Do Hassles and Uplifts Change with Age? Longitudinal Findings from the VA Normative Aging Study
Aldwin, Carolyn M.; Jeong, Yu-Jin; Igarashi, Heidi; Spiro, Avron
2014-01-01
To examine emotion regulation in later life, we contrasted the modified hedonic treadmill theory with developmental theories, using hassles and uplifts to assess emotion regulation in context. The sample was 1,315 men from the VA Normative Aging Study aged 53 to 85 years, who completed 3,894 observations between 1989 and 2004. We computed three scores for both hassles and uplifts: intensity (ratings reflecting appraisal processes), exposure (count), and summary (total) scores. Growth curves over age showed marked differences in trajectory patterns for intensity and exposure scores. Although exposure to hassles and uplifts decreased in later life, intensity scores increased. Growth based modelling showed individual differences in patterns of hassles and uplifts intensity and exposure, with relative stability in uplifts intensity, normative non-linear changes in hassles intensity, and complex patterns of individual differences in exposure for both hassles and uplifts. Analyses with the summary scores showed that emotion regulation in later life is a function of both developmental change and contextual exposure, with different patterns emerging for hassles and uplifts. Thus, support was found for both hedonic treadmill and developmental change theories, reflecting different aspects of emotion regulation in late life. PMID:24660796
Do hassles and uplifts change with age? Longitudinal findings from the VA normative aging study.
Aldwin, Carolyn M; Jeong, Yu-Jin; Igarashi, Heidi; Spiro, Avron
2014-03-01
To examine emotion regulation in later life, we contrasted the modified hedonic treadmill theory with developmental theories, using hassles and uplifts to assess emotion regulation in context. The sample was 1,315 men from the VA Normative Aging Study aged 53 to 85 years, who completed 3,894 observations between 1989 and 2004. We computed 3 scores for both hassles and uplifts: intensity (ratings reflecting appraisal processes), exposure (count), and summary (total) scores. Growth curves over age showed marked differences in trajectory patterns for intensity and exposure scores. Although exposure to hassles and uplifts decreased in later life, intensity scores increased. Group-based modeling showed individual differences in patterns of hassles and uplifts intensity and exposure, with relative stability in uplifts intensity, normative nonlinear changes in hassles intensity, and complex patterns of individual differences in exposure for both hassles and uplifts. Analyses with the summary scores showed that emotion regulation in later life is a function of both developmental change and contextual exposure, with different patterns emerging for hassles and uplifts. Thus, support was found for both hedonic treadmill and developmental change theories, reflecting different aspects of emotion regulation in late life. (c) 2014 APA, all rights reserved.
Lead Exposure and Tremor among Older Men: The VA Normative Aging Study
Power, Melinda C.; Sparrow, David; Spiro, Avron; Hu, Howard; Louis, Elan D.; Weisskopf, Marc G.
2015-01-01
Background: Tremor is one of the most common neurological signs, yet its etiology is poorly understood. Case–control studies suggest an association between blood lead and essential tremor, and that this association is modified by polymorphisms in the δ-aminolevulinic acid dehydrogenase (ALAD) gene. Objective: We aimed to examine the relationship between lead and tremor, including modification by ALAD, in a prospective cohort study, using both blood lead and bone lead—a biomarker of cumulative lead exposure. Methods: We measured tibia (n = 670) and patella (n = 672) bone lead and blood lead (n = 807) among older men (age range, 50–98 years) in the VA Normative Aging Study cohort. A tremor score was created based on an approach using hand-drawing samples. ALAD genotype was dichotomized as ALAD-2 carriers or not. We used linear regression adjusted for age, education, smoking, and alcohol intake to estimate the associations between lead biomarkers and tremor score. Results: In unadjusted analyses, there was a marginal association between quintiles of all lead biomarkers and tremor scores (p-values < 0.13), which did not persist in adjusted models. Age was the strongest predictor of tremor. Among those younger than the median age (68.9 years), tremor increased significantly with blood lead (p = 0.03), but this pattern was not apparent for bone lead. We did not see modification by ALAD or an association between bone lead and change in tremor score over time. Conclusion: Our results do not strongly support an association between lead exposure and tremor, and suggest no association with cumulative lead biomarkers, although there is some suggestion that blood lead may be associated with tremor among the younger men in our cohort. Citation: Ji JS, Power MC, Sparrow D, Spiro A III, Hu H, Louis ED, Weisskopf MG. 2015. Lead exposure and tremor among older men: the VA Normative Aging Study. Environ Health Perspect 123:445–450; http://dx.doi.org/10.1289/ehp.1408535
Do Cherished Children Age Successfully? Longitudinal Findings from the VA Normative Aging Study
Lee, Lewina O.; Aldwin, Carolyn M.; Kubzansky, Laura D.; Chen, Edith; Mroczek, Daniel K.; Wang, Joyce M.; Spiro, Avron
2015-01-01
Although early adversity has been linked to worse mental and physical health in adulthood, few studies have investigated the pathways through which positive and negative dimensions of early experiences can jointly influence psychological well-being in later life. This study examined: (1) profiles of early experiences across multiple domains; (2) the relations of these profiles to hedonic and eudaimonic well-being in later life; and (3) whether midlife social support mediated these relations. We first conducted latent class analysis of early experiences using data from 1,076 men in the VA Normative Aging Study who completed the Childhood Experiences Scale (age: M=69, SD=7). Analyses yielded three profiles of early experiences, labeled as cherished (strong support and some losses), harshly disciplined (harsh parental discipline, low positive reinforcement, and non-normative stressors), and ordinary (few stressors and low parental attention). Next, we applied structural equation modeling to data on a subset of this sample assessed seven years later on hedonic and eudaimonic well-being (n=496; age: M=76, SD=7). In general, the cherished group reported stronger qualitative social support in midlife than the harshly disciplined and ordinary groups, which in turn was related to greater hedonic (life satisfaction, positive affect) and eudaimonic (competence, positive relations with others) well-being in later life. The cherished group also reported higher autonomy than the ordinary group, but this association was independent of midlife social support. Our findings suggest that experiencing adversity in the context of a nurturing early environment can promote successful aging through the maintenance of supportive relationships in midlife. PMID:26436456
Mroczek, Daniel K.; Spiro, Avron; Turiano, Nick
2009-01-01
Studies have shown that higher levels of neuroticism are associated with greater risk of mortality. Yet what accounts for this association? One major theoretical position holds that persons higher in neuroticism engage in poorer health behaviors, such as smoking and excessive drinking, thus leading to earlier death. We tested this hypothesis using 30-year mortality in 1,788 men from the VA Normative Aging Study. Using proportional hazards (Cox) models we found that one health behavior, smoking, attenuated the effect of neuroticism on mortality by 40%. However, 60% remained unexplained, suggesting that the effects of other pathways (e.g., biological) also influence the relationship between neuroticism and mortality. PMID:20161240
Colicino, Elena; Wilson, Ander; Frisardi, Maria Chiara; Prada, Diddier; Power, Melinda C; Hoxha, Mirjam; Dioni, Laura; Spiro, Avron; Vokonas, Pantel S; Weisskopf, Marc G; Schwartz, Joel D; Baccarelli, Andrea A
2017-01-01
Long-term air pollution exposure has been associated with age-related cognitive impairment, possibly because of enhanced inflammation. Leukocytes with longer telomere length (TL) are more responsive to inflammatory stimuli, yet TL has not been evaluated in relation to air pollution and cognition. We assessed whether TL modifies the association of 1-year exposure to black carbon (BC), a marker of traffic-related air pollution, with cognitive function in older men, and we examined whether this modification is independent of age and of C-reactive protein (CRP), a marker of inflammation. Between 1999 and 2007, we conducted 1-3 cognitive examinations of 428 older men in the Veterans Affairs (VA) Normative Aging Study. We used covariate-adjusted repeated-measure logistic regression to estimate associations of 1-year BC exposure with relative odds of being a low scorer (≤ 25) on the Mini-Mental State Examination (MMSE), which is a proxy of poor cognition. Confounders included age, CRP, and lifestyle and sociodemographic factors. Each doubling in BC level was associated with 1.57 (95% CI: 1.20, 2.05) times higher odds of low MMSE scores. The BC-MMSE association was greater only among individuals with longer blood TL (5th quintile) (OR = 3.23; 95% CI: 1.37, 7.59; p = 0.04 for BC-by-TL-interaction). TL and CRP were associated neither with each other nor with MMSE. However, CRP modified the BC-MMSE relationship, with stronger associations only at higher CRP (5th quintile) and reference TL level (1st quintile) (OR = 2.68; 95% CI: 1.06, 6.79; p = 0.04 for BC-by-CRP-interaction). TL and CRP levels may help predict the impact of BC exposure on cognitive function in older men. Citation: Colicino E, Wilson A, Frisardi MC, Prada D, Power MC, Hoxha M, Dioni L, Spiro A III, Vokonas PS, Weisskopf MG, Schwartz JD, Baccarelli AA. 2017. Telomere length, long-term black carbon exposure, and cognitive function in a cohort of older men: the VA Normative Aging Study. Environ Health Perspect
Guimaraes, Sandra; Fernandes, Tiago; Costa, Patrício; Silva, Eduardo
2018-06-01
To determine a normative of tumbling E optotype and its feasibility for visual acuity (VA) assessment in children aged 3-4 years. A cross-sectional study of 1756 children who were invited to participate in a comprehensive non-invasive eye exam. Uncorrected monocular VA with crowded tumbling E with a comprehensive ophthalmological examination were assessed. Testability rates of the whole population and VA of the healthy children for different age subgroups, gender, school type and the order of testing in which the ophthalmological examination was performed were evaluated. The overall testability rate was 95% (92% and 98% for children aged 3 and 4 years, respectively). The mean VA of the first-day assessment (first-VA) and best-VA over 2 days' assessments was 0.14 logMAR (95% CI 0.14 to 0.15) (decimal=0.72, 95% CI 0.71 to 0.73) and 0.13 logMAR (95% CI 0.13 to 0.14) (decimal=0.74, 95% CI 0.73 to 0.74). Analysis with age showed differences between groups in first-VA (F(3,1146)=10.0; p<0.001; η2=0.026) and best-VA (F(3,1155)=8.8; p<0.001; η2=0.022). Our normative was very highly correlated with previous reported HOTV-Amblyopia-Treatment-Study (HOTV-ATS) (first-VA, r=0.97; best-VA, r=0.99), with 0.8 to 0.7 lines consistent overestimation for HOTV-ATS as described in literature. Overall false-positive referral was 1.3%, being specially low regarding anisometropias of ≥2 logMAR lines (0.17%). Interocular difference ≥1 line VA logMAR was not associated with age (p=0.195). This is the first normative for European Caucasian children with single crowded tumbling E in healthy eyes and the largest study comparing 3 and 4 years old testability. Testability rates are higher than found in literature with other optotypes, especially in children aged 3 years, where we found 5%-11% better testability rates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise
Cumulative Lead Exposure and Age-related Hearing Loss: The VA Normative Aging Study
Park, Sung Kyun; Elmarsafawy, Sahar; Mukherjee, Bhramar; Spiro, Avron; Vokonas, Pantel S.; Nie, Huiling; Weisskopf, Marc G.; Schwartz, Joel; Hu, Howard
2010-01-01
Although lead has been associated with hearing loss in occupational settings and in children, little epidemiologic research has been conducted on the impact of cumulative lead exposure on age-related hearing loss in the general population. We determined whether bone lead levels, a marker of cumulative lead exposure, are associated with decreased hearing ability in 448 men from the Normative Aging Study, seen between 1962 and 1996 (2,264 total observations). Air conduction hearing thresholds were measured at 0.25 to 8 kHz and pure tone averages (PTA) (mean of 0.5, 1, 2 and 4 kHz) were computed. Tibia and patella lead levels were measured using K x-ray fluorescence between 1991 and 1996. In cross-sectional analyses, after adjusting for potential confounders including occupational noise, patella lead levels were significantly associated with poorer hearing thresholds at 2, 3, 4, 6 and 8 kHz and PTA. The odds of hearing loss significantly increased with patella lead levels. We also found significant positive associations between tibia lead and the rate change in hearing thresholds at 1, 2, and 8 kHz and PTA in longitudinal analyses. Our results suggest that chronic low-level lead exposure may be an important risk factor for age-related hearing loss and reduction of lead exposure could help prevent or delay development of age-related hearing loss. PMID:20638461
Pessimistic orientation in relation to telomere length in older men: the VA Normative Aging Study
Ikeda, Ai; Schwartz, Joel; Peters, Junenette L.; Baccarelli, Andrea A.; Hoxha, Mirjam; Dioni, Laura; Spiro, Avron; Sparrow, David; Vokonas, Pantel; Kubzansky, Laura D.
2014-01-01
Background Recent research suggests pessimistic orientation is associated with shorter leukocyte telomere length (LTL). However, this is the first study to look not only at effects of pessimistic orientation on average LTL at multiple time points, but also at effects on the rate of change in LTL over time. Methods Participants were older men from the VA Normative Aging Study (n=490). The Life Orientation Test (LOT) was used to measure optimistic and pessimistic orientations at study baseline, and relative LTL by telomere to single copy gene ratio (T:S ratio) was obtained repeatedly over the course of the study (1999-2008). A total of 1,010 observations were included in the analysis. Linear mixed effect models with a random subject intercept were used to estimate associations. Results Higher pessimistic orientation scores were associated with shorter average LTL (percent difference by 1-SD increase in pessimistic orientation (95% CI): -3.08 (-5.62, -0.46)), and the finding was maintained after adjusting for the higher likelihood that healthier individuals return for follow-up visits (-3.44 (-5.95,-0.86)). However, pessimistic orientation scores were not associated with rate of change in LTL over time. No associations were found between overall optimism and optimistic orientation subscale scores and LTL. Conclusion Higher pessimistic orientation scores were associated with shorter LTL in older men. While there was no evidence that pessimistic orientation was associated with rate of change in LTL over time, higher levels of pessimistic orientation were associated with shorter LTL at baseline and this association persisted over time. PMID:24636503
Zanobetti, Antonella; Coull, Brent A.; Kloog, Itai; Sparrow, David; Vokonas, Pantel S.; Gold, Diane R.; Schwartz, Joel D.
2017-01-01
Many studies have demonstrated that cold and hot temperatures are associated with increased deaths and hospitalization rates; new findings indicate also an association with more specific cardiac risk factors. Most of these existing studies have relied on few weather stations to characterize exposures; few have used residence-specific estimates of temperature, or examined the exposure-response function. We investigated the association of arrhythmia episodes with spatial and temporal variation in temperature. We also evaluated the association between monitored ambient temperature (central) and the same outcome. This longitudinal analysis included 701 older men participating in the VA Normative Aging Study. Arrhythmia episodes were measured as ventricular ectopy (VE) (bigeminy, trigemini or couplets episodes) by 4min electrocardiogram (ECG) monitoring in repeated visits during 2000–2010. The outcome was defined as having or not VE episodes during a study visit. We applied a mixed effect logistic regression model with a random intercept for subject, controlling for seasonality, weekday, medication use, smoking, diabetes status, body mass index and age. We also examined effect modification by personal characteristics, confounding by air pollution, and the exposure-response function. For 1° C increase in the same day residence-specific temperature, the odds of having VE episodes was 1.10 (95%CI: 1.04–1.17). The odds associated with 1° C increase in central temperature was 1.05 (95%CI: 1.02–1.09). The exposure-response function was non-linear for averages of temperature, presenting a J-shaped pattern, suggesting greater risk at lower and higher temperatures. Increased warm temperature and decreased cold temperature may increase the risk of ventricular arrhythmias. PMID:28001123
Mehta, Amar J.; Kloog, Itai; Zanobetti, Antonella; Coull, Brent A.; Sparrow, David; Vokonas, Pantel; Schwartz, Joel
2014-01-01
Background The underlying mechanisms of the association between ambient temperature and cardiovascular morbidity and mortality are not well understood, particularly for daily temperature variability. We evaluated if daily mean temperature and standard deviation of temperature was associated with heart rate-corrected QT interval (QTc) duration, a marker of ventricular repolarization in a prospective cohort of older men. Methods This longitudinal analysis included 487 older men participating in the VA Normative Aging Study with up to three visits between 2000–2008 (n = 743). We analyzed associations between QTc and moving averages (1–7, 14, 21, and 28 days) of the 24-hour mean and standard deviation of temperature as measured from a local weather monitor, and the 24-hour mean temperature estimated from a spatiotemporal prediction model, in time-varying linear mixed-effect regression. Effect modification by season, diabetes, coronary heart disease, obesity, and age was also evaluated. Results Higher mean temperature as measured from the local monitor, and estimated from the prediction model, was associated with longer QTc at moving averages of 21 and 28 days. Increased 24-hr standard deviation of temperature was associated with longer QTc at moving averages from 4 and up to 28 days; a 1.9°C interquartile range increase in 4-day moving average standard deviation of temperature was associated with a 2.8 msec (95%CI: 0.4, 5.2) longer QTc. Associations between 24-hr standard deviation of temperature and QTc were stronger in colder months, and in participants with diabetes and coronary heart disease. Conclusion/Significance In this sample of older men, elevated mean temperature was associated with longer QTc, and increased variability of temperature was associated with longer QTc, particularly during colder months and among individuals with diabetes and coronary heart disease. These findings may offer insight of an important underlying mechanism of temperature
Farooqui, Zishaan; Bakulski, Kelly M; Power, Melinda C; Weisskopf, Marc G; Sparrow, David; Spiro, Avron; Vokonas, Pantel S; Nie, Linda H; Hu, Howard; Park, Sung Kyun
2017-01-01
Lead (Pb) exposure has been associated with poorer cognitive function cross-sectionally in aging adults, however the association between cumulative Pb exposure and longitudinal changes in cognition is little characterized. In a 1993-2007 subcohort of the VA Normative Aging Study (Mini-mental status exam (MMSE) n=741; global cognition summary score n=715), we used linear mixed effects models to test associations between cumulative Pb exposure (patella or tibia bone Pb) and repeated measures of cognition (MMSE, individual cognitive tests, and global cognition summary). Cox proportional hazard modeling assessed the risk of an MMSE score falling below 25. Among men 51-98 at baseline, higher patella Pb concentration (IQR: 21μg/g) was associated with -0.13 lower baseline MMSE (95% CI: -0.25, -0.004) and faster longitudinal MMSE decline (-0.016 units/year, 95% CI: -0.032, -0.0004) over 15 years. Each IQR increase in patella Pb was associated with increased risk of a MMSE score below 25 (HR=1.21, 95% CI: 0.99, 1.49; p=0.07). There were no significant associations between Pb and global cognition (both baseline and longitudinal change). Patella Pb was associated with faster longitudinal decline in Word List Total Recall in the language domain (0.014 units/year, 95% CI: -0.026, -0.001) and Word List Delayed Recall in the memory domain (0.014 units/year, 95% CI: -0.027, -0.002). We found weaker associations with tibia Pb. Cumulative Pb exposure is associated with faster declines in MMSE and Word List Total and Delayed Recall tests. These findings support the hypothesis that Pb exposure accelerates cognitive aging. Copyright © 2016 Elsevier Inc. All rights reserved.
Farooqui, Zishaan; Bakulski, Kelly M.; Power, Melinda C.; Weisskopf, Marc G.; Sparrow, David; Spiro, Avron; Vokonas, Pantel S.; Nie, Huiling; Hu, Howard; Park, Sung Kyun
2016-01-01
Background Lead (Pb) exposure has been associated with poorer cognitive function cross-sectionally in aging adults, however the association between cumulative Pb exposure and longitudinal changes in cognition is little characterized. Methods In a 1993–2007 subcohort of the VA Normative Aging Study (Mini-mental status exam (MMSE) n=741; global cognition summary score n=715), we used linear mixed effects models to test associations between cumulative Pb exposure (patella or tibia bone Pb) and repeated measures of cognition (MMSE, individual cognitive tests, and global cognition summary). Cox proportional hazard modeling assessed the risk of an MMSE score falling below 25. Results Among men 51–98 at baseline, higher patella Pb concentration (IQR: 21 µg/g) was associated with −0.13 lower baseline MMSE (95% CI: −0.25, −0.004) and faster longitudinal MMSE decline (−0.016 units/year, 95% CI: −0.032, −0.0004) over 15 years. Each IQR increase in patella Pb was associated with increased risk of a MMSE score below 25 (HR=1.21, 95% CI: 0.99, 1.49; p=0.07). There were no significant associations between Pb and global cognition (both baseline and longitudinal change). Patella Pb was associated with faster longitudinal decline in Word List Total Recall in the language domain (0.014 units/year, 95% CI: −0.026, −0.001) and Word List Delayed Recall in the memory domain (0.014 units/year, 95% CI: −0.027, −0.002). We found weaker associations with tibia Pb. Conclusions Cumulative Pb exposure is associated with faster declines in MMSE and Word List Total and Delayed Recall tests. These findings support the hypothesis that Pb exposure accelerates cognitive aging. PMID:27770710
Grashow, Rachel; Miller, Mark W; McKinney, Ann; Nie, Linda H; Sparrow, David; Hu, Howard; Weisskopf, Marc G
2013-01-01
Physiologically-based indicators of neural plasticity in humans could provide mechanistic insights into toxicant actions on learning in the brain, and perhaps prove more objective and sensitive measures of such effects than other methods. We explored the association between lead exposure and classical conditioning of the acoustic startle reflex (ASR)-a simple form of associative learning in the brain-in a population of elderly men. Fifty-one men from the VA Normative Aging Study with cumulative bone lead exposure measurements made with K-X-Ray-Fluorescence participated in a fear-conditioning protocol. The mean age of the men was 75.5years (standard deviation [sd]=5.9) and mean patella lead concentration was 22.7μg/g bone (sd=15.9). Baseline ASR eyeblink response decreased with age, but was not associated with subsequent conditioning. Among 37 men with valid responses at the end of the protocol, higher patella lead was associated with decreased awareness of the conditioning contingency (declarative learning; adjusted odds ratio [OR] per 20μg/g patella lead=0.91, 95% confidence interval [CI]: 0.84, 0.99, p=0.03). Eyeblink conditioning (non-declarative learning) was 0.44sd less (95% CI: -0.91, 0.02; p=0.06) per 20μg/g patella lead after adjustment. Each result was stronger when correcting for the interval between lead measurement and startle testing (awareness: OR=0.88, 95% CI: 0.78, 0.99, p=0.04; conditioning: -0.79sd less, 95% CI: -1.56, 0.03, p=0.04). This initial exploration suggests that lead exposure interferes with specific neural mechanisms of learning and offers the possibility that the ASR may provide a new approach to physiologically explore the effects of neurotoxicant exposures on neural mechanisms of learning in humans with a paradigm that is directly comparable to animal models. Copyright © 2013 Elsevier Inc. All rights reserved.
Effects of air pollution on heart rate variability: the VA normative aging study.
Park, Sung Kyun; O'Neill, Marie S; Vokonas, Pantel S; Sparrow, David; Schwartz, Joel
2005-03-01
Reduced heart rate variability (HRV), a marker of poor cardiac autonomic function, has been associated with air pollution, especially fine particulate matter [< 2.5 microm in aerodynamic diameter (PM2.5)]. We examined the relationship between HRV [standard deviation of normal-to-normal intervals (SDNN), power in high frequency (HF) and low frequency (LF), and LF:HF ratio] and ambient air pollutants in 497 men from the Normative Aging Study in greater Boston, Massachusetts, seen between November 2000 and October 2003. We examined 4-hr, 24-hr, and 48-hr moving averages of air pollution (PM2.5, particle number concentration, black carbon, ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide). Controlling for potential confounders, HF decreased 20.8% [95% confidence interval (CI), 4.6-34.2%] and LF:HF ratio increased 18.6% (95% CI, 4.1-35.2%) per SD (8 microg/m3) increase in 48-hr PM2.5. LF was reduced by 11.5% (95% CI, 0.4-21.3%) per SD (13 ppb) increment in 4-hr O3. The associations between HRV and PM2.5 and O3 were stronger in people with ischemic heart disease (IHD) and hypertension. The associations observed between SDNN and LF and PM2.5 were stronger in people with diabetes. People using calcium-channel blockers and beta-blockers had lower associations between O3 and PM2.5 with LF. No effect modification by other cardiac medications was found. Exposures to PM2.5 and O3 are associated with decreased HRV, and history of IHD, hypertension, and diabetes may confer susceptibility to autonomic dysfunction by air pollution.
Effects of Air Pollution on Heart Rate Variability: The VA Normative Aging Study
Park, Sung Kyun; O’Neill, Marie S.; Vokonas, Pantel S.; Sparrow, David; Schwartz, Joel
2005-01-01
Reduced heart rate variability (HRV), a marker of poor cardiac autonomic function, has been associated with air pollution, especially fine particulate matter [< 2.5 μm in aerodynamic diameter (PM2.5)]. We examined the relationship between HRV [standard deviation of normal-to-normal intervals (SDNN), power in high frequency (HF) and low frequency (LF), and LF:HF ratio] and ambient air pollutants in 497 men from the Normative Aging Study in greater Boston, Massachusetts, seen between November 2000 and October 2003. We examined 4-hr, 24-hr, and 48-hr moving averages of air pollution (PM2.5, particle number concentration, black carbon, ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide). Controlling for potential confounders, HF decreased 20.8% [95% confidence interval (CI), 4.6–34.2%] and LF:HF ratio increased 18.6% (95% CI, 4.1–35.2%) per SD (8 μg/m3) increase in 48-hr PM2.5. LF was reduced by 11.5% (95% CI, 0.4–21.3%) per SD (13 ppb) increment in 4-hr O3. The associations between HRV and PM2.5 and O3 were stronger in people with ischemic heart disease (IHD) and hypertension. The associations observed between SDNN and LF and PM2.5 were stronger in people with diabetes. People using calcium-channel blockers and beta-blockers had lower associations between O3 and PM2.5 with LF. No effect modification by other cardiac medications was found. Exposures to PM2.5 and O3 are associated with decreased HRV, and history of IHD, hypertension, and diabetes may confer susceptibility to autonomic dysfunction by air pollution. PMID:15743719
Grashow, Rachel; Spiro, Avron; Taylor, Kathryn M.; Newton, Kimberly; Shrairman, Ruth; Landau, Alexander; Sparrow, David; Hu, Howard; Weisskopf, Marc
2013-01-01
Background and Aims Lead exposure in children and occupationally-exposed adults has been associated with reduced visuomotor and fine motor function. However, associations in environmentally-exposed adults remain relatively unexplored. To address this, we examined the association between cumulative lead exposure—as measured by lead in bone—and performance on the Grooved Pegboard (GP) manual dexterity task, as well as on handwriting tasks using a novel assessment approach, among men in the VA Normative Aging Study (NAS). Methods GP testing was done with 362 NAS participants, and handwriting assessment with 328, who also had tibia and patella lead measurements made with K-X-Ray Fluorescence (KXRF). GP scores were time (sec) to complete the task with the dominant hand. The handwriting assessment approach assessed the production of signature and cursive lowercase l and m letter samples. Signature and lm task scores reflect consistency in repeated trials. We used linear regression to estimate associations and 95% confidence intervals (CI) with adjustment for age, smoking, education, income and computer experience. A backward elimination algorithm was used in the subset with both GP and handwriting assessment to identify variables predictive of each outcome. Results The mean (SD) participant age was 69.1 (7.2) years; mean patella and tibia concentrations were 25.0 (20.7) μg/g and 19.2 (14.6) μg/g, respectively. In multivariable-adjusted analyses, GP performance was associated with tibia (β per 15 μg/g bone = 4.66, 95% CI: 1.73, 7.58, p=0.002) and patella (β per 20 μg/g = 3.93, 95% CI: 1.11, 6.76, p = 0.006). In multivariable adjusted models of handwriting production, only the lm-pattern task showed a significant association with tibia (β per 15 μg/g bone = 1.27, 95% CI: 0.24, 2.29, p = 0.015), such that lm pattern production was more stable with increasing lead exposure. GP and handwriting scores were differentially sensitive to education, smoking, computer
Judi Dench's age-inappropriateness and the role of M: challenging normative temporality.
Krainitzki, Eva
2014-04-01
This article approaches Judi Dench's role as M in the long-running James Bond series from a gender and ageing studies' perspective and explores this character's subversion of normative concepts of gender and temporality. Based on the assumption that cultural narratives shape our understanding of ageing, it examines how M disrupts prescribed age- and gender roles, presenting an alternative within films which otherwise perpetuate normative notions of a sexualised, youthful femininity. It focusses on Dench's return as M in Casino Royale (2006), as an instance of anachronism (Russo, 1999), subverting viewers' expectation of linear timelines and examines M's challenge of normative age-appropriateness in Skyfall (2012). Despite M's portrayal as a more vulnerable female character in the latter, this article presents her character as an alternative to traditional portrayals of older women on screen. Copyright © 2014 Elsevier Inc. All rights reserved.
Ji, John S.; Schwartz, Joel; Sparrow, David; Hu, Howard; Weisskopf, Marc G.
2014-01-01
Objectives To examine the relation between occupation and cumulative lead exposure—assessed by measuring bone lead—in a community-dwelling population Method We measured bone lead concentration with K-shell X-Ray Fluorescence in 1,320 men in the Normative Aging Study. We categorized job titles into 14 broad US Census Bureau categories. We used ordinary least squares regression to estimate bone lead by job categories adjusted for other predictors. Results Service Workers, Construction and Extractive Craft Workers, and Installation, Maintenance and Repair Craft Workers had the highest bone lead concentrations. Including occupations significantly improved the overall model (p<0.001) and reduced by −15% to −81% the association between bone lead and education categories. Conclusion Occupation significantly predicts cumulative lead exposure in a community-dwelling population, and accounts for a large proportion of the association between education and bone lead. PMID:24709766
The normative dimensions of extending the human lifespan by age-related biomedical innovations.
Ehni, Hans-Joerg; Marckmann, Georg
2008-10-01
The current normative debate on age-related biomedical innovations and the extension of the human lifespan has important shortcomings. Mainly, the complexity of the different normative dimensions relevant for ethical and/or juridicial norms is not fully developed and the normative quality of teleological and deontological arguments is not properly distinguished. This article addresses some of these shortcomings and develops the outline of a more comprehensive normative framework covering all relevant dimensions. Such a frame necessarily has to include conceptions of a good life on the individual and societal levels. Furthermore, as a third dimension, a model for the access to and the just distribution of age-related biomedical innovations and technologies extending the human lifespan will be developed. It is argued that such a model has to include the different levels of the general philosophical theories of distributive justice, including social rights and theories of just health care. Furthermore, it has to show how these theories can be applied to the problem area of aging and extending the human lifespan.
Wilmoth, Janet M; London, Andrew S; Heflin, Colleen M
2015-07-01
Although there is substantial disability among veterans, relatively little is known about working-aged veterans' uptake of Department of Veterans Affairs (VA) Disability Compensation and Social Security Disability Insurance (DI). This study identifies levels of veteran participation in VA disability and/or DI benefit programs, examines transitions into and out of VA and DI programs among veterans, and estimates the size and composition of the veteran population receiving VA and/or DI benefits over time. Data from the 1992, 1993, 1996, 2001, 2004, and 2008 Survey of Income and Program Participation (SIPP) are used to describe VA and DI program participation among veterans under the age of 65. The majority of working-aged veterans do not receive VA or DI benefits and joint participation is low, but use of these programs has increased over time. A higher percentage of veterans receive VA compensation, which ranges from 4.9% in 1992 to 13.2% in 2008, than DI compensation, which ranges from 2.9% in 1992 to 6.7% in 2008. The rate of joint participation ranges from less than 1% in 1992 to 3.6% in 2008. Veterans experience few transitions between VA and DI programs during the 36-48 months they are observed. The number of veterans receiving benefits from VA and/or DI nearly doubled between 1992 and 2008. There have been substantial shifts in the composition of veterans using these programs, as cohorts who served prior to 1964 are replaced by those who served after 1964. The findings suggest potential gaps in veterans' access to disability programs that might be addressed through improved coordination of VA and DI benefits. Copyright © 2015 Elsevier Inc. All rights reserved.
Social representations and normative beliefs of aging.
Torres, Tatiana de Lucena; Camargo, Brigido Vizeu; Boulsfield, Andréa Barbará; Silva, Antônia Oliveira
2015-12-01
This study adopted the theory of social representations as a theoretical framework in order to characterize similarities and differences in social representations and normative beliefs of aging for different age groups. The 638 participants responded to self-administered questionnaire and were equally distributed by sex and age. The results show that aging is characterized by positive stereotypes (knowledge and experience); however, retirement is linked to aging, but in a negative way, particularly for men, involving illness, loneliness and disability. When age was considered, it was verified that the connections with the representational elements became more complex for older groups, showing social representation functionality, largely for the elderly. Adulthood seems to be preferred and old age is disliked. There were divergences related to the perception of the beginning of life phases, especially that of old age. Work was characterized as the opposite of aging, and it revealed the need for actions intended for the elderly and retired workers, with post-retirement projects. In addition, it suggests investment in public policies that encourage intergenerational contact, with efforts to reduce intolerance and discrimination based on age of people.
Ozone exposure, antioxidant genes, and lung function in an elderly cohort: VA Normative Aging Study
Alexeeff, Stacey E.; Litonjua, Augusto A.; Wright, Robert O.; Baccarelli, Andrea; Suh, Helen; Sparrow, David; Vokonas, Pantel S.; Schwartz, Joel
2008-01-01
Background Ozone exposure is known to cause oxidative stress. We investigated the acute effects of ozone (O3) on lung function in the elderly, a suspected risk group. We then investigated whether genetic polymorphisms of antioxidant genes (heme oxygenase-1 [HMOX1] and glutathione S-transferase pi [GSTP1]) modified these associations. Methods We studied 1,100 elderly men from the Normative Aging Study whose lung function (forced vital capacity [FVC] and forced expiratory volume in one second [FEV1]) was measured every 3 years from 1995–2005. We genotyped the GSTP1 Ile105Val and Ala114Val polymorphisms and the (GT)n repeat polymorphism in the HMOX1 promoter, classifying repeats as short (n<25) or long (n 25). Ambient O3 was measured continuously at locations in the Greater Boston area. We used mixed linear models, adjusting for known confounders. Results A 15 ppb increase in O3 during the previous 48 hours was associated with a 1.25% decrease in FEV1 (95% CI: −1.96%, −0.54%). This estimated effect was worsened with either the presence of a long (GT)n repeat in HMOX1 (−1.38%, 95% CI: −2.11%, −0.65) or the presence of an allele coding for Val105 in GSTP1 (−1.69%, 95% CI: −2.63%, −0.75). A stronger estimated effect of O3 on FEV1 was found in subjects carrying both the GSTP1 105Val variant and the HMOX1 long (GT)n repeat (−1.94%, 95% CI: −2.89%, −0.98%). Similar associations were also found between FVC and ozone exposure. Conclusions Our results suggest that ozone has an acute effect on lung function in the elderly, and the effects may be modified by the presence of specific polymorphisms in antioxidant genes. PMID:18524839
Preliminary normative data on the BORB for children aged 3-8.
Brunsdon, Ruth; Joy, Pamela; Patten, Erin; Burton, Karen
2018-05-09
The Birmingham Object Recognition Battery (BORB) is a theoretically based test battery that is used in adult cognitive neuropsychology in research and for clinical assessment. It allows a detailed analysis of underlying impairments in individuals with brain injury who have visual object recognition difficulties. The BORB's usefulness in pediatrics is supported by numerous research studies. However, there is no published normative data for children, making clinical use of the test difficult. The aim of this brief report is to publish some preliminary normative data in 70 children aged between 3 and 8 years to assist both researchers and clinicians with interpretation of test scores. Results indicate that children's performance on individual BORB subtests varies according to task demands and age. For some subtests there is improvement in performance with increasing age. However, very young children (age 3-4 years) perform at adult levels on some subtests, or alternatively on other subtests they perform at the level of chance. The current paper supports the need for pediatric data for the BORB due to large normal individual variation in performance and varying age-related performance on individual BORB subtests.
Age- and Gender-Specific Normative Information from Children Assessed with a Dichotic Words Test.
Moncrieff, Deborah
2015-01-01
The most widely used assessment in the clinical auditory processing disorder (APD) battery is the dichotic listening test. New tests with normative information are helpful for assessment and cross-check of results for reliable diagnosis. The Dichotic Words Test was developed for use in the clinical test battery for diagnosis of APD. The test stimuli were common single syllable words matched for average root-mean-square amplitude and each pair was temporally aligned at both onset and offset. The study was conducted to collect performance results from typically developing children to create normative information for the test. The study follows a cross-sectional design. Typically developing children (n = 416) between the ages of 5 and 12 yr were recruited from schools in the community. There were 217 males and 199 females in the study sample. Only children who passed a hearing screening were eligible to participate. Scores for each ear were recorded during administration of the first free recall version of the test. Ear advantages based on results recorded for left and right ears were used to measure prevalence of right, left, and no ear advantages. Results for each listener's dominant and non-dominant ears and the absolute difference between them were put into the data analysis. Results were analyzed for normality and because no results were normally distributed, all further analyses were done with nonparametric statistical tests. Normative data for dominant and non-dominant ear scores and ear advantages were determined at the 95% confidence interval through bootstrapping methods with 1,000 samples. Children were divided into four age groups based on results in their dominant ears. Females generally performed better than males and the prevalence of a right-ear advantage was ∼60% across all children tested. Normative lower-bound cut-off scores were established for males and females within each age group for dominant and non-dominant ear scores. Normative upper
Fitkids Treadmill Test: Age- and Sex-Related Normative Values in Dutch Children and Adolescents.
Kotte, Elles M W; de Groot, Janke F; Bongers, Bart C; Winkler, Alexander M F; Takken, Tim
2016-11-01
Recent research has shown that the Fitkids Treadmill Test (FTT) is a valid and reproducible exercise test for the assessment of aerobic exercise capacity in children and adolescents who are healthy. The study objective was to provide sex- and age-related normative values for FTT performance in children and adolescents who were healthy, developing typically, and 6 to 18 years of age. This was a cross-sectional, observational study. Three hundred fifty-six children and adolescents who were healthy (174 boys and 182 girls; mean age=12.9 years, SD=3.7) performed the FTT to their maximal effort to assess time to exhaustion (TTE). The least-mean-square method was used to generate sex- and age-related centile charts (P3, P10, P25, P50, P75, P90, and P97) for TTE on the FTT. In boys, the reference curve (P50) showed an almost linear increase in TTE with age, from 8.8 minutes at 6 years of age to 16.1 minutes at 18 years of age. In girls, the P50 values for TTE increased from 8.8 minutes at 6 years of age to 12.5 minutes at 18 years of age, with a plateau in TTE starting at approximately 10 years of age. Youth who were not white were underrepresented in this study. This study describes sex- and age-related normative values for FTT performance in children and adolescents who were healthy, developing typically, and 6 to 18 years of age. These age- and sex-related normative values will increase the usefulness of the FTT in clinical practice. © 2016 American Physical Therapy Association.
Van der Elst, Wim; Van Boxtel, Martin P J; Van Breukelen, Gerard J P; Jolles, Jelle
2006-03-01
The Stroop Color-Word Test was administered to 1,856 cognitively screened, healthy Dutch speaking participants aged 24 to 81 years. The effects of age, gender, and education on Stroop test performance were investigated to adequately stratify the normative data. The results showed that especially the speed-dependent Stroop scores (time to complete a subtest), rather than the accuracy measures (the errors made per Stroop sub-task), were profoundly affected by the demographic variables. In addition to the main effects of the demographic variables, an Age Low Level of Education interaction was found for the Error III and the Stroop Interference scores. This suggests that executive function, as measured by the Stroop test, declines with age and that the decline is more pronounced in people with a low level of education. This is consistent with the reserve hypothesis of brain aging (i.e., that education generates reserve capacity against the damaging effects of aging on brain functions). Normative Stroop data were established using both a regression-based and traditional approach, and the appropriateness of both methods for generating normative data is discussed.
Longitudinal posturography and rotational testing in children 3-9 years of age: Normative data
Casselbrant, Margaretha L.; Mandel, Ellen M.; Sparto, Patrick J; Perera, Subashan; Redfern, Mark S.; Fall, Patricia A.; Furman, Joseph M.
2010-01-01
Objective To obtain normative longitudinal vestibulo-ocular and balance test data in children from ages 3 to 9 with normal middle-ear status. Study Design Prospective, longitudinal cohort Setting Tertiary care pediatric hospital Subjects and Methods Three-year-old children were entered and tested yearly. Subjects underwent earth vertical axis rotation testing using sinusoidal and constant velocity stimuli and performed the Sensory Organization Test. Results One hundred forty-eight children were entered and usable data were collected on 127 children. A linear increase in the vestibulo-ocular reflex gain as children aged was found, without a change in the phase of the response. An age-related linear increase in Equilibrium Scores, indicating reduced postural sway, was also observed. Conclusion These normative data can be used in the evaluation of dizziness and balance disorders in children. PMID:20416461
Gerstenecker, Adam; Eakin, Amanda; Triebel, Kristen; Martin, Roy; Swenson-Dravis, Dana; Petersen, Ronald C; Marson, Daniel
2016-06-01
Financial capacity is an instrumental activity of daily living (IADL) that comprises multiple abilities and is critical to independence and autonomy in older adults. Because of its cognitive complexity, financial capacity is often the first IADL to show decline in prodromal and clinical Alzheimer's disease and related disorders. Despite its importance, few standardized assessment measures of financial capacity exist and there is little, if any, normative data available to evaluate financial skills in the elderly. The Financial Capacity Instrument-Short Form (FCI-SF) is a brief measure of financial skills designed to evaluate financial skills in older adults with cognitive impairment. In the current study, we present age- and education-adjusted normative data for FCI-SF variables in a sample of 1344 cognitively normal, community-dwelling older adults participating in the Mayo Clinic Study of Aging (MCSA) in Olmsted County, Minnesota. Individual FCI-SF raw scores were first converted to age-corrected scaled scores based on position within a cumulative frequency distribution and then grouped within 4 empirically supported and overlapping age ranges. These age-corrected scaled scores were then converted to age- and education-corrected scaled scores using the same methodology. This study has the potential to substantially enhance financial capacity evaluations of older adults through the introduction of age- and education-corrected normative data for the FCI-SF by allowing clinicians to: (a) compare an individual's performance to that of a sample of similar age and education peers, (b) interpret various aspects of financial capacity relative to a normative sample, and (c) make comparisons between these aspects. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Kenny, Rose Anne; Coen, Robert F; Frewen, John; Donoghue, Orna A; Cronin, Hilary; Savva, George M
2013-05-01
To provide normative values of tests of cognitive and physical function based on a large sample representative of the population of Ireland aged 50 and older. Data were used from the first wave of The Irish Longitudinal Study on Ageing (TILDA), a prospective cohort study that includes a comprehensive health assessment. Health assessment was undertaken at one of two dedicated health assessment centers or in the study participant's home if travel was not practicable. Five thousand eight hundred ninety-seven members of a nationally representative sample of the community-living population of Ireland aged 50 and older. Those with severe cognitive impairment, dementia, or Parkinson's disease were excluded. Measurements included height and weight, normal walking speed, Timed Up-and-Go, handgrip strength, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Color Trails Test, and bone mineral density. Normative values were estimated using generalized additive models for location shape and scale (GAMLSS) and are presented as percentiles, means, and standard deviations. Generalized additive models for location shape and scale fit the observed data well for each measure, leading to reliable estimates of normative values. Performance on all tasks decreased with age. Educational attainment was a strong determinant of performance on all cognitive tests. Tests of walking speed were dependent on height. Distribution of body mass index did not change with age, owing to simultaneous declines in weight and height. Normative values were found for tests of many aspects of cognitive and physical function based on a representative sample of the general older Irish population. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.
Both odor identification and ApoE-ε4 contribute to normative cognitive aging.
Finkel, Deborah; Reynolds, Chandra A; Larsson, Maria; Gatz, Margaret; Pedersen, Nancy L
2011-12-01
Research indicates that apoliprotein E (ApoE) plays a role in the development of Alzheimer's disease (AD) and possibly in the cognitive decline associated with normative aging. More recently, researchers have shown that ApoE is expressed in olfactory brain structures, and a relationship among ApoE, AD, and olfactory function has been proposed. In the current analyses, we investigated the contribution of ApoE and odor identification in decline trajectories associated with normative cognitive aging in various domains, using longitudinal data on cognitive performance available from the Swedish Adoption/Twin Study of Aging. Data on both ApoE status and olfactory functioning were available from 455 individuals ranging in age from 50 to 88 years at the first measurement occasion. Odor identification was measured via a mailed survey. Cognitive performance was assessed in up to 5 waves of in-person testing covering a period of 16 years. Latent growth curve analyses incorporating odor identification and ApoE status indicated a main effect of odor identification on the performance level in three cognitive domains: verbal, memory, and speed. A main effect of ApoE on rates of decline after age 65 was found for verbal, spatial, and speed factors. The consistency of results across cognitive domains provides support for theories that posit central nervous system-wide origins of the olfaction-cognition-ApoE relationship; however, olfactory errors and APOE ε4 show unique and differential effects on cognitive trajectory features.
Multivariate normative comparisons using an aggregated database
Murre, Jaap M. J.; Huizenga, Hilde M.
2017-01-01
In multivariate normative comparisons, a patient’s profile of test scores is compared to those in a normative sample. Recently, it has been shown that these multivariate normative comparisons enhance the sensitivity of neuropsychological assessment. However, multivariate normative comparisons require multivariate normative data, which are often unavailable. In this paper, we show how a multivariate normative database can be constructed by combining healthy control group data from published neuropsychological studies. We show that three issues should be addressed to construct a multivariate normative database. First, the database may have a multilevel structure, with participants nested within studies. Second, not all tests are administered in every study, so many data may be missing. Third, a patient should be compared to controls of similar age, gender and educational background rather than to the entire normative sample. To address these issues, we propose a multilevel approach for multivariate normative comparisons that accounts for missing data and includes covariates for age, gender and educational background. Simulations show that this approach controls the number of false positives and has high sensitivity to detect genuine deviations from the norm. An empirical example is provided. Implications for other domains than neuropsychology are also discussed. To facilitate broader adoption of these methods, we provide code implementing the entire analysis in the open source software package R. PMID:28267796
The Steep Ramp Test in Dutch white children and adolescents: age- and sex-related normative values.
Bongers, Bart C; de Vries, Sanne I; Obeid, Joyce; van Buuren, Stef; Helders, Paul J M; Takken, Tim
2013-11-01
The Steep Ramp Test (SRT), a feasible, reliable, and valid exercise test on a cycle ergometer, may be more appealing for use in children in daily clinical practice than the traditional cardiopulmonary exercise test because of its short duration, its resemblance to children's daily activity patterns, and the fact that it does not require respiratory gas analysis. The aim of the present study was to provide sex- and age-related normative values for SRT performance in Dutch white children and adolescents who were healthy and 8 to 19 years old. This was a cross-sectional, observational study. A total of 252 Dutch white children and adolescents, 118 boys (mean age=13.4 years, SD=3.0) and 134 girls (mean age=13.4 years, SD=2.9), performed the SRT (work rate increment of 10, 15, or 20 W·10 s(-1), depending on body height) to voluntary exhaustion to assess peak work rate (WRpeak). Normative values are presented as reference centiles developed by use of generalized additive models for location, scale, and shape. Peak work rate correlated highly with age (r=.915 and r=.811), body mass (r=.870 and r=.850), body height (r=.922 and r=.896), body surface area (r=.906 and r=.885), and fat free mass (r=.930 and r=.902) in boys and girls, respectively. The reference curves demonstrated an almost linear increase in WRpeak with age in boys, even when WRpeak was normalized for body mass. In contrast, absolute WRpeak in girls increased constantly until the age of approximately 13 years, when it started to level off. Peak work rate normalized for body mass in girls showed only a slight increase with age until 14 years of age, when a slight decrease in relative WRpeak was observed. The sample may not have been entirely representative of the Dutch population. The present study provides sex- and age-related normative values for SRT performance in terms of both absolute WRpeak and relative WRpeak, thereby facilitating the interpretation of SRT results by clinicians and researchers.
The Impact of a Change in the Price of VA Health Care on Utilization of VA and Medicare Services.
Nelson, Richard E; Hicken, Bret; Vanneman, Megan; Liu, Chuan-Fen; Rupper, Randall
2018-05-15
The passage of the Veterans Access, Choice, and Accountability Act of 2014 has expanded the non-Veteran Affairs (VA) care options for eligible US Veterans. In order for these new arrangements to provide the best care possible for Veterans, it is important to understand the relationship between VA and non-VA care options. The purpose of this study was to use another recent VA policy change, one that increased the reimbursement rate that eligible Veterans receive for travel for health care to VA, to understand the use of VA and Medicare services among Medicare-enrolled Veterans. We used a difference-in-difference technique to compare inpatient and outpatient utilization and cost in VA and Medicare between Veterans who were eligible for travel reimbursement and those who were not eligible following 2 increases in the travel reimbursement rate. We used generalized estimating equation models and 2-part models when cost outcomes were rare. Our cohort consisted of 110,007 Medicare-enrolled Veterans, including 25,076 under 65 and 84,931 over 65 years old. Following the travel reimbursement rate increases, the number of VA outpatient encounters increased for Veterans in our cohort regardless of age group or whether living in an urban or rural area. The number of non-VA outpatient encounters decreased significantly for Veterans in both age groups living in rural areas following these policy changes. Our estimates suggest that VA outpatient care may be a substitute for Medicare outpatient care for Medicare-enrolled Veterans living in rural areas. These results are important because they indicate how Veteran health care utilization might be affected by future policy changes designed to increase access to VA services. They also indicate the ripple effects that may occur in other health systems due to changes in the VA system.
Nur Yilmaz, R B; Oktay, I; Ilhan, D; Fişekçioğlu, E; Özdemir, Fulya
2017-12-01
To evaluate and compare the normative and subjective need for orthodontic treatment within different age groups in Turkey. One thousand and sixteen patients from seven different demographic regions of Turkey (Marmara, Black Sea, East Anatolia, Southeastern Anatolia, Mediterranean, Aegean, and Central Anatolia Region) (mean age ± SD: 12.80 ± 3.57 years) were randomly selected and divided into six age groups (7-8,9-10,11-12,13-14,15-16, and 17-18 year-olds) and categorized according to the dental health component (DHC) of the index for orthodontic treatment need (IOTN). Additionally, the patients were asked to indicate the photograph that was most similar to their own dentition from the 10-point scale of the aesthetic component of IOTN. The DHC of IOTN was not significantly different between the six age groups (P > 0.05). However, no/slight need (aesthetic component 1-4) for orthodontic treatment according to AC of IOTN was significantly higher in 13-14,15-16, and 17-18 age groups than 7-8, 9-10, and 11-12 age groups (P < 0.05). No sex differences were found in both DHC and aesthetic component of IOTN between age groups (P > 0.05). The normative need distribution was homogeneous within all the age groups according to DHC. However, the subjective need for orthodontic treatment was higher in the younger age groups.
ERIC Educational Resources Information Center
Van der Elst, Wim; Van Boxtel, Martin P. J.; Van Breukelen, Gerard J. P.; Jolles, Jelle
2006-01-01
The Stroop Color-Word Test was administered to 1,856 cognitively screened, healthy Dutch-speaking participants aged 24 to 81 years. The effects of age, gender, and education on Stroop test performance were investigated to adequately stratify the normative data. The results showed that especially the speed-dependent Stroop scores (time to complete…
Ramírez-Vélez, Robinson; Martínez, Martin; Correa-Bautista, Jorge E; Lobelo, Felipe; Izquierdo, Mikel; Rodríguez-Rodríguez, Fernando; Cristi-Montero, Carlos
2017-08-01
Ramírez-Vélez, R, Martínez, M, Correa-Bautista, JE, Lobelo, F, Izquierdo, M, Rodríguez-Rodríguez, F, and Cristi-Montero, C. Normative reference of standing long jump for Colombian schoolchildren aged 9-17.9 years: The FUPRECOL study. J Strength Cond Res 31(8): 2083-2090, 2017-The purpose of this study was to generate normative values for the standing long jump (SLJ) test in 9- to 17.9-year olds and to investigate sex and age-group differences. The sample comprised 8,034 healthy Colombian schoolchildren [boys n = 3,488 and girls n = 4,546; mean (SD) age 12.8 (±2.3) years old]. Each participant performed two SLJ. Centile smoothed curves, percentile, and tables for the third, 10th, 25th, 50th, 75th, 90th, and 97th percentiles were calculated using Cole's Lambda-Mu-Sigma method. The 2-way analysis of variance tests and Cohen's d showed that the maximum SLJ (centimeter) was higher in boys than in girls across age groups (p < 0.01), reaching the peak at 13 years. Posthoc analyses within the sexes showed yearly increases in SLJ in all ages. In boys, the 50th percentile SLJ score ranged from 109 to 165 cm. In girls, the 50th percentile jump ranged from 96 to 120 cm. For girls, jump scores increased yearly from age 9 to 12.9 years before reaching a plateau at an age between 13 and 15.9. Our results provide, for the first time, sex- and age-specific SLJ reference values for Colombian schoolchildren aged 9-17.9 years. The normative values presented in this study provide the basis for the determination of the proposed age- and sex-specific standards for the FUPRECOL (Association for Muscular Strength with Early Manifestation of Cardiovascular Disease Risk Factors Among Colombian Children and Adolescents) Study-Physical fitness battery for children and adolescents.
[The normative legal regulation of social protection of disabled persons of able-bodied age].
Medvedeva, O V; Afonina, N A; Draienkova, F R
2017-01-01
The article presents results of analysis of normative legal documents and basic laws relating to social protection of the disabled of able-bodied age and also to development ofpublic policy concerning the given category ofpopulation. The purpose of actual study is to analyze main normative legal documents in the field of investigation of social protection of the disabled of able-bodied age as applied to experience of the Riazanskaia oblast. The actuality of study is determined by problem of social legal defense of the disabled as one of the most complicated and requiring from society both understanding and participation in this process of many specialized institutions and structures. The analysis of study results permits to conclude that the regional legislation in its total with standards of the Federal legislation contains regulations reflecting fundamental principles and norms of the Convention of the rights of the disabled. On application of currently in force legislation and in the process of legislative activity the state and public institutions of the Riazanskaia oblast seek the possibly most broad implementation of the rights of the disabled and securing access to social, political, civil, cultural and other integration into society.
Spanish Multicenter Normative Studies (NEURONORMA Project): methods and sample characteristics.
Peña-Casanova, Jordi; Blesa, Rafael; Aguilar, Miquel; Gramunt-Fombuena, Nina; Gómez-Ansón, Beatriz; Oliva, Rafael; Molinuevo, José Luis; Robles, Alfredo; Barquero, María Sagrario; Antúnez, Carmen; Martínez-Parra, Carlos; Frank-García, Anna; Fernández, Manuel; Alfonso, Verónica; Sol, Josep M
2009-06-01
This paper describes the methods and sample characteristics of a series of Spanish normative studies (The NEURONORMA project). The primary objective of our research was to collect normative and psychometric information on a sample of people aged over 49 years. The normative information was based on a series of selected, but commonly used, neuropsychological tests covering attention, language, visuo-perceptual abilities, constructional tasks, memory, and executive functions. A sample of 356 community dwelling individuals was studied. Demographics, socio-cultural, and medical data were collected. Cognitive normality was validated via informants and a cognitive screening test. Norms were calculated for midpoint age groups. Effects of age, education, and sex were determined. The use of these norms should improve neuropsychological diagnostic accuracy in older Spanish subjects. These data may also be of considerable use for comparisons with other normative studies. Limitations of these normative data are also commented on.
Ndila, Carolyne; Bauni, Evasius; Mochamah, George; Nyirongo, Vysaul; Makazi, Alex; Kosgei, Patrick; Tsofa, Benjamin; Nyutu, Gideon; Etyang, Anthony; Byass, Peter; Williams, Thomas N
2014-01-01
The vast majority of deaths in the Kilifi study area are not recorded through official systems of vital registration. As a result, few data are available regarding causes of death in this population. To describe the causes of death (CODs) among residents of all ages within the Kilifi Health and Demographic Surveillance System (KHDSS) on the coast of Kenya. Verbal autopsies (VAs) were conducted using the 2007 World Health Organization (WHO) standard VA questionnaires, and VA data further transformed to align with the 2012 WHO VA instrument. CODs were then determined using the InterVA-4 computer-based probabilistic model. Five thousand one hundred and eighty seven deaths were recorded between January 2008 and December 2011. VA interviews were completed for 4,460 (86%) deaths. Neonatal pneumonia and birth asphyxia were the main CODs in neonates; pneumonia and malaria were the main CODs among infants and children aged 1-4, respectively, while HIV/AIDS was the main COD for adult women of reproductive age. Road traffic accidents were more commonly observed among men than women. Stroke and neoplasms were common CODs among the elderly over the age of 65. We have established the main CODs among people of all ages within the area served by the KHDSS on the coast of Kenya using the 2007 WHO VA questionnaire coded using InterVA-4. We hope that our data will allow local health planners to estimate the burden of various diseases and to allocate their limited resources more appropriately.
Why Do Older Men Report Low Stress Ratings? Findings from the Veterans Affairs Normative Aging Study
ERIC Educational Resources Information Center
Boeninger, Daria K.; Shiraishi, Ray W.; Aldwin, Carolyn M.; Spiro, Avron, III
2009-01-01
We examined the interplay between three explanatory hypotheses for why older adults appear to rate their problems as less stressful than do younger adults: age-related differences in personality, in types of problems, and in the appraisal process--specifically, the number of primary stress appraisals. A sample of 1,054 men from the Normative Aging…
Gaertner, Beate; Wagner, Michael; Luck, Tobias; Buttery, Amanda K; Fuchs, Judith; Busch, Markus A
2018-06-17
To provide normative data for the Digit Symbol Substitution Test (DSST) of the Wechsler Adult Intelligence Scale, 3rd edition (WAIS-III) in a population-based sample of community-dwelling older adults in Germany according to age, sex, and level of education. The sample comprised 1385 participants aged 65-79 years from the nationwide representative 'German Health Interview and Examination Survey for Adults' (DEGS1, 2008-2011). Participants with known cognitive impairment or dementia, other medical conditions affecting cognition, or currently using psychotropic drugs were excluded. Educational level was categorized as low, medium, and high according to the Comparative Analyses of Social Mobility in Industrial Nations (CASMIN) scale. Normative values for the DSST according to age, sex, and level of education were estimated by multiple linear regression using population weights. Mean age was 71.1 years, 48.6% were men and low, medium, and high education levels were 62.8, 24.6, and 12.6%, respectively. Younger age, female sex, and higher level of education were significantly associated with higher DSST scores. Regression-based normative data for the DSST is provided according to age, sex, and level of education. In addition, a normative score calculator is provided. These are the first age-, sex-, and education-specific normative data for older individuals for the DSST of the WAIS-III in Germany. These normative data will enable future population-level analyses on impaired cognitive function according to DSST.
Normative data for the Clock Drawing Test for French-Quebec mid- and older aged healthy adults.
Turcotte, Valérie; Gagnon, Marie-Eve; Joubert, Sven; Rouleau, Isabelle; Gagnon, Jean-François; Escudier, Frédérique; Koski, Lisa; Potvin, Olivier; Macoir, Joël; Hudon, Carol
2018-05-09
The Clock Drawing Test (CDT) is frequently used to screen for cognitive impairment, however, normative data for Rouleau et al.'s scoring system are scarce. The present study aims to provide norms for Rouleau et al.'s scoring system that are tailored to Quebec French-speaking mid- and older aged healthy adults. Six researchers from various research centers across the Province of Quebec (Canada) sent anonymous data for 593 (391 women) healthy community-dwelling volunteers (age range: 43-93 years; education range: 5-23 years) who completed the CDT 'drawing on command' version. This command version (setting the clock hands to 11:10, without a pre-drawn circle) was administrated as part of a more extensive neuropsychological assessment, or along with cognitive screening instruments. Each drawn clock was scored according to the quantitative criteria set by Rouleau et al.'s scoring system. CDT scores were significantly correlated with age (r(592) = -.132, p = .001) and years of education (r(592) = .116, p = .005), but not with sex (r(592) = .065, p = .112). Since data were skewed towards higher test scores, the percentiles method was used for analysis. Percentile ranks stratified by age and education are presented. These normative data for Rouleau et al.'s scoring system will contribute towards adequately screening for cognitive decline in Quebec French-speaking healthy adults, by also taking into account individual characteristics such as age and education.
Hazin, Izabel; Leite, Gilmara; Oliveira, Rosinda M.; Alencar, João C.; Fichman, Helenice C.; Marques, Priscila d. N.; de Mello, Claudia Berlim
2016-01-01
Verbal fluency is a basic function of language that refers to the ability to produce fluent speech. Despite being an essentially linguistic function, its measurements are also used to evaluate executive aspects of verbal behavior. Performance in verbal fluency (VF) tasks varies according to age, education, and cognitive development. Neurodevelopmental disorders that affect the functioning of frontal areas tend to cause lower performance in VF tasks. Despite the relative consensus that has been reached in terms of the use of VF tasks for the diagnosis of dyslexia and attention-deficit/hyperactivity disorder, few studies have considered regional variations in Brazil. The present study sought to provide normative data on VF tasks in children by considering gender, age, education, and geopolitical region of origin with auxiliary purposes in neuropsychological diagnosis of disorders that occur with executive changes The study included 298 participants, 7–10 years of age of both genders, who performed three letter fluency tasks and three category fluency tasks. The data were subjected to correlational and variance analyses, with age and gender as factors. No effect of gender on the children's performance was found. However, significant differences between age groups were observed, with better performance in letter tasks in older children and better performance in letter tasks compared with category tasks. Significant regional differences in performance on the letter VF task were observed. These results reinforce the importance of regional normative data in countries with high regional cultural variations, such as Brazil. PMID:27242598
Untimed Design Fluency in Aging and Alzheimer's Disease: Psychometrics and Normative Data.
Sunderaraman, Preeti; Sokolov, Elisaveta; Cines, Sarah; Sullo, Elizabeth; Orly, Aidan; Lerer, Bianca; Karlawish, Jason; Huey, Edward; Cosentino, Stephanie
2015-01-01
Design fluency tests, commonly used in both clinical and research contexts to evaluate nonverbal concept generation, have the potential to offer useful information in the differentiation of healthy versus pathological aging. Although normative data for older adults (OAs) are available for multiple timed versions of this test, similar data have been unavailable for a previously published untimed test, the Graphic Pattern Generation Test (GPG). Time constraints common to almost all of the available design fluency tests may cloud interpretation of higher-level executive abilities-for example, in individuals with slow processing speed. The current study examined the psychometric properties of the GPG and presents normative data in a sample of 167 healthy OAs and 110 individuals diagnosed with Alzheimer's disease (AD). Results suggest that a brief version of the GPG can be administered reliably and that this short form has high test-retest and interrater reliability. Number of perseverations was higher in individuals with AD as compared with OAs. A cutoff score of 4 or more perseverations showed a moderate degree of sensitivity (76%) and specificity (37%) in distinguishing individuals with AD and OAs. Finally, perseverations were associated with nonmemory indexes, thereby underscoring the nonverbal nature of this error in OAs and individuals with AD.
Haemophilia utilization group study - Part Va (HUGS Va): design, methods and baseline data.
Zhou, Z-Y; Wu, J; Baker, J; Curtis, R; Forsberg, A; Huszti, H; Koerper, M; Lou, M; Miller, R; Parish, K; Riske, B; Shapiro, A; Ullman, M; Johnson, K
2011-09-01
To describe the study design, procedures and baseline characteristics of the Haemophilia Utilization Group Study - Part Va (HUGS Va), a US multi-center observational study evaluating the cost of care and burden of illness in persons with factor VIII deficiency. Patients with factor VIII level ≤ 30%, age 2-64 years, receiving treatment at one of six federally supported haemophilia treatment centres (HTCs) were enrolled in the study. Participants completed an initial interview including questions on socio-demographical characteristics, health insurance status, co-morbidities, access to care, haemophilia treatment regimen, factor utilization, self-reported joint pain and motion limitation and health-related quality of life. A periodic follow-up survey collected data regarding time lost from usual activities, disability days, health care utilization and outcomes of care. HTC clinicians documented participants' baseline clinical characteristics and pharmacy dispensing records for 2 years. Between July 2005 and July 2007, 329 participants were enrolled. Average age was 9.7 years for children and 33.5 years for adults; two-thirds had severe haemophilia. The distributions of age, marital status, education level and barriers to haemophilia care were relatively consistent across haemophilic severity categories. Differences were found in participants' employment status, insurance status and income. Overall, children with haemophilia had quality of life scores comparable to healthy counterparts. Adults had significantly lower physical functioning than the general US population. As one of the largest economic studies of haemophilia care, HUGS Va will provide detailed information regarding the burden of illness and health care utilization in the US haemophilia A population. © 2011 Blackwell Publishing Ltd.
Hoeboer, J J A A M; Ongena, G; Krijger-Hombergen, M; Stolk, E; Savelsbergh, G J P; de Vries, S I
2018-02-07
The aim of the presented study is to provide age- and gender-related normative values and MQ values for a motor skills test, the Athletic Skills Track, among 4- to 12-year-old children. Cross-sectional. In 2016, a total of 7977 Dutch children, 4036 boys (mean age 8.6 years, SD 2.1) and 3941 girls (mean age 8.6 years, SD 2.1), performed an age-related version of the Athletic Skills Track (AST). The AST is a track consisting of 5-7 fundamental movement skill tasks that should be completed as fast as possible. The children performed the test during a regular physical education (PE) lesson under the supervision of their own PE teacher. For each version of the AST (AST-1: n=917; AST-2: n=3947; AST-3: n=3213) age- and gender-related reference centiles were derived from the gathered data using the Lambda, Mu, Sigma (LMS) method. All children completed the AST within 60s (mean 29.6s, SD 7.7). An independent samples t-test showed that boys were significantly faster in completing the track than girls, except for the 4-year-old boys. Therefore, age- and gender-related reference centiles were derived. The reference curves demonstrate an almost linear decrease in time to complete AST-1 and AST-2 with increasing age. The present study provides age- and gender-related normative values and MQ values for the AST among 4- to 12-year-old Dutch children. With these normative values PE teachers can interpret children's performance on the AST. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Riggs, Anne E; Young, Andrew G
2016-08-01
What influences children's normative judgments of conventional rules at different points in development? The current study explored the effects of two contextual factors on children's normative reasoning: the way in which the rules were learned and whether the rules apply to the self or others. Peer dyads practiced a novel collaborative board game comprising two complementary roles. Dyads were either taught both the prescriptive (i.e., what to do) and proscriptive (i.e., what not to do) forms of the rules, taught only the prescriptive form of the rules, or created the rules themselves. Children then judged whether third parties were violating or conforming to the rules governing their own roles and their partner's roles. Early school-aged children's (6- to 7-year-olds; N = 60) normative judgments were strongest when they had been taught the rules (with or without the proscriptive form), but were more flexible for rules they created themselves. Preschool-aged children's (4- to 5-year-olds; N = 60) normative judgments, however, were strongest when they were taught both the prescriptive and proscriptive forms of the rules. Additionally, preschoolers exhibited stronger normative judgments when the rules governed their own roles rather than their partner's roles, whereas school-aged children treated all rules as equally normative. These results demonstrate that children's normative reasoning is contingent on contextual factors of the learning environment and, moreover, highlight 2 specific areas in which children's inferences about the normativity of conventions strengthen over development. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers.
Wang, Virginia; Maciejewski, Matthew L; Patel, Uptal D; Stechuchak, Karen M; Hynes, Denise M; Weinberger, Morris
2013-01-18
Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both ("dual") settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans' baseline dialysis date. Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. VA expenditures for "buying" outsourced dialysis are high and increasing relative to "making" dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans' access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.
Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers
2013-01-01
Background Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. Methods We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both (“dual”) settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans’ baseline dialysis date. Results Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. Conclusions VA expenditures for “buying” outsourced dialysis are high and increasing relative to “making” dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans’ access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services. PMID:23327632
O'Connell, Megan E; Tuokko, Holly; Voll, Stacey; Simard, Martine; Griffith, Lauren E; Taler, Vanessa; Wolfson, Christina; Kirkland, Susan; Raina, Parminder
We detail a new approach to the creation of normative data for neuropsychological tests. The traditional approach to normative data creation is to make demographic adjustments based on observations of correlations between single neuropsychological tests and selected demographic variables. We argue, however, that this does not describe the implications for clinical practice, such as increased likelihood of misclassification of cognitive impairment, nor does it elucidate the impact on decision-making with a neuropsychological battery. We propose base rate analyses; specifically, differential base rates of impaired scores between theoretical and actual base rates as the basis for decisions to create demographic adjustments within normative data. Differential base rates empirically describe the potential clinical implications of failing to create an appropriate normative group. We demonstrate this approach with data from a short telephone-administered neuropsychological battery given to a large, neurologically healthy sample aged 45-85 years old. We explored whether adjustments for age and medical conditions were warranted based on differential base rates of spuriously impaired scores. Theoretical base rates underestimated the frequency of impaired scores in older adults and overestimated the frequency of impaired scores in younger adults, providing an evidence base for the creation of age-corrected normative data. In contrast, the number of medical conditions (numerous cardiovascular, hormonal, and metabolic conditions) was not related to differential base rates of impaired scores. Despite a small correlation between number of medical conditions and each neuropsychological variable, normative adjustments for number of medical conditions does not appear warranted. Implications for creation of normative data are discussed.
McGarvie, Leigh A; MacDougall, Hamish G; Halmagyi, G Michael; Burgess, Ann M; Weber, Konrad P; Curthoys, Ian S
2015-01-01
The video Head Impulse Test (vHIT) is now widely used to test the function of each of the six semicircular canals individually by measuring the eye rotation response to an abrupt head rotation in the plane of the canal. The main measure of canal adequacy is the ratio of the eye movement response to the head movement stimulus, i.e., the gain of the vestibulo-ocular reflex (VOR). However, there is a need for normative data about how VOR gain is affected by age and also by head velocity, to allow the response of any particular patient to be compared to the responses of healthy subjects in their age range. In this study, we determined for all six semicircular canals, normative values of VOR gain, for each canal across a range of head velocities, for healthy subjects in each decade of life. The VOR gain was measured for all canals across a range of head velocities for at least 10 healthy subjects in decade age bands: 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89. The compensatory eye movement response to a small, unpredictable, abrupt head rotation (head impulse) was measured by the ICS impulse prototype system. The same operator delivered every impulse to every subject. Vestibulo-ocular reflex gain decreased at high head velocities, but was largely unaffected by age into the 80- to 89-year age group. There were some small but systematic differences between the two directions of head rotation, which appear to be largely due to the fact that in this study only the right eye was measured. The results are considered in relation to recent evidence about the effect of age on VOR performance. These normative values allow the results of any particular patient to be compared to the values of healthy people in their age range and so allow, for example, detection of whether a patient has a bilateral vestibular loss. VOR gain, as measured directly by the eye movement response to head rotation, seems largely unaffected by aging.
Aldwin, Carolyn M.; Molitor, Nuoo-Ting; Avron, Spiro; Levenson, Michael R.; Molitor, John; Igarashi, Heidi
2011-01-01
We examined long-term patterns of stressful life events (SLE) and their impact on mortality contrasting two theoretical models: allostatic load (linear relationship) and hormesis (inverted U relationship) in 1443 NAS men (aged 41–87 in 1985; M = 60.30, SD = 7.3) with at least two reports of SLEs over 18 years (total observations = 7,634). Using a zero-inflated Poisson growth mixture model, we identified four patterns of SLE trajectories, three showing linear decreases over time with low, medium, and high intercepts, respectively, and one an inverted U, peaking at age 70. Repeating the analysis omitting two health-related SLEs yielded only the first three linear patterns. Compared to the low-stress group, both the moderate and the high-stress groups showed excess mortality, controlling for demographics and health behavior habits, HRs = 1.42 and 1.37, ps <.01 and <.05. The relationship between stress trajectories and mortality was complex and not easily explained by either theoretical model. PMID:21961066
Physical Discipline and Children's Adjustment: Cultural Normativeness as a Moderator
Lansford, Jennifer E.; Chang, Lei; Dodge, Kenneth A.; Malone, Patrick S.; Oburu, Paul; Palmérus, Kerstin; Bacchini, Dario; Pastorelli, Concetta; Bombi, Anna Silvia; Zelli, Arnaldo; Tapanya, Sombat; Chaudhary, Nandita; Deater-Deckard, Kirby; Manke, Beth; Quinn, Naomi
2009-01-01
Interviews were conducted with 336 mother – child dyads (children's ages ranged from 6 to 17 years; mothers' ages ranged from 20 to 59 years) in China, India, Italy, Kenya, the Philippines, and Thailand to examine whether normativeness of physical discipline moderates the link between mothers' use of physical discipline and children's adjustment. Multilevel regression analyses revealed that physical discipline was less strongly associated with adverse child outcomes in conditions of greater perceived normativeness, but physical discipline was also associated with more adverse outcomes regardless of its perceived normativeness. Countries with the lowest use of physical discipline showed the strongest association between mothers' use and children's behavior problems, but in all countries higher use of physical discipline was associated with more aggression and anxiety. PMID:16274437
Normative Data for the Cognitively Intact Oldest-Old: The Framingham Heart Study.
Miller, Ivy N; Himali, Jayandra J; Beiser, Alexa S; Murabito, Joanne M; Seshadri, Sudha; Wolf, Philip A; Au, Rhoda
2015-01-01
BACKGROUND/STUDY CONTEXT: The number of individuals who reach extreme age is quickly increasing. Much of the current literature focuses on impaired cognition in extreme age, and debate continues regarding what constitutes "normal" cognition in extreme age. This study aimed to provide oldest-old normative data and to compare cognitive performances of cognitively intact elderly individuals from the Framingham Heart Study. A total of 1302 individuals aged 65+ years from the Framingham Heart Study were separated into 5-year age bands and compared on cognitive tests. Multivariate linear regression analyses were conducted, adjusting for gender, the Wide Range Achievement Test-Third Edition (WRAT-III) Reading score, and cohort. Analyses also included comparisons between 418 individuals aged 80+ and 884 individuals aged 65-79, and comparisons within oldest-old age bands. Normative data for all participants are presented. Significant differences were found on most tests between age groups in the overall analysis between young-old and oldest-old, and analysis of oldest-old age bands also revealed select significant differences (all ps <.05). As aging increases, significant cognitive differences and increased variability in performances are evident. These results support the use of age-appropriate normative data for oldest-old individuals.
Normative Data for the Cognitively-Intact Oldest-Old: The Framingham Heart Study
Miller, Ivy N.; Himali, Jayandra J.; Beiser, Alexa S.; Murabito, Joanne M.; Seshadri, Sudha; Wolf, Philip A.; Au, Rhoda
2017-01-01
Background The number of individuals who reach extreme age is quickly increasing. Much of the current literature focuses on impaired cognition in extreme age, and debate continues regarding what constitutes “normal” cognition in extreme age. This study aimed to provide oldest-old normative data and to compare cognitive performances of cognitively-intact elderly individuals from the Framingham Heart Study. Methods 1302 individuals ages 65+ years old from the Framingham Heart Study were separated into five-year age bands and compared on cognitive tests. Multivariate linear regression analyses were conducted, adjusting for gender, the WRAT-III Reading score, and cohort. Analyses also included comparisons between 418 individuals ages 80+ and 884 individuals ages 65–79, and comparisons within oldest-old age bands. Results Normative data for all participants are presented. Significant differences were found on most tests between age groups in the overall analysis between young-old and oldest-old, and analysis of oldest-old age bands also revealed select significant differences (all p’s <.05). Conclusion As aging increases, significant cognitive differences and increased variability in performances are evident. These results support the use of age appropriate normative data for oldest-old individuals. PMID:26214098
Normative Values for Near and Distance Clinical Tests of Stereoacuity.
Piano, Marianne E F; Tidbury, Laurence P; O'Connor, Anna R
2016-12-01
Extensive literature exists on normative stereoacuity values for younger children, but there is less information about normative stereoacuity in older children/adults. Individual stereotests cannot be used interchangeably-knowing the upper limit of normality for each test is important. This report details normative stereoacuity values for 5 near/distance stereotests drawn from a large sample of participants aged 16-40 years, across 3 studies. Participants (n=206, mean age 22.18±5.31 years) were administered the following stereotests: TNO, Preschool Randot, Frisby, Distance Randot, and Frisby-Davis 2. Medians and upper limits were calculated for each test. Upper limits for each stereotest were as follows: TNO (n=127, upper limit=120" arc), Preschool Randot (PSR, n=206, upper limit=70" arc), Frisby (n=206, upper limit=40" arc), Distance Randot (n=127, upper limit=160" arc), and Frisby-Davis 2 (n=109, upper limit=25" arc). Normative values for each stereotest are identified and discussed with respect to other studies. Potential sources of variation between tests, within testing distances, are also discussed.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-01
... Clinic Application, VA Form 0928--53 hours. f. National Veterans Creative Arts Festival Application, VA... Games, National Veterans Golden Age Games, National Veterans Creative Arts Festival, National Veterans...
Identification of VaD and AD prodromes: the Cache County Study.
Hayden, K M; Warren, L H; Pieper, C F; Østbye, T; Tschanz, J T; Norton, M C; Breitner, J C S; Welsh-Bohmer, K A
2005-07-01
It is unclear whether vascular dementia (VaD) has a cognitive prodrome, akin to the mild cognitive impairment (MCI) prodrome to Alzheimer's dementia (AD). To evaluate whether VaD has a cognitive prodrome, and if it can be differentiated from prodromal AD, we examined neuropsychological test performance of participants in a nested case-control study within a population-based cohort aged 65 or older. Participants (n = 485) were identified from the Cache County Study, a large population-based study of aging and dementia. After an average of 3 years of follow-up, a total of 62 incident dementia cases were identified (14 VaD, 48 AD). We identified a number of neuropsychological tests (executive and memory) that discriminated between diagnosed VaD and AD cases. Multivariate analyses sought to differentiate between these same groups 3 years before clinical diagnosis. The Consortium to Establish a Registry for Alzheimer's Disease Word List Recognition Test correct recognition of foils (mean difference, 1.25; 95% confidence interval [CI], 0.42 to 2.07; p < 0.01), Logical Memory I (mean difference, 7.16; 95% CI, 0.78 to 13.55, p < 0.05), Logical Memory II delayed recall (mean difference, 8.67; 95% CI, 1.59 to 15.74, p < 0.05), and percent savings (mean difference, 51.07; 95% CI, 32.58 to 69.56, p < 0.0001) differentiated VaD from AD cases after adjustment for age, sex, education, and dementia severity. Three years before dementia diagnosis, word list recognition ("no" responses mean difference, 1.40; 95% CI, 0.64 to 2.17; p < 0.001, and "yes" responses mean difference, -1.14; 95% CI, -2.14 to -0.13; p < 0.03) discriminated between prodromal VaD and AD. These results suggest that VaD has a prodromal syndrome, the cognitive features of which are distinguishable from the cognitive prodrome of AD.
Normative data for penile length in Turkish newborns.
Kutlu, Alev Oğuz
2010-01-01
Local normative data for penile size will aid physicians in clinical practice. There are no studies on stretched penile length (SPL) in newborn Turkish boys. To establish normative data for SPL of newborn Turkish boys and compare these with data from different countries. 514 newborn Turkish boys, who were not small for gestational age (SGA) or premature, were included in this cross-sectional study. SPLs of the newborns were measured by the same investigator. The correlations between SPL and gestational age, weight, length, and head circumference were evaluated. The 3(rd) percentile value for SPL was found as 3.00 cm in these Turkish newborns. Positive correlations were shown between SPL and height (r=0.240, p<0.001), weight (r=0.251, p<0.001), and head circumference (r=0.235, p<0.001). Multiple linear regression analysis showed that SPL positively correlated with height and head circumference (p=0.021 and p= 0.042, respectively). This is the largest study on SPL in newborns from our country. This normative data can be used in clinical practice for defining micropenis.
Rey Figure Test with recognition trial: normative data for Lebanese adults.
Darwish, Hala; Zeinoun, Pia; Farran, Natali; Fares, Souha
2018-06-12
This study aimed to provide normative data for four trials of the Rey figure Test - a complex design used to assess visuoconstructional abilities, aspects of visual memory, and aspects of executive functioning. Despite its frequent clinical and research use in the Arab region, published studies regarding the measures' adaptation or normative data remain absent. We administered the Rey figure on a convenience sample of Lebanese (n = 254) aged 30 years to 99. We examined the impact of relevant demographics, and found that age, gender, and years of education impacted scores, and norms were derived based on these variables. Such normative data for the Rey figure enhance its practicality and psychometric adequacy for use in research and clinical settings in Lebanon.
Thirty-Second Walk Test: Expansion of Normative Data.
Lieberstein, Michael; Weingarten, Goldie; Vialu, Carlo; Itzkowitz, Adina; Doyle, Maura; Covino, Frank; Kaplan, Sandra L
2018-01-01
To collect 30-second walk test (30sWT) normative data on a large, diverse sample of school children developing typically, ages 5 to 13 years, and describe the influences of gender, body mass index, and path shape on distance walked. Five physical therapists administered the 30sWT on 1223 children developing typically (boys = 517, girls = 706) from 20 urban schools. Average distances (standard deviation) ranged from 139.1 (20.3) to 163.0 (18.6) ft; children aged 10 years walked the farthest and those aged 5 years the shortest. Distance steadily increased from ages 5 to 10 years, steadily decreased from ages 11 to 13 years; children aged 8, 9, and 10 years had statistical but not functionally meaningful gender differences. Body mass index and path shape had no meaningful effects. Distance and velocities are similar to prior studies. This study updated 30sWT normative values with a large, ethnically diverse, urban sample developing typically. Norms may be useful as part of a comprehensive examination.
... Performance VA Plans, Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report ... Management Services Veterans Service Organizations Office of Accountability & Whistleblower ...
Turiano, Nicholas A.; Hill, Patrick L.; Roberts, Brent W.; Spiro, Avron; Mroczek, Daniel K.
2013-01-01
This study examined the relationship between conscientiousness and mortality over 18 years and whether smoking behavior mediated this relationship. We utilized data from the Veterans Affairs Normative Aging Study on 1349 men who completed the Goldberg (1992) adjectival markers of the Big Five. Over the 18-year follow-up, 547 (41%) participants died. Through proportional hazards modeling in a structural equation modeling framework, we found that higher levels of conscientiousness significantly predicted longer life, and that this effect was mediated by current smoking status at baseline. Methodologically, we also demonstrate the effectiveness of using a structural equation modeling framework to evaluate mediation when using a censored outcome such as mortality. PMID:23504043
Longitudinal changes in bone lead levels: the VA Normative Aging Study.
Wilker, Elissa; Korrick, Susan; Nie, Linda H; Sparrow, David; Vokonas, Pantel; Coull, Brent; Wright, Robert O; Schwartz, Joel; Hu, Howard
2011-08-01
Bone lead is a cumulative measure of lead exposure that can also be remobilized. We examined repeated measures of bone lead over 11 years to characterize long-term changes and identify predictors of tibia and patella lead stores in an elderly male population. Lead was measured every 3 to 5 years by k-x-ray fluorescence and mixed-effect models with random effects were used to evaluate change over time. A total of 554 participants provided up to four bone lead measurements. Final models predicted a -1.4% annual decline (95% CI: -2.2 to -0.7) for tibia lead and piecewise linear model for patella with an initial decline of 5.1% per year (95% CI: -6.2 to -3.9) during the first 4.6 years but no significant change thereafter (-0.4% [95% CI: -2.4 to 1.7]). These results suggest that bone lead half-life may be longer than previously reported.
Longitudinal changes in bone lead levels: the VA Normative Aging Study
Wilker, Elissa; Korrick, Susan; Nie, Linda H; Sparrow, David; Vokonas, Pantel; Coull, Brent; Wright, Robert O.; Schwartz, Joel; Hu, Howard
2011-01-01
Objective Bone lead is a cumulative measure of lead exposure that can also be remobilized. We examined repeated measures of bone lead over 11 years to characterize long-term changes and identify predictors of tibia and patella lead stores in an elderly male population. Methods Lead was measured every 3–5 years by k-x-ray fluorescence and mixed-effect models with random effects were used to evaluate change over time. Results 554 participants provided up to 4 bone lead measurements. Final models predicted a −1.4% annual decline (95%CI: −2.2,−0.7) for tibia lead and piecewise linear model for patella with an initial decline of 5.1% per year (95%CI: −6.2,−3.9) during the first 4.6 years but no significant change thereafter (−0.4% (95% CI: −2.4, 1.7)). Conclusions These results suggest that bone lead half-life may be longer than previously reported. PMID:21788910
Marcon, Magda; Berger, Nicole; Manoliu, Andrei; Fischer, Michael A; Nanz, Daniel; Andreisek, Gustav; Ulbrich, Erika J
2016-04-01
To determine normative values for volume and fat content of the gluteus medius (GMed) and minimus (GMin) muscle in healthy volunteers and to evaluate their dependence on age, gender and leg dominance. The IRB approval was obtained for this study. 80 healthy volunteers (females, 40; males, 40; age range 20-62 years), divided into four age groups, were included. Fat- and water-signal-separated MR images of the pelvis were acquired on a 3.0 T MR with a 3-point mDIXON sequence. Normalized volume and fat-signal fraction (FSF) of the GMed (ViGMed, FSFGMed) and GMin (ViGMin, FSFGMin) muscles were determined. The overall mean volumes (normalized) and FSF ± SD: ViGMed 105.13 ± 16.30 cm(3); ViGMin 30.24 ± 5.15 cm(3); FSFGMed 8.13 ± 1.70 % and FSFGMin 9.89 ± 2.72 %. Comparing different age subgroups within each gender no significant differences were found concerning the volumes and FSFs (except FSFGMin in male subgroup aged 20-29 versus 50-62 years, P = 0.014). Comparing FSFs differences between the two genders, only in 20-29 years subgroup, FSFGMed (P =0.003) and FSFGMin (P =0.002) were greater in female. Volume differences between the two legs were not significant (P > 0.077); FSFGMed and FSFGMin (P =0.005 for both) were significantly lower in the dominant leg in female but not in male group (P = 0.454 for FSFGMed and P = 0.643 for FSFMin). No age dependency was evident for volume normative data for GMed and GMin and normative data for FSF values showed no age- or gender dependency.
Foss, Maria Paula; de Carvalho, Viviane Amaral; Machado, Thais Helena; Dos Reis, Geraldo Cássio; Tumas, Vitor; Caramelli, Paulo; Nitrini, Ricardo; Porto, Cláudia Sellitto
2013-01-01
To expand norms for the Mattis Dementia Rating Scale (DRS) for the Brazilian middle-age and elderly populations. The DRS was administered to 502 individuals without cognitive deficits, 312 women and 190 men, aged 50 years or over and with educational level ranging from 0 to 13 years or more. The sample was composed of subjects who participated in other studies, from Caeté (Minas Gerais state), Ribeirão Preto (São Paulo state) and São Paulo (São Paulo state). Participants were divided into four schooling groups (illiterate, 1 to 4 years, 5 to 12 years and 13 years or more). The subjects were divided into four groups according to age (50 to 60, 61 to 70, 71 to 80, and 80 years or over). Normative data for DRS scores are expressed as percentile values. The group with lowest schooling and subjects older than 80 years had the worst scores. As expected, age and education were strongly correlated with DRS scores. Illiterates and older old individuals performed worse than the other groups. These data might help to improve the accuracy of the diagnosis of cognitive impairment and dementia in Brazilian middle-age and elderly populations.
Normative data for near point of convergence, accommodation, and phoria
Abraham, Neethu G.; Srinivasan, Krithica; Thomas, Jyothi
2015-01-01
Background: Measurement of for near point of convergence (NPC), amplitude of accommodation (AA) and phoria are important components of diagnosing nonstrabismic binocular vision anomalies. There is a huge variation in the normative data established for orthoptic parameters because of the variation in measurement technique. There are only limited studies for normative data based on nonclinical population in Indian population. Therefore, we aim estimate the normative values for NPC, AA, and phoria measurement in Indian population using techniques, which has good repeatability and reliability. Materials and Methods: Subjects between the age group 10-35 years participated in this prospective cross-sectional study. A self-administered symptom questionnaire was used to exclude patients with asthenopic symptoms. Clinical techniques which have good repeatability and reliability were used. NPC was measured using pen light red, green glass test. AA was measured using minus lens technique. Horizontal and vertical phoria at distance and near was measured using modified Thorington method. Results: One hundred and fifty subjects participated in the study. We found that NPC receded with age, which could because of the increase in horizontal phoria at near with age. The mean normative value for objective NPC, break and recovery of subjective NPC, monocular and binocular AA, horizontal and vertical phoria at distance and near for the three age groups are reported in the study. Conclusion: The data presented in this study can be used as a cut-off by eye care practitioners while diagnosing convergence, accommodation related anomalies in Indian population. PMID:25709268
Normative values and the effects of age, gender, and handedness on the Moberg Pick-Up Test.
Amirjani, Nasim; Ashworth, Nigel L; Gordon, Tessa; Edwards, David C; Chan, K Ming
2007-06-01
The Moberg Pick-Up Test is a standardized test for assessing hand dexterity. Although reduction of sensation in the hand occurs with aging, the effect of age on a subject's performance of the Moberg Pick-Up Test has not been examined. The primary goal of this study was to examine the impact of aging and, secondarily, the impact of gender and handedness, on performance of the Moberg Pick-Up Test in 116 healthy subjects. The average time to complete each of the four subsets of the test was analyzed using the Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed-rank tests. The results show that hand dexterity of the subjects was significantly affected by age, with young subjects being the fastest and elderly subjects the slowest. Women accomplished the test faster than men, and task performance with the dominant hand was faster than with the non-dominant hand. Use of normative values established based on age and gender is a valuable objective tool to gauge hand function in patients with different neurologic disorders.
Tracing How Normative Messages May Influence Physical Activity Intention.
van Bavel, René; Esposito, Gabriele; Baranowski, Tom; Duch-Brown, Néstor
2017-04-01
Normative messages have been shown to increase intention to do physical activity. We traced how "positive" and "negative" normative messages influenced physical activity intention by comparing constructs of the model of goal-directed behavior with descriptive norms (MGDB + DNs) across control and treatment groups in an experiment. For this purpose, 16-24-year-old respondents (n = 1,200) in Bulgaria, Croatia, and Romania were asked about their age, sex, and levels of physical activity before being exposed to positive and negative normative messages and completing a questionnaire with MGDB + DNs scales. Different MGDB + DNs constructs were influenced by the normative messages: compared with the control, the negative message group showed stronger attitudes (p = .003) and the positive message group showed higher positive anticipated emotions (p = .005). The positive message's effect is consistent with the literature on conformity to social norms. The negative message's effect lends itself to interpretations based on social identity and deviance regulation theories.
Mody, Lona; Greene, M. Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W.; Wald, Heidi L.; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E.; King, Beth J.; Hogikyan, Robert; Edson, Barbara; Krein, Sarah L.
2018-01-01
OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that U.S. Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the “AHRQ Safety Program for Long-term Care” collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention. RESULTS A total of 353 (71%; 47 VA, 306 non-VA) of 494 nursing homes from 41 states responded. VA nursing homes reported more hours/week devoted to infection prevention-related activities (31 vs. 12 hours, P<.001), and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs. 66%, P<.001), sharing CAUTI data with leadership (94% vs. 70%, P=.014) and nursing personnel (85% vs. 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs. 81%, P=.004) and catheter insertion (83% vs. 94%, P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. PMID:27917728
Who pays when VA users are hospitalized in the private sector? Evidence from three data sources.
West, Alan N; Weeks, William B
2007-10-01
Older veterans enrolled in VA healthcare receive much of their medical care in the private sector, through Medicare. Less is known about younger VA enrollees' use of the private sector, or its funding. We compare payers for younger and older enrollees' private sector use in 3 hospitalization datasets. From 1998 to 2000, using private sector discharge data for VA enrollees in New York State, we categorized hospitalizations according to payer (self/family, private insurance, Medicare, Medicaid, other sources). We compared this payer distribution to population-weighted national Medical Expenditure Panel Survey (MEPS) data from 1996-2003 for veterans in VA healthcare. We also compared Medicare utilization in either dataset to hospitalizations for New York veterans from 1998-2000 in the VA-Medicare dataset. Analyses separated patients younger than age 65 from those age 65 or older. VA enrollees under age 65 obtain roughly half their hospitalizations in the private sector; older enrollees use the private sector at least twice as often as the VA. Datasets generally agree on payer distributions. Although older enrollees rely heavily on Medicare, they also use commercial insurance and self/family payments substantially. Half of younger enrollees' non-VA hospitalizations are paid by private insurance, but Medicare, Medicaid, and self/family each pay for one-quarter to one-third of admissions. VA enrollees use the private sector for most of their inpatient care, which is funded by multiple sources. Developing a national UB-92/VA dataset would be critical to understanding veterans' use of the private sector for specific diagnoses and procedures, particularly for the fast growing population of younger veterans.
Certified normal: Alzheimer's disease biomarkers and normative estimates of cognitive functioning.
Hassenstab, Jason; Chasse, Rachel; Grabow, Perri; Benzinger, Tammie L S; Fagan, Anne M; Xiong, Chengjie; Jasielec, Mateusz; Grant, Elizabeth; Morris, John C
2016-07-01
Normative samples drawn from older populations may unintentionally include individuals with preclinical Alzheimer's disease (AD) pathology, resulting in reduced means, increased variability, and overestimation of age effects on cognitive performance. A total of 264 cognitively normal (Clinical Dementia Rating = 0) older adults were classified as biomarker negative ("Robust Normal," n = 177) or biomarker positive ("Preclinical Alzheimer's Disease" [PCAD], n = 87) based on amyloid imaging, cerebrospinal fluid biomarkers, and hippocampal volumes. PCAD participants performed worse than robust normals on nearly all cognitive measures. Removing PCAD participants from the normative sample yielded higher means and less variability on episodic memory, visuospatial ability, and executive functioning measures. These results were more pronounced in participants aged 75 years and older. Notably, removing PCAD participants from the sample significantly reduced age effects across all cognitive domains. Applying norms from the robust normal sample to a separate cohort did not improve Clinical Dementia Rating classification when using standard deviation cutoff scores. Overall, removing individuals with biomarker evidence of preclinical AD improves normative sample quality and substantially reduces age effects on cognitive performance but provides no substantive benefit for diagnostic classifications. Copyright © 2016 Elsevier Inc. All rights reserved.
Richards, P M; Persinger, M A
2004-01-01
The differential representation of the toes/feet and fingers/hands along the medial and lateral surfaces of the cerebral cortices, respectively, may have diagnostic utility. Normative data for errors for toe and finger graphaesthesia and gnosis, as well as foot and finger agility, were collected for 86 children (ages 7 to 14). The fingers were more agile than the feet, and the right side of the body was more agile than the left side, regardless of age. A marked improvement in toe gnosis, but not in finger gnosis occurred in children after 11-12 years of age. A statistically significant interaction between laterality and gender was due to the greater numbers of errors for both toe and finger gnosis, displayed by girls for the left sides of their bodies compared to their right sides. This discrepancy was not significant for boys.
Certified Normal: Alzheimer’s Disease Biomarkers and Normative Estimates of Cognitive Functioning
Hassenstab, Jason; Chasse, Rachel; Grabow, Perri; Benzinger, Tammie L.S.; Fagan, Anne M.; Xiong, Chengjie; Jasielec, Mateusz; Grant, Elizabeth; Morris, John C.
2016-01-01
Normative samples drawn from older populations may unintentionally include individuals with preclinical Alzheimer’s disease (AD) pathology, resulting in reduced means, increased variability, and overestimation of age-effects on cognitive performance. 264 cognitively normal (CDR=0) older adults were classified as biomarker-negative (“Robust Normal,” n=177) or biomarker-positive (“Preclinical Alzheimer’s Disease” (PCAD), n=87) based on amyloid imaging, cerebrospinal fluid biomarkers, and hippocampal volumes. PCAD participants performed worse than Robust Normals on nearly all cognitive measures. Removing PCAD participants from the normative sample yielded higher means and less variability on episodic memory, visuospatial ability, and executive functioning measures. These results were more pronounced in participants aged 75 and older. Notably, removing PCAD participants from the sample significantly reduced age effects across all cognitive domains. Applying norms from the Robust Normal sample to a separate cohort did not improve CDR classification when using standard deviation cutoff scores. Overall, removing individuals with biomarker evidence of preclinical AD improves normative sample quality and substantially reduces age-effects on cognitive performance, but provides no substantive benefit for diagnostic classifications. PMID:27255812
Zivin, Kara; Yosef, Matheos; Levine, Debra S; Abraham, Kristen M; Miller, Erin M; Henry, Jennifer; Nelson, C Beau; Pfeiffer, Paul N; Sripada, Rebecca K; Harrod, Molly; Valenstein, Marcia
2016-03-15
Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactive. In adjusted analyses, participants with depression or anxiety (43%) were less likely to be employed, had lower job search self-efficacy, had lower levels of work performance, and reported more employment barriers. Depression and anxiety were not associated with perceived likelihood of job loss among employed or likelihood of job seeking among not employed. Single VA primary care clinic; cross-sectional study. Employment rates are low among working-aged VA primary care patients, particularly those with mental health conditions. Offering primary care interventions to patients that address mental health issues, job search self-efficacy, and work performance may be important in improving health, work, and economic outcomes. Published by Elsevier B.V.
Normative social influence is underdetected.
Nolan, Jessica M; Schultz, P Wesley; Cialdini, Robert B; Goldstein, Noah J; Griskevicius, Vladas
2008-07-01
The present research investigated the persuasive impact and detectability of normative social influence. The first study surveyed 810 Californians about energy conservation and found that descriptive normative beliefs were more predictive of behavior than were other relevant beliefs, even though respondents rated such norms as least important in their conservation decisions. Study 2, a field experiment, showed that normative social influence produced the greatest change in behavior compared to information highlighting other reasons to conserve, even though respondents rated the normative information as least motivating. Results show that normative messages can be a powerful lever of persuasion but that their influence is underdetected.
Xie, Haiqun; Zhang, Chengguo; Wang, Yukai; Huang, Shuyun; Cui, Wei; Yang, Wenbin; Koski, Lisa; Xu, Xiping; Li, Youbao; Zheng, Meili; He, Mingli; Fu, Jia; Shi, Xiuli; Wang, Kai; Tang, Genfu; Wang, Binyan; Huo, Yong
2016-01-01
Dementia is increasingly prevalent due to rapid aging of the population, but under-recognized among people with low education levels. This is partly due to a lack of appropriate and precise normative data, which underestimates cognitive aging in the use of screening tools for dementia. We aimed to improve the precision of screening for cognitive impairment, by characterizing the patterns of cognitive aging and derived normative data of the Mini-Mental State Examination (MMSE) for illiterate and low-educated populations. This community-based study included data from 2,280 individuals aged 40 years or older from two rural areas. Multiple linear modeling examined the effect of aging on cognition reflected by the MMSE, stratified by education level and gender. Threshold effect of age on cognition was performed using a smoothing function. The majority of participants (60.4%) were illiterate or had attended only primary school (24.6%). The effect of aging on cognition varied by gender and education. Primary-school educated females and males remained cognitively stable up to 62 and 71 years of age, respectively, with MMSE score declining 0.4 and 0.8 points/year in females and males thereafter. Illiterates females scored 2.3 points lower than illiterate males, and scores for both declined 0.2 points/year. According to these results, normative data stratified by age, education and gender was generated. This study suggests gender and educational differences exist in cognitive aging among adults with limited or no formal education. To improve screening precision for cognitive impairment with the use of MMSE in low-educated population, age, gender, and education level should be considered.
Foss, Maria Paula; de Carvalho, Viviane Amaral; Machado, Thais Helena; dos Reis, Geraldo Cássio; Tumas, Vitor; Caramelli, Paulo; Nitrini, Ricardo; Porto, Cláudia Sellitto
2013-01-01
OBJECTIVE To expand norms for the Mattis Dementia Rating Scale (DRS) for the Brazilian middle-age and elderly populations. METHODS The DRS was administered to 502 individuals without cognitive deficits, 312 women and 190 men, aged 50 years or over and with educational level ranging from 0 to 13 years or more. The sample was composed of subjects who participated in other studies, from Caeté (Minas Gerais state), Ribeirão Preto (São Paulo state) and São Paulo (São Paulo state). Participants were divided into four schooling groups (illiterate, 1 to 4 years, 5 to 12 years and 13 years or more). The subjects were divided into four groups according to age (50 to 60, 61 to 70, 71 to 80, and 80 years or over). RESULTS Normative data for DRS scores are expressed as percentile values. The group with lowest schooling and subjects older than 80 years had the worst scores. CONCLUSION As expected, age and education were strongly correlated with DRS scores. Illiterates and older old individuals performed worse than the other groups. These data might help to improve the accuracy of the diagnosis of cognitive impairment and dementia in Brazilian middle-age and elderly populations. PMID:29213861
Sunderaraman, Preeti; Sokolov, Elisaveta; Cines, Sarah; Sullo, Elizabeth; Orly, Aidan; Lerer, Bianca; Karlawish, Jason; Huey, Edward; Cosentino, Stephanie
2015-01-01
Design fluency tests, commonly used in both clinical and research contexts to evaluate nonverbal concept generation, have the potential to offer useful information in the differentiation of healthy versus pathological aging. While normative data for older adults are available for multiple timed versions of this test, similar data have been unavailable for a previously published untimed task, the Graphic Pattern Generation Task (GPG). Time constraints common to almost all of the available design fluency tests may cloud interpretation of higher level executive abilities, for example in individuals with slow processing speed. The current study examined the psychometric properties of the GPG and presents normative data in a sample of 167 healthy older adults (OAs) and 110 individuals diagnosed with Alzheimer's disease (AD). Results suggest that a brief version of the GPG can be administered reliably, and that this short form has high test-retest and inter-rater reliability. Number of perseverations was higher in individuals with AD as compared to OAs. A cut-off score of 4 or more perseverations showed a moderate degree of sensitivity (76%) and specificity (37%) in distinguishing individuals with AD and OAs. Finally, perseverations were associated with nonmemory indices, underscoring the nonverbal nature of this error in OAs and individuals with AD. PMID:25679880
Ramírez-Vélez, Robinson; Correa-Bautista, Jorge E; Lobelo, Felipe; Cadore, Eduardo L; Alonso-Martinez, Alicia M; Izquierdo, Mikel
2017-04-01
Ramírez-Vélez, R, Correa-Bautista, JE, Lobelo, F, Cadore, EL, Alonso-Martinez, AM, and Izquierdo, M. Vertical jump and leg power normative data for Colombian schoolchildren aged 9-17.9 years: the FUPRECOL study. J Strength Cond Res 31(4): 990-998, 2017-The aims of the present study were to generate normative vertical jump height and predicted peak power (Ppeak) data for 9- to 17.9-year-olds and to investigate between-sex and age group differences in these measures. This was a cross-sectional study of 7,614 healthy schoolchildren (boys n = 3,258 and girls n = 4,356, mean [SD] age 12.8 [2.3] years). Each participant performed 2 countermovement jumps; jump height was calculated using a Takei 5414 Jump-DF Digital Vertical (Takei Scientific Instruments Co., Ltd.). The highest jump was used for analysis and in the calculation of predicted Ppeak. Centile smoothed curves, percentiles, and tables for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles were calculated using Cole's LMS (L [curve Box-Cox], M [curve median], and S [curve coefficient of variation]) method. The 2-way analysis of variance tests showed that maximum jump height (in centimeters) and predicted Ppeak (in watts) were higher in boys than in girls (p < 0.01). Post hoc analyses within sexes showed yearly increases in jump height and Ppeak in all ages. In boys, the maximum jump height and predicted Ppeak 50th percentile ranged from 24.0 to 38.0 cm and from 845.5 to 3061.6 W, respectively. In girls, the 50th percentile for jump height ranged from 22.3 to 27.0 cm, and the predicted Ppeak was 710.1-2036.4 W. For girls, jump height increased yearly from 9 to 17.9 years old. Our results provide, for the first time, sex- and age-specific vertical jump height and predicted Ppeak reference standards for Colombian schoolchildren aged 9-17.9 years.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-16
... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... 2900-0474.'' SUPPLEMENTARY INFORMATION: Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900...
Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-27
... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900-0474. Type of Review: Revision of a...
Delye, Hans; Clijmans, Tim; Mommaerts, Maurice Yves; Sloten, Jos Vnder; Goffin, Jan
2015-12-01
Finite element models (FEMs) of the head are used to study the biomechanics of traumatic brain injury and depend heavily on the use of accurate material properties and head geometry. Any FEM aimed at investigating traumatic head injury in children should therefore use age-specific dimensions of the head, as well as age-specific material properties of the different tissues. In this study, the authors built a database of age-corrected skull geometry, skull thickness, and bone density of the developing skull to aid in the development of an age-specific FEM of a child's head. Such a database, containing age-corrected normative skull geometry data, can also be used for preoperative surgical planning and postoperative long-term follow-up of craniosynostosis surgery results. Computed tomography data were processed for 187 patients (age range 0-20 years old). A 3D surface model was calculated from segmented skull surfaces. Skull models, reference points, and sutures were processed into a MATLAB-supported database. This process included automatic calculation of 2D measurements as well as 3D measurements: length of the coronal suture, length of the lambdoid suture, and the 3D anterior-posterior length, defined as the sum of the metopic and sagittal suture. Skull thickness and skull bone density calculations were included. Cephalic length, cephalic width, intercoronal distance, lateral orbital distance, intertemporal distance, and 3D measurements were obtained, confirming the well-established general growth pattern of the skull. Skull thickness increases rapidly in the first year of life, slowing down during the second year of life, while skull density increases with a fast but steady pace during the first 3 years of life. Both skull thickness and density continue to increase up to adulthood. This is the first report of normative data on 2D and 3D measurements, skull bone thickness, and skull bone density for children aged 0-20 years. This database can help build an age
Normative beliefs, misperceptions, and heavy episodic drinking in a british student sample.
McAlaney, John; McMahon, John
2007-05-01
Numerous studies have demonstrated the existence and effect of normative misperceptions on heavy episodic drinking behavior. However, there has been little work on these processes or application of normative-belief interventions outside the U.S. college system. The aim of the current study, therefore, was to investigate heavy episodic drinking and normative misperceptions in a U.K. university setting. An email containing a link to a survey Web site was distributed to all current undergraduate students at the University of Paisley, Scotland. In addition to age and gender questions, the survey contained items on students' personal behavior and perception of the level of that behavior in three groups of increasing social distance: close friends, other students of the same age, and other people of the same age in U.K. society in general. Completed surveys from 500 respondents were returned. In keeping with previous research, significant correlations were found between the respondents' behavior and the perception of that behavior in others, with beliefs about the most proximal individuals being the most strongly correlated. The majority of respondents were also found to overestimate alcohol consumption in other students. An age effect was noted, in which misperceptions appeared to decrease with age but did not vary between genders. The findings of the study indicate that the normative-belief alcohol consumption processes that have been found on U.S. college campuses also operate in U.K. university settings. This raises the possibility of applying social-norms interventions from the United States to the United Kingdom and potentially elsewhere in the world. Furthermore, the study noted apparent age effects in the degree of misperception, the implications of which are discussed.
Eng, Goi Khia; Lam, Max; Bong, Yioe Ling; Subramaniam, Mythily; Bautista, Dianne; Rapisarda, Attilio; Kraus, Michael; Lee, Jimmy; Collinson, Simon Lowes; Chong, Siow Ann; Keefe, Richard S E
2013-12-01
There is a dearth of non-Western normative data for neuropsychological batteries designed to measure cognitive deficits in schizophrenia. Here, we provide normative data for English-speaking ethnic Chinese on the widely used Brief Assessment of Cognition in Schizophrenia acquired from 595 healthy community participants between ages 14 and 55. Means and standard deviations of subtests and composite scores were stratified by age group and sex. We also explored linear regression approaches to generate continuous norms adjusted for age, sex, and education. Notable differences in subtest performances were found against a Western comparison sample. Normative data established in the current sample are essential for clinical and research purposes as it serves as a reference source of cognition for ethnic Chinese.
Williford, Anne; Elledge, L Christian; Boulton, Aaron J; DePaolis, Kathryn J; Little, Todd D; Salmivalli, Christina
2013-01-01
Cyberbullying among school-aged children has received increased attention in recent literature. However, no empirical evidence currently exists on whether existing school-based antibullying programs are effective in targeting the unique aspects of cyberbullying. To address this important gap, the present study investigates the unique effects of the KiVa Antibullying Program on the frequency of cyberbullying and cybervictimization among elementary and middle school youth. Using data from a group randomized controlled trial, multilevel ordinal regression analyses were used to examine differences in the frequencies of cyberbullying and cybervictimization between intervention (N = 9,914) and control students (N = 8,498). The effects of age and gender on frequencies of cyber behaviors were also assessed across conditions. Results revealed a significant intervention effect on the frequency of cybervictimization; KiVa students reported lower frequencies of cybervictimization at posttest than students in a control condition. The effect of condition on the perpetration of cyberbullying was moderated by age. When student age was below the sample mean, KiVa students reported lower frequencies of cyberbullying than students in the control condition. We also found evidence of classroom level variation in cyberbullying and cybervictimization, suggesting cyberbullying is in part a classroom-level phenomenon. KiVa appears to be an efficacious program to address cyber forms of bullying and victimization. We discuss several unique aspects of KiVa that may account for the significant intervention effects. Results suggest that KiVa is an intervention option for schools concerned with reducing cyberbullying behavior and its deleterious effects on children's adjustment.
Potvin, Olivier; Dieumegarde, Louis; Duchesne, Simon
2017-08-01
We recently built normative data for FreeSurfer morphometric estimates of cortical regions using its default atlas parcellation (Desikan-Killiany or DK) according to individual and scanner characteristics. We aimed to produced similar normative values for Desikan-Killianny-Tourville (DKT) and ex vivo-based labeling protocols, as well as examine the differences between these three atlases. Surfaces, thicknesses, and volumes of cortical regions were produced using cross-sectional magnetic resonance scans from the same 2713 healthy individuals aged 18-94 years as used in the reported DK norms. Models predicting regional cortical estimates of each hemisphere were produced using age, sex, estimated intracranial volume (eTIV), scanner manufacturer and magnetic field strength (MFS) as predictors. The DKT and DK models generally included the same predictors and produced similar R 2 . Comparison between DK, DKT, ex vivo atlases normative cortical measures showed that the three protocols generally produced similar normative values. Copyright © 2017 Elsevier Inc. All rights reserved.
2014-06-18
medical centers. VA also provides care to veterans in VA-operated community-based outpatient clinics, community living centers ( nursing homes...facility or nursing home up to the point that the veteran can be safely returned to the VA facility following the emergency care treatment at the non-VA... nursing home care, compensation and pension exams, and most pharmacy expenses paid for through the Non-VA Medical Care Program. (See fig. 1.) 8VA
Rao, Mala V.; Engle, Linda J.; Mohan, Panaiyur S.; Yuan, Aidong; Qiu, Dike; Cataldo, Anne; Hassinger, Linda; Jacobsen, Stephen; Lee, Virginia M-Y.; Andreadis, Athena; Julien, Jean-Pierre; Bridgman, Paul C.; Nixon, Ralph A.
2002-01-01
The identification of molecular motors that modulate the neuronal cytoskeleton has been elusive. Here, we show that a molecular motor protein, myosin Va, is present in high proportions in the cytoskeleton of mouse CNS and peripheral nerves. Immunoelectron microscopy, coimmunoprecipitation, and blot overlay analyses demonstrate that myosin Va in axons associates with neurofilaments, and that the NF-L subunit is its major ligand. A physiological association is indicated by observations that the level of myosin Va is reduced in axons of NF-L–null mice lacking neurofilaments and increased in mice overexpressing NF-L, but unchanged in NF-H–null mice. In vivo pulse-labeled myosin Va advances along axons at slow transport rates overlapping with those of neurofilament proteins and actin, both of which coimmunoprecipitate with myosin Va. Eliminating neurofilaments from mice selectively accelerates myosin Va translocation and redistributes myosin Va to the actin-rich subaxolemma and membranous organelles. Finally, peripheral axons of dilute-lethal mice, lacking functional myosin Va, display selectively increased neurofilament number and levels of neurofilament proteins without altering axon caliber. These results identify myosin Va as a neurofilament-associated protein, and show that this association is essential to establish the normal distribution, axonal transport, and content of myosin Va, and the proper numbers of neurofilaments in axons. PMID:12403814
Normative Velopharyngeal Data in Infants: Implications for Treatment of Cleft Palate.
Schenck, Graham C; Perry, Jamie L; Fang, Xiangming
2016-09-01
Identifying normative data related to velopharyngeal muscles and structures may have clinical significance for infants born with cleft palate, especially as they relate to selection of surgical intervention and postsurgical outcomes. Previous studies suggest that patients whose anatomy postsurgically is dissimilar to that of their normative counterparts are at risk for hypernasal speech. However, studies have not documented what constitutes "normal" anatomy for the clinically relevant population-that is, the infant population. The purpose of this study is to examine a magnetic resonance imaging database (n = 29) related to normative velopharyngeal structures and provide a preliminary comparison to 2 selected patients with repaired cleft palate. Twenty-nine healthy infants between 9 and 23 months of age (mean = 15.2 months) with normal craniofacial and velopharyngeal anatomy were recruited to participate in this study. Normative data were compared to 2 infants with repaired cleft palate between 13 and 15 months of age (mean = 14 months). Quantitative craniometric and velopharyngeal measures from the sagittal and oblique coronal image planes were collected. Variables of interest included: levator muscle, velar, and craniometric measures. Females demonstrated significantly larger intravelar segments compared with males. White infants demonstrated significantly larger levator muscles compared to non-white infants. Infants with repaired cleft palate demonstrated increased overall levator muscle length and levator extravelar length compared with infants with normal velopharyngeal anatomy.Data from the present study provide a normative database for future investigators to utilize as a comparative tool when evaluating infants with normal and abnormal velopharyngeal anatomy.
A Normative Study of Children's Drawings: Preliminary Research Findings
ERIC Educational Resources Information Center
Deaver, Sarah P.
2009-01-01
This paper describes methodology, data analysis, and initial results of a research study with the long-term goal of establishing contemporary normative data on drawings from children living in the United States. The pool of participants was composed of 316 fourth graders (mean age 9.69 years) and 151 second graders (mean age 7.56 years) who each…
Animals on VA property. Final rule.
2015-08-17
The Department of Veterans Affairs (VA) amends its regulation concerning the presence of animals on VA property. This final rule expands the current VA regulation to authorize the presence of service animals consistent with applicable Federal law when these animals accompany individuals with disabilities seeking admittance to property owned or operated by VA.
VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration.
Shireman, Paula K; Rasmussen, Todd E; Jaramillo, Carlos A; Pugh, Mary Jo
2015-02-03
Limb injuries comprise 50-60% of U.S. Service member's casualties of wars in Afghanistan and Iraq. Combat-related vascular injuries are present in 12% of this cohort, a rate 5 times higher than in prior wars. Improvements in medical and surgical trauma care, including initial in-theatre limb salvage approaches (IILS) have resulted in improved survival and fewer amputations, however, the long-term outcomes such as morbidity, functional decline, and risk for late amputation of salvaged limbs using current process of care have not been studied. The long-term care of these injured warfighters poses a significant challenge to the Department of Defense (DoD) and Department of Veterans Affairs (VA). The VA Vascular Injury Study (VAVIS): VA-DoD Extremity Injury Outcomes Collaborative, funded by the VA, Health Services Research and Development Service, is a longitudinal cohort study of Veterans with vascular extremity injuries. Enrollment will begin April, 2015 and continue for 3 years. Individuals with a validated extremity vascular injury in the Department of Defense Trauma Registry will be contacted and will complete a set of validated demographic, social, behavioral, and functional status measures during interview and online/ mailed survey. Primary outcome measures will: 1) Compare injury, demographic and geospatial characteristics of patients with IILS and identify late vascular surgery related limb complications and health care utilization in Veterans receiving VA vs. non-VA care, 2) Characterize the preventive services received by individuals with vascular repair and related outcomes, and 3) Describe patient-reported functional outcomes in Veterans with traumatic vascular limb injuries. This study will provide key information about the current process of care for Active Duty Service members and Veterans with polytrauma/vascular injuries at risk for persistent morbidity and late amputation. The results of this study will be the first step for clinicians in VA and
Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-04
... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-06
... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...
Malaria epidemiology in the Pakaanóva (Wari') Indians, Brazilian Amazon.
Sá, D Ribeiro; Souza-Santos, R; Escobar, A L; Coimbra, C E A
2005-04-01
This paper reports the results of a longitudinal study of malaria incidence (1998-2002) among the Pakaanóva (Wari') Indians, Brazilian southwest Amazon region, based on data routinely gathered by Brazilian National Health Foundation outposts network in conjunction with the Indian health service. Malaria is present yearlong in the Pakaanóva. Statistically significant differences between seasons or months were not noticed. A total of 1933 cases of malaria were diagnosed in the Pakaanóva during this period. The P. vivax / P. falciparum ratio was 3.4. P. vivax accounted for 76.5% of the cases. Infections with P. malariae were not recorded. Incidence rates did not differ by sex. Most malaria cases were reported in children < 10 years old (45%). About one fourth of all cases were diagnosed on women 10-40 years old. An entomological survey carried out at two Pakaanóva villages yielded a total of 3.232 specimens of anophelines. Anopheles darlingi predominated (94.4%). Most specimens were captured outdoors and peak activity hours were noted at early evening and just before sunrise. It was observed that Pakaanóva cultural practices may facilitate outdoor exposure of individuals of both sexes and all age groups during peak hours of mosquito activities (e.g., coming to the river early in the morning for bathing or to draw water, fishing, engaging in hunting camps, etc). In a context in which anophelines are ubiquitous and predominantly exophilic, and humans of both sexes and all ages are prone to outdoor activities during peak mosquito activity hours, malaria is likely to remain endemic in the Pakaanóva, thus requiring the development of alternative control strategies that are culturally and ecologically sensitive.
Messinis, Lambros; Nasios, Grigorios; Mougias, Antonios; Politis, Antonis; Zampakis, Petros; Tsiamaki, Eirini; Malefaki, Sonia; Gourzis, Phillipos; Papathanasopoulos, Panagiotis
2016-01-01
Rey's Auditory Verbal Learning Test (RAVLT) is a widely used neuropsychological test to assess episodic memory. In the present study we sought to establish normative and discriminative validity data for the RAVLT in the elderly population using previously adapted learning lists for the Greek adult population. We administered the test to 258 cognitively healthy elderly participants, aged 60-89 years, and two patient groups (192 with amnestic mild cognitive impairment, aMCI, and 65 with Alzheimer's disease, AD). From the statistical analyses, we found that age and education contributed significantly to most trials of the RAVLT, whereas the influence of gender was not significant. Younger elderly participants with higher education outperformed the older elderly with lower education levels. Moreover, both clinical groups performed significantly worse on most RAVLT trials and composite measures than matched cognitively healthy controls. Furthermore, the AD group performed more poorly than the aMCI group on most RAVLT variables. Receiver operating characteristic (ROC) analysis was used to examine the utility of the RAVLT trials to discriminate cognitively healthy controls from aMCI and AD patients. Area under the curve (AUC), an index of effect size, showed that most of the RAVLT measures (individual and composite) included in this study adequately differentiated between the performance of healthy elders and aMCI/AD patients. We also provide cutoff scores in discriminating cognitively healthy controls from aMCI and AD patients, based on the sensitivity and specificity of the prescribed scores. Moreover, we present age- and education-specific normative data for individual and composite scores for the Greek adapted RAVLT in elderly subjects aged between 60 and 89 years for use in clinical and research settings.
Determination of VA health care costs.
Barnett, Paul G
2003-09-01
In the absence of billing data, alternative methods are used to estimate the cost of hospital stays, outpatient visits, and treatment innovations in the U.S. Department of Veterans Affairs (VA). The choice of method represents a trade-off between accuracy and research cost. The direct measurement method gathers information on staff activities, supplies, equipment, space, and workload. Since it is expensive, direct measurement should be reserved for finding short-run costs, evaluating provider efficiency, or determining the cost of treatments that are innovative or unique to VA. The pseudo-bill method combines utilization data with a non-VA reimbursement schedule. The cost regression method estimates the cost of VA hospital stays by applying the relationship between cost and characteristics of non-VA hospitalizations. The Health Economics Resource Center uses pseudo-bill and cost regression methods to create an encounter-level database of VA costs. Researchers are also beginning to use the VA activity-based cost allocation system.
Normative values for the unipedal stance test with eyes open and closed.
Springer, Barbara A; Marin, Raul; Cyhan, Tamara; Roberts, Holly; Gill, Norman W
2007-01-01
Limited normative data are available for the unipedal stance test (UPST), making it difficult for clinicians to use it confidently to detect subtle balance impairments. The purpose of this study was to generate normative values for repeated trials of the UPST with eyes opened and eyes closed across age groups and gender. This prospective, mixed-model design was set in a tertiary care medical center. Healthy subjects (n= 549), 18 years or older, performed the UPST with eyes open and closed. Mean and best of 3 UPST times for males and females of 6 age groups (18-39, 40-49, 50-59, 60-69, 70-79, and 80+) were documented and inter-rater reliability was tested. There was a significant age dependent decrease in UPST time during both conditions. Inter-rater reliability for the best of 3 trials was determined to be excellent with an intra-class correlation coefficient of 0.994 (95% confidence interval 0.989-0.996) for eyes open and 0.998 (95% confidence interval 0.996-0.999) for eyes closed. This study adds to the understanding of typical performance on the UPST. Performance is age-specific and not related to gender. Clinicians now have more extensive normative values to which individuals can be compared.
Normative Data for the Hayling and Brixton Tests in an Italian Population.
Spitoni, Grazia Fernanda; Bevacqua, Sara; Cerini, Claudia; Ciurli, Paola; Piccardi, Laura; Guariglia, Paola; Pezzuti, Lina; Antonucci, Gabriella
2018-06-01
The Hayling and Brixton tests constitute a short test battery that quickly assesses verbal and spatial inhibition and flexibility. This battery has shown high construct validity and strong reliability in clinical and experimental settings. The aim of this study was to develop an Italian version of the Hayling and Brixton tests and obtain normative values. We collected normative data from 301 healthy Italian participants aged between 16 and 94 years, taking into account all demographics. To maximize the sample size, we used the overlapping interval strategy. Adjusted scores for demographics were obtained by linear regression analysis. The performance on the Hayling and Brixton tests was influenced by age and education. In particular, age affected verbal accuracy and response time on the Hayling Sentence Completion Test, whereas education only affected the former. Differently, the spatial component, as measured by the Brixton Spatial Anticipation Test, was shaped only by age, which decreased the number of correct responses. Our study provides normative data that have been adjusted for relevant demographics and percentile grids in an Italian population. Our data support the use of the Hayling and Brixton tests as a valid instrument for performing neuropsychological evaluations and longitudinal analyses of executive functions in clinical practice and for research purposes.
Normative and self-perceived orthodontic treatment need in Nigerian school children.
Ajayi, Emmanuel Olubusayo
2015-07-01
The aim of this study was to assess the normative and self-perceived need for orthodontic treatment in Nigerian children, and to evaluate distribution of orthodontic treatment need according to gender and age. The sample consisted of 441 randomly selected school children, aged 11-18 years in Benin City, Nigeria. The subjects were further sub-grouped according to gender (229 males and 212 females) and age (246 11-13 years old and 195 14-18 years old). The Dental health Component (DHC) and Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need normatively. Self-perceived need was evaluated by asking the subjects to rate their dental aesthetics on the Aesthetic Component scale of IOTN. Chi-square tests were used to evaluate gender and age differences in distribution of treatment need. A definite need for orthodontic treatment was found among 21.5% (grades 4-5 of DHC) and 6.3% (grades 8-10 of AC) of the subjects; 3.9% of the subjects perceived a definite need for orthodontic treatment (grades 8-10 of AC). There were no statistically significant gender and age differences in distribution of orthodontic treatment need among the subjects (p > 0.05). The study revealed a need for orthodontic treatment in slightly more than one fifth (21.5%) of this sample of Nigerian children. The sample population has a lower need on aesthetic grounds and their normative and self-perceived orthodontic treatment needs were not influenced by gender and age.
Home health care and patterns of subsequent VA and medicare health care utilization for veterans.
Van Houtven, Courtney Harold; Jeffreys, Amy S; Coffman, Cynthia J
2008-10-01
The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HHC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched controls. We also consider crossover between the VA and Medicare. This is a retrospective study using propensity score and stratified analysis to control for selection bias on observable characteristics. We examined the full cohort of 2002 VA HHC users (n = 24,169) and a 2:1 sample of age- and race-based nonusers (n = 53,356). Utilization measures included VA and Medicare outpatient, inpatient, nursing home, and hospice use, as well as VA home-based primary care, respite care, and adult day health care. VA HHC users had a higher absolute probability of outpatient use by around 3%, of inpatient use by 12%, and nursing home use by 6% than their propensity-score-matched controls. Veterans who used HHC services had a higher rate of VA service use in the subsequent year than controls did, even after we adjusted for differences in observed health status, eligibility advantages, and supplemental insurance status. High utilization for VA home health users spilled over into high Medicare utilization.
Code of Federal Regulations, 2011 CFR
2011-10-01
..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...
Code of Federal Regulations, 2012 CFR
2012-10-01
..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...
Code of Federal Regulations, 2013 CFR
2013-10-01
..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...
Code of Federal Regulations, 2010 CFR
2010-10-01
..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...
Code of Federal Regulations, 2014 CFR
2014-10-01
..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...
Marques, Elisa A; Baptista, Fátima; Santos, Rute; Vale, Susana; Santos, Diana A; Silva, Analiza M; Mota, Jorge; Sardinha, Luís B
2014-01-01
This cross-sectional study was designed to develop normative functional fitness standards for the Portuguese older adults, to analyze age and gender patterns of decline, to compare the fitness level of Portuguese older adults with that of older adults in other countries, and to evaluate the fitness level of Portuguese older adults relative to recently published criterion fitness standards associated with maintaining physical independence. A sample of 4,712 independent-living older adults, age 65-103 yr, was evaluated using the Senior Fitness Test battery. Age-group normative fitness scores are reported for the 10th, 25th, 50th, 75th, and 90th percentiles. Results indicate that both women and men experience age-related losses in all components of functional fitness, with their rate of decline being greater than that observed in other populations, a trend which may cause Portuguese older adults to be at greater risk for loss of independence in later years. These newly established normative standards make it possible to assess individual fitness level and provide a basis for implementing population-wide health strategies to counteract early loss of independence.
Young Children Attribute Normativity to Novel Actions without Pedagogy or Normative Language
ERIC Educational Resources Information Center
Schmidt, Marco F. H.; Rakoczy, Hannes; Tomasello, Michael
2011-01-01
Young children interpret some acts performed by adults as normatively governed, that is, as capable of being performed either rightly or wrongly. In previous experiments, children have made this interpretation when adults introduced them to novel acts with normative language (e.g. "this is the way it goes"), along with pedagogical cues signaling…
Normative data on phases of the Valsalva maneuver
NASA Technical Reports Server (NTRS)
Denq, J. C.; O'Brien, P. C.; Low, P. A.
1998-01-01
The phases of the Valsalva maneuver have well-known pathophysiology, and are used in the evaluation of adrenergic function. Because scant normative data is available, we have evaluated normative data for the Valsalva maneuver in control subjects. The patient, supine, performed the Valsalva maneuver maintaining an expiratory pressure of 40 mm Hg for 15 seconds. We reviewed 188 Valsalva maneuver recordings of normal control subjects, and recordings were excluded if two reproducible recordings were not obtained, or if expiratory pressure was <30 mm Hg or < 10 seconds. One hundred and three recordings were acceptable for analysis; 47 female and 56 male subjects, age in years (mean +/- SD) was 52.2+/-17.3 and 44.8+/-17.3, respectively. The association of expiratory pressure with age (P < 0.001) and gender ( P < 0.001) was complex, expressed as a parabola in both men and women, but resulted in phases I and III that were not significantly different. An increase in age resulted in a progressively more negative phase II_E (P < 0.05) and attenuation of phase II_L (P < 0.01). An increase in supine blood pressure resulted in a significantly more negative phase II_E (P < 0.001) and a lower phase IV. Phase IV is unaffected by age and gender.
Teyhen, Deydre S; Riebel, Mark A; McArthur, Derrick R; Savini, Matthew; Jones, Mackenzie J; Goffar, Stephen L; Kiesel, Kyle B; Plisky, Phillip J
2014-04-01
Determine the influence of age and sex and describe normative data on field expedient tests associated with power, balance, trunk stability, mobility, and functional movement in a military population. Participants (n = 247) completed a series of clinical and functional tests, including closed-chain ankle dorsiflexion (DF), Functional Movement Screen (FMS), Y-Balance Test Lower Quarter (YBT-LQ), Y-Balance Test Upper Quarter (YBT-UQ), single leg vertical jump (SLVJ), 6-m timed hop (6-m timed), and triple hop. Descriptive statistics were calculated. Analysis of variance tests were performed to compare the results based on sex and age (<30 years, >30 years). Service members demonstrated DF of 34.2 ± 6.1°, FMS composite score of 16.2 ± 2.2, YBT-LQ normalized composite score of 96.9 ± 8.6%, YBT-UQ normalized composite score of 87.6 ± 9.6%, SLVJ of 26.9 ± 8.6 cm, 6-m hop of 2.4 ± 0.5 seconds, and a triple hop of 390.9 ± 110.8 cm. Men performed greater than women (p < 0.05) on the YBT-LQ, YBT-UQ, SLVJ, 6-m timed, and triple hop. Those <30 years of age performed better than older participants (p < 0.05) on the DF, FMS, YBT-LQ, SLVJ, 6-m hop, and triple hop. Findings provide normative data on military members. Men performed better on power, balance, and trunk stability tests, whereas younger individuals performed better on power, balance, mobility, and functional movement. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Omer, Yassir Talal; Bouserhal, Joseph; Hawas, Nuha; Abdel Moneim El Sayed, Ahmed
2016-09-01
The aims of this study were to investigate the association between normative and perceived orthodontic treatment need in a Lebanese population and the effect of sociodemographic status on orthodontic treatment need. A prospective cross-sectional clinical study was designed using a sample of 150 subjects (81 males and 69 females) aged 11-18years seeking dental treatment at Beirut Arab University. Normative orthodontic treatment need was scored using the two components of the Index of Orthodontic Treatment Need (IOTN), the Dental Health Component (DHC) and the Aesthetic Component (AC). Perceived need for orthodontic treatment was evaluated by scoring the AC of the IOTN. A total of 31.3% of the sample were in great need of orthodontic treatment according to the DHC of the IOTN. On the other hand, only 9% of the sample perceived their need to be definite. A significant positive but weak correlation was found between the normative and perceived need for orthodontic treatment. There was also a significant association between age and normative treatment need. Copyright © 2016 CEO. Published by Elsevier Masson SAS. All rights reserved.
An updated Italian normative dataset for the Stroop color word test (SCWT).
Brugnolo, A; De Carli, F; Accardo, J; Amore, M; Bosia, L E; Bruzzaniti, C; Cappa, S F; Cocito, L; Colazzo, G; Ferrara, M; Ghio, L; Magi, E; Mancardi, G L; Nobili, F; Pardini, M; Rissotto, R; Serrati, C; Girtler, N
2016-03-01
The Stroop color and word test (SCWT) is widely used to evaluate attention, information processing speed, selective attention, and cognitive flexibility. Normative values for the Italian population are available only for selected age groups, or for the short version of the test. The aim of this study was to provide updated normal values for the full version, balancing groups across gender, age decades, and education. Two kinds of indexes were derived from the performance of 192 normal subjects, divided by decade (from 20 to 90) and level of education (4 levels: 3-5; 6-8; 9-13; >13 years). They were (i) the correct answers achieved for each table in the first 30 s (word items, WI; color items, CI; color word items, CWI) and (ii) the total time required for reading the three tables (word time, WT; color time, CT; color word time, CWT). For each index, the regression model was evaluated using age, education, and gender as independent variables. The normative data were then computed following the equivalent scores method. In the regression model, age and education significantly influenced the performance in each of the 6 indexes, whereas gender had no significant effect. This study confirms the effect of age and education on the main indexes of the Stroop test and provides updated normative data for an Italian healthy population, well balanced across age, education, and gender. It will be useful to Italian researchers studying attentional functions in health and disease.
Normative Data for Interpreting the BREAST-Q: Augmentation
Mundy, Lily R.; Homa, Karen; Klassen, Anne F.; Pusic, Andrea L.; Kerrigan, Carolyn L.
2016-01-01
Background The BREAST-Q is a rigorously developed, well-validated, patient-reported outcome (PRO) instrument with a module designed for evaluating breast augmentation outcomes. However, there are no published normative BREAST-Q scores, limiting interpretation. Methods Normative data were generated for the BREAST-Q Augmentation Module via the Army of Women (AOW), an online community of women (with and without breast cancer) engaged in breast-cancer related research. Members were recruited via email, with women 18 years or older without a history of breast cancer or breast surgery invited to participate. Descriptive statistics and a linear multivariate regression were performed. A separate analysis compared normative scores to findings from previously published BREAST-Q augmentation studies. Results The preoperative BREAST-Q Augmentation Module was completed by 1,211 women. Mean age was 54 ±24 years, mean body mass index (BMI) was 27 ±6, and 39% (n=467) had a bra cup size ≥D. Mean scores were Satisfaction with Breasts (54 ±19), Psychosocial Well-being (66 ±20), Sexual Well-being (49 ±20), and Physical Well-being (86 ±15). Women with a BMI of 30 or greater and bra cup size D or greater had lower scores. In comparison to AOW scores, published BREAST-Q augmentation scores were lower before and higher after surgery for all scales except Physical Well-being. Conclusions The AOW normative data represent breast-related satisfaction and well-being in woman not actively seeking breast augmentation. This data may be used as normative comparison values for those seeking and undergoing surgery as we did, demonstrating the value of breast augmentation in this patient population. PMID:28350657
Adult normative data for phonatory aerodynamics in connected speech.
Lewandowski, Ali; Gillespie, Amanda I; Kridgen, Samantha; Jeong, Kwonho; Yu, Lan; Gartner-Schmidt, Jackie
2018-04-01
To establish normative values for phonatory aerodynamic measurements in connected speech across adult ages and gender. Prospective data collection across group design. One hundred fifty adults aged >18 years without voice complaints were stratified into three equal-age groups (group 1 [ages 18-39 years]; group 2 [ages 40-59 years], and group 3 [ages 60 + years]) and two equal-gender groups (male and female) resulting in 25 participants in each category. Participants read the first four sentences of the Rainbow Passage at comfortable pitch and loudness to obtain a connected speech sample. The following dependent variables were analyzed: breath number, reading passage duration, mean phonatory airflow, inspiratory airflow duration, and expiratory airflow duration. A gender effect was found for mean phonatory airflow, with males showing significantly greater phonatory airflow than females during connected speech (P < .001). Number of breaths was significantly greater for group 3 than group 2 (P < .001) and group 1 (P < .001). Duration, and inspiratory and expiratory airflow durations were all significantly greater for group 3 (P < .001) than group 2 (P < .001) than group 1 (P < .001). This study provides normative data for phonatory aerodynamics in adult connected speech. Significant age and gender effects were observed. Laryngoscope, 128:909-914, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Ferguson, Eamonn; Lawrence, Claire
2013-05-01
There is increasing use of counter-normative health messages (i.e., evidence-based health information about cause-effect relationships that run counter to shared normative beliefs, e.g., stress can lead to personal growth). The current studies examine the effect of normative and counter-normative messages about stress on levels of symptom reporting. Predictions are derived from reactance, social comparison, and self-enhancement theories. Two studies focus on the development of the messages, and two experimental studies examine the effect of manipulating normative and counter-normative messages on symptom reports. The final study controls for mere-measurement effects and explores the role of stress process variables (appraisals and coping). Exposure to a normative message (stress causes ill health) results in reduced symptom reporting compared to a counter-normative message (stress provides challenge, growth, and development) and control groups. The results suggest that people may use symptom reporting strategically to indicate coping. Based on the argument that beliefs about stress and health are stored as mental models, the theoretical associations derived from stress theory are only observed when a normative message is presented. Counter-normative stress messages may carry no tangible benefits compared to normative messages. Some stress research may suffer from inherent methodological bias when normative information is provided in information and consent sheets. Statement of contribution What is already known on this subject? At present, nothing is known about counter-normative health messages, despite the fact that they are becoming widely used as a public intervention. What does this study add? A clear operational definition of counter-normative messages. A test of three competing theories for counter-normative messages that focus of the stress-symptom link. Demonstrating for the first time, that in the domain of stress and health, counter-normative messages
ERIC Educational Resources Information Center
Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.
2009-01-01
Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…
Trail Making Test: normative data for Turkish elderly population by age, sex and education.
Cangoz, Banu; Karakoc, Ebru; Selekler, Kaynak
2009-08-15
Trail Making Test (TMT) is a neuropsychological test, which has parts A and B that can precisely measure executive functions, like complex visual-motor conceptual screening, planning, organization, abstract thinking and response inhibition. The main purpose of this study is to standardize TMT for Turkish adults and/or elderly population. This study primarily consists of two main parts; norm determination study and reliability/validity studies, respectively. The standardization study was carried on 484 participants (238 female and 246 male). Participants at the age of 50 years and older were selected from a pool of people employed in or retired from governmental and/or private institutions. The research design of this study involves the following variables mainly; age (7 subgroups), sex (2 subgroups) and education (3 subgroups). Age, sex and education variables have significant influence on eight different kinds of TMT scores. Statistical analysis by ANOVA revealed a major effect of age (p<0.001) and education (p<0.001) on time spent in Part A or B, or time difference between Parts B and A, or sum of Parts A and B. Similarly, influence of sex (p<0.05) on time spent on Part A or B, or sum of Parts A and B was shown to be significant. Kruskal-Wallis Test was performed and chi-square (chi(2)) values revealed that, correction scores for Part A and B were found to be influenced by age groups (p<0.001). Test-retest reliability and inter-rater reliability coefficients for time scores of Parts A and B were estimated as 0.78, 0.99 and 0.73, 0.93, respectively. This study provides normative data for a psychometric tool that reliably measures the executive functions in Turkish elderly population at the age of 50 and over.
Gerstenecker, Adam; Niccolai, Lindsay; Marson, Daniel; Triebel, Kristen L
2016-04-01
A number of measures have been developed to assess medical decision-making capacity (MDC) in adults. However, their clinical utility is limited by a lack of available normative data. In the current study, we introduce age-independent and age-adjusted normative data for a measure of MDC: the Capacity to Consent to Treatment Instrument. The sample consisted of 308 cognitively normal, community-dwelling adults ranging in age from 19 to 86 years. For age-adjusted norms, individual raw scores were first converted to age-corrected scaled scores based on position within a cumulative frequency distribution and then grouped according to empirically supported age ranges. For age-independent norms, the same method was utilized but without age-corrections being applied or participants being grouped into age ranges. This study has the potential to enhance MDC evaluations by allowing clinicians to compare a patient's performance on the Capacity to Consent to Treatment Instrument with that of adults regardless of age as well as to same age peers. Tables containing normative corrections are supplementary material available online at http://asm.sagepub.com/supplemental. © The Author(s) 2015.
Normative Values of Physical Examinations Commonly Used for Cerebral Palsy
Moon, Seung Jun; Choi, Young; Chung, Chin Youb; Sung, Ki Hyuk; Cho, Byung Chae; Chung, Myung Ki; Kim, Jaeyoung; Yoo, Mi Sun; Lee, Hyung Min
2017-01-01
Purpose The aim of this study was to establish normative values and to identify age-related change in physical examinations that are commonly used while evaluating patients with cerebral palsy (CP). Materials and Methods One hundred four healthy volunteers (mean age 36 years, standard deviation 15 years) were enrolled and divided into four age groups: 13−20, 21−35, 36−50, and 51 years and older. The eighteen physical examination tests for CP were selected by five orthopedic surgeons in consensus-building session. The measurements were taken by three orthopedic surgeons. Results There was no significant difference in the measures of physical examination among all the age groups, except for the Staheli test (p=0.002). The post hoc test revealed that the mean hip extension was 2.7° higher in the 13−20-year-old group than in the other age groups. The bilateral popliteal angle had a tendency to increase in those over 36-years-old. There were 31 participants (30%) with a unilateral popliteal angle greater than 40°. Conclusion We documented normative values that can be widely used for evaluating CP in patients 13 years and older. PMID:29047241
[Spanish verbal fluency. Normative data in Argentina].
Butman, J; Allegri, R F; Harris, P; Drake, M
2000-01-01
Letter and category fluency tasks are used to assess semantic knowledge, retrieval ability, and executive functioning. The original normative data have been obtained mainly from English speaking populations; there are few papers on norms in other languages. The purpose of this study was to collect normative scores in Argentina and to evaluate the effects of sex, age, education and cognitive status on the letter and category fluency tasks, in 266 healthy Spanish-speaking participants (16 to 86 years). Mean education span was 12.8 +/- 4 years. In each subject a neuropsychological battery (Minimental State Exam, Signoret Memory Battery, Boston Naming Test and Trail Making Test) was carried out as well as category fluency (naming animals in one minute) and letter fluency (words beginning with letter "p" in one minute). The sample was arranged into a group of subjects with less than 45 years and further groups up to 10 more years, until 75 years (or more) with three different levels of education. Significant effects were found for age, education, and Minimental State Exam on performance of both fluencies. Mean performance scores are presented for each group to be used in Argentina.
Integrated empirical ethics: loss of normativity?
van der Scheer, Lieke; Widdershoven, Guy
2004-01-01
An important discussion in contemporary ethics concerns the relevance of empirical research for ethics. Specifically, two crucial questions pertain, respectively, to the possibility of inferring normative statements from descriptive statements, and to the danger of a loss of normativity if normative statements should be based on empirical research. Here we take part in the debate and defend integrated empirical ethical research: research in which normative guidelines are established on the basis of empirical research and in which the guidelines are empirically evaluated by focusing on observable consequences. We argue that in our concrete example normative statements are not derived from descriptive statements, but are developed within a process of reflection and dialogue that goes on within a specific praxis. Moreover, we show that the distinction in experience between the desirable and the undesirable precludes relativism. The normative guidelines so developed are both critical and normative: they help in choosing the right action and in evaluating that action. Finally, following Aristotle, we plead for a return to the view that morality and ethics are inherently related to one another, and for an acknowledgment of the fact that moral judgments have their origin in experience which is always related to historical and cultural circumstances.
Demonstration of the need for cardiovascular and pulmonary normative data for cancer survivors.
Schneider, C M; Repka, C P; Brown, J M; Lalonde, T L; Dallow, K T; Barlow, C E; Hayward, R
2014-12-01
Despite evidence that cancer and its treatments severely reduce cardiorespiratory fitness (CRF), normative data for cancer survivors do not exist. The present study identifies age and gender-specific CRF distributions in a cancer population. The use of cancer-specific normative CRF data may help stratify initial fitness status and assess improvements in response to exercise interventions in cancer survivors. Data from 703 cancer survivors were analyzed for this study. Quintiles were compiled for peak oxygen consumption (VO2peak), forced vital capacity (FVC), and forced expiratory volume (FEV1) for males and females in 5 age groups (19-39, 40-49, 50-59, 60-69, and ≥70 years of age). VO2peak values for the cancer population were significantly lower than the general US population. The cancer population average in each age group fell within the "very poor" classification of VO2peak values for the general population. FVC values in the cancer population were similar to the general population. Cancer survivors had very low age group-specific VO2peak values compared to the apparently healthy general US population. Previously, CRF values of cancer survivors were compared to normative values for the apparently healthy general population, which yielded imprecise classifications of initial fitness and changes in fitness, resulting in patient discouragement. © Georg Thieme Verlag KG Stuttgart · New York.
Accessing VA Healthcare During Large-Scale Natural Disasters.
Der-Martirosian, Claudia; Pinnock, Laura; Dobalian, Aram
2017-01-01
Natural disasters can lead to the closure of medical facilities including the Veterans Affairs (VA), thus impacting access to healthcare for U.S. military veteran VA users. We examined the characteristics of VA patients who reported having difficulty accessing care if their usual source of VA care was closed because of natural disasters. A total of 2,264 veteran VA users living in the U.S. northeast region participated in a 2015 cross-sectional representative survey. The study used VA administrative data in a complex stratified survey design with a multimode approach. A total of 36% of veteran VA users reported having difficulty accessing care elsewhere, negatively impacting the functionally impaired and lower income VA patients.
ERIC Educational Resources Information Center
Chapman, Amy; Saltmarsh, Sue
2013-01-01
This article offers a consideration of the ways that the politics of normative childhoods are shaped by discourses of happiness predicated on heteronormativity. Responding to the work of Cristyn Davies and Kerry Robinson (2013, this issue), the authors argue that non-normative families and in particular, non-normative parenting, are obliged to…
Individual and Peer Group Normative Beliefs about Relational Aggression
ERIC Educational Resources Information Center
Werner, Nicole E.; Hill, Laura G.
2010-01-01
Studies show that children who use relational aggression process social information in unique ways; however, findings have been inconsistent and limited by methodological weaknesses. This short-term longitudinal study examined developmental changes in 245 (49% female; ages 8-13) 3rd through 8th graders' normative beliefs about relational…
Child sexual behavior inventory: a comparison between Latino and normative samples of preschoolers.
Kenny, Maureen C; Wurtele, Sandy K
2013-01-01
There is a relative dearth of research examining normative sexual behavior in Latino preschool children, despite an increased presence of Latinos as a minority population in the United States. To meet this need, a sample of Latino mothers were asked to complete the Child Sexual Behavior Inventory (CSBI; Friedrich et al., 1992 ) on their preschool-aged children (3 to 5 years old; n = 188). When their children's scores were compared to CSBI normative data, significant differences emerged. Compared to the normative sample, Latino boys and girls scored significantly higher on the sexual abuse specific items subscale, and Latino girls scored significantly higher on the developmentally related sexual behavior subscale. Possible cultural explanations for these elevations are explored.
Janky, Kristen L.; Shepard, Neil
2009-01-01
Background Vestibular Evoked Myogenic Potential (VEMP) testing has gained increased interest in the diagnosis of a variety of vestibular etiologies. Comparisons of P13 / N23 latency, amplitude and threshold response curves have been used to compare pathologic groups to normal controls. Appropriate characterization of these etiologies requires normative data across the frequency spectrum and age range. Purpose The objective of the current study was to test the hypothesis that significant changes in VEMP responses occur as a function of increased age across all test stimuli as well as characterize the VEMP threshold response curve across age. Research Design This project incorporated a prospective study design using a sample of convenience. Openly recruited subjects were assigned to groups according to age. Study Sample Forty-six normal controls ranging between 20 and 76 years of age participated in the study. Participants were separated by decade into 5 age categories from 20 to 60 plus years. Normal participants were characterized by having normal hearing sensitivity, no history of neurologic or balance/dizziness involvement and negative results on a direct office vestibular examination. Intervention VEMP responses were measured at threshold to click and 250, 500, 750, and 1000 Hz tone burst stimuli and at a suprathreshold level to 500 Hz toneburst stimuli at123 dBSPL. Data Collection and Analysis A mixed group factorial ANOVA and linear regression were performed to examine the effects of VEMP characteristics upon age. Results There were no significant differences between ears for any of the test parameters. There were no significant differences between age groups for n23 latency or amplitude in response to any of the stimuli. Significant mean differences did exist between age groups for p13 latency (250, 750, and 1000 Hz) and threshold (500 and 750 Hz). Age was significantly correlated with VEMP parameters. VEMP threshold was positively correlated (250, 500, 750
Janky, Kristen L; Shepard, Neil
2009-09-01
Vestibular evoked myogenic potential (VEMP) testing has gained increased interest in the diagnosis of a variety of vestibular etiologies. P13/N23 latency, amplitude and threshold response curves have been used to compare pathologic groups to normal controls. Appropriate characterization of these etiologies requires normative data across the frequency spectrum and age range. The objective of the current study was to test the hypothesis that significant changes in VEMP responses occur as a function of increased age across all test stimuli as well as characterize the VEMP threshold response curve across age. This project incorporated a prospective study design using a sample of convenience. Openly recruited subjects were assigned to groups according to age. Forty-six normal controls ranging between 20 and 76 years of age participated in the study. Participants were separated by decade into five age categories from 20 to 60 plus years. Normal participants were characterized by having normal hearing sensitivity, no history of neurologic or balance/dizziness involvement, and negative results on a direct office vestibular examination. VEMP responses were measured at threshold to click and 250, 500, 750, and 1000 Hz tone burst stimuli and at a suprathreshold level to 500 Hz toneburst stimuli at123 dB SPL. A mixed group factorial ANOVA (analysis of variance) and linear regression were performed to examine the effects of VEMP characteristics on age. There were no significant differences between ears for any of the test parameters. There were no significant differences between age groups for n23 latency or amplitude in response to any of the stimuli. Significant mean differences did exist between age groups for p13 latency (250, 750, and 1000 Hz) and threshold (500 and 750 Hz). Age was significantly correlated with VEMP parameters. VEMP threshold was positively correlated (250, 500, 750, 1000 Hz); and amplitude was negatively correlated (500 Hz maximum). The threshold
Olds, R Scott; Thombs, Dennis L; Tomasek, Jennifer Ray
2005-07-01
To examine the relations between normative beliefs and intentions to initiate cigarette, alcohol, and marijuana use among adolescents reporting no prior use. An anonymous questionnaire was administered to 6,594 seventh- to twelfth-grade students in northeast Ohio. Separate analyses were conducted on sub-samples of respondents reporting no prior use of each substance. Within each of these 3 sub-samples, respondents were classified as holding high-risk intentions if they reported that they intended to begin using that particular substance within the next 6 months or were "not sure" of their intentions. Those reporting that they did not intend to start using a substance were classified as holding low-risk intentions. Multivariate logistic regression analyses examined the relations between normative beliefs and intention status (low- vs. high-risk), while accounting for socio-demographic characteristics. Across all 3 substances, normative beliefs were stronger predictors of intention status than socio-demographic variables. Higher levels of perceived acceptability and perceived prevalence were associated with holding high-risk intentions. Normative belief measures assessing close friend and sibling reference groups were much more important in explaining intention status than those assessing other reference groups (e.g., same age peers). Among adolescents with no prior use, normative beliefs concerning close friends and siblings may play an important role in the catalysis and support of intentions to initiate substance use. These findings challenge the utility of primary prevention strategies that provide normative feedback based on rates of substance use among distal reference groups.
Robertson, K; Jiang, H; Evans, SR; Marra, CM; Berzins, B; Hakim, J; Sacktor, N; Silva, M Tulius; Campbell, TB; Nair, A; Schouten, J; Kumwenda, J; Supparatpinyo, K; Tripathy, S.; Kumarasamy, N; La Rosa, A; Montano, S; Mwafongo, A; Firnhaber, C; Sanne, I; Naini, L.; Amod, F; Walawander, A
2016-01-01
Summary ACTG A5271 collected neurocognitive normative comparison test data in 2400 at-risk HIV seronegative participants from Brazil, India, Malawi, Peru, South Africa, Thailand and Zimbabwe. The participants were enrolled in strata by site (10 levels), age (2 levels), education (2 levels), and gender (2 levels). These data provide necessary normative data infrastructure for future clinical research and care in these diverse resource limited settings. Infrastructure for conducting neurological research in resource limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment, and normative data needed for clinical interpretation impede research and clinical care. Here we report on ACTG 5271, which provided neurological training of clinical site personnel, and collected neurocognitive normative comparison data in diverse settings. At 10 sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n=240), India (n=480), Malawi (n=481), Peru (n=239), South Africa (480), Thailand (n=240) and Zimbabwe (n=240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline, and 770 at six-months. Participants were enrolled in 8 strata, gender (female and male), education (<10 years and ≥ 10 years), and age (<35 years and ≥35 years). Of 2400 enrolled, 770 completed the six-month follow up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p<.0001). There was variation between the age, gender and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the
AULA-Advanced Virtual Reality Tool for the Assessment of Attention: Normative Study in Spain.
Iriarte, Yahaira; Diaz-Orueta, Unai; Cueto, Eduardo; Irazustabarrena, Paula; Banterla, Flavio; Climent, Gema
2016-06-01
The present study describes the obtention of normative data for the AULA test, a virtual reality tool designed to evaluate attention problems, especially in children and adolescents. The normative sample comprised 1,272 participants (48.2% female) with an age range from 6 to 16 years (M = 10.25, SD = 2.83). The AULA test administered to them shows both visual and auditory stimuli, while randomized distractors of ecological nature appear progressively. Variables provided by AULA were clustered in different categories for their posterior analysis. Differences by age and gender were analyzed, resulting in 14 groups, 7 per sex group. Differences between visual and auditory attention were also obtained. Obtained normative data are relevant for the use of AULA for evaluating attention in Spanish children and adolescents in a more ecological way. Further studies will be needed to determine sensitivity and specificity of AULA to measure attention in different clinical populations. (J. of Att. Dis. 2016; 20(6) 542-568). © The Author(s) 2012.
Establishing age-associated normative ranges of the cerebral 18F-FDG uptake ratio in children.
Hua, Chiaho; Merchant, Thomas E; Li, Xingyu; Li, Yimei; Shulkin, Barry L
2015-04-01
In this study, we reported age-associated ranges of the regional cerebral (18)F-FDG uptake ratio in pediatric patients as a surrogate to normative data from healthy children. (18)F-FDG PET scans of 132 children and adolescents (age, 1-20 y) with non-central nervous system-related diseases and normal-appearing tracer distributions in the brain were retrospectively analyzed. PET images of individual patients were warped to a 3-dimensional reference template. Uptake ratio was calculated for 63 anatomic regions by normalizing the regional count per voxel with the average count per voxel in all regions. Models of regional uptake ratio as a function of age and sex were developed to calculate the 95% prediction interval. The paracentral lobule and cuneus had the highest resting metabolic state among all gray matter regions, whereas the brain stem, uncus, and hippocampus had the lowest uptake. A large left-right asymmetry was present in the angular gyrus and inferior occipital gyrus. Quantitative data of the regression, 95% confidence interval, and 95% prediction interval for each age were summarized for the 63 regions. In 52 of 63 regions, the (18)F-FDG uptake ratio had a significant age effect. The linear model was optimal for 12 regions, whereas the spline model with 1 age knot was a better fit for 40 regions. In children younger than 5 y, frontal and temporal lobes had a lower uptake than parietal and occipital lobes in general. However, uptake in the frontal lobe continued to increase with age but it decreased in the parietal and occipital lobes. Anatomic regions of the brain in children and adolescents exhibited uniquely different (18)F-FDG uptake trends with age. Our results may be useful for studying childhood development and possibly regional metabolic defects in children with traumatic brain injury or central nervous system disorders or children receiving cancer treatment. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
A Review of Norms and Normative Multiagent Systems
Mahmoud, Moamin A.; Ahmad, Mohd Sharifuddin; Mustapha, Aida
2014-01-01
Norms and normative multiagent systems have become the subjects of interest for many researchers. Such interest is caused by the need for agents to exploit the norms in enhancing their performance in a community. The term norm is used to characterize the behaviours of community members. The concept of normative multiagent systems is used to facilitate collaboration and coordination among social groups of agents. Many researches have been conducted on norms that investigate the fundamental concepts, definitions, classification, and types of norms and normative multiagent systems including normative architectures and normative processes. However, very few researches have been found to comprehensively study and analyze the literature in advancing the current state of norms and normative multiagent systems. Consequently, this paper attempts to present the current state of research on norms and normative multiagent systems and propose a norm's life cycle model based on the review of the literature. Subsequently, this paper highlights the significant areas for future work. PMID:25110739
Mayo's Older American Normative Studies: Separate Norms for WMS-R Logical Memory Stories.
ERIC Educational Resources Information Center
Smith, Glenn E.; Wong, Jennifer S.; Ivnik, Robert J.; Malec, James F.
1997-01-01
Norms are presented for persons ages 56 to 93 years for each story from the Logical Memory subtests of the revised edition of the Wechsler Memory Scale following the methods used for other Mayo's Older American Normative Studies. Means and standard deviations are presented for 3-year interval age groups from age 61 to 88. (SLD)
[Pattern-reversal electroretinogram (PERG): a normative study in adults].
Alves, Letícia Dourado; Berezovsky, Adriana; Sacai, Paula Yuri; Pereira, Josenilson Martins; Salomão, Solange Rios
2010-01-01
To determine normative values for pattern-reversal electroretinogram (PERG) in healthy adult volunteers according to the standard protocol recommended by the International Society for Clinical Electrophysiology of Vision-ISCEV. Participants were 30 healthy volunteers (15 males) with ages from 18 to 61 years (mean= 30.8 +/- 8.7 yrs.; median= 29.5 yrs). Inclusion criteria were: visual acuity of 0.0 logMAR (20/20 Snellen) in each eye, absence of visual complaints, absence of media opacities, negative history for ocular or neurological diseases, negative family history for ocular and informed consent. PERG was recorded from each eye in a darkened room at 1 m from a high resolution display monitor. Stimuli were monochromatic checkerboards subtending 60, 15 e 7.5 minutes of visual angle reversing at 1.9 Hz. Responses were obtained from modified disposable fiber electrodes developed at UNIFESP. Latency (ms) for N35, P50 and N95 components as well as peak-to-peak amplitudes (microV) for N35-P50 and P50-N95 were determined. For normative values only one randomly chosen eye was included. Normal limits were calculated as 97.5% percentiles for latency and 2.5% percentile for amplitudes for each stimulus size. Normal limits for N35, P50 and N95 latencies for 60', 15' and 7.5' stimuli were respectively: N35 - 40.1; 39.9 and 41.3 ms; P50 - 60.5; 64.4 and 65.6 ms and N95 - 103.4; 104.6 and 104.6 ms. For amplitude the normative values for N35-P50 and P50-N95 for 60', 15' and 7.5' were respectively: N35-P50 - 1.7; 1.6 and 0.9 microV; P50-N95 - 3.8; 2.8 and 1.5 microV. No gender differences were found either for latency or for amplitude in the three stimulus sizes. There was no correlation between PERG latency and amplitude with age, except for P50 amplitude for stimulus 15'(r=0.39; P=0.035). Normative values were determined for PERG parameters of amplitude and latency for three stimulus sizes. These parameters are important for evaluating the normal functioning of retinal ganglion
Normative data on the n-back task for children and young adolescents
Pelegrina, Santiago; Lechuga, M. Teresa; García-Madruga, Juan A.; Elosúa, M. Rosa; Macizo, Pedro; Carreiras, Manuel; Fuentes, Luis J.; Bajo, M. Teresa
2015-01-01
The n-back task is a frequently used measure of working memory (WM) in cognitive neuroscience research contexts, and it has become widely adopted in other areas over the last decade. This study aimed to obtain normative data for the n-back task from a large sample of children and adolescents. To this end, a computerized verbal n-back task with three levels of WM load (1-back, 2-back, and 3-back) was administered to 3722 Spanish school children aged 7–13 years. Results showed an overall age-related increase in performance for the different levels of difficulty. This trend was less pronounced at 1-back than at 2-back when hits were considered. Gender differences were also observed, with girls outperforming boys although taking more time to respond. The theoretical implications of these results are discussed. Normative data stratified by age and gender for the three WM load levels are provided. PMID:26500594
Normative data on the n-back task for children and young adolescents.
Pelegrina, Santiago; Lechuga, M Teresa; García-Madruga, Juan A; Elosúa, M Rosa; Macizo, Pedro; Carreiras, Manuel; Fuentes, Luis J; Bajo, M Teresa
2015-01-01
The n-back task is a frequently used measure of working memory (WM) in cognitive neuroscience research contexts, and it has become widely adopted in other areas over the last decade. This study aimed to obtain normative data for the n-back task from a large sample of children and adolescents. To this end, a computerized verbal n-back task with three levels of WM load (1-back, 2-back, and 3-back) was administered to 3722 Spanish school children aged 7-13 years. Results showed an overall age-related increase in performance for the different levels of difficulty. This trend was less pronounced at 1-back than at 2-back when hits were considered. Gender differences were also observed, with girls outperforming boys although taking more time to respond. The theoretical implications of these results are discussed. Normative data stratified by age and gender for the three WM load levels are provided.
Normative and self-perceived orthodontic treatment need of a Peruvian university population
Bernabé, Eduardo; Flores-Mir, Carlos
2006-01-01
Background Previous studies on orthodontic treatment need in young adults have shown that up to 50% had malocclusions that needed orthodontic treatment. The aims of this study were to assess the normative and self-perceived need for orthodontic treatment using the Index of Orthodontic Treatment Need (IOTN) and to determine if the treatment need levels were influenced by sex, age and socio-economic status (SES) in a sample of Peruvian young adults. Methods 281 first-year students (157 male and 124 female students) with a mean age of 18.1 +/- 1.6 years were randomly selected and evaluated through the Dental Health Component (DHC) and Aesthetic Component (AC) of the IOTN. Structured interview and clinical examination were used to assess the students. Descriptive statistics and Chi-square tests were used for data analysis with statistical significance set at P < 0.05. Results An intra-examiner reliability of 0.89 was obtained (weighted Kappa). The percentage of students according to SES was 51.2%, 40.6% and 8.2% corresponding to low, medium and high SES respectively. The percentage of students with DHC grades 4–5 was 29.9% whereas the percentage of students with AC grades 8–10 was 1.8%. There were no significant differences in the distribution of normative and self-perceived orthodontic treatment need based on sex, age and SES comparisons. Conclusion Normative orthodontic treatment need was not matched by a similar level of self-perceived treatment need in these young adults. Sex, age and SES were non-significant factors associated with levels of treatment need. PMID:16884542
Normativity, interpretation, and Bayesian models.
Oaksford, Mike
2014-01-01
It has been suggested that evaluative normativity should be expunged from the psychology of reasoning. A broadly Davidsonian response to these arguments is presented. It is suggested that two distinctions, between different types of rationality, are more permeable than this argument requires and that the fundamental objection is to selecting theories that make the most rational sense of the data. It is argued that this is inevitable consequence of radical interpretation where understanding others requires assuming they share our own norms of reasoning. This requires evaluative normativity and it is shown that when asked to evaluate others' arguments participants conform to rational Bayesian norms. It is suggested that logic and probability are not in competition and that the variety of norms is more limited than the arguments against evaluative normativity suppose. Moreover, the universality of belief ascription suggests that many of our norms are universal and hence evaluative. It is concluded that the union of evaluative normativity and descriptive psychology implicit in Davidson and apparent in the psychology of reasoning is a good thing.
Validity and Normative Data for the Biber Figure Learning Test: A Visual Supraspan Memory Measure.
Gifford, Katherine A; Liu, Dandan; Neal, Jacquelyn E; Acosta, Lealani Mae Y; Bell, Susan P; Wiggins, Margaret E; Wisniewski, Kristi M; Godfrey, Mary; Logan, Laura A; Hohman, Timothy J; Pechman, Kimberly R; Libon, David J; Blennow, Kaj; Zetterberg, Henrik; Jefferson, Angela L
2018-05-01
The Biber Figure Learning Test (BFLT), a visuospatial serial figure learning test, was evaluated for biological correlates and psychometric properties, and normative data were generated. Nondemented individuals ( n = 332, 73 ± 7, 41% female) from the Vanderbilt Memory & Aging Project completed a comprehensive neuropsychological protocol. Adjusted regression models related BFLT indices to structural brain magnetic resonance imaging and cerebrospinal fluid (CSF) markers of brain health. Regression-based normative data were generated. Lower BFLT performances (Total Learning, Delayed Recall, Recognition) related to smaller medial temporal lobe volumes and higher CSF tau concentrations but not CSF amyloid. BFLT indices were most strongly correlated with other measures of verbal and nonverbal memory and visuospatial skills. The BFLT provides a comprehensive assessment of all aspects of visuospatial learning and memory and is sensitive to biomarkers of unhealthy brain aging. Enhanced normative data enriches the clinical utility of this visual serial figure learning test for use with older adults.
Hospital Distance and Readmissions Among VA-Medicare Dual-Enrolled Veterans.
Wong, Edwin S; Rinne, Seppo T; Hebert, Paul L; Cook, Meredith A; Liu, Chuan-Fen
2016-09-01
Geographic access to inpatient care at the Veterans Affairs (VA) Health Care System is challenging for many veterans with chronic obstructive pulmonary disease (COPD) given relatively few VA hospitals nationwide. Veterans with lengthy travel distances may obtain non-VA care, particularly those dually enrolled in Medicare. Our primary objective was to assess whether distance from VA patients' residence to the nearest VA and non-VA hospitals was associated with 30-day all-cause readmission and the system where patients were readmitted (VA or Medicare). Using VA and Medicare administrative data, we identified 21,273 patients hospitalized for COPD between October 2008 and September 2011 and dually enrolled in VA and fee-for-service Medicare. Outcome variables were dichotomous measures denoting readmission for any cause within 30 days following discharge and whether the readmission occurred in a non-VA hospital through Medicare. Distance to the nearest hospital was defined as the number of miles between patients' residence ZIP code and the ZIP code of the nearest VA and non-VA hospital accepting Medicare, respectively. Probit models with sample selection were applied to examine the relationship between hospital distance and outcome measures. Respective distances to the nearest VA and non-VA hospital were not associated with 30-day all-cause readmission. Greater distance to the nearest VA hospital was associated with a greater conditional probability of choosing non-VA hospitals for readmission. COPD patients with poor geographic access to VA hospitals did not forgo subsequent inpatient care following their index hospitalization, but they were more likely to seek non-VA substitutes. © 2016 National Rural Health Association.
Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA)
Konrad-Martin, Dawn; Reavis, Kelly M.; McMillan, Garnett; Helt, Wendy J.; Dille, Marilyn
2015-01-01
Prevention and rehabilitation of hearing loss and tinnitus, the two most commonly awarded service-connected disabilities, are high priority initiatives in the Department of Veterans Affairs (VA). At least 4,000 Veterans, most with significant hearing loss, will receive cisplatin this year, with more than half sustaining permanent hearing shift and nearly 40% developing new tinnitus. With improved survivability following cancer treatment, Veterans treated with cisplatin are approached with the dual goals of effective treatment and preserved quality of life. This article describes COMP-VA, a comprehensive ototoxicity monitoring program developed for VA patients receiving cisplatin. The program includes an individualized pretreatment prediction model that identifies the likelihood of hearing shift given cisplatin dose and patient factors. It supports both manual and automated hearing testing with a newly developed portable audiometer capable of performing the recommended procedures on the chemotherapy unit during treatment. It also includes objective methods for identifying outer hair cell changes and predicting audiogram changes using distortion-product otoacoustic emissions. We describe this program of evidence-based ototoxicity monitoring protocols using a case example to give the reader an understanding of how this program would be applied, along with a plan for future work to accomplish the final stages of program development. PMID:24805896
Air pollution and gene-specific methylation in the Normative Aging Study
Bind, Marie-Abele; Lepeule, Johanna; Zanobetti, Antonella; Gasparrini, Antonio; Baccarelli, Andrea A; Coull, Brent A; Tarantini, Letizia; Vokonas, Pantel S; Koutrakis, Petros; Schwartz, Joel
2014-01-01
The mechanisms by which air pollution has multiple systemic effects in humans are not fully elucidated, but appear to include inflammation and thrombosis. This study examines whether concentrations of ozone and components of fine particle mass are associated with changes in methylation on tissue factor (F3), interferon gamma (IFN-γ), interleukin 6 (IL-6), toll-like receptor 2 (TLR-2), and intercellular adhesion molecule 1 (ICAM-1). We investigated associations between air pollution exposure and gene-specific methylation in 777 elderly men participating in the Normative Aging Study (1999–2009). We repeatedly measured methylation at multiple CpG sites within each gene’s promoter region and calculated the mean of the position-specific measurements. We examined intermediate-term associations between primary and secondary air pollutants and mean methylation and methylation at each position with distributed-lag models. Increase in air pollutants concentrations was significantly associated with F3, ICAM-1, and TLR-2 hypomethylation, and IFN-γ and IL-6 hypermethylation. An interquartile range increase in black carbon concentration averaged over the four weeks prior to assessment was associated with a 12% reduction in F3 methylation (95% CI: -17% to -6%). For some genes, the change in methylation was observed only at specific locations within the promoter region. DNA methylation may reflect biological impact of air pollution. We found some significant mediated effects of black carbon on fibrinogen through a decrease in F3 methylation, and of sulfate and ozone on ICAM-1 protein through a decrease in ICAM-1 methylation. PMID:24385016
Normative morphometric data for cerebral cortical areas over the lifetime of the adult human brain.
Potvin, Olivier; Dieumegarde, Louis; Duchesne, Simon
2017-08-01
Proper normative data of anatomical measurements of cortical regions, allowing to quantify brain abnormalities, are lacking. We developed norms for regional cortical surface areas, thicknesses, and volumes based on cross-sectional MRI scans from 2713 healthy individuals aged 18 to 94 years using 23 samples provided by 21 independent research groups. The segmentation was conducted using FreeSurfer, a widely used and freely available automated segmentation software. Models predicting regional cortical estimates of each hemisphere were produced using age, sex, estimated total intracranial volume (eTIV), scanner manufacturer, magnetic field strength, and interactions as predictors. The explained variance for the left/right cortex was 76%/76% for surface area, 43%/42% for thickness, and 80%/80% for volume. The mean explained variance for all regions was 41% for surface areas, 27% for thicknesses, and 46% for volumes. Age, sex and eTIV predicted most of the explained variance for surface areas and volumes while age was the main predictors for thicknesses. Scanner characteristics generally predicted a limited amount of variance, but this effect was stronger for thicknesses than surface areas and volumes. For new individuals, estimates of their expected surface area, thickness and volume based on their characteristics and the scanner characteristics can be obtained using the derived formulas, as well as Z score effect sizes denoting the extent of the deviation from the normative sample. Models predicting normative values were validated in independent samples of healthy adults, showing satisfactory validation R 2 . Deviations from the normative sample were measured in individuals with mild Alzheimer's disease and schizophrenia and expected patterns of deviations were observed. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.
Psychometric Properties and Normative Data for a Swedish Version of the Modern Health Worries Scale.
Palmquist, Eva; Petrie, Keith J; Nordin, Steven
2017-02-01
The modern health worries (MHW) scale was developed to assess individuals' worries about aspects of modernity and technology affecting personal health. The aim of this study was to psychometrically evaluate a Swedish version of the MHW scale and to provide Swedish normative data. Data were collected as part of the Västerbotten Environmental Health Study, which has a random sample of 3406 Swedish adults (18-79 years). The Swedish version of the MHW scale showed excellent internal consistency and satisfactory convergent validity. A four-factor structure consistent with the original version was confirmed. The model showed invariance across age and sex. A slightly positively skewed and platykurtic distribution was found. Normative data for the general population and for combinations of specific age groups (young, middle aged, and elderly) and sex are presented. The psychometric properties of the Swedish version of the MHW scale suggest that use of this instrument is appropriate for assessing worries about modernity in Swedish-speaking and similar populations. The scale now has the advantage of good normative data being available. MHW may hold importance for understanding and predicting the development of functional disorders, such as idiopathic environmental intolerance and other medically unexplained conditions.
77 FR 70893 - Authorization for Non-VA Medical Services
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-28
... professions, Health records, Homeless, Mental health programs, Nursing homes, Reporting and recordkeeping... restrictive modes of healthcare delivery. Although VA has made great strides to expand the delivery of... expand VA's authority to provide non-VA medical services under the non- VA care authority. As amended...
Peña-Casanova, Jordi; Quiñones-Ubeda, Sonia; Gramunt-Fombuena, Nina; Aguilar, Miquel; Casas, Laura; Molinuevo, José Luis; Robles, Alfredo; Rodríguez, Dolores; Barquero, María Sagrario; Antúnez, Carmen; Martínez-Parra, Carlos; Frank-García, Anna; Fernández, Manuel; Molano, Ana; Alfonso, Verónica; Sol, Josep M; Blesa, Rafael
2009-06-01
As part of the Spanish Multicenter Normative Studies (NEURONORMA project), we provide age- and education-adjusted norms for the Boston naming test and Token test. The sample consists of 340 and 348 participants, respectively, who are cognitively normal, community-dwelling, and ranging in age from 50 to 94 years. Tables are provided to convert raw scores to age-adjusted scaled scores. These were further converted into education-adjusted scaled scores by applying regression-based adjustments. Age and education affected the score of the both tests, but sex was found to be unrelated to naming and verbal comprehension efficiency. Our norms should provide clinically useful data for evaluating elderly Spaniards. The normative data presented here were obtained from the same study sample as all the other NEURONORMA norms and the same statistical procedures for data analyses were applied. These co-normed data allow clinicians to compare scores from one test with all tests.
77 FR 70967 - Authorization for Non-VA Medical Services
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-28
... expand the delivery of healthcare to veterans, VA is, like the rest of the healthcare industry...(a)(2)(B) to expand VA's authority to provide non-VA medical services under the non- VA care... furnished hospital care, nursing home care, domiciliary care, or medical services and who requires medical...
77 FR 67063 - VA Directive 0005 on Scientific Integrity
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-08
... policies that: Foster a culture of transparency, integrity, and ethical behavior in the development and... provided to the VA's Office of Inspector General (OIG), the Office of Government Ethics, and Congress. VA...: VA has amended Directive 0005, ] 5.b., to state that ``VA policy provides an ethical and accountable...
Chandramohan, Daniel; Clark, Samuel J.; Jakob, Robert; Leitao, Jordana; Rao, Chalapati; Riley, Ian; Setel, Philip W.
2018-01-01
Background Verbal autopsy (VA) is a practical method for determining probable causes of death at the population level in places where systems for medical certification of cause of death are weak. VA methods suitable for use in routine settings, such as civil registration and vital statistics (CRVS) systems, have developed rapidly in the last decade. These developments have been part of a growing global momentum to strengthen CRVS systems in low-income countries. With this momentum have come pressure for continued research and development of VA methods and the need for a single standard VA instrument on which multiple automated diagnostic methods can be developed. Methods and findings In 2016, partners harmonized a WHO VA standard instrument that fully incorporates the indicators necessary to run currently available automated diagnostic algorithms. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality. This VA instrument offers the opportunity to harmonize the automated diagnostic algorithms in the future. Conclusions Despite all improvements in design and technology, VA is only recommended where medical certification of cause of death is not possible. The method can nevertheless provide sufficient information to guide public health priorities in communities in which physician certification of deaths is largely unavailable. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality. PMID:29320495
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-17
... Festival Event Application, VA0929a, b, c, d, e, f, g, h. Type of Review: Revision of an already approved... Age Games, National Veterans Creative Arts Festival, National Veterans TEE Tournament, National...
78 FR 76064 - Authorization for Non-VA Medical Services; Withdrawal
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-16
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AO47 Authorization for Non-VA Medical... November 28, 2012, that would have amended its regulations regarding payment by VA for medical services under VA's statutory authority to provide non-VA medical care. VA sought to remove an outdated...
Estimating the costs of VA ambulatory care.
Phibbs, Ciaran S; Bhandari, Aman; Yu, Wei; Barnett, Paul G
2003-09-01
This article reports how we matched Common Procedure Terminology (CPT) codes with Medicare payment rates and aggregate Veterans Affairs (VA) budget data to estimate the costs of every VA ambulatory encounter. Converting CPT codes to encounter-level costs was more complex than a simple match of Medicare reimbursements to CPT codes. About 40 percent of the CPT codes used in VA, representing about 20 percent of procedures, did not have a Medicare payment rate and required other cost estimates. Reconciling aggregated estimated costs to the VA budget allocations for outpatient care produced final VA cost estimates that were lower than projected Medicare reimbursements. The methods used to estimate costs for encounters could be replicated for other settings. They are potentially useful for any system that does not generate billing data, when CPT codes are simpler to collect than billing data, or when there is a need to standardize cost estimates across data sources.
Normative Beliefs about Sharing Housing with an Older Family Member
ERIC Educational Resources Information Center
Coleman, Marilyn; Ganong, Lawrence
2008-01-01
The aims of this study were: (a) to examine general perceptions of filial obligations toward sharing housing with older parents and stepparents; and (b) to assess the effects of selected contextual factors on those normative beliefs. A national sample of 579 men and 582 women (mean age = 44.6, SD = 17.2) responded to a multiple segment factorial…
Women's veteran identity and utilization of VA health services.
Di Leone, Brooke A L; Wang, Joyce M; Kressin, Nancy; Vogt, Dawne
2016-02-01
Women have participated in the United States military since its founding. However, until the mid-20th century, there had been limited recognition of women as official members of the military, and women remain a statistical minority within military and veteran populations. It is therefore important to better understand women's veteran identity (which we define here as one's self-concept as derived from their veteran status) and associated implications for service use and experiences in the Department of Veterans Affairs (VA) health care setting. The present research examined the centrality of, and positive regard for, women's veteran identity among 407 female veterans deployed in support of the recent wars in Iraq and Afghanistan. Data were collected via a mailed national survey. Positive regard for veteran identity, but not veteran identity centrality,was positively associated with participants' age and length of time spent in the military. Results also showed that the centrality of women's veteran identity was positively related to their choice to use VA for health care and their feelings of belonging within VA, and that veteran identity centrality and positive regard for veteran identity are differentially associated with participants' military experiences (e.g., combat exposure, deployment sexual harassment) and mental health symptomatology (e.g., depression). (c) 2016 APA, all rights reserved).
Jeroncic, Ana; Gunjaca, Grgo; Mrsic, Danijela Budimir; Mudnic, Ivana; Brizic, Ivica; Polasek, Ozren; Boban, Mladen
2016-01-01
Common reference values of arterial stiffness indices could be effective screening tool in detecting vascular phenotypes at risk. However, populations of the same ethnicity may differ in vascular phenotype due to different environmental pressure. We examined applicability of normative equations for central augmentation index (cAIx) derived from Danish population with low cardiovascular risk on the corresponding Croatian population from the Mediterranean area. Disagreement between measured and predicted cAIx was assessed by Bland-Altman analysis. Both, cAIx-age distribution and normative equation fitted on Croatian data were highly comparable to Danish low-risk sample. Contrarily, Bland-Altman analysis of cAIx disagreement revealed a curvilinear deviation from the line of full agreement indicating that the equations were not equally applicable across age ranges. Stratification of individual data into age decades eliminated curvilinearity in all but the 30–39 (men) and 40–49 (women) decades. In other decades, linear disagreement independent of age persisted indicating that cAIx determinants other than age were not envisaged/compensated for by proposed equations. Therefore, established normative equations are equally applicable to both Nordic and Mediterranean populations but are of limited use. If designed for narrower age ranges, the equations’ sensitivity in detecting vascular phenotypes at risk and applicability to different populations could be improved. PMID:27230110
VaST: A variability search toolkit
NASA Astrophysics Data System (ADS)
Sokolovsky, K. V.; Lebedev, A. A.
2018-01-01
Variability Search Toolkit (VaST) is a software package designed to find variable objects in a series of sky images. It can be run from a script or interactively using its graphical interface. VaST relies on source list matching as opposed to image subtraction. SExtractor is used to generate source lists and perform aperture or PSF-fitting photometry (with PSFEx). Variability indices that characterize scatter and smoothness of a lightcurve are computed for all objects. Candidate variables are identified as objects having high variability index values compared to other objects of similar brightness. The two distinguishing features of VaST are its ability to perform accurate aperture photometry of images obtained with non-linear detectors and handle complex image distortions. The software has been successfully applied to images obtained with telescopes ranging from 0.08 to 2.5 m in diameter equipped with a variety of detectors including CCD, CMOS, MIC and photographic plates. About 1800 variable stars have been discovered with VaST. It is used as a transient detection engine in the New Milky Way (NMW) nova patrol. The code is written in C and can be easily compiled on the majority of UNIX-like systems. VaST is free software available at http://scan.sai.msu.ru/vast/.
38 CFR 77.17 - Recovery of funds by VA.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Recovery of funds by VA....17 Recovery of funds by VA. (a) Recovery of funds. VA may recover from the grantee any funds that are... additional adaptive sports grant payments. When VA makes a final decision that action will be taken to...
78 FR 62441 - VA Dental Insurance Program-Federalism
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-22
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AO85 VA Dental Insurance Program... Veterans Affairs (VA) is taking direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and...
78 FR 63143 - VA Dental Insurance Program-Federalism
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-23
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AO86 VA Dental Insurance Program... Affairs (VA) proposes to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents...
Color perception differentiates Alzheimer's Disease (AD) from Vascular Dementia (VaD) patients.
Arnaoutoglou, N A; Arnaoutoglou, M; Nemtsas, P; Costa, V; Baloyannis, S J; Ebmeier, K P
2017-08-01
Alzheimer's Disease (AD) and Vascular Dementia (VaD) are the most common causes of dementia in older people. Both diseases appear to have similar clinical symptoms, such as deficits in attention and executive function, but specific cognitive domains are affected. Current cohort studies have shown a close relationship between αβ deposits and age-related macular degeneration (Johnson et al., 2002; Ratnayaka et al., 2015). Additionally, a close link between the thinning of the retinal nerve fiber (RNFL) and AD patients has been described, while it has been proposed that AD patients suffer from a non-specific type of color blindness (Pache et al., 2003). Our study included 103 individuals divided into three groups: A healthy control group (n = 35), AD (n = 32) according to DSM-IV-TR, NINCDS-ADRDA criteria, and VaD (n = 36) based on ΝΙΝDS-AIREN, as well as Magnetic Resonance Imaging (MRI) results. The severity of patient's cognitive impairment, was measured with the Mini-Mental State Examination (MMSE) and was classified according to the Reisberg global deterioration scale (GDS). Visual perception was examined using the Ishihara plates: "Ishihara Color Vision Test - 38 Plate." The three groups were not statistically different for demographic data (age, gender, and education). The Ishihara color blindness test has a sensitivity of 80.6% and a specificity of 87.5% to discriminate AD and VaD patients when an optimal (32.5) cut-off value of performance is used. Ishihara Color Vision Test - 38 Plate is a promising potential method as an easy and not time-consuming screening test for the differential diagnosis of dementia between AD and VaD.
Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J
2006-06-01
Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P <0.001), and in each classification: always avoid (2% vs. 5%, P <0.001), rarely appropriate (8% vs. 13%, P<0.001), and some indications (15% vs. 17%, P <0.001). The rate of inappropriate drug use was lower in the VA compared with the private sector for males (21% vs. 24%, P <0.001) and females (28% vs. 32%, P <0.001). Differences were consistent when stratified by age. Compared with private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing
Marcotte, Karine; McSween, Marie-Pier; Pouliot, Monica; Martineau, Sarah; Pauzé, Anne-Marie; Wiseman-Hakes, Catherine; MacDonald, Sheila
2017-08-16
The Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES; MacDonald, 2005) test was designed for use by speech-language pathologists to assess verbal reasoning, complex comprehension, discourse, and executive skills during performance on a set of challenging and ecologically valid functional tasks. A recent French version of this test was translated from English; however, it had not undergone standardization. The development of normative data that are linguistically and culturally sensitive to the target population is of importance. The present study aimed to establish normative data for the French version of the FAVRES, a commonly used test with native French-speaking patients with traumatic brain injury in Québec, Canada. The normative sample consisted of 181 healthy French-speaking adults from various regions across the province of Québec. Age and years of education were factored into the normative model. Results indicate that age was significantly associated with performance on time, accuracy, reasoning subskills, and rationale criteria, whereas the level of education was significantly associated with accuracy and rationale. Overall, mean scores on each criterion were relatively lower than in the original English version, which reinforces the importance of using the present normative data when interpreting performance of French speakers who have sustained a traumatic brain injury.
Peng, Mingkai; Chen, Guanmin; Tang, Karen L; Quan, Hude; Smith, Eric E; Faris, Peter; Hachinski, Vladimir; Campbell, Norm R C
2017-10-27
Vascular dementia (VaD) is the second most common form of dementia. However, there were mixed evidences about the association between blood pressure (BP) and risk of VaD in midlife and late life and limited evidence on the association between pulse pressure and VaD. This is a population-based observational study. 265,897 individuals with at least one BP measurement between the ages of 60 to 65 years and 211,116 individuals with at least one BP measurement between the ages of 70 to 75 years were extracted from The Health Improvement Network in United Kingdom. Blood pressures were categorized into four groups: normal, prehypertension, stage 1 hypertension, and stage 2 hypertension. Cases of VaD were identified from the recorded clinical diagnoses. Multivariable survival analysis was used to adjust other confounders and competing risk of death. All the analysis were stratified based on antihypertensive drug use status. Multiple imputation was used to fill in missing values. After accounting for the competing risk of death and adjustment for potential confounders, there was an association between higher BP levels in the age 60-65 cohort with the risk of developing VaD (hazard ratio [HR] 1.53 (95% confidence interval: 1.04, 2.25) for prehypertension, 1.90 (1.30, 2.78) for stage 1 hypertension, and 2.19 (1.48, 3.26) for stage 2 hypertension) in the untreated group. There was no statistically significant association between BP levels and VaD in the treated group in the age 60-65 cohort and age 70-75 cohort. Analysis on Pulse Pressure (PP) stratified by blood pressure level showed that PP was not independently associated with VaD. High BP between the ages of 60 to 65 years is a significant risk for VaD in late midlife. Greater efforts should be placed on early diagnosis of hypertension and tight control of BP for hypertensive patients for the prevention of VaD.
Visionary leadership and the future of VA health system.
Bezold, C; Mayer, E; Dighe, A
1997-01-01
As the U.S. Department of Veterans Affairs (VA) makes the change over to Veterans Integrated Service Network (VISNs) the need for new and better leadership is warranted if VA wants to not only survive, but thrive in the emerging twenty-first century healthcare system. VA can prepare for the future and meet the challenges facing them by adopting a system of visionary leadership. The use of scenarios and vision techniques are explained as they relate to VA's efforts to move toward their new system of VISNs. The four scenarios provide snapshots of possible futures for the U.S. healthcare system as well as the possible future role and mission of VA--from VA disappearing to its becoming a premier virtual organization.
Mehta, Amar J; Kubzansky, Laura D; Coull, Brent A; Kloog, Itai; Koutrakis, Petros; Sparrow, David; Spiro, Avron; Vokonas, Pantel; Schwartz, Joel
2015-01-27
There is mixed evidence suggesting that air pollution may be associated with increased risk of developing psychiatric disorders. We aimed to investigate the association between air pollution and non-specific perceived stress, often a precursor to development of affective psychiatric disorders. This longitudinal analysis consisted of 987 older men participating in at least one visit for the Veterans Administration Normative Aging Study between 1995 and 2007 (n = 2,244 visits). At each visit, participants were administered the 14-item Perceived Stress Scale (PSS), which quantifies stress experienced in the previous week. Scores ranged from 0-56 with higher scores indicating increased stress. Differences in PSS score per interquartile range increase in moving average (1, 2, and 4-weeks) of air pollution exposures were estimated using linear mixed-effects regression after adjustment for age, race, education, physical activity, anti-depressant medication use, seasonality, meteorology, and day of week. We also evaluated effect modification by season (April-September and March-October for warm and cold season, respectively). Fine particles (PM2.5), black carbon (BC), nitrogen dioxide, and particle number counts (PNC) at moving averages of 1, 2, and 4-weeks were associated with higher perceived stress ratings. The strongest associations were observed for PNC; for example, a 15,997 counts/cm(3) interquartile range increase in 1-week average PNC was associated with a 3.2 point (95%CI: 2.1-4.3) increase in PSS score. Season modified the associations for specific pollutants; higher PSS scores in association with PM2.5, BC, and sulfate were observed mainly in colder months. Air pollution was associated with higher levels of perceived stress in this sample of older men, particularly in colder months for specific pollutants.
Normative data for the Stroop color word test for a North American population.
Morrow, Sarah A
2013-11-01
Cognitive impairment in multiple sclerosis (MS) often involves attentional deficits. The Stroop colour word test, a measure of attention, lacks current normative data for an english-speaking North american MS population. Further some authors suggest the Stroop actually measures processing speed. To generate normative data for the Stroop colour word test that can be used for a Canadian or North american MS population and to examine the relationship between processing speed tests--the Paced auditory Serial addition Test (PASAT) and Symbol Digit Modalities Test (SDMT)--and the Stroop. Data from 146 healthy subjects aged 18-56 was collected. age was significantly although weakly correlated with general intelligence (r=0.168, p=0.043) assessed with the North american adult Reading Test (NAART), and education (r=-0.313, p<0.001). No demographic variables were associated with SDMT or PASAT. age had a low-moderate negative correlation (r=-0.403, p<0.001) with Stroop scores. The mean (±standard deviation, SD) Stroop score was 45.4(10.4). The z-score can thus be calculated as [(X-45.4)/10.4]. if adjusted for age, Xadj = [X-(-0.47)(age-37.5)] and is substituted for X. in a comparison MS population consisting of 75 randomly selected patients from the MS Cognitive clinic, Stroop and PASAT performance were not related. a relationship existed between Stroop and SDMT scores but only 12.2% of the Stroop score variance was explained by the SDMT. Therefore, the Stroop measures selective attention independently of processing speed. This data can be used to determine impaired attention in MS patients. Données normatives pour le test mot-couleur de Stroop chez une population nord-américaine.
Ramírez-Vélez, Robinson; Palacios-López, Adalberto; Humberto Prieto-Benavides, Daniel; Enrique Correa-Bautista, Jorge; Izquierdo, Mikel; Alonso-Martínez, Alicia; Lobelo, Felipe
2017-01-01
Our aim was to determine the normative reference values of cardiorespiratory fitness (CRF) and to establish the proportion of subjects with low CRF suggestive of future cardio-metabolic risk. A total of 7244 children and adolescents attending public schools in Bogota, Colombia (55.7% girls; age range of 9-17.9 years) participated in this study. We expressed CRF performance as the nearest stage (minute) completed and the estimated peak oxygen consumption (V˙O 2peak ). Smoothed percentile curves were calculated. In addition, we present the prevalence of low CRF after applying a correction factor to account for the impact of Bogota's altitude (2625 m over sea level) on CRF assessment, and we calculated the number of participants who fell below health-related FITNESSGRAM cut-points for low CRF. Shuttles and V˙O 2peak were higher in boys than in girls in all age groups. In boys, there were higher levels of performance with increasing age, with most gains between the ages of 13 and 17. The proportion of subjects with a low CRF, suggestive of future cardio-metabolic risk (health risk FITNESSGRAM category) was 31.5% (28.2% for boys and 34.1% for girls; X 2 P = .001). After applying a 1.11 altitude correction factor, the overall prevalence of low CRF was 11.5% (9.6% for boys and 13.1% for girls; X 2 P = .001). Our results provide sex- and age-specific normative reference standards for the 20 m shuttle-run test and estimated V˙O 2peak values in a large, population-based sample of schoolchildren from a large Latin-American city at high altitude. © 2016 The Authors American Journal of Human Biology Published by Wiley Periodicals, Inc.
Normative aging of the respiratory system.
Zeleznik, Jomarie
2003-02-01
An absolute quantified normal rate of change and normal range of functions of the respiratory system applicable to all older adults as they age is elusive. Like life expectancy, which is dependent on a cohort effect, the norms of respiratory system function are related to the birth cohort to which a given individual belongs and the age at which the parameter is assessed. No single rate of change can express normal across all age ranges even for those individuals in apparently good health [29]. Analogous to defining risk factors for a disease, determining that a change in anatomy or physiology is not disease requires stringent prospective evaluation for the absence of occult disease and known risk factors for disease prior to concluding that the alteration is inevitable with the normal aging process [19,31]. Additional limitations in quantifying the norms of respiratory function with age are the lack of participation of the oldest adults in studies and the lack of precision and accuracy in these performance-based measurements. The data, although limited, do support a qualitative emphysematous change in lung histology and lung-thorax mechanics. This change plus altered lung volumes influence oxygenation and oxygen consumption. There is no evidence that the changes in the respiratory system with aging impact day-to-day function of older adults, but they may become evident under circumstances when physiologic demand reaches the limits of supply. Despite changes in cholinergic and adrenergic receptor functioning, there is no evidence to suggest altering prescribing these classes of medications for older people. Pioneer physiologists asked the original question "Is there a difference in this measurement for older people?" Researchers in pulmonary medicine, pathology, radiology, epidemiology, and public health have continued to revise the question toward the clinical implications while studying the aging process from their respective viewpoints. Clinicians who need to
Contraceptive Provision in the VA Healthcare System to Women Who Report Military Sexual Trauma
Mattocks, Kristin; Schwarz, Eleanor Bimla; Borrero, Sonya; Skanderson, Melissa; Zephyrin, Laurie; Brandt, Cynthia; Haskell, Sally
2014-01-01
Abstract Background: Women Veterans who suffered military sexual trauma (MST) may be at high risk for unintended pregnancy and benefit from contraceptive services. The objective of this study is to compare documented provision of contraceptives to women Veterans using the Department of Veterans Affairs (VA) health system who report or deny MST. Methods: This retrospective cohort study included women Veterans aged 18–45 years who served in Operation Enduring or Iraqi Freedom and had at least one visit to a VA medical center between 2002 and 2010. Data were obtained from VA administrative and clinical databases. Chi-squared tests and logistic regression were conducted to evaluate the association between MST, ascertained by routine clinical screening, and first documented receipt of hormonal or long-acting contraception. Results: Of 68,466 women Veterans, 13% reported, 59% denied and 28% had missing data for the MST screen. Among the entire study cohort, 30% of women had documented receipt of a contraceptive method. Women reporting MST were significantly more likely than those denying MST to receive a method of contraception (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 1.07–1.18) including an intrauterine device (odds ratio [OR] 1.29, 95% CI 1.17–1.41) or contraceptive injection (OR 1.17, 95% CI 1.05–1.29). Women who were younger, unmarried, seen at a women's health clinic, or who had more than one visit were more likely to receive contraception. Conclusions: A minority of women Veterans of reproductive age receive contraceptive services from the VA. Women Veterans who report MST, and particularly those who seek care at VA women's health clinics, are more likely to receive contraception. PMID:24787680
Robertson, K; Jiang, H; Evans, S R; Marra, C M; Berzins, B; Hakim, J; Sacktor, N; Silva, M Tulius; Campbell, T B; Nair, A; Schouten, J; Kumwenda, J; Supparatpinyo, K; Tripathy, S; Kumarasamy, N; la Rosa, A; Montano, S; Mwafongo, A; Firnhaber, C; Sanne, I; Naini, L; Amod, F; Walawander, A
2016-08-01
Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (<10 and ≥10 years), and age (<35 and ≥35 years). Of 2400 enrolled, 770 completed the 6-month follow-up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p < 0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.
Y-balance normative data for female collegiate volleyball players.
Hudson, Christy; Garrison, J Craig; Pollard, Kalyssa
2016-11-01
The Lower Quarter Y Balance (YBT-LQ) Test performance varies depending on competitive level, sport, gender, and age; therefore, determining normative scores specific to a population may be helpful in identifying injury-risk thresholds and return-to-play criteria following an injury. The purpose of this study was to determine normative YBT-LQ scores by assessing a subset of female, Division I volleyball players. A descriptive analysis cohort study. Ninety healthy (19.6 ± 1.2 y/o), collegiate female volleyball players. YBT-LQ was measured in 3 distinct directions of anterior (ANT), posteromedial (PM) and posterolateral (PL) on both the dominant and non-dominant limbs. In addition, a one way ANOVA was performed to determine mean group differences of YBT-LQ dominant and non-dominant limb composite score across position. Baseline values for this population were 94.1 ± 6.6% on the dominant limb and 93.9 ± 6.2% on the non-dominant limb. There were no significant differences for YBT-LQ composite scores on dominant (P = 0.867) and non-dominant (P = 0.989) limbs between position. This study identified normative YBT-LQ composite scores for healthy, female, collegiate volleyball players. Participants performed similarly despite their position. Copyright © 2016 Elsevier Ltd. All rights reserved.
Ferrett, Helen L.; Thomas, Kevin G. F.; Tapert, Susan F.; Carey, Paul D.; Conradie, Simone; Cuzen, Natalie L.; Stein, Dan J.; Fein, George
2014-01-01
Interpretation of neuropsychological tests may be hampered by confounding sociodemographic factors and by using inappropriate normative data. We investigated these factors in three tests endorsed by the World Health Organization: the Grooved Pegboard Test (GPT), the Children's Color Trails Test (CCTT), and the WHO/UCLA version of the Auditory Verbal Learning Test (AVLT). In a sample of 12-15-year-old, Afrikaans- and English-speaking adolescents from the Cape Town region of South Africa, analyses of covariance (ANCOVAs) demonstrated that quality of education was the sociodemographic factor with the biggest influence on test performance, and that age also significantly influenced GPT and CCTT performance. Based on those findings, we provide appropriately stratified normative data for the age group in question. Comparisons between diagnostic interpretations made using foreign normative data versus those using the current local data demonstrate that it is imperative to use appropriately stratified normative data to guard against misinterpreting performance. PMID:24526566
Ferrett, Helen L; Thomas, Kevin G F; Tapert, Susan F; Carey, Paul D; Conradie, Simone; Cuzen, Natalie L; Stein, Dan J; Fein, George
2014-06-01
Interpretation of neuropsychological tests may be hampered by confounding sociodemographic factors and by using inappropriate normative data. We investigated these factors in three tests endorsed by the World Health Organization: the Grooved Pegboard Test (GPT), the Children's Color Trails Test (CCTT), and the WHO/UCLA version of the Auditory Verbal Learning Test (AVLT). In a sample of 12-15-year-old, Afrikaans- and English-speaking adolescents from the Cape Town region of South Africa, analyses of covariance (ANCOVAs) demonstrated that quality of education was the sociodemographic factor with the biggest influence on test performance, and that age also significantly influenced GPT and CCTT performance. Based on those findings, we provide appropriately stratified normative data for the age group in question. Comparisons between diagnostic interpretations made using foreign normative data versus those using the current local data demonstrate that it is imperative to use appropriately stratified normative data to guard against misinterpreting performance.
48 CFR 819.7109 - VA review of application.
Code of Federal Regulations, 2010 CFR
2010-10-01
... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7109 VA review of application. (a) VA OSDBU will review the information to establish the mentor and protégé eligibility and to ensure... charge to apply for the Mentor-Protégé Program. (b) After OSDBU completes its review and provides written...
Šerek, Jan; Machackova, Hana; Macek, Petr
2018-01-01
This study investigated whether adolescents' readiness for non-normative political participation (i.e., readiness to confront social rules for political reasons) was predicted by their interpersonal problems (with parents, teachers, and classmates), low optimism, and political beliefs (political self-efficacy and distrust in public institutions). A structural equation model using two-wave longitudinal data from Czech high school students (N = 768; 54% females; age range at T1 = 14-17, M = 15.97; T2 data collected 1.5 years later) showed that the changes in adolescents' readiness for non-normative participation were predicted by their lower institutional trust. Interpersonal relationships or optimism had no cross-sectional or longitudinal effect on the readiness for non-normative participation. These results suggest that the main source of adolescents' readiness for non-normative political actions lies in their political beliefs, while the effect of adolescents' interpersonal problems is less clear. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Niaura, Raymond S; Stroud, Laura R; Todaro, John; Ward, Kenneth D; Spiro, Avron; Aldwin, Carolyn; Landsberg, Lewis; Weiss, Scott T
2003-01-01
We examined relationships between repression, general maladjustment, body mass index (BMI), and waist-to-hip ratio (WHR). The participants were 1,081 healthy older men from the Normative Aging Study. Repression and General Maladjustment Scales of the Minnesota Multiphasic Personality Inventory were composite measures of personality. Repression was associated with lower BMI and WHR, and maladjustment with higher BMI and WHR. However, associations between WHR and personality dimensions were no longer significant when controlling for BMI, but associations between BMI and personality dimensions remained significant when controlling for WHR. These effects were explained by differing relationships between WHR, repression, and maladjustment for normal weight, overweight, and obese individuals. Specifically, associations between repression, maladjustment, and body shape were significant for normal weight and overweight individuals, but not for obese individuals. Health behaviors including smoking did not mediate relationships between repression, maladjustment, and body shape, but might be considered in future studies as mechanisms underlying links between personality and body shape.
Normative data for the Fototest from neurological patients with no cognitive impairment.
Carnero Pardo, C; Carrera Muñoz, I; Triguero Cueva, L; López Alcalde, S; Vílchez Carrillo, R
2018-05-28
To contribute normative data for the Fototest from neurological patients with no cognitive impairment, including disaggregated data on each domain of the test (naming, free recall, total recall, and naming fluency). We performed a cross-sectional study in which neurological patients with no cognitive impairment were tested with the Fototest; we recorded total and domain scores. We performed a descriptive study of the total and domain scores, with data disaggregated by sex, age (over/under 65 years), and level of education (primary education completed/not completed; further study completed). We included a sample of 1,055 patients, who were mainly women (57.1%), aged over 65 (60.6%), and had a low level of education (38.6% had not completed primary education). Sex, age, and level of education influence total Fototest score (34.6 ± 5.3; P 10 : 28; P 5 : 27) and naming (5,9±0,3; 6; 5), free recall (8.5 ± 2.2; 6; 4), total recall (10.0 ± 1.5; 8; 7), and naming fluency scores (18.7 ± 4.9; 13; 12). For total score, the multivariate analysis revealed values of 1.5 ± 0.3 (ß ± SE) for sex (female), -2.4 ± 0.3 for age (> 65), and -1.6 ± 0.4 and 3.3 ± 0.4 for incomplete primary education and completed post-primary education, respectively (completed primary study was used as a reference). We provide normative data for total and domain Fototest results for each of the groups defined according to sex, age, and level of education. We also provide a percentile distribution of scores. We hope that these normative data will translate into increases in efficiency in Fototest administration in the clinical setting. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
38 CFR 1.203 - Information to be reported to VA Police.
Code of Federal Regulations, 2010 CFR
2010-07-01
... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component with...
Normative Data for the Words-in-Noise Test for 6- to 12-Year-Old Children
ERIC Educational Resources Information Center
Wilson, Richard H.; Farmer, Nicole M.; Gandhi, Avni; Shelburne, Emily; Weaver, Jamie
2010-01-01
Purpose: To establish normative data for children on the Words-in-Noise Test (WIN; R. H. Wilson, 2003; R. H. Wilson & R. McArdle, 2007). Method: Forty-two children in each of 7 age groups, ranging in age from 6 to 12 years (n = 294), and 24 young adults (age range: 18-27 years) with normal hearing for pure tones participated. All listeners…
Validation of a Measure of Normative Beliefs About Smokeless Tobacco Use
O’Connor, Richard J.; Bansal-Travers, Maansi; Cummings, K. Michael; Rees, Vaughan W.; Hatsukami, Dorothy K.
2016-01-01
Abstract Introduction: Validated methods to evaluate consumer responses to modified risk tobacco products (MRTPs) are needed. Guided by existing literature that demonstrates a relationship between normative beliefs and future intentions to use tobacco the current research sought to (1) develop a measure of normative beliefs about smokeless tobacco (ST) and establish the underlying factor structure, (2) evaluate the structure with confirmatory factor analysis utilizing an independent sample of youth, and (3) establish the measure’s concurrent validity. Methods: Respondents (smokers and nonsmokers aged 15–65; N = 2991) completed a web-based survey that included demographic characteristics, tobacco use history and dependence, and a measure of attitudes about ST adapted from the Normative Beliefs about Smoking scale. A second sample of youth (aged 14–17; N = 305) completed a similar questionnaire. Results: Exploratory factor analysis produced the anticipated three-factor solution and accounted for nearly three-quarters of the variance in the data reflecting (1) perceived prevalence of ST use, (2) popularity of ST among successful/elite, and (3) approval of ST use by parents/peers. Confirmatory factor analysis with data from the youth sample demonstrated good model fit. Logistic regression demonstrated that the scales effectively discriminate between ST users and nonusers and are associated with interest in trying snus. Conclusions: Assessment of MRTPs for regulatory purposes, which allows messages of reduced risk, should include measurement of social norms. Furthermore, surveillance efforts that track use of new MRTPs should include measures of social norms to determine how norms change with prevalence of use. PMID:26187390
A normative study of lexical verbal fluency in an educationally-diverse elderly population.
Kim, Bong Jo; Lee, Cheol Soon; Oh, Byoung Hoon; Hong, Chang Hyung; Lee, Kang Soo; Son, Sang Joon; Han, Changsu; Park, Moon Ho; Jeong, Hyun-Ghang; Kim, Tae Hui; Park, Joon Hyuk; Kim, Ki Woong
2013-12-01
Lexical fluency tests are frequently used to assess language and executive function in clinical practice. We investigated the influences of age, gender, and education on lexical verbal fluency in an educationally-diverse, elderly Korean population and provided its' normative information. We administered the lexical verbal fluency test (LVFT) to 1676 community-dwelling, cognitively normal subjects aged 60 years or over. In a stepwise linear regression analysis, education (B=0.40, SE=0.02, standardized B=0.506) and age (B=-0.10, SE=0.01, standardized B=-0.15) had significant effects on LVFT scores (p<0.001), but gender did not (B=0.40, SE=0.02, standardized B=0.506, p>0.05). Education explained 28.5% of the total variance in LVFT scores, which was much larger than the variance explained by age (5.42%). Accordingly, we presented normative data of the LVFT stratified by age (60-69, 70-74, 75-79, and ≥80 years) and education (0-3, 4-6, 7-9, 10-12, and ≥13 years). The LVFT norms should provide clinically useful data for evaluating elderly people and help improve the interpretation of verbal fluency tasks and allow for greater diagnostic accuracy.
Jia, Huanguang; Pei, Qinglin; Sullivan, Charles T; Cowper Ripley, Diane C; Wu, Samuel S; Bates, Barbara E; Vogel, W Bruce; Bidelspach, Douglas E; Wang, Xinping; Hoffman, Nannette
2016-03-01
Effective poststroke rehabilitation care can speed patient recovery and minimize patient functional disabilities. Veterans affairs (VA) community living centers (CLCs) and VA-contracted community nursing homes (CNHs) are the 2 major sources of institutional long-term care for Veterans with stroke receiving care under VA auspices. This study compares rehabilitation therapy and restorative nursing care among Veterans residing in VA CLCs versus those Veterans in VA-contracted CNHs. Retrospective observational. All Veterans diagnosed with stroke, newly admitted to the CLCs or CNHs during the study period who completed at least 2 Minimum Data Set assessments postadmission. The outcomes were numbers of days for rehabilitation therapy and restorative nursing care received by the Veterans during their stays in CLCs or CNHs as documented in the Minimum Data Set databases. For rehabilitation therapy, the CLC Veterans had lower user rates (75.2% vs. 76.4%, P=0.078) and fewer observed therapy days (4.9 vs. 6.4, P<0.001) than CNH Veterans. However, the CLC Veterans had higher adjusted odds for therapy (odds ratio=1.16, P=0.033), although they had fewer average therapy days (coefficient=-1.53±0.11, P<0.001). For restorative nursing care, CLC Veterans had higher user rates (33.5% vs. 30.6%, P<0.001), more observed average care days (9.4 vs. 5.9, P<0.001), higher adjusted odds (odds ratio=2.28, P<0.001), and more adjusted days for restorative nursing care (coefficient=5.48±0.37, P<0.001). Compared with their counterparts at VA-contracted CNHs, Veterans at VA CLCs had fewer average rehabilitation therapy days (both unadjusted and adjusted), but they were significantly more likely to receive restorative nursing care both before and after risk adjustment.
Veterans' experiences initiating VA-based mental health care.
Bovin, Michelle J; Miller, Christopher J; Koenig, Christopher J; Lipschitz, Jessica M; Zamora, Kara A; Wright, Patricia B; Pyne, Jeffrey M; Burgess, James F
2018-05-21
Military veterans who could benefit from mental health services often do not access them. Research has revealed a range of barriers associated with initiating United States Department of Veterans Affairs (VA) care, including those specific to accessing mental health care (e.g., fear of stigmatization). More work is needed to streamline access to VA mental health-care services for veterans. In the current study, we interviewed 80 veterans from 9 clinics across the United States about initiation of VA mental health care to identify barriers to access. Results suggested that five predominant factors influenced veterans' decisions to initiate care: (a) awareness of VA mental health services; (b) fear of negative consequences of seeking care; (c) personal beliefs about mental health treatment; (d) input from family and friends; and (e) motivation for treatment. Veterans also spoke about the pathways they used to access this care. The four most commonly reported pathways included (a) physical health-care appointments; (b) the service connection disability system; (c) non-VA care; and (d) being mandated to care. Taken together, these data lend themselves to a model that describes both modifiers of, and pathways to, VA mental health care. The model suggests that interventions aimed at the identified pathways, in concert with efforts designed to reduce barriers, may increase initiation of VA mental health-care services by veterans. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Ocular dimensions in relation to auxological data in a sample of Swedish children aged 4-15 years.
Raffa, Lina H; Hellström, Ann; Aring, Eva; Andersson, Susann; Grönlund, Marita Andersson
2014-11-01
The purpose was to characterize normal growth patterns of ocular and optical components and to relate them to auxological data in a sample of Swedish children aged 4-15 years. A prospective cross-sectional study was carried out in 143 Swedish children with a mean age of 9.8 years. Variables including gestational age (GA), weight, length and head circumference (HCF) at birth and at the time of assessment were registered. Visual acuity (VA), cycloplegic refraction and biometric measures were obtained. Palpebral fissure length and inner canthal distance were measured. Optic disc morphology as seen on fundus photographs was analysed. Children born more mature, with male predilection, were found to have deeper anterior and vitreous chamber depths, longer axial lengths and thinner crystalline lens thickness. No correlations were found between ocular biometric measurements and VA or refraction after adjustment for confounding variables. Inner canthal distance was significantly correlated with birth length (p = 0.03), height, weight, BMI and HCF (p = 0.0008, p = 0.0007, p = 0.037, and p = 0.04, respectively) at time of assessment. Total axial length was found to be significantly correlated with GA (p = 0.0226) and length at assessment in girls (p = 0.0084). Right optic disc and rim areas decreased with increasing age (p = 0.0078 and p = 0.0107, respectively); however, optic disc parameters were not dependent on any other variable. These normative values may serve as a basis for the ocular findings and their relationship to auxological data in Caucasian children aged 4-15 years, as well as for future comparison in patients with paediatric ocular pathologies. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Fonseca, Rochele Paz; Joanette, Yves; Côté, Hélène; Ska, Bernadette; Giroux, Francine; Fachel, Jandyra Maria Guimarães; Damasceno Ferreira, Gabriela; Parente, Maria Alice de Mattos Pimenta
2008-11-01
The lack of standardized instruments to evaluate communication disorders related to the right hemisphere was verified. A new evaluation tool was developed: Protocole Montréal d'Evaluation de la Communication--Protocole MEC, adapted to Brazilian Portuguese--Bateria Montreal de Avaliação da Comunicação--Bateria MAC (Montreal Evaluation of Communication Battery). The purpose was to present stratified normative data by age and educational level, and to verify the reliability parameters of the MEC Battery. 300 individuals, between the ages of 19 and 75 years, and levels of formal education between 2 and 35 years, participated in this study. They were divided equally into six normative groups, according to three age categories (young adults, intermediary age, and seniors) and two educational levels (low and high). Two procedures were used to check reliability: Cronbach alpha and reliability between evaluators, Results were established at the 10th percentile, and an alert point per task for each normative group. Cronbach's alpha was, in general, between .70 and .90 and the average rate of agreement between evaluators varied from .62 to .94. Standards of age and education were established. The reliability of this instrument was verified. The psychometric legitimization of the MEC Battery will contribute to the diagnostic process for communicative disorders.
Normative influences on aggression in urban elementary school classrooms.
Henry, D; Guerra, N; Huesmann, R; Tolan, P; VanAcker, R; Eron, L
2000-02-01
We report a study aimed at understanding the effects of classroom normative influences on individual aggressive behavior, using samples of 614 and 427 urban elementary school children. Participants were assessed with measures of aggressive behavior and normative beliefs about aggression. We tested hypotheses related to the effects of personal normative beliefs, descriptive classroom norms (the central tendency of classmates' aggressive behavior), injunctive classroom normative beliefs (classmates' beliefs about the acceptability of aggression), and norm salience (student and teacher sanctions against aggression) on longitudinal changes in aggressive behavior and beliefs. injunctive norms affected individual normative beliefs and aggression, but descriptive norms had no effect on either. In classrooms where students and teachers made norms against aggression salient, aggressive behavior diminished over time. Implications for classroom behavior management and further research are discussed.
ERIC Educational Resources Information Center
Prince-Embury, Sandra; Steer, Robert A.
2010-01-01
Cluster analyses with the three global scores of the Resiliency Scales for Children and Adolescents[TM] (RSCA) were used to determine personal resiliency profiles within normative (641) and outpatient clinical (285) samples of youth aged 9 to 18 years. Normative and clinical profiles were compared with each other and the clinical profiles were…
Palacios‐López, Adalberto; Humberto Prieto‐Benavides, Daniel; Enrique Correa‐Bautista, Jorge; Izquierdo, Mikel; Alonso‐Martínez, Alicia; Lobelo, Felipe
2016-01-01
Abstract Objectives Our aim was to determine the normative reference values of cardiorespiratory fitness (CRF) and to establish the proportion of subjects with low CRF suggestive of future cardio‐metabolic risk. Methods A total of 7244 children and adolescents attending public schools in Bogota, Colombia (55.7% girls; age range of 9–17.9 years) participated in this study. We expressed CRF performance as the nearest stage (minute) completed and the estimated peak oxygen consumption (V˙O2peak). Smoothed percentile curves were calculated. In addition, we present the prevalence of low CRF after applying a correction factor to account for the impact of Bogota's altitude (2625 m over sea level) on CRF assessment, and we calculated the number of participants who fell below health‐related FITNESSGRAM cut‐points for low CRF. Results Shuttles and V˙O2peak were higher in boys than in girls in all age groups. In boys, there were higher levels of performance with increasing age, with most gains between the ages of 13 and 17. The proportion of subjects with a low CRF, suggestive of future cardio‐metabolic risk (health risk FITNESSGRAM category) was 31.5% (28.2% for boys and 34.1% for girls; X2 P = .001). After applying a 1.11 altitude correction factor, the overall prevalence of low CRF was 11.5% (9.6% for boys and 13.1% for girls; X2 P = .001). Conclusions Our results provide sex‐ and age‐specific normative reference standards for the 20 m shuttle‐run test and estimated V˙O2peak values in a large, population‐based sample of schoolchildren from a large Latin‐American city at high altitude. PMID:27500986
Normative and descriptive rationality: from nature to artifice and back
NASA Astrophysics Data System (ADS)
Besold, T. R.; Uckelman, S. L.
2018-03-01
Rationality plays a key role in both the study of human reasoning and Artificial Intelligence (AI). Certain notions of rationality have been adopted in AI as guides for the development of intelligent machines and these notions have been given a normative function. The notions of rationality in AI are often taken to be closely related to conceptions of rationality in human contexts. In this paper, we argue that the normative role of rationality differs in the human and artificial contexts. While rationality in human-focused fields of study is normative, prescribing how humans ought to reason, the normative conception in AI is built on a notion of human rationality which is descriptive, not normative, in the human context, as AI aims at building agents which reason as humans do. In order to make this point, we review prominent notions of rationality used in psychology, cognitive science, and (the history of) philosophy, as well as in AI, and discuss some factors that contributed to rationality being assigned the differing normative statuses in the differing fields of study. We argue that while 'rationality' is a normative notion in both AI and in human reasoning, the normativity of the AI conception of 'rationality' is grounded in a descriptive account of human rationality.
Valuing Healthcare Improvement: Implicit Norms, Explicit Normativity, and Human Agency.
Carter, Stacy M
2018-06-01
I argue that greater attention to human agency and normativity in both researching and practicing service improvement may be one strategy for enhancing improvement science, illustrating with examples from cancer screening. Improvement science tends to deliberately avoid explicit normativity, for paradigmatically coherent reasons. But there are good reasons to consider including explicit normativity in thinking about improvement. Values and moral judgements are central to social life, so an adequate account of social life must include these elements. And improvement itself is unavoidably normative: it assumes that things could and should be better than they are. I seek to show that normativity will always be implicated in the creation of evidence, the design of programs, the practice of healthcare, and in citizens' judgements about that care, and to make a case that engaging with this normativity is worthwhile.
Hippocampal volumetry: Normative data in the Indian population.
Mohandas, Aravind Narayan; Bharath, Rose Dawn; Prathyusha, Parthipulli Vasuki; Gupta, Arun K
2014-07-01
Mesial temporal sclerosis (MTS) is the most common cause of temporal lobe epilepsy. Quantitative analysis of the hippocampus using volumetry is commonly being used in the diagnosis of MTS and is being used as a marker in prognostication of seizure control. Although normative data for hippocampal volume (HV) is available for the western population, no such data is available for the Indian population. The aim of the study was to establish normative data for HV for the Indian population, which can aid in the accurate diagnosis of MTS. Magnetic resonance imaging (MRI) scans of 200 healthy volunteers were acquired using a 3 Tesla (3T) MRI scanner. Manual segmentation and volumetry was done using Siemens Syngo software. The data was analyzed using two tailed t-test to detect associations between HV and age, gender, and education. The data so obtained was also correlated with the data available from the rest of the world. A mean HV of 2.411 cm(3) (standard deviation -0.299) was found in the study, which was significantly smaller when compared to the data from the western population. The right hippocampus was larger than the left, with a mean volume of 2.424 cm(3) and 2.398 cm(3), respectively. HV was detected to be significantly higher in males. No association was found between HV and age and education. The values obtained in this study may be adopted as a standard in the evaluation of patients with intractable epilepsy.
78 FR 32126 - VA Dental Insurance Program
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-29
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN99 VA Dental Insurance Program AGENCY... its regulations to establish rules and procedures for the VA Dental Insurance Program (VADIP), a pilot program that offers premium-based dental insurance to enrolled veterans and certain survivors and...
77 FR 12517 - VA Dental Insurance Program
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-01
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN99 VA Dental Insurance Program AGENCY... dental insurance to enrolled veterans and certain survivors and dependents of veterans. VA would contract with a private insurer through the Federal contracting process to offer dental insurance, and the...
Casals-Coll, M; Sánchez-Benavides, G; Quintana, M; Manero, R M; Rognoni, T; Calvo, L; Palomo, R; Aranciva, F; Tamayo, F; Peña-Casanova, J
2013-01-01
Lexical fluency tests are frequently used in clinical practice to assess language and executive function. As part of the Spanish normative studies project in young adults (NEURONORMA young adults project), we provide age- and education-adjusted normative data for 3 semantic fluency tasks (animals, fruits and vegetables, and kitchen tools), three formal lexical fluency tasks (words beginning with P, M and R), three excluded-letter fluency tasks (words excluding A, E and S) and a verb fluency task. The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Age- and education-adjusted scores are provided by applying linear regression techniques. The results show that education impacted most of the verbal fluency test scores, with no effects related to age and only minimal effects related to sex. The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.
Dunlop, Sally M; Romer, Daniel
2010-10-01
Failure to use seatbelts in motor vehicles is a major source of youth injuries, and previous research has noted the widespread non-use of seatbelts in popular media. To explore whether increased exposure to entertainment screen media was associated with inflated normative perceptions regarding seatbelt non-use, and to determine any associations between normative perceptions and seatbelt non-use. A nationally representative telephone survey of school-aged American adolescents (14-17 years, n=915) measuring: screen media exposure; normative perceptions with reference to friends' disapproval of non-use, and prevalence of non-use among friends, school peers and peers; and self-reported seatbelt non-use. Using structural equation modelling, analyses indicate that, after demographic and individual characteristics relevant to screen media exposure and seatbelt non-use had been controlled for, frequent exposure to entertainment media was associated with positive normative perceptions about seatbelt non-use for boys, but not for girls. Normative perceptions related to friends' and school peers' seatbelt use were associated with seatbelt non-use for both boys and girls. Attempts to increase adolescent seatbelt use could include public communication campaigns to alter normative perceptions. Broadcasting these campaigns in conjunction with the media that under-represent seatbelt use may be a successful strategy for reducing the influence of such media on male adolescents.
Designing normative open virtual enterprises
NASA Astrophysics Data System (ADS)
Garcia, Emilia; Giret, Adriana; Botti, Vicente
2016-03-01
There is an increasing interest on developing virtual enterprises in order to deal with the globalisation of the economy, the rapid growth of information technologies and the increase of competitiveness. In this paper we deal with the development of normative open virtual enterprises (NOVEs). They are systems with a global objective that are composed of a set of heterogeneous entities and enterprises that exchange services following a specific normative context. In order to analyse and design systems of this kind the multi-agent paradigm seems suitable because it offers a specific solution for supporting the social and contractual relationships between enterprises and for formalising their business processes. This paper presents how the Regulated Open Multi-agent systems (ROMAS) methodology, an agent-oriented software methodology, can be used to analyse and design NOVEs. ROMAS offers a complete development process that allows identifying and formalising of the structure of NOVEs, their normative context and the interactions among their members. The use of ROMAS is exemplified by means of a case study that represents an automotive supply chain.
Coluccia, Emanuele; Gamboz, Nadia; Brandimonte, Maria A
2011-12-01
The present study aimed to provide normative data on a large sample of the elderly Italian population (N = 464; range of age = 49-94; range of education = 3-25) on both the word and the picture versions of a battery of free recall, cued recall, and recognition tests of memory. Results from multiple regression analyses showed that both age and education were significant predictors of performance. Therefore, norms were calculated taking into account these demographic variables. The availability of normative data based on a large sample will allow a more reliable use of the battery for clinical assessment in Italian-speaking dementia population.
Release of VA Records Relating to HIV. Final rule.
2017-03-23
The Department of Veterans Affairs (VA) is amending its medical regulations governing the release of VA medical records. Specifically, VA is eliminating the restriction on sharing a negative test result for the human immunodeficiency virus (HIV) with veterans' outside providers. HIV testing is a common practice today in healthcare and the stigma of testing that may have been seen in the 1980s when HIV was first discovered is no longer prevalent. Continuing to protect negative HIV tests causes delays and an unnecessary burden on veterans when VA tries to share electronic medical information with the veterans' outside providers through electronic health information exchanges. For this same reason, VA will also eliminate restrictions on negative test results of sickle cell anemia. This final rule eliminates the current barriers to electronic medical information exchange.
Normative and Descriptive Aspects of Management Education: Differentiation and Integration
ERIC Educational Resources Information Center
Meirovich, Gavriel
2015-01-01
This study advocates strongly for clear differentiation and synthesis of descriptive and normative approaches in management education. There is a certain isolation of normative and descriptive theoretical frameworks presented in management courses. Normative frameworks in management explain how organizations "should be" managed, while…
Martin, Carol Lynn; DiDonato, Matthew D; Clary, Laura; Fabes, Richard A; Kreiger, Tyson; Palermo, Francisco; Hanish, Laura
2012-08-01
We addressed several issues concerning children who show gender non-normative (GNN) patterns of peer play. First, do young children with GNN peer preferences differ from children with gender normative (GN) peer preferences in problem behaviors? Second, do GNN and GN children differ in sociability and isolation and do they have differential socialization opportunities with externalizing, internalizing, and socially competent peers? We employed a Bayesian approach for classifying children as GNN based on their peer preferences as compared to their peers using a sample of Head Start preschool children from a large Southwestern city (N = 257; 53 % boys; M age = 51 months; 66 % Mexican American). To calculate socialization opportunities, we assessed affiliation to each child in the class and weighted that by each peer's characteristics to determine the exposure that each child had to different kinds of peers. GN children of both sexes interacted more with same-sex peers, which may limit learning of different styles of interaction. As compared to GN children, GNN children exhibited more engagement in other-sex activities and with other-sex play partners and GNN children experienced somewhat fewer peer interactions, but did not differ on problem behaviors or social competence. Boys with GNN peer preferences had increased exposure to peers with problem behaviors. GNN girls experienced little exposure to peers with problem behaviors, but they also had little exposure to socially competent peers, which may reduce learning social skills from peers. Implications of these findings for future socialization and development will be discussed.
DiDonato, Matthew D.; Clary, Laura; Fabes, Richard A.; Kreiger, Tyson; Palermo, Francisco; Hanish, Laura
2013-01-01
We addressed several issues concerning children who show gender non-normative (GNN) patterns of peer play. First, do young children with GNN peer preferences differ from children with gender normative (GN) peer preferences in problem behaviors? Second, do GNN and GN children differ in sociability and isolation and do they have differential socialization opportunities with externalizing, internalizing, and socially competent peers? We employed a Bayesian approach for classifying children as GNN based on their peer preferences as compared to their peers using a sample of Head Start preschool children from a large Southwestern city (N = 257; 53% boys; M age = 51 months; 66% Mexican American). To calculate socialization opportunities, we assessed affiliation to each child in the class and weighted that by each peer’s characteristics to determine the exposure that each child had to different kinds of peers. GN children of both sexes interacted more with same-sex peers, which may limit learning of different styles of interaction. As compared to GN children, GNN children exhibited more engagement in other-sex activities and with other-sex play partners and GNN children experienced somewhat fewer peer interactions, but did not differ on problem behaviors or social competence. Boys with GNN peer preferences had increased exposure to peers with problem behaviors. GNN girls experienced little exposure to peers with problem behaviors, but they also had little exposure to socially competent peers, which may reduce learning social skills from peers. Implications of these findings for future socialization and development will be discussed. PMID:22528037
Validation of a Measure of Normative Beliefs About Smokeless Tobacco Use.
Adkison, Sarah E; O'Connor, Richard J; Bansal-Travers, Maansi; Cummings, K Michael; Rees, Vaughan W; Hatsukami, Dorothy K
2016-05-01
Validated methods to evaluate consumer responses to modified risk tobacco products (MRTPs) are needed. Guided by existing literature that demonstrates a relationship between normative beliefs and future intentions to use tobacco the current research sought to (1) develop a measure of normative beliefs about smokeless tobacco (ST) and establish the underlying factor structure, (2) evaluate the structure with confirmatory factor analysis utilizing an independent sample of youth, and (3) establish the measure's concurrent validity. Respondents (smokers and nonsmokers aged 15-65; N = 2991) completed a web-based survey that included demographic characteristics, tobacco use history and dependence, and a measure of attitudes about ST adapted from the Normative Beliefs about Smoking scale. A second sample of youth (aged 14-17; N = 305) completed a similar questionnaire. Exploratory factor analysis produced the anticipated three-factor solution and accounted for nearly three-quarters of the variance in the data reflecting (1) perceived prevalence of ST use, (2) popularity of ST among successful/elite, and (3) approval of ST use by parents/peers. Confirmatory factor analysis with data from the youth sample demonstrated good model fit. Logistic regression demonstrated that the scales effectively discriminate between ST users and nonusers and are associated with interest in trying snus. Assessment of MRTPs for regulatory purposes, which allows messages of reduced risk, should include measurement of social norms. Furthermore, surveillance efforts that track use of new MRTPs should include measures of social norms to determine how norms change with prevalence of use. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Normative ethics does not need a foundation: it needs more science.
Quintelier, Katinka; Van Speybroeck, Linda; Braeckman, Johan
2011-03-01
The impact of science on ethics forms since long the subject of intense debate. Although there is a growing consensus that science can describe morality and explain its evolutionary origins, there is less consensus about the ability of science to provide input to the normative domain of ethics. Whereas defenders of a scientific normative ethics appeal to naturalism, its critics either see the naturalistic fallacy committed or argue that the relevance of science to normative ethics remains undemonstrated. In this paper, we argue that current scientific normative ethicists commit no fallacy, that criticisms of scientific ethics contradict each other, and that scientific insights are relevant to normative inquiries by informing ethics about the options open to the ethical debate. Moreover, when conceiving normative ethics as being a nonfoundational ethics, science can be used to evaluate every possible norm. This stands in contrast to foundational ethics in which some norms remain beyond scientific inquiry. Finally, we state that a difference in conception of normative ethics underlies the disagreement between proponents and opponents of a scientific ethics. Our argument is based on and preceded by a reconsideration of the notions naturalistic fallacy and foundational ethics. This argument differs from previous work in scientific ethics: whereas before the philosophical project of naturalizing the normative has been stressed, here we focus on concrete consequences of biological findings for normative decisions or on the day-to-day normative relevance of these scientific insights.
2. Perspective Map of Buena Vista (In Buena Vista, VA, ...
2. Perspective Map of Buena Vista (In Buena Vista, VA, NY:South Publishing Co., 1891 n.p.) (copy on file at Virginia State Library, Richmond, VA) - North River Canal System, West side of Buena Vista, Buena Vista, Roanoke City, VA
Callender, Kevin A.; Olson, Sheryl L.; Kerr, David C. R.; Sameroff, Arnold J.
2014-01-01
The central goal of this longitudinal study was to develop a laboratory-based index of children’s covert cheating behavior that distinguished normative rule violations from those that signal risk for antisocial behavior. Participants (N = 215 children) were drawn from a community population and oversampled for externalizing behavior problems (EXT). Cheating behavior was measured using two resistance-to-temptation tasks and coded for extent of cheating, latency to cheat, and inappropriate positive affect. Mothers rated internalized conduct and three forms of self-regulation: inhibitory control, impulsivity, and affective distress. Mothers and teachers reported EXT concurrently (T1) and 4 years later, when children averaged 10 years of age (T2). Children categorized as severe cheaters manifested lower inhibitory control, greater impulsivity, and lower levels of internalized conduct at T1. Children in this group also manifested higher levels of EXT in home and school settings at T1 and more EXT in the school setting at T2, even after accounting for T1 ratings. PMID:21058125
Evaluation of VA Women's Health Fellowships: developing leaders in academic women's health.
Tilstra, Sarah A; Kraemer, Kevin L; Rubio, Doris M; McNeil, Melissa A
2013-07-01
The Department of Veterans Affairs (VA) instituted the VA Women's Health Fellowship (VAWHF) Program in 1994, to accommodate the health needs of increasing numbers of female veterans and to develop academic leaders in women's health. Despite the longevity of the program, it has never been formally evaluated. To describe the training environments of VAWHFs and career outcomes of female graduates. Cross-sectional web-based surveys of current program directors (2010-2011) and VAWHF graduates (1995-2011). Responses were received from six of seven program directors (86 %) and 42 of 74 graduates (57 %). The mean age of graduates was 41.2 years, and mean time since graduation was 8.5 years. Of the graduates, 97 % were female, 74 % trained in internal medicine, and 64 % obtained an advanced degree. Those with an advanced degree were more likely than those without an advanced degree to pursue an academic career (82 % vs. 60 %; P<0.01). Of the female graduates, 76 % practice clinical women's health and spend up to 66 % of their time devoted to women's health issues. Thirty percent have held a VA faculty position. Seventy-nine percent remain in academics, with 39 % in the tenure stream. Overall, 94 % had given national presentations, 88 % had received grant funding, 79 % had published in peer-reviewed journals, 64 % had developed or evaluated curricula, 51 % had received awards for teaching or research, and 49 % had held major leadership positions. At 11 or more years after graduation, 33 % of the female graduates in academics had been promoted to the rank of associate professor and 33 % to the rank of full professor. The VAWHF Program has been successful in training academic leaders in women's health. Finding ways to retain graduates in the VA system would ensure continued clinical, educational, and research success for the VA women veteran's healthcare program.
Kessels, Roy P C; Montagne, Barbara; Hendriks, Angelique W; Perrett, David I; de Haan, Edward H F
2014-03-01
The ability to recognize and label emotional facial expressions is an important aspect of social cognition. However, existing paradigms to examine this ability present only static facial expressions, suffer from ceiling effects or have limited or no norms. A computerized test, the Emotion Recognition Task (ERT), was developed to overcome these difficulties. In this study, we examined the effects of age, sex, and intellectual ability on emotion perception using the ERT. In this test, emotional facial expressions are presented as morphs gradually expressing one of the six basic emotions from neutral to four levels of intensity (40%, 60%, 80%, and 100%). The task was administered in 373 healthy participants aged 8-75. In children aged 8-17, only small developmental effects were found for the emotions anger and happiness, in contrast to adults who showed age-related decline on anger, fear, happiness, and sadness. Sex differences were present predominantly in the adult participants. IQ only minimally affected the perception of disgust in the children, while years of education were correlated with all emotions but surprise and disgust in the adult participants. A regression-based approach was adopted to present age- and education- or IQ-adjusted normative data for use in clinical practice. Previous studies using the ERT have demonstrated selective impairments on specific emotions in a variety of psychiatric, neurologic, or neurodegenerative patient groups, making the ERT a valuable addition to existing paradigms for the assessment of emotion perception. © 2013 The British Psychological Society.
Callaway, Libby; Winkler, Dianne; Tippett, Alice; Herd, Natalie; Migliorini, Christine; Willer, Barry
2016-06-01
Consideration of the relationship between meaningful participation, health and wellbeing underpins occupational therapy intervention, and drives measurement of community integration following acquired brain injury (ABI). However, utility of community integration measures has been limited to date by lack of normative data against which to compare outcomes, and none examine the growing use of electronic social networking (ESN) for social participation. This research had four aims: (i) develop and pilot items assessing ESN to add to the Community Integration Questionnaire, producing the Community Integration Questionnaire-Revised (CIQ-R); (ii) examine factor structure of the CIQ-R; (iii) collect Australian CIQ-R normative data; and (iv) assess test-retest reliability of the revised measure. Australia. A convenience sample of adults without ABI (N = 124) was used to develop and pilot ESN items. A representative general population sample of adults without ABI aged 18-64 years (N = 1973) was recruited to gather normative CIQ-R data. Cross-sectional survey. Demographic items and the CIQ-R. The CIQ-R demonstrated acceptable psychometric properties, with minor modification to the original scoring based on the factor analyses provided. Large representative general population CIQ-R normative data have been established, detailing contribution of a range of independent demographic variables to community integration. The addition of electronic social networking items to the CIQ-R offers a contemporary method of assessing community integration following ABI. Normative CIQ-R data enhance the understanding of community integration in the general population, allowing occupational therapists and other clinicians to make more meaningful comparisons between groups. © 2016 Occupational Therapy Australia.
NORMATIVE SCIENCE: A CORRUPTING INFLUENCE IN ECOLOGICAL POLICY?
Is normative science corrupting the proper use of science in evaluating ecological policy options? Science is "normative" when it contains tacit policy values and thus, by extension, supports particular policy preferences. He will use the case study of "ecosystem health" as an ...
Normativity in Fairy Tales: Scope, Range and Modes of Communication
ERIC Educational Resources Information Center
Hohr, Hansjörg
2013-01-01
The article studies in three steps how the fairy tale articulates its normative content and what the educational consequence of this kind of communication is. First, the articulation of normativity in fictional literature in general is discussed. Second, the specific mode in which the fairy tale articulates its normativity is studied according to…
Normative beliefs and sexual risk in China.
Li, Li; Ding, Ying Ying; Wu, Zunyou; Rotheram-Borus, Mary Jane; Guo, Sam
2011-08-01
We examined normative beliefs about multiple sexual partners and social status in China and their association with risky sexual behaviors and sexually transmitted infections (STIs). Self-reported and biological markers of sexual risk were examined among 3,716 market vendors from a city in eastern China. Men who were older or with less education believed having multiple sexual partners was linked to higher social status. Adjusting for demographic characteristics, normative beliefs were significantly associated with having multiple sexual partners, while having multiple sexual partners was significantly associated with STIs. Normative beliefs regarding sexual behaviors may play an important role in individual risk behaviors. Future HIV/STI interventions must address community beliefs about the positive meaning of sexual risks, particularly among men with traditional beliefs about gender roles.
Dion, Mélissa; Potvin, Olivier; Belleville, Sylvie; Ferland, Guylaine; Renaud, Mélanie; Bherer, Louis; Joubert, Sven; Vallet, Guillaume T; Simard, Martine; Rouleau, Isabelle; Lecomte, Sarah; Macoir, Joël; Hudon, Carol
2015-01-01
Performance on verbal memory tests is generally associated with socio-demographic variables such as age, sex, and education level. Performance also varies between different cultural groups. The present study aimed to establish normative data for the Rappel libre/Rappel indicé à 16 items (16-item Free and Cued Recall; RL/RI-16), a French adaptation of the Free and Cued Selective Reminding Test (Buschke, 1984; Grober, Buschke, Crystal, Bang, & Dresner, 1988). The sample consisted of 566 healthy French-speaking older adults (50-88 years old) from the province of Quebec, Canada. Normative data for the RL/RI-16 were derived from 80% of the total sample (normative sample) and cross-validated using the remaining participants (20%; validation sample). The effects of participants' age, sex, and education level were assessed on different indices of memory performance. Results indicated that these variables were independently associated with performance. Normative data are presented as regression equations with standard deviations (symmetric distributions) and percentiles (asymmetric distributions).
Normative Values of the Sport Concussion Assessment Tool 3 (SCAT3) in High School Athletes.
Snedden, Traci R; Brooks, Margaret Alison; Hetzel, Scott; McGuine, Tim
2017-09-01
Establish sex, age, and concussion history-specific normative baseline sport concussion assessment tool 3 (SCAT3) values in adolescent athletes. Prospective cohort. Seven Wisconsin high schools. Seven hundred fifty-eight high school athletes participating in 19 sports. Sex, age, and concussion history. Sport Concussion Assessment Tool 3 (SCAT3): total number of symptoms; symptom severity; total Standardized Assessment of Concussion (SAC); and each SAC component (orientation, immediate memory, concentration, delayed recall); Balance Error Scoring System (BESS) total errors (BESS, floor and foam pad). Males reported a higher total number of symptoms [median (interquartile range): 0 (0-2) vs 0 (0-1), P = 0.001] and severity of symptoms [0 (0-3) vs 0 (0-2), P = 0.001] and a lower mean (SD) total SAC [26.0 (2.3) vs 26.4 (2.0), P = 0.026], and orientation [5 (4-5) vs 5 (5-5), P = 0.021]. There was no difference in baseline scores between sex for immediate memory, concentration, delayed recall or BESS total errors. No differences were found for any test domain based on age. Previously, concussed athletes reported a higher total number of symptoms [1 (0-4) vs 0 (0-2), P = 0.001] and symptom severity [2 (0-5) vs 0 (0-2), P = 0.001]. BESS total scores did not differ by concussion history. This study represents the first published normative baseline SCAT3 values in high school athletes. Results varied by sex and history of previous concussion but not by age. The normative baseline values generated from this study will help clinicians better evaluate and interpret SCAT3 results of concussed adolescent athletes.
Building capacity in VA to provide emergency gynecology services for women.
Cordasco, Kristina M; Huynh, Alexis K; Zephyrin, Laurie; Hamilton, Alison B; Lau-Herzberg, Amy E; Kessler, Chad S; Yano, Elizabeth M
2015-04-01
Visits to Veterans Administration (VA) emergency departments (EDs) are increasingly being made by women. A 2011 national inventory of VA emergency services for women revealed that many EDs have gaps in their resources and processes for gynecologic emergency care. To guide VA in addressing these gaps, we sought to understand factors acting as facilitators and/or barriers to improving VA ED capacity for, and quality of, emergency gynecology care. Semistructured interviews with VA emergency and women's health key informants. ED directors/providers (n=14), ED nurse managers (n=13), and Women Veteran Program Managers (n=13) in 13 VA facilities. Leadership, staff, space, demand, funding, policies, and community were noted as important factors influencing VA EDs building capacity and improving emergency gynecologic care for women Veterans. These factors are intertwined and cross multiple organizational levels so that each ED's capacity is a reflection not only of its own factors, but also those of its local medical center and non-VA community context as well as VA regional and national trends and policies. Policies and quality improvement initiatives aimed at building VA's emergency gynecologic services for women need to be multifactorial and aimed at multiple organizational levels. Policies need to be flexible to account for wide variations across EDs and their medical center and community contexts. Approaches that build and encourage local leadership engagement, such as evidence-based quality improvement methodology, are likely to be most effective.
Nogueira, Joana; Freitas, Sandra; Duro, Diana; Tábuas-Pereira, Miguel; Guerreiro, Manuela; Almeida, Jorge; Santana, Isabel
2018-02-28
The Alzheimer's Disease Assessment Scale - Cognitive Subscale is a brief battery developed to assess cognitive functioning in Alzheimer's disease that encompasses the core characteristics of cognitive decline (e.g. memory, language, praxis, constructive ability and orientation). The early detection, as well as the monitoring of cognitive decline along disease progression, is extremely important in clinical care and interventional research. The main goals of the present study were to analyze the psychometric properties of the Portuguese version of the Alzheimer's Disease Assessment Scale - Cognitive Subscale, and to establish normative values for the Portuguese population. The Portuguese version of Alzheimer's Disease Assessment Scale - Cognitive Subscale was administered to 223 cognitively healthy participants according to a standard assessment protocol consisting of the Mini-Mental State Examination, the Montreal Cognitive Assessment and the Adults and Older Adults Functional Assessment Inventory. Normal performance on the assessment protocol was the inclusion criteria for the study. The Alzheimer's Disease Assessment Scale - Cognitive Subscale revealed good psychometric properties when used in the Portuguese population. Age was the main predictor of the Alzheimer's Disease Assessment Scale - Cognitive Subscale total score (R2 = 0.123), whereas the influence of education level was lower (R2 = 0.027). These two variables explained 14.4% of the variance on the Alzheimer's Disease Assessment Scale - Cognitive Subscale scores and were used to stratify the normative values for the Portuguese population presented here. On the total sample, the average total score in the Alzheimer's Disease Assessment Scale - Cognitive Subscale was 6 points. The normative data were determined according to age and educational level as these were the sociodemographic variables that significantly contributed to the prediction of the Alzheimer's Disease Assessment Scale - Cognitive Subscale
Headache diagnoses among Iraq and Afghanistan war veterans enrolled in VA: a gender comparison.
Carlson, Kathleen F; Taylor, Brent C; Hagel, Emily M; Cutting, Andrea; Kerns, Robert; Sayer, Nina A
2013-01-01
To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care. Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample. We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses. In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back
Normative evidence accumulation in unpredictable environments
Glaze, Christopher M; Kable, Joseph W; Gold, Joshua I
2015-01-01
In our dynamic world, decisions about noisy stimuli can require temporal accumulation of evidence to identify steady signals, differentiation to detect unpredictable changes in those signals, or both. Normative models can account for learning in these environments but have not yet been applied to faster decision processes. We present a novel, normative formulation of adaptive learning models that forms decisions by acting as a leaky accumulator with non-absorbing bounds. These dynamics, derived for both discrete and continuous cases, depend on the expected rate of change of the statistics of the evidence and balance signal identification and change detection. We found that, for two different tasks, human subjects learned these expectations, albeit imperfectly, then used them to make decisions in accordance with the normative model. The results represent a unified, empirically supported account of decision-making in unpredictable environments that provides new insights into the expectation-driven dynamics of the underlying neural signals. DOI: http://dx.doi.org/10.7554/eLife.08825.001 PMID:26322383
Screening for dementia in Arabic: normative data from an elderly Lebanese sample.
Abou-Mrad, Fadi; Chelune, Gordon; Zamrini, Edward; Tarabey, Lubna; Hayek, Maryse; Fadel, Patricia
2017-01-01
Prevention and treatment of dementia is a global concern that requires involvement of international samples. The purpose of this study is to develop culturally sensitive norms based on normal older Lebanese adults using multiple cognitive screening measures translated into Arabic for regional use. Participants were 164 community dwelling older Lebanese adults without cognitive complaints. They were administered the following cognitive measures in Arabic: Alzheimer's Disease 8-item questionnaire, Montreal Cognitive Assessment, Mini Mental Status Exam, Modified Mini Mental Status, Brief Visuospatial Memory Test-Revised, Lebanese Digit Span, Cross-Linguistic Naming Test, and phonemic and semantic fluency tests. Sample characteristics and descriptive statistics for the demographically unadjusted raw scores are first presented (N = 164). Same-form test-retest reliability for each test were computed for 24 participants retested over 2-5 weeks, with reliabilities ranging from .55 to .90; Cronbach alpha coefficients ranged from .34 to .93. Two sets of normative data were constructed. First, base-rates for demographically unadjusted raw scores for the 5th, 10th and 15th percentiles are presented to identify relatively rare occurring performances. Second, using standardized regression-based procedures demographically corrected normative information adjusted for age, education and sex were generated for normative interpretation. Adapting cognitive tests for use in culturally and linguistically diverse regions of the world not only requires careful translation of test instructions and materials, but construction of culturally sensitive local norms. Our normative data should allow for more accurate identification of cognitive impairment and dementia in Arabic-speaking patients, especially those living in Lebanon.
Aurisano, A.; Backhouse, C.; Hatcher, R.; ...
2015-12-23
The NO vA experiment is a two-detector, long-baseline neutrino experiment operating in the recently upgraded NuMI muon neutrino beam. Simulating neutrino interactions and backgrounds requires many steps including: the simulation of the neutrino beam flux using FLUKA and the FLUGG interface, cosmic ray generation using CRY, neutrino interaction modeling using GENIE, and a simulation of the energy deposited in the detector using GEANT4. To shorten generation time, the modeling of detector-specific aspects, such as photon transport, detector and electronics noise, and readout electronics, employs custom, parameterized simulation applications. We will describe the NO vA simulation chain, and present details onmore » the techniques used in modeling photon transport near the ends of cells, and in developing a novel data-driven noise simulation. Due to the high intensity of the NuMI beam, the Near Detector samples a high rate of muons originating in the surrounding rock. In addition, due to its location on the surface at Ash River, MN, the Far Detector collects a large rate ((˜) 140 kHz) of cosmic muons. Furthermore, we will discuss the methods used in NO vA for overlaying rock muons and cosmic ray muons with simulated neutrino interactions and show how realistically the final simulation reproduces the preliminary NO vA data.« less
The effect of normative beliefs on anticipated emotions.
Baron, J
1992-08-01
In 3 experiments, Ss were asked how they would or should make hypothetical decisions and how they would react emotionally to the options or outcomes. The choices were those in which departures from proposed normative models had previously been found: omission bias, status quo bias, and the person-causation effect. These effects were found in all judgments, including judgments of anticipated emotion. Arguments against the departures affected judgments of anticipated emotion as well as decisions, even though the arguments were entirely directed at the question of what should be done. In all but one study, effects of these arguments on anticipated emotion were as strong as their effects on decisions or normative beliefs. Thus, in many situations, people think that their emotional reactions will fall into line with their normative beliefs. In other situations, some people think that their emotional reactions have a life of their own. It is suggested that both normative beliefs and anticipated emotions affect decisions.
Social normative beliefs about smoking among Vietnamese adolescents.
Page, Randy M; Huong, Nguyen Thanh; Chi, Hoang Khanh; Tien, Truong Quang
2012-01-01
Tobacco-related deaths in Vietnam are forecast to climb from 40 000 annually to 70 000 by 2030. Previous research in Western nations has found social factors to be important determinants of adolescent smoking. Because these factors remain unexplored in Vietnamese youth, the purpose of this study was to examine social normative beliefs regarding smoking in a school-based sample of North Vietnamese adolescents and the association of these factors with smoking behavior and susceptibility to smoking. Three measures of normative beliefs regarding smoking were evaluated in cross-sectional surveys of secondary students. Of the 3 measures, parent/peer disapproval was the most consistent normative belief associated with smoking behavior and susceptibility to smoking. Youth smoking prevention programs should consider assessing and taking into account normative beliefs and develop strategies that provide accurate information about the actual prevalence of smoking, the types of individuals who smoke, and approval/disapproval of smoking by parents and peers.
REACH VA: Moving from Translation to System Implementation.
Nichols, Linda O; Martindale-Adams, Jennifer; Burns, Robert; Zuber, Jeffrey; Graney, Marshall J
2016-02-01
Resources for Enhancing All Caregivers Health in the Department of Veterans Affairs (REACH VA) has been implemented in the VA system as a national program for caregivers. We describe the trajectory of REACH VA from national randomized clinical trial through translation to national implementation. The implementation is examined through the six stages of the Fixsen and Blasé implementation process model: exploration and adoption, program installation, initial implementation, full operation, innovation, and sustainability. Different drivers that move the implementation process forward are important at each stage, including staff selection, staff training, consultation and coaching, staff evaluation, administrative support, program evaluation/fidelity, and systems interventions. Caregivers in the REACH VA 4 session intervention currently implemented in the VA had similar outcomes to longer REACH interventions, including Resources for Enhancing Alzheimer's Caregivers Health (REACH II). Caregivers experienced significant decreases in burden, depression, anxiety, number of troubling patient behaviors reported, caregiving frustrations, stress symptoms (feeling overwhelmed, feeling like crying, being frustrated as a result of caregiving, being lonely), and general stress. Effect sizes (Cohen's d) for these significant variables were between small and medium ranging from .24 to .46. The implementation of REACH VA provides a road map for implementation of other behavioral interventions in health care delivery settings. Lessons learned include the importance of implementing a proven, needed intervention, support from both leadership and clinical staff, willingness to respond to staff and organization needs and modify the intervention while preserving its integrity, and fitting the intervention into ongoing routines and practices. Published by Oxford University Press on behalf of the Gerontological Society of America 2014.
Social normative beliefs regarding cigarette smoking in Hungarian adolescents.
Page, Randy M; Piko, Bettina F; Balazs, Mate A; Struk, Tamara
2011-10-01
Hungary will continue to experience a high burden of disease and death from lung cancer and other tobacco-induced disease unless there is a significant reduction in youth smoking. Social factors have been found to be among the most important determinants of adolescent smoking, yet few studies have investigated social normative beliefs in Hungarian youth. The purpose of the current study was to investigate three measures of smoking normative beliefs thought to influence adolescent smoking: perceived prevalence of smoking; perceived popularity of smoking among successful/elite elements of society; and perceived disapproval by friends and family. A cross-sectional school-based survey of eighth grade (n = 258) and 12th grade (n = 288) students in Mako, Hungary was conducted to assess social normative beliefs about smoking, current smoking, ever smoking, and susceptibility to smoking. The association of the normative beliefs with the smoking behavior variables was examined through logistic regression analysis, and the underlying factor structure of the normative belief items in the current sample was determined through factor analysis. The percent of boys reporting current smoking was 40.5% in 12th grade and 27.0% in eighth grade. Among girls, the percent was 44.0% of 12th graders and 29.1% of eighth graders. Parent/peer disapproval was the most consistently associated normative belief with smoking behavior and susceptibility to smoking across both samples. Youth smoking prevention programs should consider assessing and taking into account normative beliefs and develop strategies that provide accurate information about the actual prevalence of smoking, the types of individuals who smoke, and approval/disapproval of smoking by parents and peers. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.
Gellad, Walid F.; Donohue, Julie M.; Zhao, Xinhua; Mor, Maria K.; Thorpe, Carolyn T.; Smith, Jeremy; Good, Chester B.; Fine, Michael J.; Morden, Nancy E.
2013-01-01
Background Medicare Part D and the Department of Veterans Affairs (VA) use different approaches to manage prescription drug benefits, with implications for spending. Medicare relies on private plans with distinct formularies, whereas VA administers its own benefit using a national formulary. Objective To compare overall and regional rates of brand-name drug use among older adults with diabetes in Medicare and VA. Design Retrospective cohort Setting Medicare and VA Patients National sample in 2008 of 1,061,095 Part D beneficiaries and 510,485 Veterans age 65+ with diabetes. Measurements Percent of patients on oral hypoglycemics, statins, and angiotensin-converting-enzyme inhibitors/angiotensin-receptor-blockers who filled brand-name drugs and percent of patients on long-acting insulin who filled analogues. We compared sociodemographic and health-status adjusted hospital referral region (HRR) brand-name use to examine local practice patterns, and calculated changes in spending if each system’s brand-name use mirrored the other. Results Brand-name use in Medicare was 2–3 times that of VA: 35.3% vs. 12.7% for oral hypoglycemics, 50.7% vs. 18.2% for statins, 42.5% vs. 20.8% for angiotensin-converting-enzyme inhibitors/angiotensin-receptor-blockers, and 75.1% vs. 27.0% for insulin analogues. Adjusted HRR brand-name statin use ranged (5th to 95th percentile) from 41.0%–58.3% in Medicare and 6.2%–38.2% in VA. For each drug group, the HRR at the 95th percentile in VA had lower brand-name use than the 5th percentile HRR in Medicare. Medicare spending in this population would have been $1.4 billion less if brand-name use matched the VA for these medications. Limitation This analysis cannot fully describe the factors underlying differences in brand-name use. Conclusions Medicare beneficiaries with diabetes use 2–3 times more brand-name drugs than a comparable group within VA, at substantial excess cost. Primary Funding Sources VA; NIH; RWJF PMID:23752663
Madimenos, Felicia C; Snodgrass, J Josh; Blackwell, Aaron D; Liebert, Melissa A; Cepon, Tara J; Sugiyama, Lawrence S
2011-01-01
Minimal data on bone mineral density changes are available from populations in developing countries. Using calcaneal quantitative ultrasound (QUS) techniques, the current study contributes to remedying this gap in the literature by establishing a normative data set on the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon. The paucity of bone mineral density (BMD) data from populations in developing countries partially reflects the lack of diagnostic resources in these areas. Portable QUS techniques now enable researchers to collect bone health data in remote field-based settings and to contribute normative data from developing regions. The main objective of this study is to establish normative QUS data for two Ecuadorian Amazonian populations-the indigenous Shuar and non-Shuar Colonos. The effects of ethnic group, sex, age, and body size on QUS parameters are also considered. A study cohort consisting of 227 Shuar and 261 Colonos (15-91 years old) were recruited from several small rural Ecuadorian communities in the Upano River Valley. Calcaneal QUS parameters were collected on the right heel of each participant using a Sahara bone sonometer. Three ultrasound generated parameters were employed: broadband ultrasound attenuation (BUA), speed of sound (SOS), and calculated heel BMD (hBMD). In both populations and sexes, all QUS values were progressively lower with advancing age. Shuar have significantly higher QUS values than Colonos, with most pronounced differences found between pre-menopausal Shuar and Colono females. Multiple regression analyses show that age is a key predictor of QUS while weight alone is a less consistent determinant. Both Shuar males and females display comparatively greater QUS parameters than other reference populations. These normative data for three calcaneal QUS parameters will be useful for predicting fracture risk and determining diagnostic QUS criteria of osteoporosis in non-industrialized populations in South America and
Stroop Color-Word Interference Test: Normative data for Spanish-speaking pediatric population.
Rivera, D; Morlett-Paredes, A; Peñalver Guia, A I; Irías Escher, M J; Soto-Añari, M; Aguayo Arelis, A; Rute-Pérez, S; Rodríguez-Lorenzana, A; Rodríguez-Agudelo, Y; Albaladejo-Blázquez, N; García de la Cadena, C; Ibáñez-Alfonso, J A; Rodriguez-Irizarry, W; García-Guerrero, C E; Delgado-Mejía, I D; Padilla-López, A; Vergara-Moragues, E; Barrios Nevado, M D; Saracostti Schwartzman, M; Arango-Lasprilla, J C
2017-01-01
To generate normative data for the Stroop Word-Color Interference test in Spanish-speaking pediatric populations. The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the Stroop Word-Color Interference test as part of a larger neuropsychological battery. The Stroop Word, Stroop Color, Stroop Word-Color, and Stroop Interference scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. The final multiple linear regression models showed main effects for age on all scores, except on Stroop Interference for Guatemala, such that scores increased linearly as a function of age. Age2 affected Stroop Word scores for all countries, Stroop Color scores for Ecuador, Mexico, Peru, and Spain; Stroop Word-Color scores for Ecuador, Mexico, and Paraguay; and Stroop Interference scores for Cuba, Guatemala, and Spain. MLPE affected Stroop Word scores for Chile, Mexico, and Puerto Rico; Stroop Color scores for Mexico, Puerto Rico, and Spain; Stroop Word-Color scores for Ecuador, Guatemala, Mexico, Puerto Rico and Spain; and Stroop-Interference scores for Ecuador, Mexico, and Spain. Sex affected Stroop Word scores for Spain, Stroop Color scores for Mexico, and Stroop Interference for Honduras. This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the Stroop Word-Color Interference test in pediatric populations.
Normative data for the Maryland CNC Test.
Mendel, Lisa Lucks; Mustain, William D; Magro, Jessica
2014-09-01
The Maryland consonant-vowel nucleus-consonant (CNC) Test is routinely used in Veterans Administration medical centers, yet there is a paucity of published normative data for this test. The purpose of this study was to provide information on the means and distribution of word-recognition scores on the Maryland CNC Test as a function of degree of hearing loss for a veteran population. A retrospective, descriptive design was conducted. The sample consisted of records from veterans who had Compensation and Pension (C&P) examinations at a Veterans Administration medical center (N = 1,760 ears). Audiometric records of veterans who had C&P examinations during a 10 yr period were reviewed, and the pure-tone averages (PTA4) at four frequencies (1000, 2000, 3000, and 4000 Hz) were documented. The maximum word-recognition score (PBmax) was determined from the performance-intensity functions obtained using the Maryland CNC Test. Correlations were made between PBmax and PTA4. A wide range of word-recognition scores were obtained at all levels of PTA4 for this population. In addition, a strong negative correlation between the PBmax and the PTA4 was observed, indicating that as PTA4 increased, PBmax decreased. Word-recognition scores decreased significantly as hearing loss increased beyond a mild hearing loss. Although threshold was influenced by age, no statistically significant relationship was found between word-recognition score and the age of the participants. RESULTS from this study provide normative data in table and figure format to assist audiologists in interpreting patient results on the Maryland CNC test for a veteran population. These results provide a quantitative method for audiologists to use to interpret word-recognition scores based on pure-tone hearing loss. American Academy of Audiology.
78 FR 48609 - Safety Zone; James River; Newport News, VA
Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-09
...-AA00 Safety Zone; James River; Newport News, VA AGENCY: Coast Guard, DHS. ACTION: Temporary final rule...-0670 to read as follows: Sec. 165.T05-0670 Safety Zone, James River, Newport News, VA. (a) Definitions...'11'' N longitude 076[deg]38'40'' W, located near Fort Eustis in Newport News, VA. (c) Regulations. (1...
Normative Feedback Effects on Learning a Timing Task
ERIC Educational Resources Information Center
Wulf, Gabriele; Chiviacowsky, Suzete; Lewthwaite, Rebecca
2010-01-01
This study investigated the influence of normative feedback on learning a sequential timing task. In addition to feedback about their performance per trial, two groups of participants received bogus normative feedback about a peer group's average block-to-block improvement after each block of 10 trials. Scores indicated either greater (better…
Clinical Outcome Assessments: Use of Normative Data in a Pediatric Rare Disease.
Phillips, Dawn; Leiro, Beth
2018-05-01
Pediatric rare diseases present unique challenges in clinical trial design and in selection of clinical outcome assessments (COAs) used to support claims in medical product labeling. COAs that discriminate level of function relative to a normative sample are particularly important in the pediatric rare disease setting because the literature is often void of natural history data. Pediatric rare disease clinical trials will often include a wide age distribution. Gross and fine motor skills, communication, cognition, and independence in activities of daily living vary by age, and it may be difficult to distinguish between treatment effect and change due to developmental maturation. Asfotase alfa was granted breakthrough therapy designation and subsequently approved for the treatment of hypophosphatasia (HPP; a genetic metabolic musculoskeletal disorder) and is used in this discussion to illustrate COA selection in a pediatric rare disease. Multiple COAs with normative data in HPP clinical trials for asfotase alfa are presented. The assessment instruments included the Bayley Scales of Infant and Toddler Development-Third Edition, the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, the Childhood Health Assessment Questionnaire, the Pediatric Outcomes Data Collection Instrument, handheld dynamometry, the 6-minute walk test, and the Modified Performance-Oriented Mobility Assessment-Gait scale. Multiple end points were required to adequately capture the impact of asfotase alfa treatment on the multiple systems affected in HPP. These data illustrate the importance of using multiple COAs that provide normative data and to use COAs early in the drug development process for rare pediatric disease. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Normative Judgments and Individual Essence.
De Freitas, Julian; Tobia, Kevin P; Newman, George E; Knobe, Joshua
2017-04-01
A growing body of research has examined how people judge the persistence of identity over time-that is, how they decide that a particular individual is the same entity from one time to the next. While a great deal of progress has been made in understanding the types of features that people typically consider when making such judgments, to date, existing work has not explored how these judgments may be shaped by normative considerations. The present studies demonstrate that normative beliefs do appear to play an important role in people's beliefs about persistence. Specifically, people are more likely to judge that the identity of a given entity (e.g., a hypothetical nation) remains the same when its features improve (e.g., the nation becomes more egalitarian) than when its features deteriorate (e.g., the nation becomes more discriminatory). Study 1 provides a basic demonstration of this effect. Study 2 shows that this effect is moderated by individual differences in normative beliefs. Study 3 examines the underlying mechanism, which is the belief that, in general, various entities are essentially good. Study 4 directly manipulates beliefs about essence to show that the positivity bias regarding essences is causally responsible for the effect. Copyright © 2016 Cognitive Science Society, Inc.
Development of the Chinese Version of the Hooper Visual Organization Test: Normative Data
ERIC Educational Resources Information Center
Su, Chwen-Yng; Lin, Yueh-Hsien; Wu, Yuh-Yih; Wuang, Yee-Pay
2013-01-01
The present study consisted of two phases: development and psychometric validation of a Chinese version of the Hooper Visual Organization Test (HVOT) using Rasch analysis and the provision of normative data on the basis of a representative sample of the Chinese-speaking population. The HVOT was administered to 1008 healthy adults aged 15-79 years,…
33 CFR 80.510 - Chesapeake Bay Entrance, VA.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Chesapeake Bay Entrance, VA. 80.510 Section 80.510 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.510 Chesapeake Bay Entrance, VA. A...
Casaletto, Kaitlin B; Umlauf, Anya; Marquine, Maria; Beaumont, Jennifer L; Mungas, Daniel; Gershon, Richard; Slotkin, Jerry; Akshoomoff, Natacha; Heaton, Robert K
2016-03-01
Hispanics are the fastest growing ethnicity in the United States, yet there are limited well-validated neuropsychological tools in Spanish, and an even greater paucity of normative standards representing this population. The Spanish NIH Toolbox Cognition Battery (NIHTB-CB) is a novel neurocognitive screener; however, the original norms were developed combining Spanish- and English-versions of the battery. We developed normative standards for the Spanish NIHTB-CB, fully adjusting for demographic variables and based entirely on a Spanish-speaking sample. A total of 408 Spanish-speaking neurologically healthy adults (ages 18-85 years) and 496 children (ages 3-7 years) completed the NIH Toolbox norming project. We developed three types of scores: uncorrected based on the entire Spanish-speaking cohort, age-corrected, and fully demographically corrected (age, education, sex) scores for each of the seven NIHTB-CB tests and three composites (Fluid, Crystallized, Total Composites). Corrected scores were developed using polynomial regression models. Demographic factors demonstrated medium-to-large effects on uncorrected NIHTB-CB scores in a pattern that differed from that observed on the English NIHTB-CB. For example, in Spanish-speaking adults, education was more strongly associated with Fluid scores, but showed the strongest association with Crystallized scores among English-speaking adults. Demographic factors were no longer associated with fully corrected scores. The original norms were not successful in eliminating demographic effects, overestimating children's performances, and underestimating adults' performances on the Spanish NIHTB-CB. The disparate pattern of demographic associations on the Spanish versus English NIHTB-CB supports the need for distinct normative standards developed separately for each population. Fully adjusted scores presented here will aid in more accurately characterizing acquired brain dysfunction among U.S. Spanish-speakers.
Sedlander, Erica; Rimal, Rajiv N; Talegawkar, Sameera A.; Yilma, Hagere; Munar, Wolfgang
2018-01-01
Background: More than half of women of reproductive age in India are anemic. Anemia is associated with increased risk of preterm delivery, higher maternal mortality and contributes to fatigue, which affects women’s work productivity. The World Health Organization (WHO) recommends daily oral iron and folic acid (IFA) supplements during pregnancy and weekly supplements for women of reproductive age. Government programs and global donors have distributed and promoted IFA supplements in India for over four decades. However, initial intake and compliance remain inadequate. Objectives: This protocol describes the formative research phase of a larger study, which will test, through a randomized controlled trial, the hypothesis that a social norms-based behavioral intervention in Odisha, India will improve uptake of IFA supplements and reduce anemia among reproductive age women as compared to usual care. The focus of this paper is on the formative research required to develop a sound intervention. We will examine socio-normative barriers to and facilitators of IFA supplement uptake. Methods and analysis: Based on the Theory of Normative Social Behavior, we will adopt a mixed-method, multilevel approach. We will collect data using focus groups, in-depth interviews, observations, Rapid Participatory Ethnographic Evaluation and Research (PEER) techniques, and perceptual mapping methods. Our sample includes reproductive age women (pregnant and not pregnant), their husbands, their mothers/in law and key stakeholders. After analyzing the results, we will hold a convening in India to collaboratively design the intervention. Following the intervention design, we will test components of the intervention, gather user feedback and tweak as necessary. Additionally, to improve adoption and sustainability of the intervention, we will conduct policy dialogue with stakeholders throughout the formative research. Impact: This study will contribute to the social norms and behavioral
38 CFR 74.27 - How will VA store information?
Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information? VA... examination visits will be scanned onto portable media and fully secured in the Center for Veterans Enterprise...
Güner, Olcay
2017-03-01
The Early Maladaptive Schema Questionnaires Set for Children and Adolescents (SQS) was developed to assess early maladaptive schemas in children between the ages of 10 and 16 in Turkey. The SQS consists of five questionnaires that represent five schema domains in Young's schema theory. Psychometric properties (n = 983) and normative values (n = 2250) of SQS were investigated in children and adolescents between the ages of 10 and 16. Both exploratory and confirmatory factor analyses were performed. Results revealed 15 schema factors under five schema domains, with good fit indexes. A total of 14 schema factors were in line with Young's early maladaptive schemas. In addition to these factors, one new schema emerged: self-disapproval. Reliability analyses showed that SQS has high internal consistency and consistency over a 1-month interval. Correlations of SQS with the Adjective Check List (ACL), the Inventory of Parent and Peer Attachment (IPPA), the Symptom Assessment (SA-45) and the Young Schema Questionnaire (YSQ) were investigated to assess criterion validity, and the correlations revealed encouraging results. SQS significantly differentiated between children who have clinical diagnoses (n = 78) and children who have no diagnosis (n = 100). Finally, general normative values (n = 2,250) were determined for age groups, gender and age/gender groups. In conclusion, the early maladaptive schema questionnaires set for children and adolescents turned out to be a reliable and valid questionnaire with standard scores.Copyright © 2016 John Wiley & Sons, Ltd. The early maladaptive schema questionnaires set for children and adolescents (SQS) is a psychometrically reliable and valid measure of early maladaptive schemas for children between the ages of 10 and 16. SQS consists of five schema domains that represent Young's schema domains including 15 early maladaptive schemas and 97 items. Normative values for each schema were determined for age, gender and
Improving measurement of normative beliefs involving smoking among adolescents.
Primack, Brian A; Switzer, Galen E; Dalton, Madeline A
2007-05-01
To identify different components of smoking normative beliefs and determine if each component is independently associated with 2 clinically relevant measures of smoking in adolescents. Cross-sectional survey. One large suburban high school. A total of 1211 high school students aged 14 to 18 years. Current smoking and susceptibility to smoking. Of the 1138 students with data on current smoking, 216 (19.0%) reported current smoking, and 342 (38.3%) of the 893 nonsmoking students with susceptibility data were susceptible to future smoking. Factor analysis identified 3 normative belief constructs, labeled "perceived prevalence of smoking," "perceived popularity of smoking among elite/successful elements of society," and "disapproval of smoking by parents/peers." On average, students believed that 56% of people in the United States smoke cigarettes; 27.7% believed that wealthy people smoke more than poor people. Multiple logistic regression showed that each of the 3 constructs was independently associated with current smoking (adjusted odds ratios, 1.05 [95% confidence interval {CI}, 1.02-1.08], 1.12 [95% CI, 1.02-1.23], and 0.66 [95% CI, 0.59-0.75], respectively), even after controlling for covariates. Students' perceptions of smoking among the successful/elite and disapproval by parents/peers were independently associated with susceptibility to future smoking (adjusted odds ratios, 1.20 [95% CI, 1.11-1.29] and 0.87 [95% CI, 0.79-0.96], respectively). Adolescents' normative beliefs about smoking are multidimensional and include at least 3 distinct components, each of which was independently related to smoking outcomes. These distinct components should be considered in the design and evaluation of programs related to prevention and cessation of adolescent smoking.
Diagnostic frameworks and nursing diagnoses: a normative stance.
Zanotti, Renzo; Chiffi, Daniele
2015-01-01
Diagnostic frameworks are essential to many scientific and technological activities and clinical practice. This study examines the main fundamental aspects of such frameworks. The three components required for all diagnoses are identified and examined, i.e. their normative dimension, temporal nature and structure, and teleological perspective. The normative dimension of a diagnosis is based on (1) epistemic values when associated with Hempel's inductive risk concerning the balance between false-positive and false-negative outcomes, leading to probabilistic judgements; and (2) non-epistemic values when related to ideas such as well-being, normality, illness, etc, as idealized norms or ideal points of reference. It should be noted that medical diagnoses match the three necessary components, while some essential diagnostic frameworks - the taxonomies of Gordon and NANDA - in nursing lack some components. The main lack is normative as the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value-based judgements in which both epistemic and non-epistemic values may coexist. © 2014 John Wiley & Sons Ltd.
Effectiveness of the Vital Aging program to promote active aging in Mexican older adults.
Mendoza-Ruvalcaba, Neyda Ma; Fernández-Ballesteros, Rocío
2016-01-01
Aging is not only a population phenomenon but also an experience and an individual reality. Vital Aging ® is a program that considers active aging as the lifelong adaptation process of maximizing health and independence, physical and cognitive functioning, positive affect regulation and control, and social engagement. Through its different versions and editions, it has demonstrated being an effective program to promote active aging. The aim of this study is to determine the effectiveness of the "face-to-face" and "combined" versions of the program to promote active aging in Mexican older adults trial. Seventy-six older adults aged 60 years and over participated in a quasi-experimental study and were recruited in a senior center to participate in the two experimental conditions: Vital Aging face-to-face (VA-FF) (n=35) and Vital Aging combined (VA-C; multimedia/face-to-face) (n=15), and the remaining 26 adults were assigned to a control group. Pretest and posttest assessments were performed after the theoretical-practical intervention. Mean differences and size effects were calculated for estimating the effect of the program. At the end of the study, participants showed improvements in the active aging outcome measures. Positive effects were observed in the frequency of intellectual, cultural - artistic, and social activities, perceptions of aging, satisfaction with social relationships, and self-efficacy for aging. Additionally, those who participated in VA-FF showed better memory performance, meta-memory, and a trend to report less memory problems, while older persons in VA-C showed a trend to have better life satisfaction. No effects were observed in physical activity, frequency of social relationships, and subjective health. Findings show that the Vital Aging program in face-to-face and combined versions encourages active aging in Mexican older persons. These results are in general similar to those found in editions performed in Spain, revealing its consistency
Effectiveness of the Vital Aging program to promote active aging in Mexican older adults
Mendoza-Ruvalcaba, Neyda Ma; Fernández-Ballesteros, Rocío
2016-01-01
Introduction Aging is not only a population phenomenon but also an experience and an individual reality. Vital Aging® is a program that considers active aging as the lifelong adaptation process of maximizing health and independence, physical and cognitive functioning, positive affect regulation and control, and social engagement. Through its different versions and editions, it has demonstrated being an effective program to promote active aging. The aim of this study is to determine the effectiveness of the “face-to-face” and “combined” versions of the program to promote active aging in Mexican older adults trial. Methods Seventy-six older adults aged 60 years and over participated in a quasi-experimental study and were recruited in a senior center to participate in the two experimental conditions: Vital Aging face-to-face (VA-FF) (n=35) and Vital Aging combined (VA-C; multimedia/face-to-face) (n=15), and the remaining 26 adults were assigned to a control group. Pretest and posttest assessments were performed after the theoretical–practical intervention. Mean differences and size effects were calculated for estimating the effect of the program. Results At the end of the study, participants showed improvements in the active aging outcome measures. Positive effects were observed in the frequency of intellectual, cultural – artistic, and social activities, perceptions of aging, satisfaction with social relationships, and self-efficacy for aging. Additionally, those who participated in VA-FF showed better memory performance, meta-memory, and a trend to report less memory problems, while older persons in VA-C showed a trend to have better life satisfaction. No effects were observed in physical activity, frequency of social relationships, and subjective health. Conclusion Findings show that the Vital Aging program in face-to-face and combined versions encourages active aging in Mexican older persons. These results are in general similar to those found in
Medical Student Psychiatry Examination Performance at VA and Non-VA Clerkship Sites
ERIC Educational Resources Information Center
Tucker, Phebe; von Schlageter, Margo Shultes; Park, EunMi; Rosenberg, Emily; Benjamin, Ashley B.; Nawar, Ola
2009-01-01
Objective: The authors examined the effects of medical student assignment to U.S. Department of Veterans Affairs (VA) Medical Center inpatient and outpatient psychiatry clerkship sites versus other university and community sites on the performance outcome measure of National Board of Medical Examiners (NBME) subject examination scores. Methods:…
ERIC Educational Resources Information Center
Morey, Leslie C.; Lowmaster, Sara E.; Coldren, Rodney L.; Kelly, Mark P.; Parish, Robert V.; Russell, Michael L.
2011-01-01
The present study examined the normative scores and psychometric properties of the Personality Assessment Inventory (PAI; Morey, 1991) within a non-treatment-seeking sample of soldiers deployed to combat zones in Iraq, compared with a sample of community adults matched with respect to age and gender. Results indicate the scores and properties of…
Informational and Normative Influences in Conformity from a Neurocomputational Perspective.
Toelch, Ulf; Dolan, Raymond J
2015-10-01
We consider two distinct influences that drive conformity behaviour. Whereas informational influences facilitate adaptive and accurate responses, normative influences bias decisions to enhance social acceptance. We explore these influences from a perspective of perceptual and value-based decision-making models and apply these models to classical works on conformity. We argue that an informational account predicts a surprising tendency to conform. Moreover, we detail how normative influences fit into this framework and interact with social influences. Finally, we explore potential neuronal substrates for informational and normative influences based on a consideration of the neurobiological literature, highlighting conceptual shortcomings particularly with regard to a failure to segregate informational and normative influences. Copyright © 2015 Elsevier Ltd. All rights reserved.
Perez, Claudio I; Chansangpetch, Sunee; Thai, Andy; Nguyen, Anh-Hien; Nguyen, Anwell; Mora, Marta; Nguyen, Ngoc; Lin, Shan C
2018-06-05
Evaluate the distribution and the color probability codes of the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness in a healthy Vietnamese population and compare them with the original color-codes provided by the Cirrus spectral domain OCT. Cross-sectional study. We recruited non-glaucomatous Vietnamese subjects and constructed a normative database for peripapillary RNFL and macular GCIPL thickness. The probability color-codes for each decade of age were calculated. We evaluated the agreement with Kappa coefficient (κ) between OCT color probability codes with Cirrus built-in original normative database and the Vietnamese normative database. 149 eyes of 149 subjects were included. The mean age of enrollees was 60.77 (±11.09) years, with a mean spherical equivalent of +0.65 (±1.58) D and mean axial length of 23.4 (±0.87) mm. Average RNFL thickness was 97.86 (±9.19) microns and average macular GCIPL was 82.49 (±6.09) microns. Agreement between original and adjusted normative database for RNFL was fair for average and inferior quadrant (κ=0.25 and 0.2, respectively); and good for other quadrants (range: κ=0.63-0.73). For macular GCIPL κ agreement ranged between 0.39 and 0.69. After adjusting with the normative Vietnamese database, the percent of yellow and red color-codes increased significantly for peripapillary RNFL thickness. Vietnamese population has a thicker RNFL in comparison with Cirrus normative database. This leads to a poor color-code agreement in average and inferior quadrant between the original and adjusted database. These findings should encourage to create a peripapillary RNFL normative database for each ethnicity.
FACILITIES FOR EDUCATION IN VA HOSPITALS. FINAL REPORT.
ERIC Educational Resources Information Center
GREEN, ALAN C.; AND OTHERS
THIS STUDY WAS AUTHORIZED BY THE VA DEPARTMENT OF MEDICINE AND SURGERY FOR THE PURPOSE OF IDENTIFYING AND DETERMINING THE FACILITIES NEEDED TO PROPERLY HOUSE AND SUPPORT EDUCATION ACTIVITIES IN EXISTING AND FUTURE VA HOSPITALS AND TO PRODUCE ARCHITECTURAL GUIDANCE IN THE DESIGN OF THE FACILITIES. CURRENT PRACTICES AND SIGNIFICANT TRENDS IN MEDICAL…
48 CFR 852.219-71 - VA mentor-protégé program.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA mentor-protégÃ....219-71 VA mentor-protégé program. As prescribed in 819.7115(a), insert the following clause: VA Mentor-Protégé Program (DEC 2009) (a) Large businesses are encouraged to participate in the VA Mentor-Protégé...
Empirical analysis on future-cash arbitrage risk with portfolio VaR
NASA Astrophysics Data System (ADS)
Chen, Rongda; Li, Cong; Wang, Weijin; Wang, Ze
2014-03-01
This paper constructs the positive arbitrage position by alternating the spot index with Chinese Exchange Traded Fund (ETF) portfolio and estimating the arbitrage-free interval of futures with the latest trade data. Then, an improved Delta-normal method was used, which replaces the simple linear correlation coefficient with tail dependence correlation coefficient, to measure VaR (Value-at-risk) of the arbitrage position. Analysis of VaR implies that the risk of future-cash arbitrage is less than that of investing completely in either futures or spot market. Then according to the compositional VaR and the marginal VaR, we should increase the futures position and decrease the spot position appropriately to minimize the VaR, which can minimize risk subject to certain revenues.
Tracing how normative messages may influence physical activity intention
USDA-ARS?s Scientific Manuscript database
Normative messages have been shown to increase intention to do physical activity (PA). We traced how 'positive' and 'negative' normative messages influenced PA intention by comparing constructs of the model of goal-directed behaviour with descriptive norms (MGDB+DN) across control and treatment grou...
Use of VA and Medicare Services By Dually Eligible Veterans with Psychiatric Problems
Carey, Kathleen; Montez-Rath, Maria E; Rosen, Amy K; Christiansen, Cindy L; Loveland, Susan; Ettner, Susan L
2008-01-01
Objective To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders. Data Sources Primary VA data sources were the Patient Treatment (acute care), Extended Care (long-term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider-of-Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data. Study Design We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one- and two-part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs. Principal Findings Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare-certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures. Conclusions As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans. PMID:18355256
Greening America's Capitals - Richmond, VA
Report from the Greening America's Capitals project in Richmond, VA, to help the city develop design options to protect pedestrians, bicyclists, transit users, and drivers; improve stormwater management; and spur revitalization.
Normative Beliefs about Aggression as a Mediator of Narcissistic Exploitativeness and Cyberbullying
ERIC Educational Resources Information Center
Ang, Rebecca P.; Tan, Kit-Aun; Mansor, Abu Talib
2011-01-01
The current study examined normative beliefs about aggression as a mediator between narcissistic exploitativeness and cyberbullying using two Asian adolescent samples from Singapore and Malaysia. Narcissistic exploitativeness was significantly and positively associated with cyberbullying and normative beliefs about aggression and normative beliefs…
Onate, James A; Starkel, Cambrie; Clifton, Daniel R; Best, Thomas M; Borchers, James; Chaudhari, Ajit; Comstock, R Dawn; Cortes, Nelson; Grooms, Dustin R; Hertel, Jay; Hewett, Timothy E; Miller, Meghan Maume; Pan, Xueliang; Schussler, Eric; Van Lunen, Bonnie L
2018-01-01
The fourth edition of the Preparticipation Physical Evaluation recommends functional testing for the musculoskeletal portion of the examination; however, normative data across sex and grade level are limited. Establishing normative data can provide clinicians reference points with which to compare their patients, potentially aiding in the development of future injury-risk assessments and injury-mitigation programs. To establish normative functional performance and limb-symmetry data for high school-aged male and female athletes in the United States. Cross-sectional study. Athletic training facilities and gymnasiums across the United States. A total of 3951 male and female athletes who participated on high school-sponsored basketball, football, lacrosse, or soccer teams enrolled in this nationwide study. Functional performance testing consisted of 3 evaluations. Ankle-joint range of motion, balance, and lower extremity muscular power and landing control were assessed via the weight-bearing ankle-dorsiflexion-lunge, single-legged anterior-reach, and anterior single-legged hop-for-distance (SLHOP) tests, respectively. We used 2-way analyses of variance and χ 2 analyses to examine the effects of sex and grade level on ankle-dorsiflexion-lunge, single-legged anterior-reach, and SLHOP test performance and symmetry. The SLHOP performance differed between sexes (males = 187.8% ± 33.1% of limb length, females = 157.5% ± 27.8% of limb length; t = 30.3, P < .001). A Cohen d value of 0.97 indicated a large effect of sex on SLHOP performance. We observed differences for SLHOP and ankle-dorsiflexion-lunge performance among grade levels, but these differences were not clinically meaningful. We demonstrated differences in normative data for lower extremity functional performance during preparticipation physical evaluations across sex and grade levels. The results of this study will allow clinicians to compare sex- and grade-specific functional
"You should (not) do that": An Evaluative Model of Normative Appeals (EMNA).
Oceja, Luis; Villegas, Marisol; Beramendi, Maite; Salgado, Sergio
2016-01-01
Normative appeals refer to those messages that indicate that one should (or should not) engage in a certain action in a given situation. According to the psychosocial research, the decision to fulfill a normative appeal depends on both the extent to which it has captured our attention and the evaluation of what we may gain or lose by doing so. However, according to the Evaluative Model of Normative Appeals (EMNA), between these two processes we carry out an evaluation (normative appraisal) that strongly influences the decision that is ultimately made. Specifically, this normative appraisal, which is done in accordance with the dimensions of formality and protection, transforms the appeal into a particular normative representation (i.e., custom, coercive law, prescription, or legitimate law) that, in turn, influences the willingness toward compliance or violation. The results of three studies support these basic premises of EMNA.
Lohmander, Anette; Lundeborg, Inger; Persson, Christina
2017-01-01
Normative language-based data are important for comparing speech performances of clinical groups. The Swedish Articulation and Nasality Test (SVANTE) was developed to enable a detailed speech assessment. This study's aim was to present normative data on articulation and nasality in Swedish speakers. Single word production, sentence repetition and connected speech were collected using SVANTE in 443 individuals. Mean (SD) and prevalences in the groups of 3-, 5-, 7-, 10-, 16- and 19-year-olds were calculated from phonetic transcriptions or ordinal rating. For the 3- and 5-year-olds, a consonant inventory was also determined. The mean percent of oral consonants correct ranged from 77% at age 3 to 99% at age 19. At age 5, a mean of 96% was already reached, and the consonant inventory was established except for /s/, /r/, /ɕ/. The norms on the SVANTE, also including a short version, will be useful in the interpretation of speech outcomes.
Systemic Lisbon Battery: Normative Data for Memory and Attention Assessments.
Gamito, Pedro; Morais, Diogo; Oliveira, Jorge; Ferreira Lopes, Paulo; Picareli, Luís Felipe; Matias, Marcelo; Correia, Sara; Brito, Rodrigo
2016-05-04
Memory and attention are two cognitive domains pivotal for the performance of instrumental activities of daily living (IADLs). The assessment of these functions is still widely carried out with pencil-and-paper tests, which lack ecological validity. The evaluation of cognitive and memory functions while the patients are performing IADLs should contribute to the ecological validity of the evaluation process. The objective of this study is to establish normative data from virtual reality (VR) IADLs designed to activate memory and attention functions. A total of 243 non-clinical participants carried out a paper-and-pencil Mini-Mental State Examination (MMSE) and performed 3 VR activities: art gallery visual matching task, supermarket shopping task, and memory fruit matching game. The data (execution time and errors, and money spent in the case of the supermarket activity) was automatically generated from the app. Outcomes were computed using non-parametric statistics, due to non-normality of distributions. Age, academic qualifications, and computer experience all had significant effects on most measures. Normative values for different levels of these measures were defined. Age, academic qualifications, and computer experience should be taken into account while using our VR-based platform for cognitive assessment purposes. ©Pedro Gamito, Diogo Morais, Jorge Oliveira, Paulo Ferreira Lopes, Luís Felipe Picareli, Marcelo Matias, Sara Correia, Rodrigo Brito. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 04.05.2016.
Lam, Ngee Wei; Goh, Hui Ting; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Poi, Philip Jun Hua; Tan, Maw Pin
2016-10-01
Hand strength is a good indicator of physical fitness and frailty among the elderly. However, there are no published hand strength references for Malaysians aged > 65 years. This study aimed to establish normative data for hand grip strength (HGS) and key pinch strength (KPS) for Malaysians aged ≥ 60 years, and explore the relationship between hand strength and physical ability. Healthy participants aged ≥ 60 years with no neurological conditions were recruited from rural and urban locations in Malaysia. HGS and KPS were measured using hand grip and key pinch dynamometers. Basic demographic data, anthropometric measures, modified Barthel Index scores and results of the Functional Reach Test (FRT), Timed Up and Go (TUG) test and Jebsen-Taylor Hand Function Test (JTHFT) were recorded. 362 subjects aged 60-93 years were recruited. The men were significantly stronger than the women in both HGS and KPS (p < 0.001). The hand strength of the study cohort was lower than that of elderly Western populations. Significant correlations were observed between hand strength, and residential area (p < 0.001), FRT (r = 0.236, p = 0.028), TUG (r = -0.227, p = 0.009) and JTHFT (r = -0.927, p < 0.001). This study established reference ranges for the HGS and KPS of rural and urban elderly Malaysian subpopulations. These will aid the use of hand strength as a screening tool for frailty among elderly persons in Malaysia. Future studies are required to determine the modifiable factors for poor hand strength. Copyright: © Singapore Medical Association
Lam, Ngee Wei; Goh, Hui Ting; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Poi, Philip Jun Hua; Tan, Maw Pin
2016-01-01
INTRODUCTION Hand strength is a good indicator of physical fitness and frailty among the elderly. However, there are no published hand strength references for Malaysians aged > 65 years. This study aimed to establish normative data for hand grip strength (HGS) and key pinch strength (KPS) for Malaysians aged ≥ 60 years, and explore the relationship between hand strength and physical ability. METHODS Healthy participants aged ≥ 60 years with no neurological conditions were recruited from rural and urban locations in Malaysia. HGS and KPS were measured using hand grip and key pinch dynamometers. Basic demographic data, anthropometric measures, modified Barthel Index scores and results of the Functional Reach Test (FRT), Timed Up and Go (TUG) test and Jebsen-Taylor Hand Function Test (JTHFT) were recorded. RESULTS 362 subjects aged 60–93 years were recruited. The men were significantly stronger than the women in both HGS and KPS (p < 0.001). The hand strength of the study cohort was lower than that of elderly Western populations. Significant correlations were observed between hand strength, and residential area (p < 0.001), FRT (r = 0.236, p = 0.028), TUG (r = −0.227, p = 0.009) and JTHFT (r = −0.927, p < 0.001). CONCLUSION This study established reference ranges for the HGS and KPS of rural and urban elderly Malaysian subpopulations. These will aid the use of hand strength as a screening tool for frailty among elderly persons in Malaysia. Future studies are required to determine the modifiable factors for poor hand strength. PMID:26768064
VA Telemedicine: An Analysis of Cost and Time Savings.
Russo, Jack E; McCool, Ryan R; Davies, Louise
2016-03-01
The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time. All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed. Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients. Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.
Normative arguments from experts and peers reduce delay discounting.
Senecal, Nicole; Wang, Teresa; Thompson, Elizabeth; Kable, Joseph W
2012-09-01
When making decisions that involve tradeoffs between the quality and timing of desirable outcomes, people consistently discount the value of future outcomes. A puzzling finding regarding such decisions is the extremely high rate at which people discount future monetary outcomes. Most economists would argue that decision-makers should only turn down rates of return that are lower than those available to them elsewhere. Yet the vast majority of studies find discount rates that are significantly higher than market interest rates (Frederick et al., 2002). Here we ask whether a lack of knowledge about the normative strategy can explain high discount rates. In an initial experiment, we find that nearly half of subjects do not spontaneously cite elements of the normative strategy when asked how people should make intertemporal monetary decisions. In two follow-up experiments, we find that after subjects read a "financial guide" detailing the normative strategy, discount rates declined by up to 85%, but were still higher than market interest rates. This decline persisted, though attenuated, for at least one month. In a final experiment, we find that peer-generated advice influences discount rates in a similar manner to "expert" advice, and that arguments focusing on normative considerations are at least as effective as others. These studies show that part of the explanation for high discount rates is a lack of knowledge regarding the normative strategy, and quantify how much discount rates are reduced in response to normative arguments. Given the high level of discounting that remains, however, there are other contributing factors to high discount rates that remain to be quantified.
Normative arguments from experts and peers reduce delay discounting
Senecal, Nicole; Wang, Teresa; Thompson, Elizabeth; Kable, Joseph W
2013-01-01
When making decisions that involve tradeoffs between the quality and timing of desirable outcomes, people consistently discount the value of future outcomes. A puzzling finding regarding such decisions is the extremely high rate at which people discount future monetary outcomes. Most economists would argue that decision-makers should only turn down rates of return that are lower than those available to them elsewhere. Yet the vast majority of studies find discount rates that are significantly higher than market interest rates (Frederick et al., 2002). Here we ask whether a lack of knowledge about the normative strategy can explain high discount rates. In an initial experiment, we find that nearly half of subjects do not spontaneously cite elements of the normative strategy when asked how people should make intertemporal monetary decisions. In two follow-up experiments, we find that after subjects read a “financial guide” detailing the normative strategy, discount rates declined by up to 85%, but were still higher than market interest rates. This decline persisted, though attenuated, for at least one month. In a final experiment, we find that peer-generated advice influences discount rates in a similar manner to “expert” advice, and that arguments focusing on normative considerations are at least as effective as others. These studies show that part of the explanation for high discount rates is a lack of knowledge regarding the normative strategy, and quantify how much discount rates are reduced in response to normative arguments. Given the high level of discounting that remains, however, there are other contributing factors to high discount rates that remain to be quantified. PMID:23596504
77 FR 58773 - Drawbridge Operation Regulations; James River, Newport News, VA
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-24
... Operation Regulations; James River, Newport News, VA AGENCY: Coast Guard, DHS. ACTION: Notice of temporary... schedule that governs the US 17/258 Bridge across the James River, mile 5.0, at Newport News, VA. The... 17/258 Bridge over the James River, mile 5.0, at Newport News, VA opens on signal as required by 33...
Community Veterans' Decision to Use VA Services: A Multimethod Veteran Health Partnership Study.
Franco, Zeno E; Logan, Clinton; Flower, Mark; Curry, Bob; Ruffalo, Leslie; Brazauskas, Ruta; Whittle, Jeff
2016-01-01
Ensuring veterans' access to healthcare is a national priority. Prior studies of veterans' use of Veterans Health Administration (VA) healthcare have had limited success in evaluating barriers to access for certain vulnerable veteran subpopulations. Our coalition of researchers and veteran community members sought to understand factors affecting use of VA, particularly for those less likely to participate in traditional survey studies. We recruited 858 veterans to complete a collaboratively designed survey at community events or via social media. We compared our results regarding VA use with the 2010 National Survey of Veterans (NSV) using chi-square tests, multiple logistic regression to identify predictors of VA use, and content analysis for open-ended descriptions of barriers to VA use. Veterans in our study were more likely than NSV respondents to report using VA healthcare ever (76% vs. 28%; p<0.0001). Within this group, more veterans in our sample were current VA users (83% vs. 68%; p<0.0001). In multivariable analysis, VA use was predicted by self-reported physical problems (comparing "a lot" vs. "none" for each variable, adjusted odds ratio [OR], 8.35), thinking problems (OR, 1.14), need for smoking cessation (OR, 1.54), need for pain management (OR, 1.65), and need for other mental health services (OR, 3.04). We identified 15 themes summarizing veterans' perceived barriers to VA use. Persistent actual and perceived barriers prevent some veterans from using VA services. The VA can better understand and address these issues through community-academic partnerships with veterans' organizations.
ERIC Educational Resources Information Center
Westenberg, P. Michiel; Gullone, Eleonora; Bokhorst, Caroline L.; Heyne, David A.; King, Neville J.
2007-01-01
Using cross-sectional (N=910) and longitudinal (N = 261) data from Gullone and King's (1993,1997) studies of normal fear in children and adolescents aged 7 to 18 years, the normative developmental pattern of social evaluation fear and the continuity of individual differences were investigated. Participants' responses were analysed according to two…
38 CFR 74.27 - How will VA store information?
Code of Federal Regulations, 2012 CFR
2012-07-01
... information? 74.27 Section 74.27 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information? VA intends to store records provided to complete the VetBiz Vendor Information Pages registration fully...
38 CFR 74.27 - How will VA store information?
Code of Federal Regulations, 2011 CFR
2011-07-01
... information? 74.27 Section 74.27 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information? VA intends to store records provided to complete the VetBiz Vendor Information Pages registration fully...
38 CFR 74.27 - How will VA store information?
Code of Federal Regulations, 2013 CFR
2013-07-01
... information? 74.27 Section 74.27 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information? VA intends to store records provided to complete the VetBiz Vendor Information Pages registration fully...
38 CFR 74.27 - How will VA store information?
Code of Federal Regulations, 2014 CFR
2014-07-01
... information? 74.27 Section 74.27 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information? VA intends to store records provided to complete the VetBiz Vendor Information Pages registration fully...
A VaR Algorithm for Warrants Portfolio
NASA Astrophysics Data System (ADS)
Dai, Jun; Ni, Liyun; Wang, Xiangrong; Chen, Weizhong
Based on Gamma Vega-Cornish Fish methodology, this paper propose the algorithm for calculating VaR via adjusting the quantile under the given confidence level using the four moments (e.g. mean, variance, skewness and kurtosis) of the warrants portfolio return and estimating the variance of portfolio by EWMA methodology. Meanwhile, the proposed algorithm considers the attenuation of the effect of history return on portfolio return of future days. Empirical study shows that, comparing with Gamma-Cornish Fish method and standard normal method, the VaR calculated by Gamma Vega-Cornish Fish can improve the effectiveness of forecasting the portfolio risk by virture of considering the Gamma risk and the Vega risk of the warrants. The significance test is conducted on the calculation results by employing two-tailed test developed by Kupiec. Test results show that the calculated VaRs of the warrants portfolio all pass the significance test under the significance level of 5%.
NORMATIVE ACCOUNTING THEORY AND THE THEORY OF DECISION,
The paper discusses an approach to the construction of normative accounting theory with respect to both methodology and substance. The method of...postulation and deduction is outlined, with particular emphasis on its role in the social sciences in general and in accounting in particular. It is...suggested that a formal link must be established between the (normative) theory of decision and accounting , and that rigorous (economic) theories of the
Hunger, taste, and normative cues in predictions about food intake.
Vartanian, Lenny R; Reily, Natalie M; Spanos, Samantha; McGuirk, Lucy C; Herman, C Peter; Polivy, Janet
2017-09-01
Normative eating cues (portion size, social factors) have a powerful impact on people's food intake, but people often fail to acknowledge the influence of these cues, instead explaining their food intake in terms of internal (hunger) or sensory (taste) cues. This study examined whether the same biases apply when making predictions about how much food a person would eat. Participants (n = 364) read a series of vignettes describing an eating scenario and predicted how much food the target person would eat in each situation. Some scenarios consisted of a single eating cue (hunger, taste, or a normative cue) that would be expected to increase intake (e.g., high hunger) or decrease intake (e.g., a companion who eats very little). Other scenarios combined two cues that were in conflict with one another (e.g., high hunger + a companion who eats very little). In the cue-conflict scenarios involving an inhibitory internal/sensory cue (e.g., low hunger) with an augmenting normative cue (e.g., a companion who eats a lot), participants predicted a low level of food intake, suggesting a bias toward the internal/sensory cue. For scenarios involving an augmenting internal/sensory cue (e.g., high hunger) and an inhibitory normative cue (e.g., a companion who eats very little), participants predicted an intermediate level of food intake, suggesting that they were influenced by both the internal/sensory and normative cue. Overall, predictions about food intake tend to reflect a general bias toward internal/sensory cues, but also include normative cues when those cues are inhibitory. If people are systematically biased toward internal, sensory, and inhibitory cues, then they may underestimate how much food they or other people will eat in many situations, particularly when normative cues promoting eating are present. Copyright © 2017 Elsevier Ltd. All rights reserved.
Hamilton, Alison B; Frayne, Susan M; Cordasco, Kristina M; Washington, Donna L
2013-07-01
While prior research characterizes women Veterans' barriers to accessing and using Veterans Health Administration (VA) care, there has been little attention to women who access VA and use services, but then discontinue use. Recent data suggest that among women Veterans, there is a 30 % attrition rate within 3 years of initial VA use. To compare individual characteristics and perceptions about VA care between women Veteran VA attriters (those who discontinue use) and non-attriters (those who continue use), and to compare recent versus remote attriters. Cross-sectional, population-based 2008-2009 national telephone survey. Six hundred twenty-six attriters and 2,065 non-attriters who responded to the National Survey of Women Veterans. Population weighted demographic, military and health characteristics; perceptions about VA healthcare; length of time since last VA use; among attriters, reasons for no longer using VA care. Fifty-four percent of the weighted VA ever user population reported that they no longer use VA. Forty-five percent of attrition was within the past ten years. Attriters had better overall health (p = 0.007), higher income (p < 0.001), and were more likely to have health insurance (p < 0.001) compared with non-attriters. Attriters had less positive perceptions of VA than non-attriters, with attriters having lower ratings of VA quality and of gender-specific features of VA care (p < 0.001). Women Veterans who discontinued VA use since 2001 did not differ from those with more remote VA use on most measures of VA perceptions. Overall, among attriters, distance to VA sites of care and having alternate insurance coverage were the most common reasons for discontinuing VA use. We found high VA attrition despite recent advances in VA care for women Veterans. Women's attrition from VA could reduce the critical mass of women Veterans in VA and affect current system-wide efforts to provide high-quality care for women Veterans. An understanding of reasons for
Impact of the REACH II and REACH VA Dementia Caregiver Interventions on Healthcare Costs.
Nichols, Linda O; Martindale-Adams, Jennifer; Zhu, Carolyn W; Kaplan, Erin K; Zuber, Jeffrey K; Waters, Teresa M
2017-05-01
Examine caregiver and care recipient healthcare costs associated with caregivers' participation in Resources for Enhancing Alzheimer's Caregivers Health (REACH II or REACH VA) behavioral interventions to improve coping skills and care recipient management. RCT (REACH II); propensity-score matched, retrospective cohort study (REACH VA). Five community sites (REACH II); 24 VA facilities (REACH VA). Care recipients with Alzheimer's disease and related dementias (ADRD) and their caregivers who participated in REACH II study (analysis sample of 110 caregivers and 197 care recipients); care recipients whose caregivers participated in REACH VA and a propensity matched control group (analysis sample of 491). Previously collected data plus Medicare expenditures (REACH II) and VA costs plus Medicare expenditures (REACH VA). There was no increase in VA or Medicare expenditures for care recipients or their caregivers who participated in either REACH intervention. For VA care recipients, REACH was associated with significantly lower total VA costs of care (33.6%). VA caregiver cost data was not available. In previous research, both REACH II and REACH VA have been shown to provide benefit for dementia caregivers at a cost of less than $5/day; however, concerns about additional healthcare costs may have hindered REACH's widespread adoption. Neither REACH intervention was associated with additional healthcare costs for caregivers or patients; in fact, for VA patients, there were significantly lower healthcare costs. The VA costs savings may be related to the addition of a structured format for addressing the caregiver's role in managing complex ADRD care to an existing, integrated care system. These findings suggest that behavioral interventions are a viable mechanism to support burdened dementia caregivers without additional healthcare costs. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Guidelines for appropriate care: the importance of empirical normative analysis.
Berg, M; Meulen, R T; van den Burg, M
2001-01-01
The Royal Dutch Medical Association recently completed a research project aimed at investigating how guidelines for 'appropriate medical care' should be construed. The project took as a starting point that explicit attention should be given to ethical and political considerations in addition to data about costs and effectiveness. In the project, two research groups set out to design guidelines and cost-effectiveness analyses (CEAs) for two circumscribed medical areas (angina pectoris and major depression). Our third group was responsible for the normative analysis. We undertook an explorative, qualitative pilot study of the normative considerations that played a role in constructing the guidelines and CEAs, and simultaneously interviewed specialists about the normative considerations that guided their diagnostic and treatment decisions. Explicating normative considerations, we argue, is important democratically: the issues at stake should not be left to decision analysts and guideline developers to decide. Moreover, it is a necessary condition for a successful implementation of such tools: those who draw upon these tools will only accept them when they can recognize themselves in the considerations implied. Empirical normative analysis, we argue, is a crucial tool in developing guidelines for appropriate medical care.
Comparing VA and private sector healthcare costs for end-stage renal disease.
Hynes, Denise M; Stroupe, Kevin T; Fischer, Michael J; Reda, Domenic J; Manning, Willard; Browning, Margaret M; Huo, Zhiping; Saban, Karen; Kaufman, James S
2012-02-01
Healthcare for end-stage renal disease (ESRD) is intensive, expensive, and provided in both the public and private sector. Using a societal perspective, we examined healthcare costs and health outcomes for Department of Veterans Affairs (VA) ESRD patients comparing those who received hemodialysis care at VA versus private sector facilities. Dialysis patients were recruited from 8 VA medical centers from 2001 through 2003 and followed for 12 months in a prospective cohort study. Patient demographics, clinical characteristics, quality of life, healthcare use, and cost data were collected. Healthcare data included utilization (VA), claims (Medicare), and patient self-report. Costs included VA calculated costs, Medicare dialysis facility reports and reimbursement rates, and patient self-report. Multivariable regression was used to compare costs between patients receiving dialysis at VA versus private sector facilities. The cohort comprised 334 patients: 170 patients in the VA dialysis group and 164 patients in the private sector group. The VA dialysis group had more comorbidities at baseline, outpatient and emergency visits, prescriptions, and longer hospital stays; they also had more conservative anemia management and lower baseline urea reduction ratio (67% vs. 72%; P<0.001), although levels were consistent with guidelines (Kt/V≥1.2). In adjusted analysis, the VA dialysis group had $36,431 higher costs than those in the private sector dialysis group (P<0.001). Continued research addressing costs and effectiveness of care across public and private sector settings is critical in informing health policy options for patients with complex chronic illnesses such as ESRD.
Normative biometrics for fetal ocular growth using volumetric MRI reconstruction.
Velasco-Annis, Clemente; Gholipour, Ali; Afacan, Onur; Prabhu, Sanjay P; Estroff, Judy A; Warfield, Simon K
2015-04-01
To determine normative ranges for fetal ocular biometrics between 19 and 38 weeks gestational age (GA) using volumetric MRI reconstruction. The 3D images of 114 healthy fetuses between 19 and 38 weeks GA were created using super-resolution volume reconstructions from MRI slice acquisitions. These 3D images were semi-automatically segmented to measure fetal orbit volume, binocular distance (BOD), interocular distance (IOD), and ocular diameter (OD). All biometry correlated with GA (Volume, Pearson's correlation coefficient (CC) = 0.9680; BOD, CC = 0.9552; OD, CC = 0.9445; and IOD, CC = 0.8429), and growth curves were plotted against linear and quadratic growth models. Regression analysis showed quadratic models to best fit BOD, IOD, and OD and a linear model to best fit volume. Orbital volume had the greatest correlation with GA, although BOD and OD also showed strong correlation. The normative data found in this study may be helpful for the detection of congenital fetal anomalies with more consistent measurements than are currently available. © 2015 John Wiley & Sons, Ltd. © 2015 John Wiley & Sons, Ltd.
Normative data for distal line bisection and baking tray task.
Facchin, Alessio; Beschin, Nicoletta; Pisano, Alessia; Reverberi, Cristina
2016-09-01
Line bisection is one of the tests used to diagnose unilateral spatial neglect (USN). Despite its wide application, no procedure or norms were available for the distal variant when the task was performed at distance with a laser pointer. Furthermore, the baking tray task was an ecological test aimed at diagnosing USN in a more natural context. The aim of this study was to collect normative values for these two tests in an Italian population. We recruited a sample of 191 healthy subjects with ages ranging from 20 to 89 years. They performed line bisection with a laser pointer on three different line lengths (1, 1.5, and 2 m) at a distance of 3 m. After this task, the subjects performed the baking tray task and a second repetition of line bisection to test the reliability of measurement. Multiple regression analysis revealed no significant effects of demographic variables on the performance of both tests. Normative cut-off values for the two tests were developed using non-parametric tolerance intervals. The results formed the basis for clinical use of these two tools for assessing lateralized performance of patients with brain injury and for diagnosing USN.
Akin, Sakir; Dos Reis Miranda, Dinis; Caliskan, Kadir; Soliman, Osama I; Guven, Goksel; Struijs, Ard; van Thiel, Robert J; Jewbali, Lucia S; Lima, Alexandre; Gommers, Diederik; Zijlstra, Felix; Ince, Can
2017-10-26
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly adopted for the treatment of cardiogenic shock (CS). However, a marker of successful weaning remains largely unknown. Our hypothesis was that successful weaning is associated with sustained microcirculatory function during ECMO flow reduction. Therefore, we sought to test the usefulness of microcirculatory imaging in the same sublingual spot, using incident dark field (IDF) imaging in assessing successful weaning from VA-ECMO and compare IDF imaging with echocardiographic parameters. Weaning was performed by decreasing the VA-ECMO flow to 50% (F 50 ) from the baseline. The endpoint of the study was successful VA-ECMO explantation within 48 hours after weaning. The response of sublingual microcirculation to a weaning attempt (WA) was evaluated. Microcirculation was measured in one sublingual area (single spot (ss)) using CytoCam IDF imaging during WA. Total vessel density (TVDss) and perfused vessel density (PVDss) of the sublingual area were evaluated before and during 50% flow reduction (TVDss F50 , PVDss F50 ) after a WA and compared to conventional echocardiographic parameters as indicators of the success or failure of the WA. Patients (n = 13) aged 49 ± 18 years, who received VA-ECMO for the treatment of refractory CS due to pulmonary embolism (n = 5), post cardiotomy (n = 3), acute coronary syndrome (n = 2), myocarditis (n = 2) and drug intoxication (n = 1), were included. TVDss F50 (21.9 vs 12.9 mm/mm 2 , p = 0.001), PVDss F50 (19.7 vs 12.4 mm/mm 2 , p = 0.01) and aortic velocity-time integral (VTI) at 50% flow reduction (VTI F50 ) were higher in patients successfully weaned vs not successfully weaned. The area under the curve (AUC) was 0.99 vs 0.93 vs 0.85 for TVDss F50 (small vessels) >12.2 mm/mm 2 , left ventricular ejection fraction (LVEF) >15% and aortic VTI >11 cm. Likewise, the AUC was 0.91 vs 0.93 vs 0.85 for the PVDss F50 (all vessels) >14
Evaluation and validity of a LORETA normative EEG database.
Thatcher, R W; North, D; Biver, C
2005-04-01
To evaluate the reliability and validity of a Z-score normative EEG database for Low Resolution Electromagnetic Tomography (LORETA), EEG digital samples (2 second intervals sampled 128 Hz, 1 to 2 minutes eyes closed) were acquired from 106 normal subjects, and the cross-spectrum was computed and multiplied by the Key Institute's LORETA 2,394 gray matter pixel T Matrix. After a log10 transform or a Box-Cox transform the mean and standard deviation of the *.lor files were computed for each of the 2394 gray matter pixels, from 1 to 30 Hz, for each of the subjects. Tests of Gaussianity were computed in order to best approximate a normal distribution for each frequency and gray matter pixel. The relative sensitivity of a Z-score database was computed by measuring the approximation to a Gaussian distribution. The validity of the LORETA normative database was evaluated by the degree to which confirmed brain pathologies were localized using the LORETA normative database. Log10 and Box-Cox transforms approximated Gaussian distribution in the range of 95.64% to 99.75% accuracy. The percentage of normative Z-score values at 2 standard deviations ranged from 1.21% to 3.54%, and the percentage of Z-scores at 3 standard deviations ranged from 0% to 0.83%. Left temporal lobe epilepsy, right sensory motor hematoma and a right hemisphere stroke exhibited maximum Z-score deviations in the same locations as the pathologies. We conclude: (1) Adequate approximation to a Gaussian distribution can be achieved using LORETA by using a log10 transform or a Box-Cox transform and parametric statistics, (2) a Z-Score normative database is valid with adequate sensitivity when using LORETA, and (3) the Z-score LORETA normative database also consistently localized known pathologies to the expected Brodmann areas as an hypothesis test based on the surface EEG before computing LORETA.
Thankamony, Ajay; Lek, Ngee; Carroll, Dan; Williams, Martyn; Dunger, David B.; Acerini, Carlo L.; Ong, Ken K.
2013-01-01
Background: Anogenital distance (AGD) in animals is a sensitive biomarker of fetal endocrine disruption and the associated testicular dysgenesis syndrome (TDS). However, AGD in human infants with cryptorchidism and hypospadias, which are potential manifestations of TDS during childhood, is not clearly described. Objective: Our aim was to compare AGD in boys with cryptorchidism or hypospadias against normative data. Methods: Boys with isolated cryptorchidism (n = 71, age 13.4 ± 5.8 months) or hypospadias (n = 81, age 11.4 ± 6.2 months) were recruited from a tertiary center for measurement of AGD and penile length; they were compared with 487 healthy full-term boys from a birth cohort by deriving age-specific standard deviation scores (SDS). Results: Boys with cryptorchidism were older (p = 0.048) compared with boys with hypospadias. Boys with hypospadias had shorter mean AGD and penile length SDS than healthy boys (both p < 0.0001). Mean AGD and penile length SDS values in boys with cryptorchidism were longer than mean values in boys with hypospadias (both p < 0.01) and shorter than mean values in healthy boys (both p < 0.0001). Mean penile length SDS decreased as the severity of hypospadias increased (ptrend = 0.078). Conclusions: In the study population, AGD and penile length were reduced in boys with hypospadias or cryptorchidism relative to normative data derived from a longitudinal birth cohort. The findings support the use of AGD as a quantitative biomarker to examine the prenatal effects of exposure to endocrine disruptors on the development of the male reproductive tract. Citation: Thankamony A, Lek N, Carroll D, Williams M, Dunger DB, Acerini CL, Ong KK, Hughes IA. 2014. Anogenital distance and penile length in infants with hypospadias or cryptorchidism: comparison with normative data. Environ Health Perspect 122:207–211; http://dx.doi.org/10.1289/ehp.1307178 PMID:24316680
Normativity and Desirability in Observational Assessments of Family Interaction.
Deal, James E
2018-06-11
Issues of normativity (responding in a typical or average fashion) and desirability (the tendency for raters to endorse positive characteristics rather than neutral or more negative ones) are common in areas of the social sciences that frequently utilize profile correlations to measure dyadic similarity. They have implications for family scholars as well. In the present study, a pre-existing data set was used to make an initial, though limited, investigation into potential confounds of normativity and desirability for macrolevel observational assessments of family interaction. An empirical example is presented using q-sort ratings of family interaction, with variance in observational assessments decomposed into component parts. High levels of both normativity and desirability were found, indicating possible problems in terms of both reliability and validity of assessment. While the results provide an interesting beginning, they are limited due to the use of a q-sort methodology as well as an instrument with limited background and use. These limitations are discussed, as well as alternative interpretations for normativity and desirability and implications for future research. © 2018 Family Process Institute.
32 CFR 105.10 - SARC and SAPR VA procedures.
Code of Federal Regulations, 2014 CFR
2014-07-01
... CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105.10 SARC and SAPR VA procedures. (a) SARC procedures. The SARC shall: (1) Serve as the single point of contact to coordinate sexual assault response when a sexual assault is reported. All SARCs shall be authorized to perform VA duties in...
32 CFR 105.10 - SARC and SAPR VA procedures.
Code of Federal Regulations, 2013 CFR
2013-07-01
... CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105.10 SARC and SAPR VA procedures. (a) SARC procedures. The SARC shall: (1) Serve as the single point of contact to coordinate sexual assault response when a sexual assault is reported. All SARCs shall be authorized to perform VA duties in...
Job satisfaction and burnout among VA and community mental health workers.
Salyers, Michelle P; Rollins, Angela L; Kelly, Yu-Fan; Lysaker, Paul H; Williams, Jane R
2013-03-01
Building on two independent studies, we compared burnout and job satisfaction of 66 VA staff and 86 community mental health center staff in the same city. VA staff reported significantly greater job satisfaction and accomplishment, less emotional exhaustion and lower likelihood of leaving their job. Sources of work satisfaction were similar (primarily working with clients, helping/witnessing change). VA staff reported fewer challenges with job-related aspects (e.g. flexibility, pay) but more challenges with administration. Community mental health administrators and policymakers may need to address job-related concerns (e.g. pay) whereas VA administrators may focus on reducing, and helping workers navigate, administrative policies.
48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...
48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...
48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...
48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...
48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hu, H.; Kim, Rokho; Korrick, S.
1996-12-31
In an earlier report based on participants in the Veterans Administration Normative Aging Study, we found a significant association between the risk of hypertension and lead levels in tibia. To examine the possible confounding effects of education and occupation, we considered in this study five levels of education and three levels of occupation as independent variables in the statistical model. Of 1,171 active subjects seen between August 1991 and December 1994, 563 provided complete data for this analysis. In the initial logistic regression model, acre and body mass index, family history of hypertension, and dietary sodium intake, but neither cumulativemore » smoking nor alcohol ingestion, conferred increased odds ratios for being hypertensive that were statistically significant. When the lead biomarkers were added separately to this initial logistic model, tibia lead and patella lead levels were associated with significantly elevated odds ratios for hypertension. In the final backward elimination logistic regression model that included categorical variables for education and occupation, the only variables retained were body mass index, family history of hypertension, and tibia lead level. We conclude that education and occupation variables were not confounding the association between the lead biomarkers and hypertension that we reported previously. 27 refs., 3 tabs.« less
McDonald-Miszczak, L; Hunter, M A; Hultsch, D F
1994-03-01
Two experiments addressed the effects of task information and experience on younger and older adults' ability to predict their memory for words. The first study examined the effects of normative task information on subjects' predictions for 30-word lists across three trials. The second study looked at the effects of making predictions and recalling either an easy (15) or a difficult (45) word list prior to making predictions and recalling a moderately difficult (30) word list. The results from both studies showed that task information and experience affected subjects' predictions and that elderly adults predicted their performance more accurately than younger adults.
Normative Reference Values for Handgrip Strength in Colombian Schoolchildren: The FUPRECOL Study.
Ramírez-Vélez, Robinson; Morales, Olimpo; Peña-Ibagon, Jhonatan C; Palacios-López, Adalberto; Prieto-Benavides, Daniel H; Vivas, Andrés; Correa-Bautista, Jorge E; Lobelo, Felipe; Alonso-Martínez, Alicia M; Izquierdo, Mikel
2017-01-01
Ramírez-Vélez, R, Morales, O, Peña-Ibagon, JC, Palacios-López, A, Prieto-Benavides, DH, Vivas, A, Correa-Bautista, JE, Lobelo, F, Alonso-Martínez, AM, and Izquierdo, M. Normative reference values for handgrip strength in Colombian schoolchildren: the FUPRECOL study. J Strength Cond Res 31(1): 217-226, 2017-The primary aim of this study was to generate normative handgrip (HG) strength data for 10 to 17.9 year olds. The secondary aim was to determine the relative proportion of Colombian children and adolescents that fall into established Health Benefit Zones (HBZ). This cross-sectional study enrolled 7,268 schoolchildren (boys n = 3,129 and girls n = 4,139, age 12.7 [2.4] years). Handgrip was measured using a hand dynamometer with an adjustable grip. Five HBZs (Needs Improvement, Fair, Good, Very Good, and Excellent) have been established that correspond to combined HG. Centile smoothed curves, percentile, and tables for the third, 10th, 25th, 50th, 75th, 90th, and 97th percentile were calculated using Cole's LMS method. Handgrip peaked in the sample at 22.2 (8.9) kg in boys and 18.5 (5.5) kg in girls. The increase in HG was greater for boys than for girls, but the peak HG was lower in girls than in boys. The HBZ data indicated that a higher overall percentage of boys than girls at each age group fell into the "Needs Improvement" zone, with differences particularly pronounced during adolescence. Our results provide, for the first time, sex- and age-specific HG reference standards for Colombian schoolchildren aged 9-17.9 years.
Wolthers, Ole D; Mersmann, Sabine; Dissanayake, Sanjeeva
2018-04-01
For more than a decade, urinary free cortisol corrected for creatinine (OUFCC) has been used to assess the systemic bioactivity of inhaled corticosteroids in children with asthma. Paediatric normative ranges, however, have not been established. The aim of the present study was to define a preliminary range for OUFCC in Tanner stage 1 children. A post hoc analysis was performed of 26 Tanner stage one children (aged 5-11 years) with mild asthma only requiring prn (pro re nata) treatment with short-acting β 2 -agonists, who participated in a 3-way cross-over knemometry study. The study comprised a run-in, two washout periods and three treatment periods (2 weeks each). Urine was collected at the end of each period. A normative range was derived using the 95% prediction interval for the geometric mean OUFCC, calculated from run-in and washout periods. Twenty-six children contributed 41 OUFCC values. The geometric mean OUFCC was 9.0 nmol/mmol (95% PI: 3.6, 22.7 nmol/mmol). The OUFCC preliminary normative range was 3.6 to 22.7 nmol/mmol in Tanner stage one children. A larger study in healthy children is warranted to confirm these findings and to assess potential differences in OUFCC across developmental stages and age groups, and by gender and race. 2013-004719-32, CLINICALTRIALS. NCT02063139.
33 CFR 110.166 - York River, Va., naval anchorage.
Code of Federal Regulations, 2014 CFR
2014-07-01
... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false York River, Va., naval anchorage...
33 CFR 110.166 - York River, Va., naval anchorage.
Code of Federal Regulations, 2013 CFR
2013-07-01
... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false York River, Va., naval anchorage...
33 CFR 110.166 - York River, Va., naval anchorage.
Code of Federal Regulations, 2012 CFR
2012-07-01
... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false York River, Va., naval anchorage...
33 CFR 110.166 - York River, Va., naval anchorage.
Code of Federal Regulations, 2010 CFR
2010-07-01
... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false York River, Va., naval anchorage...
33 CFR 110.166 - York River, Va., naval anchorage.
Code of Federal Regulations, 2011 CFR
2011-07-01
... ANCHORAGES ANCHORAGE REGULATIONS Anchorage Grounds § 110.166 York River, Va., naval anchorage. (a) The anchorage grounds. Between Yorktown and the Naval Mine Depot, beginning at latitude 37°15′34″, longitude 76... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false York River, Va., naval anchorage...
Morey, Leslie C; Lowmaster, Sara E; Coldren, Rodney L; Kelly, Mark P; Parish, Robert V; Russell, Michael L
2011-06-01
The present study examined the normative scores and psychometric properties of the Personality Assessment Inventory (PAI; Morey, 1991) within a non-treatment-seeking sample of soldiers deployed to combat zones in Iraq, compared with a sample of community adults matched with respect to age and gender. Results indicate the scores and properties of the PAI scales were generally quite similar in the Iraq and community samples, with modest differences emerging on only 3 subscales addressing antisocial behavior, issues with close relationships, and interpersonal vigilance. These results suggest that standard normative interpretation of PAI scales is appropriate even when the instrument is administered in a combat zone. In comparison with prior research, the results may suggest that documented mental health issues among combat veterans, when present, may be particularly likely to emerge postdeployment. 2011 APA, all rights reserved
Peterson, Rachel; Gundlapalli, Adi V; Metraux, Stephen; Carter, Marjorie E; Palmer, Miland; Redd, Andrew; Samore, Matthew H; Fargo, Jamison D
2015-01-01
Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.
Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.
2015-01-01
Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386
A Role for Myosin Va in Human Cytomegalovirus Nuclear Egress.
Wilkie, Adrian R; Sharma, Mayuri; Pesola, Jean M; Ericsson, Maria; Fernandez, Rosio; Coen, Donald M
2018-03-15
Herpesviruses replicate and package their genomes into capsids in replication compartments within the nuclear interior. Capsids then move to the inner nuclear membrane for envelopment and release into the cytoplasm in a process called nuclear egress. We previously found that nuclear F-actin is induced upon infection with the betaherpesvirus human cytomegalovirus (HCMV) and is important for nuclear egress and capsid localization away from replication compartment-like inclusions toward the nuclear rim. Despite these and related findings, it has not been shown that any specific motor protein is involved in herpesvirus nuclear egress. In this study, we have investigated whether the host motor protein, myosin Va, could be fulfilling this role. Using immunofluorescence microscopy and coimmunoprecipitation, we observed associations between a nuclear population of myosin Va and the viral major capsid protein, with both concentrating at the periphery of replication compartments. Immunoelectron microscopy showed that nearly 40% of assembled nuclear capsids associate with myosin Va. We also found that myosin Va and major capsid protein colocalize with nuclear F-actin. Importantly, antagonism of myosin Va with RNA interference or a dominant negative mutant revealed that myosin Va is important for the efficient production of infectious virus, capsid accumulation in the cytoplasm, and capsid localization away from replication compartment-like inclusions toward the nuclear rim. Our results lead us to suggest a working model whereby human cytomegalovirus capsids associate with myosin Va for movement from replication compartments to the nuclear periphery during nuclear egress. IMPORTANCE Little is known regarding how newly assembled and packaged herpesvirus capsids move from the nuclear interior to the periphery during nuclear egress. While it has been proposed that an actomyosin-based mechanism facilitates intranuclear movement of alphaherpesvirus capsids, a functional role for
(4015) 1979 VA: 'Missing Link' Discovered
NASA Technical Reports Server (NTRS)
Helin, Eleanor F.
1993-01-01
Apollo Asteroid (4015) 1979 VA was discovered in November of 1979 by Helin at Palomar with the 0.46m Schmidt Telescope. It's orbital elements immediately indicated a possible cometary origin. With an extremely eccentric orbit, it approaches the orbit of Jupiter (at the time, the largest 'Q', aphelion, of any known near-Earth asteroid). Physical observations acquired during the discovery apparition suggested that it was carbonaceous in nature. Research into prediscovery observations of Near-Earth Asteroids (Bowell et. al., 1992) has located Palomar Sky Survey photographic plates taken in 1949 observations of (4015) 1979 VA, not as an asteroid, but rather a small cometary image (IAU Circular Nos. 5585 and 5586, August 13, 1992)...
30 CFR 57.22309 - Methane monitors (V-A mines).
Code of Federal Regulations, 2010 CFR
2010-07-01
... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Methane monitors (V-A mines). 57.22309 Section... Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22309 Methane monitors (V-A mines). (a) Methane monitors shall be installed on continuous mining machines used in or beyond the last open crosscut...
30 CFR 57.22309 - Methane monitors (V-A mines).
Code of Federal Regulations, 2011 CFR
2011-07-01
... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Methane monitors (V-A mines). 57.22309 Section... Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22309 Methane monitors (V-A mines). (a) Methane monitors shall be installed on continuous mining machines used in or beyond the last open crosscut...
Flexural Stiffness of Myosin Va Subdomains as Measured from Tethered Particle Motion
Michalek, Arthur J.; Kennedy, Guy G.; Warshaw, David M.; Ali, M. Yusuf
2015-01-01
Myosin Va (MyoVa) is a processive molecular motor involved in intracellular cargo transport on the actin cytoskeleton. The motor's processivity and ability to navigate actin intersections are believed to be governed by the stiffness of various parts of the motor's structure. Specifically, changes in calcium may regulate motor processivity by altering the motor's lever arm stiffness and thus its interhead communication. In order to measure the flexural stiffness of MyoVa subdomains, we use tethered particle microscopy, which relates the Brownian motion of fluorescent quantum dots, which are attached to various single- and double-headed MyoVa constructs bound to actin in rigor, to the motor's flexural stiffness. Based on these measurements, the MyoVa lever arm and coiled-coil rod domain have comparable flexural stiffness (0.034 pN/nm). Upon addition of calcium, the lever arm stiffness is reduced 40% as a result of calmodulins potentially dissociating from the lever arm. In addition, the flexural stiffness of the full-length MyoVa construct is an order of magnitude less stiff than both a single lever arm and the coiled-coil rod. This suggests that the MyoVa lever arm-rod junction provides a flexible hinge that would allow the motor to maneuver cargo through the complex intracellular actin network. PMID:26770194
Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans
ERIC Educational Resources Information Center
Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.
2008-01-01
Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…
Promoting aging well: evaluation of Vital-Aging-Multimedia Program in Madrid, Spain.
Caprara, Mariagiovanna; Fernández-Ballesteros, Rocío; Alessandri, Guido
2016-09-01
This article attests to the effectiveness of Vital Aging-Multimedia (VA-M, 'Vivir con Vitalidad-M'), a psycho-educational multimedia program designed to promote successful aging. The program was implemented over 3 months through 35 h of video lessons grouped into 15 thematic units addressing four domains of experience commonly associated with aging well: health and healthy habits, cognitive functioning, aging self-efficacy and well-being and social participation. In accordance with a quasi-experimental design, a total of 115 senior citizens (aged 54-82) participated: 73 subjects attended the VA-M, while 42 subjects with similar characteristics served as controls. All subjects were assessed before and after the program on target variables related to the above domains of functioning. Significant changes in most of the examined variables documented the positive effects of the program. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Methodology for the development of normative data for Spanish-speaking pediatric populations.
Rivera, D; Arango-Lasprilla, J C
2017-01-01
To describe the methodology utilized to calculate reliability and the generation of norms for 10 neuropsychological tests for children in Spanish-speaking countries. The study sample consisted of over 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Inclusion criteria for all countries were to have between 6 to 17 years of age, an Intelligence Quotient of≥80 on the Test of Non-Verbal Intelligence (TONI-2), and score of <19 on the Children's Depression Inventory. Participants completed 10 neuropsychological tests. Reliability and norms were calculated for all tests. Test-retest analysis showed excellent or good- reliability on all tests (r's>0.55; p's<0.001) except M-WCST perseverative errors whose coefficient magnitude was fair. All scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the models by country. The non-significant variables (p > 0.05) were removed and the analysis were run again. This is the largest Spanish-speaking children and adolescents normative study in the world. For the generation of normative data, the method based on linear regression models and the standard deviation of residual values was used. This method allows determination of the specific variables that predict test scores, helps identify and control for collinearity of predictive variables, and generates continuous and more reliable norms than those of traditional methods.
Lim, Si Huan; Ang, Rebecca P
2009-01-01
This study examined the contribution of general normative beliefs about aggression and specific normative beliefs about retaliatory aggression in predicting physical, verbal, and indirect aggressive behaviors. Two hundred and forty-nine Grade 4 and Grade 5 boys completed the Normative Beliefs about Aggression Scale (NOBAGS) and provided self-reports on the frequency of their physical, verbal, and indirect aggressive behaviors. A series of hierarchical multiple regression analyses revealed that general normative beliefs about aggression contributed significantly in predicting all three types of aggressive behaviors. When general normative beliefs about aggression were controlled for, specific normative beliefs about retaliatory aggression against males but not specific normative beliefs about retaliatory aggression against females, contributed significantly to predict physical, verbal, and indirect aggressive behaviors. Implications for intervention programs are discussed.
Krahé, Barbara; Busching, Robert
2014-01-01
In a longitudinal study with N = 1,854 adolescents from Germany, we investigated patterns of change and gender differences in physical and relational aggression in relation to normative beliefs about these two forms of aggression. Participants, whose mean age was 13 years at T1, completed self-report measures of physically and relationally aggressive behavior and indicated their normative approval of both forms of aggression at four data waves separated by 12-month intervals. Boys scored higher than did girls on both forms of aggression, but the gender difference was more pronounced for physical aggression. Physical aggression decreased and relational aggression increased over the four data waves in both gender groups. The normative acceptance of both forms of aggression decreased over time, with a greater decrease for the approval of physical aggression. In both gender groups, normative approval of relational aggression prospectively predicted relational aggression across all data waves, and the normative approval of physical aggression predicted physically aggressive behavior at the second and third data waves. A reciprocal reinforcement of aggressive norms and behavior was found for both forms of aggression. The findings are discussed as supporting a social information processing perspective on developmental patterns of change in physical and relational aggression in adolescence. PMID:25360124
Krahé, Barbara; Busching, Robert
2014-01-01
In a longitudinal study with N = 1,854 adolescents from Germany, we investigated patterns of change and gender differences in physical and relational aggression in relation to normative beliefs about these two forms of aggression. Participants, whose mean age was 13 years at T1, completed self-report measures of physically and relationally aggressive behavior and indicated their normative approval of both forms of aggression at four data waves separated by 12-month intervals. Boys scored higher than did girls on both forms of aggression, but the gender difference was more pronounced for physical aggression. Physical aggression decreased and relational aggression increased over the four data waves in both gender groups. The normative acceptance of both forms of aggression decreased over time, with a greater decrease for the approval of physical aggression. In both gender groups, normative approval of relational aggression prospectively predicted relational aggression across all data waves, and the normative approval of physical aggression predicted physically aggressive behavior at the second and third data waves. A reciprocal reinforcement of aggressive norms and behavior was found for both forms of aggression. The findings are discussed as supporting a social information processing perspective on developmental patterns of change in physical and relational aggression in adolescence.
Normative influence on condom use in the personal networks of female cocaine smokers.
Richard, A J; Bell, D C; Montoya, I D
2000-08-01
Attitudes-norms research (the theories of planned behavior and reasoned action) has been successful in accounting for many types of behavior change. One of the strengths of this approach has been to combine individual beliefs and normative influences in the explanation of behavior change. However, the conceptualization of normative influence in these theories makes very strong assumptions about self-awareness in the selection of normative referents. These assumptions are particularly problematic when applied to female cocaine smokers, who report frequent sex while under duress or while cognitively impaired. In this study the original conceptualization of normative influence and two alternatives (assuming emotion-based and interaction-based selection of normative referents) are operationalized to evaluate stage of change for condom use among women who are heavy crack cocaine users with multiple sex partners. Results show that stage of change for use of condoms with nonmain partners is best accounted for by interaction-based selection of normative referents.
Professional quality of life normative benchmarks.
De La Rosa, Gabriel M; Webb-Murphy, Jennifer A; Fesperman, Susan F; Johnston, Scott L
2018-03-01
Those responsible for the care of trauma survivors can experience both beneficial and detrimental consequences resulting from their professional demands. Research has demonstrated that among professional caregivers, compassion satisfaction (CS), burnout (BO), and compassion fatigue (CF) are important factors contributing to professional quality of life. The current research aims to provide normative information regarding the factors contributing to professional quality of life among those who interact with survivors of trauma. The Professional Quality of Life (ProQOL) Scale is a widely used measure of CS, BO, and CF. The most recent iteration of the ProQOL manual provides normative data to assist in the interpretation of scores. However, a review of the literature reporting raw scores on the ProQOL suggests that mean scores and cutoff scores for the 25th and 75th percentiles may be misleading. A review of 30 studies (total sample size of 5,612) was conducted and normative values are presented. The mean (standard deviation) level of CS, CF, and BO were 37.7 (6.5), 16.7 (5.7), and 22.8 (5.4), respectively. Values gathered from the literature review tend to align well with one another and suggest that within a given sample, CS scores tend to be higher than BO scores, and BO scores tend to be slightly higher than CF scores. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Moriwaki, Aiko; Kamio, Yoko
2014-01-21
Although child mental health problems are among the most important worldwide issues, development of culturally acceptable mental health services to serve the clinical needs of children and their families is especially lacking in regions outside Europe and North America. The Strengths and Difficulties Questionnaire (SDQ), which was developed in the United Kingdom and is now one of the most widely used measurement tools for screening child psychiatric symptoms, has been translated into Japanese, but culturally calibrated norms for Japanese schoolchildren have yet to be established. To this end, we examined the applicability of the Japanese versions of the parent and teacher SDQs by establishing norms and extending validation of its psychometric properties to a large nationwide sample, as well as to a smaller clinical sample. The Japanese versions of the SDQ were completed by parents and teachers of schoolchildren aged 7 to 15 years attending mainstream classes in primary or secondary schools in Japan. Data were analyzed to describe the population distribution and gender/age effects by informant, cut-off scores according to banding, factor structure, cross-scale correlations, and internal consistency for 24,519 parent ratings and 7,977 teacher ratings from a large nationwide sample. Inter-rater and test-retest reliabilities and convergent and divergent validities were confirmed for a smaller validation sample (total n = 128) consisting of a clinical sample with any mental disorder and community children without any diagnoses. Means, standard deviations, and banding of normative data for this Japanese child population were obtained. Gender/age effects were significant for both parent and teacher ratings. The original five-factor structure was replicated, and strong cross-scale correlations and internal reliability were shown across all SDQ subscales for this population. Inter-rater agreement was satisfactory, test-retest reliability was excellent, and convergent
48 CFR 803.7000 - Display of the VA Hotline poster.
Code of Federal Regulations, 2011 CFR
2011-10-01
... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline poster...
48 CFR 803.7000 - Display of the VA Hotline poster.
Code of Federal Regulations, 2012 CFR
2012-10-01
... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline poster...
48 CFR 803.7000 - Display of the VA Hotline poster.
Code of Federal Regulations, 2013 CFR
2013-10-01
... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline poster...
48 CFR 803.7000 - Display of the VA Hotline poster.
Code of Federal Regulations, 2014 CFR
2014-10-01
... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline poster...
48 CFR 803.7000 - Display of the VA Hotline poster.
Code of Federal Regulations, 2010 CFR
2010-10-01
... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline poster...
77 FR 38181 - VA Veteran-Owned Small Business Verification Guidelines
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-27
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 74 RIN 2900-AO49 VA Veteran-Owned Small Business... small businesses (VOSBs), including service-disabled veteran-owned small businesses (SDVOSBs) in order...- AO49--VA Veteran-Owned Small Business Verification Guidelines.'' All comments received will be...
78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan
Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-12
... and access to benefits and services through integration within VA and with our partners; and... integration within VA and with our partners; and developing our workforce with the skills, tools, and... program to coordination and integration across programs and organizations, measuring performance by the...
Age, Race, and Gender Differences in Depressive Symptoms: A Lifespan Developmental Investigation
ERIC Educational Resources Information Center
Bracken, Bruce A.; Reintjes, Cristina
2010-01-01
This study considered depressive symptoms among a normative sample of 1,900 children, adolescents, and adults (950 males and 950 females) divided across four age-levels to investigate the developmental progression of depressive symptoms by age, race/ethnicity, and gender. The national normative sample of the Clinical Assessment of Depression (CAD)…
'Nobody tosses a dwarf!' The relation between the empirical and the normative reexamined.
Leget, Carlo; Borry, Pascal; de Vries, Raymond
2009-05-01
This article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as a point of departure because it challenges the reader to look with fresh eyes upon several central bioethical themes, including human dignity, autonomy, and the protection of vulnerable people. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak to the problem of dwarf tossing: prescriptive applied ethics, theoretical ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two-way relation between empirical and normative theories. Against efforts fully to integrate the normative and the empirical into one synthesis, we propose that the two should stand in tension and relation to one another. The approach we endorse acknowledges that a social practice can and should be judged both by the gathering of empirical data and by normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical point of view. We conclude by applying our five-stage critical applied ethics to the example of dwarf tossing.
A Proposal for More Sophisticated Normative Principles in Introductory Economics
ERIC Educational Resources Information Center
Schmidt, Stephen
2017-01-01
Introductory textbooks teach a simple normative story about the importance of maximizing economic surplus that supports common policy claims. There is little defense of the claim that maximizing surplus is normatively important, which is not obvious to non-economists. Difficulties with the claim that society should maximize surplus are generally…
The disorganized family: institutions, practices and normativity.
Smyth, Lisa
2016-12-01
This paper considers the value of a normative account of the relationship between agents and institutions for contemporary efforts to explain ever more complex and disorganized forms of social life. The character of social institutions, as they relate to practices, agents and norms, is explored through an engagement with the common claim that family life has been de-institutionalized. The paper argues that a normative rather than empirical definition of institutions avoids a false distinction between institutions and practices. Drawing on ideas of social freedom and creative action from critical theory, the changes in family life are explained not as an effect of de-institutionalization, but as a shift from an organized to a disorganized institutional type. This is understood as a response to changes in the wider normative structure, as a norm of individual freedom has undermined the legitimacy of the organized patriarchal nuclear family, with gender ascribed roles and associated duties. Contemporary motherhood is drawn on to illustrate the value of analysing the dynamic interactions between institutions, roles and practices for capturing both the complexity and the patterned quality of social experience. © London School of Economics and Political Science 2016.
38 CFR 26.7 - VA environmental decision making and documents.
Code of Federal Regulations, 2010 CFR
2010-07-01
... environmental decision making and documents. (a) Relevant environmental documents shall accompany other decision documents as they proceed through the decision-making process. (b) The major decision points for VA actions... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA environmental decision...
38 CFR 26.9 - Information on and public participation in VA environmental process.
Code of Federal Regulations, 2010 CFR
2010-07-01
... participation in VA environmental process. 26.9 Section 26.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During the...
Case-mix groups for VA hospital-based home care.
Smith, M E; Baker, C R; Branch, L G; Walls, R C; Grimes, R M; Karklins, J M; Kashner, M; Burrage, R; Parks, A; Rogers, P
1992-01-01
The purpose of this study is to group hospital-based home care (HBHC) patients homogeneously by their characteristics with respect to cost of care to develop alternative case mix methods for management and reimbursement (allocation) purposes. Six Veterans Affairs (VA) HBHC programs in Fiscal Year (FY) 1986 that maximized patient, program, and regional variation were selected, all of which agreed to participate. All HBHC patients active in each program on October 1, 1987, in addition to all new admissions through September 30, 1988 (FY88), comprised the sample of 874 unique patients. Statistical methods include the use of classification and regression trees (CART software: Statistical Software; Lafayette, CA), analysis of variance, and multiple linear regression techniques. The resulting algorithm is a three-factor model that explains 20% of the cost variance (R2 = 20%, with a cross validation R2 of 12%). Similar classifications such as the RUG-II, which is utilized for VA nursing home and intermediate care, the VA outpatient resource allocation model, and the RUG-HHC, utilized in some states for reimbursing home health care in the private sector, explained less of the cost variance and, therefore, are less adequate for VA home care resource allocation.
Semi-nonparametric VaR forecasts for hedge funds during the recent crisis
NASA Astrophysics Data System (ADS)
Del Brio, Esther B.; Mora-Valencia, Andrés; Perote, Javier
2014-05-01
The need to provide accurate value-at-risk (VaR) forecasting measures has triggered an important literature in econophysics. Although these accurate VaR models and methodologies are particularly demanded for hedge fund managers, there exist few articles specifically devoted to implement new techniques in hedge fund returns VaR forecasting. This article advances in these issues by comparing the performance of risk measures based on parametric distributions (the normal, Student’s t and skewed-t), semi-nonparametric (SNP) methodologies based on Gram-Charlier (GC) series and the extreme value theory (EVT) approach. Our results show that normal-, Student’s t- and Skewed t- based methodologies fail to forecast hedge fund VaR, whilst SNP and EVT approaches accurately success on it. We extend these results to the multivariate framework by providing an explicit formula for the GC copula and its density that encompasses the Gaussian copula and accounts for non-linear dependences. We show that the VaR obtained by the meta GC accurately captures portfolio risk and outperforms regulatory VaR estimates obtained through the meta Gaussian and Student’s t distributions.
NASA Technical Reports Server (NTRS)
Vetter, Scott K.; Shervais, John W.
1993-01-01
Early studies of mare basalts from the Apollo 15 site established that two distinct groups are represented: the olivine-normative basalts (ONB) and the quartz-normative basalts (QNB). The ONB and QNB suites are distinguished petrographically by their phenocryst assemblages (the ONB's are olivine-phyric, the QNB's are generally pyroxene-phyric) and chemically by their major element compositions: the QNB's are higher in SiO2 and MgO/FeO, and lower in FeO and TiO2 than ONB's with similar MgO contents. Experimental data show that the QNB suite is derived from a more magnesian, olivine-normative parent magma, a conclusion which is supported by the recent discovery of high-SiO2 olivine-normative basalt clasts in breccia 15498. The high-SiO2 ONB's fall on olivine control lines with primitive QNB's, and least-squares mixing calculations are consistent with the high-SiO2 ONB's being parental to the more evolved QNB suite. These high-SiO2 ONB's are included as part of the 'QNB suite'. Our major element modeling results also are consistent with the conclusions of earlier studies which showed that the ONB and QNB suites cannot be related to one another by low pressure crystal fractionation. The combination of high Mg#, high SiO2, and low TiO2 in the QNB suite precludes a relationship to the ONB suite by simple removal of liquidus minerals (olivine and pigeonite). Despite these significant differences in petrography and major element composition, both groups have nearly identical trace element concentrations and chondrite-normalized abundance patterns. The major question to be addressed by any petrogenetic model for Apollo 15 mare basalts is how to form mare basalt suites with distinctly different major element characteristics but nearly identical trace element compositions. The similarity in trace element concentrations imply compositionally similar source regions and similar percent melting, but these conclusions are not easily reconciled with the observed differences in
78 FR 71041 - VA Compensation and Pension Regulation Rewrite Project
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-27
...The Department of Veterans Affairs (VA) proposes to reorganize and rewrite its compensation and pension regulations in a logical, claimant-focused, and user-friendly format. The intended effect of the proposed revisions is to assist claimants, beneficiaries, veterans' representatives, and VA personnel in locating and understanding these regulations.
38 CFR 17.66 - Notice of noncompliance with VA standards.
Code of Federal Regulations, 2010 CFR
2010-07-01
... AFFAIRS MEDICAL Community Residential Care § 17.66 Notice of noncompliance with VA standards. If the hearing official determines that an approved community residential care facility does not comply with the... standards must be met in order to avoid revocation of VA approval; (c) The community residential care...
Messinis, Lambros; Tsakona, Ioanna; Malefaki, Sonia; Papathanasopoulos, Panagiotis
2007-08-01
The present study sought to establish normative and discriminant validity data for Rey's Auditory Verbal Learning Test [Rey, A. (1964). L 'examen clinique en psychologie [Clinical tests in psychology]. Paris: Presses Universitaires de France; Schmidt, M. (1996). Rey auditory verbal learning test: A handbook. Los Angeles, CA: Western Psychological Services] using newly adapted learning lists for the Greek adult population. Applying the procedure suggested by Geffen et al. [Geffen, G., Moar, K. J., O'Hanlon, A. P., Clark, C. R., & Geffen, L. N. (1990). Performance measures of 16-86-year-old males and females on the auditory verbal learning test. The Clinical Neuropsychologist, 4, 45-63] we administered the test to 205 healthy participants, aged 18-78 years and two adult patient groups (long-term cannabis users and HIV symptomatic patients). Stepwise linear regression analyses showed that the variables age, education and gender contributed significantly to most trials of the RAVLT. Performance decreased in an age-dependent manner from young adulthood. Women, young adults and higher educated participants outperformed men, older adults and less educated individuals. The test appears to discriminate adequately between the performance of long-term heavy cannabis users and HIV seropositive symptomatic patients and matched healthy controls, as both patient groups performed more poorly than their respective control group. Normative data stratified by age, gender and education for the Greek adult population is presented for use in research and clinical settings.
Roos, Annerine; Calata, Dorothy; Jonkers, Liesl; Maritz, Stephan J; Kidd, Martin; Daniels, Willie M U; Hugo, Frans J
2010-01-01
Normative data for the Tygerberg Cognitive Battery (TCB) and Mini-Mental Status Examination (MMSE) (in South Africa) have not been formally examined before. The TCB was developed for the bedside pen-and-paper screening of cognitive impairment in each of the 6 main cognitive domains, including attention and concentration, speech, memory, praxis, gnosis, and executive functioning. The test is also used to diagnose different neuropsychiatric conditions. The MMSE is an established screen of cognitive status, which is often used as a comparative standard for novel screening tests such as the TCB. The TCB was initially developed in English and Afrikaans, and a Xhosa version was also initiated with this study so that the 3 most common languages of the region could be accommodated. The first aim of the study was to estimate normative test performance on the TCB and MMSE among controls, and the second aim was to develop a Xhosa version of the TCB. Assessments of the TCB and MMSE were carried out in a population of healthy individuals (n = 157). In addition, healthy Xhosa-speaking participants (n = 14) were screened using a Xhosa version of the TCB. Reliability scores for all forms of the TCB were satisfactory. Age and education correlated significantly with TCB scores (r = -0.26, P < .01; r = 0.64, P < .01, respectively), whereas only education significantly correlated with MMSE scores (r = 0.32, P < .05). Normative values were calculated accordingly, that is, controlled for the effects of age and education. The TCB scores also correlated significantly with MMSE scores (r = 0.49, P < .05), demonstrating the potential of the TCB to serve as an alternate cognitive assessment tool, along with the MMSE, to focus neuropsychiatric investigations. Scores on the Xhosa version differed significantly on speech, praxis, and gnosis between the Afrikaans and English participant scores. These normative data can be used to increase precision and to provide an impartial evaluation when
Ying, Gui-shuang; Huang, Jiayan; Maguire, Maureen G; Jaffe, Glenn J; Grunwald, Juan E; Toth, Cynthia; Daniel, Ebenezer; Klein, Michael; Pieramici, Dante; Wells, John; Martin, Daniel F
2013-01-01
To determine the baseline predictors of visual acuity (VA) outcomes 1 year after treatment with ranibizumab or bevacizumab for neovascular age-related macular degeneration (AMD). Cohort study within the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). A total of 1105 participants with neovascular AMD, baseline VA 20/25 to 20/320, and VA measured at 1 year. Participants were randomly assigned to ranibizumab or bevacizumab on a monthly or as-needed schedule. Masked readers evaluated fundus morphology and features on optical coherence tomography (OCT). Visual acuity was measured using electronic VA testing. Independent predictors were identified using regression techniques. The VA score, VA score change from baseline, and ≥3-line gain at 1 year. At 1 year, the mean VA score was 68 letters, mean improvement from baseline was 7 letters, and 28% of participants gained ≥3 lines. Older age, larger area of choroidal neovascularization (CNV), and elevation of retinal pigment epithelium (RPE) were associated with worse VA (all P<0.005), less gain in VA (all P<0.02), and a lower proportion gaining ≥3 lines (all P<0.04). Better baseline VA was associated with better VA at 1 year, less gain in VA, and a lower proportion gaining ≥3 lines (all P<0.0001). Predominantly or minimally classic lesions were associated with worse VA than occult lesions (66 vs. 69 letters; P=0.0003). Retinal angiomatous proliferans (RAP) lesions were associated with more gain in VA (10 vs. 7 letters; P=0.03) and a higher proportion gaining ≥3 lines (odds ratio, 1.9; 95% confidence interval, 1.2-3.1). Geographic atrophy (GA) was associated with worse VA (64 vs. 68 letters; P=0.02). Eyes with total foveal thickness in the second quartile (325-425 μm) had the best VA (P=0.01) and were most likely to gain ≥3 lines (P=0.004). Predictors did not vary by treatment group. For all treatment groups, older age, better baseline VA, larger CNV area, predominantly or minimally
78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-06
... Hospice Care to Non-VA Providers AGENCY: Department of Veterans Affairs. ACTION: Final rule. SUMMARY: The Department of Veterans Affairs (VA) amends its regulations concerning the billing methodology for non-VA... billing methodology for non-VA providers of home health services and hospice care. The proposed rulemaking...
Hanson, Corrine; Lyden, Elizabeth; Furtado, Jeremy; Campos, Hannia; Sparrow, David; Vokonas, Pantel; Litonjua, Augusto A.
2015-01-01
Background and Aims The results of studies assessing relationships between vitamin E intake and status and lung function are conflicting. This study aimed to evaluate the effect of vitamin E intake and serum levels of tocopherol isoforms on lung function in a cross-sectional sample of 580 men from the Normative Aging Study, a longitudinal aging study. Methods Regression models were used to look at associations of serum tocopherol isoform levels and vitamin E intake with lung function parameters after adjustment for confounders. Vitamin E intake was measured using a food frequency questionnaire and serum levels of γ, α, and δ-tocopherol levels were measured using high-performance liquid chromatography. Results After adjustment for potential confounders, serum γ-tocopherol had a significant inverse association with forced vital capacity (β=-0.10, p=0.05). Alpha and δ-tocopherol were not associated with any lung function parameter. After classifying COPD status according to Global Initiative for Obstructive Lung Disease (GOLD) stage criteria, serum levels of δ-tocopherol were lower in participants with more severe COPD (p=0.01). Serum levels of δ-tocopherol were also lower in participants with greater levels of smoking (p=0.02). Both vitamin E intake (β=0.03, p=0.02; β=0.03, p=0.01) and use of vitamin E supplements (β=0.05, p=0.03; β=0.06. p=0.02) were positively associated with FEV1 and FVC, after adjusting for confounders. Subjects who took vitamin E supplements had significantly higher α-tocopherol levels (p<0.0001) and lower γ-tocopherol levels (p<0.0001) than non-users. Conclusion In this study, there is a positive association between dietary vitamin E intake and lung function, and evidence of an inverse relationship between serum levels of γ-tocopherol and lung function. PMID:25715694
Darrah, Johanna; Bartlett, Doreen; Maguire, Thomas O; Avison, William R; Lacaze-Masmonteil, Thierry
2014-09-01
To compare the original normative data of the Alberta Infant Motor Scale (AIMS) (n=2202) collected 20 years ago with a contemporary sample of Canadian infants. This was a cross-sectional cohort study of 650 Canadian infants (338 males, 312 females; mean age 30.9 wks [SD 15.5], range 2 wks-18 mo) assessed once on the AIMS. Assessments were stratified by age, and infants proportionally represented the ethnic diversity of Canada. Logistic regression was used to place AIMS items on an age scale representing the age at which 50% of the infants passed an item on the contemporary data set and the original data set. Forty-three items met the criterion for stable regression results in both data sets. The correlation coefficient between the age locations of items on the original and contemporary data sets was 0.99. The mean age difference between item locations was 0.7 weeks. Age values from the original data set when converted to the contemporary scale differed by less than 1 week. The sequence and age at emergence of AIMS items has remained similar over 20 years and current normative values remain valid. Concern that the 'back to sleep' campaign has influenced the age at emergence of gross motor abilities is not supported. © 2014 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.
Normative Data for the Singapore English and Chinese SF-36 Version 2 Health Survey.
Sow, Wei Ting; Wee, Hwee Lin; Wu, Yi; Tai, E-Shyong; Gandek, Barbara; Lee, Jeannette; Ma, Stefan; Heng, Derrick; Thumboo, Julian
2014-01-01
The aim of this study is to report normative data for the Short-Form 36 version 2 (SF-36v2) for assessing health-related quality of life, in the Singapore general population. Data for English and Chinese-speaking participants of the Singapore Prospective Study Programme were analysed. The SF-36v2 scores were norm-based with the English-speaking Singapore general population as reference and reported by age (in decades), gender and ethnicity as well as for the 5 most prevalent chronic medical conditions. Scores were reported separately for the English and Chinese language versions. A total of 6151 English-speaking (61.5% Chinese and 19.2% Malay) and 1194 Chinese-speaking participants provided complete data. Mean (SD) age of all participants was 49.6 (12.58) years with 52.4% being women. In both languages, women reported lower scores than men on all scales. Among the chronic medical conditions, stroke had the largest impact on all English SF-36v2 scales and on 3 Chinese SF-36v2 scales (role-physical, general health and social functioning). We have provided detailed normative data for the Singapore English and Chinese SF-36v2, which would be valuable in furthering HRQoL research in Singapore and possibly the region.
Hoff, Kevin A; Briley, Daniel A; Wee, Colin J M; Rounds, James
2018-04-01
Vocational interests predict a variety of important outcomes and are among the most widely applied individual difference constructs in psychology and education. Despite over 90 years of research, little is known about the longitudinal development of interests. In this meta-analysis, the authors investigate normative changes in interests through adolescence and young adulthood. Effect sizes were aggregated from 49 longitudinal studies reporting mean-level changes in vocational interests, containing 98 total samples and 20,639 participants. Random effects meta-analytic regression models were used to assess age-related changes and gender differences across Holland's (1959, 1997) RIASEC categories and composite dimensions (people, things, data, and ideas). Results showed that mean-level interest scores generally increase with age, but effect sizes varied across interest categories and developmental periods. Adolescence was defined by two broad patterns of change: interest scores generally decreased during early adolescence, but then increased during late adolescence. During young adulthood, the most striking changes were found across the people and things orientations. Interests involving people tended to increase (artistic, social, and enterprising), whereas interests involving things either decreased (conventional) or remained constant (realistic and investigative). Gender differences associated with occupational stereotypes reached a lifetime peak during early adolescence, then tended to decrease in all subsequent age periods. Overall findings suggest there are normative changes in vocational interests from adolescence to adulthood, with important implications for developmental theories and the applied use of interests. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
The business case for the reduction of surgical complications in VA hospitals.
Vaughan-Sarrazin, Mary; Bayman, Levent; Rosenthal, Gary; Henderson, William; Hendricks, Ann; Cullen, Joseph J
2011-04-01
Surgical complications contribute substantially to costs. Most important, surgical complications contribute to morbidity and mortality, and some may be preventable. This study estimates costs of specific surgical complications for patients undergoing general surgery in VA hospitals using merged data from the VA Surgical Quality Improvement Program and VA Decision Support System. Costs associated with 19 potentially preventable complications within 6 broader categories were estimated using generalized, linear mixed regression models to control for patient-level determinants of costs (eg, type of operation, demographics, comorbidity, severity) and hospital-level variation in costs. Costs included costs of the index hospitalization and subsequent 30-day readmissions. In 14,639 patients undergoing general surgical procedures from 10/2005 through 9/2006, 20% of patients developed postoperative surgical complications. The presence of any complication significantly increased unadjusted costs nearly 3-fold ($61,083 vs $22,000), with the largest cost differential attributed to respiratory complications. Patients who developed complications had several markers for greater preoperative severity, including increased age and a lesser presurgery functional health status. After controlling for differences in patient severity, costs for patients with any complication were 1.89 times greater compared to costs for patients with no complications (P < .0001). Within major complication categories, adjusted costs were significantly greater for patients with respiratory, cardiac, central nervous system, urinary, wound, or other complications. Surgical complications contribute markedly to costs of inpatient operations. Investment in quality improvement that decreases the incidence of surgical complications could decrease costs. Copyright © 2011 Mosby, Inc. All rights reserved.
76 FR 63357 - VA National Academic Affiliations Council; Notice of Establishment
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-12
... DEPARTMENT OF VETERANS AFFAIRS VA National Academic Affiliations Council; Notice of Establishment... Academic Affiliations Council. The Secretary of Veterans Affairs has determined that establishing the... Secretary for Health on matters affecting partnerships between VA and its academic affiliates. The Council...
An overview of patient safety climate in the VA.
Hartmann, Christine W; Rosen, Amy K; Meterko, Mark; Shokeen, Priti; Zhao, Shibei; Singer, Sara; Falwell, Alyson; Gaba, David M
2008-08-01
To assess variation in safety climate across VA hospitals nationally. Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data were collected using an anonymous survey design. We received 4,547 responses (49 percent response rate). The percent problematic response--lower percent reflecting higher levels of patient safety climate--ranged from 12.0-23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement.
2011-01-01
post - traumatic stress disorder ( PTSD ) and...Veterans Affairs (VA) Intramural Post - Traumatic Stress Disorder ( PTSD ) Research Funding and VA’s Medical and Prosthetic Research Appropriation...Table 6: Department of Veterans Affairs (VA) Research Centers and Programs That Conduct or Support Post - Traumatic Stress Disorder ( PTSD ) Research
Davis, Alan K; Bonar, Erin E; Goldstick, Jason E; Walton, Maureen A; Winters, Jamie; Chermack, Stephen T
2017-11-01
Gambling is relatively under-assessed in Veterans Affairs (VA) substance use disorder (SUD) treatment settings, yet shared characteristics with substance addiction suggest the importance of understanding how gambling behaviors present in Veterans seeking SUD care. We evaluated substance use, mental health, and violence-related correlates of past 30-day gambling among 833 Veterans (93% male, M age 48years, 72% Caucasian) seeking treatment in VA outpatient mental health and SUD clinics who completed screening for a randomized clinical trial. A total of 288 (35%) Veterans reported past 30-day gambling. Among those who gambled, 79% had cravings/urges to gamble, whereas between 20%-27% of gamblers reported perceived relationship, legal, and daily life problems related to gambling, as well as difficulty controlling gambling. A logistic regression analysis revealed that age, recent binge-drinking, and non-partner physical aggression were associated with recent gambling. Gambling was associated with binge-drinking and non-partner physical aggression, supporting potential shared characteristics among these behaviors such as impulsivity and risk-taking, which may complicate SUD treatment engagement and effectiveness. Findings support the need to screen for gambling in the VA, and to adapt treatments to include gambling as a potential behavioral target or relapse trigger, particularly among heavy drinking patients. Copyright © 2017 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Zemore, Robert; Eames, Nancy
1979-01-01
Tested hypothesis that the institutional nature of old-age homes increases depression in the elderly. Results provided no support that the aged are more depressed. Somatic complaints can be indicators of depression in the elderly if normative differences between young and old are taken into account. (Author)
77 FR 12697 - VA Homeless Providers Grant and Per Diem Program
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-01
...We propose to revise and reorganize regulations which contain the Department of Veterans Affairs' (VA) Homeless Providers Grant and Per Diem Program. This rulemaking would update our current regulations, implement and authorize new VA policies, and generally improve the clarity of part 61.
Normative beliefs about aggression as a mediator of narcissistic exploitativeness and cyberbullying.
Ang, Rebecca P; Tan, Kit-Aun; Talib Mansor, Abu
2011-09-01
The current study examined normative beliefs about aggression as a mediator between narcissistic exploitativeness and cyberbullying using two Asian adolescent samples from Singapore and Malaysia. Narcissistic exploitativeness was significantly and positively associated with cyberbullying and normative beliefs about aggression and normative beliefs about aggression were significantly and positively associated with cyberbullying. Normative beliefs about aggression were a significant partial mediator in both samples; these beliefs about aggression served as one possible mechanism of action by which narcissistic exploitativeness could exert its influence on cyberbullying. Findings extended previous empirical research by showing that such beliefs can be the mechanism of action not only in offline but also in online contexts and across cultures. Cyberbullying prevention and intervention efforts should include modification of norms and beliefs supportive of the legitimacy and acceptability of cyberbullying.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-02
... (Application for VA Education Benefits) Activity; Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA... Under the Montgomery GI Bill, VA Form 22-1990E. c. Application for VA Education Benefits Under the...
Challenging Normative Sexual and Gender Identity Beliefs through Romeo and Juliet
ERIC Educational Resources Information Center
Ressler, Paula
2005-01-01
Paula Ressler, an English teacher, suggests unconventional ways to work with William Shakespeare's "Romeo and Juliet" in the secondary school English curriculum to challenge normative sexual and gender identity beliefs. Reading queerly to explore non-normative sex and gender identities and reading for social justice have the potential to…
Participation of Myosin Va and Pka Type I in the Regeneration of Neuromuscular Junctions
Röder, Ira Verena; Strack, Siegfried; Reischl, Markus; Dahley, Oliver; Khan, Muzamil Majid; Kassel, Olivier; Zaccolo, Manuela; Rudolf, Rüdiger
2012-01-01
Background The unconventional motor protein, myosin Va, is crucial for the development of the mouse neuromuscular junction (NMJ) in the early postnatal phase. Furthermore, the cooperative action of protein kinase A (PKA) and myosin Va is essential to maintain the adult NMJ. We here assessed the involvement of myosin Va and PKA in NMJ recovery during muscle regeneration. Methodology/Principal Findings To address a putative role of myosin Va and PKA in the process of muscle regeneration, we used two experimental models the dystrophic mdx mouse and Notexin-induced muscle degeneration/regeneration. We found that in both systems myosin Va and PKA type I accumulate beneath the NMJs in a fiber maturation-dependent manner. Morphologically intact NMJs were found to express stable nicotinic acetylcholine receptors and to accumulate myosin Va and PKA type I in the subsynaptic region. Subsynaptic cAMP signaling was strongly altered in dystrophic muscle, particularly in fibers with severely subverted NMJ morphology. Conclusions/Significance Our data show a correlation between the subsynaptic accumulation of myosin Va and PKA type I on the one hand and NMJ regeneration status and morphology, AChR stability and specificity of subsynaptic cAMP handling on the other hand. This suggests an important role of myosin Va and PKA type I for the maturation of NMJs in regenerating muscle. PMID:22815846
Darrah, Johanna; Bartlett, Doreen; Maguire, Thomas O; Avison, William R; Lacaze-Masmonteil, Thierry
2014-01-01
Aim To compare the original normative data of the Alberta Infant Motor Scale (AIMS) (n=2202) collected 20 years ago with a contemporary sample of Canadian infants. Method This was a cross-sectional cohort study of 650 Canadian infants (338 males, 312 females; mean age 30.9wks [SD 15.5], range 2wks–18mo) assessed once on the AIMS. Assessments were stratified by age, and infants proportionally represented the ethnic diversity of Canada. Logistic regression was used to place AIMS items on an age scale representing the age at which 50% of the infants passed an item on the contemporary data set and the original data set. Forty-three items met the criterion for stable regression results in both data sets. Results The correlation coefficient between the age locations of items on the original and contemporary data sets was 0.99. The mean age difference between item locations was 0.7 weeks. Age values from the original data set when converted to the contemporary scale differed by less than 1 week. Interpretation The sequence and age at emergence of AIMS items has remained similar over 20 years and current normative values remain valid. Concern that the ‘back to sleep’ campaign has influenced the age at emergence of gross motor abilities is not supported. PMID:24684556
Color Trails Test: normative data and criterion validity for the greek adult population.
Messinis, Lambros; Malegiannaki, Amaryllis-Chryssi; Christodoulou, Tessa; Panagiotopoulos, Vassillis; Papathanasopoulos, Panagiotis
2011-06-01
The Color Trails Test (CTT) was developed as a culturally fair analog of the Trail Making Test. In the present study, normative data for the CTT were developed for the Greek adult population and further the criterion validity of the CTT was examined in two clinical groups (29 Parkinson's disease [PD] and 25 acute stroke patients). The instrument was applied to 163 healthy participants, aged 19-75. Stepwise linear regression analyses revealed a significant influence of age and education level on completion time in both parts of the CTT (increased age and decreased educational level contributed to slower completion times for both parts), whereas gender did not influence time to completion of part B. Further, the CTT appears to discriminate adequately between the performance of PD and acute stroke patients and matched healthy controls.
A normative analysis of nursing knowledge.
Zanotti, Renzo; Chiffi, Daniele
2016-03-01
This study addresses the question of normative analysis of the value-based aspects of nursing. In our perspective, values in science may be distinguished into (i) epistemic when related to the goals of truth and objectivity and (ii) non-epistemic when related to social, cultural or political aspects. Furthermore, values can be called constitutive when necessary for a scientific enterprise, or contextual when contingently associated with science. Analysis of the roles of the various forms of values and models of knowledge translation provides the ground to understand the specific role of values in nursing. A conceptual framework has been built to classify some of the classical perspectives on nursing knowledge and to examine the relationships between values and different forms of knowledge in nursing. It follows that adopting a normative perspective in the analysis of nursing knowledge provides key elements to identify its proper dimension. © 2015 John Wiley & Sons Ltd.
Al-Ghatani, Ali M; Obonsawin, Marc C; Binshaig, Basmah A; Al-Moutaery, Khalaf R
2011-01-01
There are 2 aims for this study: first, to collect normative data for the Wisconsin Card Sorting Test (WCST), Stroop test, Test of Non-verbal Intelligence (TONI-3), Picture Completion (PC) and Vocabulary (VOC) sub-test of the Wechsler Adult Intelligence Scale-Revised for use in a Saudi Arabian culture, and second, to use the normative data provided to generate the regression equations. To collect the normative data and generate the regression equations, 198 healthy individuals were selected to provide a representative distribution for age, gender, years of education, and socioeconomic class. The WCST, Stroop test, TONI-3, PC, and VOC were administrated to the healthy individuals. This study was carried out at the Department of Clinical Neurosciences, Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia from January 2000 to July 2002. Normative data were obtained for all tests, and tables were constructed to interpret scores for different age groups. Regression equations to predict performance on the 3 tests of frontal function from scores on tests of fluid (TONI-3) and premorbid intelligence were generated from the data from the healthy individuals. The data collected in this study provide normative tables for 3 tests of frontal lobe function and for tests of general intellectual ability for use in Saudi Arabia. The data also provide a method to estimate pre-injury ability without the use of verbally based tests.
Normative Feedback and Adolescent Readiness to Change: A Small Randomized Trial
ERIC Educational Resources Information Center
Smith, Douglas C.; Davis, Jordan P.; Ureche, Daniel J.; Tabb, Karen M.
2015-01-01
For adolescents with substance use problems, it is unknown whether the provision of normative feedback is a necessary active ingredient in motivational interviewing (MI). This study investigated the impact of normative feedback on adolescents' readiness to change and perceptions of MI quality. Adolescents referred for substance use disorder (SUD)…
Goble, Daniel J; Baweja, Harsimran S
2018-05-17
Postural sway is routinely assessed because increased postural sway is associated with poorer performance of activities of daily living, higher rates of residential care, and increased risk of falling. Force plate technology is one of the most sensitive and objective means of assessing postural sway in the clinic. The aim of this study was to provide the first set of normative data for the BTrackS Balance Test (BBT) of postural sway. The design was descriptive and population based. BBT results from 16,357 community-dwelling individuals who were 5 to 100 years old were accumulated and assessed for effects of age, sex, height, and weight. Percentile rankings were calculated for significant groupings. BBT results were dependent on age and sex but not height or weight. Therefore, percentile rankings were determined for male and female individuals in each age category, with no consideration of participant height or weight. Data were collected by third-party practitioners with various backgrounds in more than 50 locations across the United States and Canada. There was an imbalance in the sample sizes for age and sex groupings. The findings of this study represent the largest normative dataset ever published for postural sway results. Normative data on the BBT can assist in determining abnormalities in postural sway, which have been linked to negative clinical outcomes.
78 FR 6849 - Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-31
... (Verification of VA Benefits) Activity Under OMB Review AGENCY: Veterans Benefits Administration, Department of... ``OMB Control No. 2900-0406.'' SUPPLEMENTARY INFORMATION: Title: Verification of VA Benefits, VA Form 26... eliminate unlimited versions of lender- designed forms. The form also informs the lender whether or not the...
Teacher factors contributing to dosage of the KiVa anti-bullying program.
Swift, Lauren E; Hubbard, Julie A; Bookhout, Megan K; Grassetti, Stevie N; Smith, Marissa A; Morrow, Michael T
2017-12-01
The KiVa Anti-Bullying Program (KiVa) seeks to meet the growing need for anti-bullying programming through a school-based, teacher-led intervention for elementary school children. The goals of this study were to examine how intervention dosage impacts outcomes of KiVa and how teacher factors influence dosage. Participants included 74 teachers and 1409 4th- and 5th-grade students in nine elementary schools. Teachers and students completed data collection at the beginning and end of the school year, including measures of bullying and victimization, correlates of victimization (depression, anxiety, peer rejection, withdrawal, and school avoidance), intervention cognitions/emotions (anti-bullying attitudes, and empathy toward victims), bystander behaviors, and teacher factors thought to relate to dosage (self-efficacy for teaching, professional burnout, perceived principal support, expected effectiveness of KiVa, perceived feasibility of KiVa). The dosage of KiVa delivered to classrooms was measured throughout the school year. Results highlight dosage as an important predictor of change in bullying, victimization, correlates of victimization, bystander behavior, and intervention cognitions/emotions. Of the teacher factors, professional burnout uniquely predicted intervention dosage. A comprehensive structural equation model linking professional burnout to dosage and then to child-level outcomes demonstrated good fit. Implications for intervention design and implementation are discussed. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Individual and peer group normative beliefs about relational aggression.
Werner, Nicole E; Hill, Laura G
2010-01-01
Studies show that children who use relational aggression process social information in unique ways; however, findings have been inconsistent and limited by methodological weaknesses. This short-term longitudinal study examined developmental changes in 245 (49% female; ages 8-13) 3rd through 8th graders' normative beliefs about relational aggression and tested the hypothesis that individual and classroom-level norms predict relational aggression 1 year later. Results showed that the transition to middle school was marked by increased approval of relational aggression, and individual norms predicted future relational aggression. Importantly, a contextual model showed that students in peer groups highly supportive of relational aggression became increasingly aggressive. Findings extend social information processing theories of relational aggression to focus on the role of peer group cognitions.
CoVaCS: a consensus variant calling system.
Chiara, Matteo; Gioiosa, Silvia; Chillemi, Giovanni; D'Antonio, Mattia; Flati, Tiziano; Picardi, Ernesto; Zambelli, Federico; Horner, David Stephen; Pesole, Graziano; Castrignanò, Tiziana
2018-02-05
The advent and ongoing development of next generation sequencing technologies (NGS) has led to a rapid increase in the rate of human genome re-sequencing data, paving the way for personalized genomics and precision medicine. The body of genome resequencing data is progressively increasing underlining the need for accurate and time-effective bioinformatics systems for genotyping - a crucial prerequisite for identification of candidate causal mutations in diagnostic screens. Here we present CoVaCS, a fully automated, highly accurate system with a web based graphical interface for genotyping and variant annotation. Extensive tests on a gold standard benchmark data-set -the NA12878 Illumina platinum genome- confirm that call-sets based on our consensus strategy are completely in line with those attained by similar command line based approaches, and far more accurate than call-sets from any individual tool. Importantly our system exhibits better sensitivity and higher specificity than equivalent commercial software. CoVaCS offers optimized pipelines integrating state of the art tools for variant calling and annotation for whole genome sequencing (WGS), whole-exome sequencing (WES) and target-gene sequencing (TGS) data. The system is currently hosted at Cineca, and offers the speed of a HPC computing facility, a crucial consideration when large numbers of samples must be analysed. Importantly, all the analyses are performed automatically allowing high reproducibility of the results. As such, we believe that CoVaCS can be a valuable tool for the analysis of human genome resequencing studies. CoVaCS is available at: https://bioinformatics.cineca.it/covacs .
Enhancing Cross-Cultural Collaboration between DoD and VA
2012-04-27
James A. Lovell Federal Health Care Center ( FHCC ). The NDAA 2010 authorized the DoD and VA to establish a five-year demonstration project...integrating the North Chicago VA Medical Center and the Naval Health Clinic Great Lakes.50 The FHCC is named in 15 honor of retired U.S. Naval officer...and Illinois resident, Captain James A. Lovell , who was an astronaut on Apollo 13. The joint facility serves the medical needs of active duty service
ERIC Educational Resources Information Center
Fearnow-Kenny, Melodie D.; Wyrick, David L.; Hansen, William B.; Dyreg, Doug; Beau, Dan B.
2001-01-01
Investigation (1) examined interrelations among normative beliefs, alcohol expectancies, and alcohol-related problems, and (2) investigated whether alcohol-related expectancies mediate associations between normative beliefs and alcohol-related problems. Analyses revealed that alcohol expectancies mediate the relationship between normative beliefs…
Pudendal and median nerve sensory perception threshold: a comparison between normative studies.
Quaghebeur, Jörgen; Wyndaele, Jean Jacques
2014-12-01
For the evaluation of sensory innervation, normative data are necessary as a comparison. To compare our current perception thresholds (CPTs) with normative data from other research. Healthy volunteers were assessed for 2000, 250, and 5 Hz CPTs of the median and pudendal nerve and data were compared with other studies. Normative data in the studied group n = 41 (male: 21; female: 20) for the median nerve, 2 kHz, 250 Hz, and 5 Hz were respectively: 241.85 ± 67.72 (140-444); 106.27 ± 39.12 (45-229); 82.05 ± 43.40 (13-271). Pudendal nerve CPTs 250 Hz were: 126.44 ± 69.46 (6-333). For men 2 kHz: 349.95 ± 125.76 (100-588); 5 Hz: 132.67 ± 51.81 (59-249) and women 2 kHz:226.20 ± 119.65 (64-528); 5 Hz: 92.45 ± 44.66 (35-215). For the median nerve no statistical differences for gender were shown. For the pudendal nerve, only 250 Hz showed no difference for gender (t-test: 0.516). Comparison of our data with CPTs of other normative data showed no agreement for the pudendal nerve. For the median nerve only 2 kHz showed agreement in three studies and for 5 Hz with one study. Comparing normative data of multiple studies shows a variety of results and poor agreement. Therefore, referring to normative data of other studies should be handled with caution.
The Composition of Normative Groups and Diagnostic Decision Making: Shooting Ourselves in the Foot
ERIC Educational Resources Information Center
Pena, Elizabeth D.; Spaulding, Tammie J.; Plante, Elena
2006-01-01
Purpose: The normative group of a norm-referenced test is intended to provide a basis for interpreting test scores. However, the composition of the normative group may facilitate or impede different types of diagnostic interpretations. This article considers who should be included in a normative sample and how this decision must be made relative…
Klaczynski, Paul A.
2014-01-01
In Stanovich's (2009a, 2011) dual-process theory, analytic processing occurs in the algorithmic and reflective minds. Thinking dispositions, indexes of reflective mind functioning, are believed to regulate operations at the algorithmic level, indexed by general cognitive ability. General limitations at the algorithmic level impose constraints on, and affect the adequacy of, specific strategies and abilities (e.g., numeracy). In a study of 216 undergraduates, the hypothesis that thinking dispositions and general ability moderate the relationship between numeracy (understanding of mathematical concepts and attention to numerical information) and normative responses on probabilistic heuristics and biases (HB) problems was tested. Although all three individual difference measures predicted normative responses, the numeracy-normative response association depended on thinking dispositions and general ability. Specifically, numeracy directly affected normative responding only at relatively high levels of thinking dispositions and general ability. At low levels of thinking dispositions, neither general ability nor numeric skills related to normative responses. Discussion focuses on the consistency of these findings with the hypothesis that the implementation of specific skills is constrained by limitations at both the reflective level and the algorithmic level, methodological limitations that prohibit definitive conclusions, and alternative explanations. PMID:25071639
Klaczynski, Paul A
2014-01-01
In Stanovich's (2009a, 2011) dual-process theory, analytic processing occurs in the algorithmic and reflective minds. Thinking dispositions, indexes of reflective mind functioning, are believed to regulate operations at the algorithmic level, indexed by general cognitive ability. General limitations at the algorithmic level impose constraints on, and affect the adequacy of, specific strategies and abilities (e.g., numeracy). In a study of 216 undergraduates, the hypothesis that thinking dispositions and general ability moderate the relationship between numeracy (understanding of mathematical concepts and attention to numerical information) and normative responses on probabilistic heuristics and biases (HB) problems was tested. Although all three individual difference measures predicted normative responses, the numeracy-normative response association depended on thinking dispositions and general ability. Specifically, numeracy directly affected normative responding only at relatively high levels of thinking dispositions and general ability. At low levels of thinking dispositions, neither general ability nor numeric skills related to normative responses. Discussion focuses on the consistency of these findings with the hypothesis that the implementation of specific skills is constrained by limitations at both the reflective level and the algorithmic level, methodological limitations that prohibit definitive conclusions, and alternative explanations.
76 FR 44288 - Establishment of Class E Airspace; New Market, VA
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-25
...-380; Airspace Docket No. 11-AEA-12] Establishment of Class E Airspace; New Market, VA AGENCY: Federal... proposes to establish Class E Airspace at New Market, VA, to accommodate the additional airspace needed for the Standard Instrument Approach Procedures developed for New Market Airport. This action would...
77 FR 30050 - VA National Academic Affiliations Council, Notice of meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-21
... DEPARTMENT OF VETERANS AFFAIRS VA National Academic Affiliations Council, Notice of meeting The...) that the second meeting of the National Academic Affiliations Council will be held on June 5-6, 2012... the Secretary on matters affecting partnerships between VA and its academic affiliates. On June 5, the...
Attachment reorganization following divorce: normative processes and individual differences.
Sbarra, David A; Borelli, Jessica L
2018-03-21
This paper uses attachment theory as a lens for reviewing contemporary research on how adults cope with marital separation and loss. The first section of the paper discusses the process of normative attachment reorganization, or the psychology of adaptive grief responses following relationship transitions. We argue that changes two processes, in particular, can be uses to track changes in this normative reorganization process: narrative coherence and self-concept clarity. The second section of the paper suggest that individual differences in attachment anxiety and avoidance shape the variability in this normative reorganization process, largely as a result of the characteristic ways in which these styles organize emotion-regulatory tendencies. The paper closes with a series of integrative questions for future research, including a call for new studies aimed at understanding under what contexts anxiety and avoidance may be adaptive in promoting emotion recovery to separation and divorce experiences. Copyright © 2018 Elsevier Ltd. All rights reserved.
Phrenic nerve conduction studies: normative data and technical aspects.
Maranhão, Analucia Abreu; Carvalho, Sonia Regina da Silva; Caetano, Marcelo Ribeiro; Alamy, Alexandre Hofke; Peixoto, Eduardo Mesquita; Filgueiras, Pedro Del Esporte Peçanha
2017-12-01
The aim of the present study was to define normative data of phrenic nerve conduction parameters of a healthy population. Phrenic nerve conduction studies were performed in 27 healthy volunteers. The normative limits for expiratory phrenic nerve compound muscle action potential were: amplitude (0.47 mv - 0.83 mv), latency (5.74 ms - 7.10 ms), area (6.20 ms/mv - 7.20 ms/mv) and duration (18.30 ms - 20.96 ms). Inspiratory normative limits were: amplitude (0.67 mv - 1.11 mv), latency (5.90 ms - 6.34 ms), area (5.62 ms/mv - 6.72 ms/mv) and duration (13.77 ms - 15.37 ms). The best point of phrenic nerve stimulus in the neck varies among individuals between the medial and lateral border of the clavicular head of the sternocleidomastoid muscle and stimulation of both sites, then choosing the best phrenic nerve response, seems to be the appropriate procedure.
Normative perceptions of alcohol-related consequences among college students.
Brett, Emma I; Leavens, Eleanor L; Miller, Mary Beth; Lombardi, Nathaniel; Leffingwell, Thad R
2016-07-01
College students in the U.S. continue to drink in hazardous ways and experience a range of alcohol-related consequences. Personalized feedback interventions (PFIs), which often include normative components comparing personal drinking to that of similar peers, have been effective in reducing alcohol outcomes among college students. Though normative perceptions of the quantity and frequency of alcohol use have been examined in many studies, norms for alcohol-related consequences have received less attention. The current study examined self-other discrepancies (SODs) for alcohol-related consequences among college students. Participants overestimated how often alcohol-related consequences are experienced by other same-sex students on campus and rated consequences as more acceptable for others to experience than themselves. No differences in SODs were found between those who did and did not report alcohol use. Future studies should examine the efficacy of PFIs that incorporate normative feedback on alcohol-related consequences. Copyright © 2016 Elsevier Ltd. All rights reserved.
Normative data for the Functional Movement Screen in male Gaelic field sports.
Fox, Domhnaill; O'Malley, Edwenia; Blake, Catherine
2014-08-01
To determine normative values for the Functional Movement Screen (FMS) in Elite and Sub-Elite male Gaelic Football and Hurling players. A cross sectional study of functional movement in Gaelic games at Elite and Sub-Elite level. Players were video recorded completing the Functional Movement Screen Tool and scored post-test. Comparisons were analysed using Mann-Whitney U tests. Field testing in team gym facility and university biomechanics laboratory. A total of 62 players were tested. This consisted of 41 Hurling, and 21 Gaelic Football players. 30 of these participants were deemed Elite and 32 were deemed Sub-Elite. The mean age of the sample was 22.15 ± 3.02 years. Functional Movement Screen (FMS). The FMS mean score for the sample was 15.56 ± 1.46. The Elite group (15.8 ± 1.58) scored higher than the Sub-Elite group (15.34 ± 1.31) but there was no significant difference between groups. This study provides normative reference values for Gaelic Players. Elite Gaelic Players perform no better than a young, active population in the FMS indicating a potential problem with the FMS as a measure. Copyright © 2013 Elsevier Ltd. All rights reserved.
Nativ-Zeltzer, N; Logemann, J A; Zecker, S G; Kahrilas, P J
2016-05-01
We aimed to define normative values for novel pressure topography metrics for high-resolution pharyngeal-esophageal manofluorography. The effects of age, gender, and bolus properties were examined. Concurrent high-resolution manometry (HRM) and videofluoroscopy data were collected from 22 younger (aged 21-40) and 22 older (aged 60-80) healthy subjects. Pressure topography was analyzed by correlating pressure domains with videofluoroscopic events. Nine pressure topography metrics of the pharyngeal and proximal esophageal swallow were extracted; four of these were also compared with previously obtained esophageal HRM studies to assess the effects of catheter diameter. Older individuals exhibited more vigorous contractility in the pharynx than did younger subjects with all bolus types, but the greatest values for both groups were with effortful swallow and on that measure the age groups were similar. Upper esophageal sphincter (UES) intrabolus pressure during sphincter opening was also greater in the older subjects. Some gender differences were observed, particularly related to proximal esophageal contractile vigor. Bolus consistency had no consistent effect. Studies using the larger catheter diameter resulted in significantly greater contractile vigor in the UES and proximal esophagus. Older adults exhibited more vigorous pharyngeal contractions than young adults, albeit within a similar range of capacity, perhaps reflecting a compensatory response to other age-related physiological changes. Greater UES intrabolus pressures observed during bolus transit in the older group likely reflect reduced UES compliance with age. Normative data on novel HRM metrics collected in this study can serve as a reference for future clinical studies. © 2016 John Wiley & Sons Ltd.
Forearm Torque and Lifting Strength: Normative Data.
Axelsson, Peter; Fredrikson, Per; Nilsson, Anders; Andersson, Jonny K; Kärrholm, Johan
2018-02-10
To establish reference values for new methods designed to quantitatively measure forearm torque and lifting strength and to compare these values with grip strength. A total of 499 volunteers, 262 males and 237 females, aged 15 to 85 (mean, 44) years, were tested for lifting strength and forearm torque with the Kern and Baseline dynamometers. These individuals were also tested for grip strength with a Jamar dynamometer. Standardized procedures were used and information about sex, height, weight, hand dominance, and whether their work involved high or low manual strain was collected. Men had approximately 70% higher forearm torque and lifting strength compared with females. Male subjects aged 26 to 35 years and female subjects aged 36 to 45 years showed highest strength values. In patients with dominant right side, 61% to 78% had a higher or equal strength on this side in the different tests performed. In patients with dominant left side, the corresponding proportions varied between 41% and 65%. There was a high correlation between grip strength and forearm torque and lifting strength. Sex, body height, body weight, and age showed a significant correlation to the strength measurements. In a multiple regression model sex, age (entered as linear and squared) could explain 51% to 63% of the total variances of forearm torque strength and 30% to 36% of lifting strength. Reference values for lifting strength and forearm torque to be used in clinical practice were acquired. Grip strength has a high correlation to forearm torque and lifting strength. Sex, age, and height can be used to predict forearm torque and lifting strength. Prediction equations using these variables were generated. Normative data of forearm torque and lifting strength might improve the quality of assessment of wrist and forearm disorders as well as their treatments. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Salloch, Sabine; Schildmann, Jan; Vollmann, Jochen
2012-04-13
The methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts. A considered reference to normative research questions can be expected from good quality empirical research in medical ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics. High quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis.
de Andrade, Carlos Roberto Moraes; Silva, Eliete Leão Clemente; da Matta, Maria de Fátima Bevilaqua; Castier, Marcia Bueno; Rosa, Maria Luiza Garcia; Gomes, Marília Brito
2016-12-01
To evaluate whether using vascular age (VA) instead of chronological age (CA) in the Framingham score would enhance the cardiovascular disease (CVD) risk estimation in patients with type 1 diabetes (T1D). This was a cross-sectional study comprising 58 T1D patients and 38 control subjects matched by age, gender and body mass index. To estimate the VA, we used carotid intima-media thickness normality estimation tables that took into account age, gender and ethnic group. Compared to the control group, T1D patients had an older VA with an 8.8-year difference (p < 0.001), a higher CVD risk stratification comparing CA and VA (p < 0.001). In the group of T1D patients, there was a 9.4-year difference between VA and CA (p < 0.001), mainly due to a greater increase in women compared to men (11.2 vs 6.4 years, respectively) and 29.3 % of the patients with T1D increased their CVD risk stratification using VA as a parameter. Still, in the group of T1D patients, women had a higher increase in VA for each 1-year increase in CA than men (1.2 years vs 0.8 years, respectively, p < 0.001). This difference persisted as we compared women with T1D with women in the control group (0.4 years), p = 0.006. T1D patients have an increased VA, a marker of subclinical atherosclerosis. The use of VA age may contribute to the identification of high CVD risk in T1D. In patients with T1D, a younger chronological age, particularly in women, might not be a protective factor for CVD.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-08
... (Application for VA Education Benefits) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Education Benefits, VA Form 22-1990. b. Application for Family Member to Use Transferred Benefits, VA Form 22-1990E. [[Page 40454
Gorostegi-Anduaga, Ilargi; Pérez-Asenjo, Javier; Aispuru, Gualberto Rodrigo; Fryer, Simon M; Alonso-Colmenero, Ainara; Romaratezabala, Estíbaliz; Maldonado-Martín, Sara
2017-06-01
Hypertension (HTN), obesity and low cardiorespiratory fitness (CRF) are associated with an increased risk for a cardiovascular event. Enrolling overweight/obese individuals with HTN, the current study aimed to estimate cardiovascular risk (CVR) and vascular age (VA) profiles analyzing potential sex differences, determine whether VA is higher than chronological age, and whether CVR is associated with a low level of CRF. Overweight/obese non-Hispanic White participants (n=209; 141 men and 68 women) with primary HTN had their CVR and VA determined using the New Pooled Cohort Risk Equations and The Framingham method, respectively. Considering values of peak oxygen uptake, participants were divided into tertiles for each sex. The CVR, but not VA (P=0.339), was higher (P<0.001) in men compared with women irrespective of age. Irrespective of sex, VA was higher than chronological age (P<0.001). Age and BMI were higher (P<0.05) in the low CRF group compared with that in other groups. There were no differences in CVR (P=0.907) and VA (P=1.643) when values were separated into CRF groups. Pooled Cohort Equations could underestimate the risk of suffering a cardiovascular event in the following 10 years in overweight/obese non-Hispanic White women with HTN compared with men. The VA appears to be a useful tool in communicating CVR in this population irrespective of sex. The CRF alone may not be enough to moderate the CVR.
An Overview of Patient Safety Climate in the VA
Hartmann, Christine W; Rosen, Amy K; Meterko, Mark; Shokeen, Priti; Zhao, Shibei; Singer, Sara; Falwell, Alyson; Gaba, David M
2008-01-01
Objective To assess variation in safety climate across VA hospitals nationally. Study Setting Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. Study Design We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data Collection Data were collected using an anonymous survey design. Principal Findings We received 4,547 responses (49 percent response rate). The percent problematic response—lower percent reflecting higher levels of patient safety climate—ranged from 12.0–23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. Conclusions This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement. PMID:18355257
Military and VA general dentistry training: a national resource.
Atchison, Kathryn A; Bachand, William; Buchanan, C Richard; Lefever, Karen H; Lin, Sylvia; Engelhardt, Rita
2002-06-01
In 1999, HRSA contracted with the UCLA School of Dentistry to evaluate the postgraduate general dentistry (PDG) training programs. The purpose of this article is to compare the program characteristics of the PGD training programs sponsored by the Armed Services (military) and VA. Surveys mailed to sixty-six VA and forty-two military program directors in fall 2000 sought information regarding the infrastructure of the program, the program emphasis, resident preparation prior to entering the program, and a description of patients served and types of services provided. Of the eighty-one returned surveys (75 percent response rate), thirty were received from military program directors and fifty-one were received from VA program directors. AEGDs reported treating a higher proportion of children patients and GPRs more medically intensive, disadvantaged and HIV/AIDS patients. Over half of the directors reported increases in curriculum emphasis in implantology. The program directors reported a high level of inadequate preparation among incoming dental residents. Having a higher ratio of residents to total number of faculty predicted inadequate preparation (p=.022) although the model was weak. Although HRSA doesn't financially support federally sponsored programs, their goal of improved dental training to care for medically compromised individuals is facilitated through these programs, thus making military and VA general dentistry programs a national resource.
Wright, Michelle F; Li, Yan
2013-01-01
This longitudinal study examined normative beliefs about aggression (e.g., face-to-face, cyber) in relation to the engagement in cyber aggression 6 months later among 126 (69 women) young adults. Participants completed electronically administered measures assessing their normative beliefs, face-to-face and cyber aggression at Time 1, and cyber aggression 6 months later (Time 2). We found that men reported more cyber relational and verbal aggression when compared to women. After controlling for each other, Time 1 face-to-face relational aggression was positively related to Time 2 cyber relational aggression, whereas Time 1 face-to-face verbal aggression was positively related to Time 2 cyber verbal aggression. Normative beliefs regarding cyber aggression was positively related to both forms of cyber aggression 6 months later, after controlling for normative beliefs about face-to-face aggression. Furthermore, a significant two-way interaction between Time 1 cyber relational aggression and normative beliefs about cyber relational aggression was found. Follow-up analysis showed that Time 1 cyber relational aggression was more strongly related to Time 2 cyber relational aggression when young adults held higher normative beliefs about cyber relational aggression. A similar two-way interaction was found for cyber verbal aggression such that the association between Time 1 and Time 2 cyber verbal aggression was stronger at higher levels of normative beliefs about cyber verbal aggression. Results are discussed in terms of the social cognitive and behavioral mechanisms associated with the engagement of cyber aggression. © 2013 Wiley Periodicals, Inc.
MyHealtheVet (VA's personal health record)
... Overview Site Map Help & User Guides FAQ Privacy & Security Terms and Conditions Policies Privacy Policy Web Policies FOIA Accessibility System Use Important Links VA Home White House USA.gov Inspector ...
van Olden, G D J
2014-12-01
The aim of this investigation was to evaluate the introduction of the VA-LCP anterior clavicle plate in the treatment of clavicle fractures. From March 2011 to March 2013, 42 clavicle fractures were treated; 40 were middle-third and 2 lateral-third, and 13/42 (31 %) patients were treated due to painful nonunion. Patient age ranged from 16 to 81 years. Complications were screw placement through the AC-joint, one superficial wound infection and one neuropraxia of the nervus radialis with dropping hand. We had some difficulties prebending both lateral to low and lateral to high but without clinical consequences. In all cases, the fracture healed with full functionality. After 1 year, 4 patients underwent a removal of the hardware. The VA-LCP anterior plate showed good reliability and sufficient stability with both middle-third, lateral and nonunion fractures of the clavicle.
Early Understanding of Normativity and Freedom to Act in Turkish Toddlers
ERIC Educational Resources Information Center
Tunçgenç, Bahar; Hohenberger, Annette; Rakoczy, Hannes
2015-01-01
Two studies investigated young 2- and 3-year-old Turkish children's developing understanding of normativity and freedom to act in games. As expected, children, especially 3-year-olds, protested more when there was a norm violation than when there was none. Surprisingly, however, no decrease in normative protest was observed even when the actor…
Normative Discourse and Persuasion: An Analysis of Ga'dang Informal Litigation.
ERIC Educational Resources Information Center
Walrod, Michael R.
A study of the discourse of Ga'dang, a Philippine language, focuses on normative discourse and persuasion, especially the ways in which the former is used to accomplish the latter. The first five chapters outline the theoretical framework of the study, placing normative and persuasive discourse in a philosophical context and relating them to the…
What the VA can teach us about geriatric care.
Ratner, Edward R; West, Melissa; Hartwig, Kristopher N; Meyer, Bruce C
2013-01-01
The innovation now being demanded by Medicare is creating new opportunities for health care organizations to redesign how they deliver care for elderly people. For many years, the VA Health System has experimented with ways to deliver care more effectively and efficiently. Hospital-based postacute and palliative care and home-based primary care are two examples of successful approaches that non-VA providers should be looking at as they move away from fee-for-service reimbursement and invent new care-delivery models.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-11
... of Waiver of VA Compensation or Pension To Receive Military Pay and Allowances) Activity; Comment... Pension to Receive Military Pay and Allowances, VA Form 21-8951 and VA Form 21-8951-2. OMB Control Number... to waive VA disability benefits in order to receive active or inactive duty training pay are required...
Palomo, R; Casals-Coll, M; Sánchez-Benavides, G; Quintana, M; Manero, R M; Rognoni, T; Calvo, L; Aranciva, F; Tamayo, F; Peña-Casanova, J
2013-05-01
The Rey-Osterrieth Complex Figure (ROCF) and the Free and Cued Selective Reminding Test (FCSRT) are widely used in clinical practice. The ROCF assesses visual perception, constructional praxis, and visuo-spatial memory. The FCSRT assesses verbal learning and memory. In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present age- and education-adjusted normative data for both tests obtained by using linear regression techniques. The sample consisted of 179 healthy participants ranging in age from 18 to 49 years. We provide tables for converting raw scores to scaled scores in addition to tables with scores adjusted by socio-demographic factors. The results showed that education affects scores for some of the memory tests and the figure-copying task. Age was only found to have an effect on the performance of visuo-spatial memory tests, and the effect of sex was negligible. The normative data obtained will be extremely useful in the clinical neuropsychological evaluation of young Spanish adults. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.
Liu, Shan; Barnett, Paul G.; Holodniy, Mark; Lo, Jeanie; Joyce, Vilija R.; Gidwani, Risha; Asch, Steven M.; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.
2018-01-01
Background Chronic hepatitis C viral (HCV) infection affects millions of Americans. Healthcare systems face complex choices between multiple highly efficacious, costly treatments. This study assessed the cost-effectiveness of HCV treatments for chronic, genotype 1 HCV monoinfected, treatment-naïve individuals in the Department of Veterans Affairs (VA) and general U.S. healthcare systems. Methods We conducted a decision-analytic Markov model-based cost-effectiveness analysis, employing appropriate payer perspectives and time horizons, and discounting benefits and costs at 3% annually. Interventions included: Sofosbuvir/ledipasvir (SOF-LDV); ombitasvir/paritaprevir/ritonavir/dasabuvir (3D); sofosbuvir/simeprevir (SOF-SMV); sofosbuvir/pegylated interferon/ribavirin (SOF-RBV-PEG); boceprevir/pegylated interferon/ribavirin (BOC-RBV-PEG); and pegylated interferon/ribavirin (PEG-RBV). Outcomes were sustained virologic response (SVR), advanced liver disease, costs, quality adjusted life years (QALYs), and incremental cost-effectiveness. Results SOF-LDV and 3D achieve higher SVR rates compared to older regimens and reduce advanced liver disease (>20% relative to no treatment), increasing QALYs by over 2 years per person. For the non-VA population, at current prices ($5,040 per week for SOF-LDV and $4,796 per week for 3D), SOF-LDV’s lifetime cost ($293,370) is $18,000 lower than 3D’s because of its shorter treatment duration in subgroups. SOF-LDV costs $17,100 per QALY gained relative to no treatment. 3D costs $208,000 per QALY gained relative to SOF-LDV. Both dominate other treatments and are even more cost-effective for the VA, though VA aggregate treatment costs still exceed $4 billion at SOF-LDV prices of $3,308 per week. Drug prices strongly determine relative cost-effectiveness for SOF-LDV and 3D; With sufficient price reductions (approximately 20–30% depending on the health system), 3D could be cost-effective relative to SOF-LDV. Limitations include the lack of
Normative prompts reduce consumer food waste in restaurants.
Stöckli, Sabrina; Dorn, Michael; Liechti, Stefan
2018-05-03
This field study demonstrates that prompts reduce food waste in a restaurant. Based on the behavioral change literature, it was hypothesized that (1) informational prompts encourage consumers to reduce food waste, and that (2) an informational prompt with a normative message is more effective than a prompt with only an informative message. The results were mixed. As expected, diners who were exposed to prompts asked to take away their leftovers more frequently than diners who were exposed to no prompts. However, prompts with an informative and normative message were no more powerful than prompts with only an informative message. Copyright © 2018 Elsevier Ltd. All rights reserved.
The influence of advanced age on venous-arterial extracorporeal membrane oxygenation outcomes.
Salna, Michael; Takeda, Koji; Kurlansky, Paul; Ikegami, Hirohisa; Fan, Liqiong; Han, Jiho; Stein, Samantha; Topkara, Veli; Yuzefpolskaya, Melana; Colombo, Paolo C; Karmpaliotis, Dimitrios; Naka, Yoshifumi; Kirtane, Ajay J; Garan, Arthur R; Takayama, Hiroo
2018-01-22
Ethical and health care economic concerns surround the use of venous-arterial extracorporeal membrane oxygenation (VA-ECMO) in elderly patients. Patients requiring VA-ECMO are often in critical condition and the decision to cannulate is time-sensitive. We investigated the relationship between age and VA-ECMO outcomes to better inform this decision. This is a retrospective study of 355 patients placed on VA-ECMO between March 2007 and August 2016 at our institution. Using piecewise modelling, age became associated with in-hospital mortality after 63 years. Based on further analysis with the χ2 statistic maximization, patients were divided into 2 age groups: ≤72 years old [Group Y (Young), n = 310] and >72 years old [Group O (Old), n = 45]. Multivariable logistic regression was performed to identify preoperative predictors of in-hospital mortality. Patients over the age of 72 had a significantly higher prevalence of comorbidities, including coronary disease, previous strokes and chronic kidney disease. Weaning from ECMO was achieved in 76% of Group Y and 47% of Group O (P < 0.001). In-hospital mortality was 52% among Group Y and 69% among Group O (P = 0.037). Multivariable logistic regression using preoperative risk factors identified coronary artery disease, acute decompensated heart failure and an age >72 years as independent predictors of mortality (age >72 years: odds ratio 2.71, 95% confidence interval 1.22-6.00; P = 0.01). VA-ECMO in-hospital mortality is considerable across all age groups. However, age only becomes associated with mortality after 63 years and rises dramatically after 72 years. This study provides useful insight into these time-sensitive decisions for the development of possible practice guidelines. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
VA/Q distribution during heavy exercise and recovery in humans: implications for pulmonary edema
NASA Technical Reports Server (NTRS)
Schaffartzik, W.; Poole, D. C.; Derion, T.; Tsukimoto, K.; Hogan, M. C.; Arcos, J. P.; Bebout, D. E.; Wagner, P. D.
1992-01-01
Ventilation-perfusion (VA/Q) inequality has been shown to increase with exercise. Potential mechanisms for this increase include nonuniform pulmonary vasoconstriction, ventilatory time constant inequality, reduced large airway gas mixing, and development of interstitial pulmonary edema. We hypothesized that persistence of VA/Q mismatch after ventilation and cardiac output subside during recovery would be consistent with edema; however, rapid resolution would suggest mechanisms related to changes in ventilation and blood flow per se. Thirteen healthy males performed near-maximal cycle ergometry at an inspiratory PO2 of 91 Torr (because hypoxia accentuates VA/Q mismatch on exercise). Cardiorespiratory variables and inert gas elimination patterns were measured at rest, during exercise, and between 2 and 30 min of recovery. Two profiles of VA/Q distribution behavior emerged during heavy exercise: in group 1 an increase in VA/Q mismatch (log SDQ of 0.35 +/- 0.02 at rest and 0.44 +/- 0.02 at exercise; P less than 0.05, n = 7) and in group 2 no change in VA/Q mismatch (n = 6). There were no differences in anthropometric data, work rate, O2 uptake, or ventilation during heavy exercise between groups. Group 1 demonstrated significantly greater VA/Q inequality, lower vital capacity, and higher forced expiratory flow at 25-75% of forced vital capacity for the first 20 min during recovery than group 2. Cardiac index was higher in group 1 both during heavy exercise and 4 and 6 min postexercise. However, both ventilation and cardiac output returned toward baseline values more rapidly than did VA/Q relationships. Arterial pH was lower in group 1 during exercise and recovery. We conclude that greater VA/Q inequality in group 1 and its persistence during recovery are consistent with the hypothesis that edema occurs and contributes to the increase in VA/Q inequality during exercise. This is supported by observation of greater blood flows and acidosis and, presumably therefore
Bex, Peter J; Woods, Russell L
2013-01-01
Background Crowdsourcing has become a valuable method for collecting medical research data. This approach, recruiting through open calls on the Web, is particularly useful for assembling large normative datasets. However, it is not known how natural language datasets collected over the Web differ from those collected under controlled laboratory conditions. Objective To compare the natural language responses obtained from a crowdsourced sample of participants with responses collected in a conventional laboratory setting from participants recruited according to specific age and gender criteria. Methods We collected natural language descriptions of 200 half-minute movie clips, from Amazon Mechanical Turk workers (crowdsourced) and 60 participants recruited from the community (lab-sourced). Crowdsourced participants responded to as many clips as they wanted and typed their responses, whereas lab-sourced participants gave spoken responses to 40 clips, and their responses were transcribed. The content of the responses was evaluated using a take-one-out procedure, which compared responses to other responses to the same clip and to other clips, with a comparison of the average number of shared words. Results In contrast to the 13 months of recruiting that was required to collect normative data from 60 lab-sourced participants (with specific demographic characteristics), only 34 days were needed to collect normative data from 99 crowdsourced participants (contributing a median of 22 responses). The majority of crowdsourced workers were female, and the median age was 35 years, lower than the lab-sourced median of 62 years but similar to the median age of the US population. The responses contributed by the crowdsourced participants were longer on average, that is, 33 words compared to 28 words (P<.001), and they used a less varied vocabulary. However, there was strong similarity in the words used to describe a particular clip between the two datasets, as a cross-dataset count
2012-01-01
Background The methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts. Discussion A considered reference to normative research questions can be expected from good quality empirical research in medical ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics. Summary High quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis. PMID:22500496
Maddock, Jay; Glanz, Karen
2005-02-01
Heavy drinking among college students is a major concern across the country. Several studies have shown that students tend to overestimate the alcohol consumption of students, in general (global social norms), and of their close friends (proximal normative beliefs). Research has also shown that beliefs about others' alcohol consumption is strongly related to alcohol use. We hypothesized that normative beliefs about important referent individuals would mediate the relationship between campus social norms and alcohol consumption. A survey of alcohol use and related variables was completed by 433 university students. Multiple regression was used to examine the mediational role of normative beliefs on social norms and alcohol consumption. These analyses indicate that normative beliefs are a significant mediator of the relationship between social norms and alcohol consumption. Normative beliefs accounted for 52-62% of the proportion of variance mediated. Normative beliefs are an important construct in understanding the relationship between social norms and alcohol use among college students and may be an important area for future interventions.
A normative study of the Children's Color Trails Test (CCTT) in the Cypriot population.
Konstantopoulos, K; Vogazianos, P; Thodi, C; Nikopoulou-Smyrni, P
2015-01-01
The Children's Color Trails Test (CCTT) is a neuropsychological test that measures attention, divided attention, and speed of mental processing. It has been increasingly used in the assessment of children in cross-cultural environments for neurological and psychiatric disorders such as seizures and closed head injuries, learning and/or language disabilities, attention deficit/hyperactivity disorder, children with manganese exposure, and children diagnosed with HIV virus. However, there is a paucity of studies presenting normative data. The aim of the present study was to provide normative data for the CCTT in the Cypriot population. A total of 709 native Cypriot children aged 7-16 years, recruited from various public schools across the island, took part in the study. Exclusion criteria involved the existence of neurological, psychiatric, cardiological, and metabolic diseases, premature birth, history of maternal alcohol and drug abuse during pregnancy, low birth weight, hearing loss, visual problems, native language other than Greek, and abnormality in fine-motor movements. Age and gender were found to be important factors for the interpretation of scores in all CCTT variables. Older children required less time and exhibited fewer errors, near misses, and prompts compared to younger children. There was a consistent pattern of a 3-4 seconds improvement (less time in seconds) in the CCTT completion time as age increased. CCTT is a promising tool for the measurement of attention in the native Cypriot population. Further research is needed in children diagnosed with various neurological and psychiatric diseases in order to estimate validity of the CCTT in clinical populations.
Normative data for Aδ contact heat evoked potentials in adult population: a multicenter study.
Granovsky, Yelena; Anand, Praveen; Nakae, Aya; Nascimento, Osvaldo; Smith, Benn; Sprecher, Elliot; Valls-Solé, Josep
2016-05-01
There has been a significant increase over recent years in the use of contact heat evoked potentials (CHEPs) for the evaluation of small nerve fiber function. Measuring CHEP amplitude and latency has clinical utility for the diagnosis and assessment of conditions with neuropathic pain. This international multicenter study aimed to provide reference values for CHEPs to stimuli at 5 commonly examined body sites. Contact heat evoked potentials were recorded from 226 subjects (114 females), distributed per age decade between 20 and 79 years. Temperature stimuli were delivered by a thermode (32°C-51°C at a rate of 70°C/s). In phase I of the study, we investigated side-to-side differences and reported the maximum normal side-to-side difference in Aδ CHEP peak latency and amplitude for leg, forearm, and face. In phase II, we obtained normative data for 3 CHEP parameters (N2P2 amplitude, N2 latency, and P2 latency), stratified for gender and age decades from face, upper and lower limbs, and overlying cervical and lumbar spine. In general, larger CHEP amplitudes were associated with higher evoked pain scores. Females had CHEPs of larger amplitude and shorter latency than males. This substantive data set of normative values will facilitate the clinical use of CHEPs as a rapid, noninvasive, and objective technique for the assessment of patients presenting with neuropathic pain.
30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).
Code of Federal Regulations, 2010 CFR
2010-07-01
... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Self-contained breathing apparatus (V-A mines... NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22315 Self-contained breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape from...
30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).
Code of Federal Regulations, 2011 CFR
2011-07-01
... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Self-contained breathing apparatus (V-A mines... NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Equipment § 57.22315 Self-contained breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape from...
The Combined Influence of Affective, Continuance and Normative Commitment on Employee Withdrawal
ERIC Educational Resources Information Center
Somers, Mark John
2009-01-01
In a sample of 288 hospital nurses, commitment profiles were compared to turnover intentions, job search behavior, work withdrawal (absenteeism and lateness) and job stress. Five empirically-derived commitment profiles emerged: highly committed, affective-normative dominant, continuance-normative dominant, continuance dominant, and uncommitted.…
Rogers, Katherine H; Biesanz, Jeremy C
2015-12-01
There are strong differences between individuals in the tendency to view the personality of others as similar to the average person. That is, some people tend to form more normatively accurate impressions than do others. However, the process behind the formation of normatively accurate first impressions is not yet fully understood. Given that the average individual's personality is highly socially desirable (Borkenau & Zaltauskas, 2009; Wood, Gosling & Potter, 2007), individuals may achieve high normative accuracy by viewing others as similar to the average person or by viewing them in an overly socially desirable manner. The average self-reported personality profile and social desirability, despite being strongly correlated, independently and strongly predict first impressions. Further, some individuals have a more accurate understanding of the average individual's personality than do others. Perceivers with more accurate knowledge about the average individual's personality rated the personality of specific others more normatively accurately (more similar to the average person), suggesting that individual differences in normative judgments include a component of accurate knowledge regarding the average personality. In contrast, perceivers who explicitly evaluated others more positively formed more socially desirable impressions, but not more normatively accurate impressions. (c) 2015 APA, all rights reserved).
Normative values of isometric elbow strength in healthy adults: a systematic review.
Kotte, Shamala H P; Viveen, Jetske; Koenraadt, Koen L M; The, Bertram; Eygendaal, Denise
2018-07-01
Post-traumatic deformities such as biceps tendon rupture or (peri-)articular fractures of the elbow are often related to a decrease in muscle strength. Postoperative evaluation of these deformities requires normative values of elbow strength. The purpose of this systematic review was to determine these normative values of isometric elbow strength in healthy adults resulting from studies evaluating this strength (i.e. flexion, extension, pronation and supination strength). The databases of PubMed, EMBASE and Web of Sciences were searched and screened for studies involving the isometric elbow strength as measured in asymptomatic volunteers. The quality of the studies was assessed and studies of low quality were excluded. Nineteen studies met the inclusion criteria and were of sufficiently high quality to be included in the present review. In these studies, elbow strength was measured in a total of 1880 healthy volunteers. The experimental set-up and devices used to measure elbow strength varied between studies. Using some assumptions, a normative values table was assembled. Large standard deviations of normative values in combination with different measurement devices used, as well as the different measurement positions of the subjects, demonstrated that there is no consensus about measuring the isometric elbow strength and therefore the normative values have to be interpreted with caution.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-07
... Clinic Application, VA Form 0928a series. f. National Veterans Creative Arts Festival Application, VA... Veterans Creative Arts Festival, National Veterans TEE Tournament, National Disabled Veterans Winter Sports...
Establishing Baseline Normative Values for the Child Sport Concussion Assessment Tool.
Brooks, M Alison; Snedden, Traci R; Mixis, Benjamin; Hetzel, Scott; McGuine, Timothy A
2017-07-01
The Child Sport Concussion Assessment Tool (SCAT3) is a postconcussion sideline assessment tool measuring symptoms, cognition, and balance in preadolescent children. Minimal normative baseline data exist to aid decision making in clinical and athletic settings. To collect normative baseline data for the Child SCAT3 in a large cohort of young athletes. A cross-sectional study was conducted from May 31 to August 12, 2014, at various sporting events (basketball, soccer, baseball, and swimming) in Central Wisconsin among children 5 to 13 years of age who were English-speaking and did not report a lower leg injury within the past 2 months or a concussion within the past month. Data were analyzed between October 8, 2014, and September 12, 2016. All Child SCAT3 components were assessed: child and parent report of symptom number and severity, cognition (Standardized Assessment of Concussion-child version [SAC-C]), and balance (modified Balance Error Scoring System [mBESS] and tandem gait). Summary statistics, mean differences, and effect sizes were calculated for each test component. Participants included 478 children (234 girls and 241 boys; mean [SD] age, 9.9 [1.9] years]) and their parents. Age had the largest effect on all Child SCAT3 components, with children 5 to 7 years of age reporting higher mean (SD) symptom severity scores compared with those 11 to 13 years of age (18.2 [10.0] vs 11.3 [9.0]; mean difference, 6.86 [95% CI, 4.22-9.50]; effect size, 0.74) and performing more poorly on the total SAC-C (mean [SD] score, 19.5 [5.1] vs 26.1 [2.1]; mean difference, -6.59 [95% CI, -7.49 to -5.68]; effect size, -2.1), mBESS (mean [SD] score, 1.67 [1.8] vs 0.76 [1.2]; mean difference, 0.91 [95% CI, 0.53-1.29]; effect size, 0.68), and tandem gait (mean [SD] time, 22.2 [8.3] vs 14.0 [3.7] seconds; mean difference, 8.23 seconds [95% CI, 6.63-9.82]; effect size, 1.55). Sex had a small effect on the mean (SD) number and severity of symptoms reported by the child (severity: boys
Brown, David K; Cameron, Sharon; Martin, Jeffrey S; Watson, Charlene; Dillon, Harvey
2010-01-01
The Listening in Spatialized Noise-Sentences test (LiSN-S; Cameron and Dillon, 2009) was originally developed to assess auditory stream segregation skills in children aged 6 to 11 yr with suspected central auditory processing disorder. The LiSN-S creates a three-dimensional auditory environment under headphones. A simple repetition-response protocol is used to assess a listener's speech reception threshold (SRT) for target sentences presented in competing speech maskers. Performance is measured as the improvement in SRT in dB gained when either pitch, spatial, or both pitch and spatial cues are incorporated in the maskers. A North American-accented version of the LiSN-S (NA LiSN-S) is available for use in the United States and Canada. To develop normative data for adolescents and adults on the NA LiSN-S, to compare these data with those of children aged 6 to 11 yr as documented in Cameron et al (2009), and to consolidate the child, adolescent, and adult normative and retest data to allow the software to be used with a wider population. In a descriptive design, normative data and test-retest reliability data were collected. One hundred and twenty normally hearing participants took part in the normative data study (67 adolescents aged 12 yr, 1 mo, to 17 yr, 10 mo, and 53 adults aged 19 yr, 10 mo, to 30 yr, 30 mo). Forty-nine participants returned between 1 and 4 mo after the initial assessment for retesting. Participants were recruited from sites in Cincinnati, Dallas, and Calgary. When combined with data collected from children aged 6 to 11 yr, a trend of improved performance as a function of increasing age was found across performance measures. ANOVA (analysis of variance) revealed a significant effect of age on performance. Planned contrasts revealed that there were no significant differences between adults and children aged 13 yr and older on the low-cue SRT; 14 yr and older on talker and spatial advantage; 15 yr and older on total advantage; and 16 yr and older
46 CFR 7.45 - Cape Henlopen, DE to Cape Charles, VA.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 1 2011-10-01 2011-10-01 false Cape Henlopen, DE to Cape Charles, VA. 7.45 Section 7.45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.45 Cape Henlopen, DE to Cape Charles, VA. (a) A line drawn from the easternmost...
Hanson, Corrine; Lyden, Elizabeth; Furtado, Jeremy; Campos, Hannia; Sparrow, David; Vokonas, Pantel; Litonjua, Augusto A
2016-02-01
The results of studies assessing relationships between vitamin E intake and status and lung function are conflicting. This study aimed to evaluate the effect of vitamin E intake and serum levels of tocopherol isoforms on lung function in a cross-sectional sample of 580 men from the Normative Aging Study, a longitudinal aging study. Regression models were used to look at associations of serum tocopherol isoform levels and vitamin E intake with lung function parameters after adjustment for confounders. Vitamin E intake was measured using a food frequency questionnaire and serum levels of γ, α, and δ-tocopherol levels were measured using high-performance liquid chromatography. After adjustment for potential confounders, serum γ-tocopherol had a significant inverse association with forced vital capacity (β = -0.10, p = 0.05). Alpha and δ-tocopherol were not associated with any lung function parameter. After classifying COPD status according to Global Initiative for Obstructive Lung Disease (GOLD) stage criteria, serum levels of δ-tocopherol were lower in participants with more severe COPD (p = 0.01). Serum levels of δ-tocopherol were also lower in participants with greater levels of smoking (p = 0.02). Both vitamin E intake (β = 0.03, p = 0.02; β = 0.03, p = 0.01) and use of vitamin E supplements (β = 0.05, p = 0.03; β = 0.06. p = 0.02) were positively associated with FEV1 and FVC, after adjusting for confounders. Subjects who took vitamin E supplements had significantly higher α-tocopherol levels (p < 0.0001) and lower γ-tocopherol levels (p < 0.0001) than non-users. In this study, there is a positive association between dietary vitamin E intake and lung function, and evidence of an inverse relationship between serum levels of γ-tocopherol and lung function. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Famous face recognition and naming test: a normative study.
Rizzo, S; Venneri, A; Papagno, C
2002-10-01
Tests of famous face recognition and naming, and tasks assessing semantic knowledge about famous people after presentation either of their faces or their names are often used in the neuropsychological examination of aphasic, amnesic and demented patients. A total of 187 normal subjects took part in this study. The aim was to collect normative data for a newly devised test including five subtests: famous face naming, fame judgement after face presentation and after name presentation, semantic knowledge about famous people after face presentation and after name presentation. Norms were calculated taking into account demographic variables such as age, sex and education and adjusted scores were used to determine inferential cut-off scores and to compute equivalent scores. Multiple regression analyses showed that age and education influenced significantly the performance on most subtests, but sex had no effect on any of them. Scores of the subtest evaluating fame judgements after name presentation were significantly influenced only by education. The only subtest whose scores were not influenced by any demographic variable was fame judgement after face presentation.
“Nobody tosses a dwarf!” The relation between the empirical and normative reexamined
Leget, C.; Borry, P.; De Vries, R.
2009-01-01
This article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as point of departure because it challenges the reader to look upon several central bioethical themes – including human dignity, autonomy, and the protection of vulnerable people – with fresh eyes. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak to the problem of dwarf tossing: prescriptive applied ethics, theorist ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two-way relation between empirical and normative theories. The approach we endorse acknowledges that a social practice can and should be judged by both the gathering of empirical data and by the normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical poles that, in our view, should operate as two independent focuses of the ellipse that is called bioethics. We conclude by applying our five stage critical applied ethics to the example of dwarf tossing. PMID:19338523
Scalici, Francesca; Schulz, Peter J
2017-01-21
Adolescents observe and imitate people to whom they are associated in their social context, and the normative factors sent out by reference groups are crucial determinants of their decision to smoke. The aim of the study is to investigate how adolescents' smoking changes when they are exposed to factors of pro-smoking normative influence by parents and peers, and how age moderate this relation. A cross sectional survey collected data from 5657 students, aged between 11 and 14, from public and private middle schools in the Italian region of Switzerland (Ticino) on their smoking habits, perceived parents' and peers' approval and smoking. Multinomial logistic regression show that, as adolescents get older, more of the pro-smoking factors come from peers and parents, the higher the risk gets of being a "heavy smoker" has compared against having no experience with smoking. Living in a context with no factor of normative influence toward smoking play a protective role against smoking, and this effect becomes more important than more harmful the smoking behavior in question is. Furthermore, peers' descriptive norms are more influential for adolescents to become "light" and "heavy smokers", while smoking being approved by peers is important for adolescents to become accustomed to smoking. Findings support the different influence of parents' and peers' norms on adolescents' smoking, and highlight the importance of peers' model behavior as the most important factor influencing smoking during adolescence. Such results have implications for programs that aim to prevent or reduce smoking in early adolescence when friendship choice starts to become crucial.
Siciliano, Mattia; Raimo, Simona; Tufano, Dario; Basile, Giuseppe; Grossi, Dario; Santangelo, Franco; Trojano, Luigi; Santangelo, Gabriella
2016-03-01
The Addenbrooke's Cognitive Examination Revised (ACE-R) is a rapid screening battery, including five sub-scales to explore different cognitive domains: attention/orientation, memory, fluency, language and visuospatial. ACE-R is considered useful in discriminating cognitively normal subjects from patients with mild dementia. The aim of present study was to provide normative values for ACE-R total score and sub-scale scores in a large sample of Italian healthy subjects. Five hundred twenty-six Italian healthy subjects (282 women and 246 men) of different ages (age range 20-93 years) and educational level (from primary school to university) underwent ACE-R and Montreal Cognitive Assessment (MoCA). Multiple linear regression analysis revealed that age and education significantly influenced performance on ACE-R total score and sub-scale scores. A significant effect of gender was found only in sub-scale attention/orientation. From the derived linear equation, a correction grid for raw scores was built. Inferential cut-offs score were estimated using a non-parametric technique and equivalent scores (ES) were computed. Correlation analysis showed a good significant correlation between ACE-R adjusted scores with MoCA adjusted scores (r = 0.612, p < 0.001). The present study provided normative data for the ACE-R in an Italian population useful for both clinical and research purposes.
75 FR 41577 - VBA/VHA Musculoskeletal Forum: Improving VA's Disability Evaluation Criteria
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-16
... medical science information from presentations made by subject matter experts. VA plans to use this information to update the sections of VA's Schedule for Rating Disabilities (VASRD) that pertain to diseases... FURTHER INFORMATION CONTACT: Mr. Brad Tuttle, VASRD Coordinator, Compensation and Pension Service...
ERIC Educational Resources Information Center
Bishop-Fitzpatrick, Lauren; Hong, Jinkuk; Smith, Leann E.; Makuch, Renee A.; Greenberg, Jan S.; Mailick, Marsha R.
2016-01-01
This study aims to extend the definition of quality of life (QoL) for adults with autism spectrum disorder (ASD, n = 180, ages 23-60) by: (1) characterizing the heterogeneity of normative outcomes (employment, independent living, social engagement) and objective QoL (physical health, neighborhood quality, family contact, mental health issues); and…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-11
... treatment of eligible veterans at non-VA facilities and expand the circumstances under which payment for..., potentially eligible veterans would be appropriately afforded ample opportunity to qualify for this expanded...; 64.010, Veterans Nursing Home Care; and 64.011, Veterans Dental Care. Signing Authority The Secretary...
48 CFR 833.103 - Protests to VA.
Code of Federal Regulations, 2011 CFR
2011-10-01
... encouraged to use alternative dispute resolution (ADR) procedures to resolve protests at any stage in the protest process. If ADR is used, VA will not furnish any documentation in an ADR proceeding beyond what is...
78 FR 21817 - Amendment of Restricted Area R-6601; Fort A.P. Hill, VA
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-12
...; Airspace Docket No. 12-AEA-7] RIN 2120-AA66 Amendment of Restricted Area R-6601; Fort A.P. Hill, VA AGENCY... limits and time of designation of restricted area R-6601, Fort A.P. Hill, VA. The U.S. Army requested... limits and increase the time of designation of restricted area R-6601, Fort A.P. Hill, VA, (77 FR 35308...
The VA Computerized Patient Record — A First Look
Anderson, Curtis L.; Meldrum, Kevin C.
1994-01-01
In support of its in-house DHCP Physician Order Entry/Results Reporting application, the VA is developing the first edition of a Computerized Patient Record. The system will feature a physician-oriented interface with real time, expert system-based order checking, a controlled vocabulary, a longitudinal repository of patient data, HL7 messaging support, a clinical reminder and warning system, and full integration with existing VA applications including lab, pharmacy, A/D/T, radiology, dietetics, surgery, vitals, allergy tracking, discharge summary, problem list, progress notes, consults, and online physician order entry. PMID:7949886
76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-21
... concerning the billing methodology for non-VA providers of home health services and hospice care. The proposed rulemaking would include home health services and hospice care under the VA regulation governing payment for other non-VA health care providers. Because the newly applicable methodology cannot supersede...
Eisenberg, Dan; Lohnberg, Jessica A; Kubat, Eric P; Bates, Cheryl C; Greenberg, Lauren M; Frayne, Susan M
2017-04-01
Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management. This is a description of an interdisciplinary clinic and bariatric program at a VA healthcare system and a report on program evaluation findings. Retrospective data of a prospective database was abstracted. For program evaluation, we abstracted charts to characterize patient data and conducted a patient survey. Since 2009, 181 veterans have undergone bariatric surgery. Referrals came from 7 western U.S. states. Mean preoperative body mass index was 46 kg/m 2 (maximum 71). Mean age was 53 years, with 33% aged>60 years; 79% were male. Medical co-morbidity included diabetes (70%), hypertension (85%), and lower back or extremity joint pain (84%). A psychiatric diagnosis was present in 58%. At 12 months, follow-up was 81% and percent excess body mass index loss was 50.5%. Among 54 sequential clinic patients completing anonymous surveys, overall satisfaction with the interdisciplinary team approach and improved quality of life were high (98% and 94%, respectively). The integrated, interdisciplinary team approach using a hub-and-spokes model is well suited to the VA bariatric surgery population, with its heavy burden of medical and mental health co-morbidity and its system of geographically dispersed patients receiving treatment at specialty centers. As the VA seeks to expand the use of bariatric surgery as an option for obese veterans, interdisciplinary models crafted to address case complexity, care coordination, and long-term outcomes should be part of policy planning efforts. Published by
Feenstra, Heleen Em; Vermeulen, Ivar E; Murre, Jaap Mj; Schagen, Sanne B
2018-05-30
Online tests enable efficient self-administered assessments and consequently facilitate large-scale data collection for many fields of research. The Amsterdam Cognition Scan is a new online neuropsychological test battery that measures a broad variety of cognitive functions. The aims of this study were to evaluate the psychometric properties of the Amsterdam Cognition Scan and to establish regression-based normative data. The Amsterdam Cognition Scan was self-administrated twice from home-with an interval of 6 weeks-by 248 healthy Dutch-speaking adults aged 18 to 81 years. Test-retest reliability was moderate to high and comparable with that of equivalent traditional tests (intraclass correlation coefficients: .45 to .80; .83 for the Amsterdam Cognition Scan total score). Multiple regression analyses indicated that (1) participants' age negatively influenced all (12) cognitive measures, (2) gender was associated with performance on six measures, and (3) education level was positively associated with performance on four measures. In addition, we observed influences of tested computer skills and of self-reported amount of computer use on cognitive performance. Demographic characteristics that proved to influence Amsterdam Cognition Scan test performance were included in regression-based predictive formulas to establish demographically adjusted normative data. Initial results from a healthy adult sample indicate that the Amsterdam Cognition Scan has high usability and can give reliable measures of various generic cognitive ability areas. For future use, the influence of computer skills and experience should be further studied, and for repeated measurements, computer configuration should be consistent. The reported normative data allow for initial interpretation of Amsterdam Cognition Scan performances. ©Heleen EM Feenstra, Ivar E Vermeulen, Jaap MJ Murre, Sanne B Schagen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.05.2018.
Molinari, Victor A; Brown, Lisa M; Frahm, Kathryn A; Schinka, John A; Casey, Roger
2013-05-01
To understand the needs and challenges encountered by older homeless veterans. We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.
Binocular vision anomalies and normative data (BAND) in Tamil Nadu: report 1.
Hussaindeen, Jameel Rizwana; Rakshit, Archayeeta; Singh, Neeraj Kumar; Swaminathan, Meenakshi; George, Ronnie; Kapur, Suman; Scheiman, Mitchell; Ramani, Krishna Kumar
2017-05-01
This population-based, cross-sectional study was designed to determine normative data for binocular vision and accommodative testing in rural and urban populations of Tamil Nadu. A sample of 936 was determined, based on a previous pilot study. The epidemiological field work included a comprehensive eye examination and a binocular vision and accommodative assessment carried out in a total of four public schools, two each in the rural and urban arms of Chennai. An overall sample of 3,024 children between seven and 17 years of age was screened in the four schools and 920 children were included in the study. We found significant differences in expected values from the current clinical criteria for near point of convergence (NPC) with penlight, distance and near horizontal phorias, vergence facility, accommodation convergence/accommodation (AC/A) ratio, accommodative amplitudes, monocular and binocular accommodative facility (t-test: p < 0.001). The mean and standard deviation break/recovery values for NPC (in centimetres) with an accommodative target and penlight with red filter was 3 ± 3/4 ± 4 and 7 ± 5/10 ± 7, respectively. The mean accommodative amplitudes for the population could be estimated from the linear regression equation 16 - 0.3 × (age). The vergence facility was 12 ± 4 cycles/minute and 14 ± 4 cycles/minute in the seven to 10 and 11 to 17 age groups, respectively. Monocular accommodative facility was 11 ± 4 cycles/minute and 14 ± 5 cycles/minute and binocular accommodative facility was 10 ± 4 cycles/minute and 14 ± 5 cycles/minute in the seven to 12 and 13 to 17 age groups, respectively. The mean calculated AC/A ratio was 5.4 ± 0.6/1. The normative data for vergence and accommodative parameters for the Indian children between seven and 17 years of age are reported. The developmental trend of accommodation and vergence differences and significant differences in cut-off between the current data and available literature are reported. These
Aging and the Baseline Code: An Alternative to the "Normless Elderly."
ERIC Educational Resources Information Center
Offenbacher, Deborah I.; Poster, Constance H.
1985-01-01
A projective test administered to 120 older persons revealed a "baseline normative code" to which respondents held themselves and their contemporaries. Findings suggest that, in the absence of age-specific norms, the elderly do not become "normless" but develop their own normative prescriptions to fit their past socialization and present…
Machackova, Hana; Pfetsch, Jan
2016-04-01
Cyberbullying often takes place with the virtual presence or knowledge of bystanders. While we have some evidence about the determinants of bystanders' responses to offline bullying, we lack empirical studies concerning the variables that influence bystanders' responses to cyberbullying. The current study examines bystanders' responses to offline bullying and cyberbullying incidents. Two types of responses were captured: support toward the victims and the reinforcement of bullies' actions. Using data from 321 German adolescents (ages 12-18; M = 14.99; 44% girls), the association between bystanders' responses and normative beliefs about verbal aggression and cyberaggression, and affective and cognitive empathy, were tested in a path model. Both types of normative beliefs positively predicted the reinforcement of bullies, and normative belief about verbal aggression also predicted support for the victims of offline bullying. Both types of empathy predicted support in offline bullying, but only affective empathy predicted support in cyberbullying. There was no link between affective or cognitive empathy to the reinforcement of bullies. Moreover, bystanders' tendencies to respond supportively to the victim or to reinforce the bully were rather consistent in both cyber- and offline bullying, but there was no link between support and reinforcement. The findings are discussed with regard to implications for prevention and intervention efforts. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.
Predicting Behavior from Normative Influences: What Insights Can the Fishbein Model Offer?
ERIC Educational Resources Information Center
Walster, Dian E.
The Fishbein Model is an attitude behavior consistency model which is used in both laboratory and field settings for predicting and understanding attitudinal and normative influences on behavior. This paper examines controversy surrounding the Fishbein Model's normative component in the context of a study of library and information science (LIS)…
Effects of inspired CO2, hyperventilation, and time on VA/Q inequality in the dog
NASA Technical Reports Server (NTRS)
Tsukimoto, K.; Arcos, J. P.; Schaffartzik, W.; Wagner, P. D.; West, J. B.
1992-01-01
In a recent study by Tsukimoto et al. (J. Appl. Physiol. 68: 2488-2493, 1990), CO2 inhalation appeared to reduce the size of the high ventilation-perfusion ratio (VA/Q) mode commonly observed in anesthetized mechanically air-ventilated dogs. In that study, large tidal volumes (VT) were used during CO2 inhalation to preserve normocapnia. To separate the influences of CO2 and high VT on the VA/Q distribution in the present study, we examined the effect of inspired CO2 on the high VA/Q mode using eight mechanically ventilated dogs (4 given CO2, 4 controls). The VA/Q distribution was measured first with normal VT and then with increased VT. In the CO2 group at high VT, data were collected before, during, and after CO2 inhalation. With normal VT, there was no difference in the size of the high VA/Q mode between groups [10.5 +/- 3.5% (SE) of ventilation in the CO2 group, 11.8 +/- 5.2% in the control group]. Unexpectedly, the size of the high VA/Q mode decreased similarly in both groups over time, independently of the inspired PCO2, at a rate similar to the fall in cardiac output over time. The reduction in the high VA/Q mode together with a simultaneous increase in alveolar dead space (estimated by the difference between inert gas dead space and Fowler dead space) suggests that poorly perfused high VA/Q areas became unperfused over time. A possible mechanism is that elevated alveolar pressure and decreased cardiac output eliminate blood flow from corner vessels in nondependent high VA/Q regions.
ERIC Educational Resources Information Center
Zimmermann, Peter; Iwanski, Alexandra
2014-01-01
Despite the growing research on emotion regulation, the empirical evidence for normative age-related emotion regulation patterns is rather divergent. From a life-span perspective, normative age changes in emotion regulation may be more salient applying the same methodological approach on a broad age range examining both growth and decline during…
RadNet Air Data From Richmond, VA
This page presents radiation air monitoring and air filter analysis data for Richmond, VA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.
RadNet Air Data From Harrisonburg, VA
This page presents radiation air monitoring and air filter analysis data for Harrisonburg, VA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.
78 FR 66265 - Drawbridge Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-05
... Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA AGENCY: Coast Guard, DHS. ACTION: Notice... Elizabeth River Eastern Branch, mile 1.1, at Norfolk, VA. This deviation is necessary to facilitate... maintenance. The Norfolk Southern 5 railroad Bridge, at mile 1.1, across the Elizabeth River (Eastern Branch...
78 FR 36715 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines; Correction
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-19
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 74 RIN 2900-AO63 VA Veteran-Owned Small Business (VOSB... Department of Veterans Affairs (VA) amended its Veteran-Owned Small Business (VOSB) Verification Guidelines... Office of Small and Disadvantaged Business Utilization (00SB), Department of Veterans Affairs, 810...
Fuller, G W; Govind, O; Tucker, R; Raftery, M
2018-04-01
To establish normative reference data for the SCAT3 in professional Rugby Union players. A cross sectional study in professional Rugby Union players competing in national and international professional competitions between 2015 and 2016. The SCAT3 was administered pre-season or prior to tournaments. Data was collected electronically using a custom tablet application. SCAT3 subcomponents distributions were described and normative ranges determined using percentile cut-offs for average, unusually low/high, and extremely low/high scores. The association between player characteristics and performance in SCAT3 subcomponents was also investigated in exploratory analyses. A total of 3611 professional Rugby Union players were included. The most common baseline symptom was fatigue (14%). The symptom score median (md) was 0 (interquartile range (IQR)=0-1). Symptom severity md was 0 (IQR=0-1). The md of the SAC score was 28 (IQR=26-29). The md of the MBESS was 2 (IQR=0-4). The Tandem gait md was 11.1s (IQR=10.0-12.7s). Upper limb coordination was normal in 98.4%. Younger age and lower educational level were associated with worse performance on delayed recall and reverse month sub-components of the SCAT3 (p<0.0001). No statistically significant differences in SCAT3 subcomponents were evident across gender. Representative normative reference values for the SCAT3 among professional Rugby Union players are provided. Baseline performance on concentration and delayed recall tests may be lower in younger athletes or in those with lower educational level. Copyright © 2017. Published by Elsevier Ltd.
46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 1 2010-10-01 2010-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2” to...
van Toutert, Meta; Diesfeldt, Han; Hoek, Dirk
2016-10-01
The six tests in the Amsterdam Dementia Screening Test (ADST) examine the cognitive domains of episodic memory (delayed picture recognition, word learning), orientation, category fluency (animals and occupations), constructional ability (figure copying) and executive function (alternating sequences). New normative data were collected in a sample of 102 elderly volunteers (aged 65-94), including subjects with medical or other health conditions, except dementia or frank cognitive impairment (MMSE > 24). Included subjects were independent in complex instrumental activities of daily living.Fluency, not the other tests, needed adjustment for age and education. A deficit score (0-1) was computed for each test. Summation (range 0-6) proved useful in differentiating patients with dementia (N = 741) from normal elderly (N = 102).Positive and negative predictive power across a range of summed deficit scores and base rates are displayed in Bayesian probability tables.In the normal elderly, delayed recall for eight words was tested and adjusted for initial recall. A recognition test mixed the target words with eight distractors. Delayed recognition was adjusted for immediate and delayed recall.The ADST and the normative data in this paper help the clinical neuropsychologist to make decisions concerning the presence or absence of neurocognitive disorder in individual elderly examinees.
Brazilian normative data for the Short Form 36 questionnaire, version 2.
Laguardia, Josue; Campos, Monica Rodrigues; Travassos, Claudia; Najar, Alberto Lopes; Anjos, Luiz Antonio dos; Vasconcellos, Miguel Murat
2013-12-01
The study Pesquisa Dimensões Sociais das Desigualdades (PDSD) (Social Dimensions of Inequalities) involves 12,423 randomly selected Brazilian men and women aged 18 years old or more from urban and rural areas of the five Brazilian regions, and the information collected included the SF-36 as a measure of health-related quality of life. This provided a unique opportunity to develop age and gender-adjusted normative data for the Brazilian population. Brazilian men scored substantially higher than women on all eight domains and the two summary component scales of the SF-36. Brazilians scored less than their international counterparts on almost all of SF-36 domains and both summary component scales, except on general health status (US), pain (UK) and vitality (Australia, US and Canada). The differences in the SF-36 scores between age groups, genders and countries confirm that these Brazilian norms are necessary for comparative purposes. The data will be useful for assessing the health status of the general population and of patient populations, and the effect of interventions on health-related quality of life.
Normative influence and desired family size among young people in rural Egypt.
Harbour, Catherine
2011-06-01
Research has identified the lack of acceptance of a two-child-family norm as the biggest obstacle to achieving replacement-level fertility in Egypt. This analysis examines norms about desired family size for 1,366 males and 1,367 females aged 15-24 in 2004 in rural Minya governorate. Two-level random-effects multivariate logistic regression models, stratified by sex and grouped by neighborhood, are used to assess normative influence at the household and neighborhood levels, controlling for individual- and household-level covariates. In the final model, young males in neighborhoods where more people desire a small family are 33 percent more likely to desire a small family than are young males in other neighborhoods. Young females in households with one or more adults preferring a small family are 78 percent more likely to desire a small family, and young females in households with one or more young people who prefer a small family are 37 percent more likely to desire a small family themselves, compared with those living with adults or with young people, respectively, who do not prefer a small family. Programs aiming to reduce fertility should be aware of gender differences in the sources of normative influence on desired family size.
ERIC Educational Resources Information Center
Riggs, Anne E.; Young, Andrew G.
2016-01-01
What influences children's normative judgments of conventional rules at different points in development? The current study explored the effects of two contextual factors on children's normative reasoning: the way in which the rules were learned and whether the rules apply to the self or others. Peer dyads practiced a novel collaborative board game…
A Normative Approach to the Legitimacy of Muslim Schools in Multicultural Britain
ERIC Educational Resources Information Center
Hills, Peter Matthew
2015-01-01
Debate has grown about the legitimacy of Muslim faith schools within the British education system. At the same time, scepticism has developed towards multiculturalism as a normative approach for dealing with diversity. This article argues that it is worth retaining the normative impetus of multiculturalism by returning to its roots in political…
VA's National PTSD Brain Bank: a National Resource for Research.
Friedman, Matthew J; Huber, Bertrand R; Brady, Christopher B; Ursano, Robert J; Benedek, David M; Kowall, Neil W; McKee, Ann C
2017-08-25
The National PTSD Brain Bank (NPBB) is a brain tissue biorepository established to support research on the causes, progression, and treatment of PTSD. It is a six-part consortium led by VA's National Center for PTSD with participating sites at VA medical centers in Boston, MA; Durham, NC; Miami, FL; West Haven, CT; and White River Junction, VT along with the Uniformed Services University of Health Sciences. It is also well integrated with VA's Boston-based brain banks that focus on Alzheimer's disease, ALS, chronic traumatic encephalopathy, and other neurological disorders. This article describes the organization and operations of NPBB with specific attention to: tissue acquisition, tissue processing, diagnostic assessment, maintenance of a confidential data biorepository, adherence to ethical standards, governance, accomplishments to date, and future challenges. Established in 2014, NPBB has already acquired and distributed brain tissue to support research on how PTSD affects brain structure and function.
Revised NEO Personality Inventory normative data for police officer selection.
Detrick, Paul; Chibnall, John T
2013-11-01
The Revised NEO Personality Inventory (NEO PI-R) has demonstrated utility in the personnel selection context. Its use in police officer selection has been relatively limited, in part, because there are no published normative data for the NEO PI-R for police officer applicants. The authors present normative data on NEO PI-R domain and facet scores for a large sample (N = 288) of police officer applicants in a large, urban, Midwestern police department who completed the NEO PI-R as part of a preemployment psychological evaluation. Applicants reported low levels of Neuroticism and high levels of Extraversion and Conscientiousness. Neuroticism and Conscientiousness scores were strongly and consistently correlated with the Positive Presentation Management (PPM) research validity scale of the NEO PI-R. Extraversion and Agreeableness scores were moderately and less consistently correlated with PPM. These data may serve as a normative comparison group for professionals and researchers who use or may want to use the NEO PI-R in the police officer selection context.
2017-03-01
address challenges in managing projects to build medical facilities. In response to statutory requirements and additional congressional direction, VA...is outsourcing management of certain such projects to the U.S. Army Corps of Engineers (USACE). As of October 2016, VA had 23 ongoing projects...costing $100 million or more. VA and USACE have entered into interagency agreements for 12 of these 23 projects. The agreements entail USACE’s managing
Feasibility and acceptability of interventions to delay gun access in VA mental health settings.
Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia
2012-01-01
The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.
Nudges and coercion: conceptual, empirical, and normative considerations.
Cratsley, Kelso
2015-01-01
Given that the concept of coercion remains a central concern for bioethics, Quigley's (Monash Bioethics Rev 32:141-158, 2014) recent article provides a helpful analysis of its frequent misapplication in debates over the use of 'nudges'. In this commentary I present a generally sympathetic response to Quigley's argument while also raising several issues that are important for the larger debates about nudges and coercion. I focus on several closely related topics, including the definition of coercion, the role of empirical research, and the normative concerns at the core of these disputes. I suggest that while a degree of precision is certainly required when deploying the relevant concepts, perhaps informed by empirical data, we need to continue to push these debates towards more pressing normative considerations.
Harrison, Allyson G; Armstrong, Irene T; Harrison, Laura E; Lange, Rael T; Iverson, Grant L
2014-12-01
Psychologists practicing in Canada must decide which set of normative data to use for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). The purpose of this study was to compare the interpretive effects of applying American versus Canadian normative systems in a sample of 432 Canadian postsecondary-level students who were administered the WAIS-IV as part of an evaluation for a learning disability, attention-deficit hyperactivity disorder, or other mental health problems. Employing the Canadian normative system yielded IQ, Index, and subtest scores that were systematically lower than those obtained using the American norms. Furthermore, the percentage agreement in normative classifications, defined as American and Canadian index scores within five points or within the same classification range, was between 49% and 76%. Substantial differences are present between the American and Canadian WAIS-IV norms. Clinicians should consider carefully the implications regarding which normative system is most appropriate for specific types of evaluations. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Gooley, Robert P; Cameron, James D; Soon, Jennifer; Loi, Duncan; Chitale, Gauri; Syeda, Rifath; Meredith, Ian T
2015-09-01
Multidetector computed tomographic (MDCT) assessment of the aortoventricular interface has gained increased importance with the advent of minimally invasive treatment modalities for aortic and mitral valve disease. This has included a standardised technique of identifying a plane through the nadir of each coronary cusp, the basal plane, and taking further measurements in relation to this plane. Despite this there is no published data defining normal ranges for these aortoventricular metrics in a healthy cohort. This study seeks to quantify normative ranges for MDCT derived aortoventricular dimensions and evaluate baseline demographic and anthropomorphic associates of these measurements in a normal cohort. 250 consecutive patients undergoing MDCT coronary angiography were included. Aortoventricular dimensions at multiple levels of the aortoventricular interface were assessed and normative ranges quantified. Multivariate linear regression was performed to identify baseline predictors of each metric. The mean age was 59±12 years. The basal plane was eccentric (EI=0.22±0.06) while the left ventricular outflow tract was more eccentric (EI=0.32±0.06), with no correlation to gender, age or hypertension. Male gender, height and body mass index were consistent independent predictors of larger aortoventricular dimensions at all anatomical levels, while age was predictive of supra-annular measurements. Male gender, height and BMI are independent predictors of all aortoventricular dimensions while age predicts only supra-annular dimensions. Use of defined metrics such as the basal plane and formation of normative ranges for these metrics allows reference for clinical reporting and for future research studies by using a standardised measurement technique. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
33 CFR 334.290 - Elizabeth River, Southern Branch, Va., naval restricted areas.
Code of Federal Regulations, 2011 CFR
2011-07-01
..., Va., naval restricted areas. 334.290 Section 334.290 Navigation and Navigable Waters CORPS OF....290 Elizabeth River, Southern Branch, Va., naval restricted areas. (a) The areas—(1) St. Helena Annex Area. Beginning at a point at St. Helena Annex of the Norfolk Naval Shipyard, on the eastern shore of...
33 CFR 334.290 - Elizabeth River, Southern Branch, Va., naval restricted areas.
Code of Federal Regulations, 2010 CFR
2010-07-01
..., Va., naval restricted areas. 334.290 Section 334.290 Navigation and Navigable Waters CORPS OF....290 Elizabeth River, Southern Branch, Va., naval restricted areas. (a) The areas—(1) St. Helena Annex Area. Beginning at a point at St. Helena Annex of the Norfolk Naval Shipyard, on the eastern shore of...
Gangji, Nazneen; Pascoe, Michelle; Smouse, Mantoa
2015-01-01
Swahili is widely spoken in East Africa, but to date there are no culturally and linguistically appropriate materials available for speech-language therapists working in the region. The challenges are further exacerbated by the limited research available on the typical acquisition of Swahili phonology. To describe the speech development of 24 typically developing first language Swahili-speaking children between the ages of 3;0 and 5;11 years in Dar es Salaam, Tanzania. A cross-sectional design was used with six groups of four children in 6-month age bands. Single-word speech samples were obtained from each child using a set of culturally appropriate pictures designed to elicit all consonants and vowels of Swahili. Each child's speech was audio-recorded and phonetically transcribed using International Phonetic Alphabet (IPA) conventions. Children's speech development is described in terms of (1) phonetic inventory, (2) syllable structure inventory, (3) phonological processes and (4) percentage consonants correct (PCC) and percentage vowels correct (PVC). Results suggest a gradual progression in the acquisition of speech sounds and syllables between the ages of 3;0 and 5;11 years. Vowel acquisition was completed and most of the consonants acquired by age 3;0. Fricatives/z, s, h/ were later acquired at 4 years and /θ/and /r/ were the last acquired consonants at age 5;11. Older children were able to produce speech sounds more accurately and had fewer phonological processes in their speech than younger children. Common phonological processes included lateralization and sound preference substitutions. The study contributes a preliminary set of normative data on speech development of Swahili-speaking children. Findings are discussed in relation to theories of phonological development, and may be used as a basis for further normative studies with larger numbers of children and ultimately the development of a contextually relevant assessment of the phonology of Swahili
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-25
... use of other forms of information technology. Title: Dependents' Application for VA Educational... (Dependents' Application for VA Educational Benefits) Activity; Comment Request AGENCY: Veterans Benefits...' Educational Assistance and Fry Scholarship benefits. DATES: Written comments and recommendations on the...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-05
... VA facilities and the business relationships between VA staff and sales representatives promoting..., and provide sales representatives with a consistent standard of permissible business practice at VA... include suspension of a sales representative's access privileges, or, in extreme cases, denying access to...
ERIC Educational Resources Information Center
Sukhodolsky, Denis G.; Ruchkin, Vladislav V.
2004-01-01
Examined the association of anger experience and two types of normative beliefs with physical aggression and nonaggressive antisocial behavior in 361 juvenile offenders and 206 high school students in Russia. All participants were male and ranged in age from 14 to 18 years. Higher frequency of aggressive acts was significantly associated with…
Myosin Va Bound to Phagosomes Binds to F-Actin and Delays Microtubule-dependent Motility
Al-Haddad, Ahmed; Shonn, Marion A.; Redlich, Bärbel; Blocker, Ariel; Burkhardt, Janis K.; Yu, Hanry; Hammer, John A.; Weiss, Dieter G.; Steffen, Walter; Griffiths, Gareth; Kuznetsov, Sergei A.
2001-01-01
We established a light microscopy-based assay that reconstitutes the binding of phagosomes purified from mouse macrophages to preassembled F-actin in vitro. Both endogenous myosin Va from mouse macrophages and exogenous myosin Va from chicken brain stimulated the phagosome–F-actin interaction. Myosin Va association with phagosomes correlated with their ability to bind F-actin in an ATP-regulated manner and antibodies to myosin Va specifically blocked the ATP-sensitive phagosome binding to F-actin. The uptake and retrograde transport of phagosomes from the periphery to the center of cells in bone marrow macrophages was observed in both normal mice and mice homozygous for the dilute-lethal spontaneous mutation (myosin Va null). However, in dilute-lethal macrophages the accumulation of phagosomes in the perinuclear region occurred twofold faster than in normal macrophages. Motion analysis revealed saltatory phagosome movement with temporarily reversed direction in normal macrophages, whereas almost no reversals in direction were observed in dilute-lethal macrophages. These observations demonstrate that myosin Va mediates phagosome binding to F-actin, resulting in a delay in microtubule-dependent retrograde phagosome movement toward the cell center. We propose an “antagonistic/cooperative mechanism” to explain the saltatory phagosome movement toward the cell center in normal macrophages. PMID:11553713
Ekşioğlu, Mahmut
2016-01-01
Normative data are of importance in ergonomics and clinical settings. Applying normative data internationally is questionable. To this end, this study aimed to establish gender- and age-specific reference values for static (isometric) hand grip strength of normal population of Turkey with special regard to occupational demand, and compare them with the international norms. The secondary aims were to investigate the effects of gender, age-group, weight-group, job-group, hand and several anthropometric variables on static grip strength. A sample of 211 (128 male and 83 female) volunteers aged between 18 and 69 with various occupations participated in the study. Grip strength data were collected using a Jamar dynamometer with standard testing position, protocol and instructions. The mean and std deviation of maximum voluntary static grip strength values (in N) for dominant and non-dominant hands respectively were 455.2 ± 73.6 and 441.5 ± 72.6 for males, and 258 ± 46.1 and 246.2 ± 49.1 for females. The mean female strength was about 57% of the mean male strength value for both dominant and non-dominant hands. There was a curvilinear relationship of grip strength to age, significant differences between genders, hands, and some age-groups, and a correlation to height, body-mass, BMI and hand dimensions depending on the gender. The comparisons with the norms of other world populations indicate that there are cross-national grip strength variations among some nations but not all. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.
The role of behavioral, normative and control beliefs in breast self-examination.
Mason, Tania E; White, Katherine M
2008-01-01
A limited number of studies have been conducted examining the role of beliefs in the prediction of breast self-examination (BSE) behavior in Australian women, particularly women under 50 years of age for which it is the primary method of early detection of breast cancer. The present research investigated the differences in behavioral, normative and control beliefs between BSE performers and non-performers, within a theory of planned behavior framework, to assist in the development of specific education programs aimed at increasing BSE amongst this demographic group. Two hundred and fifty-three women enrolled in an undergraduate psychology course completed a questionnaire assessing beliefs regarding BSE. One month later, these women reported their BSE behavior during the previous month. Multivariate analyses were performed to identify belief-based differences between BSE performers and non-performers. Underlying behavioral and control, but not normative, beliefs about BSE distinguished between BSE performers and non-performers. Performers were more likely than non-performers to believe that engaging in BSE would be associated with identifying a lump or breast change sooner and detecting a breast cancer earlier in its course. Non-performers were more likely to perceive factors such as forgetting to perform the behavior, lack of time, lack of knowledge about how to perform the behavior, laziness, and a lack of confidence in their ability to identify lumps and breast changes as factors preventing their control over the performance of BSE. The belief-based differences between BSE performers and non-performers found in this study can be used to inform health promotion strategies aimed at increasing BSE behavior in women less than 50 years of age.
Gellad, Walid F.; Zhao, Xinhua; Thorpe, Carolyn T.; Thorpe, Joshua M.; Sileanu, Florentina E.; Cashy, John P.; Mor, Maria; Hale, Jennifer A.; Radomski, Thomas; Hausmann, Leslie R. M.; Fine, Michael J.; Good, Chester B.
2016-01-01
Background Buprenorphine is a key tool in the management of opioid use disorder, but there are growing concerns about abuse, diversion and safety. These concerns are amplified for the Department of Veterans Affairs (VA), whose patients may receive care concurrently from multiple prescribers within and outside VA. To illustrate the extent of this challenge, we examined overlapping prescriptions for buprenorphine, opioids, and benzodiazepines among Veterans dually enrolled in VA and Medicare Part D. Methods We constructed a cohort of all Veterans dually enrolled in VA and Part D who filled an opioid prescription in 2012. We identified patients who received tablet or film buprenorphine products from either source. We calculated the proportion of buprenorphine recipients with any overlapping prescription (based on days supply) for a non-buprenorphine opioid or benzodiazepine, focusing on Veterans who received overlapping prescriptions from a different system than their buprenorphine prescription (Part D buprenorphine recipients receiving overlapping opioids or benzodiazepines from VA and vice versa). Results We identified 1,790 dually enrolled Veterans with buprenorphine prescriptions, including 760 (43%) from VA and 1,091 (61%) from Part D (61 Veterans with buprenorphine from both systems were included in each group). Among VA buprenorphine recipients, 199 (26%) received an overlapping opioid prescription and 11 (1%) received an overlapping benzodiazepine prescription from Part D. Among Part D buprenorphine recipients, 208 (19%) received an overlapping opioid prescription and 178 (16%) received an overlapping benzodiazepine prescription from VA. Among VA and Part D buprenorphine recipients with cross-system opioid overlap, 25% (49/199) and 35% (72/208), respectively, had >90 days of overlap. Conclusions Many buprenorphine recipients receive overlapping prescriptions for opioids and benzodiazepines from a different health care system than the one in which their
Massarwi, Adeem Ahmad; Khoury-Kassabri, Mona
2017-01-01
This study adopted a social-ecological perspective to exploring perpetration of serious physical violence against others among Arab-Palestinian adolescents. A total of 3178 adolescents (aged 13-18) completed anonymous, structured, self-report questionnaire, which included selected items from several instruments that measured variables relating to the constructs examined in the study. We explored the association of individual characteristics (age, gender, normative beliefs about violence, and perceived ethnic discrimination), familial characteristics (parent-adolescent communication and socioeconomic status), and contextual characteristics (exposure to community violence in the neighborhood) with perpetration of serious physical violence against others. A moderation-mediation model was tested, and 28.4% of the adolescents reported that they had perpetrated serious physical violence against others at least once during the month preceding the study. The findings also show that exposure of youth to violence in their neighborhood correlated significantly and positively with their perpetration of serious physical violence against others. A similar trend was revealed with respect to personal perceptions of ethnic discrimination. These correlations were mediated by the adolescents' normative beliefs about violence. Furthermore, the correlation of direct exposure to violence in the neighborhood and normative beliefs about violence with perpetration of serious physical violence against others was stronger among adolescents who have poor communication with their parents than among those who have strong parental communication. Copyright © 2016 Elsevier Ltd. All rights reserved.
Normative Measurements of Grip and Pinch Strengths of 21st Century Korean Population
Shim, Jin Hee; Kim, Jin Soo; Lee, Dong Chul; Ki, Sae Hwi; Yang, Jae Won; Jeon, Man Kyung; Lee, Sang Myung
2013-01-01
Background Measuring grip and pinch strength is an important part of hand injury evaluation. Currently, there are no standardized values of normal grip and pinch strength among the Korean population, and lack of such data prevents objective evaluation of post-surgical recovery in strength. This study was designed to establish the normal values of grip and pinch strength among the healthy Korean population and to identify any dependent variables affecting grip and pinch strength. Methods A cross-sectional study was carried out. The inclusion criterion was being a healthy Korean person without a previous history of hand trauma. The grip strength was measured using a Jamar dynamometer. Pulp and key pinch strength were measured with a hydraulic pinch gauge. Intra-individual and inter-individual variations in these variables were analyzed in a standardized statistical manner. Results There were a total of 336 healthy participants between 13 and 77 years of age. As would be expected in any given population, the mean grip and pinch strength was greater in the right hand than the left. Male participants (137) showed mean strengths greater than female participants (199) when adjusted for age. Among the male participants, anthropometric variables correlated positively with grip strength, but no such correlations were identifiable in female participants in a statistically significant way. Conclusions Objective measurements of hand strength are an important component of hand injury evaluation, and population-specific normative data are essential for clinical and research purposes. This study reports updated normative hand strengths of the South Korean population in the 21st century. PMID:23362480
On the Normative Foundations of Economic Education.
ERIC Educational Resources Information Center
Leming, James S.
1987-01-01
Reports research which indicates current economics curricula fail to significantly influence student commitment to the normative foundations of the free enterprise system. Demonstrates how schools have potential for teaching economic values to youth. Concludes economic education should include latent and manifest curricula to better develop…
38 CFR 74.26 - What types of business information will VA collect?
Code of Federal Regulations, 2010 CFR
2010-07-01
... VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.26 What types of business information will VA collect? VA will examine a variety of business records. See § 74.12, “What is... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false What types of business...
Labrie, Joseph W; Napper, Lucy E; Hummer, Justin F
2014-01-01
Multi-component parent-based interventions (PBIs) provide a promising avenue for targeting alcohol use and related consequences in college students. Parents of college-aged children can have a significant influence on their children's alcohol use decisions. However, parents tend to underestimate their own child's alcohol use and overestimate other similar parents' approval of student drinking. These misperceptions could have important implications for parents' own attitudes and alcohol-related communication with their student. Targeting these misperceptions through normative feedback could help promote greater and more in-depth alcohol-related communication. The present study examines the potential efficacy of web-based alcohol-related normative feedback for parents of college students. A sample of 144 parents of college students received web-based normative feedback about students' alcohol use and approval, as well as other same-college parents' alcohol approval. Parents completed measures of perceived student alcohol use, student alcohol approval, other-parent alcohol approval, and intentions to discuss alcohol use both pre- and post-normative feedback. Post-feedback, parents reported stronger intentions to talk to their student about alcohol, were less confident in their knowledge of their students' alcohol use, and believed that their student drank in greater quantity and more frequently than pre-feedback. Parents also perceived other parents to be less approving of alcohol use after viewing normative feedback. These findings provide preliminary support for the use of web-based normative feedback for parents of college students. Given these promising results, further research developing and testing this approach merits attention. © 2013.
LaBrie, Joseph W.; Napper, Lucy E.; Hummer, Justin F.
2013-01-01
Objective Multi-component parent-based interventions (PBIs) provide a promising avenue for targeting alcohol use and related consequences in college students. Parents of college-aged children can have a significant influence on their children’s alcohol use decisions. However, parents tend to underestimate their own child’s alcohol use and overestimate other similar parents’ approval of student drinking. These misperceptions could have important implications for parents’ own attitudes and alcohol-related communication with their student. Targeting these misperceptions through normative feedback could help promote greater and more in-depth alcohol-related communication. The present study examines the potential efficacy of web-based alcohol-related normative feedback for parents of college students. Method A sample of 144 parents of college students received web-based normative feedback about students’ alcohol use and approval, as well as other same-college parents’ alcohol approval. Parents completed measures of perceived student alcohol use, student alcohol approval, other-parent alcohol approval, and intentions to discuss alcohol use both pre- and post-normative feedback. Results Post-feedback, parents reported stronger intentions to talk to their student about alcohol, were less confident in their knowledge of their students’ alcohol use, and believed that their student drank in greater quantity and more frequently than pre-feedback. Parents also perceived other parents to be less approving of alcohol use after viewing normative feedback. Conclusions These findings provide preliminary support for the use of web-based normative feedback for parents of college students. Given these promising results, further research developing and testing this approach merits attention. PMID:24099892
A facet approach to extending the normative component of the theory of reasoned action.
Donald, I; Cooper, S R
2001-12-01
Using facet theory, this study addresses the weak explanatory power of normative influence in theories of reasoned action or planned behaviour. A broad normative construct is hypothesized as being characterized by two facets--social unit and behavioural modality--each of which is examined in relation to recreational drug use. A questionnaire was developed from the facets and administered to undergraduate students. Data (N = 181) were analysed using Smallest Space Analysis (SSA). The results suggest that the facets provide an adequate description of the normative construct and that personal and social normative beliefs, behavioural norms and behavioural intentions can be distinguished empirically. The results also lend partial support to Ajzen's (1988; Ajzen & Fishbein, 1977) principle of compatibility. Implications for how social influence is operationalized and conceptualized are also discussed.
Terluin, Berend; Smits, Niels; Brouwers, Evelien P M; de Vet, Henrica C W
2016-09-15
The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire measuring distress, depression, anxiety and somatization with separate scales. The 4DSQ has extensively been validated in clinical samples, especially from primary care settings. Information about measurement properties and normative data in the general population was lacking. In a Dutch general population sample we examined the 4DSQ scales' structure, the scales' reliability and measurement invariance with respect to gender, age and education, the scales' score distributions across demographic categories, and normative data. 4DSQ data were collected in a representative Dutch Internet panel. Confirmatory factor analysis was used to examine the scales' structure. Reliability was examined by Cronbach's alpha, and coefficients omega-total and omega-hierarchical. Differential item functioning (DIF) analysis was used to evaluate measurement invariance across gender, age and education. The total response rate was 82.4 % (n = 5273/6399). The depression scale proved to be unidimensional. The other scales were best represented as bifactor models consisting of a large general factor and one or more smaller specific factors. The general factors accounted for more than 95 % of the reliable variance of the scales. Reliability was high (≥0.85) by all estimates. The distress-, depression- and anxiety scales were invariant across gender, age and education. The somatization scale demonstrated some lack of measurement invariance as a result of decreased thresholds for some of the items in young people (16-24 years) and increased thresholds in elderly people (65+ years). The somatization scale was invariant regarding gender and education. The 4DSQ scores varied significantly across demographic categories, but the explained variance was small (<6 %). Normative data were generated for gender and age categories. Approximately 17 % of the participants scored above average on de distress scale
Homeless Veterans: Management Improvements Could Help VA Better Identify Supportive Housing Projects
2016-12-01
HOMELESS VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects Report to...VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects What GAO Found As of September 2016, for veterans who...disabled veterans. These supportive-housing EULs receive project -based HUD-VASH vouchers, which provide housing subsidies, on-site case management
The Impact of VA and Navy Hospital Collaboration on Medical School Education
ERIC Educational Resources Information Center
Atre-Vaidya, Nutan; Ross, Arthur, III; Sandu, Ioana C.; Hassan, Tariq
2009-01-01
Objective: The U.S. Department of Veterans Affairs (VA) is the largest single provider of medical education in the United States and is often the preferred training site for medical students and residents. However, changing priorities of patients and the marketplace are forcing medical schools and the VA to consider new ways of practicing medicine…
The Memory Failures of Everyday (MFE) test: normative data in adults.
Montejo Carrasco, Pedro; Montenegro Peña, Mercedes; Sueiro, Manuel J
2012-11-01
One approach to the study of everyday memory failures is to use multiple-item questionnaires. The Memory Failures of Everyday (MFE) test is one of the most frequently used in Spain. Our objective is to provide normative data from the MFE in a sample of healthy, Spanish, adult participants for use in clinical practice. The sample consists of 647 employees at a large company ranging in age from 19-64 years-old. Everyday memory failures were evaluated by means of the MFE with the following response format: 0-2 (0 = never or rarely; 1 = occasionally, sometimes; 2 = frequently, often). Mean MFE = 15.25 (SD = 7.50), range 0-40. Correlation with age: .133 (p = .001); and with years of education: - .059 (n.s.). A constant increase in MFE was not observed across age groups (F = 4, 59; p = .003, eta2 = .02), but differences were revealed between the 19-29 and 40-49 age groups; no differences were observed between the remaining age groups. Only slight differences between men and women occurred, the women's mean being slightly higher than the men's, but the confidence intervals overlapped (F = 5, 71; p = .017, eta2 = .01). These results indicate that age, years of education, and sex had no significant effects. In light of the above, the sample was viewed as a whole when computing the percentiles reported here.
Gilliaux, Maxime; Lejeune, Thierry M; Sapin, Julien; Dehez, Bruno; Stoquart, Gaëtan; Detrembleur, Christine
2016-04-01
Kinematics is recommended for the quantitative assessment of upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish normative values in healthy subjects. Three hundred and seventy healthy subjects, aged 3-93 years, participated in the study. They performed two unidirectional and two geometrical tasks ten consecutive times with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-six kinematic indices were computed for the four tasks. For the four tasks, nineteen of the computed kinematic indices showed an age effect. Seventeen indices (the accuracy, speed and smoothness indices and the reproducibility of the accuracy, speed and smoothness) improved in young subjects aged 3-30 years, showed stabilization in adults aged 30-60 years and declined in elderly subjects aged 60-93 years. Additionally, for both geometrical tasks, the speed index exhibited a decrease throughout life. Finally, a principal component analysis provided the relations between the kinematic indices, tasks and subjects' age. This study is the first to assess age effects on upper limb kinematics and establish normative values in subjects aged 3-93 years.
VA Health Care: Improved Monitoring Needed for Effective Oversight of Care for Women Veterans
2016-12-01
November 2014. VHA officials also said that after reviewing information from sources such as veteran surveys and feedback from regional VA business...authorizations for care (of both men and women) from early calendar year 2016. In one case, almost a month and a half elapsed from the time of the...veteran’s initial pregnancy confirmation appointment at VA (when she was 6 weeks pregnant) to when the Choice authorization was sent by the VA facility to
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-15
... of Veteran Enrollees (Quality and Efficiency of VA Health Care)) Activity; Comment Request AGENCY... of Veteran Enrollees (Quality and Efficiency of VA Health Care), VA Form 10-21088. OMB Control Number... will be used to collect data that is necessary to promote quality and efficient delivery of health care...
Knowledge Of Memory Aging In Adulthood
ERIC Educational Resources Information Center
Hawley, Karri S.; Cherry, Katie E.; Su, L. Joseph; Chiu, Yu-Wen; Jazwinski, S. Michal
2006-01-01
The Knowledge of Memory Aging Questionnaire (KMAQ) measures laypersons' knowledge of memory changes in adulthood for research or educational purposes. Half of the questions pertain to normal memory aging and the other half cover pathological memory deficits due to non-normative factors, such as adult dementia. In this study, we compared memory…
ERIC Educational Resources Information Center
Ohlsson, Stellan
2013-01-01
The cognitive sciences, including psychology and education, have their roots in antiquity. In the historically early disciplines like logic and philosophy, the purpose of inquiry was normative. Logic sought to formalize valid inferences, and the various branches of philosophy sought to identify true and certain knowledge. Normative principles are…
76 FR 59765 - Virginia Disaster # VA-00036
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-27
... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12843 and 12844] Virginia Disaster VA-00036 AGENCY: U.S. Small Business Administration. ACTION: Notice SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated 09/21/2011. Incident: Hurricane Irene...
2012-01-01
Using a population-based sampling strategy, the National Institutes of Health (NIH) Magnetic Resonance Imaging Study of Normal Brain Development compiled a longitudinal normative reference database of neuroimaging and correlated clinical/behavioral data from a demographically representative sample of healthy children and adolescents aged newborn through early adulthood. The present paper reports brain volume data for 325 children, ages 4.5-18 years, from the first cross-sectional time point. Measures included volumes of whole-brain gray matter (GM) and white matter (WM), left and right lateral ventricles, frontal, temporal, parietal and occipital lobe GM and WM, subcortical GM (thalamus, caudate, putamen, and globus pallidus), cerebellum, and brainstem. Associations with cross-sectional age, sex, family income, parental education, and body mass index (BMI) were evaluated. Key observations are: 1) age-related decreases in lobar GM most prominent in parietal and occipital cortex; 2) age-related increases in lobar WM, greatest in occipital, followed by the temporal lobe; 3) age-related trajectories predominantly curvilinear in females, but linear in males; and 4) small systematic associations of brain tissue volumes with BMI but not with IQ, family income, or parental education. These findings constitute a normative reference on regional brain volumes in children and adolescents.
Effects of Normative Feedback for Drinkers Who Consume Less than the Norm: Dodging the Boomerang
Prince, Mark A.; Reid, Allecia; Carey, Kate B.; Neighbors, Clayton
2014-01-01
A number of alcohol interventions designed for college students attempt to correct exaggerated perceptions of alcohol use on college campuses through the use of personalized normative feedback. Personalized normative feedback has been shown effective in reducing drinking both as a stand-alone intervention and as a part of a multi-component intervention. Typically, this feedback is targeted to heavier drinkers, in order to create a discrepancy between their personal beliefs and behavior and the actual lower levels of use on campus. However, little is known about how this form of normative feedback might affect lighter drinkers who learn that they are drinking less than the typical student at their school. The risk is a potential boomerang effect, or an increase in drinking among lighter drinkers receiving personalized feedback. The current study examined four samples from three geographic locations, two employing computer delivered personalized normative feedback alone and two delivering personalized feedback in the context of a brief motivational intervention. We found no evidence for a boomerang effect among lighter drinkers receiving personalized normative feedback in any of the four samples. These findings help to assuage fears of increasing drinking among lighter drinkers through widespread implementation of normative interventions for college students in the absence of screening for current drinking status. PMID:24955672
Effects of normative feedback for drinkers who consume less than the norm: Dodging the boomerang.
Prince, Mark A; Reid, Allecia; Carey, Kate B; Neighbors, Clayton
2014-06-01
Several alcohol interventions designed for college students attempt to correct exaggerated perceptions of alcohol use on college campuses through the use of personalized normative feedback. Personalized normative feedback has been shown to be effective in reducing drinking as a stand-alone intervention and as a part of a multicomponent intervention. This feedback is typically targeted to heavier drinkers to create a discrepancy between their personal beliefs and behavior and the actual lower levels of use on campus. However, little is known about how this form of normative feedback might affect lighter drinkers who learn that they are drinking less than the typical student at their school. The risk is a potential boomerang effect, or an increase in drinking among lighter drinkers receiving personalized feedback. The current study examined four samples from three geographic locations: two using computer-delivered personalized normative feedback alone and two delivering personalized feedback in the context of a brief motivational intervention. We found no evidence for a boomerang effect among lighter drinkers receiving personalized normative feedback in any of the four samples. These findings help to assuage fears of increasing drinking among lighter drinkers through widespread implementation of normative interventions for college students in the absence of screening for current drinking status.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-25
... of Veteran Enrollees (Quality and Efficiency of VA Health Care)) Activities Under OMB Review AGENCY... of Veteran Enrollees (Quality and Efficiency of VA Health Care), VA Form 10-21088. OMB Control Number... will be used to collect data that is necessary to promote quality and efficient delivery of health care...
Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-26
... enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the... approved collection. Abstract: VA personnel complete VA Form 0120 to document pre- employment history and...
Vickers, Caroline H.; Deckert, Sharon K.; Goble, Ryan
2013-01-01
The purpose of this study is to examine the construction of language normativity as medical providers interact with patients and animate stance within Spanish language medical consultations. The context of the study is a clinic in which providers use Spanish to communicate with monolingual Spanish-speaking patients. This clinic is in the United States, an English-speaking macro-societal context. Findings indicate that providers who are second language users of Spanish animate stance and interact with patients in ways that English is constructed as normative and Spanish as marked. Implications include the need to consider how the construction of language normativity within medical consultations affects health outcomes. PMID:24156518
Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Rubenstein, Lisa V; Gelberg, Lillian
2014-05-01
The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program-the VA's Housing First effort-is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. We performed a secondary database analysis of Veterans (n=62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care.
Health Promotion in an Age of Normative Equity and Rampant Inequality
Labonté, Ronald
2016-01-01
The world was different when the Ottawa Charter for Health Promotion was released 30 years ago. Concerns over the environment and what we now call the ‘social determinants of health’ were prominent in 1986. But the acceleration of ecological crises and economic inequalities since then, in a more complex and multi-polar world, pose dramatically new challenges for those committed to the original vision of the Charter. Can the 2015 Sustainable Development Goals (SDGs), agreed to by all the world’s governments, offer a new advocacy and programmatic platform for a renewal of health promotion’s founding ethos? Critiqued from both the right and the left for, respectively, their aspirational idealism and lack of political analysis, the SDGs are an imperfect but still compelling normative statement of how much of the world thinks the world should look like. Many of the goals and targets provide signals for what we need to achieve, even if there remains a critical lacuna in articulating how this is to be done. The fundamental flaw in the SDGs is the implicit assumption that the same economic system, and its still-present neoliberal governing rules, that have created or accelerated our present era of rampaging inequality and environmental peril can somehow be harnessed to engineer the reverse. This flaw is not irrevocable, however, if health promoters – practitioners, researchers, advocates – focus their efforts on a few key SDGs that, with some additional critique, form a basic blueprint for a system of national and global regulation of capitalism (or even its transformation) that is desperately needed for social and ecological survival into the 22nd century. Whether or not these efforts succeed is a future unknown; but that the efforts are made is a present urgency. PMID:28005546
Basic anthropometry and health status of elderly: findings of the Maracaibo Aging Study.
Muñoz, Angélica M; Falque-Madrid, Luis; Zambrano, Raquel Ch; Maestre, Gladys E
2010-03-01
Determine basic anthropometry for elderly participants in a Venezuelan community and compare results for subgroups with different health status. Standardized anthropometric, nutritional, neurological, neuropsychiatric, and cardiovascular assessments generated data on weight, height, and body mass index (BMI) by sex and age for the total sample, for normative groups without health problems that might impact anthropometry, and for reference groups with no major health problems. Centile curves of anthropometric measurements versus age are determined for women and men in the normative group. Mean weight and height are significantly different between sexes, but not BMI. All three parameters show gradual declines with age. The mean 90% central interval for BMI in the normative and reference groups is 20-29 kg/m(2). The anthropometric data for healthy elderly Venezuelans can be used in monitoring anthropometric changes and disease risk analysis for this population and possibly for other Latin American populations.
Toward a virtue-based normative ethics for the health professions.
Pellegrino, E D
1995-09-01
Virtue is the most perdurable concept in the history of ethics, which is understandable given the ineradicability of the moral agent in the events of the moral life. Historically, virtue enjoyed normative force as long as the philosophical anthropology and the metaphysics of the good that grounded virtue were viable. That grounding has eroded in both general and medical ethics. If virtue is to be restored to a normative status, its philosophical underpinnings must be reconstructed. Such reconstruction seems unlikely in general ethics, where the possibility of agreement on the good for humans is remote. However, it is a realistic possibility in the professional ethics fo the health professions where agreement on the telos of the healing relationship is more likely to arise. Nevertheless, virtue-based ethics must be related conceptually and normatively to other ethical theories in a comprehensive moral philosophy of the health professions. If he really does think there is no distinction between virtue and vice, why, sir, when he leaves our house, let us count our spoons. Samuel Johnson
Hartwell, Christopher J; Campion, Michael A
2016-06-01
This study explores normative feedback as a way to reduce rating errors and increase the reliability and validity of structured interview ratings. Based in control theory and social comparison theory, we propose a model of normative feedback interventions (NFIs) in the context of structured interviews and test our model using data from over 20,000 interviews conducted by more than 100 interviewers over a period of more than 4 years. Results indicate that lenient and severe interviewers reduced discrepancies between their ratings and the overall normative mean rating after receipt of normative feedback, though changes were greater for lenient interviewers. When various waves of feedback were presented in later NFIs, the combined normative mean rating over multiple time periods was more predictive of subsequent rating changes than the normative mean rating from the most recent time period. Mean within-interviewer rating variance, along with interrater agreement and interrater reliability, increased after the initial NFI, but results from later NFIs were more complex and revealed that feedback interventions may lose effectiveness over time. A second study using simulated data indicated that leniency and severity errors did not impact rating validity, but did affect which applicants were hired. We conclude that giving normative feedback to interviewers will aid in minimizing interviewer rating differences and enhance the reliability of structured interview ratings. We suggest that interviewer feedback might be considered as a potential new component of interview structure, though future research is needed before a definitive conclusion can be drawn. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Normative data for idiomatic expressions.
Nordmann, Emily; Jambazova, Antonia A
2017-02-01
Idiomatic expressions such as kick the bucket or go down a storm can differ on a number of internal features, such as familiarity, meaning, literality, and decomposability, and these types of features have been the focus of a number of normative studies. In this article, we provide normative data for a set of Bulgarian idioms and their English translations, and by doing so replicate in a Slavic language the relationships between the ratings previously found in Romance and Germanic languages. Additionally, we compared whether collecting these types of ratings in between-subjects or within-subjects designs affects the data and the conclusions drawn, and found no evidence that design type affects the final outcome. Finally, we present the results of a meta-analysis that summarizes the relationships found across the literature. As in many previous individual studies, we found that familiarity correlates with a number of other features; however, such studies have shown conflicting results concerning literality and decomposability ratings. The meta-analysis revealed reliable relationships of decomposability with a number of other measures, such as familiarity, meaning, and predictability. Conversely, literality was shown to have little to no relationship with any of the other subjective ratings. The implications for these relationships in the context of the wider experimental literature are discussed, with a particular focus on the importance of attaining familiarity ratings for each sample of participants in experimental work.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-15
... Operation Regulation; James River, Between Isle of Wight and Newport News, VA AGENCY: Coast Guard, DHS... River, mile 5.0, between Isle of Wight and Newport News, VA. This deviation is necessary to facilitate... Isle of Isle and Newport News, VA opens on signal. The James River Bridge has vertical clearances in...
Evaluating Level of Specificity of Normative Referents in Relation to Personal Drinking Behavior*
Larimer, Mary E.; Kaysen, Debra L.; Lee, Christine M.; Kilmer, Jason R.; Lewis, Melissa A.; Dillworth, Tiara; Montoya, Heidi D.; Neighbors, Clayton
2009-01-01
Objective: Research has found perceived descriptive norms to be one of the strongest predictors of college student drinking, and several intervention approaches have incorporated normative feedback to correct misperceptions of peer drinking behavior. Little research has focused on the role of the reference group in normative perceptions. The current study sought to examine whether normative perceptions vary based on specificity of the reference group and whether perceived norms for more specific reference-group norms are related to individual drinking behavior. Method: Participants were first-year undergraduates (n = 1,276, 58% female) randomly selected from a university list of incoming students. Participants reported personal drinking behavior and perceived descriptive norms for eight reference groups, including typical student; same gender, ethnicity, or residence; and combinations of those reference groups (e.g., same gender and residence). Results: Findings indicated that participants distinguished among different reference groups in estimating descriptive drinking norms. Moreover, results indicated misperceptions in drinking norms were evident at all levels of specificity of the reference group. Additionally, findings showed perceived norms for more specific groups were uniquely related to participants' own drinking. Conclusions: These results suggest that providing normative feedback targeting at least one level of specificity to the participant (i.e., beyond what the “typical” student does) may be an important tool in normative feedback interventions. PMID:19538919
75 FR 8005 - Safety Zone; Wicomico Community Fireworks, Great Wicomico River, Mila, VA
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-23
...-AA00 Safety Zone; Wicomico Community Fireworks, Great Wicomico River, Mila, VA AGENCY: Coast Guard, DHS... the Great Wicomico River in the vicinity of Mila, VA in support of the Wicomico Community Fireworks... protect mariners from the hazards associated with fireworks displays. DATES: Comments and related material...
2013-08-20
The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations.
Optimizing Personalized Normative Feedback: The Use of Gender-Specific Referents*
LEWIS, MELISSA A.; NEIGHBORS, CLAYTON
2008-01-01
Objective Many brief interventions include personalized normative feedback (PNF) using gender-specific or gender-neutral referents. Several theories suggest that information pertaining to more socially proximal referents should have greater influence on one’s behavior compared with more socially distal referents. The current research evaluated whether gender specificity of the normative referent employed in PNF related to intervention efficacy. Method Following baseline assessment, 185 college students (45.2% women) were randomly assigned to one of three intervention conditions: gender-specific feedback, gender-neutral feedback, or assessment-only control. Immediately after completing measures of perceived norms, alcohol consumption, and gender identity, participants in the gender-neutral and gender-specific intervention conditions were provided with computerized information detailing their own drinking behavior, their perceptions of student drinking, and actual student drinking. Results After a 1-month follow-up, the results indicated that normative feedback was effective in changing perceived norms and reducing alcohol consumption for both intervention groups for women and men. The results provide support, however, for changes in perceived gender-specific norms as a mediator of the effects of normative feedback on reduced drinking behavior for women only. Additionally, gender-specific feedback was found to be more effective for women higher in gender identity, relative to the gender-neutral feedback. A post-assessment follow-up telephone survey administered to assess potential demand characteristics corroborated the intervention effects. Conclusions Results extend previous research documenting efficacy of computer delivered PNF. Gender specificity and gender identity appear to be important elements to consider for PNF intervention efficacy for women. PMID:17286341
Optimizing personalized normative feedback: the use of gender-specific referents.
Lewis, Melissa A; Neighbors, Clayton
2007-03-01
Many brief interventions include personalized normative feedback (PNF) using gender-specific or gender-neutral referents. Several theories suggest that information pertaining to more socially proximal referents should have greater influence on one's behavior compared with more socially distal referents. The current research evaluated whether gender specificity of the normative referent employed in PNF related to intervention efficacy. Following baseline assessment, 185 college students (45.2% women) were randomly assigned to one of three intervention conditions: gender-specific feedback, gender-neutral feedback, or assessment-only control. Immediately after completing measures of perceived norms, alcohol consumption, and gender identity, participants in the gender-neutral and gender-specific intervention conditions were provided with computerized information detailing their own drinking behavior, their perceptions of student drinking, and actual student drinking. After a 1-month follow-up, the results indicated that normative feedback was effective in changing perceived norms and reducing alcohol consumption for both intervention groups for women and men. The results provide support, however, for changes in perceived gender-specific norms as a mediator of the effects of normative feedback on reduced drinking behavior for women only. Additionally, gender-specific feedback was found to be more effective for women higher in gender identity, relative to the gender-neutral feedback. A post-assessment follow-up telephone survey administered to assess potential demand characteristics corroborated the intervention effects. Results extend previous research documenting efficacy of computer delivered PNF. Gender specificity and gender identity appear to be important elements to consider for PNF intervention efficacy for women.
ERIC Educational Resources Information Center
Kikas, Eve; Peets, Katlin; Tropp, Kristiina; Hinn, Maris
2009-01-01
The purpose of the present study was to examine the impact of sex, verbal reasoning, and normative beliefs on direct and indirect forms of aggression. Three scales from the Peer Estimated Conflict Behavior Questionnaire, Verbal Reasoning tests, and an extended version of Normative Beliefs About Aggression Scale were administered to 663 Estonian…
Health and aging: development of the Irish Longitudinal Study on Ageing health assessment.
Cronin, Hilary; O'Regan, Clare; Finucane, Ciaran; Kearney, Patricia; Kenny, Rose Anne
2013-05-01
To assist researchers planning studies similar to The Irish Longitudinal Study on Ageing (TILDA), concerning the development of the health assessment component, to promote use of the archived data set, to inform researchers of the methods employed, and to complement the accompanying article on normative values. Prospective, longitudinal study of older adults. Republic of Ireland. Eight thousand five hundred four community-dwelling adults who participated in wave 1 of the TILDA study. The main areas of focus for the TILDA health assessments are neurocardiovascular instability, locomotion, and vision. The article describes the scientific rationale for the choice of assessments and seeks to determine the potential advantages of incorporating novel biomeasures and technologies in population-based studies to advance understanding of aging-related disorders. The detailed description of the physical measures will facilitate cross-national comparative research and put into context the normative values outlined in the subsequent article. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.
Turusheva, A.; Frolova, E.; Degryse, J-M.
2017-01-01
Objectives: This paper sought to provide normative values for grip strength among older adults across different age groups in northwest Russia and to investigate their predictive value for adverse events. Methods: A population-based prospective cohort study of 611 community-dwelling individuals 65+. Grip strength was measured using the standard protocol applied in the Groningen Elderly Tests. The cut-off thresholds for grip strength were defined separately for men and women of different ages using a weighted polynomial regression. A Cox regression analysis, the c-statistic, a risk reclassification analysis, and bootstrapping techniques were used to analyze the data. The outcomes were the 5-year mortality rate, the loss of autonomy and mental decline. Results: We determined the age-related reference intervals of grip strength for older adults. The 5th and 10th percentiles of grip strength were associated with a higher risk for malnutrition, low autonomy, physical and mental functioning and 5-year mortality. The 5th percentile of grip strength was associated with a decline in autonomy. Conclusions: This study presents age- and sex-specific reference values for grip strength in the 65+ Russian population derived from a prospective cohort study. The norms can be used in clinical practice to identify patients at increased risk for adverse outcomes. PMID:28250246
Escobar, A L; Coimbra, C E A; Camacho, L A B; Santos, R V
2004-01-01
To investigate the characteristics of tuberculin skin test reactivity in the Pakaanóva Indians, in Amazonia, Brazil, after revaccination of all study participants with bacille Calmette-Guerin (BCG). The investigation was designed as a post-BCG vaccination purified protein derivative (PPD) survey. Data included PPD readings, age, sex, nutritional status, place of residence, previous tuberculosis, physical examinations and BCG status. Bivariate and multivariate logistic regression analyses were conducted. About 90% (n = 505) of the total population participated. One third (32.1%) of the subjects presented induration > or = 10 mm at 72 h. Induration sizes showed weak linear correlation with age; differences between sexes were not observed. Skin reaction was not associated with nutritional status. Individuals with a history of tuberculosis were six times more likely to test positive. History of tuberculosis, age, and previous BCG vaccination were significantly associated with PPD reactivity in the multivariate analyses. The Pakaanóva showed a high proportion (58.4%) of non-reactors, even with a recent BCG booster. Sex differences in PPD reactivity were either not present or could not be demonstrated. The association between age and PPD reactivity resembles that observed in other Amazonian populations. The authors discuss the potential of PPD testing as a screening tool to enhance tuberculosis detection, especially in indigenous populations in Amazonia with limited access to health services.