-call syndrome', 'affecting personal lives' and 'managing on-call shift'. The midwives experienced mixed feelings of being with women and expressed their adaptation to being on-call, which was the essence of this study. They played important roles in caring for women, gained a sense of self-achievement and developed suitable coping strategies. However, they also indicated the impact of the on-call system upon them in the process of providing continuity of care. midwives have gained both positive and negative experiences when providing continuity of care to labouring women. The positive aspects may facilitate other professional midwives working in a similar role, whereas the negative aspects may inform them of learning to live with this situation, and may also have implications for managers to develop new approaches to the organisation and provision of continuity of care to support midwives' practice, and to fully utilise 'flexibility' under an on-call system. Copyright © 2009 Elsevier Ltd. All rights reserved.

Sleep continuity is positively correlated with sleep duration in laboratory nighttime sleep recordings

PubMed Central

Van Dongen, Hans P. A.; Natelson, Benjamin H.; Bender, Amy M.; Palombini, Luciana O.; Bittencourt, Lia; Tufik, Sergio; Ayappa, Indu; Rapoport, David M.

2017-01-01

Sleep duration varies widely across individuals and appears to be trait-like. Differences in the stability of underlying sleep processes may underlie this phenomenon. To investigate underlying mechanisms, we examined the relationship between sleep duration and sleep continuity in baseline polysomnography (PSG) recordings from three independently collected datasets: 1) 134 healthy controls (ages 37 ± 13 years) from the São Paulo Epidemiologic Sleep Study, who spent one night in a sleep laboratory, 2) 21 obstructive sleep apnea (OSA) patients who were treated with continuous positive airway pressure for at least 2 months (45 ± 12 years, respiratory disturbance index <15), who spent one night in a sleep laboratory with previous experience of multiple PSG studies, and 3) 62 healthy controls (28 ± 6 years) who, as part of larger experiments, spent 2 consecutive nights in a sleep laboratory. For each dataset, we used total sleep time (TST) to separate subjects into those with shorter sleep (S-TST) and those with longer sleep (L-TST). In all three datasets, survival curves of continuous sleep segments showed greater sleep continuity in L-TST than in S-TST. Correlation analyses with TST as a continuous variable corroborated the results; and the results also held true after controlling for age. There were no significant differences in baseline waking performance and sleepiness between S-TST and L-TST. In conclusion, in both healthy controls and treated OSA patients, sleep continuity was positively correlated with sleep duration. These findings suggest that S-TST may differ from L-TST in processes underlying sleep continuity, shedding new light on mechanisms underlying individual differences in sleep duration. PMID:28394943

'Palliative sedation'? A retrospective cohort study on the use and labelling of continuously administered sedatives on a palliative care unit.

PubMed

Schildmann, Eva; Pörnbacher, Sebastian; Kalies, Helen; Bausewein, Claudia

2018-03-01

Sedatives are frequently used towards the end of life. However, there is scarce information when their use is labelled as 'palliative sedation'. To assess the use and labelling of 'continuous administration of sedatives within the last 7 days of life', based on objective operational criteria, on a palliative care unit. Retrospective cohort study, using medical records. Explorative statistical analysis (SPSS 23). Patients who died on a palliative care unit from August 2014 to July 2015. Sedatives recorded were benzodiazepines, levomepromazine, haloperidol ⩾5 mg/day and propofol. Of the 192 patients, 149 (78%) patients received continuous sedatives within the last week of life. The prevalence of delirium/agitation was significantly higher in patients with continuous sedatives compared to those without continuous sedatives at admission to the unit (35% vs 16%, p = 0.02) and on the day before death (58% vs 40%, p = 0.04). The term '(palliative) sedation' was used in the records for 22 of 149 (15%) patients with continuous sedatives. These patients had significantly higher total daily midazolam doses 2 days before death (median (range), 15.0 (6.0-185.0) mg vs 11.5 (1.0-70.0) mg, p = 0.04) and on the day of death (median (range), 19.5 (7.5-240.0) mg vs 12.5 (2.0-65.0) mg, p = 0.01). The dose range was large in both groups. The prevalence of delirium/agitation was associated with the administration of continuous sedatives. There was no consistent pattern regarding labelling the use of continuous sedatives as '(palliative) sedation'. Multicentre mixed-methods research is needed for a better characterization of sedation practices in palliative care.

'Continuation rate', 'use-effectiveness' and their assessment for the diaphragm and jelly method.

PubMed

Chandrasekaran, C; Karkal, M

1972-11-01

Abstract The application of the life-table technique in the calculation of use-effectiveness of a contraceptive was proposed by Potter in 1963.(1) The technique was also found to be useful in assessing the duration for which the use of a contraceptive was continued. The keen interest that existed in the use of IUD in the mid-1960's was reflected in the terminology developed for assessment of the continuity of use. 'Retention rate' was a frequently used index.(2) Because of the development of the concept of segments whose end-period determined either termination of the use of a method or its continuance on a cut-off date, 'closure rate' and 'termination rate' have been used as measures of the discontinuance of the use of methods primarily of the IUD.(3) While discussing concepts relating to acceptance, use and effectiveness of family planning methods, more generally, an expert group suggested that 'continuation' should be used to denote that a client (or a couple) had begun to practise a method and that the method was still being practised.(4) Since this group defined 'an acceptor' as a person taking service and/or advice, i.e. having an IUD insertion or a sterilization operation or receiving supplies (or advice on methods such as 'rhythm' or coitus-interruptus with the intent of using the method), the base for the assessment of continuation rates, according to this group, would be only those acceptors who had begun using the method. The lifetable method has also been used for the study of the continuation rate for pill acceptors.(5) Balakrishnan, et al., made a study of continuation rates of oral contraceptives using the multiple decrement life-table technique.(6).

Steep delay discounting and addictive behavior: a meta-analysis of continuous associations.

PubMed

Amlung, Michael; Vedelago, Lana; Acker, John; Balodis, Iris; MacKillop, James

2017-01-01

To synthesize continuous associations between delayed reward discounting (DRD) and both addiction severity and quantity-frequency (QF); to examine moderators of these relationships; and to investigate publication bias. Meta-analysis of published studies examining continuous associations between DRD and addictive behaviors. Published, peer-reviewed studies on addictive behaviors (alcohol, tobacco, cannabis, stimulants, opiates and gambling) were identified via PubMed, MEDLINE and PsycInfo. Studies were restricted to DRD measures of monetary gains. Random-effects meta-analysis was conducted using Pearson's r as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger's tests, meta-regression of publication year and effect size and imputation of missing studies. The primary meta-analysis revealed a small magnitude effect size that was highly significant (r = 0.14, P < 10 -14 ). Significantly larger effect sizes were observed for studies examining severity compared with QF (P = 0.01), but not between the type of addictive behavior (P = 0.30) or DRD assessment (P = 0.90). Indices of publication bias suggested a modest impact of unpublished findings. Delayed reward discounting is associated robustly with continuous measures of addiction severity and quantity-frequency. This relation is generally robust across type of addictive behavior and delayed reward discounting assessment modality. © 2016 Society for the Study of Addiction.

Comparative study and evaluation of SCRAM use, recidivism rates, and characteristics.

DOT National Transportation Integrated Search

2015-04-01

SCRAM (Secure Continuous Remote Alcohol Monitoring) is an ankle bracelet that conducts transdermal readings by sampling alcohol vapor just above the skin or insensible perspiration. It provides continuous monitoring of sobriety. The impact of SCRAM o...

Performance, Productivity and Continuous Improvement. Symposium.

ERIC Educational Resources Information Center

2002

This document contains four papers from a symposium on performance, productivity, and continuous improvement. "Investigating the Association between Productivity and Quality Performance in Two Manufacturing Settings" (Constantine Kontoghiorghes, Robert Gudgel) summarizes a study that identified the following quality management variables…

Continued Monitoring of Indiana's SPS9-A Site

DOT National Transportation Integrated Search

2012-07-01

This study was initiated to continue monitoring the performance of five test sections placed in 1997 to compare the performance of : Superpave asphalt mixtures with different binder grades and one test section designed using the Marshall mix design m...

Continued monitoring of instrumented pavement in Ohio

DOT National Transportation Integrated Search

2003-12-01

Performance and environmental data continued to be monitored throughout this study on the Ohio SHRP Test Road. : Response testing included three new series of controlled vehicle tests and two sets of nondestructive tests. Cracking in two : SPS-2 sect...

Continued monitoring of instrumented pavement in Ohio.

DOT National Transportation Integrated Search

2002-12-01

Performance and environmental data continued to be monitored throughout this study on the Ohio SHRP Test Road. Response testing included three new series of controlled vehicle tests and two sets of nondestructive tests. Cracking in two SPS-2 sections...