Diabetes disease management in a community-based setting.

PubMed

Berg, Gregory D; Wadhwa, Sandeep

2002-06-01

The medical cost of diabetes in the United States in 1997 was at least $98 billion. This study illustrates the behavioral change and medical-care utilization impact that occurs in a community-based setting of a diabetes disease-management program that is applied to program participants in a health insurance plan's health maintenance organization and preferred provider organization. A historical control comparison of diabetes-management participants. One hundred twenty-seven identified diabetes patients are followed from baseline through 1 year. Differences in behavior are compared at program intake and at a 6-month reassessment. Differences in medical-service utilization are compared in the baseline year and the year subsequent to program enrollment. Poisson multivariate-regression models are estimated for counts of inpatient, emergency department, physician evaluation and management, and facility visits, while also controlling for potential confounders. Behaviors improved between program intake and the 6-month reassessment. From patient reports, the number of participants having a hemoglobin A1c test increased by 44.9 percent (p < .001), and there was a 53.2-percent decrease in symptoms of hyperglycemia (p = .002). From medical claims after program enrollment, a drop occurred during the program year in every dimension of medical-service utilization. Regression results show that in-patient admissions decreased by 391 (p < .001) per 1,000 for each group, while controlling for age, length of membership, and the number of comorbid claims for congestive heart failure. In the analysis of costs that were pre- and post-enrollment, which included disease-management program costs, a 4.34:1 return on investment was calculated. The diabetes program provides patients with comprehensive information and counseling relative to practicing self-management of diabetes through a number of integrated program components. This study strongly suggests that the implementation of such a program is associated with positive behavioral change and, thus, with substantial reduction in medical-service utilization. In addition, the intervention resulted in a net decrease in direct medical costs.

Strategic Plan for Information Systems and Technology, Fiscal Years 1994-1998.

ERIC Educational Resources Information Center

National Archives and Records Administration, Washington, DC.

The information systems and technology management program of the National Archives and Records Administration (NARA) establishes broad policy guidance and technical standards for information management to ensure that appropriate resource sharing can occur, while providing cost-effective support for mission requirements of program offices. The NARA…

Attitudes of Ohio Vocational Agriculture Teachers toward Summer Programs.

ERIC Educational Resources Information Center

Short, Gary E.; Miller, Larry E.

Because many experiences needed by vocational agriculture students typically occur during the summer, the contracts of Ohio vocational agriculture teachers have been longer than the typical 9-month academic school year. A study examined the attitudes of vocational agriculture instructors throughout Ohio toward summer programs so that policymakers…

76 FR 17128 - Agency Information Collection Request. 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

.... Proposed Project: The Children's Health Insurance Program Reauthorization Act (CHIPRA) 10-State Evaluation... into how the Children's Health Insurance Program (CHIP) has evolved since its early years, what impacts on children's coverage and access to care have occurred, and what new issues have arisen as a result...

Harmonizing General Education Programs in Career and Professional Curricula.

ERIC Educational Resources Information Center

Prager, Carolyn

The emergence of vocational curricula each with specific proficiencies has led to a new concept of the major dominated by technical rather than liberal learning. Although this has occurred at both two- and four-year institutions, applied curricula tend to disadvantage two-year students more than than their four-year counterparts because of less…

Dynamics of a deep-water seagrass population on the Great Barrier Reef: annual occurrence and response to a major dredging program.

PubMed

York, Paul H; Carter, Alex B; Chartrand, Kathryn; Sankey, Tonia; Wells, Linda; Rasheed, Michael A

2015-08-17

Global seagrass research efforts have focused on shallow coastal and estuarine seagrass populations where alarming declines have been recorded. Comparatively little is known about the dynamics of deep-water seagrasses despite evidence that they form extensive meadows in some parts of the world. Deep-water seagrasses are subject to similar anthropogenic threats as shallow meadows, particularly along the Great Barrier Reef lagoon where they occur close to major population centres. We examine the dynamics of a deep-water seagrass population in the GBR over an 8 year period during which time a major capital dredging project occurred. Seasonal and inter-annual changes in seagrasses were assessed as well as the impact of dredging. The seagrass population was found to occur annually, generally present between July and December each year. Extensive and persistent turbid plumes from a large dredging program over an 8 month period resulted in a failure of the seagrasses to establish in 2006, however recruitment occurred the following year and the regular annual cycle was re-established. Results show that despite considerable inter annual variability, deep-water seagrasses had a regular annual pattern of occurrence, low resistance to reduced water quality but a capacity for rapid recolonisation on the cessation of impacts.

Dynamics of a deep-water seagrass population on the Great Barrier Reef: annual occurrence and response to a major dredging program

PubMed Central

York, Paul H.; Carter, Alex B.; Chartrand, Kathryn; Sankey, Tonia; Wells, Linda; Rasheed, Michael A.

2015-01-01

Global seagrass research efforts have focused on shallow coastal and estuarine seagrass populations where alarming declines have been recorded. Comparatively little is known about the dynamics of deep-water seagrasses despite evidence that they form extensive meadows in some parts of the world. Deep-water seagrasses are subject to similar anthropogenic threats as shallow meadows, particularly along the Great Barrier Reef lagoon where they occur close to major population centres. We examine the dynamics of a deep-water seagrass population in the GBR over an 8 year period during which time a major capital dredging project occurred. Seasonal and inter-annual changes in seagrasses were assessed as well as the impact of dredging. The seagrass population was found to occur annually, generally present between July and December each year. Extensive and persistent turbid plumes from a large dredging program over an 8 month period resulted in a failure of the seagrasses to establish in 2006, however recruitment occurred the following year and the regular annual cycle was re-established. Results show that despite considerable inter annual variability, deep-water seagrasses had a regular annual pattern of occurrence, low resistance to reduced water quality but a capacity for rapid recolonisation on the cessation of impacts. PMID:26279474

Evaluation of a Sex Education Program for Children and Their Parents: Attitude and Interactional Changes

ERIC Educational Resources Information Center

Carton, Jacqueline; Carton, John

1971-01-01

Within a small group of ten and eleven year-old children, and a separate group of their parents, changes occurred in attitudes in parent child communications following participation in a planned sex education program. Attitude changes pointed to movement in both groups from lesser to greater permissiveness. (Author)

76 FR 36926 - National Institute for Occupational Safety and Health (NIOSH); Request for Nominations To Serve...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-23

... industrial hygienist; 1 toxicologist; 1 epidemiologist; and, at least 1 mental health professional. For the mental health professional category, specific expertise is sought in trauma-related psychiatry or... WTC Program Administrator based on program needs. Meetings may occur up to four times a year. Members...

Perceptions and Experiences of Baccalaureate Nursing Program Leaders Related to Nursing Informatics

ERIC Educational Resources Information Center

Larson, Lisa R.

2017-01-01

Nursing program leadership for integrating nursing informatics (NI) into curricula is essential. NI is a specialty that combines nursing science, computer science, and information science to manage health information and improve patient health outcomes (American Nurses Association, 2008). Approximately 98,000 patient deaths per year occur due to…

Reading Probe Will Continue on Capitol Hill

ERIC Educational Resources Information Center

Manzo, Kathleen Kennedy

2007-01-01

The recent wrap-up of an intensive, two-year examination of the federal Reading First initiative is not expected to halt debate over the program. Given the broad agreement in seven federal reports that serious problems occurred in the oversight of the program's implementation, the findings have sparked interest on Capitol Hill, as lawmakers…

The U.S. EPA ToxCast Program: Moving from Data Generation to Application (SOT Tox21 update symposium presentation)

EPA Science Inventory

The U.S. EPA ToxCast program is entering its tenth year. Significant learning and progress have occurred towards collection, analysis, and interpretation of the data. The library of ~1,800 chemicals has been subject to ongoing characterization (e.g., identity, purity, stability...

7 CFR 400.55 - Qualification for actual production history coverage program.

Code of Federal Regulations, 2013 CFR

2013-01-01

... APH yield is calculated from a database containing a minimum of four yields and will be updated each subsequent crop year. The database may contain a maximum of the 10 most recent crop years and may include... only occur in the database when there are less than four years of actual and/or assigned yields. (b...

7 CFR 400.55 - Qualification for actual production history coverage program.

Code of Federal Regulations, 2011 CFR

2011-01-01

... APH yield is calculated from a database containing a minimum of four yields and will be updated each subsequent crop year. The database may contain a maximum of the 10 most recent crop years and may include... only occur in the database when there are less than four years of actual and/or assigned yields. (b...

7 CFR 400.55 - Qualification for actual production history coverage program.

Code of Federal Regulations, 2010 CFR

2010-01-01

... APH yield is calculated from a database containing a minimum of four yields and will be updated each subsequent crop year. The database may contain a maximum of the 10 most recent crop years and may include... only occur in the database when there are less than four years of actual and/or assigned yields. (b...

7 CFR 400.55 - Qualification for actual production history coverage program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... APH yield is calculated from a database containing a minimum of four yields and will be updated each subsequent crop year. The database may contain a maximum of the 10 most recent crop years and may include... only occur in the database when there are less than four years of actual and/or assigned yields. (b...

Status and progress of the RERTR program in the year 2002.

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

Travelli, A.; Technology Development

2003-01-01

Following the cancellation of the 2001 International RERTR Meeting, which had been planned to occur in Bali, Indonesia, this paper describes the progress achieved by the Reduced Enrichment for Research and Test Reactors (RERTR) Program in collaboration with its many international partners during the years 2001 and 2002, and discusses the main activities planned for the year 2003. The past two years have been characterized by very important achievements of the RERTR program, but these technical achievements have been overshadowed by the terrible events of September 11, 2001. Those events have caused the U.S. Government to reevaluate the importance andmore » urgency of the RERTR program goals. A recommendation made at the highest levels of the government calls for an immediate acceleration of the program activities, with the goal of converting all the world's research reactors to low-enriched fuel at the earliest possible time, and including both Soviet-designed and United States-designed research reactors.« less

Mandatory presuit mediation: 5-year results of a medical malpractice resolution program.

PubMed

Jenkins, Randall C; Smillov, Arlene E; Goodwin, Matthew A

2014-01-01

The Florida Patient Safety and Presuit Mediation Program (FLPSMP) is a mandatory mediation program designed to provide deserving patients with fast, fair compensation while limiting the healthcare provider expenses incurred during traditional litigation. Mediation occurs before litigation begins; therefore, patients with meritorious claims receive compensation often years earlier than they would with extended litigation. This early mediation fosters confidential and candid communication between doctors and patients, which promotes early fact-finding and candid discussion. The program went into effect across the University of Florida (UF) Health system on January 1, 2008. In an article previously published in this journal, we discussed the positive trend observed 2 years after the implementation of the FLPSMP. This article incorporates 5 years of data, which includes new benchmarks with state and national data, to demonstrate that the program can be used successfully as a medical malpractice solution. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

34 CFR 686.23 - Calculation of a grant for a payment period that occurs in two award years.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH) GRANT PROGRAM Determination of Awards § 686.23... 34 Education 4 2011-07-01 2011-07-01 false Calculation of a grant for a payment period that occurs...

34 CFR 686.23 - Calculation of a grant for a payment period that occurs in two award years.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH) GRANT PROGRAM Determination of Awards § 686.23... 34 Education 3 2010-07-01 2010-07-01 false Calculation of a grant for a payment period that occurs...

International Heliophysical Year

NASA Technical Reports Server (NTRS)

Davila, J. M.; Harrison, R.; Poland, A.; St.Cyr, O. C.; Thompson, B. J.; Rabin, Douglas (Technical Monitor)

2002-01-01

In 1957 a program of international research, inspired by the International Polar Years of 1882-83 and 1932-33, was organized as the International Geophysical Year (IGY) to study global phenomena of the Earth and geospace. The IGY involved about 60,000 scientists from 66 nations, working at thousands of stations, from pole to pole to obtain simultaneous, global observations on Earth and in space. There had never been anything like it before. The fiftieth anniversary of the International Geophysical Year will occur in 2007. We propose to organize an international program of scientific collaboration for this time period called the International Heliophysical Year (IHY). Like it predecessors, the IHY will focus on fundamental global questions of Earth science.

7 CFR 1485.14 - Application approval and formation of agreements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... occur when the Administrator signs the agreement on behalf of CCC. The application, the program... will allocate resources among participants based on the following factors, in addition to those in... to a single company for brand promotion in a single country for more than five years. This five year...

7 CFR 1485.14 - Application approval and formation of agreements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... occur when the Administrator signs the agreement on behalf of CCC. The application, the program... will allocate resources among participants based on the following factors, in addition to those in... to a single company for brand promotion in a single country for more than five years. This five year...

Budgeting Based on Results

ERIC Educational Resources Information Center

Cooper, Kelt L.

2011-01-01

Every program in a school or school district has, or once had, a purpose. The purpose was most likely promoted, argued and debated among school constituencies--parents, teachers, administrators and school board members--before it was eventually approved. This process occurs year after year, budget after budget. In itself, this is not necessarily a…

[HPV Vaccination Program - The History and Recent Progress].

PubMed

Yoshikawa, Hiroyuki

2017-09-01

Four years have passed since HPV vaccination "crisis" occurred in June 2013. In Japan,a publicly funded HPV vaccination program for adolescent females aged 12-16 years began in December 2010. However,the Japanese government withdrew its recommendation for HPV vaccination in June, 2013 because news reports on potential adverse effects of HPV vaccines without any medical evidence appeared repeatedly. The vaccination coverage among adolescent females decreased quickly from around 70%in females born between 1994 and 1999 to only 1%in females born since 2001 over the country. The suspension of recommendation for vaccination has continued to the present,though there is no scientific or epidemiologic evidence to demonstrate the causal linkage between post-vaccination symptoms and the HPV vaccines. Very recently,an ecological investigation reported that similar symptoms also occur in unvaccinated adolescents in Japan. Medical organizations in Japan are also calling for a resumption of the HPV vaccination program. Now,the resumption of the recommendation needs a political judgment.

Management and Economic Implications of Bundling and Block Booking of Television and Cable Programming.

ERIC Educational Resources Information Center

Picard, Robert G.

Bundling, a practice which has increased dramatically in the television and cable industries in recent years, occurs when program distributors package groups of movies and episodes of series, and then sell licenses to use these packages to TV stations and cable channels. Typically, such bundled packages include both highly desirable and less…

An Evaluation of the Federal Class-Size Reduction Program in Wake County, North Carolina--1999-2000.

ERIC Educational Resources Information Center

Scudder, David F.

An empirical evaluation of the federal class-size reduction (CSR) program in Wake County, North Carolina, during the 1999-2000 school year is presented. The qualitative process evaluation showed implementation issues involving the mechanics and the meaning of CSR. Often, schools did not understand where CSR occurred because of changing enrollment…

Emphasizing Multiple Levels of Representation to Enhance Students' Understandings of the Changes Occurring during Chemical Reactions

ERIC Educational Resources Information Center

Chandrasegaran, A. L.; Treagust, David F.; Mocerino, Mauro

2009-01-01

An alternative program of instruction was implemented with 33 high-achieving Grade 9 students (15-16 years old) in Singapore that overtly focused on the use of macroscopic, submicroscopic, and symbolic representations to describe and explain the changes that occurred during the burning of metals, reactions of dilute acids, ionic precipitations,…

Impact of the Garrett Lee Smith youth suicide prevention program on suicide mortality.

PubMed

Walrath, Christine; Garraza, Lucas Godoy; Reid, Hailey; Goldston, David B; McKeon, Richard

2015-05-01

We examined whether a reduction in youth suicide mortality occurred between 2007 and 2010 that could reasonably be attributed to Garrett Lee Smith (GLS) program efforts. We compared youth mortality rates across time between counties that implemented GLS-funded gatekeeper training sessions (the most frequently implemented suicide prevention strategy among grantees) and a set of matched counties in which no GLS-funded training occurred. A rich set of background characteristics, including preintervention mortality rates, was accounted for with a combination of propensity score-based techniques. We also analyzed closely related outcomes that we did not expect to be affected by GLS as control outcomes. Counties implementing GLS training had significantly lower suicide rates among the population aged 10 to 24 years the year after GLS training than similar counties that did not implement GLS training (1.33 fewer deaths per 100 000; P = .02). Simultaneously, we found no significant difference in terms of adult suicide mortality rates or nonsuicide youth mortality the year after the implementation. These results support the existence of an important reduction in youth suicide rates resulting from the implementation of GLS suicide prevention programming.

How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years.

PubMed

Innes, Stanley I; Leboeuf-Yde, Charlotte; Walker, Bruce F

2018-01-01

Evidence suggests that a students' beliefs already prior to entering a program may be important as a determinant in sustaining unsuitable health care beliefs. Our objectives were to investigate the proportion of Australian chiropractic students who hold non-evidence-based beliefs in the first year of study and the extent to which they may be involved in non-musculoskeletal health conditions. Finally, to see if this proportion varies over the course of the chiropractic program. In 2016, students from two Australian chiropractic programs answered a questionnaire on how often they would give advice on five common health conditions in their future practices as well as their opinion on whether chiropractic spinal adjustments could prevent or help seven health-related conditions. From a possible 831 students, 444 responded (53%). Students were highly likely to offer advice (often/quite often) on a range of non-musculoskeletal conditions. The proportions were lowest in first year and highest the final year. Also, high numbers of students held non-evidence-based beliefs about 'chiropractic spinal adjustments' which tended to occur in gradually decreasing in numbers in sequential years, except for fifth year when a reversal of the pattern occurred. New strategies are required for chiropractic educators if they are to produce graduates who understand and deliver evidence-based health care and able to be part of the mainstream health care system.

Student Retention: Helping Underprepared Students Succeed at North Carolina Agricultural and Technical State University

ERIC Educational Resources Information Center

Lee, Melinda L.

2013-01-01

Higher education institutions have been challenged with retaining students until graduation over the past forty years. The greatest attrition occurs during the freshman-to-sophomore year. College administrators must evaluate data trends to determine the academic needs of enrolled students so effective programming can be developed and executed to…

76 FR 75427 - Farm Loan Programs Loan Making Activities

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-02

... prior farming experience of the applicant. This amendment is required by sections 5001 and 5101 of the... years prior to the date of the application, if all prior farming occurred more than five years prior to...: (1) Is a beginning farmer or socially disadvantaged farmer engaged primarily in farming in the United...

Random Network Models to Predict the Long-Term Impact of HPV Vaccination on Genital Warts

PubMed Central

Díez-Domingo, Javier; Sánchez-Alonso, Víctor; Acedo, Luis; Villanueva-Oller, Javier

2017-01-01

The Human papillomaviruses (HPV) vaccine induces a herd immunity effect in genital warts when a large number of the population is vaccinated. This aspect should be taken into account when devising new vaccine strategies, like vaccination at older ages or male vaccination. Therefore, it is important to develop mathematical models with good predictive capacities. We devised a sexual contact network that was calibrated to simulate the Spanish epidemiology of different HPV genotypes. Through this model, we simulated the scenario that occurred in Australia in 2007, where 12–13 year-old girls were vaccinated with a three-dose schedule of a vaccine containing genotypes 6 and 11, which protect against genital warts, and also a catch-up program in women up to 26 years of age. Vaccine coverage were 73% in girls with three doses and with coverage rates decreasing with age until 52% for 20–26 year-olds. A fast 59% reduction in the genital warts diagnoses occurred in the model in the first years after the start of the program, similar to what was described in the literature. PMID:29035332

Random Network Models to Predict the Long-Term Impact of HPV Vaccination on Genital Warts.

PubMed

Díez-Domingo, Javier; Sánchez-Alonso, Víctor; Villanueva, Rafael-J; Acedo, Luis; Moraño, José-Antonio; Villanueva-Oller, Javier

2017-10-16

The Human papillomaviruses (HPV) vaccine induces a herd immunity effect in genital warts when a large number of the population is vaccinated. This aspect should be taken into account when devising new vaccine strategies, like vaccination at older ages or male vaccination. Therefore, it is important to develop mathematical models with good predictive capacities. We devised a sexual contact network that was calibrated to simulate the Spanish epidemiology of different HPV genotypes. Through this model, we simulated the scenario that occurred in Australia in 2007, where 12-13 year-old girls were vaccinated with a three-dose schedule of a vaccine containing genotypes 6 and 11, which protect against genital warts, and also a catch-up program in women up to 26 years of age. Vaccine coverage were 73 % in girls with three doses and with coverage rates decreasing with age until 52 % for 20-26 year-olds. A fast 59 % reduction in the genital warts diagnoses occurred in the model in the first years after the start of the program, similar to what was described in the literature.

The use of blood-type tattoos during the Cold War.

PubMed

Wolf, Elizabeth K; Laumann, Anne E

2008-03-01

We have seen a number of individuals who received blood-type tattoos on the left side of the chest as schoolchildren in northwest Indiana during the 1950s. To investigate the history of blood-type tattooing. Historical research was conducted using newspaper and journal articles found in medical libraries, online archives, American Medical Association archives, Chicago Historical Society records, local medical society documents, in addition to personal interviews. Blood-type tattoos were used during the Cold War to enable rapid transfusions as part of a "walking blood bank" in case of atomic attack. Nationwide blood-typing programs occurred to inform individuals of their own blood types and to provide local communities with lists of possible donors. The blood-type tattooing program was part of this effort, but community-wide tattooing occurred only in two parts of the United States: Lake County, Indiana, and Cache and Rich counties, Utah. In these communities, during 1951 and 1952, schoolchildren were tattooed to facilitate emergency transfusions. Events occurred more than 50 years ago, so we relied on original documents and interviews from individuals involved in the program who are still alive. The use of blood-type tattoos was short lived, lasting less than a year, and ultimately failed because physicians did not trust tattoos for medical information.

Enrollment and Follow-Up Trends of Students of Full-Time Day Programs of Minnesota Area Vocational-Technical Institutes.

ERIC Educational Resources Information Center

Pucel, David J.; Murphy, Herb

The study examines trends among students and graduates of the Minnesota Area Vocational Technical Institutes (AVTIs). Some of the data were gathered yearly between 1970-71 and 1973-74; some were gathered yearly between 1971-72 and 1973-74. Seventeen selected variables were reviewed. Relatively minor changes occurred over the years on seven of the…

A Case Study of the Introduction of Computer Science in NZ Schools

ERIC Educational Resources Information Center

Bell, Tim; Andreae, Peter; Robins, Anthony

2014-01-01

For many years computing in New Zealand schools was focused on teaching students how to use computers, and there was little opportunity for students to learn about programming and computer science as formal subjects. In this article we review a series of initiatives that occurred from 2007 to 2009 that led to programming and computer science being…

Supplemental Summer Literacy Instruction: Implications for Preventing Summer Reading Loss

ERIC Educational Resources Information Center

McDaniel, Sara C.; McLeod, Ragan; Carter, Coddy L.; Robinson, Cecil

2017-01-01

Summer reading loss is a prevalent problem that occurs primarily for students who are not exposed to or encouraged to read at home or in summer programs when school is out. This problem prevails among early readers from low-income backgrounds. This study provided 31 six and seven-year-old children with a structured guided reading program through…

Caries risk assessment/treatment programs in U.S. dental schools: an eleven-year follow-up.

PubMed

Yorty, Jack S; Walls, Allan Todd; Wearden, Stanley

2011-01-01

The purpose of this survey was to identify the number and characteristics of caries risk assessment/treatment (CRA/ Tx) programs in U.S. dental schools in 2009 and compare the results to those of the 1998 survey. A survey of U.S. dental schools was conducted in 2009 using the same eleven-question survey instrument as in 1998. Results were analyzed using stratified random sampling and chi-square tests for six of the questions. Additionally, data from the other questions were directly compared. Two questions showed a statistically significant difference: an increase in programs supervised by one school department and the number of schools using CRA as a graduation requirement. Positive changes are occurring in the development of CRA/Tx programs in U.S. dental schools. A wide variety of approaches to teaching this subject, including use of terminology and treatment philosophies, is evident. The evolution of this subject has been slow and varied over the past eleven years. Changing from a mainly surgical approach model to a medical model is occurring, but a more integrated method is needed to clarify terminology, diagnosis, treatment, and communications with researchers, clinicians, teachers, patients, and third-party payers.

Creating an Educational Program for Young Children Who Are Blind and Who Have Autism

ERIC Educational Resources Information Center

Jamieson, Sheila

2004-01-01

Autism, a lifelong neurological disorder that affects the functioning of the brain, occurs in about one out of every thousand individuals. This disorder can occur at or before birth and the symptoms are usually manifested during the first 3 to 5 years of life. Males are four times as likely to have the disorder, but it affects females more…

The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil.

PubMed

Urrutia-Pereira, Marilyn; Avila, Jennifer; Solé, Dirceu

2016-01-01

To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program. Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents (< 18 years of age) with asthma or suspected asthma. Patients either enroll in PIPA spontaneously or are referred by pediatricians or primary care physicians. In this retrospective study, we use a standardized protocol to assess PIPA patients. By the end of the study period, 646 patients were being followed. Of those, 298 (46.1%) were ≤ 3 years of age. In this group of patients, recurrent wheezing was identified in 60.7%, and the first episode of wheezing occurred in the first six months of life in 86.0%. Severe wheezing was identified in 29.5% and 45.4% in the children ≤ 3 and > 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%), occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood.

The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil

PubMed Central

Urrutia-Pereira, Marilyn; Avila, Jennifer; Solé, Dirceu

2016-01-01

Objective : To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program. Methods : Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents (< 18 years of age) with asthma or suspected asthma. Patients either enroll in PIPA spontaneously or are referred by pediatricians or primary care physicians. In this retrospective study, we use a standardized protocol to assess PIPA patients. Results : By the end of the study period, 646 patients were being followed. Of those, 298 (46.1%) were ≤ 3 years of age. In this group of patients, recurrent wheezing was identified in 60.7%, and the first episode of wheezing occurred in the first six months of life in 86.0%. Severe wheezing was identified in 29.5% and 45.4% in the children ≤ 3 and > 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%), occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. Conclusions : A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood. PMID:26982040

Environmental Baseline Survey, Real Property Transaction Between Nellis Air Force Base and the City of North Las Vegas for Construction of a Wastewater Treatment Facility, Clark County, Nevada. Phase 1

DTIC Science & Technology

2007-12-06

established action levels characterized pursuant to the Environmental Restoration Program (ERP) that is managed by the Restoration Program Manager (RPM) of...interviews are presented in Appendix E. Mr. D.J. Haarklau, 99 CES/CEVC, Environmental POLs Program Manager Mr. Haarklau provided GSRC with...Program Manager for 10 years, and according to a records search, no reportable spills have occurred within or in the vicinity of the subject property. He

Sexual sensation seeking, co-occurring sex and alcohol use, and sexual risk behavior among adolescents in treatment for substance use problems.

PubMed

Oshri, Assaf; Tubman, Jonathan G; Morgan-Lopez, Antonio A; Saavedra, Lissette M; Csizmadia, Annamaria

2013-01-01

This study evaluated relations between sexual sensation seeking, co-occurring sex and alcohol use, and sexual risk behaviors (eg, unprotected intercourse and multiple sex partners) among adolescents receiving treatment for substance abuse problems. The ethnically diverse sample included 394 adolescents recruited from outpatient treatment (280 males; Mage  = 16.33 years, SDage  = 1.15). Structural equation modeling (SEM) was used to test direct and indirect paths between sexual sensation seeking and sexual risk behaviors via the frequency of co-occurring sex and alcohol use. Conditional indirect effects by gender were also tested. Analyses identified significant effects of sexual sensation seeking on co-occurring sex and alcohol use and sexual risk behaviors. The path from co-occurring sex and alcohol use to unprotected intercourse was significantly stronger among adolescent girls, suggesting a mediation effect moderated by gender. No gender difference was found for the indirect path from sexual sensation seeking and number of past year sexual partners via co-occurring sex and alcohol use. Selected prevention efforts are needed to promote HIV risk reduction among adolescents in substance abuse treatment. The documented conditional indirect effect for unprotected intercourse suggests that HIV prevention programs should pay special attention to gender-specific patterns of alcohol use and sexual risk behavior when tailoring program content. (Am J Addict 2013; 22:197-205). Copyright © American Academy of Addiction Psychiatry.

Opening the Window on Comprehensible Pronunciation after 19 Years: A Workplace Training Study

ERIC Educational Resources Information Center

Derwing, Tracey M.; Munro, Murray J.; Foote, Jennifer A.; Waugh, Erin; Fleming, Jason

2014-01-01

We present the outcomes of a pronunciation training program conducted in a workplace setting with second language speakers who had lived in an English-speaking environment for an average of 19 years. The research questions concerned whether improvement would occur in the learners' perception of certain segments and prosody; in the…

Engaging Inner City Students in Learning through Designing Remote Operated Vehicles

ERIC Educational Resources Information Center

Barnett, Michael

2005-01-01

For the past year we have been developing and implementing a program in which students design and construct remote operated vehicles. In this paper, we report on a pilot study that occurred over the course of an academic year in an inner city high school. Specifically, we have been investigating whether students learn meaningful science content…

A Four-Year Follow-Up of Means-End Outcomes from Outdoor Adventure Programs

ERIC Educational Resources Information Center

Goldenberg, Marni; Soule, Katherine E.

2015-01-01

Means-end theory was used to analyze differences in outcomes from original interviews and follow-up interviews occurring four years after Outward Bound (OB) and National Outdoor Leadership School (NOLS) 2006 course participation. In 2006, a semi-structured, in-person interview was conducted after participants (N = 510) completed their course. In…

34 CFR 668.61 - Recovery of funds from interim disbursements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... disbursements in the award year in which the overpayment occurred; or (2) Reimbursing the appropriate program...: (A) Sixty days after the applicant's last day of attendance. (B) The last day of the award year in... financial assistance to an applicant under § 668.58(a)(3), and did not receive the valid SAR or valid ISIR...

34 CFR 668.61 - Recovery of funds from interim disbursements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... disbursements in the award year in which the overpayment occurred; or (2) Reimbursing the appropriate program...: (A) Sixty days after the applicant's last day of attendance. (B) The last day of the award year in... financial assistance to an applicant under § 668.58(a)(3), and did not receive the valid SAR or valid ISIR...

34 CFR 668.61 - Recovery of funds from interim disbursements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... disbursements in the award year in which the overpayment occurred; or (2) Reimbursing the appropriate program...: (A) Sixty days after the applicant's last day of attendance. (B) The last day of the award year in... financial assistance to an applicant under § 668.58(a)(3), and did not receive the valid SAR or valid ISIR...

E-ZPass evaluation report

DOT National Transportation Integrated Search

2000-08-01

The implementation of electronic toll collection equipment on the New York State Thruway occurred over a four-year period beginning in the 1993 and ending in 1997. In conjunction with implementation program, the Authority set a list of goals and obje...

76 FR 26489 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

...This final rule implements a Hospital Inpatient Value-Based Purchasing program (Hospital VBP program or the program) under section 1886(o) of the Social Security Act (the Act), under which value-based incentive payments will be made in a fiscal year to hospitals that meet performance standards with respect to a performance period for the fiscal year involved. The program will apply to payments for discharges occurring on or after October 1, 2012, in accordance with section 1886(o) (as added by section 3001(a) of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act)). Scoring in the Hospital VBP program will be based on whether a hospital meets or exceeds the performance standards established with respect to the measures. By adopting this program, we will reward hospitals based on actual quality performance on measures, rather than simply reporting data for those measures.

NASA flight cell and battery issues

NASA Technical Reports Server (NTRS)

Schulze, N. R.

1989-01-01

The author presents the important battery and cell problems, encompassing both test failures and accidents, which were encountered during the past year. Practical issues facing programs, which have to be considered in the development of a battery program strategy, are addressed. The problems of one program, the GRO (Gamma Ray Observatory), during the past year are focused on to illustrate the fundamental types of battery problems that occur. Problems encountered by other programs are briefly mentioned to complete the accounting. Two major categories of issues are defined, namely, whose which are quality and design related, i.e., problems having inherent manufacturing-process-related aspects with an impact on cell reliability, and these which are accident triggered or man induced, i.e., those operational issues having an impact on battery and cell reliability.

A Case Study of Teacher Education Reform: Issues and Challenges

ERIC Educational Resources Information Center

Beck, Judy; Shanks, Joyce

2005-01-01

The purpose of this paper is to present a case study and analysis of programmatic change over two years of reform in a teacher education program. The data shows that the types of change occurring in program reform may not be as substantive as educators may hope to see. Two main obstacles to change that were revealed are workload issues and a lack…

Understanding the Impact of Academic Support Programs on First-Time Bar Passage for Students at the University of Idaho College of Law

ERIC Educational Resources Information Center

Albertson, Helen

2013-01-01

As racial and ethnic population changes occur in the United States these same changes should be reflected in the legal community of lawyers and judges. Although Black and Hispanic populations have been increasing over the past 30 years in the United States, this same proportionate increase has not occurred in the American Bar Association (ABA)…

Effects of the Family Bereavement Program on Academic Outcomes, Educational Expectations and Job Aspirations 6 Years Later: The Mediating Role of Parenting and Youth Mental Health Problems

PubMed Central

Schoenfelder, Erin N.; Tein, Jenn-Yun; Wolchik, Sharlene; Sandler, Irwin N.

2014-01-01

Experiencing the death of a parent during childhood is associated with a variety of difficulties, including lower academic achievement, that have implications for functioning in childhood and adulthood. This study examines effects of the Family Bereavement Program (FBP), a preventive intervention for parentally-bereaved youth and their caregivers, on grade point averages (GPA), educational expectations and job aspirations of youths 6 years after the intervention. A total of 244 bereaved youths ages 8-16 and their caregivers were randomized to either the FBP or a comparison group that received books about bereavement. Assessments occurred at pretest, post-test, and 11-month and 6-year follow-ups. Direct program effects on educational outcomes and job aspirations 6 years later were non-significant, although the program improved educational expectations for children with fewer behavior problems at program entry, and GPA for younger children. Mediational pathways for program effects on educational outcomes were also tested. Program-induced improvements in effective parenting at 11-month follow-up were associated with higher GPAs at 6-year follow-up for youth who were younger or for whom more time had passed since the loss. Program-induced improvements in parenting and teacher-rated youth mental health problems at the 6-year follow-up mediated program effects on youths’ educational expectations for those with fewer behavior problems at program entry. The implications of these findings for understanding processes related to academic and educational outcomes following the death of a parent and for prevention efforts to help bereaved and other high-risk children succeed in school are discussed. PMID:25052624

Examining the Sustainability of Pre-Service Teachers' Visions of Literacy Instruction in Their Practice

ERIC Educational Resources Information Center

Scales, Roya

2013-01-01

This is a study of teachers' visions. Five participants were followed through their pre-service years in the teacher education program and into their first year of teaching to see if their vision was sustained and whether it appeared in their practice. This paper describes the coding process for visions and discusses changes that occurred in the…

Results and Implications of a 12-Year Longitudinal Study of Science Concept Learning

ERIC Educational Resources Information Center

Novak, Joseph D.

2005-01-01

This paper describes the methods and outcomes of a 12-year longitudinal study into the effects of an early intervention program, while reflecting back on changes that have occurred in approaches to research, learning and instruction since the preliminary inception stages of the study in the mid 1960s. We began the study to challenge the prevailing…

Medicare program; inpatient psychiatric facilities prospective payment system--update for fiscal year beginning October 1, 2014 (FY 2015). Final rule.

PubMed

2014-08-06

This final rule will update the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs). These changes will be applicable to IPF discharges occurring during the fiscal year (FY) beginning October 1, 2014 through September 30, 2015. This final rule will also address implementation of ICD-10-CM and ICD-10-PCS codes; finalize a new methodology for updating the cost of living adjustment (COLA), and finalize new quality measures and reporting requirements under the IPF quality reporting program.

Reformulation of Engineering Education at Undergraduate Level in the Faculdad de Ingenieria y Ciencias Hidricas Universidad Nacional del Litoral--Water Resources and Engineering Degrees.

ERIC Educational Resources Information Center

Theiler, Julio; Isla, Miguel; Arrillaga, Hugo; Ceirano, Eduardo; Lozeco, Cristobal

This paper explains the educational changes in the Water Resources Engineering program offered by the Universidad Nacional del Litoral in Santa Fe, Argentina, for the last 20 years at the undergraduate level. The need for modernizing the engineering teaching program occurred due to changes in the social system in which the concepts of development…

Suggestions for Enhancing the Procurement Career Management Program in the United States Coast Guard.

DTIC Science & Technology

1987-06-01

37 D ALTERNATIVE vlEwS ...... .............. 37 I E. PROCUREMENT INITIATIVES TO PROFESSIONALIZE THE WORKFORCE... 38 F. PROFESSIONALISM...Procurement Research The objective of this element is to identify sources for completed research, list alternatives for conducting further research, and...year depending on what new program starts occur, however the general pattern is relatively representative through FY1986. With the MLCs coming online in

IRIG Serial Time Code Formats

DTIC Science & Technology

2016-08-01

codes contain control functions (CFs) that are reserved for encoding various controls, identification, and other special- purpose functions. Time...set of CF bits for the encoding of various control, identification, and other special- purpose functions. The control bits may be programmed in any... recycles yearly. • There are 18 CFs occur between position identifiers P6 and P8. Any CF bit or combination of bits can be programmed to read a

The U.S. RERTR program status and progress.

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

Travelli, A.

1998-01-21

The progress of the Reduced Enrichment Research and Test Reactor (RERTR) Program since its inception in 1978 is described. A brief summary of the results which the RERTR Program had achieved by the end of 1996 in collaboration with its many international partners is followed by a detailed review of the major events, findings, and activities of 1997. Significant progress has been made during the past year. In the area of U.S. acceptance of spent fuel from foreign research reactors, several shipments have taken place and additional are being planned. Intense fuel development activities are in progress, including procurement ofmore » equipment, screening of candidate materials, and production of microplates. Irradiation of the first series of microplates began in August 1997 in the Advanced Test Reactor, in Idaho. Progress has been made in the Russian RERTR program, which aims to develop and demonstrate within five years the technical means needed to convert Russian-supplied research reactors to LEU fuels. The study of an alternative LEU core for the FRM-II design has been extended to address, with favorable results, controversial performance issues which were raised at last year's meeting. Progress was also made on several aspects of producing molybdenum-99 from fission targets utilizing LEU instead of HEU. Various types of targets and processes are being pursued, with FDA approval of an LEU process projected to occur within two years. The feasibility of LEU Fuel conversion for three important DOE research reactors (BMRR, HFBR, and HFIR) has been evaluated by the RERTR program. In spite of the many momentous events which have occurred during the intervening years, and the excellent progress achieved, the most important challenges that the RERTR program faces today are not very different in type from those that were faced during the first RERTR meeting. Now, as then, the most important task is to develop new LEU fuels satisfying requirements which cannot be satisfied by any existing fuel. These new advanced fuels will enable conversion of the reactors which cannot be converted today, ensure better efficiency and performance for all research reactors, and allow the design of more powerful new advanced LEU reactors. As in the past, the success of the RERTR program will depend on free exchange of ideas and information, and on the international friendship and cooperation that have been a trademark of the RERTR program since its inception.« less

A comparison survey of seizures and other symptoms of Pokemon phenomenon.

PubMed

Furusho, Junichi; Suzuki, Masakazu; Tazaki, Izumi; Satoh, Hiroyuki; Yamaguchi, Katuhiko; Iikura, Yoji; Kumagai, Komei; Kubagawa, Tetuji; Hara, Tsunekatsu

2002-11-01

On 16 December 1997, many Japanese children developed neurologic problems while watching the animated television series Pokemon. This study included children who visited the outpatient departments of 14 pediatric clinics for other reasons within 2 months after this incident. Volunteering children and parents or guardians were asked to complete questionnaires. We obtained 1,373 replies (including 800 males, 558 females, and 15 children without information on sex; mean age, 6.8 +/- 3.5 years). The majority of children included in this study (80%) watched this program, and 67 (6.1%; 40 males, 27 females) were affected by the program. There were 10 patients with seizures (0.9%; four males and six females). Fifty-seven patients developed other symptoms. Compared with nonaffected children, significantly more affected children reported that they concentrated on watching this program, watched it at a short distance from the screen, and did not watch this program in a brightly lit room. Seizures tended to occur in older children (average = 10.8 years) and in children with a high rate of familial histories of seizures. Symptoms other than seizures occurred more frequently, and autonomic and psychologic factors, such as motion sickness, could be considered possible mechanisms. Children who developed symptoms seemed to have problems in viewing conditions.

The environment power system analysis tool development program

NASA Technical Reports Server (NTRS)

Jongeward, Gary A.; Kuharski, Robert A.; Kennedy, Eric M.; Stevens, N. John; Putnam, Rand M.; Roche, James C.; Wilcox, Katherine G.

1990-01-01

The Environment Power System Analysis Tool (EPSAT) is being developed to provide space power system design engineers with an analysis tool for determining system performance of power systems in both naturally occurring and self-induced environments. The program is producing an easy to use computer aided engineering (CAE) tool general enough to provide a vehicle for technology transfer from space scientists and engineers to power system design engineers. The results of the project after two years of a three year development program are given. The EPSAT approach separates the CAE tool into three distinct functional units: a modern user interface to present information, a data dictionary interpreter to coordinate analysis; and a data base for storing system designs and results of analysis.

U.S. Department of Energy Illness, and Injury Surveillance Program, Worker Health At A Glance, 1995-2004

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

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-01

The Department of Energy’s (DOE) Illness and Injury Surveillance Program (IISP) has monitored the health of contractor workers at selected DOE sites since 1990. For the first time, the IISP has sufficient data to describe, in a collective manner, the health trends occurring among workers at a number of DOE sites during a 10-year period. This brief report and the more detailed Worker Health Summary assess illness and injury trends of DOE workers according to gender, age, occupational group, and program office over the 10-year period, 1995 through 2004. During this time, over 137,000 individual contractor workers were employed atmore » the 15 DOE sites participating in the IISP.« less

Midwest Nuclear Science and Engineering Consortium

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

Dr. Wynn Volkert; Dr. Arvind Kumar; Dr. Bryan Becker

2010-12-08

The objective of the Midwest Nuclear Science and Engineering Consortium (MNSEC) is to enhance the scope, quality and integration of educational and research capabilities of nuclear sciences and engineering (NS/E) programs at partner schools in support of the U.S. nuclear industry (including DOE laboratories). With INIE support, MNSEC had a productive seven years and made impressive progress in achieving these goals. Since the past three years have been no-cost-extension periods, limited -- but notable -- progress has been made in FY10. Existing programs continue to be strengthened and broadened at Consortium partner institutions. The enthusiasm generated by the academic, state,more » federal, and industrial communities for the MNSEC activities is reflected in the significant leveraging that has occurred for our programs.« less

Pupils.

ERIC Educational Resources Information Center

Lufler, Henry S., Jr.; Bielsky, Donald J.

Litigation having to do with pupils occurred with greater frequency in 1980 than in the past. The greatest increase dealt with the handicapped and with substantive rights of students. Cases involving handicapped students generally focused on parent requests for residential treatment, extended-year programs, and in-class assistance for their…

Violence and sex in television programs do not sell products in advertisements.

PubMed

Bushman, Brad J

2005-09-01

Adults (N = 336) 18 to 54 years old watched a television program containing violence, sex, both violence and sex, or no violence and sex. Programs were shown in a comfortable room containing padded chairs and tasty snacks. Each program contained the same 12 ads. Embedding an ad in a program containing violence or sex reduced (a) viewers' likelihood of remembering the advertised brand, (b) their interest in buying that brand, and (c) their likelihood of selecting a coupon for that brand. These effects occurred for males and females of all ages, regardless of whether they liked programs containing violence and sex. These results show that violence and sex in television programs do not sell products in advertisements.

Sudden Cardiac Arrest during Participation in Competitive Sports.

PubMed

Landry, Cameron H; Allan, Katherine S; Connelly, Kim A; Cunningham, Kris; Morrison, Laurie J; Dorian, Paul

2017-11-16

The incidence of sudden cardiac arrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiac arrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiac arrests that occurred during participation in sports activities within a specific region of Canada and to determine their causes. In this retrospective study, we used the Rescu Epistry cardiac arrest database (which contains records of every cardiac arrest attended by paramedics in the network region) to identify all out-of-hospital cardiac arrests that occurred from 2009 through 2014 in persons 12 to 45 years of age during participation in a sport. Cases were adjudicated as sudden cardiac arrest (i.e., having a cardiac cause) or as an event resulting from a noncardiac cause, on the basis of records from multiple sources, including ambulance call reports, autopsy reports, in-hospital data, and records of direct interviews with patients or family members. Over the course of 18.5 million person-years of observation, 74 sudden cardiac arrests occurred during participation in a sport; of these, 16 occurred during competitive sports and 58 occurred during noncompetitive sports. The incidence of sudden cardiac arrest during competitive sports was 0.76 cases per 100,000 athlete-years, with 43.8% of the athletes surviving until they were discharged from the hospital. Among the competitive athletes, two deaths were attributed to hypertrophic cardiomyopathy and none to arrhythmogenic right ventricular cardiomyopathy. Three cases of sudden cardiac arrest that occurred during participation in competitive sports were determined to have been potentially identifiable if the athletes had undergone preparticipation screening. In our study involving persons who had out-of-hospital cardiac arrest, the incidence of sudden cardiac arrest during participation in competitive sports was 0.76 cases per 100,000 athlete-years. The occurrence of sudden cardiac arrest due to structural heart disease was uncommon during participation in competitive sports. (Funded by the National Heart, Lung, and Blood Institute and others.).

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

Ziritt, Jose Luis

The results from Annex XIII of the Cooperative Agreement between the United States Department of Energy (DOE) and the Ministry of Energy and Mines of the Republic of Venezuela (MEMV) have been documented and published with many researchers involved. Integrate comprehensive research programs in the area of Microbial Enhanced Oil Recovery (MEOR) ranged from feasibility laboratory studies to full-scale multi-well field pilots. The objective, to cooperate in a technical exchange of ideas and information was fully met throughout the life of the Annex. Information has been exchanged between the two countries through published reports and technical meetings between experts inmore » both country's research communities. The meetings occurred every two years in locations coincident with the International MEOR conferences & workshops sponsored by DOE (June 1990, University of Oklahoma, September 1992, Brookhaven, September 1995, National Institute of Petroleum and Energy Research). Reports and publications produced during these years are listed in Appendix B. Several Annex managers have guided the exchange through the years. They included Luis Vierma, Jose Luis Zirritt, representing MEMV and E. B. Nuckols, Edith Allison, and Rhonda Lindsey, representing the U.S. DOE. Funding for this area of research remained steady for a few years but decreased in recent years. Because both countries have reduced research programs in this area, future exchanges on this topic will occur through ANNEX XV. Informal networks established between researchers through the years should continue to function between individuals in the two countries.« less

Prevalence and burden of headaches as assessed by the health family program.

PubMed

Silva Junior, Ariovaldo A; Bigal, Marcelo; Vasconcelos, Luiz P B; Rodrigues, Joismar; Gomez, Rodrigo S; Krymchantowski, Abouch V; Moreira Filho, Pedro; Teixeira, Antonio L

2012-03-01

Unified health systems often have Family Health Programs (FHPs) as a core component of their preventive and early curative strategies. In Brazil, the FHP is established to proactively identify diseases such as diabetes and hypertension. To use the FHP in order to assess the prevalence of primary headaches, as per the Second Edition of the International Classification of Headache Disorders in a Brazilian city covered by the program, and to document the burden of migraine and tension-type headache (TTH) in this population. FHP agents were trained on how to apply questionnaires that screened for the occurrence of headaches in the past year. Screening method had been previously validated. Respondents that screened positively were interviewed by a headache specialist, and all their headache types were classified. Additionally, disability (Migraine Disability Assessment Scale and Headache Impact Test) and health-related quality of life were assessed. The 1-year prevalence of migraine was 18.2% [95% confidence interval = 13.7; 23.5]. TTH occurred in 22.9% [18.0%; 28.6%]. Other primary headaches occurred in 10.8% of the participants. Idiopathic stabbing headache was significantly more common in individuals with migraine relative to those without migraine (44.7% vs 10.3%, P < .001). Contrasting with TTH, migraineurs had a mean of 3.1 headache types vs 1.9 in TTH (P < .001). Secondary headaches occurred in 21.7% of the participants over a 1-year period [16.9%; 27.3%]. Most cases were headaches attributed to infection (mostly respiratory). The impact of migraine was bimodal. Most sufferers had little impact, but a sizable minority was severely impaired. The FHP can be effectively used to bring individuals with headache to the attention of providers. Future investigations should assess whether this increased attention translates into improved outcomes. © 2012 American Headache Society.

The effectiveness of a health promotion program after 3 years: evidence from the University of Minnesota.

PubMed

Nyman, John A; Abraham, Jean M; Jeffery, Molly Moore; Barleen, Nathan A

2012-09-01

Health promotion programs for the workplace are often sold to employers with the promise that they will pay for themselves with lowered health care expenditures and reduced absenteeism. In a recent review of the literature, it was noted that analysts often caution not to expect a positive return on investment until the third year of operation. This study investigates whether a positive return on investment was generated in the third year for the health promotion program used by the University of Minnesota. It further investigates what it is about the third year that would explain such a phenomenon. The study uses health care expenditure data and absenteeism data from 2004 to 2008 to investigate the effect of the University's lifestyle and disease management programs. It also investigates the effectiveness of participation in Minnesota's 10,000 Steps walking program and Miavita self-help programs. A differences-in-differences equations approach is used to address potential selection bias. Possible regression to the mean is dealt with by using only those who were eligible to participate as control observations. Propensity score weighting was used to balance the sample on observable characteristics and reduce bias due to omitted variables. The study finds that a 1.76 return on investment occurs in the third year of operation that is generated solely by the effect of disease management program participation in reducing health care expenditures. However, neither of the explanations for a third-year effect we tested seemed to be able to explain this phenomenon.

Attrition in an undergraduate program in allied health education.

PubMed

Hedl, J J

1987-08-01

The present study compared the characteristics of allied health professionals who completed a bachelor's degree program in allied health education with those who failed to complete the program, in order to develop recommendations for a retention program. The data base included all graduates and dropouts for the period September 1972 to August 1986. Analyses indicated that alumni and those who dropped out were remarkedly similar with regard to demographic characteristics such as age, sex, ethnicity, and prior academic achievement. Fifty percent of the dropouts occurred within the first semester, although attrition continued to occur over a five-year period. The reasons for dropping out were varied, and few were recorded for academic reasons. It was concluded that adult allied health professionals pose difficult problems for retention because motivation and commitment variables appear more important than academic ability or social/academic integration factors. These findings were consistent with research on attrition in higher education, and with the literature on adult learning.

Effects of specific muscle imbalance improvement training on the balance ability in elite fencers.

PubMed

Kim, Taewhan; Kil, Sekee; Chung, Jinwook; Moon, Jeheon; Oh, Eunyoung

2015-05-01

[Purpose] The lunge Motion that occurs frequently in fencing training and matches results in imbalance of the upper and lower limbs muscles. This research focuses on the improvement of the imbalance that occurs in the national team fencers of the Republic of Korea through specific muscle imbalance improvement training. [Subjects] The subjects of this research were limited to right-handed male fencers. Nine male, right-handed national fencing athletes were selected for this study (4 epee, 5 sabre; age 28.2 ± 2.2 years; height 182.3 ± 4.0 cm; weight 76.5 ± 8.2 kg; experience 12.4 ± 3.0 years). [Methods] The specific muscle imbalance improvement training program was performed for 12 weeks and Pre-Post tests were to evaluate its effect on the experimental group. Measurements comprised anthropometry, test of balance, and movement analysis. [Results] After the training program, mediolateral sway of the nondominant lower limb and the balance scale showed statistically significant improvement. [Conclusion] The specific muscle imbalance improvement training program used in this research was proven to be effective for improving the muscle imbalance of elite fencers.

Adverse events associated with pediatric exposures to dextromethorphan.

PubMed

Paul, Ian M; Reynolds, Kate M; Kauffman, Ralph E; Banner, William; Bond, G Randall; Palmer, Robert B; Burnham, Randy I; Green, Jody L

2017-01-01

Dextromethorphan is the most common over-the-counter (OTC) antitussive medication. We sought to characterize adverse events associated with dextromethorphan in children <12 years old from a surveillance program of OTC cough/cold medication exposures. This is a retrospective case series of oral exposures to dextromethorphan with ≥1 adverse event from multiple U.S. sources (National Poison Data System, FDA Adverse Event Reporting System, manufacturer safety reports, news/media, medical literature) reported between 2008 and 2014. An expert panel determined the relationship between exposure and adverse events, estimated dose ingested, intent of exposure, and identified contributing factors to exposure. 1716 cases contained ≥1 adverse event deemed at least potentially related to dextromethorphan; 1417 were single product exposures. 773/1417 (55%) involved only one single-ingredient dextromethorphan product (dextromethorphan-only). Among dextromethorphan-only cases, 3% followed ingestion of a therapeutic dose; 78% followed an overdose. 69% involved unsupervised self-administration and 60% occurred in children <4 years old. No deaths or pathologic dysrhythmias occurred. Central nervous system [e.g., ataxia (N = 420)] and autonomic symptoms [e.g., tachycardia (N = 224)] were the most common adverse events. Flushing and/or urticarial rash occurred in 18.1% of patients. Dystonia occurred in 5.4%. No fatalities were identified in this multifaceted surveillance program following a dextromethorphan-only ingestion. Adverse events were predominantly associated with overdose, most commonly affecting the central nervous and autonomic systems.

77 FR 40310 - Federal Housing Administration (FHA) Section 232 Healthcare Mortgage Insurance Program: Partial...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-09

... would occur 3 to 7 years after origination, following 10 to 30 months of delinquency. The savings to HUD... requirements, unless the agency certifies that the rule will not have a significant economic impact on a... [[Page 40314

Gainesville, Florida increases pedestrian safety by implementing year-long program : traffic tech.

DOT National Transportation Integrated Search

2013-08-01

In large cities, pedestrians account for 40% to 50% of traffic : fatalities. In 2011, there were 4,432 pedestrian fatalities : and about 69,000 injuries in the United States (NHTSA, : 2013). Many of these incidents occur at crosswalks where : drivers...

AOA Approval of ACGME Internship and Residency Training.

PubMed

Duffy, Thomas; Martinez, Bulmaro

2011-04-01

Since the 1970s, the American Osteopathic Association (AOA) has provided a means for osteopathic physicians to apply for approval of their postdoctoral training in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Osteopathic physicians who trained in ACGME programs need this approval to meet AOA licensure and board certification requirements. The AOA approves ACGME residency training with several different approval processes. Approval of the first year of postdoctoral training occurs through Resolution 42, specialty approval (for specialties in which the first year of training is part of the residency), or federal or military training approval. For residency training, the AOA verifies successful completion of an ACGME training program before approving the training. The AOA is using customer surveys and online applications to improve the review process for applicants.

Status of shuttle fuel cell technology program.

NASA Technical Reports Server (NTRS)

Rice, W. E.; Bell, D., III

1972-01-01

The hydrogen-oxygen fuel cell has been proved as an efficient and reliable electrical power supply for NASA manned-space-flight vehicles. It has thus ensured a role in the Space Shuttle Program as the primary electrical power supply for the Orbiter vehicle. The advanced fuel cell technology programs conducted under the management of the NASA Manned Spacecraft Center over the past two years have resulted in a high level of technical readiness in fuel cell power generation to support shuttle mission requirements. These programs have taken advantage of technological developments that have occurred since the designs were completed for the Gemini and Apollo fuel cells.

7 CFR 250.15 - Financial management.

Code of Federal Regulations, 2011 CFR

2011-01-01

... any single storage facility during the fiscal year in which the loss occurred, or during the period... the direct costs for intrastate storage and distribution of donated food through distribution charges... program costs referenced in paragraph (f)(2) of this section, i.e. transportation, storage and handling of...

7 CFR 250.15 - Financial management.

Code of Federal Regulations, 2013 CFR

2013-01-01

... any single storage facility during the fiscal year in which the loss occurred, or during the period... the direct costs for intrastate storage and distribution of donated food through distribution charges... program costs referenced in paragraph (f)(2) of this section, i.e. transportation, storage and handling of...

7 CFR 250.15 - Financial management.

Code of Federal Regulations, 2012 CFR

2012-01-01

... any single storage facility during the fiscal year in which the loss occurred, or during the period... the direct costs for intrastate storage and distribution of donated food through distribution charges... program costs referenced in paragraph (f)(2) of this section, i.e. transportation, storage and handling of...

7 CFR 250.15 - Financial management.

Code of Federal Regulations, 2014 CFR

2014-01-01

... any single storage facility during the fiscal year in which the loss occurred, or during the period... the direct costs for intrastate storage and distribution of donated food through distribution charges... program costs referenced in paragraph (f)(2) of this section, i.e. transportation, storage and handling of...

7 CFR 1467.4 - Program requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ownership change occurred due to foreclosure on the land and the owner of the land immediately before the..., or adjacent land uses, such as airports, that would either impede complete restoration or prevent... to restore, protect, or enhance wetlands on eligible private and Tribal lands. The 30-year contract...

Evaluation of the Race/Human Relations Program: Observations--A Second Year's Look at Racial Mixing and Quality of Interactions at School Sites. Evaluation Department Report No. 370.

ERIC Educational Resources Information Center

Stein, Robert Christopher

The evaluation of long-range goals of the Race/Human Relations Program of the San Diego City Schools consisted of observations to determine the degree to which racial mixing was occurring at school sites and the quality of interactions among students and adults. Fifty district employees were trained in the use of the Contextual Evaluation Form. A…

Safety in Study Abroad Programs. Hearing before the Subcommittee on Oversight and Investigations of the Committee on Education and the Workforce. House of Representatives, One Hundred Sixth Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and the Workforce.

This document contains the transcript and related written statements of a hearing held to discuss the safety standards and practices of study abroad programs. The tragedies that have occurred in recent years are not the norm in study abroad, but they focus attention on this rapidly growing and unstructured field. The report contains the opening…

Career Development Institute with Enhanced Mentoring: A Revisit

PubMed Central

Kupfer, David J.; Schatzberg, Alan F.; Dunn, Leslie O.; Schneider, Andrea K.; Moore, Tara L.; DeRosier, Melissa

2015-01-01

Objective The need for innovative methods to promote training, advancement, and retention of clinical and translational investigators in order to build a pipeline of trainees to focus on mental health-relevant research careers is pressing. The specific aim of the Career Development Institute for Psychiatry is to provide the necessary skill set and support to a nationally selected broad-based group of young psychiatrists and PhD researchers to launch and maintain successful research careers in academic psychiatry. The program targets such career skills as writing, negotiating, time management, juggling multiple demanding responsibilities, networking, project management, responsible conduct of research, and career goal setting. The current program builds on the previous program by adding a longitudinal, long-distance, virtual mentoring and training program, seen as integral components to sustaining these career skills. Methods Career development activities occur in four phases over a 24-month period for each annual class of up to 18 participants: online baseline career and skills self-assessment and goal setting, preparations for four-day in-person workshop, long-distance structured mentoring and online continued learning, peer- mentoring activities and post-program career progress and process evaluation. Program instructors and mentors consist of faculty from the University of Pittsburgh and Stanford University as well as successful past program graduates from other universities as peer-mentors. A comprehensive website facilitates long-distance activities to occur on-line. Continued training occurs via webinars every other month by experts discussing topics selected for the needs of each particular class. Personally assigned mentors meet individually bi-monthly with participants via a secure web-based “mentor center” that allows mentor dyads to collaborate, share, review, and discuss career goals and research activities. Results Preliminary results after the first 24 months are favorable. Almost uniformly, participants felt the program was very helpful. They had regular contact with their long-distance mentor at least every two months over the two-year period. At the end of the 2 year period, the majority of participants had full-time faculty appointments with K-award support and very few were doing primarily clinical work. Conclusions The longitudinal program of education, training, mentoring, peer support, and communications for individuals making the transition to academic research should increase the number of scientists committed to research careers in mental health. PMID:26048460

Career Development Institute with Enhanced Mentoring: A Revisit.

PubMed

Kupfer, David J; Schatzberg, Alan F; Dunn, Leslie O; Schneider, Andrea K; Moore, Tara L; DeRosier, Melissa

2016-06-01

The need for innovative methods to promote training, advancement, and retention of clinical and translational investigators in order to build a pipeline of trainees to focus on mental health-relevant research careers is pressing. The specific aim of the Career Development Institute for Psychiatry is to provide the necessary skill set and support to a nationally selected broad-based group of young psychiatrists and PhD researchers to launch and maintain successful research careers in academic psychiatry. The program targets such career skills as writing, negotiating, time management, juggling multiple demanding responsibilities, networking, project management, responsible conduct of research, and career goal setting. The current program builds on the previous program by adding a longitudinal, long-distance, virtual mentoring, and training program, seen as integral components to sustaining these career skills. Career development activities occur in four phases over a 24-month period for each annual class of up to 18 participants: online baseline career and skills self-assessment and goal setting, preparations for 4-day in-person workshop, long-distance structured mentoring and online continued learning, peer-mentoring activities, and post-program career progress and process evaluation. Program instructors and mentors consist of faculty from the University of Pittsburgh and Stanford University as well as successful past program graduates from other universities as peer mentors. A comprehensive website facilitates long-distance activities to occur online. Continued training occurs via webinars every other month by experts discussing topics selected for the needs of each particular class. Personally assigned mentors meet individually bimonthly with participants via a secure web-based "mentor center" that allows mentor dyads to collaborate, share, review, and discuss career goals and research activities. Preliminary results after the first 24 months are favorable. Almost uniformly, participants felt the program was very helpful. They had regular contact with their long-distance mentor at least every 2 months over the 2-year period. At the end of the 2-year period, the majority of participants had full-time faculty appointments with K-award support and very few were doing primarily clinical work. The longitudinal program of education, training, mentoring, peer support, and communications for individuals making the transition to academic research should increase the number of scientists committed to research careers in mental health.

An economic evaluation: Simulation of the cost-effectiveness and cost-utility of universal prevention strategies against osteoporosis-related fractures

PubMed Central

Nshimyumukiza, Léon; Durand, Audrey; Gagnon, Mathieu; Douville, Xavier; Morin, Suzanne; Lindsay, Carmen; Duplantie, Julie; Gagné, Christian; Jean, Sonia; Giguère, Yves; Dodin, Sylvie; Rousseau, François; Reinharz, Daniel

2013-01-01

A patient-level Markov decision model was used to simulate a virtual cohort of 500,000 women 40 years old and over, in relation to osteoporosis-related hip, clinical vertebral, and wrist bone fractures events. Sixteen different screening options of three main scenario groups were compared: (1) the status quo (no specific national prevention program); (2) a universal primary prevention program; and (3) a universal screening and treatment program based on the 10-year absolute risk of fracture. The outcomes measured were total directs costs from the perspective of the public health care system, number of fractures, and quality-adjusted life-years (QALYs). Results show that an option consisting of a program promoting physical activity and treatment if a fracture occurs is the most cost-effective (CE) (cost/fracture averted) alternative and also the only cost saving one, especially for women 40 to 64 years old. In women who are 65 years and over, bone mineral density (BMD)-based screening and treatment based on the 10-year absolute fracture risk calculated using a Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool is the best next alternative. In terms of cost-utility (CU), results were similar. For women less than 65 years old, a program promoting physical activity emerged as cost-saving but BMD-based screening with pharmacological treatment also emerged as an interesting alternative. In conclusion, a program promoting physical activity is the most CE and CU option for women 40 to 64 years old. BMD screening and pharmacological treatment might be considered a reasonable alternative for women 65 years old and over because at a healthcare capacity of $50,000 Canadian dollars ($CAD) for each additional fracture averted or for one QALY gained its probabilities of cost-effectiveness compared to the program promoting physical activity are 63% and 75%, respectively, which could be considered socially acceptable. Consideration of the indirect costs could change these findings. PMID:22991210

Development and evaluation of a peer-tutoring program for graduate students*.

PubMed

Copeland, H Liesel; Kinzy, Terri Goss

2005-03-01

Many interdisciplinary Ph.D. programs admit students of different educational backgrounds who receive a first year of a general curriculum education. However, student preparation for this curriculum varies, and methods are needed to provide academic support. Graduate student peer tutoring was piloted as an initiative funded by a National Institutes of Health (NIH) Initiative for Minority Student Development award to the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School (UMDNJ-RWJMS) and is now offered to all students in the interdisciplinary Molecular Biosciences Ph.D. program between Rutgers, The State University of New Jersey, and UMDNJ-RWJMS. Tutoring occurs individually or in small groups and has grown over the past 5 years in the number of students tutored and hours of tutoring. The program was evaluated by surveying and interviewing both tutors and students concerning process variables (e.g. awareness, frequency) and impact variables (e.g. perceived benefits, motivators), as well as by assessing changes in exam scores for the four core courses of the first-year graduate curriculum. Copyright © 2005 International Union of Biochemistry and Molecular Biology, Inc.

Development and Families: Implications for Home Economics.

ERIC Educational Resources Information Center

Murray, Eloise

1985-01-01

This article integrates literature from such diverse sources as population, agriculture, women in development, macro-economics, and health studies to document the changes that have occurred in families in the last 20-25 years. Program issues for the home economics profession are considered in light of these changes. (CT)

22 CFR 1501.3 - Description of central organization and location of offices.

Code of Federal Regulations, 2011 CFR

2011-04-01

... researchers in Africa working in development projects at the local level. (3) Office of Program and Field... knowledgeable about development activities in Africa, and to consult with the Council at least once each year... selected cities in Africa, but this has not yet occurred. ...

All Stirred Up

ERIC Educational Resources Information Center

Borja, Rhea R.

2004-01-01

This article describes the growth and popularity of Newport Harbor's culinary arts program, which reflects a nationwide trend. The trend is occurring in part, because more Americans are eating out. As the number of people eating out increases, their appetite for learning about food also increases. Over the past few years, Dukes has expanded…

Climate-change signals in national atmospheric deposition program precipitation data

USGS Publications Warehouse

Wetherbee, Gregory A.; Mast, M. Alisa

2016-01-01

National Atmospheric Deposition Program (NADP)/National Trends Network precipitation type, snow-season duration, and annual timing of selected chemical wet-deposition maxima vary with latitude and longitude within a 35-year (1979–2013) data record for the contiguous United States and Alaska. From the NADP data collected within the region bounded by 35.6645°–48.782° north latitude and 124°–68° west longitude, similarities in latitudinal and longitudinal patterns of changing snow-season duration, fraction of annual precipitation recorded as snow, and the timing of chemical wet-deposition maxima, suggest that the chemical climate of the atmosphere is linked to physical changes in climate. Total annual precipitation depth has increased 4–6 % while snow season duration has decreased from approximately 7 to 21 days across most of the USA, except in higher elevation regions where it has increased by as much as 21 days. Snow-season precipitation is increasingly comprised of snow, but annually total precipitation is increasingly comprised of liquid precipitation. Meanwhile, maximum ammonium deposition occurs as much as 27 days earlier, and the maximum nitrate: sulfate concentration ratio in wet-deposition occurs approximately 10–21 days earlier in the year. The maximum crustal (calcium + magnesium + potassium) cation deposition occurs 2–35 days earlier in the year. The data suggest that these shifts in the timing of atmospheric wet deposition are linked to a warming climate, but the ecological consequences are uncertain.

Dual peer mentoring program for undergraduate medical students: exploring the perceptions of mentors and mentees

PubMed Central

Abdolalizadeh, Parya; Pourhassan, Saeed; Gandomkar, Roghayeh; Heidari, Farrokh; Sohrabpour, Amir Ali

2017-01-01

Background: Despite the advantages of dual peer mentoring, there are a few reports of implementing and evaluating such programs for medical students. This study aimed at exploring the perceptions of mentors and mentees about the dual peer mentoring program for the first year undergraduate medical students of Tehran University of Medical Sciences. Methods: This qualitative study was conducted at the end of the first year of implementing the mentoring program. All mentees and mentors were invited to participate in focus group discussions. Data were analyzed using a qualitative content analysis. Results: All mentors (n= 12) and a group of mentees (n= 21) participated in focus group discussion sessions. We provided a variety of supports for the mentees including academic and psychosocial support and positive relationship; as a result, some developments occurred to the mentors We also explored participants’ views on some unique aspects of the program such as student-authorized, dual mentoring, and role model sessions. Conclusion: Our participants found the mentoring program beneficial in various academic achievements and psychosocial supports for both the mentors and the mentees. Dual peer mentoring program can be an alternative to school administered programs. PMID:28638809

Dual peer mentoring program for undergraduate medical students: exploring the perceptions of mentors and mentees.

PubMed

Abdolalizadeh, Parya; Pourhassan, Saeed; Gandomkar, Roghayeh; Heidari, Farrokh; Sohrabpour, Amir Ali

2017-01-01

Background: Despite the advantages of dual peer mentoring, there are a few reports of implementing and evaluating such programs for medical students. This study aimed at exploring the perceptions of mentors and mentees about the dual peer mentoring program for the first year undergraduate medical students of Tehran University of Medical Sciences. Methods: This qualitative study was conducted at the end of the first year of implementing the mentoring program. All mentees and mentors were invited to participate in focus group discussions. Data were analyzed using a qualitative content analysis. Results: All mentors ( n= 12 ) and a group of mentees ( n= 21 ) participated in focus group discussion sessions. We provided a variety of supports for the mentees including academic and psychosocial support and positive relationship; as a result, some developments occurred to the mentors We also explored participants' views on some unique aspects of the program such as student-authorized, dual mentoring, and role model sessions. Conclusion: Our participants found the mentoring program beneficial in various academic achievements and psychosocial supports for both the mentors and the mentees. Dual peer mentoring program can be an alternative to school administered programs.

Long-term follow-up of a facilitated peer mentoring program.

PubMed

Mayer, Anita P; Blair, Janis E; Ko, Marcia G; Patel, Salma I; Files, Julia A

2014-03-01

Mentoring plays an important role in career success of academic medical faculty. New mentoring models such as peer mentoring have emerged. To evaluate the long-term impact of a facilitated peer mentoring program on academic achievements. Women faculty at the instructor or assistant professor rank were recruited to voluntarily participate in a facilitated peer mentoring program. Recruitment occurred over 3.8 years between 2005 and 2009. A 26-item questionnaire to assess academic skill, career satisfaction, and self-efficacy was administered before program participation and again with seven additional questions in 2011. Curriculum vitae were reviewed retrospectively to tally peer-reviewed publications, other academic activities, and promotions. Participants had long-term improvement in their perceived mastery of academic skills. Peer-reviewed publications, book chapters, abstracts, posters, and other academic activities increased when activities before the program were compared to those in the five years after program enrollment. At follow-up, participants reported positive perceptions of the program and 44% continued to work with their original peer mentor groups. Involvement in the facilitated peer mentoring program was associated with increased skills and academic activities for most participants. Future studies are needed to assess its applicability and success among various demographic groups in academic medicine.

Long-term Effects of the Family Bereavement Program (FBP) on Spousally-Bereaved Parents: Grief, Mental Health, Alcohol Problems, and Coping Efficacy

PubMed Central

Sandler, Irwin; Tein, Jenn-Yun; Cham, Heining; Wolchik, Sharlene; Ayers, Tim

2016-01-01

Objective Reports on the finding from a six-year follow-up of a randomized trial of the Family Bereavement Program (FBP) on outcomes for spousally-bereaved parents. Method Spousally-bereaved parents (N=131) participated in the trial in which they were randomly assigned to receive the FBP (N = 72) or literature control (LC, N = 59). Parents were assessed at four time points, pre-test, post-test, 11-months, and six-year follow-up. Parents reported on mental health problems, grief and parenting at all four time periods. At the six-year follow-up parents reported on additional measures of persistent complex bereavement disorder, alcohol abuse problems, and coping efficacy. Results Bereaved parents in the FBP as compared to those in the LC had lower levels of symptoms of depression, general psychiatric distress, prolonged grief, alcohol problems, and higher coping efficacy at the six-year follow-up. Multiple characteristics of the parent (e.g., gender, age, baseline mental health problems) and of the spousal death (e.g., cause of death) were tested as moderators of program effects on each outcome. Latent-growth modeling found that the effects of the FBP on depression, psychiatric distress and grief occurred immediately following program participation and were maintained over six-years. Mediation analysis found that improvement in positive parenting partially mediated program effects to reduce depression and psychiatric distress, but had an indirect effect to higher levels of grief at the six years follow-up. Mediation analysis also found that improved parenting at the six year follow-up was partially mediated by program effects to reduce depression and that program effects to increase coping efficacy at the six-year follow-up was partially mediated through reduced depression and grief and improved parenting. Conclusions FBP reduced mental health problems, prolonged grief and alcohol abuse and increased coping efficacy of spousally-bereaved parents six years later. Mediation pathways for program effects differed across outcomes at the six-year follow-up. PMID:27427807

Web-based flood database for Colorado, water years 1867 through 2011

USGS Publications Warehouse

Kohn, Michael S.; Jarrett, Robert D.; Krammes, Gary S.; Mommandi, Amanullah

2013-01-01

In order to provide a centralized repository of flood information for the State of Colorado, the U.S. Geological Survey, in cooperation with the Colorado Department of Transportation, created a Web-based geodatabase for flood information from water years 1867 through 2011 and data for paleofloods occurring in the past 5,000 to 10,000 years. The geodatabase was created using the Environmental Systems Research Institute ArcGIS JavaScript Application Programing Interface 3.2. The database can be accessed at http://cwscpublic2.cr.usgs.gov/projects/coflood/COFloodMap.html. Data on 6,767 flood events at 1,597 individual sites throughout Colorado were compiled to generate the flood database. The data sources of flood information are indirect discharge measurements that were stored in U.S. Geological Survey offices (water years 1867–2011), flood data from indirect discharge measurements referenced in U.S. Geological Survey reports (water years 1884–2011), paleoflood studies from six peer-reviewed journal articles (data on events occurring in the past 5,000 to 10,000 years), and the U.S. Geological Survey National Water Information System peak-discharge database (water years 1883–2010). A number of tests were performed on the flood database to ensure the quality of the data. The Web interface was programmed using the Environmental Systems Research Institute ArcGIS JavaScript Application Programing Interface 3.2, which allows for display, query, georeference, and export of the data in the flood database. The data fields in the flood database used to search and filter the database include hydrologic unit code, U.S. Geological Survey station number, site name, county, drainage area, elevation, data source, date of flood, peak discharge, and field method used to determine discharge. Additional data fields can be viewed and exported, but the data fields described above are the only ones that can be used for queries.

Alarm Fatigue: Use of an Evidence-Based Alarm Management Strategy.

PubMed

Turmell, Jacob W; Coke, Lola; Catinella, Rachel; Hosford, Tracy; Majeski, Amy

The purpose of this article is to describe the impact of an evidence-based alarm management strategy on patient safety. An alarm management program reduced alarms up to 30%. Evaluation of patients on continuous cardiac monitoring showed a 3.5% decrease in census. This alarm management strategy has the potential to save $136 500 and 841 hours of registered nurses' time per year. No patient harm occurred during the 2-year project.

Decreased Management of Genital Warts in Young Women in Australian General Practice Post Introduction of National HPV Vaccination Program: Results from a Nationally Representative Cross-Sectional General Practice Study

PubMed Central

Harrison, Christopher; Britt, Helena; Garland, Suzanne; Conway, Lynne; Stein, Alicia; Pirotta, Marie; Fairley, Christopher

2014-01-01

Objectives Since the introduction of Australia's human papillomavirus vaccination program, the management rate of genital warts in sexual health clinics and private hospitals has decreased in women of vaccine-eligible age. However, most genital warts in Australia are managed in general practice. This study examines whether a similar decrease occurred in Australian general practice after the introduction of the program. Methods Analysis of a nationally representative cross-sectional database of Australian general practice activity (1,175,879 patient encounters with 11,780 general practitioners). Genital warts management rates were estimated for the periods before and after introduction of the program (Pre-program, July 2002-June 2006; Post-program, July 2008-June 2012). Control conditions included genital herpes and gardnerella/bacterial vaginosis in female patients and genital herpes and urethritis in male patients. Trends in management rates by year, pre-vaccine (July 2000-June 2007) and post-vaccine (July 2007-June 2012) were also calculated. Results Management rate of genital warts among women potentially covered by program (aged 15–27 years) decreased by 61% from 4.33 per 1,000 encounters in the Pre-program period to 1.67 in the Post-program period. Trend analysis of the post-vaccine period showed, among women of vaccine eligible age, a significant year-on-year reduction in the rate of genital warts management (p<0.0001) and a significant increase in the management rate of control conditions per year (p<0.0001). For all other age-sex groups there was no significant change in the management rate of genital warts between the Pre- and Post-program periods. Conclusion The large decrease in general practice management of genital warts in women of vaccine-eligible age highlights the success of the program in the wider community. PMID:25180698

Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study.

PubMed

Harrison, Christopher; Britt, Helena; Garland, Suzanne; Conway, Lynne; Stein, Alicia; Pirotta, Marie; Fairley, Christopher

2014-01-01

Since the introduction of Australia's human papillomavirus vaccination program, the management rate of genital warts in sexual health clinics and private hospitals has decreased in women of vaccine-eligible age. However, most genital warts in Australia are managed in general practice. This study examines whether a similar decrease occurred in Australian general practice after the introduction of the program. Analysis of a nationally representative cross-sectional database of Australian general practice activity (1,175,879 patient encounters with 11,780 general practitioners). Genital warts management rates were estimated for the periods before and after introduction of the program (Pre-program, July 2002-June 2006; Post-program, July 2008-June 2012). Control conditions included genital herpes and gardnerella/bacterial vaginosis in female patients and genital herpes and urethritis in male patients. Trends in management rates by year, pre-vaccine (July 2000-June 2007) and post-vaccine (July 2007-June 2012) were also calculated. Management rate of genital warts among women potentially covered by program (aged 15-27 years) decreased by 61% from 4.33 per 1,000 encounters in the Pre-program period to 1.67 in the Post-program period. Trend analysis of the post-vaccine period showed, among women of vaccine eligible age, a significant year-on-year reduction in the rate of genital warts management (p<0.0001) and a significant increase in the management rate of control conditions per year (p<0.0001). For all other age-sex groups there was no significant change in the management rate of genital warts between the Pre- and Post-program periods. The large decrease in general practice management of genital warts in women of vaccine-eligible age highlights the success of the program in the wider community.

[A critical evaluation of food programs in Argentina].

PubMed

Abeyá Gilardon, Enrique O

2016-01-01

Argentina has an over 60-year history of food programs which have received few to no evaluations, even considering the highly important epidemiological and social changes that have occurred in the target population. In this article, nationwide State-run food programs with the objective of contributing to the food security of the families in greatest need are reviewed, the nutritional situation of the target population is reassessed, and arguments for analyzing current programs using a typology based in the components of food security are proposed. A general review of the conceptions, content and reach of food programs should be carried out, in order for these programs to cease to act as mere social assistance and instead be transformed in bearers of the right to better food and nutrition.

Copycat Suicides Without an Intention to Die After Watching TV Programs: Two Cases at Five Years of Age.

PubMed

Çelik, Mustafa; Kalenderoğlu, Aysun; Almiş, Habib; Turgut, Mehmet

2016-03-01

Suicide is an intentional self-destructive act. As conceptualization of death as an irreversible end occurs at approximately 8-10 years, attempted and completed suicides are rare before 7 years of age. Studies have suggested that media may contribute to increased suicides in adolescents through social learning. Effects of media on suicides were thoroughly evaluated in children and adolescents who committed suicide after identifying with the subject of a TV program, movie, or book. We present 2 cases at 5 years of age who committed suicide by hanging themselves after watching a TV program. These cases differed from copycat suicides reported in the literature that are performed mostly by adolescents because victims are very young children and because they died without an actual intent to die while they were imitating suicides. By presenting these cases, we want to emphasize that destructive effects of media may involve not only adults and adolescents but also very young children who do not have a completely developed concept of death.

Continuity and Change From Full-Inclusion Early Childhood Programs Through the Early Elementary Period

PubMed Central

Guralnick, Michael J.; Neville, Brian; Hammond, Mary A.; Connor, Robert T.

2010-01-01

A large and well-characterized group of children with mild developmental delays initially enrolled in full-inclusion preschool or kindergarten programs was followed for 3 years. Changes in the type of inclusive placements as children transitioned to first and second grades were monitored, and associations between placement type and child and family characteristics were examined. Results revealed a high level of continuity in that most children remained in partial or full inclusion settings over time. However, a substantial reduction in full-inclusion placements occurred between the 2nd and 3rd year when children were completing the transition to first and second grades. Placements in less inclusive settings were associated with children’s levels of cognitive and language development but not their adaptive, social, or behavioral characteristics. A hypothesis was put forward that placement in full-inclusion programs during the early childhood years creates a momentum to continue maximum participation in inclusive settings over time. PMID:20890373

A four year prospective study of injuries in elite Ontario youth provincial and national soccer players during training and matchplay

PubMed Central

Mohib, Milad; Moser, Nicholas; Kim, Richard; Thillai, Maathavan; Gringmuth, Robert

2014-01-01

Introduction: With over 200 million amateur players worldwide, soccer is one of the most popular and internationally recognized sports today. By understanding how and why soccer injuries occur we hope to reduce prevalent injuries amongst elite soccer athletes. Methods: Via a prospective cohort, we examined both male and female soccer players eligible to train with the Ontario Soccer Association provincial program between the ages of 13 to 17 during the period of October 10, 2008 and April 20, 2012. Data collection occurred during all player exposures to potential injury. Exposures occurred at the Soccer Centre, Ontario Training grounds and various other venues on multiple playing surfaces. Results: A total number of 733 injuries were recorded. Muscle strain, pull or tightness was responsible for 45.6% of all injuries and ranked as the most prevalent injury. Discussion: As anticipated, the highest injury reported was muscular strain, which warrants more suitable preventive programs aimed at strengthening and properly warming up the players’ muscles. PMID:25550661

Developmental cascade models of a parenting-focused program for divorced families on mental health problems and substance use in emerging adulthood.

PubMed

Wolchik, Sharlene A; Tein, Jenn-Yun; Sandler, Irwin N; Kim, Han-Joe

2016-08-01

A developmental cascade model from functioning in adolescence to emerging adulthood was tested using data from a 15-year longitudinal follow-up of 240 emerging adults whose families participated in a randomized, experimental trial of a preventive program for divorced families. Families participated in the program or literature control condition when the offspring were ages 9-12. Short-term follow-ups were conducted 3 months and 6 months following completion of the program when the offspring were in late childhood/early adolescence. Long-term follow-ups were conducted 6 years and 15 years after program completion when the offspring were in middle to late adolescence and emerging adulthood, respectively. It was hypothesized that the impact of the program on mental health and substance use outcomes in emerging adulthood would be explained by developmental cascade effects of program effects in adolescence. The results provided support for a cascade effects model. Specifically, academic competence in adolescence had cross-domain effects on internalizing problems and externalizing problems in emerging adulthood. In addition, adaptive coping in adolescence was significantly, negatively related to binge drinking. It was unexpected that internalizing symptoms in adolescence were significantly negatively related to marijuana use and alcohol use. Gender differences occurred in the links between mental health problems and substance use in adolescence and mental health problems and substance use in emerging adulthood.

Developmental Cascade Models of a Parenting-focused Program for Divorced Families on Mental Health Problems and Substance Use in Emerging Adulthood

PubMed Central

Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.; Kim, Han-Joe

2017-01-01

A developmental cascade model from functioning in adolescence to emerging adulthood was tested using data from a 15-year longitudinal follow-up of 240 emerging adults whose families participated in a randomized, experimental trial of a preventive program for divorced families. Families participated in the program or literature control condition when the offspring were ages 9 – 12. Short-term follow-ups were conducted 3 months and 6 months following completion of the program when the offspring were in middle to late adolescence. Long-term follow-ups were conducted 6 years and 15 years after program completion when the offspring were in emerging adulthood. It was hypothesized that the impact of the program on mental health and substance use outcomes in emerging adulthood would be explained by developmental cascade effects of program effects in adolescence. The results provided support for a cascade effects model. Specifically, academic competence in adolescence had spillover effects on internalizing problems and externalizing problems in emerging adulthood. Also, adaptive coping in adolescence was significantly, negatively related to binge drinking. Unexpectedly, internalizing symptoms in adolescence were significantly negatively related to marijuana use and alcohol use. Gender differences occurred in the links between mental health and substance use outcomes in adolescence and mental health and substance use outcomes in emerging adulthood. PMID:27427811

Nationwide cervical cancer screening in Korea: data from the National Health Insurance Service Cancer Screening Program and National Cancer Screening Program, 2009-2014.

PubMed

Shim, Seung Hyuk; Kim, Hyeongsu; Sohn, In Sook; Hwang, Han Sung; Kwon, Han Sung; Lee, Sun Joo; Lee, Ji Young; Kim, Soo Nyung; Lee, Kunsei; Chang, Sounghoon

2017-09-01

The rates of participation in the Korean nationwide cervical cancer screening program and the rates of abnormal test results were determined. The database of the National Health Insurance Service (NHIS) was used during the study period (2009-2014). The participation rate increased from 41.10% in 2009 to 51.52% in 2014 (annual percentage change, 4.126%; 95% confidence interval [CI]=2.253-6.034). During the study period, women ≥70 years of age had the lowest rate of participation (range, 21.7%-31.9%) and those 30-39 years of age the second-lowest (27.7%-44.9%). The participation rates of National Health Insurance beneficiaries (range, 48.6%-52.5%) were higher than those of Medical Aid Program (MAP) recipients (29.6%-33.2%). The rates of abnormal results were 0.65% in 2009 and 0.52% in 2014, with a decreasing tendency in all age groups except the youngest (30-39 years). Every year the abnormal result rates tended to decrease with age, from the age groups of 30-39 years to 60-69 years but increased in women ≥70 years of age. The ratio of patients with atypical squamous cells of undetermined significance compared with those with squamous intraepithelial lesions increased from 2.71 in 2009 to 4.91 in 2014. Differences related to age and occurring over time were found in the rates of participation and abnormal results. Further efforts are needed to encourage participation in cervical cancer screening, especially for MAP recipients, elderly women and women 30-39 years of age. Quality control measures for cervical cancer screening programs should be enforced consistently. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

The effects of school physical education grants on obesity, fitness, and academic achievement.

PubMed

von Hippel, Paul T; Bradbury, W Kyle

2015-09-01

Foundations and governments fund a number of programs that provide grants to improve school physical education or other forms of school-based physical activity. The effects of these grant programs are unknown. We evaluate the effects of Texas Fitness Now, a program in which the state of Texas granted $37 million to improve physical education in high-poverty middle schools over the 4 school years from 2007-08 to 2010-11. The stated goals of Texas Fitness Now were to reduce obesity, increase fitness, and raise academic achievement. We summarize how Texas Fitness Now funds were spent and estimate the impact of Texas Fitness Now using a fixed-effects longitudinal model that exploits changes in schools' eligibility over time. Changes in eligibility occurred when eligibility expanded to new schools after year 2 and when the program was terminated after year 4. Most Texas Fitness Now funds were spent on sports and fitness equipment. Smaller amounts were spent on anti-obesity curricula. Texas Fitness Now improved strength and flexibility, especially among girls, but it did not improve BMI or academic achievement, and it had mixed effects on aerobic capacity. The fitness benefits were not lost in the year after the program ended, perhaps because schools kept the equipment that they had bought during their years of eligibility. The results of Texas Fitness Now were typical for an intervention that relied almost exclusively on physical activity. Programs that improve BMI as well as fitness tend to have a more fully developed nutrition component. Copyright © 2015 Elsevier Inc. All rights reserved.

What Are Those Checkerboard Things?: How QR Codes Can Enrich Student Projects

ERIC Educational Resources Information Center

Tucker, Al

2011-01-01

Students enrolled in commercial arts program design and publish their school's yearbook. For the 2010-2011 school year, the students applied Quick Response (QR) code technology to include links to events that occurred after the yearbook's print deadline, including graduation. The technology has many applications in the school setting, and the…

75 FR 41553 - Report to Congress on Abnormal Occurrences Fiscal Year 2009; Dissemination of Information

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

... Affairs (the licensee), National Health Physics Program (NHPP) reported that a medical event occurred at.... Nuclear Regulatory Commission (NRC) determines to be significant from the standpoint of public health or... that the patient consult with a genetic counselor for any potential health effects to the embryo/fetus...

Developing an Impella Educational Program for the Critical Care Registered Nurse

ERIC Educational Resources Information Center

Jackson, Sara

2018-01-01

Every year, hundreds of thousands of patients have coronary angiograms performed in the United States. The Impella is a percutaneous ventricular support device that provides hemodynamic support for patients if hemodynamic instability occurs during the procedure. The critical care nurse is responsible for the recovery and management of the patient…

Programming "Loose Training" as a Strategy to Facilitate Language Generalization.

ERIC Educational Resources Information Center

Campbell, C. Robert; Stremel-Campbell, Kathleen

1982-01-01

Results showed that "loose training" (conducting concurrent language training during an academic task and allowing the student to initiate a language response based on a wide array of naturaly occurring stimulus events) was effective in establishing a specific set of language responses in two moderately retarded 10 and 12 year olds. (Author/CL)

A Resource Manual For Implementing Bilingual Education Programs.

ERIC Educational Resources Information Center

Good Neighbor Commission of Texas, Austin.

Bilingualism has occurred for many years wherever countries with different languages border each other. Recently, bilingual education has begun to have a position in the formal education process of schools throughout the United States with students whose first language is not English. This bulletin, designed with the hope that it can assist school…

Lasting Lessons: Following up with Recipients of the Forum's Undergraduate Research Award

ERIC Educational Resources Information Center

Forum on Education Abroad, 2012

2012-01-01

The annual Forum on Education Abroad Undergraduate Research Award showcases rigorous and significant undergraduate research that occurs as part of education abroad programs. Every year, the award recipients present their research at a plenary luncheon at the Forum's Annual Conference. The Forum granted the first Undergraduate Research Awards in…

National trends in IPPE programs at US schools of pharmacy from 2008-2013.

PubMed

Devine, Patricia S; Darbishire, Patricia L

2015-04-25

To determine trends and challenges in introductory pharmacy practice experience (IPPE) programs from 2008-2013. In 2013, a web-based survey was sent to IPPE program administrators at 107 fully accredited colleges and schools of pharmacy. The survey addressed administrative personnel, program structure, and quality assurance issues. Sixty-nine IPPE administrators responded to the survey (64.5% response rate). Within the past 5 years, 4 significant trends occurred in the area of administrative personnel, 7 trends in program structure, and 6 in quality assurance. Clarifications of ACPE Standards through new guidelines and policy statements likely influence many of the 17 trends. Understaffed programs, competition for institutional sites, difficulty conducting site visits, preceptor training, program assessment, documentation maintenance, and individual site requirements are all challenges. The results of this study can be used as a stimulus to address ongoing issues and to enhance the quality of IPPE programs.

Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving.

PubMed

Prusa, Andrea-Romana; Kasper, David C; Sawers, Larry; Walter, Evelyn; Hayde, Michael; Stillwaggon, Eileen

2017-07-01

Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are outstanding. Our results are of relevance for health care providers by supplying economic data based on a unique national dataset including long-term follow-up of affected infants.

Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving

PubMed Central

Prusa, Andrea-Romana; Kasper, David C.; Sawers, Larry; Walter, Evelyn; Hayde, Michael

2017-01-01

Background Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. Methodology/Principal findings We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Conclusions/Significance Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are outstanding. Our results are of relevance for health care providers by supplying economic data based on a unique national dataset including long-term follow-up of affected infants. PMID:28692640

Neutrinos: Nature's Identity Thieves?

ScienceCinema

Lincoln, Don

2017-12-09

The oscillation of neutrinos from one variety to another has long been suspected, but was confirmed only about 15 years ago. In order for these oscillations to occur, neutrinos must have a mass, no matter how slight. Since neutrinos have long been thought to be massless, in a very real way, this phenomena is a clear signal of physics beyond the known. In this video, Fermilab's Dr Don Lincoln explains how we know it occurs and hints at the rich experimental program at several international laboratories designed to understand this complex mystery.

Neutrinos: Nature's Identity Thieves?

ScienceCinema

Lincoln, Don

2018-01-16

The oscillation of neutrinos from one variety to another has long been suspected, but was confirmed only about 15 years ago. In order for these oscillations to occur, neutrinos must have a mass, no matter how slight. Since neutrinos have long been thought to be massless, in a very real way, this phenomena is a clear signal of physics beyond the known. In this video, Fermilab's Dr Don Lincoln explains how we know it occurs and hints at the rich experimental program at several international laboratories designed to understand this complex mystery.

Forecasting client transitions in British Columbia's Long-Term Care Program.

PubMed Central

Lane, D; Uyeno, D; Stark, A; Gutman, G; McCashin, B

1987-01-01

This article presents a model for the annual transitions of clients through various home and facility placements in a long-term care program. The model, an application of Markov chain analysis, is developed, tested, and applied to over 9,000 clients (N = 9,483) in British Columbia's Long Term Care Program (LTC) over the period 1978-1983. Results show that the model gives accurate forecasts of the progress of groups of clients from state to state in the long-term care system from time of admission until eventual death. Statistical methods are used to test the modeling hypothesis that clients' year-over-year transitions occur in constant proportions from state to state within the long-term care system. Tests are carried out by examining actual year-over-year transitions of each year's new admission cohort (1978-1983). Various subsets of the available data are analyzed and, after accounting for clear differences among annual cohorts, the most acceptable model of the actual client transition data occurred when clients were separated into male and female groups, i.e., the transition behavior of each group is describable by a different Markov model. To validate the model, we develop model estimates for the numbers of existing clients in each state of the long-term care system for the period (1981-1983) for which actual data are available. When these estimates are compared with the actual data, total weighted absolute deviations do not exceed 10 percent of actuals. Finally, we use the properties of the Markov chain probability transition matrix and simulation methods to develop three-year forecasts with prediction intervals for the distribution of the existing total clients into each state of the system. The tests, forecasts, and Markov model supplemental information are contained in a mechanized procedure suitable for a microcomputer. The procedure provides a powerful, efficient tool for decision makers planning facilities and services in response to the needs of long-term care clients. PMID:3121537

Vector-borne diseases on Fire Island, New York (Fire Island National Seashore Science Synthesis Paper)

USGS Publications Warehouse

Ginsberg, H.S.

2005-01-01

This paper discusses eleven tick-borne and five mosquito-borne pathogens that are known to occur at FIlS, or could potentially occur. The potential for future occurrence, and ecological factors that influence occurrence, are assessed for each disease. Lyme disease is the most common vector-borne disease on Fire Island. The Lyme spirochete, Borrelia burgdorferi, is endemic in local tick and wildlife populations. Public education, personal precautions against tick bite, and prompt treatment of early-stage infections can help manage the risk of Lyme disease on Fire Island. The pathogens that cause Human Monocytic Ehrlichiosis and Tularemia have been isolated from ticks or wildlife on Fire Island, and conditions suggest that other tickborne diseases (including Babesiosis, Rocky Mountain Spotted Fever, and Human Granulocytic Ehrlichiosis) might also occur, but these are far less common than Lyme disease, if present. West Nile Virus (WNV) is the primary mosquito- borne human pathogen that is known to occur on Fire Island. Ecological conditions and recent epizootiological events suggest that WNV occurs in foci that can shift from year to year. Therefore, a surveillance program with appropriate responses to increasing epizootic activity can help manage the risk of WNV transmission on Fire Island.

Multipurpose Wetlands Phase II/III: final design and ongoing research investigations

USGS Publications Warehouse

Babbitt, Bruce; Beard, Daniel P.; Hancock, Lawrence F.

1994-01-01

The Eastern Municipal Water District (EMWD), the Bureau of Reclamation (USBR), and the National Biological Survey (NBS), in consultation with other governmental agencies, the academic community, and environmental groups, are involved in a cooperative wetlands research and demonstration effort. This report reflects progress through the first 3 years of a 5-year program. The goal of the Multipurpose Wetlands Research and Demonstration Project is to evaluate and expand the use of reclaimed water and contaminated ground water through the incorporation of multipurpose constructed wetlands into EMWD's total water resources management program. The focus of the wetlands is the development of design, construction, and operation criteria that will provide a cost-effective and innovative alternative for managing water resources and provide other public benefits in arid areas. The program also recognizes the fact that naturally-occurring wetlands, both coastal and inland, have been disappearing at an alarming rate.

Motor control of handwriting in the developing brain: A review.

PubMed

Palmis, Sarah; Danna, Jeremy; Velay, Jean-Luc; Longcamp, Marieke

This review focuses on the acquisition of writing motor aspects in adults, and in 5-to 12-year-old children without learning disabilities. We first describe the behavioural aspects of adult writing and dominant models based on the notion of motor programs. We show that handwriting acquisition is characterized by the transition from reactive movements programmed stroke-by-stroke in younger children, to an automatic control of the whole trajectory when the motor programs are memorized at about 10 years old. Then, we describe the neural correlates of adult writing, and the changes that could occur with learning during childhood. The acquisition of a new skill is characterized by the involvement of a network more restricted in space and where neural specificity is increased in key regions. The cerebellum and the left dorsal premotor cortex are of fundamental importance in motor learning, and could be at the core of the acquisition of handwriting.

Wisconsin Twin Research: early development, childhood psychopathology, autism, and sensory over-responsivity.

PubMed

Schmidt, Nicole L; Van Hulle, Carol A; Brooker, Rebecca J; Meyer, Lauren R; Lemery-Chalfant, Kathryn; Goldsmith, H Hill

2013-02-01

The Wisconsin Twin Research Program comprises multiple longitudinal studies that utilize a panel recruited from statewide birth records for the years 1989 through 2004. Our research foci are the etiology and developmental course of early emotions, temperament, childhood anxiety and impulsivity, autism, sensory over-responsivity, and related topics. A signature feature of this research program is the breadth and depth of assessment during key periods of development. The assessments include extensive home- and laboratory-based behavioral batteries, recorded sibling and caregiver interactions, structured psychiatric interviews with caregivers and adolescents, observer ratings of child behavior, child self-report, cognitive testing, neuroendocrine measures, medical records, dermatoglyphics, genotyping, and neuroimaging. Across the various studies, testing occasions occurred between 3 months and 18 years of age. Data collection for some aspects of the research program has concluded and, for other aspects, longitudinal follow-ups are in progress.

Wisconsin Twin Research: Early Development, Childhood Psychopathology, Autism, and Sensory Over-responsivity

PubMed Central

Schmidt, Nicole L.; Van Hulle, Carol; Brooker, Rebecca J.; Meyer, Lauren R.; Lemery-Chalfant, Kathryn; Goldsmith, H. H.

2012-01-01

The Wisconsin Twin Research Program comprises multiple longitudinal studies that utilize a panel recruited from statewide birth records for the years 1989 through 2004. Our research foci are the etiology and developmental course of early emotions, temperament, childhood anxiety and impulsivity, autism, sensory over-responsivity, and related topics. A signature feature of this research program is the breadth and depth of assessment during key periods of development. The assessments include extensive home and laboratory-based behavioral batteries, recorded sibling and caregiver interactions, structured psychiatric interviews with caregivers and adolescents, observer ratings of child behavior, child self-report, cognitive testing, neuroendocrine measures, medical records, dermatoglyphics, genotyping, and neuroimaging. Across the various studies, testing occasions occurred between 3 months and 18 years of age. Data collection for some aspects of the research program has concluded and, for other aspects, longitudinal follow-ups are in progress. PMID:23200241

Retention and Risk Factors for Attrition in a Large Public Health ART Program in Myanmar: A Retrospective Cohort Analysis

PubMed Central

Thida, Aye; Tun, Sai Thein Than; Zaw, Sai Ko Ko; Lover, Andrew A.; Cavailler, Philippe; Chunn, Jennifer; Aye, Mar Mar; Par, Par; Naing, Kyaw Win; Zan, Kaung Nyunt; Shwe, Myint; Kyaw, Thar Tun; Waing, Zaw Htoon; Clevenbergh, Philippe

2014-01-01

Background The outcomes from an antiretroviral treatment (ART) program within the public sector in Myanmar have not been reported. This study documents retention and the risk factors for attrition in a large ART public health program in Myanmar. Methods A retrospective analysis of a cohort of adult patients enrolled in the Integrated HIV Care (IHC) Program between June 2005 and October 2011 and followed up until April 2012 is presented. The primary outcome was attrition (death or loss-follow up); a total of 10,223 patients were included in the 5-year cumulative survival analysis. Overall 5,718 patients were analyzed for the risk factors for attrition using both logistic regression and flexible parametric survival models. Result The mean age was 36 years, 61% of patients were male, and the median follow up was 13.7 months. Overall 8,564 (84%) patients were retained in ART program: 750 (7%) were lost to follow-up and 909 (9%) died. During the 3 years follow-up, 1,542 attritions occurred over 17,524 person years at risk, giving an incidence density of 8.8% per year. The retention rates of participants at 12, 24, 36, 48 and 60 months were 86, 82, 80, 77 and 74% respectively. In multivariate analysis, being male, having high WHO staging, a low CD4 count, being anaemic or having low BMI at baseline were independent risk factors for attrition; tuberculosis (TB) treatment at ART initiation, a prior ART course before program enrollment and literacy were predictors for retention in the program. Conclusion High retention rate of IHC program was documented within the public sector in Myanmar. Early diagnosis of HIV, nutritional support, proper investigation and treatment for patients with low CD4 counts and for those presenting with anaemia are crucial issues towards improvement of HIV program outcomes in resource-limited settings. PMID:25268903

Retention and risk factors for attrition in a large public health ART program in Myanmar: a retrospective cohort analysis.

PubMed

Thida, Aye; Tun, Sai Thein Than; Zaw, Sai Ko Ko; Lover, Andrew A; Cavailler, Philippe; Chunn, Jennifer; Aye, Mar Mar; Par, Par; Naing, Kyaw Win; Zan, Kaung Nyunt; Shwe, Myint; Kyaw, Thar Tun; Waing, Zaw Htoon; Clevenbergh, Philippe

2014-01-01

The outcomes from an antiretroviral treatment (ART) program within the public sector in Myanmar have not been reported. This study documents retention and the risk factors for attrition in a large ART public health program in Myanmar. A retrospective analysis of a cohort of adult patients enrolled in the Integrated HIV Care (IHC) Program between June 2005 and October 2011 and followed up until April 2012 is presented. The primary outcome was attrition (death or loss-follow up); a total of 10,223 patients were included in the 5-year cumulative survival analysis. Overall 5,718 patients were analyzed for the risk factors for attrition using both logistic regression and flexible parametric survival models. The mean age was 36 years, 61% of patients were male, and the median follow up was 13.7 months. Overall 8,564 (84%) patients were retained in ART program: 750 (7%) were lost to follow-up and 909 (9%) died. During the 3 years follow-up, 1,542 attritions occurred over 17,524 person years at risk, giving an incidence density of 8.8% per year. The retention rates of participants at 12, 24, 36, 48 and 60 months were 86, 82, 80, 77 and 74% respectively. In multivariate analysis, being male, having high WHO staging, a low CD4 count, being anaemic or having low BMI at baseline were independent risk factors for attrition; tuberculosis (TB) treatment at ART initiation, a prior ART course before program enrollment and literacy were predictors for retention in the program. High retention rate of IHC program was documented within the public sector in Myanmar. Early diagnosis of HIV, nutritional support, proper investigation and treatment for patients with low CD4 counts and for those presenting with anaemia are crucial issues towards improvement of HIV program outcomes in resource-limited settings.

9975 SHIPPING PACKAGE LIFE EXTENSION SURVEILLANCE PROGRAM RESULTS SUMMARY

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

Daugherty, W.; Dunn, K.; Hackney, B.

2011-01-06

Results from the 9975 Surveillance Program at the Savannah River Site (SRS) are summarized for justification to extend the life of the 9975 packages currently stored in the K-Area Materials Storage (KAMS) facility from 10 years to 15 years. This justification is established with the stipulation that surveillance activities will continue throughout this extended time to ensure the continued integrity of the 9975 materials of construction and to further understand the currently identified degradation mechanisms. The current 10 year storage life was developed prior to storage. A subsequent report was later used to extend the qualification of the 9975 shippingmore » packages for 2 years for shipping plus 10 years for storage. However the qualification for the storage period was provided by the monitoring requirements of the Storage and Surveillance Program. This report summarizes efforts to determine a new safe storage limit for the 9975 shipping package based on the surveillance data collected since 2005 when the surveillance program began. KAMS is a zero-release facility that depends upon containment by the 9975 to meet design basis storage requirements. Therefore, to confirm the continued integrity of the 9975 packages while stored in KAMS, a 9975 Storage and Surveillance Program was implemented alongside the DOE required Integrated Surveillance Program (ISP) for 3013 plutonium-bearing containers. The 9975 Storage and Surveillance Program performs field surveillance as well as accelerated aging tests to ensure any degradation due to aging, to the extent that could affect packaging performance, is detected in advance of such degradation occurring in the field. The Program has demonstrated that the 9975 package has a robust design that can perform under a variety of conditions. As such the primary emphasis of the on-going 9975 Surveillance Program is an aging study of the 9975 Viton(reg.sign) GLT containment vessel O-rings and the Celotex(reg.sign) fiberboard thermal insulation at bounding conditions of radiation and elevated temperatures. Other materials of construction, however, are also discussed.« less

Pack-Year Cigarette Smoking History for Determination of Lung Cancer Screening Eligibility. Comparison of the Electronic Medical Record versus a Shared Decision-making Conversation.

PubMed

Modin, Hannah E; Fathi, Joelle T; Gilbert, Christopher R; Wilshire, Candice L; Wilson, Andrew K; Aye, Ralph W; Farivar, Alexander S; Louie, Brian E; Vallières, Eric; Gorden, Jed A

2017-08-01

Implementation of lung cancer screening programs is occurring across the United States. Programs vary in approaches to patient identification and shared decision-making. The eligibility of persons referred to screening programs, the outcomes of eligibility determination during shared decision-making, and the potential for the electronic medical record (EMR) to identify eligible individuals have not been well described. Our objectives were to assess the eligibility of individuals referred for lung cancer screening and compare information extracted from the EMR to information derived from a shared decision-making conversation for the determination of eligibility for lung cancer screening. We performed a retrospective analysis of individuals referred to a centralized lung cancer screening program serving a five-hospital health services system in Seattle, Washington between October 2014 and January 2016. Demographics, referral, and outcomes data were collected. A pack-year smoking history derived from the EMR was compared with the pack-year history obtained during a shared decision-making conversation performed by a licensed nurse professional representing the lung cancer screening program. A total of 423 individuals were referred to the program, of whom 59.6% (252 of 423) were eligible. Of those, 88.9% (224 of 252) elected screening. There was 96.2% (230 of 239) discordance in pack-year smoking history between the EMR and the shared decision-making conversation. The EMR underreported pack-years of smoking for 85.2% (196 of 230) of the participants, with a median difference of 29.2 pack-years. If identification of eligible individuals relied solely on the accuracy of the pack-year smoking history recorded in the EMR, 53.6% (128 of 239) would have failed to meet the 30-pack-year threshold for screening. Many individuals referred for lung cancer screening may be ineligible. Overreliance on the EMR for identification of individuals at risk may lead to missed opportunities for appropriate lung cancer screening.

Emergence and Continuous Evolution of Genotype 1E Rubella Viruses in China

PubMed Central

Zhu, Zhen; Cui, Aili; Wang, Huanhuan; Zhang, Yan; Liu, Chunyu; Wang, Changyin; Zhou, Shujie; Chen, Xia; Zhang, Zhenying; Feng, Daxin; Wang, Yan; Chen, Haiyun; Pan, Zhengfan; Zeng, Xiangjie; Zhou, Jianhui; Wang, Shuang; Chang, Xin; Lei, Yue; Tian, Hong; Liu, Yang; Zhou, Shunde; Zhan, Jun; Chen, Hui; Gu, Suyi; Tian, Xiaoling; Liu, Jianfeng; Chen, Ying; Fu, Hong; Yang, Xiuhui; Zheng, Huanying; Liu, Leng; Zheng, Lei; Gao, Hui; He, Jilan; Sun, Li

2012-01-01

In China, rubella vaccination was introduced into the national immunization program in 2008, and a rubella epidemic occurred in the same year. In order to know whether changes in the genotypic distribution of rubella viruses have occurred in the postvaccination era, we investigate in detail the epidemiological profile of rubella in China and estimate the evolutionary rate, molecular clock phylogeny, and demographic history of the predominant rubella virus genotypes circulating in China using Bayesian Markov chain Monte Carlo phylodynamic analyses. 1E was found to be the predominant rubella virus genotype since its initial isolation in China in 2001, and no genotypic shift has occurred since then. The results suggest that the global 1E genotype may have diverged in 1995 and that it has evolved at a mutation rate of 1.65 × 10−3 per site per year. The Chinese 1E rubella virus isolates were grouped into either cluster 1 or cluster 2, which likely originated in 1997 and 2006, respectively. Cluster 1 viruses were found in all provinces examined in this study and had a mutation rate of 1.90 × 10−3 per site per year. The effective number of infections remained constant until 2007, and along with the introduction of rubella vaccine into the national immunization program, although the circulation of cluster 1 viruses has not been interrupted, some viral lineages have disappeared, and the epidemic started a decline that led to a decrease in the effective population size. Cluster 2 viruses were found only in Hainan Province, likely because of importation. PMID:22162559

Emergence and continuous evolution of genotype 1E rubella viruses in China.

PubMed

Zhu, Zhen; Cui, Aili; Wang, Huanhuan; Zhang, Yan; Liu, Chunyu; Wang, Changyin; Zhou, Shujie; Chen, Xia; Zhang, Zhenying; Feng, Daxin; Wang, Yan; Chen, Haiyun; Pan, Zhengfan; Zeng, Xiangjie; Zhou, Jianhui; Wang, Shuang; Chang, Xin; Lei, Yue; Tian, Hong; Liu, Yang; Zhou, Shunde; Zhan, Jun; Chen, Hui; Gu, Suyi; Tian, Xiaoling; Liu, Jianfeng; Chen, Ying; Fu, Hong; Yang, Xiuhui; Zheng, Huanying; Liu, Leng; Zheng, Lei; Gao, Hui; He, Jilan; Sun, Li; Xu, Wenbo

2012-02-01

In China, rubella vaccination was introduced into the national immunization program in 2008, and a rubella epidemic occurred in the same year. In order to know whether changes in the genotypic distribution of rubella viruses have occurred in the postvaccination era, we investigate in detail the epidemiological profile of rubella in China and estimate the evolutionary rate, molecular clock phylogeny, and demographic history of the predominant rubella virus genotypes circulating in China using Bayesian Markov chain Monte Carlo phylodynamic analyses. 1E was found to be the predominant rubella virus genotype since its initial isolation in China in 2001, and no genotypic shift has occurred since then. The results suggest that the global 1E genotype may have diverged in 1995 and that it has evolved at a mutation rate of 1.65 × 10(-3) per site per year. The Chinese 1E rubella virus isolates were grouped into either cluster 1 or cluster 2, which likely originated in 1997 and 2006, respectively. Cluster 1 viruses were found in all provinces examined in this study and had a mutation rate of 1.90 × 10(-3) per site per year. The effective number of infections remained constant until 2007, and along with the introduction of rubella vaccine into the national immunization program, although the circulation of cluster 1 viruses has not been interrupted, some viral lineages have disappeared, and the epidemic started a decline that led to a decrease in the effective population size. Cluster 2 viruses were found only in Hainan Province, likely because of importation.

Bolivia renewable energy development

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

Smith, P.

1997-12-01

The author summarizes changes which have occurred in Bolivia in the past year which have had an impact on renewable energy source development. Political changes have included the privatization of power generation and power distribution, and resulted in a new role for state level government and participation by the individual. A National Rural Electrification Plan was adopted in 1996, which stresses the use of GIS analysis and emphasizes factors such as off grid, economic index, population density, maintenance risk, and local organizational structure. The USAID program has chosen to stress economic development, environmental programs, and health over village power programs.more » The national renewables program has adopted a new development direction, with state projects, geothermal projects, and private sector involvement stressed.« less

Environmental statement for National Aeronautics and Space Administration, Office of Space Science, launch vehicle and propulsion programs

NASA Technical Reports Server (NTRS)

1972-01-01

NASA OSS Launch Vehicle and Propulsion Programs are responsible for the launch of approximately 20 automated science and applications spacecraft per year. These launches are for NASA programs and those of other U. S. government agencies, private organizations, such as the Comsat Corporation, foreign countries, and international organizations. Launches occur from Cape Kennedy, Florida; Vandenberg Air Force Base, California; Wallops Island, Virginia; and the San Marco Platform in the Indian Ocean off Kenya. Spacecraft launched by this program contribute in a variety of ways to the control of and betterment of the environment. Environmental effects caused by the launch vehicles are limited in extent, duration, and intensity and are considered insignificant.

An economic evaluation: Simulation of the cost-effectiveness and cost-utility of universal prevention strategies against osteoporosis-related fractures.

PubMed

Nshimyumukiza, Léon; Durand, Audrey; Gagnon, Mathieu; Douville, Xavier; Morin, Suzanne; Lindsay, Carmen; Duplantie, Julie; Gagné, Christian; Jean, Sonia; Giguère, Yves; Dodin, Sylvie; Rousseau, François; Reinharz, Daniel

2013-02-01

A patient-level Markov decision model was used to simulate a virtual cohort of 500,000 women 40 years old and over, in relation to osteoporosis-related hip, clinical vertebral, and wrist bone fractures events. Sixteen different screening options of three main scenario groups were compared: (1) the status quo (no specific national prevention program); (2) a universal primary prevention program; and (3) a universal screening and treatment program based on the 10-year absolute risk of fracture. The outcomes measured were total directs costs from the perspective of the public health care system, number of fractures, and quality-adjusted life-years (QALYs). Results show that an option consisting of a program promoting physical activity and treatment if a fracture occurs is the most cost-effective (CE) (cost/fracture averted) alternative and also the only cost saving one, especially for women 40 to 64 years old. In women who are 65 years and over, bone mineral density (BMD)-based screening and treatment based on the 10-year absolute fracture risk calculated using a Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool is the best next alternative. In terms of cost-utility (CU), results were similar. For women less than 65 years old, a program promoting physical activity emerged as cost-saving but BMD-based screening with pharmacological treatment also emerged as an interesting alternative. In conclusion, a program promoting physical activity is the most CE and CU option for women 40 to 64 years old. BMD screening and pharmacological treatment might be considered a reasonable alternative for women 65 years old and over because at a healthcare capacity of $50,000 Canadian dollars ($CAD) for each additional fracture averted or for one QALY gained its probabilities of cost-effectiveness compared to the program promoting physical activity are 63% and 75%, respectively, which could be considered socially acceptable. Consideration of the indirect costs could change these findings. Copyright © 2013 American Society for Bone and Mineral Research.

EPSAT - A workbench for designing high-power systems for the space environment

NASA Technical Reports Server (NTRS)

Kuharski, R. A.; Jongeward, G. A.; Wilcox, K. G.; Kennedy, E. M.; Stevens, N. J.; Putnam, R. M.; Roche, J. C.

1990-01-01

The Environment Power System Analysis Tool (EPSAT) is being developed to provide space power system design engineers with an analysis tool for determining the performance of power systems in both naturally occurring and self-induced environments. This paper presents the results of the project after two years of a three-year development program. The relevance of the project result for SDI are pointed out, and models of the interaction of the environment and power systems are discussed.

Horizon sensor errors calculated by computer models compared with errors measured in orbit

NASA Technical Reports Server (NTRS)

Ward, K. A.; Hogan, R.; Andary, J.

1982-01-01

Using a computer program to model the earth's horizon and to duplicate the signal processing procedure employed by the ESA (Earth Sensor Assembly), errors due to radiance variation have been computed for a particular time of the year. Errors actually occurring in flight at the same time of year are inferred from integrated rate gyro data for a satellite of the TIROS series of NASA weather satellites (NOAA-A). The predicted performance is compared with actual flight history.

Modification of school attendance for an elementary population

PubMed Central

Barber, Robert M.; Kagey, J. Robert

1977-01-01

The staff and students of a school composed of Grades 1 through 3 participated in a program to increase school attendance. Children earned the opportunity to attend part or all of a monthly party by their attendance. Immediate feedback occurred each morning by placing stars on a classroom chart for each child present. The school's attendance during the program was compared both with attendance during preceding years and with attendance at other schools. The experimental school's attendance improved dramatically to become the best of all elementary schools in the system. PMID:16795547

What Are Those Checkerboard Things? How Quick Response Codes Can Enrich Student Projects

ERIC Educational Resources Information Center

Tucker, Al

2011-01-01

Students enrolled in the author's commercial arts program design and publish the school's yearbook. For the 2010-2011 school year, the students applied Quick Response (QR) code technology to include links to events that occurred after the yearbook's print deadline, including graduation. The technology has many applications in the school setting,…

Early generation selection at multiple locations may identify potato parents that produce more widely adapted progency

USDA-ARS?s Scientific Manuscript database

Potato production in the eastern U.S. occurs over a wide range of environments from Maine to Florida; many of these states do not have a breeding program. Initial selections are usually made at the breeding location for more than two years before undergoing evaluation elsewhere, at which point, few...

78 FR 40152 - World Trade Center Health Program Scientific/Technical Advisory Committee; Nominations of Candidates

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... industrial hygienist; 1 toxicologist; 1 epidemiologist; and 1 mental health professional. At this time the... occur up to four times a year. Members are paid the Special Government Employee rate of $250 per day, and travel costs and per diem are included and based on the Federal Travel Regulations. Any interested...

32 CFR Appendix B to Part 50 - Overseas Life Insurance Registration Program

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Insurers must be listed in Best's Life-Health Insurance Reports and be assigned a rating of B+ (Very Good... that occur during the fiscal year of registration must be reported to the MWR Policy Directorate at the.... Failure to report such material changes may result in termination of registration regardless of how it...

32 CFR Appendix B to Part 50 - Overseas Life Insurance Registration Program

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Insurers must be listed in Best's Life-Health Insurance Reports and be assigned a rating of B+ (Very Good... that occur during the fiscal year of registration must be reported to the MWR Policy Directorate at the.... Failure to report such material changes may result in termination of registration regardless of how it...

32 CFR Appendix B to Part 50 - Overseas Life Insurance Registration Program

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Insurers must be listed in Best's Life-Health Insurance Reports and be assigned a rating of B+ (Very Good... that occur during the fiscal year of registration must be reported to the MWR Policy Directorate at the.... Failure to report such material changes may result in termination of registration regardless of how it...

PROCEEDINGS OF THE ANNUAL FOREIGN LANGUAGE CONFERENCE (31ST, NEW YORK UNIVERSITY, NOVEMBER 13, 1965).

ERIC Educational Resources Information Center

GUERRA, EMILIO L.; AND OTHERS

THE SIX PAPERS COLLECTED IN THIS VOLUME DISCUSS CHANGES WHICH HAVE OCCURRED IN FOREIGN LANGUAGE INSTRUCTION IN RECENT YEARS. THE PRINCIPAL PRESENTATION MADE AT THE CONFERENCE, "SOME THOUGHTS ON PAST, PRESENT, AND FUTURE," BY W. FREEMAN TWADDELL, DEALS PRIMARILY WITH THE PROBLEMS FACING THE PROGRAMER WHO WORKS WITH PRONUNCIATION PRACTICE…

Exploring First-Term Online College Dropout Relative to High School Certification, Gap Years, and Computer Literacy

ERIC Educational Resources Information Center

Suydan, Ava Birgitte

2014-01-01

Despite university efforts to decrease the number of students dropping out of college, attrition of online students occurs at an annual rate of 50% or more (Wang & Wu, 2004). Educational leaders understand the increased demand for online programs and courses because of students' requirements of convenience and flexibility (Kuo, Walker,…

Biking Is Booming

ERIC Educational Resources Information Center

Truesdell, William H.; Wicks, Carol A.

1978-01-01

One hundred thousand bicycle-motor vehicle accidents will occur this year. Close to 1,100 of the mishaps will result in death. Education is the first, last and best hope for cyclists and motorists alike and one facet of bike safety programs is teaching students to understand a machine they may take for granted. Here are some ideas for starters.…

Obesity Prevention in Young Schoolchildren: Results of a Pilot Study

ERIC Educational Resources Information Center

Manger, William M.; Manger, Lynn S.; Minno, Alexander M.; Killmeyer, Mike; Holzman, Robert S.; Schullinger, John N.; Roccella, Edward J.

2012-01-01

Background: Overweight and obesity occur in 17% of children in the United States. Complications of excess weight in Americans cause 216,000 to 300,000 deaths yearly and cost $147 billion. Methods: A convenience sample of 14 intervention and 15 control schools in the Catholic Diocese of Pittsburgh was used. A program to improve lifestyle (Values…

Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report.

PubMed

McBride, Michael G; Binder, Tracy Jo; Paridon, Stephen M

2007-01-01

To determine the safety and feasibility of an inpatient exercise training program for a group of pediatric heart transplantation candidates on multiple inotropic support. Children with end-stage heart disease often require heart transplantation. Currently, no data exist on the safety and feasibility of an inpatient exercise training program in pediatric patients awaiting heart transplantation while on inotropic support. Twenty ambulatory patients (11 male; age, 13.6 +/- 3.2 years) were admitted, listed, and subsequently enrolled into an exercise training program while awaiting heart transplantation. Patient diagnoses consisted of dilated cardiomyopathy (n = 15), restrictive cardiomyopathy (n = 1), and failing single-ventricle physiology (n = 4). Inotropic support consisted of a combination of dobutamine, dopamine, or milrinone. Exercise sessions were scheduled three times a week lasting from 30 to 60 minutes and consisted of aerobic and musculoskeletal conditioning. Over 6.2 +/- 4.2 months, 1,251 of a possible 1,508 exercise training sessions were conducted, with a total of 615 hours (26.3 +/- 2.7 min/session) dedicated to low-intensity aerobic exercise. Reasons for noncompliance included a change in medical status, staffing, or patient cooperation. Two adverse episodes (seizures) occurred, neither of which resulted in termination from the program. No adverse episodes of hypotension or significant complex arrhythmias occurred. No complication of medication administration or loss of intravenous access occurred. Data from this study indicate that pediatric patients on inotropic support as a result of systemic ventricular or biventricular heart failure can safely participate in exercise training programs with relatively moderate to high compliance.

Dynamic aspects of prescription drug use in an elderly population.

PubMed Central

Stuart, B; Coulson, N E

1993-01-01

OBJECTIVE. This study explores longitudinal patterns in outpatient prescription drug use in an elderly population. DATA SOURCES/STUDY SETTING. Enrollment records and prescription drug claims were obtained for a sample of elderly Pennsylvanians (N = 27,301) who had enrolled in the Pharmaceutical Assistance Contract for the Elderly (PACE) program at any time between July 1984 and June 1987. Study Design. The study tracks monthly prescription fill rates for sampled PACE beneficiaries from their initial enrollment month through disenrollment, death, or the end of the study (whichever occurred first). We specify two-part multivariate models to assess the effect of calendar time, length of time in the PACE program, and progression to disenrollment or death both on the probability of any prescription use and on the level of use among those who filled at least one prescription claim per month. Control variables include age, gender, race, income, residence, and marital status. DATA COLLECTION/EXTRACTION METHODS. Data were extracted from administrative files maintained by the PACE program, checked for errors, and then formatted as person-month records. PRINCIPAL FINDINGS/CONCLUSIONS. We find a strong positive relationship between drug use and the length of time persons are PACE-enrolled. Persons whose death occurs within a year have much higher prescription utilization rates than do persons whose death is at least a year away, and the differential increases as death nears. Persons who fail to renew PACE coverage use significantly fewer prescription drugs in the year prior to disenrollment. Holding age and other factors constant, we find that average levels of prescription use actually declined over the study period. PMID:8514502

Cost effectiveness analysis of a smoke alarm giveaway program in Oklahoma City, Oklahoma.

PubMed

Haddix, A C; Mallonee, S; Waxweiler, R; Douglas, M R

2001-12-01

To estimate the cost effectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program. In 1990, the LRFIPP distributed over 10,000 smoke alarms in an area of Oklahoma City at high risk for residential fire injuries. The program also included fire prevention education and battery replacement components. A cost effectiveness analysis was conducted from the societal and health care systems perspectives. The study compared program costs with the total costs of medical treatment and productivity losses averted over a five year period. Fatal and non-fatal residential fire related injuries prevented were estimated from surveillance data. Medical costs were obtained from chart reviews of patients with fire related injuries that occurred during the pre-intervention period. During the five years post-intervention, it is estimated that the LRFIPP prevented 20 fatal and 24 non-fatal injuries. From the societal perspective, the total discounted cost of the program was $531,000. Total discounted net savings exceeded $15 million. From the health care system perspective, the total discounted net savings were almost $1 million and would have a net saving even if program effectiveness was reduced by 64%. The program was effective in reducing fatal and non-fatal residential fire related injuries and was cost saving. Similar programs in other high risk areas would be good investments even if program effectiveness was lower than that achieved by the LRFIPP.

Strategies to overcome seasonal anestrus in water buffalo.

PubMed

de Carvalho, Nelcio Antonio Tonizza; Soares, Julia Gleyci; Baruselli, Pietro Sampaio

2016-07-01

Reproductive seasonality in buffalo (Bubalus bubalis) is characterized by behavioral, endocrine, and reproductive changes that occur over distinct periods of the year. During the nonbreeding season (spring and summer), the greater light-dark ratio (long days) suppresses estrus behavior and the occurrence of ovulation. Anestrous buffaloes have insufficient pulsatile of LH to support the final stages of follicular development, and subsequently, estrus behavior and ovulation do not occur, limiting reproductive efficiency, especially in artificial insemination (AI) programs. A number of therapeutic strategies designed to synchronize follicular wave emergence and ovulation have allowed for the use of AI throughout the year, overcoming seasonal anestrus in buffalo. These therapies also improve reproductive performance by increasing the service rate and pregnancy per AI in buffalo herds, regardless of reproductive seasonality. Copyright © 2016 Elsevier Inc. All rights reserved.

Academic Outcomes in High-School Students after a Concussion: A Retrospective Population-Based Analysis

PubMed Central

Russell, Kelly; Hutchison, Michael G.; Selci, Erin; Leiter, Jeff; Chateau, Daniel; Ellis, Michael J.

2016-01-01

Background Many concussion symptoms, such as headaches, vision problems, or difficulty remembering or concentrating may deleteriously affect school functioning. Our objective was to determine if academic performance was lower in the academic calendar year that students sustain a concussion compared to the previous year when they did not sustain a concussion. Methods Using Manitoba Health and Manitoba Education data, we conducted a population-based, controlled before-after study from 2005–2006 to 2010–2011 academic years. Grade 9–12 students with an ICD9/10 code for concussion were matched to non-concussed controls. Overall changes in grade point average (GPA) were compared for the academic year prior to the concussion to the academic year the concussion occurred (or could have occurred among non-concussed matched students). Results Overall, 8240 students (1709 concussed, 6531 non-concussed students) were included. Both concussed and non-concussed students exhibited a lower overall GPA from one year to the next. Having sustained a concussion resulted in a -0.90% (95% CI: -1.88, 0.08) reduction in GPA. Over the same period, non-concussed matched students’ GPA reduced by -0.57% (95% CI: -1.32, 0.19). Students who sustained a concussion during high school were just as likely to graduate within four years as their non-concussed peers (ORadj: 0.84; 95% CI: 0.73, 1.02). Conclusions We found that, at a population level, a concussion had minimal long-term effects on academic performance during high school. While academic accommodations and Return-to-Learn programs are an important component of pediatric concussion management, research is needed to identify risk factors for poor academic performance after a concussion and who should receive these programs. PMID:27764223

Orthotopic heart transplantation in the prince sultan cardiac center.

PubMed

Al Fagih, M R

1996-01-01

In this report we attempt to demonstrate the efforts involved in establishing and organizing the heart transplant program at the Armed Forces Hospital in Riyadh, Saudi Arabia. From 1986 to date, 25 orthotopic heart transplants were performed at this center. Patient age ranged from 22 months to 57 years; 4 patients were below 12 years of age and 4 aged 50 years and above. The incidations for transplantation were cardiomyopathy in 15 patients, ischemic heart disease in 6 patients, and valvular heart disease in 4 patients. Fourteen recipients have died. Three of them were classified as hospital deaths, occuring before the patient could be discharged after the procedure; the reminder died from rejection and associated problems. Eight patients of them died within the first year. The longest survival period was almost 8 years. The overall 8 years survival rate was 45%, which is comparable to the international figures. Shortage of donors may affect the future of the transplant programs. Increasing the awareness of the public about the importance of organ donation and transplantation is crucial in this regard.

Youth programmes in Mexico.

PubMed

Rodriguez De Macias, G

1990-12-01

Research indicates that in-school adolescents in Mexico have their first sexual contact at the average age of 15.5 years. In 50% of cases, such contact is with a boyfriend or girlfriend, 28.1% with a fiance, and 18.3% with a prostitute. First sexual intercourse occurs with a spouse in only 1.3% of cases. Since only one in six young people in Mexico use a form of contraception, many unwanted pregnancies outside of marriage result. 450,000 births in 1989 were to mothers below 20 years old, with 15% of births annually being among teenage mothers. An estimated three million abortions occur annually in Mexico, and abortions are the fifth major cause of death at the national level. Teen pregnancy is decisively linked with poor living conditions and life expectancy, a relatively lower level of education, and rural residence. As for psychological and anthropological variables, most teens who become pregnant belong to large, unstable families with poor family communication, and are characterized as submissive, highly dependent, and of low self-esteem. Targeting students, workers, and other youths, the MEXFAM Youth Program selects and trains program coordinators over age 21 and volunteer promoters of both sexes aged 16-20 in urban/marginal communities. Promoters offer information to their peers and other youths in their local communities, distribute barrier contraceptives, and channel medical, psychological, and legal services to young people in need. Program procedure is described.

Association of Time to Attrition in Surgical Residency With Individual Resident and Programmatic Factors.

PubMed

Yeo, Heather L; Abelson, Jonathan S; Symer, Matthew M; Mao, Jialin; Michelassi, Fabrizio; Bell, Richard; Sedrakyan, Art; Sosa, Julie A

2018-02-21

Attrition in general surgery residency remains high, and attrition that occurs in the later years is the most worrisome. Although several studies have retrospectively investigated the timing of attrition, no study to date has prospectively evaluated a national cohort of residents to understand which residents are at risk for attrition and at what point during residency. To prospectively evaluate individual resident and programmatic factors associated with the timing of attrition during general surgery residency. This longitudinal, national cohort study administered a survey to all categorical general surgery interns from the class of 2007-2008 during their first 30 days of residency and linked the data with 9-year follow-up data assessing program completion. Data were collected from June 1, 2007, through June 30, 2016. Kaplan-Meier curves evaluating time to attrition during the 9 years after the start of residency. Among our sample of 836 residents (306 women [36.6%] and 528 men [63.2%]; gender unknown in 2), cumulative survival analysis demonstrated overall attrition for the cohort of 20.8% (n = 164). Attrition was highest in the first postgraduate year (67.6% [n = 111]; absolute rate, 13.3%) but continued during the next 6 years, albeit at a lower rate. Beginning in the first year, survival analysis demonstrated higher attrition among Hispanic compared with non-Hispanic residents (21.1% vs 12.4%; P = .04) and at military programs compared with academic or community programs after year 1 (32.3% vs 11.0% or 13.5%; P = .01). Beginning in year 4 of residency, higher attrition was encountered among women compared with men (23.3% vs 17.4%; P = .05); at year 5, at large compared with small programs (26.0% vs 18.4%; P = .04). Race and program location were not associated with attrition. Although attrition was highest during the internship year, late attrition persists, particularly among women and among residents in large programs. These results provide a framework for timing of interventions in graduate surgical training that target residents most at risk for late attrition.

A cost/benefit analysis of commercial fusion-fission hybrid reactor development

NASA Astrophysics Data System (ADS)

Kostoff, Ronald N.

1983-04-01

A simple algorithm was developed that allows rapid computation of the ratio, R, of present worth of benefits to present worth of hybrid R&D program costs as a function of potential hybrid unit electricity cost savings, discount rate, electricity demand growth rate, total hybrid R&D program cost, and time to complete a demonstration reactor. In the sensitivity study, these variables were assigned nominal values (unit electricity cost savings of 4 mills/kW-hr, discount rate of 4%/year, growth rate of 2.25%/year, total R&D program cost of 20 billion, and time to complete a demonstration reactor of 30 years), and the variable of interest was varied about its nominal value. Results show that R increases with decreasing discount rate and increasing unit electricity savings and ranges from 4 to 94 as discount rate ranges from 5 to 3%/year and unit electricity savings range from 2 to 6 mills/kW-hr. R increases with increasing growth rate and ranges from 3 to 187 as growth rate ranges from 1 to 3.5%/year and unit electricity cost savings range from 2 to 6 mills/kW-hr. R attains a maximum value when plotted against time to complete a demonstration reactor. The location of this maximum value occurs at shorter completion times as discount rate increases, and this optimal completion time ranges from 20 years for a discount rate of 4%/year to 45 years for a discount rate of 3%/year.

Poor Performance Among Trainees in a Dutch Postgraduate GP Training Program.

PubMed

Vermeulen, Margit I; Kuyvenhoven, Marijke M; de Groot, Esther; Zuithoff, Nicolaas Pa; Pieters, Honore M; van der Graaf, Yolanda; Damoiseaux, Roger Amj

2016-06-01

Poor performance among trainees is an important issue, for patient safety and economic reasons. While early identification might enhance remediation measures, we explored the frequency, nature, and risk factors of poor performance in a Dutch postgraduate general practitioner (GP) training program. All trainees who started the GP training between 2005 and 2007 were included. Multivariate logistic regression analysis was applied to examine associations between individual characteristics; early assessments of competencies and knowledge, training process characteristics (eg, illness, maternal leave), and the outcome poor performance; sub-analyses were performed for each year. A total of 215 trainees started the 3-year GP program, and 49 (22.8%) exhibited poor performance (in one or more years). In the first and second years, problem areas among poor performers were equally distributed across the roles of "medical expert," "communicator," and "professional." In the third year, shortcomings in "professionalism" were the most common problem. Increasing age was a risk factor for poor performance as were insufficient scores in communication and knowledge. Poor performance in the previous year was a risk factor for poor performance in the second and third years; OR=4.20 (CI=1.31--13.47) and OR=5.40 (CI=1.58--18.47), respectively. Poor performance is prevalent but primarily occurring within a single training year. This finding suggests that trainees are capable of solving trainee problems. Increasing age, insufficient assessment scores early in the training, and poor performance in a previous year constitute risk factors for poor performance.

Family medicine's search for manpower: the American Osteopathic Association accreditation option.

PubMed

Cummings, Mark; Kunkle, Judith L; Doane, Cheryl

2006-03-01

In recent years, family medicine has encountered problems recruiting and filling its Accreditation Council for Graduate Medical Education (ACGME)-accredited residencies. In addressing these reverses, one increasingly popular strategy has been to acquire American Osteopathic Association (AOA) accreditation as a way to tap into the growing number of osteopathic graduates. This stratagem is founded on assumptions that parallel-accredited postdoctoral programs are attractive to doctor of osteopathy (DO) graduates, that collaboration with sponsoring colleges of osteopathic medicine (COMs) provides direct access to osteopathic students, and that DOs can play an important role in replacing the increasing scarcity of United States medical graduates who are selecting specialty residencies. Within the past 5 years, nearly 10% of all ACGME family medicine residency programs have voluntarily obtained a second level of accreditation to also qualify as AOA-accredited family medicine residency programs. This strategy has produced mixed outcomes, as noted from the results of the osteopathic matching program. The flood of osteopathic graduates into these parallel-accredited programs has not occurred. In addition, recent AOA policy changes now require ACGME-accredited programs to make a deeper educational commitment to osteopathic postdoctoral education. The most successful ACGME/AOA-accredited programs have been those that are closely affiliated with and in near proximity of a COM and also train osteopathic students in required clerkship rotations.

Atezolizumab (MPDL3280A) Monotherapy for Patients With Metastatic Urothelial Cancer: Long-term Outcomes From a Phase 1 Study.

PubMed

Petrylak, Daniel P; Powles, Thomas; Bellmunt, Joaquim; Braiteh, Fadi; Loriot, Yohann; Morales-Barrera, Rafael; Burris, Howard A; Kim, Joseph W; Ding, Beiying; Kaiser, Constanze; Fassò, Marcella; O'Hear, Carol; Vogelzang, Nicholas J

2018-04-01

Atezolizumab (anti-programmed death ligand 1) has demonstrated safety and activity in advanced and metastatic urothelial carcinoma, but its long-term clinical profile remains unknown. To report long-term clinical outcomes with atezolizumab therapy for patients with metastatic urothelial carcinoma. Patients were enrolled in an expansion cohort of an ongoing, open-label, phase 1 study. Median follow-up was 37.8 months (range, >0.7 to 44.4 months). Enrollment occurred between March 2013 and August 2015 at US and European academic medical centers. Eligible patients had measurable disease per Response Evaluation Criteria in Solid Tumors version 1.1, Eastern Cooperative Oncology Group performance status 0 to 1, and a representative tumor sample. Programmed death ligand 1 expression on immune cells was assessed (VENTANA SP142 assay). Atezolizumab was given intravenously every 3 weeks until unacceptable toxic effects, protocol nonadherence, or loss of clinical benefit. Primary outcome was safety. Secondary outcomes included objective response rate, duration of response, and progression-free survival. Response and overall survival were assessed in key baseline subgroups. Ninety-five patients were evaluable (72 [76%] male; median age, 66 years [range, 36-89 years]). Forty-five (47%) received atezolizumab as third-line therapy or greater. Nine patients (9%) had a grade 3 to 4 treatment-related adverse event, mostly within the first treatment year; no serious related adverse events were observed thereafter. One patient (1%) discontinued treatment due to a related event. No treatment-related deaths occurred. Responses occurred in 26% (95% CI, 18%-36%) of patients. Median duration of response was 22.1 months (range, 2.8 to >41.0 months), and median progression-free survival was 2.7 months (95% CI, 1.4-4.3 months). Median overall survival was 10.1 months (95% CI, 7.3-17.0 months); 3-year OS rate was 27% (95% CI, 17%-36%). Response occurred in 40% (95% CI, 26%-55%; n = 40) and 11% (95% CI, 4%-25%; n = 44) of patients with programmed death ligand 1 expression of at least 5% tumor-infiltrating immune cells (IC2/3) or less than 5% (IC0/1), respectively. Median overall survival in patients with IC2/3 and IC0/1 was 14.6 months (95% CI, 9.0 months to not estimable) and 7.6 months (95% CI, 4.7 to 13.9 months), respectively. Atezolizumab remained well tolerated and provided durable clinical benefit to a heavily pretreated metastatic urothelial carcinoma population in this long-term study. clinicaltrials.gov Identifier: NCT01375842.

Epidemiology of electrical and lightning-related injuries among Canadian children and youth, 1997-2010: A Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) study.

PubMed

Böhrer, Madeleine; Stewart, Samuel A; Hurley, Katrina F

2017-06-27

Introduction Although death due to electrical injury and lightning are rare in children, these injuries are often preventable. Twenty years ago, most injuries occurred at home, precipitated by oral contact with electrical cords, contact with wall sockets and faulty electrical equipment. We sought to assess the epidemiology of electrical injuries in children presenting to Emergency Departments (EDs) that participate in the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). This study is a retrospective review of electrical and lightning injury data from CHIRPP. The study population included children and youth aged 0-19 presenting to participating CHIRPP EDs from 1997-2010. Age, sex, year, setting, circumstance and disposition were extracted. Variables were tested using Fisher's exact test and simple linear regression. The dataset included 1183 electrical injuries, with 84 (7%) resulting in hospitalization. Most events occurred at home in the 2-5 year age group and affected the hands. Since 1997 there has been a gradual decrease in the number of electrical injuries per year (p<0.01) and there is an annual surge in electrical injuries over the summer (p<0.01). Forty-six percent of injuries involved electrical outlets, 65% of injuries involved some sort of electrical equipment. Injuries due to lightning were rare (n=19). No deaths were recorded in the database. Despite the decrease in the number of electrical injuries per year, a large portion of injuries still appear to be preventable. Further research should focus on effective injury prevention strategies.

"Canary Islands, a volcanic window in the Atlantic Ocean": a 7 year effort of public awareness on volcano hazards and risk management

NASA Astrophysics Data System (ADS)

Rodríguez, Fátima; Calvo, David; Pérez, Nemesio M.; Padrón, Eleazar; Melián, Gladys; Padilla, Germán; Barrancos, José; Hernández, Pedro A.; Asensio-Ramos, María; Alonso, Mar

2016-04-01

"Canary Islands: A volcanic window in the Atlantic Ocean" is an educational program born from the need to inform and educate citizens residing in the Canary Islands on the various hazards associated to volcanic phenomena. The Canary Islands is the only territory of Spain that hosts active volcanism, as is shown by the 16 historical eruptions that have occurred throughout this territory, being the last one a submarine eruption taking place on October 12, 2011, offshore El Hierro Island. In the last 7 years, ITER as well as INVOLCAN have been performing an educative program focused on educating to the population about the benefits of a volcanic territory, volcanic hazards, how to reduce volcanic risk and the management of volcanic risk in the Canary Islands. "Canary Islands: A volcanic window in the Atlantic Ocean" consists of three units, the first two dedicated to the IAVCEI/UNESCO videos "Understanding Volcanic Hazards" and "Reducing Volcanic Risk" and the third one dedicated to the management of volcanic risk in the Canary Islands, as well as some other aspects of the volcanic phenomena. Generally the three units are shown consecutively on Tuesday, Wednesday and Thursday. This educative program has been roaming all around the 88 municipalities of the archipelago since this initiative started in 2008. The total number of attendees since then amounts to 18,911 people. The increase of assistance was constant until 2011, with annual percentages of 7.8, 17.1 and 20.9 respectively, regarding to ratio assistant/municipality. Despite the heterogeneity of the audience, the main audience is related to aged people of 45 years and older. This could be related to the memories of the recent eruptions occurred at La Palma Island in 1949 and 1971. It is important to point out that many of those people attending the educative program are representatives of local government (i.e. civil protection). Regarding the interest of the audience, the educational program attendees have shown special interest on the possibility that a lateral collapse may occur in the volcanic edifices of Teide in Tenerife and Cumbre Vieja in La Palma. In addition, a volcanic trivial is provided to the attendees before the educative program starts. They have to answer to several questions directly related to each unit before and after the unit is taught, so it's possible to estimate the impact of the program. It's also important to highlight that after each unit ends, the rates of success in the answers sharply increase. Therefore, the ultimate goal of this educational program is to contribute to a better organized and informed community in relation to volcanic risk in Canary Islands and become much less vulnerable than a community that does not know or ignores volcanic hazards, and it is not organized to respond to them.

Intentional Interprofessional Experiential Education.

PubMed

Grice, Gloria R; Thomason, Angela R; Meny, Lisa M; Pinelli, Nicole R; Martello, Jay L; Zorek, Joseph A

2018-04-01

The experiential component of a doctor of pharmacy curricula is an ideal, yet underutilized vehicle to advance interprofessional education (IPE) initiatives. To date, most experiential-based IPE initiatives occur in a naturally occurring, non-deliberate fashion. The American Association of Colleges of Pharmacy (AACP) Experiential Education Section formed the Task Force on Intentional Interprofessional Education in Experiential Education in academic year 2015-2016 to explore the issue. This commentary describes the work of the task force, including the following elements: defining intentional interprofessional experiential education as "the explicit effort by preceptors and practice sites to create/foster educational opportunities or activities designed specifically to achieve interprofessional educational competencies;" conducting a systematic literature review to identify examples of intentional interprofessional experiential education in the published literature; surveying faculty with oversight of experiential education programs and preceptors within those programs; and generating recommendations to stakeholders including AACP, pharmacy schools, and experiential education administrators.

Screening Program Reduced Melanoma Mortality at the Lawrence Livermore National Laboratory, 1984-1996

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

Schneider, MD, J S; II, PhD, D; MD, PhD, M

Worldwide incidence of cutaneous malignant melanoma has increased substantially, and no screening program has yet demonstrated reduction in mortality. We evaluated the education, self examination and targeted screening campaign at the Lawrence Livermore National Laboratory (LLNL) from its beginning in July 1984 through 1996. The thickness and crude incidence of melanoma from the years before the campaign were compared to those obtained during the 13 years of screening. Melanoma mortality during the 13-year period was based on a National Death Index search. Expected yearly deaths from melanoma among LLNL employees were calculated by using California mortality data matched by age,more » sex, and race/ethnicity and adjusted to exclude deaths from melanoma diagnosed before the program began or before employment at LLNL. After the program began, crude incidence of melanoma thicker than 0.75 mm decreased from 18 to 4 cases per 100,000 person-years (p = 0.02), while melanoma less than 0.75mm remained stable and in situ melanoma increased substantially. No eligible melanoma deaths occurred among LLNL employees during the screening period compared with a calculated 3.39 expected deaths (p = 0.034). Education, self examination and selective screening for melanoma at LLNL significantly decreased incidence of melanoma thicker than 0.75 mm and reduced the melanoma-related mortality rate to zero. This significant decrease in mortality rate persisted for at least 3 yr after employees retired or otherwise left the laboratory.« less

Cost savings threshold analysis of a capacity-building program for HIV prevention organizations.

PubMed

Dauner, Kim Nichols; Oglesby, Willie H; Richter, Donna L; LaRose, Christopher M; Holtgrave, David R

2008-06-01

Although the incidence of HIV each year remains steady, prevention funding is increasingly competitive. Programs need to justify costs in terms of evaluation outcomes, including economic ones. Threshold analyses set performance standards to determine program effectiveness relative to that threshold. This method was used to evaluate the potential cost savings of a national capacity-building program for HIV prevention organizations. Program costs were compared with the lifetime treatment costs of HIV, yielding an estimate of the HIV infections that would have to be prevented for the program to be cost saving. The 136 persons who completed the capacity-building program between 2000 and 2003 would have to avert 41 cases of HIV for the program to be considered cost saving. These figures represent less than one tenth of 1% of the 40,000 new HIV infections that occur in the United States annually and suggest a reasonable performance standard. These data underscore the resources needed to prevent HIV.

The Changing Work Place: Perceptions, Reality. Trend Analysis Program.

ERIC Educational Resources Information Center

American Council of Life Insurance, Washington, DC.

An examination of the changes that are likely to occur in work and productivity in the future reveals that, at least before the year 2000, Americans are not likely to see many new jobs created and will probably not be required to alter their skills greatly for existing jobs. It will be difficult to duplicate the sustained productivity attained…

Perceived Problems of Public School Prekindergarten Teachers in Florida Related to Demographic Variables.

ERIC Educational Resources Information Center

Micklo, Stephen J.

This study was conducted to identify and validate the work-related problems of public school teachers in Florida's Prekindergarten Early Intervention Program which targets economically at-risk 3- and 4-year olds. The study was designed to answer three questions: (1) What problems are perceived to be most bothersome and occur most frequently? (2)…

Final Report on Third and Fourth Year Operations of the Alum Rock Voucher Project.

ERIC Educational Resources Information Center

Sequoia Inst., San Jose, CA.

Covered in this report are the main events that occurred in the Alum Rock voucher project between July 1974 and January 1976. Measures considered to be functioning effectively at the beginning of this time span were the concepts of alternative education, open enrollment, programs that vary their capacity in response to parent demand within the…

High School Matters: Jump off the Pendulum! Staying Balanced within Educational Change

ERIC Educational Resources Information Center

Lucas, Amy Magnafichi

2013-01-01

Amy Magnafichi Lucas is a graduate teaching assistant in the English Studies program at Illinois State university. Prior to her graduate work, she spent ten years in the secondary English classroom. In this article, she points out that most teachers are their own worst enemies. Most of the time this occurs during times of educational change…

Impact of Transfer of Schools and Pupils from BIA to Public Schools. A Position Paper.

ERIC Educational Resources Information Center

Wight, Edgar L.

The transfer of schools operated by the Bureau of Indian Affairs (BIA) to public school systems has been occurring for more than 100 years. When these schools are transferred to the public school systems, a financial impact on school operations, school construction, and the instructional program is felt by the public schools. Because of the…

Digital Competences and Long-Term ICT Integration in School Culture: The Perspective of Elementary School Leaders

ERIC Educational Resources Information Center

Blau, Ina; Shamir-Inbal, Tamar

2017-01-01

This study examines how the leaders of technology integration in educational institutions--school principals and ICT facilitators--assess systemic changes that occurred in their schools. The study collected the data from Israeli elementary schools towards the end of the third and the fourth years of the gradual National ICT program. The research…

Social Justice and Music Education: Claiming the Space of Music Education as a Site of Postcolonial Contestation

ERIC Educational Resources Information Center

Vaugeois, Lise

2007-01-01

In recent years, music educators have become interested in linking music education practices, programs and projects to issues of social justice. However, theoretical approaches to conceptualizing the problem or to developing strategic interventions have yet to occur within the field. In this paper, the author argues that to address social justice…

Estimating Cone and Seed Production and Monitoring Pest Damage in Southern Pine Seed Orchards

Treesearch

Carl W. Fatzinger; H. David Muse; Thomas Miller; Helen T. Bhattacharyya

1988-01-01

Field sampling procedures and computer programs are described for monitoring seed production and pest damage in southern pine seed orchards. The system estimates total orchard yields of female strobili and seeds, quantifies pest damage, determines times of year when losses occur, and produces life tables for female strobili. An example is included to illustrate the...

Computational Proficiency and Algorithmic Learning of Sixth-Graders Using DMP Materials: A Formative Evaluation. Technical Report No. 401.

ERIC Educational Resources Information Center

Wiles, Clyde

Two questions were investigated in this study: (1) How did the computational proficiency of sixth graders who had one year's experience with Developing Mathematical Processes (DMP) materials compare with an equivalent group of students who used the usual textbook program; and (2) What occurs when sixth graders study algorithms as sequences of rule…

Global expansion of high pathogenicity avian influenza: implications on prevention and control programs

USDA-ARS?s Scientific Manuscript database

The H5N1 high pathogenicity avian influenza (HPAI) virus emerged in China during 1996 and has spread to infect poultry and/or wild birds in 63 countries during the past 18 years. The majority of the recent outbreaks of H5N1 HPAI have occurred in Indonesia, Egypt, Vietnam, and Bangladesh, in decreas...

Global expansion of high pathogenicity avian influenza: implications on prevention and control programs

USDA-ARS?s Scientific Manuscript database

The H5N1 high pathogenicity avian influenza (HPAI) virus emerged in China during 1996 and has spread to infect poultry and/or wild birds in 63 countries during the past 18 years. The majority of the recent outbreaks of H5N1 HPAI have occurred in Indonesia, Egypt, Vietnam, and Bangladesh, in decreasi...

Family Intervention Effects on Co-Occurring Early Childhood Behavioral and Emotional Problems: A Latent Transition Analysis Approach

ERIC Educational Resources Information Center

Connell, Arin; Bullock, Bernadette Marie; Dishion, Thomas J.; Shaw, Daniel; Wilson, Melvin; Gardner, Frances

2008-01-01

This study used latent transition analysis (LTA) to examine changes in early emotional and behavioral problems in children age 2 to 4 years resulting from participation in a family-centered intervention. A sample of 731 economically disadvantaged families was recruited from among participants in a national food supplement and nutrition program.…

An Attachment-Based Home Visiting Program for Distressed Mothers of Young Infants

ERIC Educational Resources Information Center

Kaitz, Marsha; Tessler, Naomi; Chriki, Miriam

2012-01-01

Mom2Mom is an attachment-based home visiting project for distressed mothers of young infants, based in Israel. Home visitors, who are volunteer mothers from the community, are trained and supervised by professionals. Home visits occur weekly for 1-2 hours and continue until the infant is 1 year old. The project was founded in Jerusalem in year…

Estimates of the timing of reductions in genital warts and high grade cervical intraepithelial neoplasia after onset of human papillomavirus (HPV) vaccination in the United States.

PubMed

Chesson, Harrell W; Ekwueme, Donatus U; Saraiya, Mona; Dunne, Eileen F; Markowitz, Lauri E

2013-08-20

The objective of this study was to estimate the number of years after onset of a quadrivalent HPV vaccination program before notable reductions in genital warts and cervical intraepithelial neoplasia (CIN) will occur in teenagers and young adults in the United States. We applied a previously published model of HPV vaccination in the United States and focused on the timing of reductions in genital warts among both sexes and reductions in CIN 2/3 among females. Using different coverage scenarios, the lowest being consistent with current 3-dose coverage in the United States, we estimated the number of years before reductions of 10%, 25%, and 50% would be observed after onset of an HPV vaccination program for ages 12-26 years. The model suggested female-only HPV vaccination in the intermediate coverage scenario will result in a 10% reduction in genital warts within 2-4 years for females aged 15-19 years and a 10% reduction in CIN 2/3 among females aged 20-29 years within 7-11 years. Coverage had a major impact on when reductions would be observed. For example, in the higher coverage scenario a 25% reduction in CIN2/3 would be observed with 8 years compared with 15 years in the lower coverage scenario. Our model provides estimates of the potential timing and magnitude of the impact of HPV vaccination on genital warts and CIN 2/3 at the population level in the United States. Notable, population-level impacts of HPV vaccination on genital warts and CIN 2/3 can occur within a few years after onset of vaccination, particularly among younger age groups. Our results are generally consistent with early reports of declines in genital warts among youth. Published by Elsevier Ltd.

Attitudes toward aging: implications for a caring profession.

PubMed

Holroyd, Ann; Dahlke, Sherry; Fehr, Cindy; Jung, Piera; Hunter, Andrea

2009-07-01

With the predicted increase in the age of Canada's overall population, it is estimated that by 2020, up to 75% of nurses' time will be spent with older adults. It is recognized that care of older adults occurs in a cultural context in which the older members of society are poorly valued, often referred to as ageism. Based on the premise that attitudes affect behavior and knowledge acquisition, a comparative cross-sectional study using the Attitudes Toward Old People scale measured nursing students' attitudes at different points in a baccalaureate nursing program. Although analysis of variance revealed no significant differences in students' attitudes during the 4 years, post hoc analysis revealed a drop in positive attitudes and a rise in negative attitudes at the beginning of the second and fourth years of the baccalaureate program.

Early Career Summer Interdisciplinary Team Experiences and Student Persistence in STEM Fields

NASA Astrophysics Data System (ADS)

Cadavid, A. C.; Pedone, V. A.; Horn, W.; Rich, H.

2015-12-01

STEPS (Students Targeting Engineering and Physical Science) is an NSF-funded program designed to increase the number of California State University Northridge students getting bachelor's degrees in the natural sciences, mathematics, engineering and computer science. The greatest loss of STEM majors occurs between sophomore and junior- years, so we designed Summer Interdisciplinary Team Experience (SITE) as an early career program for these students. Students work closely with a faculty mentor in teams of ten to investigate regionally relevant problems, many of which relate to sustainability efforts on campus or the community. The projects emphasize hands-on activities and team-based learning and decision making. We report data for five years of projects, qualitative assessment through entrance and exit surveys and student interviews, and in initial impact on retention of the participants.

An analysis of the first two years of GASP data. [Global Atmospheric Sampling Program

NASA Technical Reports Server (NTRS)

Holdeman, J. D.; Nastrom, G. D.; Falconer, P. D.

1978-01-01

Distributions of mean ozone levels from the first two years of data from the NASA Global Atmospheric Sampling Program (GASP) show spatial and temporal variations in agreement with previous measurements. The standard deviations of these distributions reflect the large natural variability of ozone levels in the altitude range of the GASP measurements. Monthly mean levels of ozone below the tropopause show an annual cycle with a spring maximum which is believed to result from transport from the stratosphere. Correlations of ozone with independent meteorological parameters, and meteorological parameters obtained by the GASP systems show that this transport occurs primarily through cyclogenesis at mid-latitudes. The GASP water vapor data, analyzed with respect to the location of the tropopause, correlates well with the simultaneously obtained ozone and cloud data.

Twenty-five years of accomplishments of the College of American Pathologists Q-probes program for clinical pathology.

PubMed

Howanitz, Peter J; Perrotta, Peter L; Bashleben, Christine P; Meier, Frederick A; Ramsey, Glenn E; Massie, Larry W; Zimmerman, Roberta L; Karcher, Donald S

2014-09-01

During the past 25 years, the College of American Pathologists' (CAP) Q-Probes program has been available as a subscription program to teach laboratorians how to improve the quality of clinical laboratory services. To determine the accomplishments of the CAP Q-Probes program. We reviewed Q-Probes participant information, study data and conclusions, author information, and program accomplishments. During this time 117 Q-Probes clinical pathology studies were conducted by 54 authors and coauthors, 42,899 laboratories enrolled from 24 countries, 98 peer-reviewed publications occurred and were cited more than 1600 times, and the studies were featured 59 times in CAP Today. The most frequent studies (19) focused on turnaround times for results or products at specific locations (emergency department, operating room, inpatients, outpatients), specific diseases (acute myocardial infarction, urinary tract), availability for specific events such as morning rounds or surgery, a specific result (positive blood cultures), and a method on how to use data for improvement (stat test outliers). Percentile ranking of study participants with better performance provided benchmarks for each study with attributes statistically defined that influenced improved performance. Other programs, such as an ongoing quality improvement program (Q-Tracks), a laboratory competency assessment program, a pathologist certification program, and an ongoing physician practice evaluation program (Evalumetrics), have been developed from Q-Probes studies. The CAP's Q-Probes program has made significant contributions to the medical literature and has developed a worldwide reputation for improving the quality of clinical pathology services worldwide.

Acute lymphoblastic leukemia in very young children. Diagnostic and therapeutic aspects of 43 cases

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

Leverger, G.; Bancillon, A.; Schaison, G.

Between 1974 and 1982, 43 children less than 2 years of age were treated in the hematology department of Hospital Saint-Louis for acute lymphoblastic leukemia (ALL). Of the patients who presented before 18 months of age, 80% had a WBC greater than 100,000 microliter and/or a great tumor bulk. As a result of our experience, treatment regimens have been changed here from conventional chemotherapy to a very intensive program with a heavy induction (vincristine, daunorubicin, cyclophosphamide, prednisone, and L-asparaginase) and monthly reinductions with the same drugs plus ArA-C, without maintenance. Prophylaxis included CNS irradiation (16-24 Gy) after 12 months ofmore » age, plus intrathecal methotrexate. Complete remission (CR) occurred in 78% before 18 months and in 100% between 18 and 24 months of age at diagnosis. In this report the probability of a prolonged CR (33% at 2 years) was the same before and after 12 months of age. However, younger patients were more intensively treated. The prognosis for children less than 1 year of age who received very intensive chemotherapy has greatly improved, with a significantly higher probability of long CR (p less than 0.02). Presently, 10 of 43 children are in CR 27 months to 8 years after diagnosis. Of 18 patients aged less than 1 year at diagnosis, four are in CR. No relapse occurred after 23 months. None of these patients presented with important sequellae, with the exception of one child who suffered from severe bacterial meningitis. An aggressive chemotherapy program is indicated in patients less than 2 years of age. The feasibility of this mode of treatment in young patients is possible only with the help of specific supportive care.« less

Nationwide cervical cancer screening in Korea: data from the National Health Insurance Service Cancer Screening Program and National Cancer Screening Program, 2009–2014

PubMed Central

Hwang, Han-Sung; Kwon, Han-Sung; Lee, Sun Joo; Lee, Ji Young; Kim, Soo-Nyung; Lee, Kunsei; Chang, Sounghoon

2017-01-01

Objective The rates of participation in the Korean nationwide cervical cancer screening program and the rates of abnormal test results were determined. Methods The database of the National Health Insurance Service (NHIS) was used during the study period (2009–2014). Results The participation rate increased from 41.10% in 2009 to 51.52% in 2014 (annual percentage change, 4.126%; 95% confidence interval [CI]=2.253–6.034). During the study period, women ≥70 years of age had the lowest rate of participation (range, 21.7%–31.9%) and those 30–39 years of age the second-lowest (27.7%–44.9%). The participation rates of National Health Insurance beneficiaries (range, 48.6%–52.5%) were higher than those of Medical Aid Program (MAP) recipients (29.6%–33.2%). The rates of abnormal results were 0.65% in 2009 and 0.52% in 2014, with a decreasing tendency in all age groups except the youngest (30–39 years). Every year the abnormal result rates tended to decrease with age, from the age groups of 30–39 years to 60–69 years but increased in women ≥70 years of age. The ratio of patients with atypical squamous cells of undetermined significance compared with those with squamous intraepithelial lesions increased from 2.71 in 2009 to 4.91 in 2014. Conclusion Differences related to age and occurring over time were found in the rates of participation and abnormal results. Further efforts are needed to encourage participation in cervical cancer screening, especially for MAP recipients, elderly women and women 30–39 years of age. Quality control measures for cervical cancer screening programs should be enforced consistently. PMID:28657224

San Joaquin kit fox Vulpes macrotis mutica program, Camp Roberts, California

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

Not Available

Camp Roberts is a California Army National Guard Training Site located in central California. The San Joaquin kit fox, an endangered subspecies of kit fox, has been known to occur at Camp Roberts since 1960. The population of foxes began to increase in the early 1970's when use of rodenticides decreased. In 1987 the California Army National Guard contracted EG G Energy Measurements to conduct a 3-year study to assess the effects of Camp Roberts activities on the kit fox population. The major objective of the Camp Roberts Environmental Studies Program is to prepare a comprehensive Biological Assessment of themore » effects of all NGB-authorized activities (includes military training, anticipated construction projects, repair and maintenance activities, and all NGB-authorized non-military activities such as hunting and fishing programs, grazing leases, etc.) on San Joaquin kit fox. The program also provides NGB with the scientific expertise necessary to insure compliance with the Endangered Species Act. The specific objective of this report is to summarize progress and results of the Environmental Studies Program made during Fiscal Years 1989 and 1990 (FY89/90). 32 refs., 9 figs., 14 tabs.« less

Ten Years and 1 Master Settlement Agreement Later: The Nature and Frequency of Alcohol and Tobacco Promotion in Televised Sports, 2000 Through 2002

PubMed Central

Zwarun, Lara

2006-01-01

Objectives. I sought to identify what kinds of promotion for alcohol and tobacco products are found in televised sports programming, as well as how frequently they occur. I compared my findings with data from 5 and 10 years earlier to examine the effects of the Master Settlement Agreement and detect industry trends. Method. A content analysis of more than 83 hours of televised sports programming from 2000 through 2002 was conducted. Composite week sampling was used to ensure results were representative of the overall population of television sports programs. Programs were examined for traditional advertising (commercials) and nontraditional advertising (stadium signs, announcer voiceovers, etc.). Results. Rates of certain types of alcohol advertising have decreased, but what remains is strategically chosen to increase the likelihood of audience exposure. Despite the Master Settlement Agreement, tobacco advertising remains prevalent in many sports. A new trend of placing alcohol and tobacco brand names in commercials for other products is evident. Conclusions. Alcohol and tobacco marketers appear able to cleverly adapt to advertising challenges, such as digital video recorders and legislation. Alcohol and tobacco brands remain visible on sports programming. PMID:16809598

Ten years and 1 master settlement agreement later: the nature and frequency of alcohol and tobacco promotion in televised sports, 2000 through 2002.

PubMed

Zwarun, Lara

2006-08-01

I sought to identify what kinds of promotion for alcohol and tobacco products are found in televised sports programming, as well as how frequently they occur. I compared my findings with data from 5 and 10 years earlier to examine the effects of the Master Settlement Agreement and detect industry trends. Method. A content analysis of more than 83 hours of televised sports programming from 2000 through 2002 was conducted. Composite week sampling was used to ensure results were representative of the overall population of television sports programs. Programs were examined for traditional advertising (commercials) and nontraditional advertising (stadium signs, announcer voiceovers, etc.). Rates of certain types of alcohol advertising have decreased, but what remains is strategically chosen to increase the likelihood of audience exposure. Despite the Master Settlement Agreement, tobacco advertising remains prevalent in many sports. A new trend of placing alcohol and tobacco brand names in commercials for other products is evident. Alcohol and tobacco marketers appear able to cleverly adapt to advertising challenges, such as digital video recorders and legislation. Alcohol and tobacco brands remain visible on sports programming.

Attempts by one local health department to provide only essential public health services: a 10-year retrospective case study.

PubMed

Richardson, J Matthew; Pierce, J Rush; Lackan, Nuha

2012-01-01

Because of local political circumstances, in 1996, the local public health department in Amarillo, Texas, divested itself of almost all personal health services and chose to retain only essential population-based public health services. We analyzed function, funding, and staffing for various health department activities in FY 1997 and again in FY 2007. The figures were adjusted for inflation and population growth. We interviewed key personnel about the motivation and effects of the changes that occurred with this 10-year period. The local health department both transferred and reassumed some personal health services during this period. This was primarily in the area of immunization services and care for special population such as refugees. Public health preparedness also became a significant new area of activity. Most personal health services provided by the health department before 1996 remained the function of other health care entities in the community. When adjusted for inflation and population growth, most of the growth in the health department's personnel and budget was the result of state and federally mandated program changes. Growth in this local health department, which was committed to provide only essential health services, was driven primarily by state and federally mandated programs. Real growth for essential public health services did not occur over a 10-year period.

A School-Based Human Papillomavirus Vaccination Program in Barretos, Brazil: Final Results of a Demonstrative Study

PubMed Central

Fregnani, José Humberto Tavares Guerreiro; Carvalho, André Lopes; Eluf-Neto, José; Ribeiro, Karina de Cássia Braga; Kuil, Larissa de Melo; da Silva, Tauana Arcadepani; Rodrigues, Silvia Lapola; Mauad, Edmundo Carvalho; Longatto-Filho, Adhemar; Villa, Luisa Lina

2013-01-01

Introduction The implementation of a public HPV vaccination program in several developing countries, especially in Latin America, is a great challenge for health care specialists. Aim To evaluate the uptake and the three-dose completion rates of a school-based HPV vaccination program in Barretos (Brazil). Methods The study included girls who were enrolled in public and private schools and who regularly attended the sixth and seventh grades of elementary school (mean age: 11.9 years). A meeting with the parents or guardians occurred approximately one week before the vaccination in order to explain the project and clarify the doubts. The quadrivalent vaccine was administered using the same schedule as in the product package (0–2–6 months). The school visits for regular vaccination occurred on previously scheduled dates. The vaccine was also made available at Barretos Cancer Hospital for the girls who could not be vaccinated on the day when the team visited the school. Results Among the potential candidates for vaccination (n = 1,574), the parents or guardians of 1,513 girls (96.1%) responded to the invitation to participate in the study. A total of 1,389 parents or guardians agreed to participate in the program (acceptance rate = 91.8%). The main reason for refusing to participate in the vaccination program was fear of adverse events. The vaccine uptake rates for the first, second, and third doses were 87.5%, 86.3% and 85.0%, respectively. The three-dose completion rate was 97.2%. Conclusions This demonstrative study achieved high rates of vaccination uptake and completion of three vaccine doses in children 10–16 years old from Brazil. The feasibility and success of an HPV vaccination program for adolescents in a developing country may depend on the integration between the public health and schooling systems. PMID:23638130

Status and Trend of Regal Fritillary (Speyeria idalia) (Lepidoptera: Nymphalidae) in the 4th of July Butterfly Count Program in 1977–2014

PubMed Central

2016-01-01

Regal Fritillary (Speyeria idalia) primarily inhabits prairie, a native grassland of central North America, and occurs rarely in nonprairie grasslands further east. This butterfly has experienced widespread decline and marked range contraction. We analyze Regal Fritillary incidence and abundance during 1977–2014 in 4th of July Butterfly Counts, an annual census of butterflies in North America. Volunteers count within the same 24 km diameter circle each year. Only 6% of counts in range reported a Regal, while 18% of counts in core range in the Midwest and Great Plains did. 99.9% of Regal individuals occurred in core range. Only four circles east of core range reported this species, and only during the first half of the study period. All individuals reported west of its main range occurred in two circles in Colorado in the second half of the study. The number of counts per year and survey effort per count increased during the study. During 1991–2014, >31 counts occurred per year in core Regal range, compared to 0–23 during 1975–1990. During 1991–2014, all measures of Regal presence and abundance declined, most significantly. These results agree with other sources that Regal Fritillary has contracted its range and declined in abundance. PMID:27239370

A Case Study of Obsolescence Management Constraints During Development of Sustainment-Dominated Systems

NASA Astrophysics Data System (ADS)

Welch, Jonathan

This case study focused on obsolescence management constraints that occur during development of sustainment-dominated systems. Obsolescence management constraints were explored in systems expected to last 20 years or more and that tend to use commercial off-the-shelf products. The field of obsolescence has received little study, but obsolescence has a large cost for military systems. Because developing complex systems takes an average of 3 to 8 years, and commercial off-the-shelf components are typically obsolete within 3 to 5 years, military systems are often deployed with obsolescence issues that are transferred to the sustainment community to determine solutions. The main problem addressed in the study was to identify the constraints that have caused 70% of military systems under development to be obsolete when they are delivered. The purpose of the study was to use a qualitative case study to identify constraints that interfered with obsolescence management occurring during the development stages of a program. The participants of this case study were managers, subordinates, and end-users who were logistics and obsolescence experts. Researchers largely agree that proactive obsolescence management is a lower cost solution for sustainment-dominated systems. Program managers must understand the constraints and understand the impact of not implementing proactive solutions early in the development program lifecycle. The conclusion of the study found several constraints that prevented the development program from early adoption of obsolescence management theories, specifically pro-active theories. There were three major themes identified: (a) management commitment, (b) lack of details in the statement of work, and (c) vendor management. Each major theme includes several subthemes. The recommendation is future researchers should explore two areas: (a) comparing the cost of managing obsolescence early in the development process versus the costs of managing later, (b) exploring the costs and value to start a centralized obsolescence group at each major defense contractor location.

Resident health advocates in public housing family developments.

PubMed

Bowen, Deborah J; Bhosrekar, Sarah Gees; Rorie, Jo-Anna; Goodman, Rachel; Thomas, Gerry; Maxwell, Nancy Irwin; Smith, Eugenia

2015-01-01

Translation of research to practice often needs intermediaries to help the process occur. Our Prevention Research Center has identified a total of 89 residents of public housing in the last 11 years who have been working in the Resident Health Advocate (RHA) program to engage residents in improving their own and other residents' health status by becoming trained in skills needed by community health workers. Future directions include training for teens to become Teen RHAs and further integration of our RHA program with changes in the health care system and in the roles of community health workers in general.

Resident Health Advocates in Public Housing Family Developments

PubMed Central

Bowen, Deborah J; Bhosrekar, Sarah Gees; Rorie, Jo-Anna; Goodman, Rachel; Thomas, Gerry; Maxwell, Nancy Irwin; Smith, Eugenia

2015-01-01

Translation of research to practice often needs intermediaries to help the process occur. Our Prevention Research Center has identified a total of 89 residents of public housing in the last 11 years who have been working in the Resident Health Advocate (RHA) program to engage residents in improving their own and other residents’ health status, by becoming trained in skills needed by Community Health Workers. Future directions include training for teens to become Teen RHAs and further integration of our RHA program with changes in the health care system and in the roles of community health workers in general. PMID:25739061

Factors affecting vocational outcomes of people with chronic illness participating in a supported competitive open employment program in Hong Kong.

PubMed

Lee, Rosalia K Y; Chan, Chetwyn C H

2005-01-01

This study aimed to analyze the ability of the Patient Retraining and Vocational Resettlement (PRAVR) program to enhance the vocational outcomes of individuals with chronic illness, and to study the socio-demographic factors associated with successful vocational outcome. A retrospective study of 548 individuals with various types of chronic illness who enrolled in the program between 1995 and 2003. Their socio-demographic data and their employment outcome after a six-month job skills retraining and job settlement service were collected for analysis. The program was found to enhance the vocational outcomes of patients who completed the program. Logistic regression identified significant factors predicting successful vocational outcomes. For the male patients, the chances of employment were higher if the onset of illness had occurred at least 10 years before (odd ratios = 0.326). For the female patients, the chances of employment were higher if they had been unemployed for less than 1 year (odd ratio = 3.8). The PRAVR program is able to enhance the vocational outcomes of people with chronic illness in Hong Kong. The factors which were found to relate to successful employment were unique to the local situation. Further studies should explore these factors in a more in-depth manner.

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

PubMed

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-10-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ± 24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ± 7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care

PubMed Central

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-01-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1 PMID:22893665

Nondestructive Examination for Nuclear Power Plant Cable Aging Management Programs

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

Glass, Samuel W.; Fifield, Leonard S.

2016-01-01

Degradation of the cable jacket, electrical insulation, and other cable components of installed cables within nuclear power plants (NPPs) is known to occur as a function of age, temperature, radiation, and other environmental factors. System tests verify cable function under normal loads; however, the concern is over cable performance under exceptional loads associated with design-basis events (DBEs). The cable’s ability to perform safely over the initial 40 year planned and licensed life has generally been demonstrated and there have been very few age-related cable failures. With greater than 1000 km of power, control, instrumentation, and other cables typically found inmore » an NPP, replacing all the cables would be a severe cost burden. Justification for life extension to 60 and 80 years requires a cable aging management program (AMP) to justify cable performance under normal operation as well as accident conditions. This paper addresses various NDE technologies that constitute the essence of an acceptable aging management program.« less

Overview of the U.S. Environmental Protection Agency's Hazardous Air Pollutant Early Reduction Program.

PubMed

Laznow, J; Daniel, J

1992-01-01

Under provision of the Clean Air Act Amendments of 1990 Title III, the EPA has proposed a regulation (Early Reduction Program) to allow a six-year compliance extension from Maximum Achievable Control Technology (MACT) standards for sources that voluntarily reduce emissions of Hazardous Air Pollutants (HAPs) by 90 percent or more (95 percent or more for particulates) from a base year of 1987 or later. The emission reduction must be made before the applicable MACT standard is proposed for the source category or be subject to an enforceable commitment to achieve the reduction by January 1, 1994 for sources subject to MACT standards prior to 1994. The primary purpose of this program is to encourage reduction of HAPs emissions sooner than otherwise required. Industry would be allowed additional time in evaluating emission reduction options and developing more cost-effective compliance strategies, although, under strict guidelines to ensure actual, significant and verifiable emission reductions occur.

Progress in HPV vaccination in low- and lower-middle-income countries.

PubMed

LaMontagne, D Scott; Bloem, Paul J N; Brotherton, Julia M L; Gallagher, Katherine E; Badiane, Ousseynou; Ndiaye, Cathy

2017-07-01

The past 10 years have seen remarkable progress in the global scale-up of human papillomavirus (HPV) vaccinations. Forty-three low- and lower-middle-income countries (LLMICs) have gained experience in delivering this vaccine to young adolescent girls through pilot programs, demonstration programs, and national introductions and most of these have occurred in the last 4 years. The experience of Senegal is summarized as an illustrative country case study. Publication of numerous delivery experiences and lessons learned has demonstrated the acceptability and feasibility of HPV vaccinations in LLMICs. Four areas require dedicated action to overcome remaining challenges to national scaling-up: maintaining momentum politically, planning successfully, securing financing, and fostering sustainability. Advances in policy, programming, and science may help accelerate reaching 30 million girls in LLMICs with HPV vaccine by 2020. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Trends in teachers' recommendations for changing elementary and junior-high school science programs

NASA Astrophysics Data System (ADS)

Stronck, David R.

Since 1978 many studies have called for changes in the practices of science teaching. These changes in instruction will occur only when the teachers decide to change their practices. This study uses surveys to consider the question of what were the trends in the teachers' recommendations for changes in elementary and junior-high school science programs between the years of 1978 and 1982. Large samples of teachers in British Columbia, Canada, responded anonymously to questionnaires in these years: 3040 teachers in 1978 and 1631 in 1982, with return rates ranging from 77.5% to 85%. These teachers described themselves as shifting their classroom practices toward ones that emphasize passive learning and memorization. The British Columbia Science Assessments recommend more inservice programs to stop this trend. There were very few differences in the teachers' recommendations for changes in the schools. The elementary-school teachers had major changes in their rankings of only two activities: they increased their ranking of activity-centered learning and reduced their ranking of outdoor education.

Careers in Drug and Alcohol Research: AN Innovative Program for Young Appalachian Women

NASA Astrophysics Data System (ADS)

Noland, Melody Powers; Leukefeld, Carl; Reid, Caroline

Supported by a grant from the National Institute on Drug Abuse, the University of Kentucky's Center on Drug and Alcohol Research developed the Young Women in Science Program to encourage young women from Appalachia to pursue scientific careers гп drug and alcohol research. This 3-year program, which involved 26 young women entering the ninth grade in 13 counties in southeastern Kentucky, included a summer residential program, community educational sessions, and matching students with mentors. When participants' scores prior to and after the 3-week residential program were compared, it was found that participants increased their science knowledge and improved their scores on confidence in science. Other significant changes occurred as well. These preliminary data indicated that some positive changes resulted from the program, even though contact time with the young women has been modest to date. The program shows considerable promise for providing the encouragement and skills needed for these young women to pursue careers in drug and alcohol research.

[Psychophysiological studies in the pre-school children].

PubMed

Ullner, R; von Braun, G S; Ziegelmayer, G

1976-10-14

The behavior of 24 children, aged 3-6 years, was recorded on video-tape. Simultaneously the ECG was recorded telemetrically. These observations were made during two pre-school educational programs lasting 90 minutes each: "Didactic games" and "Elementary music and movement program". For each child a scale was developed to show the correlation of mean heart-rate and well defined motor-activity. It was evident that the mean heart-rate was higher during the music program than during the didactic program, corresponding to the higher motor-activity. But it was found that in the didactic program the variation of the heart-rate within short intervals was higher due to the more frequent occurrence of respiratory arrhythmias. It was also seen that during the music program the children showed no signs of exertion as they did towards the end of the didactic program. Respiratory arrhythmias were not seen in children who according to the Schellong-test were classified as stable in their cardiovascular system. The arrhythmias occurred mainly when the children showed signs of fatigue.

Improvements to the adaptive maneuvering logic program

NASA Technical Reports Server (NTRS)

Burgin, George H.

1986-01-01

The Adaptive Maneuvering Logic (AML) computer program simulates close-in, one-on-one air-to-air combat between two fighter aircraft. Three important improvements are described. First, the previously available versions of AML were examined for their suitability as a baseline program. The selected program was then revised to eliminate some programming bugs which were uncovered over the years. A listing of this baseline program is included. Second, the equations governing the motion of the aircraft were completely revised. This resulted in a model with substantially higher fidelity than the original equations of motion provided. It also completely eliminated the over-the-top problem, which occurred in the older versions when the AML-driven aircraft attempted a vertical or near vertical loop. Third, the requirements for a versatile generic, yet realistic, aircraft model were studied and implemented in the program. The report contains detailed tables which make the generic aircraft to be either a modern, high performance aircraft, an older high performance aircraft, or a previous generation jet fighter.

Using distance technologies to facilitate a learning collaborative to implement stagewise treatment.

PubMed

Covell, Nancy H; Foster, Forrest P; Margolies, Paul J; Lopez, Luis O; Dixon, Lisa B

2015-06-01

This report describes experiences and outcomes of an online learning collaborative focused on implementation of stagewise treatment. Eleven participating programs convened online monthly for a year. Between meetings, program staff created an implementation plan and programs collected performance indicator data, including assessment of staff knowledge of integrated treatment for people with co-occurring disorders, whether a person's current stage of treatment was documented in his or her chart, and whether the treatments were appropriate for the stage of treatment. Descriptive statistics were used to characterize performance indicators and feedback. Wilcoxon matched-pairs signed-rank tests examined changes in performance indicators over time. Program staff generally demonstrated significant improvements in performance indicators over time and rated the distance learning collaborative favorably. Distance learning collaboratives can be structured to provide opportunities for program staff to interact and learn from one another and to implement and sustain changes.

Effects of therapeutic goal management (TGM) on treatment attendance and drug abstinence among men with co-occurring substance use and axis I mental disorders who are homeless: results of the Birmingham EARTH program

PubMed Central

2013-01-01

Purpose This study describes the implementation and impact of Therapeutic Goal Management (TGM) in a Substance Abuse and Mental Health Services Administration (SAMHSA)-sponsored demonstration project entitled Enhanced Addiction Recovery through Housing (EARTH). Participants The sample included 28 male participants followed at six months who completed some treatment. Forty-three percent were Caucasian, and 57% were African American. The average age of participants was 42 years. Design The relationships between TGM goal achievement, treatment attendance, and drug abstinence outcomes were studied among EARTH program participants who were homeless and met criteria for co-occurring substance use and severe DSM-IV Axis I mental disorders. Results The results revealed an overall drug abstinence rate of 72.4% over six months and significant positive relationships between TGM goal achievement and drug abstinence (r = 0.693) and TGM goal achievement and treatment attendance (r = 0.843). Conclusions This research demonstrated the relationship and potential positive impact of systematically setting, monitoring, and reinforcing personalized goals in multiple life areas on drug abstinence and treatment attendance outcomes among persons who are homeless with co-occurring substance use and other Axis I disorders in a integrated community service delivery program. PMID:24499617

The immediate and long-term effects of exercise and patient education on physical, functional, and quality-of-life outcome measures after single-level lumbar microdiscectomy: a randomized controlled trial protocol.

PubMed

Selkowitz, David M; Kulig, Kornelia; Poppert, Elizabeth M; Flanagan, Sean P; Matthews, Ndidiamaka D; Beneck, George J; Popovich, John M; Lona, Jose R; Yamada, Kimiko A; Burke, Wendy S; Ervin, Carolyn; Powers, Christopher M

2006-08-25

Low back pain remains a costly quality-of-life-related health problem. Microdiscectomy is often the surgical procedure of choice for a symptomatic, single-level, lumbar disc herniation in younger and middle-aged adults. The question of whether a post-microdiscectomy exercise program enhances function, quality of life, and disability status has not been systematically explored. Thus, the overall purpose of this study is to assess immediate and long-term outcomes of an exercise program, developed at University of Southern California (USC), targeting the trunk and lower extremities (USC Spine Exercise Program) for persons who have undergone a single-level microdiscectomy for the first time. One hundred individuals between the ages of 18 and 60 who consent to undergo lumbar microdiscectomy will be recruited to participate in this study. Subjects will be randomly assigned to one of two groups: 1) one session of back care education, or 2) a back care education session followed by the 12-week USC Spine Exercise Program. The outcome examiners (evaluators), as well as the data managers, will be blinded to group allocation. Education will consist of a one-hour "one-on-one" session with the intervention therapist, guided by an educational booklet specifically designed for post-microdiscectomy care. This session will occur four to six weeks after surgery. The USC Spine Exercise Program consists of two parts: back extensor strength and endurance, and mat and upright therapeutic exercises. This exercise program is goal-oriented, performance-based, and periodized. It will begin two to three days after the education session, and will occur three times a week for 12 weeks. Primary outcome measures include the Oswestry Disability Questionnaire, Roland-Morris Disability Questionnaire, SF-36 quality of life assessment, Subjective Quality of Life Scale, 50-foot Walk, Repeated Sit-to-Stand, and a modified Sorensen test. The outcome measures in the study will be assessed before and after the 12-week post-surgical intervention program. Long-term follow up assessments will occur every six months beginning one year after surgery and ending five years after surgery. Immediate and long-term effects will be assessed using repeated measures multivariate analysis of variance (MANOVA). If significant interactions are found, one-way ANOVAs will be performed followed by post-hoc testing to determine statistically significant pairwise comparisons. We have presented the rationale and design for a randomized controlled trial evaluating the effectiveness of a treatment regimen for people who have undergone a single-level lumbar microdiscectomy.

Factors influencing the choice of specialty of Australian medical graduates.

PubMed

Harris, Mary G; Gavel, Paul H; Young, Jeannette R

2005-09-19

To identify the relative importance of extrinsic determinants of doctors' choice of specialty. A self-administered postal questionnaire. Australian vocational training programs. 4259 Australian medical graduates registered in September 2002 with one of 16 Australian clinical colleges providing vocational training programs. Choice of specialist vocational training program; extrinsic factors influencing choice of program, and variation by sex, age, marital status and country of birth. In total, 79% of respondents rated "appraisal of own skills and aptitudes" as influential in their choice of specialty followed by "intellectual content of the specialty" (75%). Extrinsic factors rated as most influential were "work culture" (72%), "flexibility of working arrangements" (56%) and "hours of work" (54%). We observed variation across training programs in the importance ascribed to factors influencing choice of specialty, and by sex, age and marital status. Factors of particular importance to women, compared with men, were "appraisal of domestic circumstances" (odds ratio [OR], 1.9), "hours of work" (OR, 1.8) and "opportunity to work flexible hours" (OR, 2.6). Partnered doctors, compared with single doctors, rated "hours of work" and "opportunity to work flexible hours" as more important (OR, 1.3), while "domestic circumstances" was more important to doctors with children than those without children (OR, 1.7). In total, 80% of doctors had chosen their specialty by the end of the third year after graduation. Experience with discipline-based work cultures and working conditions occurs throughout medical school and the early postgraduate years, and most doctors choose their specialty during these years. It follows that interventions to influence doctors' choice of specialty need to target these critical years.

The Effects of Mother Education Programs on the Functionality, Anger Management and Conflict Solution Levels of Families

ERIC Educational Resources Information Center

Kabasakal, Zekavet

2013-01-01

Problem Statement: Studies carried out in recent years both in Turkey and abroad indicate that child and teenage violence has increased and become widespread. Annually, 91.1% of deaths due to violence in the world occur in low and middle-income countries. Family life is an important element in understanding violent behavior as it relates to family…

Multiscale Modeling of Ionospheric Irregularities

DTIC Science & Technology

2014-10-22

REPORT TYPE 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER...Taylor (RT) instabilities, occurs in settings that are as varied as exploding stars (supernovae), inertial confinement fusion (ICF) and macroscopic...These global models, together with the large observational data sets that have been accu- mulated over the years, have led to a much greater under

Equity Starts Early: How Chiefs Will Build High-Quality Early Education. A Policy Statement of the Council of Chief State School Officers

ERIC Educational Resources Information Center

Stark, Deborah Roderick

2016-01-01

With the achievement gap beginning to manifest in children as young as nine months, and 90 percent of brain development occurring during the first five years of life, chiefs are committed to expanding and upgrading early childhood programs and strengthening early elementary teaching and learning to provide equal educational opportunities for every…

13 CFR 108.760 - How a change in size or activity of a Portfolio Concern affects the NMVC Company and the...

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Effect of a change in business activity occurring within one year of NMVC Company's initial Financing—(1... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false How a change in size or activity... Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM...

Getting to the Bottom Line: How Using Evaluation Results to Enhance Extension Programs Can Lead to Greater Levels of Accountability

ERIC Educational Resources Information Center

Lamm, Alexa J.; Israel, Glenn D.; Harder, Amy

2011-01-01

Extension has enhanced the lives of U.S. citizens through adult education in a myriad of ways. However, as budgets get tighter, accountability becomes increasingly more important. Over the years, Extension has reported low level impacts rather than the long-term successes that those working within the system know are occurring. Without enhanced…

A Vision in Aeronautics: The K-12 Wind Tunnel Project

NASA Technical Reports Server (NTRS)

1997-01-01

A Vision in Aeronautics, a project within the NASA Lewis Research Center's Information Infrastructure Technologies and Applications (IITA) K-12 Program, employs small-scale, subsonic wind tunnels to inspire students to explore the world of aeronautics and computers. Recently, two educational K-12 wind tunnels were built in the Cleveland area. During the 1995-1996 school year, preliminary testing occurred in both tunnels.

Mumps in the US Army 1980-86: should recruits be immunized?

PubMed Central

Arday, D R; Kanjarpane, D D; Kelley, P W

1989-01-01

The US Army's experience with mumps hospitalizations was examined for the years 1980 through 1986. One hundred fifty-two cases among active duty Army soldiers were identified. Mumps rates declined from 3.85 per 100,000 active duty soldiers per year in 1980 to 1.28 in 1985, but an outbreak during 1986 caused rates to jump to 6.65. Attack rates were found to decline dramatically with increasing age or length of military service, with 74 per cent of cases occurring in soldiers with three years or less of service. Rates for Blacks and Whites were similar, but were higher for other minorities. Complications reported were mild. A cost-benefit analysis, assuming all recruits were to be vaccinated, estimated average annual vaccination program costs of $286,789; this figure exceeds average annual reported hospitalized mumps disease costs of $61,525 by a factor of 4.7. Mumps attack rates would have to reach at least 15.0 per 100,000 per year before savings would equal recruit vaccination costs. Failure to show that a vaccine program would be cost-saving may be due to limitations in identifying cases or to the requirement that all recruits be immunized regardless of prior immune status. It is likely that a program to immunize susceptible individuals alone would show benefit. PMID:2494895

Local Residents Trained As ‘Influence Agents’ Most Effective In Persuading African Couples On HIV Counseling and Testing

PubMed Central

Lambdin, Barrot; Kanweka, William; Inambao, Mubiana; Mwananyanda, Lawrence; Shah, Heena; Linton, Sabriya; Wong, Frank; Luisi, Nicole; Tichacek, Amanda; Kalowa, James; Chomba, Elwyn; Allen, Susan

2011-01-01

Couples in sub-Saharan Africa are the largest group in the world at risk for HIV infection. Couples counseling and testing programs have been shown to reduce HIV transmission, but such programs remain rare in Africa. Before couples counseling and testing can become the norm, it is essential to increase demand for the services. We evaluated the effectiveness of several promotional strategies during a two -year program in Kitwe and Ndola, Zambia. The program attracted more than 7,600 couples through the use of radio broadcasts, billboards, and other strategies. The most effective recruiting technique was the use of local residents trained as “influence agents” to reach out to friends, neighbors, and others in their sphere of influence. Of the estimated 2.5 million new cases of HIV in adults and children in 2009, more than two-thirds occurred in sub-Saharan Africa.1 In Zambia, the prevalence of HIV among adults in urban and rural areas is estimated at 19 and 10 percent, respectively.2 Most HIV transmission in sub-Saharan Africa is heterosexual and occurs between cohabiting partners with discordant HIV test results3–5—that is, only one partner is HIV-positive. Thus, most new cases of HIV occur when someone infects his or her heterosexual partner. Sub-Saharan African couples with discordant HIV test results are the world’s largest risk group for HIV.6 Approximately 20 percent of Zambian couples have discordant HIV results, a rate consistent with estimates from Uganda, Rwanda, Tanzania, and Kenya.7–14 PMID:21821565

Human health and ecological assessment programs for Hebei Spirit oil spill accident of 2007: Status, lessons, and future challenges.

PubMed

Jung, Dawoon; Kim, Jung-Ah; Park, Myung-Sook; Yim, Un Hyuk; Choi, Kyungho

2017-04-01

Hebei Spirit oil spill (HSOS) of December 2007 is one of the worst oil spill accidents that occurred in Yellow Sea. The affected coastline along the west coast of Korean Peninsula hosts one of the largest tidal flats worldwide, and is home to tens of thousands of human residents. Based on nation-wide concerns on ecosystem damages and adverse human health effects, two separate surveillance programs on ecosystem and human health were initiated: a 10-year follow-up program by Ministry of Oceans and Fisheries to assess ecological impacts of the oil spill, and an exposure and health effect assessment program by Ministry of Environment for the residents of Taean and its vicinity. For the past eight years, extensive monitoring and surveillance data on ecosystem and humans have been accumulated through these programs. But these studies have been conducted mostly independently, and collaborations were seldom made between two programs. The lack of communication resulted in gaps and overlaps between the programs which led to loss of critical information and efficiency. As oil spill can affect both humans and ecosystem through various pathways, collaboration and communication between human and ecosystem health surveillance programs are necessary, and will synergize the success of both programs. Such concerted efforts will provide better platform for understanding the status of impact, and for developing approaches to address human and ecosystem health challenges that may be faced following environmental disasters like HSOS. Copyright © 2017 Elsevier Ltd. All rights reserved.

Problem neurology residents: a national survey.

PubMed

Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

2011-06-14

Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

Medicare program; inpatient rehabilitation facility prospective payment system for federal fiscal year 2014. Final rule.

PubMed

2013-08-06

This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2014 (for discharges occurring on or after October 1, 2013 and on or before September 30, 2014) as required by the statute. This final rule also revised the list of diagnosis codes that may be counted toward an IRF's "60 percent rule'' compliance calculation to determine "presumptive compliance,'' update the IRF facility-level adjustment factors using an enhanced estimation methodology, revise sections of the Inpatient Rehabilitation Facility-Patient Assessment Instrument, revise requirements for acute care hospitals that have IRF units, clarify the IRF regulation text regarding limitation of review, update references to previously changed sections in the regulations text, and revise and update quality measures and reporting requirements under the IRF quality reporting program.

Safety of Outpatient Autologous Hematopoietic Cell Transplantation for Multiple Myeloma and Lymphoma

PubMed Central

Graff, Tara M.; Singavi, Arun K.; Schmidt, William; Eastwood, Daniel; Drobyski, William R.; Horowitz, Mary; Palmer, Jeanne; Pasquini, Marcelo; Rizzo, Douglas J.; Saber, Wael; Hari, Parmeswaran; Fenske, Timothy S.

2015-01-01

Autologous peripheral stem cell transplantation (AutoHCT) is commonly an inpatient procedure. However, AutoHCT is increasingly being offered on an outpatient basis. To better characterize the safety of outpatient AutoHCT, we compared the outcome of 230 patients who underwent AutoHCT on an inpatient (IP) versus outpatient (OP) basis for myeloma or lymphoma within a single transplant program. All OP transplants occurred in a cancer center day hospital. Hematopoietic recovery occurred earlier in the OP cohort, with median time to neutrophil recovery of 10 vs. 11 days (p<0.001) and median time to platelet recovery of 19 vs. 20 days (p=0.053). 51% of the OP cohort never required admission, with this percentage increasing in later years. Grade 3–4 non-hematologic toxicities occurred in 29% of both cohorts. Non-relapse mortality at one year was 0% in the OP cohort and 1.5% in the IP cohort (p=0.327). Two year progression-free survival was 62% for OP vs. 54% for IP (p=0.155). One and two year overall survival was 97% and 83% for OP vs. 91% and 80% for IP, respectively (p=0.271). We conclude that, with daily outpatient evaluation and aggressive supportive care, outpatient AutoHCT can result in excellent outcomes for myeloma and lymphoma patients. PMID:25867651

Anticipating rotavirus vaccines: hospital-based surveillance for rotavirus diarrhea and estimates of disease burden in Bangladesh.

PubMed

Unicomb, L E; Kilgore, P E; Faruque, S G; Hamadani, J D; Fuchs, G J; Albert, M J; Glass, R I

1997-10-01

Rotavirus is the most common cause of severe diarrhea in children worldwide, and a vaccine may soon be licensed and available for use in immunization programs. To assess the need for a rotavirus vaccine in Bangladesh, we estimated the disease burden of rotavirus diarrhea from national vital statistics for births and diarrheal deaths, together with hospital surveillance data on the proportion of severe childhood diarrhea attributed to rotavirus. From 1990 through 1993, hospital surveillance was conducted of a systematic, random 4% sample of >80,000 patients with diarrhea who sought care each year at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). Rotavirus was detected in 20% (1561 of 7709) of fecal specimens from children with diarrhea <5 years of age; 92% of all cases (1436) occurred in children <2 years of age, but only 3% (50) of cases occurred in infants <3 months of age. Children infected with rotavirus were more likely to have watery stools (P < 0.001), severe vomiting (P < 0.001) but less severe dehydration (P = 0.007) than children infected with other enteropathogens. We estimate that in this setting, where 18% of children die by age 5 and about 25% of these succumb to diarrhea, between 14,850 and 27,000 of the 3 million Bangladeshi children born in 1994 will die of rotavirus by the age of 5 years, equivalent to 1 rotavirus death per 111 to 203 children. The estimated burden of rotavirus diarrhea in Bangladesh is sufficiently great to warrant field testing of rotavirus vaccines for possible inclusion in the current immunization program.

Childhood vision impairment, hearing loss and co-occurring autism spectrum disorder

PubMed Central

Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn

2015-01-01

Background Limited population-based data on prevalence of childhood vision impairment (VI) and hearing loss (HL), and their co-occurrence with autism spectrum disorder (ASD) exists. Objective To examine prevalence and characteristics of VI, HL and co-occurring ASD among 8-year-olds in metropolitan Atlanta 2000–2008. Methods We used data from the population-based Metropolitan Atlanta Developmental Disabilities Surveillance Program. Prevalence, birth and parental characteristics, presence and severity of other co-occurring developmental disabilities, and age of earliest identification of ASD, were examined for children with VI and HL, by co-occurring ASD. Results VI and HL prevalences were 1.2 and 1.3 per 1000 8-year-olds, respectively. Approximately 6–7% of children with VI or HL had co-occurring ASD. Children with VI or HL with co-occurring ASD differed from those without co-occurring ASD by select birth characteristics and the presence of other co-occurring DDs. The median age of earliest known ASD diagnosis was significantly later among children with VI and ASD compared to children with ASD without VI (79 vs. 56 months). Children with HL and ASD were first evaluated by a community provider significantly earlier than those with ASD without HL (40 vs. 50 months). Conclusions The frequency of co-occurring ASD with VI and HL is higher than the population prevalence of ASD. The significant delays in diagnosis of ASD in children with VI and lack of earlier diagnosis of ASD among children with HL despite earlier evaluation highlight the importance of developing screening tools for early identification of ASD among children with VI and HL. PMID:24060256

Sobriety Treatment and Recovery Teams: Implementation Fidelity and Related Outcomes.

PubMed

Huebner, Ruth A; Posze, Lynn; Willauer, Tina M; Hall, Martin T

2015-01-01

Although integrated programs between child welfare and substance abuse treatment are recommended for families with co-occurring child maltreatment and substance use disorders, implementing integrated service delivery strategies with fidelity is a challenging process. This study of the first five years of the Sobriety Treatment and Recovery Team (START) program examines implementation fidelity using a model proposed by Carroll et al. (2007). The study describes the process of strengthening moderators of implementation fidelity, trends in adherence to START service delivery standards, and trends in parent and child outcomes. Qualitative and quantitative measures were used to prospectively study three START sites serving 341 families with 550 parents and 717 children. To achieve implementation fidelity to service delivery standards required a pre-service year and two full years of operation, persistent leadership, and facilitative actions that challenged the existing paradigm. Over four years of service delivery, the time from the child protective services report to completion of five drug treatment sessions was reduced by an average of 75 days. This trend was associated with an increase in parent retention, parental sobriety, and parent retention of child custody. Conclusions/Importance: Understanding the implementation processes necessary to establish complex integrated programs may support realistic allocation of resources. Although implementation fidelity is a moderator of program outcome, complex inter-agency interventions may benefit from innovative measures of fidelity that promote improvement without extensive cost and data collection burden. The implementation framework applied in this study was useful in examining implementation processes, fidelity, and related outcomes.

Expected 10-year treatment cost of breast cancer detected within and outside a public screening program in Norway.

PubMed

Moger, Tron A; Bjørnelv, Gudrun M W; Aas, Eline

2016-07-01

The shift towards earlier stages of disease advancement at diagnosis when introducing mammography screening is expected to affect the treatment costs of breast cancer. We collected data on hospital resource use in Norway following a breast cancer diagnosis for the period 1 January, 2008 through 31 December, 2009 for women aged 50-69 years, diagnosed with breast cancer during the period 1 January, 1999 through 31 December, 2009. We estimated treatment costs using a function that included the probability of being at risk for receiving treatment, estimated by means of the Cox proportional hazard model. In total, 16,045 patients were included for the analyses among which 10.5 % died during the study period. The mean 10-year per-person treatment cost was €31,940 (95 % CI €31,030-32,880), and lower for cancers detected within the public screening program (€30,730) than for those detected elsewhere (€36,230). For ductal carcinoma in situ (DCIS) and cancers in stages I thru IV, treatment costs were €15,740, €23,570, €46,550, €55,230 and €60,430, respectively. Interval cancers occurring within the screening program were generally more resource demanding than both cancers detected at screening or elsewhere. Ten-year treatment costs increased by increasing stage at diagnosis. Patients whose cancer was detected within the public screening program had lower treatment costs than those detected elsewhere. Interval cancers had higher costs than others.

Ethics education in family medicine training in the United States: a national survey.

PubMed

Manson, Helen M; Satin, David; Nelson, Valerie; Vadiveloo, Thenmalar

2014-01-01

Although professional organizations endorse ethics education in family medicine training, there is little published evidence that ethics teaching occurs. This survey collated data on the aims, content, pedagogical methods, assessment, and barriers relating to formal ethics education in family medicine residency programs in the United States. A questionnaire surveyed all 445 family medicine residency programs in the United States. Forty percent of programs responded (178/445). Of these, 95% formally teach at least one ethics topic, 68.2% teach six or more topics, and 7.1% teach all 13 core topics specified in the questionnaire. Programs show variation, providing between zero to 100 hours' ethics education over the 3 years of residency training. Of the responding programs, 3.5% specify well-defined aims for ethics teaching, 25.9% designate overall responsibility for the ethics curriculum to one individual, and 33.5% formally assess ethics competencies. The most frequent barriers to ethics education are finding time in residents' schedules (59.4%) and educator expertise (21.8%). Considerable variation in ethics education is apparent in both curricular content and delivery among family medicine residency programs in the United States. Additional findings included a lack of specification of explicit curricular aims for ethics teaching allied to ACGME or AAFP competencies, a tendency not to designate one faculty member with lead responsibility for ethics teaching in the residency program, and a lack of formal assessment of ethics competencies. This has occurred in the context of an absence of robust assessment of ethics competencies at board certification level.

Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years

PubMed Central

Toffola, Elena Dalla; Pavese, Chiara; Cecini, Miriam; Petrucci, Lucia; Ricotti, Susanna; Bejor, Maurizio; Salimbeni, Grazia; Biglioli, Federico; Klersy, Catherine

2014-01-01

Summary Our study evaluates the grade and timing of recovery in 30 patients with complete facial paralysis (House-Brackmann grade VI) treated with hypoglossal-facial nerve (XII-VII) anastomosis and a long-term rehabilitation program, consisting of exercises in facial muscle activation mediated by tongue movement and synkinesis control with mirror feedback. Reinnervation after XII-VII anastomosis occurred in 29 patients, on average 5.4 months after surgery. Three years after the anastomosis, 23.3% of patients had grade II, 53.3% grade III, 20% grade IV and 3.3% grade VI ratings on the House-Brackmann scale. Time to reinnervation was associated with the final House-Brackmann grade. Our study demonstrates that patients undergoing XII-VII anastomosis and a long-term rehabilitation program display a significant recovery of facial symmetry and movement. The recovery continues for at least three years after the anastomosis, meaning that prolonged follow-up of these patients is advisable. PMID:25473738

Factors associated with no or delayed linkage to care in newly diagnosed human immunodeficiency virus (HIV)-1-infected patients identified by emergency department-based rapid HIV screening programs in two urban EDs.

PubMed

Rothman, Richard E; Kelen, Gabor D; Harvey, Leah; Shahan, Judy B; Hairston, Heather; Burah, Avanthi; Moring-Parris, Daniel; Hsieh, Yu-Hsiang

2012-05-01

The objective was to describe the proportions of successful linkage to care (LTC) and identify factors associated with LTC among newly diagnosed human immunodeficiency virus (HIV)-positive patients, from two urban emergency department (ED) rapid HIV screening programs. This was a retrospective analysis of programmatic data from two established urban ED rapid HIV screening programs between November 2005 and October 2009. Trained HIV program assistants interviewed all patients tested to gather risk behavior data using a structured data collection instrument. Reactive results were confirmed by Western blot testing. Patients were provided with scheduled appointments at HIV specialty clinics at the institutions where they tested positive within 30 days of their ED visit. "Successful" LTC was defined as attendance at the HIV outpatient clinic within 30 days after HIV diagnosis, in accordance with the ED National HIV Testing Consortium metric. "Any" LTC was defined as attendance at the outpatient HIV clinic within 1 year of initial HIV diagnosis. Multivariate logistic regression was performed to determine factors associated with any LTC or successful LTC. Of the 15,640 tests administered, 108 (0.7%) were newly identified HIV-positive cases. Nearly half (47.2%) of the patients had been previously tested for HIV. Successful LTC occurred in 54% of cases; any LTC occurred in 83% of cases. In multivariate analysis, having public medical insurance and being self-pay were negatively associated with successful LTC (odds ratio [OR] = 0.33, 95% confidence interval [CI] = 0.12 to 0.96; OR = 0.34, 95% CI = 0.13 to 0.89, respectively); being female and having previously tested for HIV was negatively associated with any LTC (OR = 0.30, 95% CI = 0.10 to 0.93; OR = 0.23, 95% CI = 0.07 to 0.77, respectively). In spite of dedicated resources for arranging LTC in the ED HIV testing programs, nearly 50% of patients did not have successful LTC (i.e., LTC occurred at >30 days), although >80% of patients were LTC within 1 year of initial diagnosis. Further evaluation of the barriers associated with successful LTC for those with public insurance and self-pay is warranted. © 2012 by the Society for Academic Emergency Medicine.

Community Pharmacy-Based Inducement Programs Associated With Better Medication Adherence: A Cohort Study.

PubMed

Simpson, Scot H; Lin, Mu; Eurich, Dean T

2017-08-01

Inducement programs can promote customer loyalty; however, the clinical effects of these programs are unknown. To examine relationships among inducement program use, medication adherence, and health outcomes. Alberta residents with ≥ 1 physician visit for diabetes or hypertension between April 2008 and March 2014 were eligible for this study and included if they were new statin users and alive at least 455 days after the first statin dispensation. Group assignment was based on whether all statin dispensations in the first year were obtained from pharmacies with or without inducement programs. Discontinuation was defined as no statin dispensations between 275 and 455 days after the first statin dispensation. Acute coronary syndrome (ACS) hospitalizations or deaths were identified between 456 days and 3 years after the first statin dispensation. Multivariable regression analyses were conducted to examine relationships among inducement program use, discontinuation, and ACS events. Among the 159 998 new statin users, mean age was 60.2 (±13.7) years and 67 534 (42%) were women. Statin discontinuation occurred in 22 455 (28.9%) of 77 803 inducement group participants and 25 816 (31.4%) of 82 195 noninducement group participants (adjusted odds ratio = 0.88; 95% CI = 0.86-0.90). Risk of an ACS event was similar between groups (adjusted hazard ratio = 1.00; 95% CI 0.92-1.08); however, discontinuing statin therapy was associated with a higher risk of an ACS event (adjusted hazard ratio = 1.27; 95% CI = 1.16-1.39). Inducement programs are associated with better adherence and not directly associated with risk of health outcomes.

A case study of the Physics Enhancement Project for Two Year Colleges, its effects and outcomes on the teaching of undergraduate physics at two year colleges

NASA Astrophysics Data System (ADS)

Leif, Todd Robert

This dissertation reports on a naturalistic evaluation study of a series of NSF grant projects collectively known as PEPTYC -- Physics Enhancement Project for Two Year College Physics Instructors. The project encompassed seven different cycles of professional development occurring during the 1990's via May Institutes, held at Texas A&M University. Follow-up meetings were held at American Association of Physics Teachers - Texas Section Meetings. The research was conducted post hoc. The research evaluated the characteristics of effective professional development under an evaluation frame work designed by D.L. Kirkpatrick (1959) and adapted by the researcher to address issues that are pertinent to the professional development of faculty. This framework was adapted to be viewed through an educator's eye in an effort to ascertain the long term affects of the program and determine how the program affected the participants' attitudes, pedagogical knowledge, and instructional practices. The PEPTYC program philosophy was based on the premise, supported by research, that professional development programs addressing specific teaching practices are more successful than generic programs. Furthermore, professional development is more effective in helping teachers use alternative approaches when teachers are engaged in active learning experiences rather than passively listening to lectures or presentations. The naturalistic study was based on surveys and semi-structured interviews with 14 individuals who participated in PEPTYC workshops, as well as presenters of the PEPTYC program. The interviews were analyzed to describe how the PEPTYC project influenced the participants long after they had completed their training. This project can inform the development of similar evaluation studies of other professional development programs.

"I Didn't Know of a Better Way to Prepare to Teach": A Case Study of Paired Student Teaching Abroad

ERIC Educational Resources Information Center

Cross, Stephanie Behm; Dunn, Alyssa Hadley

2016-01-01

It has been a year since Sarah and Brian traveled to Malmo, Sweden, as part of a fellowship through their U.S. teacher preparation program. Their experience was unique and life changing, not only because it occurred in another country but because they completed their student teaching in a paired format. They planned and implemented all of their…

Reserve Component Programs, Fiscal Year 1987.

DTIC Science & Technology

1987-01-01

would fight. War- time missions are executed with United States and foreign forces, just as would occur &WV ft Ra RDdNemv cowei hr ~u~, FY M87 Exwutdm...Luxembourg Somalia Bermuda Greece Madagascar South Korea Bolivia Greenland Malaysia Spain Brazil Grenada Marshall Islands Sweden Cameroon Guam Mexico...Major Dell M. Dempsey, USMCR Ecuadoran Military attache in Panama 0 Colonel James V. Dugar, ANGUS * Young, Colonel Ralph R. (USAR) 0 Colonel

Effects of an age-specific anterior cruciate ligament injury prevention program on lower extremity biomechanics in children.

PubMed

DiStefano, Lindsay J; Blackburn, J Troy; Marshall, Stephen W; Guskiewicz, Kevin M; Garrett, William E; Padua, Darin A

2011-05-01

Implementing an anterior cruciate ligament injury prevention program to athletes before the age at which the greatest injury risk occurs (15-17 years) is important from a prevention standpoint. However, it is unknown whether standard programs can modify lower extremity biomechanics in pediatric populations or if specialized training is required. To compare the effects of traditional and age-specific pediatric anterior cruciate ligament injury prevention programs on lower extremity biomechanics during a cutting task in youth athletes. The authors hypothesized that the age-specific pediatric program would result in greater sagittal plane motion (ie, hip and knee flexion) and less motion in the transverse and frontal plane (ie, knee valgus, knee and hip rotation) as compared with the traditional program. Randomized controlled trial; Level of evidence, 1. Sixty-five youth soccer athletes (38 boys, 27 girls) volunteered to participate. The mean age of participants was 10 ± 1 years. Teams (n, 7) were cluster randomized to a pediatric injury prevention program, a traditional injury prevention program, or a control group. The pediatric program was modified from the traditional program to include more feedback, progressions, and variety. Teams performed their programs as part of their normal warm-up routine. Three-dimensional lower extremity biomechanics were assessed during a sidestep cutting task before and after completion of the 9-week intervention period. The pediatric program reduced the amount of knee external rotation at initial ground contact during the cutting task, F ((2,62)) = 3.79, P = .03 (change: pediatric, 7.73° ± 10.71°; control, -0.35° ± 7.76°), as compared with the control group after the intervention period. No other changes were observed. The injury prevention program designed for a pediatric population modified only knee rotation during the cutting task, whereas the traditional program did not result in any changes in cutting biomechanics. These findings suggest limited effectiveness of both programs for athletes younger than 12 years of age in terms of biomechanics during a cutting task.

Engaging diverse community college students in the geosciences through a year-round career mentoring and research workforce program

NASA Astrophysics Data System (ADS)

Sloan, V.; Barge, L. M.; Smith, M.

2017-12-01

Student attrition from STEM majors most often occurs in the first or second year of college. To retain underrepresented minority students who are largely enrolled in community colleges in STEM pathways, it is critical to provide hands-on experiences and exposure to STEM occupations in a supportive community, before the students transfer to four-year colleges. The goal of the Bridge to the Geosciences is to provide community college students with year-round career mentoring, exposure to different fields and organizations in the geosciences through small field or research experiences, and community-building within the cohort and in connection with a broader community of scientists. Each year, 20 students from Citrus College in Glendora, California participate in research "geomodules" organized around the planetary, atmospheric, ocean, and environmental science subfields of the geosciences at: (1) the Oak Crest Institute of Science, a chemistry research and diversity-oriented education organization in Monrovia, CA; (2) the NASA Jet Propulsion Laboratory (JPL), a NASA center in Pasadena, CA; (3) the University of Southern California's (USC) Wrigley Institute for Environmental Studies, a research center on Catalina Island; and (4) the University Corporation for Atmospheric Research (UCAR) in Boulder, CO. A peak experience of the program is a ten-day mini-internship at UCAR in Colorado where the students are immersed in atmospheric research, training, fieldwork, and presenting at a premier facility. Professional development, mentoring, science communication and cohort-development are woven across all four geomodules and throughout the year. This program is funded by the National Science Foundation's Improving Undergraduate STEM Education or IUSE program. Preliminary results indicate that the students' interest in the geosciences, confidence in their skills and identify as a scientist, and their sense of belonging to a cohort are increased by participation in this program.

The U.S. Antarctic and space programs, a useful alliance

NASA Astrophysics Data System (ADS)

Wilkniss, Peter E.

Antarctica has been called 'Space on Earth' because the continent's extreme isolation, combining with extremely low temperatures, alternating cycles of light and dark, and the lack of any naturally occurring life support, simulates planetary conditions. For scientists, the polar regions, particularly the Antarctic, are 'Earth's window to outer space.' Originally, this term applied to this study of the aurora and other phenomena related top solar-terrestrial interactions. Today this concept has broadened considerably to include research on processes occurring near or on the Earth, such as the study of solar ultra-violet radiation and related processes resulting from the depletion of stratospheric ozone above Antarctica or the investigation of high-energy solar or galactic particles from sites in central Antarctica. The alliance between the antarctic and space science can be traced to 1957-the year that Sputnik was launched and modern science programs began during the International Geophysical Year. The National Science Foundation (NSF) and the National Aeronautics and Space Administration (NASA) have a long history of cooperative projects in the Antarctic. This collaboration ranges from the use of satellite- based technology for communications, research weather observations, and data acquisition to testing and calibrating equipment that will be used aboard space crafts. In January 1991, the two agencies signed a Memorandum of Agreement that will extend this collaboration.

Behavior modification therapy in hyperactive children. Research and clinical implications.

PubMed

Wolraich, M L

1979-09-01

One hundred fifty-seven studies employing behavior modification in the management of hyperactive and disruptive children were reviewed. The studies were analyzed against standards of scientific validity. The review found: (1) behavior modification was effective in alleviating problem behaviors; (2) token programs were the most commonly used; (3) both positive reinforcement and punishment were effective; positive reinforcement, however, had the advantage of improving self-esteem; (4) behavioral problems occurring in the home most likely require a home-based program; (5) behavior modification and stimulant medication can be used simultaneously, often with additive effects; and (6) long-term benefits beyond one year have not been assessed.

Teaching College Physics at the Local Elementary School

NASA Astrophysics Data System (ADS)

Hagedorn, Eric A.

2006-12-01

For several years physics faculty at the University of Texas at El Paso (UTEP) have taught physics to pre-service elementary and middle school teachers in an unusual location: the local elementary school! The participating pre-service elementary and middle school teachers are typically in their last semester and are fully immersed in their internships (called "student teaching" elsewhere. See Fig. 1). Rather than bringing the students back to campus for class during four of their field semesters, UTEP sends education, mathematics, and physics faculty out to the schools as part of what is referred to as the "field-based program" (FBP) even though some of this program occurs on campus.

Residency Training in Robotic General Surgery: A Survey of Program Directors

PubMed Central

George, Lea C.; O'Neill, Rebecca

2018-01-01

Objective Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. Methods An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. Results 20 program directors were surveyed, a majority being from medium-sized programs (4–7 graduating residents per year). Most respondents (73.68%) had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%), with simulation training prior to console use (84.21%). About two-thirds of the respondents (63.16%) believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%). Conclusion A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training. PMID:29854454

Residency Training in Robotic General Surgery: A Survey of Program Directors.

PubMed

George, Lea C; O'Neill, Rebecca; Merchant, Aziz M

2018-01-01

Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. 20 program directors were surveyed, a majority being from medium-sized programs (4-7 graduating residents per year). Most respondents (73.68%) had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%), with simulation training prior to console use (84.21%). About two-thirds of the respondents (63.16%) believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%). A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

The effects of an exercise program on several abilities associated with driving performance in older adults.

PubMed

Marmeleira, José F; Godinho, Mário B; Fernandes, Orlando M

2009-01-01

The purpose of this study was to investigate the effects of participation in an exercise program on several abilities associated with driving performance in older adults. Thirty-two subjects were randomly assigned to either an exercise group (60-81 years, n=16) or a control group (60-82 years, n=16). The exercise program was planned to stress perceptive, cognitive, and physical abilities. It lasted 12 weeks with a periodicity of three sessions of 60 min per week. Assessments were conducted before and after the intervention on behavioral speed (in single- and dual-task conditions), visual attention, psychomotor performance, speed perception (time-to-contact), and executive functioning. Significant positive effects were found at 12-week follow-up resulting from participation in the exercise program. Behavioral speed improvements were found in reaction time, movement time, and response time (both in single- and dual-task conditions); visual attention improvements took place in speed processing and divided attention; psychomotor performance improvements occurred in lower limb mobility. These results showed that exercise is capable of enhancing several abilities relevant for driving performance and safety in older adults and, therefore, should be promoted.

Prognostic value of programmed electrical stimulation in Brugada syndrome: 20 years experience.

PubMed

Sieira, Juan; Conte, Giulio; Ciconte, Giuseppe; de Asmundis, Carlo; Chierchia, Gian-Battista; Baltogiannis, Giannis; Di Giovanni, Giacomo; Saitoh, Yukio; Irfan, Ghazala; Casado-Arroyo, Ruben; Juliá, Justo; La Meir, Mark; Wellens, Francis; Wauters, Kristel; Van Malderen, Sophie; Pappaert, Gudrun; Brugada, Pedro

2015-08-01

The prognostic value of electrophysiological investigations in individuals with Brugada syndrome remains controversial. Different groups have published contradictory data. Long-term follow-up is needed to clarify this issue. Patients presenting with spontaneous or drug-induced Brugada type I ECG and in whom programmed electric stimulation was performed at our institution were considered eligible for this study. A total of 403 consecutive patients (235 males, 58.2%; mean age, 43.2±16.2 years) were included. Ventricular arrhythmias during programmed electric stimulation were induced in 73 (18.1%) patients. After a mean follow-up time of 74.3±57.3 months (median 57.3), 25 arrhythmic events occurred (16 in the inducible group and 9 in the noninducible). Ventricular arrhythmias inducibility presented a hazard ratio for events of 8.3 (95% confidence interval, 3.6-19.4), P<0.01. Programmed ventricular stimulation of the heart is a good predictor of outcome in individuals with Brugada syndrome. It might be of special value to guide further management when performed in asymptomatic individuals. The overall accuracy of the test makes it a suitable screening tool to reassure noninducible asymptomatic individuals. © 2015 American Heart Association, Inc.

PROFAM now self-supporting.

PubMed

1984-01-01

Mexico's 6-year contraceptive social marketing organization, known as PROFAM, has realized its goal of becoming self supporting. The organization now serves a much smaller consumer base than during its past subsidized years, yet it has been selling a mix of products to reach self sufficiency. According to Luis de la Macorra, the director, the organization established its own manufacturing plant and office, and the program's cost is now sustained by sales revenues. PROFAM's current cost per couple-years-protection (CYP) compares favorably with other programs. PROFAM rebounded from 2 devastating setbacks to expand its operations, while trimming its cost per CYP from $18.60 US in 1979 to $2.85 (exclusive of contraceptives) in 1983. Both setbacks occurred in 1981, when a change of political administration led to a government withdrawal of support, abrupt cessation of US Agency for International Development financial backing, and a cancellation of the program's permits to sell all products but condoms. Cancelled products included an oral contraceptive as well as foam and cream spermicides and a vaginal suppository. In 1984 PROFAM once again began social marketing sales of pills and injectables and selling spermicides and IUDs at regular prices. Additionally, the program has begun to branch out, expanding its family planning clinics to cover marginally urban locales and selling both a broad line of medical equipment and various consumer goods. Since its creation in 1978, PROFAM has substantially increased consumer awareness of contraceptives.

H-alpha synoptic charts of solar activity during the first year of solar cycle 20, October 1964 - August 1965. [Skylab program

NASA Technical Reports Server (NTRS)

Mcintosh, P. S.

1975-01-01

Solar activity during the period October 28, 1964 through August 27, 1965 is presented in the form of charts for each solar rotation constructed from observations made with the chromospheric H-alpha spectra line. These H-alpha synoptic charts are identical in format and method of construction to those published for the period of Skylab observations. The sunspot minimum marking the start of Solar Cycle 20 occurred in October, 1964; therefore, charts represent solar activity during the first year of this solar cycle.

Fifty-Year Record of Glacier Change Reveals Shifting Climate in the Pacific Northwest and Alaska, USA

USGS Publications Warehouse

,

2009-01-01

Fifty years of U.S. Geological Survey (USGS) research on glacier change shows recent dramatic shrinkage of glaciers in three climatic regions of the United States. These long periods of record provide clues to the climate shifts that may be driving glacier change. The USGS Benchmark Glacier Program began in 1957 as a result of research efforts during the International Geophysical Year (Meier and others, 1971). Annual data collection occurs at three glaciers that represent three climatic regions in the United States: South Cascade Glacier in the Cascade Mountains of Washington State; Wolverine Glacier on the Kenai Peninsula near Anchorage, Alaska; and Gulkana Glacier in the interior of Alaska (fig. 1).

Treatment of an assaultive, sensory-impaired adolescent through a multicomponent behavioral program.

PubMed

Luiselli, J K

1984-03-01

This project examined the effects of a multicomponent behavioral treatment program on assaultive behavior in a deaf, visually-impaired adolescent boy. Two types of assaultiveness were monitored: aggression towards adults and destruction of the physical environment. Intervention consisted of a token economy system, a response cost procedure, a "relaxation" technique, and skill training sessions. Through use of a multiple baseline across behaviors design, it was demonstrated that differentially reinforcing the absence of target behaviors on a weekly basis was the crucial ingredient in the treatment package. During a maintenance programming phase, the boy was gradually weaned off the token system. At 1- and 2-year follow-ups, no aggressive or destructive acts had occurred and the boy was showing improved communication and interpersonal skills.

An Historical Perspective of the NERVA Nuclear Rocket Engine Technology Program

NASA Technical Reports Server (NTRS)

Robbins, W. H.; Finger, H. B.

1991-01-01

Nuclear rocket research and development was initiated in the United States in 1955 and is still being pursued to a limited extent. The major technology emphasis occurred in the decade of the 1960s and was primarily associated with the Rover/NERVA Program where the technology for a nuclear rocket engine system for space application was developed and demonstrated. The NERVA (Nuclear Engine for Rocket Vehicle Application) technology developed twenty years ago provides a comprehensive and viable propulsion technology base that can be applied and will prove to be valuable for application to the NASA Space Exploration Initiative (SEI). This paper, which is historical in scope, provides an overview of the conduct of the NERVA Engine Program, its organization and management, development philosophy, the engine configuration, and significant accomplishments.

CDC's DELTA FOCUS Program: Identifying Promising Primary Prevention Strategies for Intimate Partner Violence.

PubMed

Armstead, Theresa L; Rambo, Kirsten; Kearns, Megan; Jones, Kathryn M; Dills, Jenny; Brown, Pamela

2017-01-01

According to 2011 data, nearly one in four women and one in seven men in the United States experience severe physical violence by an intimate partner, creating a public health burden requiring population-level solutions. To prevent intimate partner violence (IPV) before it occurs, the CDC developed Domestic Violence Prevention Enhancements and Leadership Through Alliances, Focusing on Outcomes for Communities United with States to identify promising community- and societal-level prevention strategies to prevent IPV. The program funds 10 state domestic violence coalitions for 5 years to implement and evaluate programs and policies to prevent IPV by influencing the environments and conditions in which people live, work, and play. The program evaluation goals are to promote IPV prevention by identifying promising prevention strategies and describing those strategies using case studies, thereby creating a foundation for building practice-based evidence with a health equity approach.

Constellation Program Thermal and Environmental Control and Life Support System Status: 2009 - 2010

NASA Technical Reports Server (NTRS)

Williams, David E.; Carrasquillo, Robyn L.; Bagdigian, Robert M.

2009-01-01

The Constellation Program (CxP) consists of spacecrafts, launch vehicles, and support systems to execute the Exploration Architecture. The Program is currently divided into three distinct phases. The first phase is to develop a vehicle to provide limited cargo resupply capability and allow crew member rotation to the International Space Station (ISS). The second phase is to support the return of humans to the moon. The final phase is currently envisioned to allow the delivery of humans and cargo to Mars for an extended time. To implement this phased approach the CxP is currently working on the first vehicle and support systems to replace the Space Shuttle and allow continued access to space. This paper provides a summary of the CxP Thermal and Environmental Control and Life Support (ECLS) work that that has occurred across the different parts of the Program in support of these three phases over the past year.

The Massachusetts HIV, hepatitis, addiction services integration (HHASI) experience: responding to the comprehensive needs of individuals with co-occurring risks and conditions.

PubMed

Hoffman, Heidi L; Castro-Donlan, Carolyn A; Johnson, Victoria M; Church, Daniel R

2004-01-01

Categorical funding mechanisms traditionally used to fund public health programs are a challenge to providers serving individuals with complex needs that often span multiple service areas. Integration--a formalized, collaborative process among service systems--responds to the challenge by decreasing fragmentation of care and improving coordination. In 2000, the Massachusetts Department of Public Health (MDPH) received a one-year planning grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to evaluate opportunities for integrating HIV/AIDS programs and substance abuse treatment programs. The project was later expanded to include viral hepatitis programming. Outcomes include the development of a strategic plan, joint procurement initiatives, and an ongoing commitment to sustain inter-bureau integration efforts, even in the face of substantial budget reductions. Integrated approaches can promote greater efficiency, improving communication and coordination among clients, providers, and government funding agencies.

Effective Dose Calculation Program (EDCP) for the usage of NORM-added consumer product.

PubMed

Yoo, Do Hyeon; Lee, Jaekook; Min, Chul Hee

2018-04-09

The aim of this study is to develop the Effective Dose Calculation Program (EDCP) for the usage of Naturally Occurring Radioactive Material (NORM) added consumer products. The EDCP was developed based on a database of effective dose conversion coefficient and the Matrix Laboratory (MATLAB) program to incorporate a Graphic User Interface (GUI) for ease of use. To validate EDCP, the effective dose calculated with EDCP by manually determining the source region by using the GUI and that by using the reference mathematical algorithm were compared for pillow, waist supporter, eye-patch and sleeping mattress. The results show that the annual effective dose calculated with EDCP was almost identical to that calculated using the reference mathematical algorithm in most of the assessment cases. With the assumption of the gamma energy of 1 MeV and activity of 1 MBq, the annual effective doses of pillow, waist supporter, sleeping mattress, and eye-patch determined using the reference algorithm were 3.444 mSv year -1 , 2.770 mSv year -1 , 4.629 mSv year -1 , and 3.567 mSv year -1 , respectively, while those calculated using EDCP were 3.561 mSv year -1 , 2.630 mSv year -1 , 4.740 mSv year -1 , and 3.780 mSv year -1 , respectively. The differences in the annual effective doses were less than 5%, despite the different calculation methods employed. The EDCP can therefore be effectively used for radiation protection management in the context of the usage of NORM-added consumer products. Additionally, EDCP can be used by members of the public through the GUI for various studies in the field of radiation protection, thus facilitating easy access to the program. Copyright © 2018. Published by Elsevier Ltd.

[Tail Plane Icing

NASA Technical Reports Server (NTRS)

1997-01-01

The Aviation Safety Program initiated by NASA in 1997 has put greater emphasis in safety related research activities. Ice-contaminated-tailplane stall (ICTS) has been identified by the NASA Lewis Icing Technology Branch as an important activity for aircraft safety related research. The ICTS phenomenon is characterized as a sudden, often uncontrollable aircraft nose- down pitching moment, which occurs due to increased angle-of-attack of the horizontal tailplane resulting in tailplane stall. Typically, this phenomenon occurs when lowering the flaps during final approach while operating in or recently departing from icing conditions. Ice formation on the tailplane leading edge can reduce tailplane angle-of-attack range and cause flow separation resulting in a significant reduction or complete loss of aircraft pitch control. In 1993, the Federal Aviation Authority (FAA) and NASA embarked upon a four-year research program to address the problem of tailplane stall and to quantify the effect of tailplane ice accretion on aircraft performance and handling characteristics. The goals of this program, which was completed in March 1998, were to collect aerodynamic data for an aircraft tail with and without ice contamination and to develop analytical methods for predicting the effects of tailplane ice contamination. Extensive dry air and icing tunnel tests which resulted in a database of the aerodynamic effects associated with tailplane ice contamination. Although the FAA/NASA tailplane icing program generated some answers regarding ice-contaminated-tailplane stall (ICTS) phenomena, NASA researchers have found many open questions that warrant further investigation into ICTS. In addition, several aircraft manufacturers have expressed interest in a second research program to expand the database to other tail configurations and to develop experimental and computational methodologies for evaluating the ICTS phenomenon. In 1998, the icing branch at NASA Lewis initiated a second multi-phase research program for tailplane icing (TIP II) to develop test methodologies and tailplane performance and handling qualities evaluation tools. The main objectives of this new NASA/Industry/Academia collaborative research programs were: (1) define and evaluate a sub-scale wind tunnel test methodology for determining tailplane performance degradation due to icing. (2) develop an experimental database of tailplane aerodynamic performance with and without ice contamination for a range of tailplane configurations. Wind tunnel tests were planned with representative general aviation aircraft, i.e., the Learjet 45, and a twin engine low speed aircraft. This report summarizes the research performed during the first year of the study, and outlines the work tasks for the second year.

[Treatment of overweight. Use of a program].

PubMed

López de la Llave y Rodríguez, A; Ruiz González, M D; Conejo Olmedilla, M A

1998-01-01

This article publicizes the results of an overweight treatment program carried out as a working model under the auspices of Primary Health Care. This program placed special emphasis on educational aspects, preventive as well as promoting healthy ways of living; and one in which activities planned towards establishing means of conduct which play a direct role in their users health factors are focused on. This treatment program occurred as a group activity. The 27 participating subjects, 23 women and 4 men, were recommended by their doctor/nurse. Their average age was 37.6 years, +/- 11.3. 19 subjects were overweight with an IMC between 25 and 30; the other 8 had been diagnosed as obese with an IMC over 30. This program took place in the Health Center meeting hall over 4 months, from February through June. Among the elements of this program, these deserve special mention: the use of a vocabulary exempt of adverse connotations, for example, instead of diet we spoke of menus; the establishment of behavioral goals before weight loss goals; the practice of elaborating and designing hypercaloric menus; providing positive reinforcement for those behaviors which increased the level of physical activity which was objectively measured by means of podometers; the practice of eating slowly; etc. At the end of the program, the results showed an average weight loss of 4.2 kilograms, a range of 0.9 to 6.12 K, with respect to the average weight at the start of the program. One can foresee that this loss will continue to occur, especially in those cases where the subject had modified some habits such as eating rapidly or performing physical exercise related to overweightness. These results are open to discussion regarding the efficiency of the program and with regards to this program as an example of a coordinated effort between the Mental Health Unit and a Primary Health Care Team in relation to the design and implementation of health programs directed towards the attention of people with overweight problems.

New Directions in Space: A Report on the Lunar and Mars Initiatives

NASA Technical Reports Server (NTRS)

Seitz, Frederick; Hawkins, Willis; Jastrow, Robert; Nierenberg, William A.

1990-01-01

This report focuses on one aspect of the current space program: The establishment of a manned base on the Moon and the manned exploration of Mars. These missions were announced by the President last year as a major U.S. space policy objective to be implemented under the leadership of the Vice President, acting as Chairman of the National Space Council. On March 8, 1990, the White House released Presidential guidelines for the execution of the lunar and Mars programs. The guidelines stressed the need for new approaches and the development of innovative technologies with a potential for major cost, schedule and performance improvements. They also called for a competitive environment, with several years allotted to the definition of at least two significantly different human space exploration "reference architectures." Selection of the final technical concepts for the mission is scheduled to occur only after the relative merits of the competing reference architectures have been evaluated.

Federal immunization policy and funding: a history of responding to crises.

PubMed

Johnson, K A; Sardell, A; Richards, B

2000-10-01

This article outlines the history of federal immunization policy and funding, with a focus on discretionary federal funding under Section 317 of the Public Health Service Act, paying particular attention to the role of Congress in shaping the program in the past 2 decades. This review of funding trends and initiatives indicates that when both a presidential administration and key congressional actors viewed immunization as a priority and made sufficient funds available to support the public health delivery system and its infrastructure, coverage levels would continue to rise and disease levels continue to decline. From the beginning, immunization financing was explicitly structured as a federal-state-private-sector partnership. Section 317 program's statute has not changed much in 35 years, despite significant changes to the health care delivery system, other federal immunization activities, and rates of immunization coverage. Although the creation and implementation of the Vaccines for Children (VFC) program in the mid-1990s resulted in some congressional deliberations over immunization policies, no explicit restructuring of the 317 program occurred as a result. The Section 317 program retains its traditional authority and mission to address urgent needs, sustain public delivery systems, and provide funds for purchase of vaccines. The question remains whether the resources to sustain progress in immunization can be secured during times with no crisis, to ensure constant "readiness" in immunization (as in defense), or whether another epidemic must occur before the federal government is willing to commit optimal resources.

Evaluating and Understanding Parameterized Convective Processes and Their Role in the Development of Mesoscale Precipitation Systems

NASA Technical Reports Server (NTRS)

Fritsch, J. Michael (Principal Investigator); Kain, John S.

1995-01-01

Research efforts during the first year focused on numerical simulations of two convective systems with the Penn State/NCAR mesoscale model. The first of these systems was tropical cyclone Irma, which occurred in 1987 in Australia's Gulf of Carpentaria during the AMEX field program. Comparison simulations of this system were done with two different convective parameterization schemes (CPS's), the Kain-Fritsch (1993 - KF) and the Betts-Miller (Betts 1986- BM) schemes. The second system was the June 10-11 1985 squall line simulation, which occurred over the Kansas-Oklahoma region during the PRE-STORM experiment. Simulations of this system using the KF scheme were examined in detail.

Evaluating social marketing programs.

PubMed

1988-01-01

Contraceptive social marketing programs (CSM) which use commercial marketing techniques and distribution networks to sell contraceptives at subsidized prices, have become an important source of contraceptives in many developing countries. However, research is needed to determine the extent to which CSM programs are recruiting new users or simply serving as an alternate source for those who already use contraceptives. 1st begun in India in 1967, today CSM programs are selling contraceptives in more than 20 countries, mostly selling condoms because they do not require medical supervision or usually have to be registered with governments as a pharmaceutical product. Most also sell oral contraceptives. Advertising is used to promote the program, both brand and generic, about family planning and the advantages of small families. In some countries only generic promotion is permitted. A CSM program begins with research on the marketplace and needs of potential customers, including baseline studies, group discussions, and personal interviews. Monitoring is done by market research on usage, acceptability and adequacy of distribution. Focus groups and surveys are also used. Evaluation methodologies are similar to those used in program planning and monitoring, including consumer intercept surveys and tracking studies. Program impact is an area often neglected, probably because of the unusual relationship between the private and public sectors that occurs in CSM. Couple-years of protection is the common measurement of impact, estimated from sales data (13 cycles of pills or 100 condoms or doses of spermicide/year is assumed to prevent conception). This method can be used to assess the contributions of different methods and distribution systems and to compare their cost-effectiveness by calculating the cost per couple-year of protection provided. Limitations on this measurement method are inability to discriminate sporadic use from careful compliance; sales may be substitutes for obtaining contraceptives from other sources. Consumer-intercept surveys can distinguish "switchers" from users. National, household and census surveys can also have a few questions directly related to CSM and provide secondary data to measure program impact.

Incident cancers and late mortality in Australian children treated by allogeneic stem cell transplantation for non-malignant diseases.

PubMed

Nelson, Adam S; Vajdic, Claire M; Ashton, Lesley J; Le Marsney, Renate E; Nivison-Smith, Ian; Wilcox, Leonie; Dodds, Anthony J; O'Brien, Tracey A

2017-01-01

Hematopoietic stem cell transplantation (HSCT) is a life-saving procedure for children with a variety of non-malignant conditions. However, these children face an increased risk of late death and incident cancers after HSCT, which may occur many years after their initial HSCT. We examined cancer occurrence and late mortality in a population-based cohort of 318 Australian children who underwent allogeneic HSCT for non-malignant disease. Standardized incident ratios (SIRs) and standardized mortality ratios (SMRs) were calculated and compared with population controls. We identified six (1.9%) cancers at a median 9.2 years post-HSCT. Cancer occurred 15 times more frequently than in the general population (SIR 15.4, 95% CI = 6.9-34.2). Of the 198 patients who survived for at least 2 years post-HSCT, 11 (5.6%) died at a median 7.5 years post-HSCT. The mortality rate was 17 times higher than in the general population (SMR 17.5, 95% CI = 9.7-31.2). Children transplanted for non-malignant conditions require evidence-based survivorship programs to reduce excess morbidity and mortality. © 2016 Wiley Periodicals, Inc.

Subsidence and well failure in the South Belridge Diatomite field

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

Rouffignac, E.P. de; Bondor, P.L.; Karanikas, J.M. Hara, S.K.

1995-12-31

Withdrawal of fluids from shallow, thick and low strength rock can cause substantial reservoir compaction leading to surface subsidence and well failure. This is the case for the Diatomite reservoir, where over 10 ft of subsidence have occurred in some areas. Well failure rates have averaged over 3% per year, resulting in several million dollars per year in well replacement and repair costs in the South Belridge Diatomite alone. A program has been underway to address this issue, including experimental, modeling and field monitoring work. An updated elastoplastic rock law based on laboratory data has been generated which includes notmore » only standard shear failure mechanisms but also irreversible pore collapse occurring at low effective stresses (<150 psi). This law was incorporated into a commercial finite element geomechanics simulator. Since the late 1980s, a network of level survey monuments has been used to monitor subsidence at Belridge. Model predictions of subsidence in Section 33 compare very well with field measured data, which show that water injection reduces subsidence from 7--8 inches per year to 1--2 inches per year, but does not abate well failure.« less

Eta Carinae - A Demanding Mistress

NASA Technical Reports Server (NTRS)

Gull, Theodore R.

2011-01-01

Over the past 15 years, a number of observers and modelers have increasingly focused on this massive system that is approaching its end stage, a supernova? a hypernova? When? The discovery by Augusto Damineli that Eta Carinae had a 5.5-year period proved timely as the newly-installed STIS was primed to observe its properties in the visible and ultraviolet. Initial observations occurred on January 1998, and through multiple programs, including the multi-cycle Hubble Treasury program, have sampled changes across two cycles. Now a multi-cycle program, focused on mapping variations in the extended wind-wind collision zones through early 2015, will test 3-D models of the interacting winds. In parallel, studies have been accomplished in X-rays with RXTE and CHANDRA, now in the far infrared with Herschel and from the ground with VLT. Each new observation is helping to peel back the veil of mystery on this massive binary system, but also opening up more questions to be answered. Timely inclusion of laboratory studies and models have greatly enhanced the observational results. We will summarize the latest results including submitted papers and very recent results with Herschel.

Weight maintenance through behaviour modification with a cooking course or neurolinguistic programming.

PubMed

Sørensen, Lone Brinkmann; Greve, Tine; Kreutzer, Martin; Pedersen, Ulla; Nielsen, Claus Meyer; Toubro, Søren; Astrup, Arne

2011-01-01

We compared the effect on weight regain of behaviour modification consisting of either a gourmet cooking course or neurolinguistic programming (NLP) therapy. Fifty-six overweight and obese subjects participated. The first step was a 12-week weight loss program. Participants achieving at least 8% weight loss were randomized to five months of either NLP therapy or a course in gourmet cooking. Follow-up occurred after two and three years. Forty-nine participants lost at least 8% of their initial body weight and were randomized to the next step. The NLP group lost an additional 1.8 kg and the cooking group lost 0.2 kg during the five months of weight maintenance (NS). The dropout rate in the cooking group was 4%, compared with 26% in the NLP group (p=0.04). There was no difference in weight maintenance after two and three years of follow-up. In conclusion, weight loss in overweight and obese participants was maintained equally efficiently with a healthy cooking course or NLP therapy, but the dropout rate was lower during the active cooking treatment.

Hazelden's model of treatment and its outcome.

PubMed

Stinchfield, R; Owen, P

1998-01-01

Although the Minnesota Model of treatment for alcohol and drug addiction is a common treatment approach, there are few published reports of its effectiveness. This study describes the Minnesota Model treatment approach as practiced at Hazelden, a private residential alcohol and drug abuse treatment center located in Center City, Minnesota (a founding program of the Minnesota Model) and presents recent outcome results from this program. This study includes 1,083 male and female clients admitted to Hazelden for treatment of a psychoactive substance-use disorder between 1989 and 1991. The outcome study is a one group pretest/posttest design. Data collection occurred at admission to treatment and at 1-month, 6-month, and 12-month posttreatment. At 1-year follow-up, 53% reported that they remained abstinent during the year following treatment and an additional 35% had reduced their alcohol and drug use. These results are similar to those reported by other private treatment programs. The Minnesota Model has consistently yielded satisfactory outcome results, and future research needs to focus on the therapeutic process of this common treatment approach.

Dental laboratory technology education in China: current situation and challenges.

PubMed

Zheng, Liwei; Yue, Li; Zhou, Min; Yu, Haiyang

2013-03-01

Modern dentistry and dental education in China were first introduced from abroad by Dr. Lindsay in 1907. However, advancements in the field of dental laboratory technology did not occur to the same degree in specialties such as prosthodontics and orthodontics. Since the 1990s, orders from abroad demanding dental appliances surged as the image of China as the "world's factory" strengthened. The assembly line model, in which technicians work like simple procedure workers, was rapidly applied to denture production, while the traditional education system and apprenticeship systems demonstrated little progress in these years. The lack of advancement in dental laboratory technology education caused insufficient development in China's dental technology industry. In order to alter the situation, a four-year dental laboratory technology undergraduate educational program was established in 2005 by West China School of Stomatology, Sichuan University (WCSS, SCU). This program was based on SCU's undergraduate education and WCSS's junior college education systems. The program introduced scientific methods in relevant subjects into laboratory technicians' training and made many improvements in the availability of trained faculty, textbooks, laboratory facilities, and curriculum.

Achieving Full Scope of Practice Readiness Using Evidence for Psychotherapy Teaching in Web and Hybrid Approaches in Psychiatric Mental Health Advanced Practice Nursing Education.

PubMed

McCoy, Kathleen T

2018-01-01

Radical changes in role, education, and practice have affected how education of advance practice nurses and practice deliverables occur. This article examines the effects of distance education upon the teaching/learning of psychotherapy in integrating Web-based technology and platforms. With the advent and proliferation of online programs of study, the question begs: How do distance-linked programs successfully introduce, practice, and supervise one-to-one and group psychotherapy training? By employing evidence-based education strategies, technology, and strong interpersonal skills and evidence-based therapies, a charter Psychiatric Mental Health Nurse Practitioner Doctor of Nursing Practice program paved an innovative and successful path. In that program, they prepared their students for full scope of practice, upon graduation, inclusive of psychotherapy as well as the other highly demanding and compressed requirements of the 3-year program. This article explores that journey and its recommendations for application derived from this 2010 cohort. © 2017 Wiley Periodicals, Inc.

Impact of a nutrition intervention program on the growth and nutritional status of Nicaraguan adolescent girls.

PubMed

Pawloski, Lisa Renee; Moore, Jean Burley

2007-06-01

This research examines the impact of a nutrition education intervention program on the nutritional status and knowledge of Nicaraguan adolescent girls. Anthropometric measurements, hemoglobin values, and data concerning nutritional knowledge were collected from adolescent girls living in Managua, Nicaragua. Using a pre-test/post-test design, data are compared prior to and after the nutrition intervention program. When using Mexican American reference data, statistically significant differences in height-for-age z-scores and weight-for-age z-scores were found when comparing the entire sample of baseline data with data collected after three years of the nutrition intervention program (p < 0.05). Significant improvement was also found concerning the indicators of nutritional knowledge (p < 0.05). However, hemoglobin data revealed a significant decrease which may be due to specific environmental factors and pubertal changes. This research has implications concerning the development of successful adolescent focused nutrition intervention programs in Nicaragua, and examines the possibility that catch-up growth occurs during adolescence.

Effectiveness of the Civil Aviation Security Program.

DTIC Science & Technology

1979-04-25

the airline and airport security measures in effect. Moreover, of the 25 U.S. airline hijackings that occurred over this 6-year period, none was caused...Furthermore, it is estimated that 75 hijackings or related crimes may have been prevented by the airline and airport security measures in effect...system. Moreover, it is estimated that at least 75 hijackings or related crimes may have been prevented by U.S. airline and airport security measures

People, wings, and forests: an international program for conservation of migratory birds and their habitats to benefit people

Treesearch

Jack C. Capp

2005-01-01

One in eight bird species in the world have a real risk of becoming extinct in the next 100 years (Birdlife International 2000). About three-fourths of these species occur in forests and over half of these species suffer from severe fragmentation of their habitats. Tropical deforestation is the major reason for bird decline in the world (Youth 2003). Almost half the...

Marine Fuel Cell Technology Verification Trainer Program: Operator Curriculum Development

DTIC Science & Technology

2004-06-01

collection of tnormiratin is estimiate to average 1 hour per response, Including the time INr reviewing InatruCtlona. ear-ching existing =ata aourcas...guidelines and standards are provided. With the anticipation that up to several years’ delay will occur between the time of this report and the maturity of...reference only, given as foundation sources available at the time of this project. The supplemental references to published materials are considered the

Take Your Child to Work Day Shows Children that Science Is Fun | Poster

Cancer.gov

There’s still time to register your child for NCI at Frederick’s annual Take Your Child to Work Day, which will be held on Wednesday, June 27. Children who attend will be able to choose from nearly 30 activities this year. Several programs are scheduled to occur at various locations throughout the day, while others will be open on a “come as you please” basis all day long.

Why does cervical cancer occur in a state-of-the-art screening program?

PubMed

Castle, Philip E; Kinney, Walter K; Cheung, Li C; Gage, Julia C; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas S; Wentzensen, Nicolas; Befano, Brian; Schussler, John; Katki, Hormuzd A; Schiffman, Mark

2017-09-01

The goal of cervical screening is to detect and treat precancers before some become cancer. We wanted to understand why, despite state-of-the-art methods, cervical cancers occured in relationship to programmatic performance at Kaiser Permanente Northern California (KPNC), where >1,000,000 women aged ≥30years have undergone cervical cancer screening by triennial HPV and cytology cotesting since 2003. We reviewed clinical histories preceding cervical cancer diagnoses to assign "causes" of cancer. We calculated surrogate measures of programmatic effectiveness (precancers/(precancers and cancers)) and diagnostic yield (precancers and cancers per 1000 cotests), overall and by age at cotest (30-39, 40-49, and ≥50years). Cancer was rare and found mainly in a localized (treatable) stage. Of 623 cervical cancers with at least one preceding or concurrent cotest, 360 (57.8%) were judged to be prevalent (diagnosed at a localized stage within one year or regional/distant stage within two years of the first cotest). Non-compliance with recommended screening and management preceded 9.0% of all cancers. False-negative cotests/sampling errors (HPV and cytology negative), false-negative histologic diagnoses, and treatment failures preceded 11.2%, 9.0%, and 4.3%, respectively, of all cancers. There was significant heterogeneity in the causes of cancer by histologic category (p<0.001 for all; p=0.002 excluding prevalent cases). Programmatic effectiveness (95.3%) and diagnostic yield were greater for squamous cell versus adenocarcinoma histology (p<0.0001) and both decreased with older ages (p trend <0.0001). A state-of-the-art intensive screening program results in very few cervical cancers, most of which are detected early by screening. Screening may become less efficient at older ages. Copyright © 2017 Elsevier Inc. All rights reserved.

Assessment of Creep Capability of HSR-EPM Turbine Airfoil Alloys

NASA Technical Reports Server (NTRS)

MacKay, Rebecca A.; Garg, Anita; Ritzert, Frank J.; Locci, Ivan E.

2007-01-01

The High Speed Civil Transport (HSCT) mission of the High Speed Research-Enabling Propulsion Materials (HSR-EPM) Program represented a unique challenge for turbine airfoil materials because the highest operating temperatures occur during climb and supersonic cruise. The accumulated hot time of an HSCT engine before overhaul is many thousands of hours. This is significantly different from subsonic engines, where the maximum operating temperatures occur during takeoff and thrust reverse after landing, and the accumulated hot time before overhaul is about 300 hr. The goal of airfoil alloy development under the HSR-EPM Program was to develop an alloy with a 75 F increase in creep rupture capability over the average Rene N5/PWA 1484 baseline. Airfoil alloy development under the HSR-EPM Program pursued a path that led to evolutionary mechanical behavior improvements, resulting from increased amounts of high density, refractory metals. The purpose of the present paper is to describe the experimental work that was performed at NASA Glenn Research Center after the HSR-EPM Program ended. Emphasis will be placed on the creep behavior of coated specimens, as well as on the development and progression of phase instabilities during creep deformation. Mitigation techniques that were used to reduce phase instabilities are also discussed. Most of the work described in this report was performed at NASA Glenn during the years 2000 and 2001.

Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up.

PubMed

Berggren, M; Stenvall, M; Olofsson, B; Gustafson, Y

2008-06-01

A randomized, controlled fall-prevention study including 199 patients operated on for femoral neck fracture reduced inpatient falls and injuries. No statistically significant effects of the intervention program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone old people. This study evaluates whether a postoperative multidisciplinary, multifactorial fall-prevention program performed by a geriatric team that reduced inpatient falls and injuries had any continuing effect after discharge. The intervention consisted of staff education, systematic assessment and treatment of fall risk factors and vitamin D and calcium supplementation. The randomized, controlled trial with a one-year follow-up at Umeå University Hospital, Sweden, included 199 patients operated on for femoral neck fracture, aged > or = 70 years. After one year 44 participants had fallen 138 times in the intervention group compared with 55 participants and 191 falls in the control group. The crude postoperative fall incidence was 4.16/1,000 days in the intervention group vs. 6.43/1,000 days in the control group. The incidence rate ratio was 0.64 (95% CI: 0.40-1.02, p = 0.063). Seven new fractures occurred in the intervention group and 11 in the control group. A team applying comprehensive geriatric assessment and rehabilitation, including prevention and treatment of fall-risk factors, reduced inpatient falls and injuries, but no statistically significant effects of the program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone elderly.

Leaflets and continual educational offerings led to increased coverage rate of newborn hearing screening in Akita.

PubMed

Sato, Teruyuki; Nakazawa, Misao; Takahashi, Shin; Mizuno, Tomomi; Sato, Akira; Noguchi, Atsuko; Sato, Megumi; Katagiri, Sadako; Yamada, Takechiyo

2018-08-01

Newborn hearing screening (NHS) has been actively performed in Japan since 2001. The NHS coverage rate has increased each year in Akita Prefecture. We analyzed the details of the NHS program and how the Akita leaflets and the many educational offerings about the importance of NHS led to the high NHS coverage rate. A retrospective study was conducted in liveborn newborns in hospitals and in clinics where hearing screening was performed from the program's beginning in 2001 through the end of 2015. We describe the chronological history of NHS. The outcome data of NHS were collected from our department and analyzed. From the founding of the program in 2001 to 2015, the live birth rate in Akita continually declined. Nevertheless, the number of infants receiving NHS rose each year. Since 2012, the coverage rate of NHS has been over 90%. From 2001 to 2015, 75,331 newborns constituted the eligible population for the NHS program. Since 2012, the number of NHS tests has stabilized. We prepared educational leaflets for Akita Prefecture early in 2002. We also provided many educational classes about the importance of NHS for not only pregnant women but also professionals including obstetricians and gynecologists, pediatricians and municipal staff members. The NHS program received the complete endorsement of the Akita Association of Obstetricians and Gynecologists in 2010. The largest increase in the NHS coverage rate occurred from 2001 to 2002, and the second largest increase occurred from 2009 to 2010. The number of participating institutions increased the coverage rate. The coverage rate is strongly correlated with the number of participating institutions (rs=0.843, p<0.001, Spearman's rank correlation coefficient). Comparing the coverage rate for 5 years before and after the Akita Association of Obstetricians and Gynecologists reached their consensus on the importance of NHS, the coverage rate after 2010 was significantly higher than before 2010 (p<0.001, paired sample t-test). The NHS coverage rate ultimately reached 95.4% without need for legislation or subsidization. The number of participating institutions increased each year, and the number of NHS tests and the coverage rate increased proportionately. The number of participating institutions statistically has a strong correlation with the number of NHS tests and the coverage rate. Our research indicates that the Akita leaflets and the provision of educational sessions about the importance of NHS were the most significant factors in establishing the high NHS coverage rate. Copyright © 2017 Elsevier B.V. All rights reserved.

Heart failure disease management program experience in 4,545 heart failure admissions to a community hospital.

PubMed

Pazin-Filho, Antonio; Peitz, Pamela; Pianta, Thomas; Carson, Kathryn A; Russell, Stuart D; Boulware, Leigh Ebony; Coresh, Josef

2009-09-01

Disease management programs (DMPs) are developed to address the high morbi-mortality and costs of congestive heart failure (CHF). Most studies have focused on intensive programs in academic centers. Washington County Hospital (WCH) in Hagerstown, MD, the primary reference to a semirural county, established a CHF DMP in 2001 with standardized documentation of screening and participation. Linkage to electronic records and state vital statistics enabled examination of the CHF population including individuals participating and those ineligible for the program. All WCH inpatients with CHF International Classification of Diseases, Ninth Revision code in any position of the hospital list discharged alive. Of 4,545 consecutive CHF admissions, only 10% enrolled and of those only 52.2% made a call. Enrollment in the program was related to: age (OR 0.64 per decade older, 95% CI 0.58-0.70), CHF as the main reason for admission (OR 3.58, 95% CI 2.4-4.8), previous admission for CHF (OR 1.14, 95% CI 1.09-1.2), and shorter hospital stay (OR 0.94 per day longer, 95% CI 0.87-0.99). Among DMP participants mortality rates were lowest in the first month (80/1000 person-years) and increased subsequently. The opposite mortality trend occurred in nonenrolled groups with mortality in the first month of 814 per 1000 person-years in refusers and even higher in ineligible (1569/1000 person-years). This difference remained significant after adjustment. Re-admission rates were lower among participants who called consistently (adjusted incidence rate ratio 0.62, 95% CI 0.52-0.77). Only a small and highly select group participated in a low-intensity DMP for CHF in a community-based hospital. Design of DMPs should incorporate these strong selective factors to maximize program impact.

Establishment of a Canine Rabies Burden in Haiti through the Implementation of a Novel Surveillance Program

PubMed Central

Wallace, Ryan M; Reses, Hannah; Franka, Richard; Dilius, Pierre; Fenelon, Natael; Orciari, Lillian; Etheart, Melissa; Destine, Apollon; Crowdis, Kelly; Blanton, Jesse D; Francisco, Calvin; Ludder, Fleurinord; Del Rio Vilas, Victor; Haim, Joseph; Millien, Max

2015-01-01

The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average. In 2013, Haiti initiated a community-based animal rabies surveillance program comprised of two components: active community bite investigation and passive animal rabies investigation. From January 2013 –December 2014, 778 rabies suspect animals were reported for investigation. Rabies was laboratory-confirmed in 70 animals (9%) and an additional 36 cases were identified based on clinical diagnosis (5%), representing an 18-fold increase in reporting of rabid animals compared to the three years before the program was implemented. Dogs were the most frequent rabid animal (90%). Testing and observation ruled out rabies in 61% of animals investigated. A total of 639 bite victims were reported to the program and an additional 364 bite victims who had not sought medical care were identified during the course of investigations. Only 31% of people with likely rabies exposures had initiated rabies post-exposure prophylaxis prior to the investigation. Rabies is a neglected disease in-part due to a lack of surveillance and understanding about the burden. The surveillance methods employed by this program established a much higher burden of canine rabies in Haiti than previously recognized. The active, community-based bite investigations identified numerous additional rabies exposures and bite victims were referred for appropriate medical care, averting potential human rabies deaths. The use of community-based rabies surveillance programs such as HARSP should be considered in canine rabies endemic countries. PMID:26600437

Operation CeaseFire-New Orleans: an infectious disease model for addressing community recidivism from penetrating trauma.

PubMed

McVey, Erin; Duchesne, Juan C; Sarlati, Siavash; O'Neal, Michael; Johnson, Kelly; Avegno, Jennifer

2014-07-01

CeaseFire, using an infectious disease approach, addresses violence by partnering hospital resources with the community by providing violence interruption and community-based services for an area roughly composed of a single city zip code (70113). Community-based violence interrupters start in the trauma center from the moment penetrating trauma occurs, through hospital stay, and in the community after release. This study interprets statistics from this pilot program, begun May 2012. We hypothesize a decrease in penetrating trauma rates in the target area compared with others after program implementation. This was a 3-year prospective data collection of trauma registry from May 2010 to May 2013. All intentional, target area, penetrating trauma treated at our Level I trauma center received immediate activation of CeaseFire personnel. Incidences of violent trauma and rates of change, by zip code, were compared with the same period for 2 years before implementation. During this period, the yearly incidence of penetrating trauma in Orleans Parish increased. Four of the highest rates were found in adjacent zip codes: 70112, 70113, 70119, and 70125. Average rates per 100,000 were 722.7, 523.6, 286.4, and 248, respectively. These areas represent four of the six zip codes citywide that saw year-to-year increases in violent trauma during this period. Zip 70113 saw a lower rate of rise in trauma compared with 70112 and a higher but comparable rise compared with that of 70119 and 70125. Hospital-based intervention programs that partner with culturally appropriate personnel and resources outside the institution walls have potential to have meaningful impact over the long term. While few conclusions of the effect of such a program can be drawn in a 12-month period, we anticipate long-term changes in the numbers of penetrating injuries in the target area and in the rest of the city as this program expands. Therapeutic study, level IV.

Sun-Earth Day: Growth and Impact of NASA E/PO Program

NASA Astrophysics Data System (ADS)

Hawkins, I.; Thieman, J.

2004-12-01

Over the past six years, the NASA Sun-Earth Connection Education Forum has sponsored and coordinated education public outreach events to highlight NASA Sun-Earth Connection research and discoveries. Our strategy involves using celestial phenomena, such as total solar eclipses and the Transit of Venus to celebrate Sun-Earth Day, a popular Education and Public Outreach international program. Sun-Earth Day also focuses attention on Equinoxes and Solstices to engage K-12 schools and the general public in space science activities, demonstrations, and interactions with space scientists. In collaboration with partners that include the Exploratorium, Maryland Science Center, NASA Connect, Sun-Earth Connection missions, Ideum, and others, we produce webcasts, other multi-media, and print resources for use by school and informal educators nation-wide. We provide training and professional development to K-12 educators, museum personnel, amateur astronomers, Girl Scout leaders, etc., so they can implement their own outreach programs taking advantage of our resources. A coordinated approach promotes multiple programs occurring each year under a common theme. We will report lessons learned from several years of experience, and strategies for growth and sustainability. We will also share our plans for "Ancient Observatories - Timeless Knowledge" our theme for Sun-Earth Day 2005, which will feature solar alignments at ancient sites that mark the equinoxes and/or solstices. The video and webcast programming will feature several sites including: Chaco Canyon (New Mexico), Hovenweep (Utah), and Chichen Itza (Mexico). Many of these sites present unique opportunities to develop authentic cultural connections to Native Americans, highlighting the importance of the Sun across the ages.

Predictors of Survival among Adult Ethiopian Patients in the National ART Program at Seven University Teaching Hospitals: A Prospective Cohort Study.

PubMed

Fekade, Daniel; Weldegebreal, Teklu; Teklu, Alula M; Damen, Melake; Abdella, Saro; Baraki, Nega; Belayhun, Bekele; Berhan, Eyoel; Kebede, Amha; Assefa, Yibeltal

2017-02-01

In Ethiopia, the publicly funded antiretroviral treatment (ART) program was started in 2005. Two hundred seventy-five thousand patients were enrolled in the national ART program by 2012. However, there is limited data on mortality and predictors of death among adult patients in the ART program. The study aimed to estimate mortality and risk factors for death among adult, ART-naïve patients, started in the national ART program from January 2009 to July 2013. Multi-site, prospective, observational cohort study of adult, age > 18 years, ART-naïve patients, started in the national ART program at seven university-affiliated hospitals from January 2009 - July 2013. Kaplan-Meier and Cox regression analyses were used to estimate survival and determine risk factors for death. A total of 976 patients, 594 females (60.9 %), were enrolled into the study. Median age of the cohort was 33years. The median CD4 count at start of ART was 144 cells/µl (interquartile range (IQR) 78-205), and 34.2% (330/965) had CD4 < 100. Sixty-three percent (536/851) had viral load greater than 5 log copies/ml (IQR 4.7-5.7) at base line. One hundred and one deaths were recorded during follow-up period, all-cause mortality rate 10.3%; 5.4 deaths/100 person years of observation, 95% confidence interval 4.4-6.5. Seventy percent of the deaths occurred within six months of starting ART. Cox regression analyses showed that the following measures independently predicted mortality: age >51 years, (Adjusted Hazard Ratio (AHR) 4.01, P=0.003), WHO stages III&IV, (AHR 1.76, p = 0.025), CD4 count, <100, (AHR 2.36, p =0.006), and viral load >5 log copies /ml (CHR 1.71, p = 0.037). There is high early on- ART mortality in patients presenting with advanced immunodeficiency. Detecting cases and initiating ART before onset of advanced immunodeficiency might improve survival.

[Provide comprehensive service for state policy].

PubMed

Wu, X

1991-04-01

In recent years, Chinese insurance companies introduced family planning (FP) insurance series. These schemes originated from the "one child" and life insurance and accident insurance of the early 1980s, which were established in response to the need that came with the "one child" policy. In order to help relieve the difficulties of rural FP work, the People's Insurance Corporation extended these programs to a series of schemes. These schemes included e.g., and old age security program for the families with 1 daughter only, old age security for families with an only child, and the program for FP workers' personal safety. The purpose of these schemes was to guarantee security in old age for families with few children, to ensure compensation if accident occurs during delivery or as a result of birth control operations; and compensation for FP workers for physical assaults they encountered. As FP organizations have been directly involved in advertising the insurance programs, there has been support from local governments with human and financial resources, and these insurance programs have been expanding every year. The payment of the policy has been either entirely or partially borne by the employers of the insured. In the process of the development of the insurance program, some problems have occurred. 1st, competition between FP organizations and insurance companies have evolved in sponsoring the program for its profit. 2nd, some media reports have confused the payment of premiums with the compulsory levy of undue fees, which in a way, hindered the expansion of program enrollment. 3rd, some local administrations are short of funds to pay for the insurance premiums. 4th, the accrued income from the premiums is lower than the expected sum of the principle and interest if the same funds were deposited in a bank at current interest rate. Therefore, some schemes lack appeal. FP series insurance is a longer term program which will have an important impact on the realization of the aim of population policy, and on the welfare of the population. The government should give adequate emphasis to the management of the program. The fund from the policy premiums could be used in high return and low risk investment in order to increase the appeal of the insurance schemes. Besides the current resources for the payment of premiums, funds from government allocation, penalty payment from those who have birth above the quota, one-child allowance, donations from communities or individuals, and income from special lotteries could also be used to pay the premiums.

Effect of the Garrett Lee Smith Memorial Suicide Prevention Program on Suicide Attempts Among Youths.

PubMed

Godoy Garraza, Lucas; Walrath, Christine; Goldston, David B; Reid, Hailey; McKeon, Richard

2015-11-01

Youth suicide prevention is a major public health priority. Studies documenting the effectiveness of community-based suicide prevention programs in reducing the number of nonlethal suicide attempts have been sparse. To determine whether a reduction in suicide attempts among youths occurs following the implementation of the Garrett Lee Smith Memorial Suicide Prevention Program (hereafter referred to as the GLS program), consistent with the reduction in mortality documented previously. We conducted an observational study of community-based suicide prevention programs for youths across 46 states and 12 tribal communities. The study compared 466 counties implementing the GLS program between 2006 and 2009 with 1161 counties that shared key preintervention characteristics but were not exposed to the GLS program. The unweighted rounded numbers of respondents used in this analysis were 84 000 in the control group and 57 000 in the intervention group. We used propensity score-based techniques to increase comparability (on background characteristics) between counties that implemented the GLS program and counties that did not. We combined information on program activities collected by the GLS national evaluation with information on county characteristics from several secondary sources. The data analysis was performed between April and August 2014. P < .05 was considered statistically significant. Comprehensive, multifaceted suicide prevention programs, including gatekeeper training, education and mental health awareness programs, screening activities, improved community partnerships and linkages to service, programs for suicide survivors, and crisis hotlines. Suicide attempt rates for each county following implementation of the GLS program for youths 16 to 23 years of age at the time the program activities were implemented. We obtained this information from the National Survey on Drug Use and Health administered to a large national probabilistic sample between 2008 and 2011. Counties implementing GLS program activities had significantly lower suicide attempt rates among youths 16 to 23 years of age in the year following implementation of the GLS program than did similar counties that did not implement GLS program activities (4.9 fewer attempts per 1000 youths [95% CI, 1.8-8.0 fewer attempts per 1000 youths]; P = .003). More than 79 000 suicide attempts may have been averted during the period studied following implementation of the GLS program. There was no significant difference in suicide attempt rates among individuals older than 23 years during that same period. There was no evidence of longer-term differences in suicide attempt rates. Comprehensive GLS program activities were associated with a reduction in suicide attempt rates. Sustained suicide prevention programming efforts may be needed to maintain the reduction in suicide attempt rates.

Unexpected plateauing of childhood obesity rates in developed countries

PubMed Central

2014-01-01

Surveys performed in the past 10 to 15 years show a yet unexplained stabilization or decline in prevalence rates of childhood obesity in developed countries. The projected continuous increase in obesity prevalence throughout future decades seems not to occur at present. Apparently, saturation has been reached, which might be related to societal adjustments. Hence, we postulate a cumulative effect of public health programs for obesity prevention resulting, for example, in an increase in physical activity, and a decline in television viewing and in the consumption of sugar-sweetened soft drinks by children. Effective public health programs are urgently needed for developing countries, where obesity rates in children still continued to increase during the past decade. PMID:24485015

Building Resilience After School for Early Adolescents in Urban Poverty: Open Trial of Leaders @ Play.

PubMed

Frazier, Stacy L; Dinizulu, Sonya Mathies; Rusch, Dana; Boustani, Maya M; Mehta, Tara G; Reitz, Kristin

2015-11-01

Leaders @ Play is a park after-school program for urban middle school youth designed to leverage recreational activities for social emotional learning. Mental health and park staff co-facilitated sports and games to teach and practice problem solving, emotion regulation, and effective communication. Additional practice occurred during multi-family groups and summer internships as junior camp counselors. We examined feasibility and promise via an open trial (n = 3 parks, 46 youth, 100 % African American, 100 % low-income, 59 % female, M = 13.09 years old). Improvements in social skills and reductions in problem behaviors lend support to after school programs as a space for mental health promotion.

Recent trends in psychiatry residency workforce with special reference to international medical graduates.

PubMed

Rao, Nyapati R

2003-01-01

This study examines trends in the supply, distribution, and demographics of psychiatry residents during the 1990s. It evaluates the extent to which the predicted downsizing of psychiatry residency training programs actually occurred and how it affected training programs of different sizes and locations. Data for this study were obtained from the American Medical Association's (AMA) Annual Survey of Graduate Medical Education (GME) Programs, the AMA GME directory, and the APA Graduate Medical Census. The study compares the roles played by international medical graduates (IMGs) in contrast to U.S. medical graduates (USMGs) in these trends. There was a significant decline in the number of residents during the years studied. The median training program size also decreased. International medical graduates found broad acceptance in training programs of all locations and sizes, including medical school based programs. Implications of the findings are discussed regarding the impact of current graduate medical education (GME) and immigration policies on future workforce patterns. The field will have to decide whether it can afford anymore residency downsizing in light of emerging evidence of a shortage of psychiatrists.

Realistic expectations for public access defibrillation programs.

PubMed

Atkins, Dianne L

2010-06-01

Public access defibrillation programs have increased dramatically over the past 15 years. This review will focus on their effectiveness and operational characteristics and discuss the characteristics of successful programs, which can improve outcomes. Automated external defibrillators increase survival from cardiac arrest when used by a bystander. Recent studies show that the best outcomes are achieved when devices are placed in areas with a high frequency of cardiac arrest and there is ongoing supervision with emergency plans and cardiopulmonary resuscitation training. Programs are cost-effective under these circumstances, but become very inefficient when placed in areas of low risk. There are few adverse events related to the public access defibrillation programs and volunteers are not harmed. Unguided placement results in devices not being used and a decline in organizational structure of the program. As most cardiac arrests occur in the home, the impact on overall survival remains low. Automated external defibrillators are highly effective at reducing death from ventricular fibrillation and easy access in public areas is most effective. Placement must be prioritized based on public health impact and characteristics of the community.

Pregnant Employee Protection Program in a Large Chemical Company.

PubMed

Frey, Gunild; Schuster, Michael; Oberlinner, Christoph; Queier-Wahrendorf, Annette; Lang, Stefan; Yong, Mei

2015-09-01

To assess whether a structured employee protection program for pregnant workers at a chemical company has an impact on pregnancy outcomes. Reported pregnancies (n = 1402) between 2003 and 2010 and their outcomes were documented using questionnaires at the time of pregnancy report, end of pregnancy, and 1 year later. Potential maternal exposures were assessed using job histories, workplace inspections, and questionnaires. Participation was 86% overall and was consistently high across subgroups.Pregnancy losses (10.9%), pregnancy complications, and preterm births (8.1%) were in agreement with rates in the general population and were independent of type of work and maternal exposure category. Pregnancy complication rates in this chemical company are not statistically elevated than that in the general population, as suggested in a previous study. The protection program may play a role in preventing complications that may have occurred.

Fractional Consumption of Liquid Hydrogen and Liquid Oxygen During the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Partridge, Jonathan K.

2011-01-01

The Space Shuttle uses the propellants, liquid hydrogen and liquid oxygen, to meet part of the propulsion requirements from ground to orbit. The Kennedy Space Center procured over 25 million kilograms of liquid hydrogen and over 250 million kilograms of liquid oxygen during the 3D-year Space Shuttle Program. Because of the cryogenic nature of the propellants, approximately 55% of the total purchased liquid hydrogen and 30% of the total purchased liquid oxygen were used in the Space Shuttle Main Engines. The balance of the propellants were vaporized during operations for various purposes. This paper dissects the total consumption of liqUid hydrogen and liqUid oxygen and determines the fraction attributable to each of the various processing and launch operations that occurred during the entire Space Shuttle Program at the Kennedy Space Center.

Serotype-Specific Changes in Invasive Pneumococcal Disease after Pneumococcal Conjugate Vaccine Introduction: A Pooled Analysis of Multiple Surveillance Sites

PubMed Central

Feikin, Daniel R.; Kagucia, Eunice W.; Loo, Jennifer D.; Link-Gelles, Ruth; Puhan, Milo A.; Cherian, Thomas; Levine, Orin S.; Whitney, Cynthia G.; O’Brien, Katherine L.; Moore, Matthew R.

2013-01-01

Background Vaccine-serotype (VT) invasive pneumococcal disease (IPD) rates declined substantially following introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into national immunization programs. Increases in non-vaccine-serotype (NVT) IPD rates occurred in some sites, presumably representing serotype replacement. We used a standardized approach to describe serotype-specific IPD changes among multiple sites after PCV7 introduction. Methods and Findings Of 32 IPD surveillance datasets received, we identified 21 eligible databases with rate data ≥2 years before and ≥1 year after PCV7 introduction. Expected annual rates of IPD absent PCV7 introduction were estimated by extrapolation using either Poisson regression modeling of pre-PCV7 rates or averaging pre-PCV7 rates. To estimate whether changes in rates had occurred following PCV7 introduction, we calculated site specific rate ratios by dividing observed by expected IPD rates for each post-PCV7 year. We calculated summary rate ratios (RRs) using random effects meta-analysis. For children <5 years old, overall IPD decreased by year 1 post-PCV7 (RR 0·55, 95% CI 0·46–0·65) and remained relatively stable through year 7 (RR 0·49, 95% CI 0·35–0·68). Point estimates for VT IPD decreased annually through year 7 (RR 0·03, 95% CI 0·01–0·10), while NVT IPD increased (year 7 RR 2·81, 95% CI 2·12–3·71). Among adults, decreases in overall IPD also occurred but were smaller and more variable by site than among children. At year 7 after introduction, significant reductions were observed (18–49 year-olds [RR 0·52, 95% CI 0·29–0·91], 50–64 year-olds [RR 0·84, 95% CI 0·77–0·93], and ≥65 year-olds [RR 0·74, 95% CI 0·58–0·95]). Conclusions Consistent and significant decreases in both overall and VT IPD in children occurred quickly and were sustained for 7 years after PCV7 introduction, supporting use of PCVs. Increases in NVT IPD occurred in most sites, with variable magnitude. These findings may not represent the experience in low-income countries or the effects after introduction of higher valency PCVs. High-quality, population-based surveillance of serotype-specific IPD rates is needed to monitor vaccine impact as more countries, including low-income countries, introduce PCVs and as higher valency PCVs are used. Please see later in the article for the Editors' Summary PMID:24086113

Hospital-Based Mortality in Federal Capital Territory Hospitals-Nigeria, 2005 - 2008

PubMed Central

Preacely, Nykiconia; Biya, Oladayo; Gidado, Saheed; Ayanleke, Halima; Kida, Mohammed; Akhimien, Moses; Abubakar, Aisha; Kurmi, Ibrahim; Ajayi, Ikeoluwapo; Nguku, Patrick; Akpan, Henry

2012-01-01

Background Cause-specific mortality data are important to monitor trends in mortality over time. Medical records provide reliable documentation of the causes of deaths occurring in hospitals. This study describes all causes of mortality reported at hospitals in the Federal Capital Territory (FCT) of Nigeria. Methods Deaths reported in 15 secondary and tertiary FCT hospitals occurring from January 1, 2005 and December 31, 2008 were identified by a retrospective review of hospital records conducted by the Nigeria Field Epidemiology and Laboratory Program (NFELTP). Data extracted from the records included sociodemographics, geographic area of residence and underlying cause-of-death information. Results A total of 4,623 deaths occurred in the hospitals. Overall, the top five causes of death reported were: HIV 951 (21%), road traffic accidents 422 (9%), malaria 264 (6%), septicemia 206 (5%), and hypertension 194 (4%). The median age at death was 30 years (range: 0-100); 888 (20%) of deaths were among those less than one year of age. Among children < 1 year, low birth weight and infections were responsible for the highest proportion 131 (15%) of reported mortality. Conclusion Many of the leading causes of mortality identified in this study are preventable. Infant mortality is a large public health problem in FCT hospitals. Although these findings are not representative of all FCT deaths, they may be used to quantify mortality in that occurs in FCT hospitals. These data combined with other mortality surveillance data can provide evidence to inform policy on public health strategies and interventions for the FCT. PMID:22655100

Immunocontraception in Wild Horses (Equus caballus) Extends Reproductive Cycling Beyond the Normal Breeding Season

PubMed Central

Nuñez, Cassandra M. V.; Adelman, James S.; Rubenstein, Daniel I.

2010-01-01

Background Although the physiological effects of immunocontraceptive treatment with porcine zona pellucida (PZP) have been well studied, little is known about PZP's effects on the scheduling of reproductive cycling. Recent behavioral research has suggested that recipients of PZP extend the receptive breeding period into what is normally the non-breeding season. Methodology/Principal Findings To determine if this is the case, we compiled foaling data from wild horses (Equus caballus) living on Shackleford Banks, North Carolina for 4 years pre- and 8 years post-contraception management with PZP (pre-contraception, n = 65 births from 45 mares; post-contraception, n = 97 births from 46 mares). Gestation lasts approximately 11–12 months in wild horses, placing conception at approximately 11.5 months prior to birth. Since the contraception program began in January 2000, foaling has occurred over a significantly broader range than it had before the contraception program. Foaling in PZP recipients (n = 45 births from 27 mares) has consistently occurred over a broader range than has foaling in non-recipients (n = 52 births from 19 mares). In addition, current recipients of PZP foaled later in the year than did prior recipient and non-recipient mares. Females receiving more consecutive PZP applications gave birth later in the season than did females receiving fewer applications. Finally, the efficacy of PZP declined with increasing consecutive applications before reaching 100% after five consecutive applications. Conclusions/Significance For a gregarious species such as the horse, the extension of reproductive cycling into the fall months has important social consequences, including decreased group stability and the extension of male reproductive behavior. In addition, reproductive cycling into the fall months could have long-term effects on foal survivorship. Managers should consider these factors before enacting immunocontraceptive programs in new populations. We suggest minor alterations to management strategies to help alleviate such unintended effects in new populations. PMID:21049017

Indirect exposure to a family planning mass media campaign in Nepal.

PubMed

Boulay, Marc; Storey, J Douglas; Sood, Suruchi

2002-01-01

It is often noted that some individuals become aware of a mass media program's messages through discussions with other individuals. However, the extent to which indirect exposure occurs, and its influence on behavior, are somewhat unclear. This study examines the role of indirect exposure in extending the reach of a family planning mass media campaign in Nepal. Sociometric data, gathered from nearly all women between the ages of 15 and 49 years living in six villages in Dang District, Nepal (N = 667), assessed indirect exposure to the radio program. Indirect exposure was extensive; half of all respondents were indirectly exposed to the program's messages and the overall reach of the program increased from 50% to 75% when indirect exposure was considered. Members of community groups had higher levels of direct exposure to the radio program and more extensive and diverse social networks, allowing them to serve as a conduit for these messages into the wider community. While direct exposure to the radio program appeared to influence family planning knowledge, indirect exposure was more strongly associated with contraceptive use. These findings suggest that program evaluations that ignore indirect exposure underestimate the impact of a mass media program on behavior.

Persistence of Immunity Acquired after a Single Dose of Rubella Vaccine in Japan.

PubMed

Okafuji, Takao; Okafuji, Teruo; Nakayama, Tetsuo

2016-05-20

To date, Takahashi, Matsuura, and TO-336 strains of live-attenuated rubella vaccine have been used in Japan. Japan implemented a single-dose rubella vaccination program until 2006. However, few reports are available on the persistence of immunity after this vaccination program. We collected 276 serum samples from January 2009 to December 2011 at Okafuji Pediatric Clinic and assessed the immune status of these samples against rubella virus during 1-10 years after vaccination with a single dose of Takahashi rubella vaccine. Regional outbreak of rubella did not occur during 1999-2011. The collected serum samples were tested for antibodies against the rubella virus by performing a standard hemagglutination inhibition (HAI) test. Our results showed that all the tested serum samples contained antibodies against the rubella virus 10 years after the vaccination. Geometric mean titer of HAI antibodies was 1:180 and decreased to 1:68 at 10 years after the vaccination. The levels of HAI antibodies decreased logarithmically with time after the vaccination. In conclusion, vaccine-acquired immunity after vaccination with a single dose of live-attenuated Takahashi rubella vaccine was retained for at least 10 years when rubella was under regional control.

Prevalence of Dental Caries among School Children in Chennai, Based on ICDAS II

PubMed Central

Arangannal, Ponnudurai; Jayaprakash, Jeevarathan

2016-01-01

Introduction Dental caries is a common dental disease, which occurs during childhood and continues to be a major public health problem. The prevalence of dental caries was associated with oral hygiene practice, sugar consumption and implementation of the preventive oral health program. Aim The purpose of this study was to assess the prevalence of dental caries in school children aged between 6-14 years using the International Caries Detection and Assessment System (ICDAS II). Materials and Methods The study population consisted of 2796 school children living in Pallikkaranai, Chennai, India and studying in government recognized schools. Each student was examined by a single examiner using ICDAS system under natural light during normal school hours. Results The prevalence of dental caries was 68.8% in the total surveyed population. The gender-wise prevalence of dental caries shows, females to have slightly higher prevalence than male. The prevalence of dental caries at the age group of 6 years was 57%, seven year 67%, eight year 63%, nine year 74%, 10 year 76%, 11 year 74%, 12 year 69%, 13 year 71%, and 14 year 69%. The distribution of CARS (Caries associated with Sealants and Restorations) in the surveyed population was only 1.4% Conclusion The distribution of non-cavitated/early enamel lesions was higher in the studied population and indicated a requirement of a sustained dental health preventive program targeting specific segments of the population. PMID:27190939

An analysis of the first two years of GASP data

NASA Technical Reports Server (NTRS)

Holdeman, J. D.; Nastrom, G. D.; Falconer, P. D.

1977-01-01

Distributions of mean ozone levels from the first two years of data from the NASA Global Atmospheric Sampling Program (GASP) show spatial and temporal variations in agreement with previous measurements. The standard deviations of these distributions reflect the large natural variability of ozone levels in the altitude range of the GASP measurements. Monthly mean levels of ozone below the tropopause show an annual cycle with a spring maximum which is believed to result from transport from the stratosphere. Correlations of ozone with independent meteorological parameters, and meteorological parameters obtained by the GASP systems show that this transport occurs primarily through cyclogenesis at mid-latitudes.

Long-term benthic monitoring studies in the freshwater portion of the Potomac River: 1983 to 1985, cumulative report. Volume 1. Text

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

Shaughnessy, A.T.; Holland, A.F.

1989-12-01

The report summarizes data from the first three years of a long-term monitoring program to establish baseline conditions in benthic communities on the upper Potomac River. Major sources of variation were considered in an effort to characterize the effect of two power plants on distribution and abundance of the benthos. Distinct changes occurred in benthic communities in the vicinity of power plant discharges. These included decreased abundances of dominant species and reduced occurrences of rare species. Impacts associated with power plants were most severe during summer months and during low flow years.

Long-term benthic monitoring studies in the freshwater portion of the Potomac River: 1983 to 1985, cumulative report. Volume 2. Appendices

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

Shaughnessy, A.T.; Holland, A.F.

1989-12-01

The report summarizes data from the first three years of a long-term monitoring program to establish baseline conditions in benthic communities on the upper Potomac River. Major sources of variation were considered in an effort to characterize the effect of two power plants on distribution and abundance of the benthos. Distinct changes occurred in benthic communities in the vicinity of power plant discharges. These included decreased abundances of dominant species and reduced occurrences of rare species. Impacts associated with power plants were most severe during summer months and during low flow years.

76 FR 26431 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Rate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

...This final rule updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) for discharges occurring during the rate year (RY) beginning July 1, 2011 through September 30, 2012. The final rule also changes the IPF prospective payment system (PPS) payment rate update period to a RY that coincides with a fiscal year (FY). In addition, the rule implements policy changes affecting the IPF PPS teaching adjustment. It also rebases and revises the Rehabilitation, Psychiatric, and Long-Term Care (RPL) market basket, and makes some clarifications and corrections to terminology and regulations text.

Open source tools and toolkits for bioinformatics: significance, and where are we?

PubMed

Stajich, Jason E; Lapp, Hilmar

2006-09-01

This review summarizes important work in open-source bioinformatics software that has occurred over the past couple of years. The survey is intended to illustrate how programs and toolkits whose source code has been developed or released under an Open Source license have changed informatics-heavy areas of life science research. Rather than creating a comprehensive list of all tools developed over the last 2-3 years, we use a few selected projects encompassing toolkit libraries, analysis tools, data analysis environments and interoperability standards to show how freely available and modifiable open-source software can serve as the foundation for building important applications, analysis workflows and resources.

Prevalence of soil transmitted nematodes on Nukufetau, a remote Pacific island in Tuvalu

PubMed Central

Speare, Rick; Latasi, Falatea Fab; Nelesone, Tekaai; Harmen, Sonia; Melrose, Wayne; Durrheim, David; Heukelbach, Jorg

2006-01-01

Background The population of Nukufetau, a remote coral atoll island in Tuvalu in the Western Pacific, received annual mass drug administration (MDA) of diethylcarbamazine and albendazole under the Pacific Elimination of Lymphatic Filariasis program in 2001, 2002 and 2003, with the last MDA occurring six months before a cross-sectional survey of the whole population for soil transmitted helminths (STH). Methods A cross-sectional survey in May 2004 recruited 206 residents (35.2% of the population) who provided a single faecal sample that was preserved, concentrated and examined microscopically. Results Overall prevalence of STH was 69.9%; only hookworm and Trichuris trichiura were diagnosed. Trichuris was present in 68.4% with intensity of infection being light in 56.3%, medium in 11.7% and heavy in 0.5%. Hookworm occurred in 11.7% with intensity of infection 11.2% being light and medium in 0.5%. Twenty individuals (9.7%) had dual infections. The prevalence of Trichuris was constant across all ages while the prevalence of hookworm was significantly lower in residents below 30 years of age. In the age group 5–12 years comparison of results with a 2001 survey [1] suggested that the prevalence of STH has declined minimally, due to sustained high prevalence of Trichuris, while hookworm has declined dramatically from 34.4% to 1.6%. Conclusion The results of this survey suggest that although the MDA appears to have reduced hookworm prevalence in residents below 30 years of age, there has been minimal effect on Trichuris prevalence. An integrated program to control STH is required. PMID:16836746

Pilot Inventory of mammals, reptiles, and amphibians, Golden Gate National Recreation Area, California, 1990-1997

USGS Publications Warehouse

Semenoff-Irving, M.; Howell, J.A.

2005-01-01

The United States Geological Survey Golden Gate Field Station conducted a baseline inventory of terrestrial vertebrates within the Golden Gate National Recreation Area (GGNRA), Marin, San Francisco, and San Mateo Counties, California between 1990 and 1997. We established 456 permanent study plots in 6 major park habitats, including grassland, coastal scrub, riparian woodland, coastal wetland, broad-leaved evergreen forest, and needle-leaved evergreen forest. We tested multiple inventory methods, including live traps, track plate stations, and artificial cover boards, across all years and habitats. In most years, sampling occurred in 3?4 primary sampling sessions between July and September. In 1994, additional sampling occurred in February and May in conjunction with an assessment of Hantavirus exposure in deer mice (Peromyscus maniculatus). Overall, we detected 32 mammal, 14 reptile, and 6 amphibian species during 25,222 trap-nights of effort. The deer mouse?the most abundant species detected--accounted for 67% of total captures. We detected the Federal Endangered salt marsh harvest mouse (Reithrodontomys raviventris) at one coastal wetland plot in 1992. This project represents the first phase in the development of a comprehensive terrestrial vertebrate inventory and monitoring program for GGNRA. This report summarizes data on relative abundance, frequency of occurrence, distribution across habitat types, and trap success for terrestrial vertebrates detected during this 7-year effort. It includes comprehensive descriptions of the inventory methods and sampling strategies employed during this survey and is intended to help guide the park in the implementation of future longterm ecological monitoring programs.

Pilot Inventory of Mammals, Reptiles, and Amphibians, Golden Gate National Recreation Area, California, 1990-1997

USGS Publications Warehouse

Semenoff-Irving, Marcia; Howell, Judd A.

2005-01-01

The United States Geological Survey Golden Gate Field Station conducted a baseline inventory of terrestrial vertebrates within the Golden Gate National Recreation Area (GGNRA), Marin, San Francisco, and San Mateo Counties, California between 1990 and 1997. We established 456 permanent study plots in 6 major park habitats, including grassland, coastal scrub, riparian woodland, coastal wetland, broad-leaved evergreen forest, and needle-leaved evergreen forest. We tested multiple inventory methods, including live traps, track plate stations, and artificial cover boards, across all years and habitats. In most years, sampling occurred in 3-4 primary sampling sessions between July and September. In 1994, additional sampling occurred in February and May in conjunction with an assessment of Hantavirus exposure in deer mice (Peromyscus maniculatus). Overall, we detected 32 mammal, 14 reptile, and 6 amphibian species during 25,222 trap-nights of effort. The deer mouse-the most abundant species detected--accounted for 67% of total captures. We detected the Federal Endangered salt marsh harvest mouse (Reithrodontomys raviventris) at one coastal wetland plot in 1992. This project represents the first phase in the development of a comprehensive terrestrial vertebrate inventory and monitoring program for GGNRA. This report summarizes data on relative abundance, frequency of occurrence, distribution across habitat types, and trap success for terrestrial vertebrates detected during this 7-year effort. It includes comprehensive descriptions of the inventory methods and sampling strategies employed during this survey and is intended to help guide the park in the implementation of future longterm ecological monitoring programs.

Increasing Residency Research Output While Cultivating Community Research Collaborations.

PubMed

Weaver, Sally P

2018-06-01

Having a research curriculum in addition to hosting a resident research day stimulates research activity in residency programs. Research collaborations outside an individual residency program may also promote research in residency. This paper describes a community-wide health research forum that engages faculty and residents in research while bringing together potential research collaborators from the community. A yearly research forum has been held at a large community-based family medicine residency program for the past 10 years. This forum invites both residency faculty and residents to present scholarly works, and also invites researchers from the community to present health-related research. Presenters outside the residency come from hospital systems, the local university, other residency programs, and community private physicians. Peer-reviewed research publications have increased greatly since the advent of the research forum in 2006, with six publications from 1997-2006 and 26 from 2007-2016. Greater increases in numbers of peer reviewed presentations were also seen. Collaborative research has occurred between residency faculty and multiple departments at the local university including the business school, social work, public health, physiology, and statistics. There are now 28 collaborative projects completed or in progress. Development and implementation of a regional health research event has been a success in increasing faculty and resident research productivity. The even greater success however, is the progress made in advancing research collaborations between the local university and the residency program.

Fertilizing ROSES through the STEM: Interdisciplinary Modules as Pre-service Research Experiences for Secondary STEM Educators (IMPRESS-Ed)

NASA Astrophysics Data System (ADS)

Kavic, Michael; Wiita, P. J.; Benoit, M.; Magee, N.

2013-01-01

IMPRESS-Ed is a program designed to provide authentic summer research experiences in the space, earth, and atmospheric sciences for pre-service K-12 educators at Long Island University (LIU) and The College of New Jersey (TCNJ). In 2011 and 2012, the program involved five students and took place over eight weeks with recruitment occurring during the preceding academic year. The program was divided into two modules: A common core module and an individual mentored research experience. The common module consisted of three units focusing on data-driven pedagogical approaches in astrophysics, tectonophysics, and atmospheric science, respectively. The common module also featured training sessions in observational astronomy, and use of a 3D geowall and state of the art planetarium. Participants in the program are also offered the opportunity to utilize the available TCNJ facilities with their future students. The individual mentored research module matched student interests with potential projects. All five students demonstrated strong gains in earth and space science literacy compared to a baseline measurement. Each student also reported gaining confidence to incorporate data and research-driven instruction in the space and earth sciences into the K-12 STEM classroom setting. All five research projects were also quite successful: several of the students plan to continue research during the academic year and two students are presenting research findings as first authors here at AAS. Other research results are likely to be presented at this year's American Geophysical Union meeting.

Viper NHEXS Program: A Viper Pilot Neck Health & Conditioning Guide

DTIC Science & Technology

2012-11-01

recommended in this manual. The Neck vs. Gs Problem At least one acute neck pain episode is reported to occur in an estimated 85% of all pilots flying...high-performance fighter type aircraft, with the yearly prevalence of neck-related pain for all pilots at 56% [1]. Vandebeek reported over 50% of...72% of fighter pilots experience neck pain in relation to flying, while 35% experience some low back pain . The reported average G level for acute

Tacit Knowledge Involvement in the Production of Nuclear Weapons: A Critical Component of a Credible US Nuclear Deterrent in the 21st Century

DTIC Science & Technology

2013-02-14

important in sustaining a credible nuclear deterrent without testing. Thinking in the early days of the Manhattan Project was that designing a nuclear...weapon would occur quickly. Renowned physicist Edward Teller recalled being discouraged from joining the Manhattan Project at Los Alamos National...difficulties with their nuclear program in the early years despite involvement with portions of the Manhattan Project . With permission, the British

[Literature review on human influenza epidemics occurred before the implementation plan for sentinel surveillance program in the DRC].

PubMed

Nkwembe-Ngabana, Edith; Ahuka-Mundeke, Steve; Kebela-Ilunga, Benoit; Londa, Emile Okitolo; Muyembe-Tamfum, Jean-Jacques

2017-01-01

In the Democratic Republic of the Congo (DRC), several influenza epidemics are ignored because they are confused with other infectious diseases which have similar symptoms. Our study aims to assess influenza epidemics occurred in the DRC before 2008, year of the implementation of the influenza surveillance program in the DRC. We searched all the documents [articles, report,…] about influenza epidemic or acute respiratory infections [ARI] in the DRC before 2008 by using chosen key words. Epidemic description elements were identified and analyzed in each report. 4 documents have been found that had no article published. The sites of the epidemic outbreak were the rural health zones in Koshibanda and Kahemba, Bandundu [1995 and 2007], in Bosobolo, Equator [2002] and in Kinshasa [2002-2003]. Attack and lethality rates were 3.9% and 16% in Koshibanda respectively; 0.1% and 2% in Kinshasa; 47.5% and 1.5% in Bosobolo and 14.6% and 2.9% in Kahemba. Children less than 5 years of age were the most affected. Their attack rates ranged between 22.6 and 57.7% and lethality rates ranged between 3.2 and 3.7%. The two epidemics in Bosobolo and Kinshasa were associated with H3N2 influenza virus. This literature review highlights a high morbidity and mortality due to rare influenza epidemics in the DRC.

Aging and Down syndrome: implications for physical therapy.

PubMed

Barnhart, Robert C; Connolly, Barbara

2007-10-01

The number of people over the age of 60 years with lifelong developmental delays is predicted to double by 2030. Down syndrome (DS) is the most frequent chromosomal cause of developmental delays. As the life expectancy of people with DS increases, changes in body function and structure secondary to aging have the potential to lead to activity limitations and participation restrictions for this population. The purpose of this update is to: (1) provide an overview of the common body function and structure changes that occur in adults with DS as they age (thyroid dysfunction, cardiovascular disorders, obesity, musculoskeletal disorders, Alzheimer disease, depression) and (2) apply current research on exercise to the prevention of activity limitations and participation restrictions. As individuals with DS age, a shift in emphasis from disability prevention to the prevention of conditions that lead to activity and participation limitations must occur. Exercise programs appear to have potential to positively affect the overall health of adults with DS, thereby increasing the quality of life and years of healthy life for these individuals.

Descriptive Epidemiology of Musculoskeletal Injuries in Naval Special Warfare Sea, Air, and Land Operators.

PubMed

Lovalekar, Mita; Abt, John P; Sell, Timothy C; Wood, Dallas E; Lephart, Scott M

2016-01-01

The purpose of this analysis was to describe medical chart reviewed musculoskeletal injuries among Naval Special Warfare Sea, Air, and Land Operators. 210 Operators volunteered (age: 28.1 ± 6.0 years, height: 1.8 ± 0.1 m, weight: 85.4 ± 9.3 kg). Musculoskeletal injury data were extracted from subjects' medical charts, and injuries that occurred during 1 year were described. Anatomic location of injury, cause of injury, activity when injury occurred, and injury type were described. The frequency of injuries was 0.025 per Operator per month. Most injuries involved the upper extremity (38.1% of injuries). Frequent anatomic sublocations for injuries were the shoulder (23.8%) and lumbopelvic region of the spine (12.7%). Lifting was the cause of 7.9% of injuries. Subjects were participating in training when 38.1% of injuries occurred and recreational activity/sports when 12.7% of injuries occurred. Frequent injury types were strain (20.6%), pain/spasm/ache (19.0%), fracture (11.1%), and sprain (11.1%). The results of this analysis underscore the need to investigate the risk factors, especially of upper extremity and physical activity related injuries, in this population of Operators. There is a scope for development of a focused, customized injury prevention program, targeting the unique injury profile of this population. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Boutique to Booming: Medicare Managed Care and the Private Path to Policy Change.

PubMed

Kelly, Andrew S

2016-06-01

In 2014, Medicare Advantage (MA) enrollment surpassed 30 percent of eligible beneficiaries. Twenty-five years earlier, enrollment hovered at just 3 percent. The expansion of private Medicare plans presents a puzzling instance of policy change within Medicare-a program long held to be a quintessential case of policy stasis. This article investigates the policy features that made Medicare susceptible to this dramatic policy shift, as well as the processes by which the initial policy change remade the politics of Medicare and solidified the MA program. The first enrollment surge occurred in the absence of a proximate legislative or administrative change. Instead, increased spending and expanded benefits were the result of the interaction of new market dynamics with an existing legislative framework-demonstrating an expansionary form of policy drift. The 1982 Tax Equity and Fiscal Responsibility Act created a policy space that gave the new and lightly controlled managed care industry considerable operational discretion. As the interests of the government's private partners changed in response to new market dynamics, a change occurred in the output and performance of the Medicare managed care program. As enrollment and spending increased, Medicare's politics were remade by the political empowerment of the managed care industry and the creation of a new subconstituency of beneficiaries. Copyright © 2016 by Duke University Press.

Zinc sulfate therapy of vocal process granuloma.

PubMed

Sun, Guang-Bin; Sun, Na; Tang, Hai-Hong; Zhu, Qiu-Bei; Wen, Wu; Zheng, Hong-Liang

2012-09-01

Vocal process granuloma is a benign lesion that occurs on the arytenoid cartilage. It tends to recur locally, and there is a great diversity of methods to treat it. Here, we reviewed the effects of zinc sulfate therapy program in 16 patients with vocal process granulomas. Eleven patients had a history of trauma or laryngeal intubation and five patients had unknown origin. Eleven had recurrence after one to three failed surgeries, and the others had no prior treatment. Symptoms included hoarseness, sore throat, lump sensation in the throat and cough that apparently improved. The granulomas did not recur for at least 1 year. No complications occurred. For vocal process granuloma, zinc sulfate therapy is good either as an initial or compensatory treatment.

Integrated Financial Management Program

NASA Technical Reports Server (NTRS)

Pho, Susan

2004-01-01

Having worked in the Employees and Commercial Payments Branch of the Financial Management Division for the past 3 summers, I have seen the many changes that have occurred within the NASA organization. As I return each summer, I find that new programs and systems have been adapted to better serve the needs of the Center and of the Agency. The NASA Agency has transformed itself the past couple years with the implementation of the Integrated Financial Management Program (IFMP). IFMP is designed to allow the Agency to improve its management of its Financial, Physical, and Human Resources through the use of multiple enterprise module applications. With my mentor, Joseph Kan, being the branch chief of the Employees and Commercial Payments Branch, I have been exposed to several modules, such as Travel Manager, WebTads, and Core Financial/SAP, which were implemented in the last couple of years under the IFMP. The implementation of these agency-wide systems has sometimes proven to be troublesome. Prior to IFMP, each NASA Center utilizes their own systems for Payroll, Travel, Accounts Payable, etc. But with the implementation of the Integrated Financial Management Program, all the "legacy" systems had to be eliminated. As a result, a great deal of enhancement and preparation work is necessary to ease the transformation from the old systems to the new. All this work occurs simultaneously; for example, e-Payroll will "go live" in several months, but a system like Travel Manager will need to have information upgraded within the system to meet the requirements set by Headquarters. My assignments this summer have given me the opportunity to become involved with such work. So far, I have been given the opportunity to participate in projects resulting from a congressional request, several bankcard reconciliations, updating routing lists for Travel Manager, updating the majordomo list for Travel Manager approvers and point of contacts, and a NASA Headquarters project involving improper payments on firm fixed price contracts. Each of the projects that I have worked on this summer presents a different aspect of the work performed on a regular basis by members of this branch. Not only do I get to see the "big picture" of what occurs within the organization, but I also get to experience the "little stuff" that goes on here and throughout the NASA Agency.

Financial Incentives and Diabetes Disease Control in Employees: A Retrospective Cohort Analysis.

PubMed

Misra-Hebert, Anita D; Hu, Bo; Taksler, Glen; Zimmerman, Robert; Rothberg, Michael B

2016-08-01

Many employers offer worksite wellness programs, including financial incentives to achieve goals. Evidence supporting such programs is sparse. To assess whether diabetes and cardiovascular risk factor control in employees improved with financial incentives for participation in disease management and for attaining goals. Retrospective cohort study using insurance claims linked with electronic medical record data from January 2008-December 2012. Employee patients with diabetes covered by the organization's self-funded insurance and propensity-matched non-employee patient comparison group with diabetes and commercial insurance. Financial incentives for employer-sponsored disease management program participation and achieving goals. Change in glycosylated hemoglobin (HbA1c), low-density lipoprotein (LDL), systolic blood pressure (SBP), and weight. A total of 1092 employees with diabetes were matched to non-employee patients. With increasing incentives, employee program participation increased (7 % in 2009 to 50 % in 2012, p < 0.001). Longitudinal mixed modeling demonstrated improved diabetes and cardiovascular risk factor control in employees vs. non-employees [HbA1c yearly change -0.05 employees vs. 0.00 non-employees, difference in change (DIC) p <0.001]. In their first participation year, employees had larger declines in HbA1c and weight vs. non-employees (0.33 vs. 0.14, DIC p = 0.04) and (2.3 kg vs. 0.1 kg, DIC p < 0.001), respectively. Analysis of employee cohorts corresponding with incentive offerings showed that fixed incentives (years 1 and 2) or incentives tied to goals (years 3 and 4) were not significantly associated with HbA1c reductions compared to non-employees. For each employee cohort offered incentives, SBP and LDL also did not significantly differ in employees compared with non-employees (DIC p > 0.05). Financial incentives were associated with employee participation in disease management and improved cardiovascular risk factors over 5 years. Improvements occurred primarily in the first year of participation. The relative impact of specific incentives could not be discerned.

The impact of a 3-year after-school obesity prevention program in elementary school children.

PubMed

Yin, Zenong; Moore, Justin B; Johnson, Maribeth H; Vernon, Marlo M; Gutin, Bernard

2012-02-01

Children tend to be sedentary during the after-school hours, and this has deleterious effects on their health. The objective of the present study was to determine the effects of a 3-year after-school physical activity (PA) program, without restriction of dietary energy intake, on percent body fat (%BF), cardiorespiratory fitness (CRF), and cardiometabolic markers in children. A cluster randomization design was employed. A total of 574 3rd grade children from 18 elementary schools in the southeastern United States participated. The intervention consisted of 80 minutes of age-appropriate moderate-to-vigorous PA each school day. The main outcomes of interest were %BF measured by dual-energy X-ray absorptiometry; CRF measured by heart rate in response to a submaximal step test; nonfasting total and high-density lipoprotein cholesterol (HDL-C); and resting blood pressure (BP). Intent-to-treat analyses showed significant treatment by time interactions for %BF (p = 0.009) and CRF (p = 0.0003). The change pattern of the means suggested that %BF and CRF in intervention children improved relative to control children during the school months, rebounding to the levels of control children over the summers following years 1 and 2. Year-by-year analyses of what occurred during the months when the program was offered revealed dose–response relations for %BF and CRF, such that the clearest beneficial effects were seen for those youth who attended at least 60% of the after-school sessions. No significant intervention effects were seen for cholesterol or BP. An after-school PA program was effective in reducing adiposity and improving CRF, especially in the children who attended the sessions at least 3 days/week. However, the favorable effects on %BF and CRF were lost over the summer. Thus, it is critical to incorporate strategies that attract and retain the children to receive an adequate dose of PA year-round.

The SAGES Fundamental Use of Surgical Energy program (FUSE): history, development, and purpose.

PubMed

Fuchshuber, P; Schwaitzberg, S; Jones, D; Jones, S B; Feldman, L; Munro, M; Robinson, T; Purcell-Jackson, G; Mikami, D; Madani, A; Brunt, M; Dunkin, B; Gugliemi, C; Groah, L; Lim, R; Mischna, J; Voyles, C R

2018-06-01

Adverse events due to energy device use in surgical operating rooms are a daily occurrence. These occur at a rate of approximately 1-2 per 1000 operations. Hundreds of operating room fires occur each year in the United States, some causing severe injury and even mortality. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) therefore created the first comprehensive educational curriculum on the safe use of surgical energy devices, called Fundamental Use of Surgical Energy (FUSE). This paper describes the history, development, and purpose of this important training program for all members of the operating room team. The databases of SAGES and the FUSE committee as well as personal photographs and documents of members of the FUSE task force were used to establish a brief history of the FUSE program from its inception to its current status. The authors were able to detail all aspects of the history, development, and national as well as global implementation of the third SAGES Fundamentals Program FUSE. The written documentation of the making of FUSE is an important contribution to the history and mission of SAGES and allows the reader to understand the idea, concept, realization, and implementation of the only free online educational tool for physicians on energy devices available today. FUSE is the culmination of the SAGES efforts to recognize gaps in patient safety and develop state-of-the-art educational programs to address those gaps. It is the goal of the FUSE task force to ensure that general FUSE implementation becomes multinational, involving as many countries as possible.

Integrated Child Development Services (ICDS): harbinger of safe motherhood and child development.

PubMed

Lal, S

1993-01-01

Editorial comment was provided on the features that made the Integrated Child Development Services (ICDS) program in India unique and on whether or not the system could focus on younger age groups (e.g., 2-3 years of age). As part of a worldwide effort, India's ICDS program has been directed to human resource development. Over the past 17 years, the program has expanded to include almost 50% of the country's most vulnerable and deprived population. The focus on children aimed to improve their nutrition and health by reducing the incidence of morbidity, mortality, malnutrition, and school dropouts. The concern encompassed physical, social, and psychological development. The focus on mothers stressed enabling them to better care for the health and nutrition of their children. The program included prenatal care, safe delivery, and post natal concern for lactation, breast feeding, and physical growth monitoring in the early years. The program's unique features were its voluntary membership of community health workers, integrated services, and targeted coverage of economically weaker and deprived populations during critical child development periods. Indigenous Indian resources provided the primary financial support. Nation coverage was given for universal immunization, family welfare, child and maternal health, diarrheal disease control, vitamin A supplementation, and anemia screening and treatment. The multisectoral nature of the program has been realized at the village, sector, block, and district levels with linkages within Health, Education, and Social Welfare sectors, and with the Medical Colleges and Home Science Colleges. Feedback from operations research studies and other research activities was provided at the local program level, and interactions occurred between students in training programs and health care delivery systems. The program will be expanded to include the entire country. Health and nutrition education were considered the weakest part of ICDS. IEC has been expanding, but community participation has not kept pace. The strong community based infrastructure needs additional support particularly from the health sector. Program expansion into adolescent health and sex education was considered desirable. ICDs should be viewed as a development activity at the village level to astute women an integrated learning for life experience.

Preparation of the Professional Athletic Trainer: A Descriptive Study of Undergraduate and Graduate Degree Programs.

PubMed

Cavallario, Julie M; Van Lunen, Bonnie L

2015-07-01

The examination of the appropriate professional degree for preparation as an athletic trainer is of interest to the profession. Descriptive information concerning universal outcomes is needed to understand the effect of a degree change. To obtain and compare descriptive information related to professional athletic training programs and a potential degree change and to determine if any of these factors contribute to success on existing universal outcome measures. Cross-sectional study. Web-based survey. We contacted 364 program directors; 178 (48.9%; 163 undergraduate, 15 postbaccalaureate) responded. The survey consisted of 46 questions: 45 questions that dealt with 5 themes (institutional demographics [n = 13], program admissions [n = 6], program outcomes [n = 10], program design [n = 9], faculty and staff [n = 7]) and 1 optional question. Descriptive statistics for all programs were calculated. We compared undergraduate and postbaccalaureate programs by examining universal outcome variables. Descriptive statistics demonstrated that 33 programs could not support postbaccalaureate degrees, and a substantial loss of faculty could occur if the degree requirement changed (553 graduate assistants, 642 potentially underqualified instructors). Postbaccalaureate professional programs had higher 2011-2012 first-time Board of Certification (BOC) passing rates (U = 464.5, P = .001), 3-year aggregate first-time BOC passing rates (U = 451.5, P = .001), and employment rates for 2011-2012 graduates employed within athletic training (U = 614.0, P = .01). Linear multiple-regression models demonstrated that program and institution type contributed to the variance of the first-time BOC passing rates and the 3-year aggregate first-time BOC passing rates (P < .05). Students in postbaccalaureate athletic training programs performed better in universal outcome measures. Our data supported the concerns that this transition could result in the loss of some programs and an additional immediate strain on current staff due to potential staffing changes and the loss of graduate assistant positions.

A new look at NHTSA's evaluation of the 1984 Charlottesville Sobriety Checkpoint Program: implications for current checkpoint issues.

PubMed

Voas, Robert B

2008-03-01

Currently, the implementation of sobriety checkpoint programs, which have been demonstrated to be effective in reducing alcohol-related crashes, is limited by the belief that they require large consignments of police officers and result in few arrests. However, one of the earliest evaluations of a checkpoint program in Charlottesville, Virginia, demonstrated that effective checkpoints could be mounted in which police officers made as many arrests as officers on regular patrols. That study was printed by the NHTSA but was not published in a peer-reviewed journal. Because of its significance to current issues in the staffing of and procedures for checkpoint operations, this article reanalyzes the results of that study and describes the procedures implemented in checkpoints. A before-and-after control design was used to measure the change in nighttime crashes from three baseline years to the program year. Two analyses were conducted: the first on the percentage of all crashes occurring at night in the test city--Charlottesville--and the second on the percentage of all nighttime crashes in the state of Virginia that occurred in the test city. In addition, three waves of random-digit-dialing telephone surveys were conducted: one before and two during the checkpoint program in the test city, and the comparison city, Blacksburg. Finally, the number of impaired-driving arrests per officer hour at the checkpoints was compared with the number of arrests per hour by officers on regular patrol and the effect on arrests of the use of passive sensors was determined. The monthly percentage of nighttime crashes in Charlottesville was reduced by 17% (p = 000) in relation to the baseline level. The percentage of nighttime crashes in the state of Virginia that occurred in Charlottesville was reduced by 11% (p = .013) from baseline levels. Drivers arrested at checkpoints had lower BACs than those arrested by the regular patrols; however, the conviction rates were the same. The arrest per officer hour did not differ significantly between the two types of enforcement operations. Awareness of the checkpoint activity was high (72%) among nighttime at-risk drivers in the test city. Half reported seeing a checkpoint operation, and a quarter reported being interviewed. Use of a passive alcohol sensor by officers at the checkpoint increased arrests by almost a factor of three. The results of the evaluation suggest that small-scale sobriety checkpoints can be implemented as part of the regular enforcement program in moderate-sized jurisdictions and that they can be as efficient in producing arrests as standard enforcement patrols, particularly if passive alcohol sensors are used.

Effectiveness of a self-regulated remedial program for handwriting difficulties.

PubMed

Van Waelvelde, Hilde; De Roubaix, Amy; Steppe, Lien; Troubleyn, Evy; De Mey, Barbara; Dewitte, Griet; Debrabant, Julie; Van de Velde, Dominique

2017-09-01

Handwriting difficulties may have pervasive effects on a child's school performance. I Can! is a remedial handwriting program with a focus on self-regulated learning and applying motor learning principles combined with a behavioural approach. It is developed for typically developing children with handwriting problems. The study aim was to evaluate the program's effectiveness. Thirty-one children aged 7-8 year participated in a cross-over study. Handwriting quality and speed were repeatedly assessed by means of the Systematic Screening of Handwriting Difficulties test. Difficulties addressed were fluency in letter formation, fluency in letter connections, letter height, regularity of letter height, space between words, and line path. Mixed model analysis revealed improved quality of writing and speed for all children but significantly more improvement in handwriting quality for the children participating in the program. Although writing speed improved over time, no additional effects of the program occurred. 'I Can!' is found to be an effective instructive program to ameliorate handwriting quality in typically developing children with handwriting difficulties. The program's success was by a therapy burst of only 7 weeks focusing on the child's self-regulated learning capacities, within an individualized education plan according to their needs and goals.

Multidimensional exercise for people with Parkinson's disease: a case report.

PubMed

Kluding, Patricia; McGinnis, Patricia Quinn

2006-06-01

The primary impairments associated with Parkinson's disease occur in combination with the secondary, preventable effects of immobility. A community-based fitness program may help increase activity and maintain function in people in the early or middle stages of the disease. This article describes a unique program designed to reduce fall risk and promote independent exercise for people with Parkinson's disease. Two 66-year-old males, both community ambulators and in early or middle stages of Parkinson's disease, participated in 3 months of various physical activities. Group balance classes were held twice weekly during the first month, participants joined a fitness center and self-directed their exercise program during the second month, and group Tai Chi classes were held twice weekly during the third month. At conclusion of the program, participants were given suggestions for continued physical fitness activities. After the 3-month program, improvements were noted for both individuals in functional reach, Timed Up and Go, and Berg Balance scores. Both participants continued to exercise regularly for at least 8 months following the program. Two individuals with Parkinson's disease demonstrated improvement in their balance test performance over a 3-month period. Perhaps most importantly, these participants independently continued exercising after completing this program.

Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibrillators.

PubMed

Drezner, Jonathan A; Rao, Ashwin L; Heistand, Justin; Bloomingdale, Megan K; Harmon, Kimberly G

2009-08-11

US high schools are increasingly adopting automated external defibrillators (AEDs) for use in campus settings. We analyzed the effectiveness of emergency response planning for sudden cardiac arrest (SCA) in a large cohort of US high schools that had onsite AED programs. A cohort of US high schools with at least 1 onsite AED was identified from the National Registry for AED Use in Sports. A school representative completed a comprehensive survey on emergency planning and provided details of any SCA incident occurring within 6 months of survey completion. Surveys were completed between December 2006 and July 2007. In total, 1710 high schools with an onsite AED program were studied. Although 83% (1428 of 1710) of schools have an established emergency response plan for SCA, only 40% practice and review the plan at least annually with potential school responders. A case of SCA was reported by 36 of 1710 schools (2.1%). The 36 SCA victims included 14 high school student athletes (mean age, 16 years; range, 14 to 17 years) and 22 older nonstudents (mean age, 57 years; range, 42 to 71 years) such as employees and spectators. No cases were reported in student nonathletes. Of the 36 SCA cases, 35 (97%) were witnessed, 34 (94%) received bystander cardiopulmonary resuscitation, and 30 (83%) received an AED shock. Twenty-three SCA victims (64%) survived to hospital discharge, including 9 of the 14 student athletes and 14 of the 22 older nonstudents. School-based AED programs provide a high survival rate for both student athletes and older nonstudents who suffer SCA on school grounds. High schools are strongly encouraged to implement onsite AED programs as part of a comprehensive emergency response plan to SCA.

Development and Evaluation of Innovative Peer-Led Physical Activity Programs for Mental Health Service Users

PubMed Central

Graham, Candida R.; Larstone, Roseann; Griffiths, Brenda; de Leeuw, Sarah; Anderson, Lesley; Powell-Hellyer, Stephanie; Long, Nansi

2017-01-01

Abstract Mental health service users (MHSUs) have elevated rates of cardiometabolic disturbance. Improvements occur with physical activity (PA) programs. We report the development and evaluation of three innovative peer-developed and peer-led PA programs: 1) walking; 2) fitness; and 3) yoga. Qualitative evaluation with 33 MHSUs in British Columbia, Canada, occurred. These programs yielded improvements for participants, highlighted by powerful narratives of health improvement, and improved social connections. The feasibility and acceptability of innovative peer-developed and peer-led programs were shown. Analyses revealed concepts related to engagement and change. Relating core categories, we theorize effective engagement of MHSUs requires accessibility on three levels (geographic, cost, and program flexibility) and health behavior change occurs within co-constituent relationships (to self, to peers, and to the wider community). This study highlights the benefits of peer involvement in developing and implementing PA programs and provides a theoretical framework of understanding engagement and behavior change in health programs for MHSUs. PMID:28953007

Change in interpersonal problems after cognitive agoraphobia and schema-focused therapy versus psychodynamic treatment as usual of inpatients with agoraphobia and Cluster C personality disorders.

PubMed

Gude, Tore; Hoffart, Asle

2008-04-01

The aim was to study whether patients with panic disorder with agoraphobia and co-occurring Cluster C traits would respond differently regarding change in interpersonal problems as part of their personality functioning when receiving two different treatment modalities. Two cohorts of patients were followed through three months' in-patient treatment programs and assessed at follow-up one year after end of treatment. The one cohort comprised 18 patients treated with "treatment as usual" according to psychodynamic principles, the second comprised 24 patients treated in a cognitive agoraphobia and schema-focused therapy program. Patients in the cognitive condition showed greater improvement in interpersonal problems than patients in the treatment as usual condition. Although this quasi-experimental study has serious limitations, the results may indicate that agoraphobic patients with Cluster C traits should be treated in cognitive agoraphobia and schema-focused programs rather than in psychodynamic treatment as usual programs in order to reduce their level of interpersonal problems.

School-Based Influenza Vaccination: Parents’ Perspectives

PubMed Central

Lind, Candace; Russell, Margaret L.; MacDonald, Judy; Collins, Ramona; Frank, Christine J.; Davis, Amy E.

2014-01-01

Background School-age children are important drivers of annual influenza epidemics yet influenza vaccination coverage of this population is low despite universal publicly funded influenza vaccination in Alberta, Canada. Immunizing children at school may potentially increase vaccine uptake. As parents are a key stakeholder group for such a program, it is important to consider their concerns. Purpose We explored parents’ perspectives on the acceptability of adding an annual influenza immunization to the immunization program that is currently delivered in Alberta schools, and obtained suggestions for structuring such a program. Participants Forty-eight parents of children aged 5-18 years participated in 9 focus groups. Participants lived in urban areas of the Alberta Health Services Calgary Zone. Findings Three major themes emerged: Advantages of school-based influenza vaccination (SBIV), Disadvantages of SBIV, and Implications for program design & delivery. Advantages were perceived to occur for different populations: children (e.g. emotional support), families (e.g. convenience), the community (e.g. benefits for school and multicultural communities), the health sector (e.g. reductions in costs due to burden of illness) and to society at large (e.g. indirect conduit of information about health services, building structure for pandemic preparedness, building healthy lifestyles). Disadvantages, however, might also occur for children (e.g. older children less likely to be immunized), families (e.g. communication challenges, perceived loss of parental control over information, choices and decisions) and the education sector (loss of instructional time). Nine second-level themes emerged within the major theme of Implications for program design & delivery: program goals/objectives, consent process, stakeholder consultation, age-appropriate program, education, communication, logistics, immunizing agent, and clinic process. Conclusions Parents perceived advantages and disadvantages to delivering annual seasonal influenza immunizations to children at school. Their input gives a framework of issues to address in order to construct robust, acceptable programs for delivering influenza or other vaccines in schools. PMID:24686406

Tobacco imagery on prime time UK television.

PubMed

Lyons, Ailsa; McNeill, Ann; Britton, John

2014-05-01

Smoking in films is a common and well documented cause of youth smoking experimentation and uptake and hence a significant health hazard. The extent of exposure of young people to tobacco imagery in television programming has to date been far less investigated. We have therefore measured the extent to which tobacco content occurs in prime time UK television, and estimated exposure of UK youth. The occurrence of tobacco, categorised as actual tobacco use, implied tobacco use, tobacco paraphernalia, other reference to tobacco, tobacco brand appearances or any of these, occurring in all prime time broadcasting on the five most popularly viewed UK television stations during 3 separate weeks in 2010 were measured by 1-minute interval coding. Youth exposure to tobacco content in the UK was estimated using media viewing figures. Actual tobacco use, predominantly cigarette smoking, occurred in 73 of 613 (12%) programmes, particularly in feature films and reality TV. Brand appearances were rare, occurring in only 18 programmes, of which 12 were news or other factual genres, and 6 were episodes of the same British soap opera. Tobacco occurred with similar frequency before as after 21:00, the UK watershed for programmes suitable for youth. The estimated number of incidences of exposure of the audience aged less than 18 years for any tobacco, actual tobacco use and tobacco branding were 59 million, 16 million and 3 million, respectively on average per week. Television programming is a source of significant exposure of youth to tobacco imagery, before and after the watershed. Tobacco branding is particularly common in Coronation Street, a soap opera popular among youth audiences. More stringent controls on tobacco in prime time television therefore have the potential to reduce the uptake of youth smoking in the UK.

Tobacco imagery on prime time UK television

PubMed Central

Lyons, Ailsa; McNeill, Ann; Britton, John

2014-01-01

Background Smoking in films is a common and well documented cause of youth smoking experimentation and uptake and hence a significant health hazard. The extent of exposure of young people to tobacco imagery in television programming has to date been far less investigated. We have therefore measured the extent to which tobacco content occurs in prime time UK television, and estimated exposure of UK youth. Methods The occurrence of tobacco, categorised as actual tobacco use, implied tobacco use, tobacco paraphernalia, other reference to tobacco, tobacco brand appearances or any of these, occurring in all prime time broadcasting on the five most popularly viewed UK television stations during 3 separate weeks in 2010 were measured by 1-minute interval coding. Youth exposure to tobacco content in the UK was estimated using media viewing figures. Findings Actual tobacco use, predominantly cigarette smoking, occurred in 73 of 613 (12%) programmes, particularly in feature films and reality TV. Brand appearances were rare, occurring in only 18 programmes, of which 12 were news or other factual genres, and 6 were episodes of the same British soap opera. Tobacco occurred with similar frequency before as after 21:00, the UK watershed for programmes suitable for youth. The estimated number of incidences of exposure of the audience aged less than 18 years for any tobacco, actual tobacco use and tobacco branding were 59 million, 16 million and 3 million, respectively on average per week. Conclusions Television programming is a source of significant exposure of youth to tobacco imagery, before and after the watershed. Tobacco branding is particularly common in Coronation Street, a soap opera popular among youth audiences. More stringent controls on tobacco in prime time television therefore have the potential to reduce the uptake of youth smoking in the UK. PMID:23479113

Tornado Mechanics

NASA Technical Reports Server (NTRS)

1976-01-01

The Nimbus and other weather satellites are helping determine why and how tornadoes form their structure and dynamics and ultimately how they can be prevented or artificially dissipated. NASA's Marshall Space Flight Center is also planning a cooperative research program later this year with the University of Arkansas to investigate how tornado damage occurs, and to develop tornado resistant building designs. Hardware and field-data collection are funded by the Technology Utilization Office while data reduction is being performed by the National Oceanic and Atmospheric Administration.

Dredging Operations Technical Support Program. A Framework for Assessing the Need for Seasonal Restrictions on Dredging and Disposal Operations

DTIC Science & Technology

1991-07-01

size will influence whether burial will occur. Although meiofaunal or- ganisms such as nematodes and harpacticoid copepods are relatively mobile, they...Saloman and Naughton 1977, Simon and Dauer 1977). Meiobenthic assemblages, on the other hand, have been reported to have very low rates (years) of...pp 541-558. Shulenberger, E. 1970. Responses of Gemma gemma to a Catastrophic Burial," Veliger, Vol 13, pp 163-170. Simon, J. L., and Dauer , D. M. 1977

Environmental Impact Research Program: Tall Wheatgrass (Agropyron elongatum). Section 7.1.3. US Army Corps of Engineers Wildlife Resources Management Manual.

DTIC Science & Technology

1986-07-01

years. Powdery mildew may infest plants seasonally when prolonged damp weather occurs (Wasser 1982). Th . 13 LITERATURE CITED Association of Official...truncate (square) tips. The seeds are similar to small grains of wheat (Cronquist 3 ~’ auricle .4. * ligule glume-t / I a Figure 1. Distribution and...distinguishing characteristics of tall wheat - grass (Agropyron elongatwn): (a) culms, (b) ligule and auricle, (c) seedhead, (d) spikelet, and (e) floret

Proceedings, Annual Meeting, Aquatic Plant Control Research Program (20th) Held at Atlanta, Georgia on 18-21 November 1985.

DTIC Science & Technology

1986-06-01

Technology Development -Ed A. Theriot, WES Chemical Control Technology Development -Howard E. Westerdahl , WES 12:00 noon LUNCH iv 1:30 p.m. APCRP...PO Box 631 Vicksburg, MS 39180-0631 Vicksburg, MS 39180-0631 VkDan Thayer Howard Westerdahl Center for Aquatic Weeds USAE Waterways Experiment 7922...Technology Development, A Review by Howard E. Westerdahl * INTRODUCTION Over the past 8 years many advancements and a few disappointing events occurred that

Special Flood Hazard Evaluation Report, Maumee River, Defiance and Paulding Counties, Ohio

DTIC Science & Technology

1988-01-01

into the Flood Flow Frequency Analysis (FFFA) computer program (Reference 3) to determine the discharge-frequency relationship for the Maumee River...although the flood may occur in any year. It is based on statistical analysis of streamflow records available for the watershed and analysis of rainfall...C) K) K4 10 ERFODBUDR .S ryEgne itit ufI N - FODA ONAYSEIA LO AADEAUTO 6 ? -F -C )I= ~ - %E )tvXJ. AE LO LVTO MAMERVE CROS SECIONLOCAION DEFINCEAND

A Military-Relevant Model of Closed Concussive Head Injury: Longitudinal Studies Characterizing and Validating Single and Repetitive mTBI

DTIC Science & Technology

2014-10-01

Research Program (CCCRP). Provided in this Year 2 Annual Report are the results of our Phase I studies focused on characterizing the neuropathologic...effects of a single concussive impact to repeated concussive impacts using the PCI model. Phase I studies have been completed and these results set...the foundation for Phase II studies designed to evaluate the effects of repeated concussions that occur prior to and after the resolution of the

Early history of neutron scattering at oak ridge

NASA Astrophysics Data System (ADS)

Wilkinson, M. K.

1986-03-01

Most of the early development of neutron scattering techniques utilizing reactor neutrons occurred at the Oak Ridge National Laboratory during the years immediately following World War II. C.G. Shull, E.O. Wollan, and their associates systematically established neutron diffraction as a quantitative research tool and then applied this technique to important problems in nuclear physics, chemical crystallography, and magnetism. This article briefly summarizes the very important research at ORNL during this period, which laid the foundation for the establishment of neutron scattering programs throughout the world.

Fifth Annual Report: 2008 Pre-Construction Eelgrass Monitoring and Propagation for King County Outfall Mitigation

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

Woodruff, Dana L.; Judd, Chaeli; Thom, Ronald M.

2010-01-01

This is the fifth and final report in a series documenting progress of the pre-construction eelgrass restoration and mitigation activities for the proposed King County Brightwater marine outfall, discharging to Puget Sound near Point Wells, Washington. King County began implementing a multiyear eelgrass monitoring and restoration program in 2004, with the primary goal of returning intertidal and shallow subtidal habitat and eelgrass to pre-construction conditions, after construction of the outfall. Major eelgrass mitigation program elements include: a) pre-construction monitoring, i.e., documenting initial eelgrass conditions and degree of fluctuation over a 5 year period prior to construction, b) eelgrass transplanting, includingmore » harvesting, offsite propagation and stockpiling of local plants for post-construction planting, and c) post-construction planting and subsequent monitoring, occurring in 2009 and beyond. The overall program is detailed in the Eelgrass Restoration and Biological Resources Implementation Workplan (King County 2008).« less

A genomic lifespan program that reorganises the young adult brain is targeted in schizophrenia.

PubMed

Skene, Nathan G; Roy, Marcia; Grant, Seth Gn

2017-09-12

The genetic mechanisms regulating the brain and behaviour across the lifespan are poorly understood. We found that lifespan transcriptome trajectories describe a calendar of gene regulatory events in the brain of humans and mice. Transcriptome trajectories defined a sequence of gene expression changes in neuronal, glial and endothelial cell-types, which enabled prediction of age from tissue samples. A major lifespan landmark was the peak change in trajectories occurring in humans at 26 years and in mice at 5 months of age. This species-conserved peak was delayed in females and marked a reorganization of expression of synaptic and schizophrenia-susceptibility genes. The lifespan calendar predicted the characteristic age of onset in young adults and sex differences in schizophrenia. We propose a genomic program generates a lifespan calendar of gene regulation that times age-dependent molecular organization of the brain and mutations that interrupt the program in young adults cause schizophrenia.

The National Geothermal Energy Research Program

NASA Technical Reports Server (NTRS)

Green, R. J.

1974-01-01

The continuous demand for energy and the concern for shortages of conventional energy resources have spurred the nation to consider alternate energy resources, such as geothermal. Although significant growth in the one natural steam field located in the United States has occurred, a major effort is now needed if geothermal energy, in its several forms, is to contribute to the nation's energy supplies. From the early informal efforts of an Interagency Panel for Geothermal Energy Research, a 5-year Federal program has evolved whose objective is the rapid development of a commercial industry for the utilization of geothermal resources for electric power production and other products. The Federal program seeks to evaluate the realistic potential of geothermal energy, to support the necessary research and technology needed to demonstrate the economic and environmental feasibility of the several types of geothermal resources, and to address the legal and institutional problems concerned in the stimulation and regulation of this new industry.

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

Sathaye, Jayant; Andrasko, Ken; Chan, Peter

Greenhouse gas emissions from the forestry sector are estimated to be 8.4 GtCO2-eq./year or about 17percent of the global emissions. We estimate that the cost forreducing deforestation is low in Africa and several times higher in Latin America and Southeast Asia. These cost estimates are sensitive to the uncertainties of how muchunsustainable high-revenue logging occurs, little understood transaction and program implementation costs, and barriers to implementation including governance issues. Due to lack of capacity in the affected countries, achieving reduction or avoidance of carbon emissions will require extensive REDD-plus programs. Preliminary REDD-plus Readiness cost estimates and program descriptions for Indonesia,more » Democratic Republic of the Congo, Ghana, Guyana and Mexico show that roughly one-third of potential REDD-plus mitigation benefits might come from avoided deforestation and the rest from avoided forest degradation and other REDD-plus activities.« less

Factors Related to Learning Occurring in an Adult Education Program.

ERIC Educational Resources Information Center

Okoro, Daniel; Miller, Larry E.

A study examined the factors related to learning occurring in an adult education program. A purposeful sample of Ohio counties and 151 participants in a specific 1993-1993 adult education program who self-selected to participate in the study was used. A descriptive ex post facto study design was used. Pretests-posttests were administered to…

2000-2002 Sultandağı-Afyon Earthquake Activity in Western Anatolia, Turkey

NASA Astrophysics Data System (ADS)

Kalafat, D.

2016-12-01

Western Anatolia is one of the seismically active region in Turkey. The high seismic activity is a result of the complex tectonic deformation of the Anatolian plate which has been dominated by the N-S extensional tectonic regime in the western edge. This extensional tectonic regime is partially maintained by a relative movement of the African-Arabian plates to north, average 2.5 cm per year. In western Turkey, relatively 3 major earthquakes (Mw≥6.0) were identified on the Sultandağı Fault zone (Afyon-Akşehir Graben) between years of 2000-2002. First event occurred at the year of 2000 (Eber-Sultandagi Earthquake, Mw=6.0) , and both events were occurred at February 3, 2002 Sultandağı (Mw=6.5) and Cay-Sultandagi (Mw=6.0). In this study, mentioned local earthquake activity, have been investigated to understand their nature and relation of the regional seismic activity and tectonic deformation on the Sultandağı Fault Zone (Afyon-Akşehir Graben) in western Anatolia. At first, we analyzed the distribution of mainshock and aftershocks of the two earthquakes which occurred in February 3, 2002 in the region. Fault mechanism solutions of the selected earthquakes and detailed stress regime analyses performed for the mainshock and aftershock sequences of two earthquakes. In regard with mentioned earthquakes, the identified surface ruptures have been investigated by detailed geological field study in the region. Also source mechanism solutions of the selected 17 regional earthquakes between years of 2000 and 2009 years in the region provided to understand the relation of the Sultandagi earthquakes sequences and regional seismic activity. Regional and local seismic investigations shows that, consecutive seismic activity is a result of the disturbance of stress balance in the region which has been triggered by sequentially occuring of earthquakes and triggering in short interval in years of 2000-2002. Also all seismic source studies approved that extensional deformation and normal faulting is dominant in the region. This study was supported by the Department of Science Fellowship and Grant programs (2014-2219) of TUBITAK (The Scientific and Technological Research Council of Turkey) and by Massachusetts Institute of Technology (MIT) The Earth Resources Laboratory (ERL).

Operations analysis (study 2.1): Program manual and users guide for the LOVES computer code

NASA Technical Reports Server (NTRS)

Wray, S. T., Jr.

1975-01-01

Information is provided necessary to use the LOVES Computer Program in its existing state, or to modify the program to include studies not properly handled by the basic model. The Users Guide defines the basic elements assembled together to form the model for servicing satellites in orbit. As the program is a simulation, the method of attack is to disassemble the problem into a sequence of events, each occurring instantaneously and each creating one or more other events in the future. The main driving force of the simulation is the deterministic launch schedule of satellites and the subsequent failure of the various modules which make up the satellites. The LOVES Computer Program uses a random number generator to simulate the failure of module elements and therefore operates over a long span of time typically 10 to 15 years. The sequence of events is varied by making several runs in succession with different random numbers resulting in a Monte Carlo technique to determine statistical parameters of minimum value, average value, and maximum value.

Attachment and caregiving relationships in families affected by parental incarceration

PubMed Central

Shlafer, Rebecca J.; Poehlmann, Julie

2011-01-01

This longitudinal, mixed method study focused on 57 families of children who participated in a mentoring program for children of incarcerated parents. Children ranged in age from 4 to 15 years. Monthly interviews were conducted with children, caregivers, and mentors during the first six months of program participation, and questionnaires were administered at intake and six months to assess caregiver–child and incarcerated parent–child relationships, contact with incarcerated parents, and children’s behavior problems. Although some children viewed their incarcerated parents as positive attachment figures, other children reported negative feelings toward or no relationship with incarcerated parents. In addition, our assessments of children nine years old and older revealed that having no contact with the incarcerated parent was associated with children reporting more feelings of alienation toward that parent compared to children who had contact. Children’s behavior problems were a primary concern, often occurring in a relational context or in reaction to social stigma associated with parental imprisonment. PMID:20582847

Use of the SPARC software program to calculate hydrolysis rate constants for the polymeric brominated flame retardants BC-58 and FR-1025.

PubMed

Rayne, Sierra; Forest, Kaya

2016-01-01

The SPARC software program was used to estimate the acid-catalyzed, neutral, and base-catalyzed hydrolysis rate constants for the polymeric brominated flame retardants BC-58 and FR-1025. Relatively rapid hydrolysis of BC-58, producing 2,4,6-tribromophenol-and ultimately tetrabromobisphenol A-as the hydrolytically stable end products from all potential hydrolysis reactions, is expected in both environmental and biological systems with starting material hydrolytic half-lives (t(1/2,hydr)) ranging from less than 1 h in marine systems, several hours in cellular environments, and up to several weeks in slightly acid fresh waters. Hydrolysis of FR-1025 to give 2,3,4,5,6-pentabromobenzyl alcohol is expected to be slower (t(1/2,hydr) less than 0.5 years in marine systems up to several years in fresh waters) than BC-58, but is also expected to occur at rates that will contribute significantly to environmental and in vivo loadings of this compound.

Assessment of water quality in canals of eastern Broward County, Florida, 1969-74

USGS Publications Warehouse

Waller, Bradley G.; Miller, Wesley L.

1982-01-01

An intensive water-quality monitoring program was started in 1969 to determine the effects of man-induced contaminants on the water quality in the primary canal system of eastern Broward County, Florida. This report covers the first 6 years of the program and provides a data base that can be used to compare future changes in water-quality conditions. Most data indicate that beyond the small seasonal fluctuation in constituent level, the greatest adverse effect on the quality of water is caused by discharge of sewage and treated sewage effluent to the canals. The areas affected by sewage have greater concentrations of macronutrients, trace metals, and pesticides than unaffected areas. Major-ion concentrations were affected only by season and local lithology. Over the 6-year study a gradual decrease in macronutrient concentration and an increase in dissolved oxygen have occurred. This improvement in water quality is attributed to a decrease of sewage discharge into canals and better treatment of sewage effluents. (USGS)

Evaluation of an 18-year CMAQ simulation: Seasonal variations and long-term temporal changes in sulfate and nitrate

NASA Astrophysics Data System (ADS)

Civerolo, Kevin; Hogrefe, Christian; Zalewsky, Eric; Hao, Winston; Sistla, Gopal; Lynn, Barry; Rosenzweig, Cynthia; Kinney, Patrick L.

2010-10-01

This paper compares spatial and seasonal variations and temporal trends in modeled and measured concentrations of sulfur and nitrogen compounds in wet and dry deposition over an 18-year period (1988-2005) over a portion of the northeastern United States. Substantial emissions reduction programs occurred over this time period, including Title IV of the Clean Air Act Amendments of 1990 which primarily resulted in large decreases in sulfur dioxide (SO 2) emissions by 1995, and nitrogen oxide (NO x) trading programs which resulted in large decreases in warm season NO x emissions by 2004. Additionally, NO x emissions from mobile sources declined more gradually over this period. The results presented here illustrate the use of both operational and dynamic model evaluation and suggest that the modeling system largely captures the seasonal and long-term changes in sulfur compounds. The modeling system generally captures the long-term trends in nitrogen compounds, but does not reproduce the average seasonal variation or spatial patterns in nitrate.

Developing NDE Techniques for Large Cryogenic Tanks

NASA Technical Reports Server (NTRS)

Parker, Don; Starr, Stan

2009-01-01

The Shuttle and Constellation Programs require very large cryogenic ground storage tanks in which to store liquid oxygen and hydrogen. The existing LC-39 pad tanks, which will be passed onto Constellation, are 40 years old and have received minimal refurbishment or even inspection, because they can only be temperature cycled a few times before being overhauled (a costly operation in both time and dollars). Numerous questions exist on the performance and reliability of these old tanks which could cause a major Program schedule disruption. Consequently, with the passing of the first two tanks to Constellation to occur this year, there is growing awareness that NDE is needed to detect problems early in these tanks so that corrective actions can be scheduled when least disruptive. Time series thermal images of two sides of the Pad B LH2 tank have been taken over multiple days to demonstrate the effects of environmental conditions to the solar heating of the tank and therefore the effectiveness of thermal imaging.

Work-related traumatic spinal cord lesions in Chile, a 20-year epidemiological analysis.

PubMed

Correa, G I; Finkelstein, J M; Burnier, L A; Danilla, S E; Tapia, L Z; Torres, V N; Castillo, J C

2011-02-01

Retrospective cohort study. To describe the characteristics of patients with work-related traumatic spinal cord injuries (TSCI) in Chile. Hospital del Trabajador in Santiago, Santiago, Chile. Patients suffering from TSCI incurred at the workplace from 1986 to 2005 were identified through records of the Asociación Chilena de Seguridad (ACHS, Chilean Safety Association). The medical records of 173 patients, 172 men and 1 woman, were analyzed. The yearly average incidence was 7.8 per million workers. Age at TSCI onset was 38.2 ± 12.1 years. The principal external causes for TSCI incurred at the workplace were falls from a height in 86 cases (49.7%) and trauma blows to the vertebral spine in 61 cases (35.3 %). More falls occurred in the field construction, and other traumas occurred as a result of traumatic blows caused by tree trunks and stones in forestry and mining sectors. Mortality in this series was 8.7%, and the worst prognosis was for older patients with complete tetraplegia. The paraplegia:tetraplegia ratio was 3.2:1. The characteristics of workplace TSCI are specific to this population. It is important therefore to develop prevention programs for specific work-related TSCI.

Ergonomic office design and aging: a quasi-experimental field study of employee reactions to an ergonomics intervention program.

PubMed

May, Douglas R; Reed, Kendra; Schwoerer, Catherine E; Potter, Paul

2004-04-01

A naturally occurring quasi-experimental longitudinal field study of 87 municipal employees using pretest and posttest measures investigated the effects of an office workstation ergonomics intervention program on employees' perceptions of their workstation characteristics, levels of persistent pain, eyestrain, and workstation satisfaction. The study examined whether reactions differed between younger and older employees. Results revealed that workstation improvements were associated with enhanced perceptions of the workstation's ergonomic qualities, less upper back pain, and greater workstation satisfaction. Among those experiencing an improvement, the perceptions of workstation ergonomic qualities increased more for younger than older employees, supporting the "impressionable years" framework in the psychological literature on aging. Implications for human resources managers are discussed.

[From aviation to surgery: the challenge of safety].

PubMed

Suva, D; Haller, G; Lübbeke-Wolff, A; Macheret, F; Kindler, V; Hoffmeyer, P

2011-03-23

Medical errors result in 44,000 to 98,000 deaths per year in the United States of America. Within the surgical specialties, half of these errors occur in the operating room. The origin of these errors is multifactorial, and is generally associated with problems in communication and teamwork. In order to improve safety in the operating room, many hospitals now propose to the medical staff "crew resource management" (CRM) training programs inspired by the aviation industry. This approach favors a better utilization of surgical checklists, improves efficiency during chirurgical interventions, and reduces patient mortality. In October 2009 we introduced a CRM course within the department of surgery at the Geneva University Hospitals. We are presenting this program as well as the first results following its application.

Why invest in a national public health program for stroke? An example using Australian data to estimate the potential benefits and cost implications.

PubMed

Cadilhac, Dominique A; Carter, Robert C; Thrift, Amanda G; Dewey, Helen M

2007-10-01

Stroke is the world's second leading cause of death in people aged over 60 years. Approximately 50,000 strokes occur annually in Australia with numbers predicted to increase by about one third over 10-years. Our objectives were to assess the economic implications of a public health program for stroke by: (1) predicting what potential health-gains and cost-offsets could be achieved; and (2) determining the net level of annual investment that would offer value-for-money. Lifetime costs and outcomes were calculated for additional cases that would benefit if 'current practice' was feasibly improved, estimated for one indicative year using: (i) local epidemiological data, coverage rates and costs; and (ii) pooled effect sizes from systematic reviews. blood pressure lowering; warfarin for atrial fibrillation; increased access to stroke units; intravenous thrombolysis and aspirin for ischemic events; and carotid endarterectomy. Value-for-money threshold: AUD$30,000/DALY recovered. Improved, prevention and management could prevent about 27,000 (38%) strokes in 2015. In present terms (2004), about 85,000 DALYs and AUD$1.06 billion in lifetime cost-offsets could be recovered. The net level of annual warranted investment was AUD$3.63 billion. Primary prevention, in particular blood pressure lowering, was most effective. A public health program for stroke is warranted.

Evidence for the treatment of co-occurring stuttering and speech sound disorder: A clinical case series.

PubMed

Unicomb, Rachael; Hewat, Sally; Spencer, Elizabeth; Harrison, Elisabeth

2017-06-01

There is a paucity of evidence to guide treatment for children with co-occurring stuttering and speech sound disorder. Some guidelines suggest treating the two disorders simultaneously using indirect treatment approaches; however, the research supporting these recommendations is over 20 years old. In this clinical case series, we investigate whether these co-occurring disorders could be treated concurrently using direct treatment approaches supported by up-to-date, high-level evidence, and whether this could be done in an efficacious, safe and efficient manner. Five pre-school-aged participants received individual concurrent, direct intervention for both stuttering and speech sound disorder. All participants used the Lidcombe Program, as manualised. Direct treatment for speech sound disorder was individualised based on analysis of each child's sound system. At 12 months post commencement of treatment, all except one participant had completed the Lidcombe Program, and were less than 1.0% syllables stuttered on samples gathered within and beyond the clinic. These four participants completed Stage 1 of the Lidcombe Program in between 14 and 22 clinic visits, consistent with current benchmark data for this programme. At the same assessment point, all five participants exhibited significant increases in percentage of consonants correct and were in alignment with age-expected estimates of this measure. Further, they were treated in an average number of clinic visits that compares favourably with other research on treatment for speech sound disorder. These preliminary results indicate that young children with co-occurring stuttering and speech sound disorder may be treated concurrently using direct treatment approaches. This method of service delivery may have implications for cost and time efficiency and may also address the crucial need for early intervention in both disorders. These positive findings highlight the need for further research in the area and contribute to the limited evidence base.

Incidence of first ever stroke during Hajj ceremony

PubMed Central

2013-01-01

Background The Hajj Ceremony, the largest annual gathering in the world, is the most important life event for any Muslim. This study was designed to evaluate the incidence of stroke among Iranian pilgrims during the Hajj ceremony. Methods We ascertained all cases of stroke occurring in a population of 92,974 Iranian pilgrims between November 27, 2007 and January 12, 2008. Incidence and risk factors of the first ever stroke in Hajj pilgrims were compared, within the same time frame, to those of the Mashhad residents, the second largest city in Iran. Data for the latter group were extracted from the Mashhad Stroke Incidence Study (MSIS) database. Results During the study period, 17 first-ever strokes occurred in the Hajj pilgrims and 40 first-ever stroke strokes occurred in the MSIS group. Overall, the adjusted incidence rate of first ever stroke in the Hajj cohort was lower than that of the MSIS population (9 vs. 16 per 100,000). For age- and gender-specific subgroups, the Hajj stroke crude rates were in general similar to or lower than the general population of Mashhad, Iran, with the exception of women aged 35 to 44 years and aged >75 years who were at greater risk of having first-ever stroke than the non-pilgrims of the same age. Conclusion The first ever stroke rate among Iranian Hajj pilgrims was lower than that of the general population in Mashhad, Iran, except for females 35–44 or more than 75 years old. The number of events occurring during the Hajj suggests that Islamic countries should consider designing preventive and screening programs for pilgrims. PMID:24308305

Assessment and Treatment of Co-occurring Eating Disorders in Privately Funded Addiction Treatment Programs

PubMed Central

Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M.

2011-01-01

Privately-funded addiction treatment programs were surveyed to increase understanding of assessment and current treatment options for patients with co-occurring substance use and eating disorders. Data were collected from face-to-face interviews with program administrators of a nationally representative sample of 345 private addiction treatment programs. Although the majority of programs reported screening for eating disorders, programs varied in screening instruments used. Sixty-seven percent reported admitting cases of low severity. Twenty-one percent of programs attempt to treat eating disorders. These results highlight the need for education of addiction treatment professionals in assessment, referral and treatment of eating disorders. PMID:21477048

Cost-Effectiveness of Healthcare Worker Pneumococcal Polysaccharide Vaccination During Pandemic Influenza

PubMed Central

Smith, Kenneth J.; Raymund, Mahlon; Nowalk, Mary Patricia; Roberts, Mark S.; Zimmerman, Richard K.

2010-01-01

Objective In prior influenza pandemics, pneumococcal complications of influenza have caused substantial morbidity and mortality. The usefulness and cost-effectiveness of pneumococcal vaccination for healthcare workers during an influenza pandemic is unknown. Study Design Markov modeling was used to estimate the cost-effectiveness of pneumococcal polysaccharide vaccination (PPV) in previously unvaccinated healthcare workers during an influenza pandemic. Methods Invasive pneumococcal disease (IPD) incidence rates were incorporated into the model, assuming that IPD events occurred at twice the usual rate during the year of pandemic influenza. Both societal and hospital perspectives were examined. Assumptions were that: pneumococcal disease transmission from healthcare worker to patient did not occur, heightened IPD risk occurred for only 1 year, and PPV did not prevent noninvasive pneumonia, all of which potentially bias against vaccination. Results From a societal standpoint, pneumococcal vaccination of healthcare workers during an influenza pandemic is economically reasonable, costing $2,935 per quality adjusted life year gained; results were robust to variation in multiple sensitivity analyses. However, from the hospital perspective vaccinating healthcare workers was expensive, costing $1,676 per employee absence day avoided, given an IPD risk that, though increased, would still remain <1%. Conclusion Vaccinating all healthcare workers to protect against pneumococcal disease during a pandemic influenza outbreak is likely to be economically reasonable from the societal standpoint. However, pneumococcal vaccination is expensive from the hospital perspective, which might prevent implementation of a PPV program unless it is externally subsidized. PMID:20225915

Kidney transplantation after desensitization in sensitized patients: a Korean National Audit.

PubMed

Huh, Kyu Ha; Kim, Beom Seok; Yang, Jaeseok; Ahn, Jeongmyung; Kim, Myung-Gyu; Park, Jae Berm; Kim, Jong Man; Chung, Byung-Ha; Kim, Joong Kyung; Kong, Jin Min

2012-10-01

The number of end-stage renal disease (ESRD) patients with preformed antibodies waiting for a kidney transplant has been increasing lately. We conducted a nationwide study on the outcomes of kidney transplantation after desensitization in Korea. Six transplant centers have run desensitization programs. The patients who underwent living donor kidney transplantation after desensitization from 2002 to 2010 were retrospectively analyzed. A total of 86 cases were enrolled. Thirty-five of these were cases of re-transplantation (40.7 %). Indications of desensitization were positive complement-dependent cytotoxicity (CDC) cross-match responses (CDC(+), 36.0 %), positive flow-cytometric cross-match responses (FCX(+), 54.7 %), and positive donor-specific antibodies (DSA(+), 8.1 %). The desensitization protocols used pre-transplant plasmapheresis (95.3 %), intravenous immunoglobulin (62.8 %), and rituximab (67.4 %). Acute rejection occurred in 18 patients (20.9 %), graft failure occurred in 4 patients, and the 3-year graft survival rate was 93.8 %. The presence of DSA increased the acute rejection rate (P = 0.015) and decreased the 1-year post-transplant estimated glomerular filtration rate (P = 0.006). Although rejection-free survival rates did not differ significantly between the CDC(+) and FCX(+) groups, the 1-year estimated glomerular filtration rate was lower in the CDC(+) group (P = 0.010). Infectious and significant bleeding complications occurred in 15.5 % and 4.7 % of cases, respectively. Kidney transplantation after desensitization had good graft outcomes and tolerable complications in Korea, and therefore, this therapy can be recommended for sensitized ESRD patients.

Profile of children and adolescents admitted to a Burn Care Unit in the countryside of the state of São Paulo☆

PubMed Central

Biscegli, Terezinha Soares; Benati, Larissa Delázari; Faria, Rafaela Sperandio; Boeira, Taís Romano; Cid, Felipe Biscegli; Gonsaga, Ricardo Alessandro Teixeira

2014-01-01

Objective: To describe the profile of pediatric burn victims hospitalized at Hospital-Escola Padre Albino (HEPA), in Catanduva, São Paulo, Brazil. Methods: This was a cross-sectional, retrospective study analyzing 446 medical records of patient aged 0-18 years old hospitalized in the Burn Care Unit of HEPA, from 2002 to 2012. The following variables were recorded: demographic data, skin burn causes, lesions characteristics, complications, surgical procedures, length of hospital stay, and outcome. Descriptive statistics were used. Results: 382 patients with full medical records were included in the study. Burns were more frequent in males (64.4%) and in children aged less than 6 years (52.9%). Most accidents occurred at home (67.3%) and hot liquids were responsible for 47.1% of them. Mean burnt body surface was 18% and the most affected body areas were chest and limbs. First- and second-degree burns were observed in 64.4% of the cases. Secondary infection and surgical procedures occurred in 6.5% and 45.0% of the patients, respectively. Mean length of hospital stay was 9.8 days. The mortality rate was 1.6%. Conclusions: Preschool children were the main victims of burns occurring at home, representing the largest contingent of hospitalizations due to this cause in individuals aged < 18 years. It is important to develop strategies to alert parents and general society through educational programs and preventive campaigns. PMID:25479846

Stroke as the Initial Manifestation of Atrial Fibrillation: The Framingham Heart Study.

PubMed

Lubitz, Steven A; Yin, Xiaoyan; McManus, David D; Weng, Lu-Chen; Aparicio, Hugo J; Walkey, Allan J; Rafael Romero, Jose; Kase, Carlos S; Ellinor, Patrick T; Wolf, Philip A; Seshadri, Sudha; Benjamin, Emelia J

2017-02-01

To prevent strokes that may occur as the first manifestation of atrial fibrillation (AF), screening programs have been proposed to identify patients with undiagnosed AF who may be eligible for treatment with anticoagulation. However, the frequency with which patients with AF present with stroke as the initial manifestation of the arrhythmia is unknown. We estimated the frequency with which AF may present as a stroke in 1809 community-based Framingham Heart Study participants with first-detected AF and without previous strokes, by tabulating the frequencies of strokes occurring on the same day, within 30 days before, 90 days before, and 365 days before first-detected AF. Using previously reported AF incidence rates, we estimated the incidence of strokes that may represent the initial manifestation of AF. We observed 87 strokes that occurred ≤1 year before AF detection, corresponding to 1.7% on the same day, 3.4% within 30 days before, 3.7% within 90 days before, and 4.8% ≤1 year before AF detection. We estimated that strokes may present as the initial manifestation of AF at a rate of 2 to 5 per 10 000 person-years, in both men and women. We observed that stroke is an uncommon but measureable presenting feature of AF. Our data imply that emphasizing cost-effectiveness of population-wide AF-screening efforts will be important given the relative infrequency with which stroke represents the initial manifestation of AF. © 2017 American Heart Association, Inc.

Home visiting programs for HIV-affected families: a comparison of service quality between volunteer-driven and paraprofessional models.

PubMed

Kidman, Rachel; Nice, Johanna; Taylor, Tory; Thurman, Tonya R

2014-10-02

Home visiting is a popular component of programs for HIV-affected children in sub-Saharan Africa, but its implementation varies widely. While some home visitors are lay volunteers, other programs invest in more highly trained paraprofessional staff. This paper describes a study investigating whether additional investment in paraprofessional staffing translated into higher quality service delivery in one program context. Beneficiary children and caregivers at sites in KwaZulu-Natal, South Africa were interviewed after 2 years of program enrollment and asked to report about their experiences with home visiting. Analysis focused on intervention exposure, including visit intensity, duration and the kinds of emotional, informational and tangible support provided. Few beneficiaries reported receiving home visits in program models primarily driven by lay volunteers; when visits did occur, they were shorter and more infrequent. Paraprofessional-driven programs not only provided significantly more home visits, but also provided greater interaction with the child, communication on a larger variety of topics, and more tangible support to caregivers. These results suggest that programs that invest in compensation and extensive training for home visitors are better able to serve and retain beneficiaries, and they support a move toward establishing a professional workforce of home visitors to support vulnerable children and families in South Africa.

10 CFR Appendix R to Part 50 - Fire Protection Program for Nuclear Power Facilities Operating Prior to January 1, 1979

Code of Federal Regulations, 2010 CFR

2010-01-01

... could occur in a nuclear power plant. These sessions shall provide brigade members with experience in... A. Fire protection program. A fire protection program shall be established at each nuclear power... fires that could occur in the plant and in using the types of equipment available in the nuclear power...

Developing Entrepreneurial and Technology Commercialization Policies to Promote Cooperative Ventures Between NIH and Industry

NASA Astrophysics Data System (ADS)

Rossomando, Edward F.

2001-03-01

The NIH has had a great influence in guiding the biological research agenda for the last half of the 20th century. This may change if the increases in research funding from the private sector that occurred in the last ten years continue into the 21st century. Ten years ago, industry supplied 55% of the US R&D funds. In 2000, industry support of R&D had increased to 76%, with industry carrying out 70% of the nations applied and 91% of its development research. Given this shift, one of the biggest challenges that NIH may face in coming years is sharing control of America's research agenda with industry. For this to occur policies that encourage cooperative ventures with industry are needed. In a unique experiment, I was invited to the National Institute of Dental and Craniofacial Research (NIDCR), one of the 25 NIH Institutes and Centers, to develop programs and policies that would promote interactions with industry. This talk will introduce the strategy and programs developed to commercialize products and technologies from basic science discoveries and introducing an entrepreneurial atmosphere within the Institute. The results of this experiment will be discussed by comparing differences between discovery-driven and customer-driven innovation. One outcome of this experience is a greater appreciation of the obstacles to introducing disruptive technologies into the market place and of the paradigms that serve as barriers to commercialization. One recommendation is that the NIDCR consider a policy that allows for some participation by industry in setting the research and training agenda of the Institute, and that a mechanism for industry input be introduced into its administrative organization.

A Perspective on Promoting Diversity in the Biomedical Research Workforce: The National Heart, Lung, and Blood Institute’s PRIDE Program

PubMed Central

Boyington, Josephine E.A.; Maihle, Nita J.; Rice, Treva K.; Gonzalez, Juan E.; Hess, Caryl A.; Makala, Levi H.; Jeffe, Donna B.; Ogedegbe, Gbenga; Rao, Dabeeru C.; Dávila-Román, Victor G.; Pace, Betty S.; Jean-Louis, Girardin; Boutjdir, Mohamed

2016-01-01

Aspiring junior investigators from groups underrepresented in the biomedical sciences face various challenges as they pursue research independence. However, the biomedical research enterprise needs their participation to effectively address critical research issues such as health disparities and health inequities. In this article, we share a research education and mentoring initiative that seeks to address this challenge: Programs to Increase Diversity among Individuals Engaged in Health Related Research (PRIDE), funded by the National Heart, Lung, and Blood Institute (NHLBI). This longitudinal research-education and mentoring program occurs through summer institute programs located at US-based academic institutions. Recruited participants are exposed to didactic and lab-based research-skill enhancement experiences, with year-round mentoring over the course of two years. Mentor-mentee matching is based on shared research interests to promote congruence and to enhance skill acquisition. Program descriptions and sample narratives of participants’ perceptions of PRIDE’s impact on their career progress are showcased. Additionally, we highlight the overall program design and structure of four of seven funded summer institutes that focus on cardiovascular disease, related conditions, and health disparities. Mentees’ testimonials about the value of the PRIDE mentoring approach in facilitating career development are also noted. Meeting the clinical and research needs of an increasingly diverse US population is an issue of national concern. The PRIDE initiative, which focuses on increasing research preparedness and professional development of groups underrepresented in the biomedical research workforce, with an emphasis on mentoring as the critical approach, provides a robust model that is impacting the careers of future investigators. PMID:27440978

A Perspective on Promoting Diversity in the Biomedical Research Workforce: The National Heart, Lung, and Blood Institute's PRIDE Program.

PubMed

Boyington, Josephine E A; Maihle, Nita J; Rice, Treva K; Gonzalez, Juan E; Hess, Caryl A; Makala, Levi H; Jeffe, Donna B; Ogedegbe, Gbenga; Rao, Dabeeru C; Dávila-Román, Victor G; Pace, Betty S; Jean-Louis, Girardin; Boutjdir, Mohamed

2016-07-21

Aspiring junior investigators from groups underrepresented in the biomedical sciences face various challenges as they pursue research independence. However, the biomedical research enterprise needs their participation to effectively address critical research issues such as health disparities and health inequities. In this article, we share a research education and mentoring initiative that seeks to address this challenge: Programs to Increase Diversity among Individuals Engaged in Health Related Research (PRIDE), funded by the National Heart, Lung, and Blood Institute (NHLBI). This longitudinal research-education and mentoring program occurs through summer institute programs located at US-based academic institutions. Recruited participants are exposed to didactic and lab-based research-skill enhancement experiences, with year-round mentoring over the course of two years. Mentor-mentee matching is based on shared research interests to promote congruence and to enhance skill acquisition. Program descriptions and sample narratives of participants' perceptions of PRIDE's impact on their career progress are showcased. Additionally, we highlight the overall program design and structure of four of seven funded summer institutes that focus on cardiovascular disease, related conditions, and health disparities. Mentees' testimonials about the value of the PRIDE mentoring approach in facilitating career development are also noted. Meeting the clinical and research needs of an increasingly diverse US population is an issue of national concern. The PRIDE initiative, which focuses on increasing research preparedness and professional development of groups underrepresented in the biomedical research workforce, with an emphasis on mentoring as the critical approach, provides a robust model that is impacting the careers of future investigators.

Investigations on potential bacteria for the bioremediation treatment of environments contaminated with hydrocarbons

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

Lazar, I.; Voicu, A.; Dobrota, S.

1995-12-31

In Romania after more than 135 years of oil production and processing, some severe environmental pollution problems have accumulated. In this context a joint research group from Institute of Biology Bucharest and S.C. Petrostar S.A. Ploiesti became involved in a research project on bioremediation of an environment contaminated with hydrocarbon waste. In the first stage of this project, investigations on microbial communities occurring in environments contaminated with oil were carried out. In the second stage, the hundreds of bacterial strains and populations isolated from soils, slops, and water sites contaminated with waste oil and water waste oil mix were submittedmore » to a screening program, to select a naturally occurring mixed culture with a high ability to degrade hydrocarbons.« less

Estimating cost-effectiveness of mass cardiopulmonary resuscitation training strategies to improve survival from cardiac arrest in private locations.

PubMed

Swor, Robert; Compton, Scott

2004-01-01

Most cardiopulmonary resuscitation (CPR) trainees are young, and most cardiac arrests occur in private residences witnessed by older individuals. To estimate the cost-effectiveness of a CPR training program targeted at citizens over the age of 50 years compared with that of current nontargeted public CPR training. A model was developed using cardiac arrest and known demographic data from a single suburban zip code (population 36,325) including: local data (1997-1999) regarding cardiac arrest locations (public vs. private); incremental survival with CPR (historical survival rate 7.8%, adjusted odds ratio for CPR 2.0); arrest bystander demographics obtained from bystander telephone interviews; zip code demographics regarding population age and distribution; and 12.50 dollars per student for the cost of CPR training. Published rates of CPR training programs by age were used to estimate the numbers typically trained. Several assumptions were made: 1) there would be one bystander per. arrest; 2) the bystander would always perform CPR if trained; 3) cardiac arrest would be evenly distributed in the population; and 4) CPR training for a proportion of the population would proportionally increase CPR provision. Rates of arrest, bystanders by age, number of CPR trainees needed to result in increased arrest survival, and training cost per life saved for a one-year study period were calculated. There were 24.3 cardiac arrests per year, with 21.9 (90%) occurring in homes. In 66.5% of the home arrests, the bystander was more than 50 years old. To yield one additional survivor using the current CPR training strategy, 12,306 people needed to be trained (3,510 bystanders aged < or = 50 years and 8,796 bystanders aged > 50 years), which resulted in CPR provision to 7.14 additional patients. The training cost per life saved for a bystander aged < or = 50 years was 313,214 dollars, and that for a bystander aged > 50 years was 785,040 dollars. Using a strategy of training only those < or = 50 years, 583 elders per cardiac arrest would need to be trained, with a cost of 53,383 dollars per life saved. Using these assumptions, current CPR training strategy is not a cost-effective intervention for home cardiac arrests. The high rate of elders witnessing CPR mandates focused CPR interventions for this population.

Boston University Pre-Majors Program (BU Pre-Map): Promoting Diversity through First-Year Undergraduate Research

NASA Astrophysics Data System (ADS)

West, Andrew A.

2014-06-01

One of largest points of attrition for underrepresented minorities in STEM fields is the transition from high school to college. A report from Building Engineering and Science Talent (BEST) demonstrates that underrepresented minorities begin college interested in STEM fields at rates equal to (if nor slightly above) their representation in both college and the population (25%). However, by the time they graduate, underrepresented minorities make up only 15% of STEM majors and only 9% of the STEM advanced degrees. Most of the attrition occurs during the first year of college, when large classes, a lack of mentors and challenging courses lead many students (from all backgrounds) to consider other majors.In 2011 I started the Boston University Pre-Majors Program (or BU Pre-MaP), which is modeled after the University of Washington Pre-Majors in Astronomy Program (UW Pre-MAP), a program for recruiting, mentoring and training underrepresented, first-year introductory astronomy students (and of which I was an architect). As a significant part of the Pre-MAP (or Pre-MaP) model, first-year students are engaged in a research project with a faculty or grad-student mentor and learn many of the skills needed to be successful in science.The BU Pre-MaP uses weekly seminars to introduce students to BU and the college environment, discuss ways to be successful in and out of the classroom, highlights the importance of peer mentoring and cohort building and serves as a mechanism to introduce first-year students to research skills. In teams of two, the Pre-MaP students select (with assistance) a research mentor and work with him/her on a original research project.In addition, Pre-MaP students attend several field trips including (but not limited to) viewing original science documents at the Boston Public Library (including a first edition Copernicus) and an observing run at Lowell Observatory in Arizona.

Boston University Pre-Majors Program (BU Pre-Map): Promoting Diversity through First-Year Undergraduate Research

NASA Astrophysics Data System (ADS)

West, Andrew A.

2015-01-01

One of largest points of attrition for underrepresented minorities in STEM fields is the transition from high school to college. A report from Building Engineering and Science Talent (BEST) demonstrates that underrepresented minorities begin college interested in STEM fields at rates equal to (if nor slightly above) their representation in both college and the population (25%). However, by the time they graduate, underrepresented minorities make up only 15% of STEM majors and only 9% of the STEM advanced degrees. Most of the attrition occurs during the first year of college, when large classes, a lack of mentors and challenging courses lead many students (from all backgrounds) to consider other majors.In 2012 I started the Boston University Pre-Majors Program (or BU Pre-MaP), which is modeled after the University of Washington Pre-Majors in Astronomy Program (UW Pre-MAP), a program for recruiting, mentoring and training underrepresented, first-year introductory astronomy students (and of which I was an architect). As a significant part of the Pre-MAP (or Pre-MaP) model, first-year students are engaged in a research project with a faculty or grad-student mentor and learn many of the skills needed to be successful in science.The BU Pre-MaP uses weekly seminars to introduce students to BU and the college environment, discuss ways to be successful in and out of the classroom, highlights the importance of peer mentoring and cohort building and serves as a mechanism to introduce first-year students to research skills. In teams of two, the Pre-MaP students select (with assistance) a research mentor and work with him/her on a original research project.In addition, Pre-MaP students attend several field trips including (but not limited to) viewing original science documents at the Boston Public Library (including a first edition Copernicus) and an observing run at Lowell Observatory in Arizona.

Very Low Prevalence of Vaccine Human Papillomavirus Types Among 18- to 35-Year Old Australian Women 9 Years Following Implementation of Vaccination.

PubMed

Machalek, Dorothy A; Garland, Suzanne M; Brotherton, Julia M L; Bateson, Deborah; McNamee, Kathleen; Stewart, Mary; Rachel Skinner, S; Liu, Bette; Cornall, Alyssa M; Kaldor, John M; Tabrizi, Sepehr N

2018-04-23

A quadrivalent human papillomavirus vaccination program targeting females aged 12-13 years commenced in Australia in 2007, with catch-up vaccination of 14-26 year olds through 2009. We evaluated the program's impact on HPV prevalence among women aged 18-35 in 2015. HPV prevalence among women aged 18-24 and 25-35 was compared with prevalence in these age groups in 2005-2007. For women aged 18-24, we also compared prevalence with that in a postvaccine study conducted in 2010-2012. For the 2015 sample, Vaccination Register-confirmed 3-dose coverage was 53.3% (65.0% and 40.3% aged 18-24 and 25-35, respectively). Prevalence of vaccine HPV types decreased from 22.7% (2005-2007) and 7.3% (2010-2012), to 1.5% (2015) (P trend < .001) among women aged 18-24, and from 11.8% (2005-2007) to 1.1% (2015) (P = .001) among those aged 25-35. This study, reporting the longest surveillance follow-up to date, shows prevalence of vaccine-targeted HPV types has continued to decline among young women. A substantial fall also occurred in women aged 25-35, despite lower coverage. Strong herd protection and effectiveness of less than 3 vaccine doses likely contributed to these reductions.

Urban transport safety assessment in akure based on corresponding performance indicators

NASA Astrophysics Data System (ADS)

Oye, Adedamola; Aderinlewo, Olufikayo; Croope, Silvana

2013-03-01

The level of safety of the transportation system in Akure, Nigeria was assessed by identifying the associated road safety problems and developing the corresponding safety performance indicators. These indicators were analysed with respect to accidents that occurred within the city from the year 2005 to 2009 based on the corresponding attributable risk measures. The results of the analysis showed the state of existing safety programs in Akure town. Six safety performance indicators were identified namely alcohol and drug use, excessive speeds, protection system (use of seat belts and helmets), use of day time running lights, state of vehicles (passive safety) and road condition. These indicators were used to determine the percentage of injury accidents as follows: 83.33% and 86.36% for years 2005 and 2006 respectively, 81.46% for year 2007 while years 2008 and 2009 had 82.86% and 78.12% injury accidents respectively.

Sustainability Science as a Transdisciplinary Framework for Institutional Transformation at Unity College

NASA Astrophysics Data System (ADS)

Mulkey, S. S.

2012-12-01

Interdisciplinary programming in higher education is accepted as necessary for effective instructional delivery of complex environmental problems. Difficulties in sharing resources among disciplinary units and the need for students to sequentially access information from different disciplines limit the effectiveness of this approach. In contrast, transdisciplinary programming requires that the perspectives of various disciplines be simultaneously integrated in problem-focused pedagogy. Unity College, an environmental college in Maine, has recently adopted Sustainability Science (sensu U.S. National Academy of Science) as a framework for transdisciplinary pedagogy throughout all of its degree programs. Sustainability Science is a promising alternative framework that focuses on the dynamics of coupled human-natural systems and is defined by the problems that it addresses rather than by the disciplines it employs. Students are empowered to become brokers of knowledge, while faculty perform a curatorial role to provide students with networked resources generally external to the classroom. Although the transdisciplinary framework is effective for delivery of Sustainability Science in upper division and capstone courses, we propose this approach also for elements of our general education curriculum during the first two years of our baccalaureate programs. Classroom time is liberated for experiential student engagement and recitation. Our experience suggests that transdisciplinary programming can provide students with critical thinking skills and thus enhance the postgraduate value of their baccalaureate degree. We are coordinating the development of this distinctive curriculum delivery with a marketing program that will make Unity College accessible to a wider range of clientele. Our implementation of transdisciplinary programming will occur over a four-year period and requires explicit and fundamental change in essentially all aspects of College administration and academics.

Hundreds of Cruises, Thousands of People, Endless Discoveries - Education and Outreach in the Integrated Ocean Drilling Program

NASA Astrophysics Data System (ADS)

Peart, L.; Niemitz, M.; Boa, S.; Corsiglia, J.; Klaus, A.; Petronotis, K.; Iturrino, G.

2005-12-01

For 37 years, scientific ocean drilling programs have sponsored hundreds of expeditions, drilled at over 1,800 sites and recovered over 200 miles of core. The discoveries of these programs have led to important realizations of how our earth works. Past expeditions have validated the theory of plate tectonics, provided unparalleled ancient climate records and recovered evidence of the asteroid impact that wiped out the dinosaurs 65 million years ago - and new discoveries occur with every expedition. By producing education materials and programs and encouraging mass media journalists' interest in our news, we strive to fulfill our commitment to communicate our programs' scientific discoveries to the public, in a way that people - not just other scientists - understand. With the advent of the Integrated Ocean Drilling Program (IODP), education and outreach efforts have expanded to pursue new opportunities and engage wider audiences. Through our strategy of Teaching for Science, Learning for LifeTM, our education efforts seek to utilize the interdisciplinary nature of scientific ocean drilling to teach career awareness, scientific methods, teamwork, and problem solving techniques for a lifetime of learning, decision making and good citizenship. In pursuit of this goal, we have implemented professional and resource development programs and expanded our outreach at education-focused conferences to help teachers use IODP science to satiate the student's need to learn the methods of science that apply to everyday life. We believe that this message also applies to life-long learners and thus we have focused our efforts on news media outreach and education opportunities surrounding ports of call of the JOIDES Resolution, permanent and traveling museum exhibits. In addition, our outreach to undergraduate and graduate audiences, through a lecture series, research fellowships and internships, helps to create future generations of science leaders.

Flying high-altitude balloon-borne telescopes 50 years ago

NASA Astrophysics Data System (ADS)

Fazio, Giovanni G.

Based on theoretical predictions of cosmic gamma-ray fluxes by P. Morrison (1958) and M. Savedoff (1959), we started, at the University of Rochester, a program in high-energy gammaray astronomy to search for these sources using high-altitude balloon-borne telescopes. The first flight occurred in 1959 from Sioux Falls, SD, using scintillator/Cerenkov detectors. In 1962 I initiated a gamma-ray astronomy program at the Smithsonian Astrophysical Observatory (SAO) using vidicon spark chambers. Later Henry Helmken (SAO) developed a program in low-energy gamma-ray astronomy based on a gas Cerenkov detector. During the 1960's more flights followed from San Angelo, TX; Holloman AFB, NM; Hyderabad, India, and finally, Palestine, TX. All of these flights just produced upper limits to the cosmic gamma-ray flux. We also entered a collaboration with the Cornell Group (K. Greisen) to fly a large gas-Cerenkov telescope to search for ˜ 100 MeV gamma-rays. In the early 1970's, using this telescope, gammarays from the Crab Nebula pulsar were detected (McBreen et al. 1973). It soon became evident that gamma-ray astronomy, to be successful, had to be performed from space telescopes. In 1970, somewhat frustrated, I changed fields and started at SAO/Harvard the construction of a 1-meter balloon-borne telescope for far-infrared astronomy. This was a collaborative program with the University of Arizona (F. Low). This program was extremely successful, resulting in 19 flights over 20 years, and produced the first far-infrared high-resolution maps of many new galactic regions and detection of solar system sources. Experience gained from these programs later led to the development and flight of space gamma-ray and infrared telescopes and many of the participants were, and some still are, active in numerous space programs.

Health care transition for youth living with HIV/AIDS.

PubMed

Dowshen, Nadia; D'Angelo, Lawrence

2011-10-01

There are ~1 million people in the United States living with HIV/AIDS, and >50,000 new infections occur each year. With an estimated 13% of all new infections occurring among young people aged 13 to 24 years and an increasing number of perinatally infected youth surviving to adulthood, there is now an increasing need to transition both perinatally and behaviorally infected youth to the adult health care setting. Recently, pediatric providers and professional societies have prioritized the development of transition programs for adolescents with chronic disease to address the many challenges these youth face in the process. Although multiple position papers have called for continuous, coordinated, culturally appropriate, compassionate, family-centered transition programs for youth with special health care needs and have recognized the need for evidence-based models, few data exist on what strategies are most effective. To date, published data on health care transition for HIV-positive youth are limited and include only 2 studies, which considered behaviorally infected youth. In this state-of-the-art review, we discuss the unique transition challenges to consider for this population, including socioeconomic and health insurance status, the special role of the pediatric or adolescent provider as family, stigma and disclosure issues, cognitive development and mental health issues, medication adherence, and sexual, reproductive, and gender health concerns. Future research will need to include the experiences of transition in low-resource settings and examine clinical outcomes and factors that may predict success or failure of the transition process.

Youth exposure to alcohol advertising on radio--United States, June-August 2004.

PubMed

2006-09-01

In the United States, more underage youth drink alcohol than smoke tobacco or use illicit drugs. Excessive alcohol consumption leads to many adverse health and social consequences and results in approximately 4,500 deaths among underage youth each year. Recent studies have emphasized the contribution of alcohol marketing to underage drinking and have demonstrated that a substantial proportion of alcohol advertising appears in media for which the audience composition is youth-oriented (i.e., composed disproportionately of persons aged 12-20 years). To determine the proportion of radio advertisements that occurred on radio programs with audiences composed disproportionately of underage youth and the proportion of total youth exposure to alcohol advertising that occurs as a result of such advertising, researchers at the Center on Alcohol Marketing and Youth (Health Policy Institute, Georgetown University, District of Columbia) evaluated the placement of individual radio advertisements for the most advertised U.S. alcohol brands and the composition of audiences in the largest 104 markets in the United States. This report summarizes the results of that study, which indicate that alcohol advertising is common on radio programs which have disproportionately large youth audiences and that this advertising accounts for a substantial proportion of all alcohol radio advertising heard by underage youth. These results further indicate that 1) the current voluntary standards limiting alcohol marketing to youth should be enforced and ultimately strengthened, and 2) ongoing monitoring of youth exposure to alcohol advertising should continue.

First-Year Analysis of a New, Home-Based Palliative Care Program Offered Jointly by a Community Hospital and Local Visiting Nurse Service.

PubMed

Pouliot, Katherine; Weisse, Carol S; Pratt, David S; DiSorbo, Philip

2017-03-01

There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid hospitalizations and remain with their regular outside care providers. To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine's community hospital serving New York's Capital District. This prospective cohort study assessed patient outcomes over the course of 1 year for 123 patients (49 men and 74 women) with serious illnesses who were new enrollees in the program. Quality of life was assessed at baseline and after 1 month on service. Satisfaction with care was measured after 1 and 3 months on service. The number of emergency department visits and inpatient hospitalizations pre- and postenrollment was measured for all enrollees. Patients were highly satisfied (72.7%-100%) with their initial care and reported greater satisfaction ( P < .05) and stable symptom management over time. Fewer emergency department ( P < .001) and inpatient hospital admissions ( P < .001) occurred among enrollees while on the palliative care service. An in-home palliative care program offered jointly through a visiting nurse service and community hospital may be a successful model for providing quality care that satisfies chronically ill patients' desire to remain at home and avoid hospital admissions.

Complications and Failure to Rescue After Inpatient Noncardiac Surgery in the Veterans Affairs Health System.

PubMed

Massarweh, Nader N; Kougias, Panagiotis; Wilson, Mark A

2016-12-01

The quality of surgical care in the Veterans Health Administration improved markedly in the 1990s after implementation of the Veterans Affairs (VA) National Surgical Quality Improvement Program (now called the VA Surgical Quality Improvement Program). Although there have been many recent evaluations of surgical care in the private sector, to date, a contemporary global evaluation has not been performed within the VA health system. To provide a contemporaneous report of noncardiac postoperative outcomes in the VA health system during the past 15 years. A retrospective cohort study was conducted using data from the VA Surgical Quality Improvement Program among veterans who underwent inpatient general, vascular, thoracic, genitourinary, neurosurgical, orthopedic, or spine surgery from October 1, 1999, through September 30, 2014. Rates of 30-day morbidity, mortality, and failure to rescue (FTR) over time. Among 704 901 patients (mean [SD] age, 63.7 [11.8] years; 676 750 [96%] male) undergoing noncardiac surgical procedures at 143 hospitals, complications occurred in 97 836 patients (13.9%), major complications occurred in 66 816 (9.5%), FTR occurred in 12 648 of the 97 836 patients with complications (12.9%), FTR after major complications occurred in 12 223 of the 66 816 patients with major complications (18.3%), and 18 924 patients (2.7%) died within 30 days of surgery. There were significant decreases from 2000 to 2014 in morbidity (8202 of 59 421 [13.8%] vs 3368 of 32 785 [10.3%]), major complications (5832 of 59 421 [9.8%] vs 2284 of 32 785 [7%]), FTR (1445 of 8202 [17.6%] vs 351 of 3368 [10.4%]), and FTR after major complications (1388 of 5832 [23.8%] vs 343 of 2284 [15%]) (trend test, P < .001 for all). Although there were no clinically meaningful differences in rates of complications and major complications across hospital risk-adjusted mortality quintiles (any complications: lowest quintile, 20 945 of 147 721 [14.2%] vs highest quintile, 18 938 of 135 557 [14%]; major complications: lowest quintile, 14 044 of 147 721 [9.5%] vs highest quintile, 12 881 of 135 557 [9.5%]), FTR rates (any complications: lowest quintile, 2249 of 20 945 [10.7%] vs highest quintile, 2769 of 18 938 [14.6%]; major complications: lowest quintile, 2161 of 14 044 [15.4%] vs highest quintile, 2663 of 12 881 [20.7%]) were significantly higher with increasing quintile (P < .001). However, across hospital quintiles, there were significant decreases in morbidity (20.6%-29.9% decrease; trend test, P < .001 for all) and FTR (29.2%-50.6% decrease; trend test, P < .001 for all) during the study period. After hierarchical modeling, the odds of postoperative mortality, FTR, and FTR after a major complication were approximately 40% to 50% lower in the most recent study year compared with 15 years ago (P < .001 for all). For the past 15 years, morbidity, mortality, and FTR have improved within the VA health system. Other integrated health systems providing a high volume of surgical care for their enrollees may benefit by critically evaluating the system-level approaches of the VA health system to surgical quality improvement.

Water-quality, streamflow, and ancillary data for nutrients in streams and rivers across the nation, 1992-2001

USGS Publications Warehouse

Mueller, David K.; Spahr, Norman E.

2005-01-01

Introduction: This report is the companion data report for: Nutrients in Streams and Rivers Across the Nation - 1992-2001 (D.K. Mueller and N.E. Spahr, U.S. Geological Survey written commun., 2005). The data contained in this report were collected as part of the National Water-Quality Assessment (NAWQA) Program. Investigations were conducted in 51 large river basins and aquifer systems, which are referred to as 'study units.' Implementation of study-unit investigations were phased so that high-intensity sampling occurred in about one-third of the study units at a time. Investigations in the first 20 study units began in 1991, and stream sampling began in 1992; however, most samples were collected during water years 1993-95. (Water year is defined as the period from October through September and is identified by the year in which it ends.) A second group of 16 study-unit investigations began in 1994, with most of the sampling completed during water years 1996-98. A third group, consisting of 15 study units, began in 1997 with most of the data collected during water years 1999-2001. At some sites, additional sampling continued after the high-intensity time period. Gilliom and others (1995) provide additional information about study-unit sampling design. Additional information about the NAWQA program is available at http://water.usgs.gov/nawqa/index.html.

Hazardous materials in aquatic environments of the Mississippi River Basin. Annual technical report, December 30, 1992--December 29, 1993

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

Not Available

1993-12-31

Tulane and Xavier Universities have singled out the environment as a major strategic focus for research and training for now and by the year 2000. In December, 1992, the Tulane/Xavier CBR was awarded a five year grant to study pollution in the Mississippi River system. The ``Hazardous Materials in Aquatic Environments of the Mississippi River Basin`` project is a broad research and education program aimed at elucidating the nature and magnitude of toxic materials that contaminate aquatic environments of the Mississippi River Basin. Studies include defining the complex interactions that occur during the transport of contaminants, the actual and potentialmore » impact on ecological systems and health, and the mechanisms through which these impacts might be remediated. The Mississippi River Basin represents a model system for analyzing and solving contamination problems that are found in aquatic systems world-wide. These research and education projects are particularly relevant to the US Department of Energy`s programs aimed at addressing aquatic pollution problems associated with DOE National Laboratories. First year funding supported seven collaborative cluster projects and twelve initiation projects. This report summarizes research results for period December 1992--December 1993.« less

Geospatial Analysis for Flood-Risk Management, Resilience, and US Policy

NASA Astrophysics Data System (ADS)

Pinter, N.; Hui, R.; Conrad, D. R.; Schaefer, K.

2016-12-01

The National Flood Insurance Program (NFIP) was established in 1968 to curtail unfettered development on US floodplains and spiraling taxpayer expenditures for disaster relief. Currently NFIP underwrites >5 million policies, providing >1.25 trillion in coverage, and taking in >3.5 billion in annual premiums. Cumulative flood-damage payouts to date exceed premiums collected by >$20 billion. Our group has obtained nationwide databases of NFIP flood-damage claims back to 1972, annual policies since 1994, and selective Federal Emergency Management Agency (FEMA) repetitive losses. Attributes include property, claims, and loss characteristics. Other attributes were stripped to maintain policyholder anonymity. At present, locations are to the nearest 0.1° lat/long, zip code, and by community. We combine NFIP data with GIS information from a variety of other sources. Over the past 44 years, 1,625,470 non-zero flood claims are documented. Numbers of claims and losses have increased over time, even with extreme events (Hurricanes Katrina and Sandy) excluded. Flood losses have occurred within 100-year floodplains (1% annual exceedance), in coastal hazard zones, and 25% of claims occur outside of mapped flood-hazard areas. We hypothesize that a many losses outside of FEMA's designated Special Flood Hazard Area (SFHA) correlate with (1) outdated map panels, (2) contrasting levels of enforcement and mitigation by state. Other distributed flood losses represent stormwater/drainage damage. Claim rates substantially exceed 1%, both in and outside the SFHA, and for "pre-FIRM" and "post-FIRM" structures. This suggests that ≥100-year floods are occurring more frequently than statutory frequencies suggest. For US homeowners, this suggests that flood insurance is a good deal in a variety of settings. The NFIP data analyzed here contrasts with our group's previous, largely model-driven research. Such empirical flood data exclude model assumptions, but add dizzying array of human and political factors into the resulting spatial and temporal patterns. Parsing out the hydrologic, climatic, social, and political factors influencing flood risk and resilience is crucial for sound management of NFIP and other programs. The US Congress will debate reauthorization and possible revision of NFIP in 2017.

Transient disablement in the physically active with musculoskeletal injuries, part I: a descriptive model.

PubMed

Vela, Luzita I; Denegar, Craig

2010-01-01

Disablement theory has been characterized as the sequence of events that occurs after an injury, but little research has been conducted to establish how disablement is experienced and described by physically active persons. To describe the disablement process in physically active persons with musculoskeletal injuries. Concurrent, embedded mixed-methods study. For the qualitative portion, interviews were conducted to create descriptive disablement themes. For the quantitative portion, frequencies analysis was used to identify common terminology. National Collegiate Athletic Association Division I collegiate and club sports, collegiate intramural program, large high school athletics program, and outpatient orthopaedic center. Thirty-one physically active volunteers (15 males, 16 females; mean age  =  21.2 years; range, 14-53 years) with a current injury (18 lower extremity injuries, 13 upper extremity injuries) participated in individual interviews. Six physically active volunteers (3 males, 3 females; mean age  =  22.2 years; range, 16-28 years) participated in the group interview to assess trustworthiness. We analyzed interviews through a constant-comparison method, and data were collected until saturation occurred. Common limitations were transformed into descriptive themes and were confirmed during the group interview. Disablement descriptors were identified with frequencies and fit to the themes. A total of 15 overall descriptive themes emerged within the 4 disablement components, and descriptive terms were identified for each theme. Impairments were marked by 4 complaints: pain, decreased motion, decreased muscle function, and instability. Functional limitations were denoted by problems with skill performance, daily actions, maintaining positions, fitness, and changing directions. Disability consisted of problems with participation in desired activities. Lastly, problems in quality of life encompassed uncertainty and fear, stress and pressure, mood and frustration, overall energy, and altered relationships. A preliminary generic outcomes instrument was generated from the findings. Our results will help clinicians understand how disablement is described by the physically active. The findings also have implications for how disablement outcomes are measured.

Risk of ischemic stroke after atrial fibrillation diagnosis: A national sample cohort

PubMed Central

Son, Mi Kyoung; Lim, Nam-Kyoo; Kim, Hyung Woo

2017-01-01

Atrial fibrillation (AF) is a major risk factor for ischemic stroke and associated with a 5-fold higher risk of stroke. In this retrospective cohort study, the incidence of and risk factors for ischemic stroke in patients with AF were identified. All patients (≥30 years old) without previous stroke who were diagnosed with AF in 2007–2013 were selected from the National Health Insurance Service-National Sample Cohort. To identify factors that influenced ischemic stroke risk, Cox proportional hazard regression analysis was conducted. During a mean follow-up duration of 3.2 years, 1022 (9.6%) patients were diagnosed with ischemic stroke. The overall incidence rate of ischemic stroke was 30.8/1000 person-years. Of all the ischemic stroke that occurred during the follow-up period, 61.0% occurred within 1-year after AF diagnosis. Of the patients with CHA2DS2-VASc score of ≥2, only 13.6% were receiving warfarin therapy within 30 days after AF diagnosis. Relative to no antithrombotic therapy, warfarin treatment for >90 days before the index event (ischemic stroke in stroke patients and death/study end in non-stroke patients) associated with decreased ischemic stroke risk (Hazard Ratio = 0.41, 95%confidence intervals = 0.32–0.53). Heart failure, hypertension, and diabetes mellitus associated with greater ischemic stroke risk. AF patients in Korea had a higher ischemic stroke incidence rate than patients in other countries and ischemic stroke commonly occurred at early phase after AF diagnosis. Long-term (>90 days) continuous warfarin treatment may be beneficial for AF patients. However, warfarin treatment rates were very low. To prevent stroke, programs that actively detect AF and provide anticoagulation therapy are needed. PMID:28636620

Land Cover and Rainfall Interact to Shape Waterbird Community Composition

PubMed Central

Studds, Colin E.; DeLuca, William V.; Baker, Matthew E.; King, Ryan S.; Marra, Peter P.

2012-01-01

Human land cover can degrade estuaries directly through habitat loss and fragmentation or indirectly through nutrient inputs that reduce water quality. Strong precipitation events are occurring more frequently, causing greater hydrological connectivity between watersheds and estuaries. Nutrient enrichment and dissolved oxygen depletion that occur following these events are known to limit populations of benthic macroinvertebrates and commercially harvested species, but the consequences for top consumers such as birds remain largely unknown. We used non-metric multidimensional scaling (MDS) and structural equation modeling (SEM) to understand how land cover and annual variation in rainfall interact to shape waterbird community composition in Chesapeake Bay, USA. The MDS ordination indicated that urban subestuaries shifted from a mixed generalist-specialist community in 2002, a year of severe drought, to generalist-dominated community in 2003, of year of high rainfall. The SEM revealed that this change was concurrent with a sixfold increase in nitrate-N concentration in subestuaries. In the drought year of 2002, waterbird community composition depended only on the direct effect of urban development in watersheds. In the wet year of 2003, community composition depended both on this direct effect and on indirect effects associated with high nitrate-N inputs to northern parts of the Bay, particularly in urban subestuaries. Our findings suggest that increased runoff during periods of high rainfall can depress water quality enough to alter the composition of estuarine waterbird communities, and that this effect is compounded in subestuaries dominated by urban development. Estuarine restoration programs often chart progress by monitoring stressors and indicators, but rarely assess multivariate relationships among them. Estuarine management planning could be improved by tracking the structure of relationships among land cover, water quality, and waterbirds. Unraveling these complex relationships may help managers identify and mitigate ecological thresholds that occur with increasing human land cover. PMID:22558286

Land cover and rainfall interact to shape waterbird community composition.

PubMed

Studds, Colin E; DeLuca, William V; Baker, Matthew E; King, Ryan S; Marra, Peter P

2012-01-01

Human land cover can degrade estuaries directly through habitat loss and fragmentation or indirectly through nutrient inputs that reduce water quality. Strong precipitation events are occurring more frequently, causing greater hydrological connectivity between watersheds and estuaries. Nutrient enrichment and dissolved oxygen depletion that occur following these events are known to limit populations of benthic macroinvertebrates and commercially harvested species, but the consequences for top consumers such as birds remain largely unknown. We used non-metric multidimensional scaling (MDS) and structural equation modeling (SEM) to understand how land cover and annual variation in rainfall interact to shape waterbird community composition in Chesapeake Bay, USA. The MDS ordination indicated that urban subestuaries shifted from a mixed generalist-specialist community in 2002, a year of severe drought, to generalist-dominated community in 2003, of year of high rainfall. The SEM revealed that this change was concurrent with a sixfold increase in nitrate-N concentration in subestuaries. In the drought year of 2002, waterbird community composition depended only on the direct effect of urban development in watersheds. In the wet year of 2003, community composition depended both on this direct effect and on indirect effects associated with high nitrate-N inputs to northern parts of the Bay, particularly in urban subestuaries. Our findings suggest that increased runoff during periods of high rainfall can depress water quality enough to alter the composition of estuarine waterbird communities, and that this effect is compounded in subestuaries dominated by urban development. Estuarine restoration programs often chart progress by monitoring stressors and indicators, but rarely assess multivariate relationships among them. Estuarine management planning could be improved by tracking the structure of relationships among land cover, water quality, and waterbirds. Unraveling these complex relationships may help managers identify and mitigate ecological thresholds that occur with increasing human land cover.

Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?

PubMed

Franklin, Corinna C; Bosch, Patrick P; Grudziak, Jan S; Dede, Ozgur; Ramirez, Rey N; Mendelson, Steven A; Ward, W Timothy; Brooks, Maria; Kenkre, Tanya; Lubahn, John D; Deeney, Vincent F; Roach, James W

2017-03-01

Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores. Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (P<0.0001). Compared with the preconference years, Hamot residents answered 3.99 more questions correctly (P<0.0001) and Pitt residents answered 2.93 more questions correctly (P<0.0001). Before the conference, site was not a predictor of OITE score (P=0.06) or percentile (P=0.08); there was no significant difference found between the mean scores per program. However, in the postconference years, site did predict OITE scores. Controlling for year in training, Hamot residents scored higher on the OITE (2.3 points higher, P=0.003) and had higher percentiles (0.07 higher, P=0.004) than Pitt residents during the postconference years. This study suggests that adding a didactic pediatric lecture improved residents' scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores. Level III-retrospective case-control study.

Use of a Web-based Delphi for identifying critical components of a professional science master's program in biotechnology

NASA Astrophysics Data System (ADS)

Kantz, Jeannine Wells

The primary purpose of this research was to develop a model for a professional science master's program combining biotechnology and business. The objectives were to identify stakeholder preferences for various dimensions of a professional science master's program combining biotechnology and business and to identify differences in priorities between subgroups. A secondary purpose was to examine user preferences between Web-based and traditional methods of conducting a Delphi study and the panelist's impressions of its usefulness for program development. Prior to the first round, demographic data were collected on panelists regarding their gender, age, years experience in their current field, position title and education levels. Round 1 started with eight open-ended questions designed to investigate (a) learning objectives, (b) internships, (c) thesis vs. non-thesis degrees, (d) program focus (e) possible entry level positions, (f) roles for the industry advisory board, (g) recommended hours of hands-on experience and (h) other issues of importance. The final round ended with three questions to assess the panelists' perception of the usefulness of the Delphi for program development in higher education. Twenty-four panelists started Round 1 and participation in subsequent rounds varied from 17 in Round 2 to 11 in Round 4. Education level varied and included all levels of education in science and business. Issues emerged early in the study regarding development of different program tracks and the program goals, which were clarified in subsequent rounds. Significant differences occurred between industry and academic subgroups for two tracks, six skills designated for tracks, method of evaluating the internship, and entry-level positions appropriate for new graduates. When analyzed by level of confidence (high confidence vs. low confidence), significant differences occurred for (a) the number of semesters of hands-on experience students should have upon graduation, (b) skills recommended for core curriculum, (c) skills recommended for tracks, (d) compensation level and (e) entry level positions for new graduates. Perceived usefulness of the Delphi for program development was varied with only 10 panelists responding---five in favor, three undecided, and two against.

Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training.

PubMed

Stiers, William; Barisa, Mark; Stucky, Kirk; Pawlowski, Carey; Van Tubbergen, Marie; Turner, Aaron P; Hibbard, Mary; Caplan, Bruce

2015-05-01

This study describes the results of a multidisciplinary conference (the Baltimore Conference) that met to develop consensus guidelines for competency specification and measurement in postdoctoral training in rehabilitation psychology. Forty-six conference participants were chosen to include representatives of rehabilitation psychology training and practice communities, representatives of psychology accreditation and certification bodies, persons involved in medical education practice and research, and consumers of training programs (students). Consensus education and training guidelines were developed that specify the key competencies in rehabilitation psychology postdoctoral training, and structured observation checklists were developed for their measurement. This study continues the development of more than 50 years of thinking about education and training in rehabilitation psychology and builds on the existing work to further advance the development of guidelines in this area. The conference developed aspirational guidelines for competency specification and measurement in rehabilitation psychology postdoctoral training (i.e., for studying the outcomes of these training programs). Structured observation of trainee competencies allows examination of actual training outcomes in relation to intended outcomes and provides a methodology for studying how program outcomes are related to program structures and processes so that program improvement can occur. Best practices in applying program evaluation research methods to the study of professional training programs are discussed. (c) 2015 APA, all rights reserved).

One hundred US EVAs: a perspective on spacewalks.

PubMed

Wilde, Richard C; McBarron, James W; Manatt, Scott A; McMann, Harold J; Fullerton, Richard K

2002-01-01

In the 36 years between June 1965 and February 2001, the US human space flight program has conducted 100 spacewalks, or extravehicular activities (EVAs), as NASA officially calls them. EVA occurs when astronauts wearing spacesuits travel outside their protective spacecraft to perform tasks in the space vacuum environment. US EVA started with pioneering feasibility tests during the Gemini Program. The Apollo Program required sending astronauts to the moon and performing EVA to explore the lunar surface. EVA supported scientific mission objectives of the Skylab program, but may be best remembered for repairing launch damage to the vehicle and thus saving the program. EVA capability on Shuttle was initially planned to be a kit that could be flown at will, and was primarily intended for coping with vehicle return emergencies. The Skylab emergency and the pivotal role of EVA in salvaging that program quickly promoted Shuttle EVA to an essential element for achieving mission objectives, including retrieving satellites and developing techniques to assemble and maintain the International Space Station (ISS). Now, EVA is supporting assembly of ISS. This paper highlights development of US EVA capability within the context of the overarching mission objectives of the US human space flight program. c2002 International Astronautical Federation. Published by Elsevier Science Ltd. All rights reserved.

Alumni Perspectives on Career Preparation during a Postdoctoral Training Program: A Qualitative Study

PubMed Central

Faupel-Badger, Jessica M.; Raue, Kimberley; Nelson, David E.; Tsakraklides, Sophia

2015-01-01

Published evaluations of career preparation of alumni from long-standing postdoctoral fellowship programs in the biomedical sciences are limited and often focus on quantitative analysis of data from extant publicly available sources. Qualitative methods provide the opportunity to gather robust information about specific program elements from structured postdoctoral training programs and the influence of this training on subsequent career paths of alumni. In-depth interviews with a subset of the National Cancer Institute’s Cancer Prevention Fellowship Program (CPFP) alumni (n = 27), representing more than 25 years of the program’s history and multiple career sectors, were conducted to assess alumni reflections on the training environment and career preparation during their time in the CPFP. NVivo software was used to analyze data and identify major themes. Four main themes emerged from these interviews, including: the value of structured training curriculum, mentorship, transdisciplinary environment, and professional identity. Even when reflecting on training that occurred one to two decades earlier, alumni were able to highlight specific components of a structured postdoctoral training program as influencing their research and career trajectories. These results may have relevance for those interested in assessing how postdoctoral training can influence fellows throughout their careers and understanding salient features of structured programs. PMID:25673353

Two-Year Healthy Eating Outcomes: An RCT in Afterschool Programs.

PubMed

Beets, Michael W; Weaver, R Glenn; Turner-McGrievy, Gabrielle; Huberty, Jennifer; Moore, Justin B; Ward, Dianne S; Freedman, Darcy A; Beighle, Aaron

2017-09-01

Across the U.S., afterschool programs (ASPs, 3:00pm-6:00pm) are trying to achieve nationally endorsed nutrition standards (Healthy Eating Standards) calling for fruits/vegetables and water to be served every day, while eliminating sugar-sweetened beverages and foods. The purpose of this study was to evaluate the 2-year changes in the types of foods and beverages served during a community-based intervention designed to achieve the Healthy Eating Standards. Randomized delayed treatment trial with an immediate (1-year baseline and 2-year intervention) or delayed (2-year baseline and 1-year intervention) group. Twenty ASPs serving 1,700 children (aged 5-12 years) were recruited, with baseline occurring spring 2013, and outcome assessment occurring spring 2014 and 2015. The multistep intervention, Strategies To Enhance Practice for Healthy Eating, assisted ASP leaders/staff to serve foods/beverages that meet the nutrition standards. The foods and beverages served for snack were observed directly. Compared with non-intervention years, both the immediate and delayed groups increased the number of days/week that fruits/vegetables (0.6 vs 1.7 days/week and 0.6 vs 4.4 days/week, OR=3.80, 95% CI=1.45, 9.95) and water (2.3 vs 3.7 days/week and 2.7 vs 4.8 days/week, OR=4.65, 95% CI=1.69, 12.79) were served. Sugar-sweetened beverages were almost eliminated by post-assessment (1.2 vs 0.2 days/week and 3.2 vs 0.0 days/week, OR=0.05, 95% CI=0.02, 0.13). Only the immediate group decreased the number of days/week desserts were served (2.9 vs 0.6 days/week, OR=0.10, 95% CI=0.03, 0.33). Implementation barriers for the delayed group included once/month delivery schedules for fruits/vegetables and limited storage space for foods meeting the Healthy Eating Standards. Improvements in the foods/beverages served in ASPs can be made, yet were hindered by structural barriers related to procurement and storage of perishable foods. Additional efforts are needed to support ASPs as they work toward fully achieving the Healthy Eating Standards. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

International Education Opportunities during the IHY: Bridging the Geographic, Cultural and Linguistic Divide between Participating IHY Nations

NASA Technical Reports Server (NTRS)

Thompson, B.J.; Morrow, C.A.; Rabello-Soares, M.C.; Smith, R.W.

2006-01-01

Currently there are over 70 U.N. Member States participating in the International Heliophysical Year (IHY 2007- 8), and most of these nations do not use English as their primary language. The IHY contains four main program elements: Science, Observatory Development, Outreach, and History. For these elements to be successful, each requires successful communication within and adaptation for the individual member states. The IHY Outreach program contains many educational activities targeting a wide range of languages and contexts. The other three program elements, however, offer a means to extend the impact of the educational programs and reinforce educational activities. IHY's scientific activities involve partnerships with institutions and observatories, many of which have outreach activities in their local communities. Scientists and participation programs from around the world have begun translating materials into their local languages and adapting educational tools for use in their communities. IHY's Observatory Development program, which began deploying instrumentation worldwide in 2004, encourages a strong educational component to each new observatory site as a means of ensuring long-lasting viability of the research program. The history program gathers important information and educates the public about the development of space science. This presentation will discuss efforts occurring within the IHY program that support cross-cultural communication and education and present opportunities to reach new audiences.

International Education Opportunities During the IHY: Bridging the Geographic, Cultural and Linguistic Divide Between Participating IHY Nations

NASA Astrophysics Data System (ADS)

Thompson, B. J.; Morrow, C. A.; Rabello-Soares, M. C.; Smith, R. W.

2006-12-01

Currently there are over 70 U.N. Member States participating in the International Heliophysical Year (IHY 2007- 8), and most of these nations do not use English as their primary language. The IHY contains four main program elements: Science, Observatory Development, Outreach, and History. For these elements to be successful, each requires successful communication within and adaptation for the individual member states. The IHY Outreach program contains many educational activities targetting a wide range of languages and contexts. The other three program elements, however, offer a means to extend the impact of the educational programs and reinforce educational activities. IHY's scientific activities involve partnerships with institutions and observatories, many of which have outreach activities in their local communities. Scientists and participation programs from around the world have begun translating materials into their local languages and adapting educational tools for use in their communities. IHY's Observatory Development program, which began deploying instrumentation worldwide in 2004, encourages a strong educational component to each new observatory site as a means of ensuring long-lasting viability of the research program. The history program gathers important information and educates the public about the development of space science. This presentation will discuss efforts occurring within the IHY program that support cross-cultural communication and education and present opportunities to reach new audiences.

Training and education in religion/spirituality within APA-accredited clinical psychology programs: 8 years later.

PubMed

Schafer, Rachel M; Handal, Paul J; Brawer, Peter A; Ubinger, Megan

2011-06-01

This study was a follow up investigation of Brawer et al.'s (Prof Psychol Res Pr 33(2):203-206, 2002) survey of education and training of clinical psychologists in religion/spirituality. Directors of clinical training were surveyed to determine whether changes had occurred in the coverage of religion and spirituality through course work, research, supervision, and in the systematic coverage of the content area. Results indicated an increased coverage in the areas of supervision, dedicated courses, inclusion as part of another course, and research. There was no increase in systematic coverage, but significantly more programs provided at least some coverage. The current study also assesses other areas of incorporation as well as directors' opinions regarding the importance of religion/spirituality in the field of psychology.

Teleplaneta: a 7 year-long effort to spread natural hazard's knowledge

NASA Astrophysics Data System (ADS)

Calvo, David; Álvarez, Domingo; Marrero, Nieves; Pérez, Nemesio M.

2016-04-01

One of the main and toughest goals for a geoscientist is to have a properly communication with the society when the time comes for showing results, scientific advances or whatever kind of remarkable event. The complexity of the scientific terminology, and the existence of a few communication channels, often prevents lay people to know about how the advance of science is occurring or how new discoveries are helping us to have a better understanding about the Planet Earth. In that respect, mass media provide the most powerful tool to enhance this communication, both radio and TV broadcasting, since the wealth of Earth-sciences' related information available on issues like global climate, water, energy and natural hazards remain largely unknown to the public and often untapped by policy and decision makers. Almost 75% of the Earth population lives in areas that had been hit, at least once in the last 20 years, by earthquakes, severe storms, flooding or droughts. TELEPLANETA is a joint effort of the Spanish National Public Television in the Canary Islands (RTVE-Canarias) and the Instituto Volcanológico de Canarias (INVOLCAN) for raising public awareness of the impact of these natural hazards in the society, with an understandable language away from too much technical terms but basically avoiding the gruesome side of this kind of events. TELEPLANETA tries to give a scientific explanation of why these hazards occur, focusing on the visual communication with the viewers. This weekly TV program is broadcasted through the worldwide coverage news channel - 24 Hours Channel - of the Spanish National Public TV (TVE). Actually immersed on our 7th season, TELEPLANETA has gone through a challenging improvement, from a barely 4 minute outsider program to a 20 minutes long, full enhanced TV show. We actually provide accurate information about natural hazards, but also a weekly review of twitteŕs best pictures and comments regarding nature, as well as scientific report at the most impressive natural scenarios and technology and research institutions. TELEPLANETA has collected several awards and public acknowledgments along these seven years. The TV program is available at its own website in the RTVE matrix web (http://www.rtve.es/alacarta/videos/teleplaneta/).

An Ongoing Program for Monitoring the Moon for Meteoroid Impacts (Abstract)

NASA Astrophysics Data System (ADS)

Cudnik, B.; Saganti, S.; Ali, F.; Ali, S.; Beharie, T.; Anugwom, B.

2017-12-01

(Abstract only) Lunar meteor impacts are surprisingly frequent phenomena, with well over one hundred observable events occurring each year. Of these a little over half arise from members of annual meteor showers (e.g. Perseids, Leonids, etc.), with the rest being sporadic in origin. Five years ago, I (BC) introduced to the SAS Symposium the idea of observing lunar meteoroid impact phenomena and applying these observations to a space mission (LADEE-Lunar Atmosphere and Dust Environment Explorer) that launched the following year. Now, five years later I revisit and reintroduce the activities of the Association of Lunar and Planetary Observers-Lunar Meteoritic Impact Search (ALPO-LMIS) section and share some of the latest observations that have been received. For over 17 years now, ALPO has hosted the LMIS section, for which I have served as coordinator since its inception. In this paper, I will revisit the main ideas of the earlier paper, share some recent observations of lunar meteors, and provide new initiatives and projects interested persons can participate in.

What makes an effective Chagas disease vector? Factors underlying Trypanosoma cruzi-triatomine interactions.

PubMed

de Fuentes-Vicente, José A; Gutiérrez-Cabrera, Ana E; Flores-Villegas, A Laura; Lowenberger, Carl; Benelli, Giovanni; Salazar-Schettino, Paz M; Córdoba-Aguilar, Alex

2018-07-01

The Chagas disease is caused by the parasite Trypanosoma cruzi, which infect blood-feeding triatomine bugs to finally reach mammal hosts. Chagas disease is endemic in Latin America, and is ranked among the 13 neglected tropical diseases worldwide. Currently, an estimate of 7 million people is infected by T. cruzi, leading to about 22 000 deaths per year throughout the Americas. As occurs with other vectors, a major question towards control programs is what makes a susceptible bug. In this review, we focus on findings linked to insect gut structure and microbiota, immunity, genetics, blood sources, abiotic factors (with special reference to ambient temperature and altitude) to understand the interactions occurring between T. cruzi and triatomine bugs, under a co-evolutionary scenario. These factors lead to varying fitness benefits and costs for bugs, explaining why infection in the insect takes place and how it varies in time and space. Our analysis highlights that major factors are gut components and microbiota, blood sources and temperature. Although their close interaction has never been clarified, knowledge reviewed here may help to boost the success of triatomine control programs, reducing the use of insecticides. Copyright © 2018 Elsevier B.V. All rights reserved.

Ultrahigh-Strength Magnesium Alloys for the Future Force: A Final Report on the 5-Year Mission Program, 2009-2013

DTIC Science & Technology

2014-01-01

discoloration of the deposit once it was outside the direct line of the spray nozzle and the flow of inert carrier gas . This oxidation is very likely to be a...24 Figure 23. Schematic of the active liquid nitrogen cooling plate used in an attempt to minimize grain growth that occurs during processing... gas temperature of (A) 200 °C, (B) 250 °C, (C) 300 °C, (D) 350 °C, and (E) 400 °C. .................29 Figure 28. Representative micrographs for cold

Water-resources investigations in Wisconsin, 1999

USGS Publications Warehouse

Maertz, D. E.

1999-01-01

Low flows occurred at 21 gaging stations where the annual minimum 7-consecutive day average flows (Q7) had recurrence intervals of 5 or more years. Precipitation was well below normal from July through September in northern Wisconsin. Monthly precipitation values were 4.46, 5.69, and 4.24 inches below normal in northwestern, north central, and northeastern Wisconsin, respectively, in the July through September period (from tables provided by Lyle Anderson, Program Assistant, UW-Extension, Geological and Natural History Survey, written commun., 1999). The precipitation for the April to October period was

Lead poisoning prevention for preschool settings: a program template.

PubMed

Saatciler, Eda

2015-01-01

Lead is a naturally occurring metal that has been linked to neurological impairments and insanity since ancient times. It has been used in many products such as paint, pipes, and ceramics and still remains a public hazard. Young children between the ages of 6 months and 6 years with lead-contaminated housing are at the greatest risk for cognitive, neurological, and behavioral health problems. Briefly, lead exposure is around us and it correlates with learning deficits and violent behaviors as these children become adults. It also can cause anemia, abdominal pain, seizure, and death.

Developmental biology in marine invertebrate symbioses.

PubMed

McFall-Ngai, M J; Ruby, E G

2000-12-01

Associations between marine invertebrates and their cooperative bacterial symbionts offer access to an understanding of the roots of host-microbe interaction; for example, several symbioses like the squid-vibrio light organ association serve as models for investigating how each partner affects the developmental biology of the other. Previous results have identified a program of specific developmental events that unfolds as the association is initiated. In the past year, published studies have focused primarily on describing the mechanisms underlying the signaling processes that occur between the juvenile squid and the luminous bacteria that colonize it.

RECOMMENDATIONS FOR UO3 PLANT BIOASSAY

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

Carbaugh, Eugene H.

2010-07-12

Alternative urine bioassay programs are described for application with decontamination and decommissioning activities at the Hanford UO3 Plant. The alternatives are based on quarterly or monthly urine bioassay for recycled uranium, assuming multiple acute inhalation intakes of recycled uranium occurring over a year. The inhalations are assumed to be 5µm AMAD particles of 80% absorption type F and 20% absorption type M. Screening levels, expressed as daily uranium mass excretion rates in urine, and the actions associated with these levels are provided for both quarterly and monthly sampling frequencies.

Historical Landsat data comparisons: illustrations of land surface change

USGS Publications Warehouse

Cross, Matthew D.

1990-01-01

This booklet provides an overview of the Landsat program and shows the application of the data to monitor changes occurring on the surface of the Earth. To show changes that have taken place within the last 20 years or less, image pairs were constructed from the Landsat multispectral scanner (MSS) and thematic mapper (TM) sensors. Landsat MSS data provide a historical global record of the land surface from the early 1970's to present. Landsat TM data provide land surface information from the early 1980's to present.

Sustained impact of rotavirus vaccine introduction on rotavirus gastroenteritis hospitalizations in children <5 years of age, Ghana, 2009-2016.

PubMed

Enweronu-Laryea, Christabel C; Armah, George; Sagoe, Kwamena W; Ansong, Daniel; Addo-Yobo, Emmanuel; Diamenu, Stanley K; Mwenda, Jason M; Parashar, Umesh D; Tate, Jacqueline E

2018-05-08

Ghana introduced monovalent rotavirus vaccine in April 2012. We sought to determine the long-term impact of routine rotavirus vaccination on rotavirus gastroenteritis hospitalizations in Ghana during the first 4 years following rotavirus vaccine introduction. Active sentinel surveillance for acute gastroenteritis hospitalizations among children <5 years of age was conducted at two sites from July 2009 through June 2016. Stool specimens were collected from enrolled children and tested by enzyme immunoassay. Changes in the proportion of all-cause gastroenteritis hospitalizations due to rotavirus pre- (July 2009-June 2012) and post-vaccine introduction (July 2012-June 2016) were compared using chi-square test. The proportion of acute gastroenteritis hospitalizations due to rotavirus among children <5 years of age significantly declined by 42% from a pre-vaccine median of 50% (343/684) to a post-vaccine median of 29% (118/396) (p < 0.001). The age distribution of rotavirus hospitalizations shifted toward older ages with 64% (759/1197) of rotavirus hospitalizations occurring in children <12 months of age pre-vaccine introduction to 47% (212/453) occurring in children <12 months of age post-vaccine introduction (p < 0.001). The decline in rotavirus hospitalizations following rotavirus vaccine introduction have been sustained over the first 4 years of the vaccination program in Ghana. Continued vaccination against rotavirus will ensure that this burden remains low. Copyright © 2018. Published by Elsevier Ltd.

Combating the stress of residency: one school's approach.

PubMed

Dabrow, Sharon; Russell, Stephen; Ackley, Karen; Anderson, Eric; Fabri, Peter Jeff

2006-05-01

Residency is a time of stress and turmoil for many residents. The stresses are varied and great, often involving both personal and professional issues. One institutional mechanism that has been shown to help residents cope with stress is the use of residents' wellness, or assistance, programs. The University of South Florida (USF) College of Medicine developed the USF Residency Assistance Program (RAP) in 1997, modeled after business employee assistance programs but tailored to enhance the well-being of residents. The program was developed in an organized, thoughtful manner starting with a Request for Proposals to all local employee assistance programs and the selection of one of these to run the program. The RAP is broad-based, readily available, easily accessible, totally voluntary and confidential, and not reportable to the state board of medicine. It is well integrated into all residency programs and has had excellent acceptance from the administration; information about access to the RAP is available to all residents through multiple venues. The cost is minimal, at only seven cents a day per resident. The authors present data from the eight years the RAP has been operating, including information on program use, referral rates, acceptance, and types of problems encountered. One suicide occurred during this time period, and the RAP provided a significant role in grief counseling. Assistance programs are critical to the well-being of residents. The USF program presents a model that can be used by other programs around the country.

Unprogrammed Deworming in the Kibera Slum, Nairobi: Implications for Control of Soil-Transmitted Helminthiases

PubMed Central

Harris, Julie R.; Worrell, Caitlin M.; Davis, Stephanie M.; Odero, Kennedy; Mogeni, Ondari D.; Deming, Michael S.; Mohammed, Aden; Montgomery, Joel M.; Njenga, Sammy M.; Fox, LeAnne M.; Addiss, David G.

2015-01-01

Background Programs for control of soil-transmitted helminth (STH) infections are increasingly evaluating national mass drug administration (MDA) interventions. However, “unprogrammed deworming” (receipt of deworming drugs outside of nationally-run STH control programs) occurs frequently. Failure to account for these activities may compromise evaluations of MDA effectiveness. Methods We used a cross-sectional study design to evaluate STH infection and unprogrammed deworming among infants (aged 6–11 months), preschool-aged children (PSAC, aged 1–4 years), and school-aged children (SAC, aged 5–14 years) in Kibera, Kenya, an informal settlement not currently receiving nationally-run MDA for STH. STH infection was assessed by triplicate Kato-Katz. We asked heads of households with randomly-selected children about past-year receipt and source(s) of deworming drugs. Local non-governmental organizations (NGOs) and school staff participating in school-based deworming were interviewed to collect information on drug coverage. Results Of 679 children (18 infants, 184 PSAC, and 477 SAC) evaluated, 377 (55%) reported receiving at least one unprogrammed deworming treatment during the past year. PSAC primarily received treatments from chemists (48.3%) or healthcare centers (37.7%); SAC most commonly received treatments at school (55.0%). Four NGOs reported past-year deworming activities at 47 of >150 schools attended by children in our study area. Past-year deworming was negatively associated with any-STH infection (34.8% vs 45.4%, p = 0.005). SAC whose most recent deworming medication was sourced from a chemist were more often infected with Trichuris (38.0%) than those who received their most recent treatment from a health center (17.3%) or school (23.1%) (p = 0.05). Conclusion Unprogrammed deworming was received by more than half of children in our study area, from multiple sources. Both individual-level treatment and unprogrammed preventive chemotherapy may serve an important public health function, particularly in the absence of programmed deworming; however, they may also lead to an overestimation of programmed MDA effectiveness. A standardized, validated tool is needed to assess unprogrammed deworming. PMID:25763577

Slumgullion; Colorado’s natural landslide laboratory

USGS Publications Warehouse

Highland, L.M.

1993-01-01

The mountains of Colorado, and the Rocky Mountains in general, have one of the highest levels of landslide hazard in the nation. In a typical year, landslides hazard in the nation. In a typical year, landslides cause several fatalities and millions of dollars in damage to highways, pipelines, buildings, and forests in Colorado. To reduce such losses we need to understand why landslides occur and how they behave once they form. The Slumgullion landslide, an ideal natural laboratory, offers a unique opportunity to carefully observe and monitor the movement of a large, active landslide. In 1990, soon after the State of Colorado assigned high priority to hazard evaluation of the Slumgullion landslide, the USGS began an intensive study as part of its Landslide Hazards Reduction Program. 

NITARP: Bridging the Gap Between the Traditional Science Classroom and Authentic Research

NASA Astrophysics Data System (ADS)

Stalnaker, Olivia K.; Evans, Sam; Rutherford, Thomas; Taylor, John; Rebull, Luisa

2018-01-01

In this poster, the differences between what occurs in the traditional secondary science classroom and what happens in the actual research world is examined. Secondary classroom teachers generally have limited, if any, research experience beyond what is presented through their undergraduate college lab coursework. A disparity exists between classroom laboratory work and professional research. Opportunities like NITARP provide research elements that bridge this gap. NITARP teams are in a unique situation, joining a small team working alongside Caltech researchers on cutting edge investigations in astrophysics. In this poster it is shown how the NITARP program provides key components and experiences to expand the skill sets that teachers bring to their classrooms, bridging the gap between the typical secondary classroom and the world of the professional researcher. The NASA/IPAC program immerses participating teachers into a year-long training experience via online and face-to-face learning that translates into enhanced instruction at the secondary level. This work was made possible through the NASA/IPAC Teacher Archive Research Program (NITARP) and was funded by NASA Astrophysics Data Program.

Study of the National Science Foundation's South Pole Station as an analogous data base for the logistical support of a Moon laboratory

NASA Technical Reports Server (NTRS)

Hickam, H. H., Jr.

1993-01-01

The day will come when the United States will want to return to the Earth's Moon. When that occurs, NASA may look to the Apollo program for technical and inspirational guidance. The Apollo program, however, was designed to be an end to itself--the landing of a man on the Moon and his return safely within the decade of the 1960's. When that was accomplished, the program folded because it was not self-sustaining. The next time we return to the Moon, we should base our planning on a program that is designed to be a sustained effort for an indefinite period. It is the thrust of this report that the South Pole Station of the National Science Foundation can be used to develop analogs for the construction, funding, and logistical support of a lunar base. Other analogs include transportation and national efforts versus international cooperation. A recommended lunar base using the South Pole Station as inspiration is provided, as well as details concerning economical construction of the base over a 22-year period.

Surveillance programs for detection and characterization of emergent pathogens and antimicrobial resistance: results from the Division of Infectious Diseases, UNIFESP.

PubMed

Colombo, Arnaldo L; Janini, Mario; Salomão, Reinaldo; Medeiros, Eduardo A S; Wey, Sergio B; Pignatari, Antonio C C

2009-09-01

Several epidemiological changes have occurred in the pattern of nosocomial and community acquired infectious diseases during the past 25 years. Social and demographic changes possibly related to this phenomenon include a rapid population growth, the increase in urban migration and movement across international borders by tourists and immigrants, alterations in the habitats of animals and arthropods that transmit disease, as well as the raise of patients with impaired host defense abilities. Continuous surveillance programs of emergent pathogens and antimicrobial resistance are warranted for detecting in real time new pathogens, as well as to characterize molecular mechanisms of resistance. In order to become more effective, surveillance programs of emergent pathogens should be organized as a multicenter laboratory network connected to the main public and private infection control centers. Microbiological data should be integrated to guide therapy, adapting therapy to local ecology and resistance patterns. This paper presents an overview of data generated by the Division of Infectious Diseases, Federal University of São Paulo, along with its participation in different surveillance programs of nosocomial and community acquired infectious diseases.

Certification of UAW/Ford thermographers

NASA Astrophysics Data System (ADS)

Barth, Ken; Spring, Robert W.

2000-03-01

Ford Motor Company has been using infrared thermography in the maintenance of its production facilities for more than fifteen years. It has proven to be a key tool, which has helped the company continuously achieved high standards of production quality by using a work force trained with the essential technical skills. Many early successes in thermography provided an environment in which expansion of the program could occur. A group of key Ford and United Auto Workers personnel was formed to promote the use of infrared technology to help meet worldwide quality standards. The committee also addressed the need for standardized training, qualification, and certification. The program that has evolved, which is based on the qualification and certification standards of the American Society for Nondestructive Testing, is a strong partnership created between the UAW-Ford National Programs Center, UAW and Ford Motor Company with assistance from an outside training contractor. The paper will detail the experiences of establishing the program, the lessons that have been learned in the problem solving process, and the costs and benefits of the solutions that were developed.

Integrating TeamSTEPPS® into ambulatory reproductive health care: Early successes and lessons learned.

PubMed

Paul, Maureen E; Dodge, Laura E; Intondi, Evelyn; Ozcelik, Guzey; Plitt, Ken; Hacker, Michele R

2017-04-01

Most medical teamwork improvement interventions have occurred in hospitals, and more efforts are needed to integrate them into ambulatory care settings. In 2014, Affiliates Risk Management Services, Inc. (ARMS), the risk management services organization for a large network of reproductive health care organizations in the United States, launched a voluntary 5-year initiative to implement a medical teamwork system in this network using the TeamSTEPPS model. This article describes the ARMS initiative and progress made during the first 2 years, including lessons learned. The ARMS TeamSTEPPS program consists of the following components: preparation of participating organizations, TeamSTEPPS master training, implementation of teamwork improvement programs, and evaluation. We used self-administered questionnaires to assess satisfaction with the ARMS program and with the master training course. In the first 2 years, 20 organizations enrolled. Participants found the preparation phase valuable and were highly satisfied with the master training course. Although most attendees felt that the course imparted the knowledge and tools critical for TeamSTEPPS implementation, they identified time restraints and competing initiatives as potential barriers. The project team has learned valuable lessons about obtaining buy-in, consolidating the change teams, making the curriculum relevant, and evaluation. Ambulatory care settings require innovative approaches to integration of teamwork improvement systems. Evaluating and sharing lessons learned will help to hone best practices as we navigate this new frontier in the field of patient safety. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

United States Food and Drug Administration Product Label Changes

PubMed Central

Sung, Julie C.; Stein-Gold, Linda; Goldenberg, Gary

2017-01-01

Once a drug has been approved by the United States Food and Drug Administration and is on the market, the Food and Drug Administration communicates new safety information through product label changes. Most of these label changes occur after a spontaneous report to either the drug manufacturing companies or the Food and Drug Administration MedWatch program. As a result, 400 to 500 label changes occur every year. Actinic keratosis treatments exemplify the commonality of label changes throughout the postmarket course of a drug. Diclofenac gel, 5-fluorouracil cream, imiquimod, and ingenol mebutate are examples of actinic keratosis treatments that have all undergone at least one label revision. With the current system of spontaneous reports leading to numerous label changes, each occurrence does not necessarily signify a radical change in the safety of a drug. PMID:28367259

United States Food and Drug Administration Product Label Changes

PubMed Central

Sung, Julie C.; Stein-Gold, Linda; Goldenberg, Gary

2016-01-01

Once a drug has been approved by the United States Food and Drug Administration and is on the market, the Food and Drug Administration communicates new safety information through product label changes. Most of these label changes occur after a spontaneous report to either the drug manufacturing companies or the Food and Drug Administration MedWatch program. As a result, 400 to 500 label changes occur every year. Actinic keratosis treatments exemplify the commonality of label changes throughout the postmarket course of a drug. Diclofenac gel, 5-fluorouracil cream, imiquimod, and ingenol mebutate are examples of actinic keratosis treatments that have all undergone at least one label revision. With the current system of spontaneous reports leading to numerous label changes, each occurrence does not necessarily signify a radical change in the safety of a drug. PMID:26962391

A health promotion program at a Japanese newspaper undergoing restructuring.

PubMed

Ariyoshi, Hiromi; Suzaki, Yoshika; Takayama, Naoko; Wakeshima, Ruriko; Ishitake, Tatsuya

2010-09-01

Occupational health activities based on a health promotion philosophy and focused on primary and secondary prevention were introduced at a Japanese newspaper company where restructuring had occurred. Japanese metabolic syndrome diagnostic standards were used to determine changes in certain lifestyle disease risk factors over 10 years. The amount of change from 1998 to 2007 was determined, and two groups (i.e., 1998 and 2007) were compared using paired t-tests. Results suggested that the occupational health activities focused on primary prevention had been effective. The authors concluded that, in situations where industrial change and corporate restructuring are occurring, occupational health activities based on a health promotion philosophy and focused on primary and secondary prevention are more effective than diagnostic activities and other types of health management focused on tertiary prevention. Copyright 2010, SLACK Incorporated.

United States Food and Drug Administration Product Label Changes.

PubMed

Kircik, Leon; Sung, Julie C; Stein-Gold, Linda; Goldenberg, Gary

2017-02-01

Once a drug has been approved by the United States Food and Drug Administration and is on the market, the Food and Drug Administration communicates new safety information through product label changes. Most of these label changes occur after a spontaneous report to either the drug manufacturing companies or the Food and Drug Administration MedWatch program. As a result, 400 to 500 label changes occur every year. Actinic keratosis treatments exemplify the commonality of label changes throughout the postmarket course of a drug. Diclofenac gel, 5-fluorouracil cream, imiquimod, and ingenol mebutate are examples of actinic keratosis treatments that have all undergone at least one label revision. With the current system of spontaneous reports leading to numerous label changes, each occurrence does not necessarily signify a radical change in the safety of a drug.

Growth and differentiation of mammalian embryonic tissues exposed to hypergravity in vivo and in vitro

NASA Technical Reports Server (NTRS)

Duke, P. J.

1984-01-01

In about 10 years or so, men and women from Earth will be long-term inhabitants of a space station aboard which plants and animals will be growing and developing in gravities other than that of Earth. The effect of gravitational changes on development was examined. It is indicated that differentiation is speeded up under excess G and slowed in low or null G. The effects of exposure to excess gravity on fusion of the embryonic mouse secondary palate were studied. During fusion, the palatal shelves first adhere by means of glycoproteins appearing along the medial epithelial edge (MEE). The contacting epithelia then reorganize and undergo programmed cell death, allowing the underlying mesenchymes to come in contact. The process of cell death occurs in vitro at about the same rate that it occurs in vivo.

Spring Chinook Salmon Oncorhynchus tshawytscha Supplementation in the Clearwater Subbasin ; Nez Perce Tribal Hatchery Monitoring and Evaluation Project, 2007 Annual Report.

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

Backman, Thomas; Sprague, Sherman; Bretz, Justin

The Nez Perce Tribal Hatchery (NPTH) program has the following goals (BPA, et al., 1997): (1) Protect, mitigate, and enhance Clearwater Subbasin anadromous fish resources; (2) Develop, reintroduce, and increase natural spawning populations of salmon within the Clearwater Subbasin; (3) Provide long-term harvest opportunities for Tribal and non-Tribal anglers within Nez Perce Treaty lands within four generations (20 years) following project initiation; (4) Sustain long-term fitness and genetic integrity of targeted fish populations; (5) Keep ecological and genetic impacts to non-target populations within acceptable limits; and (6) Promote Nez Perce Tribal management of Nez Perce Tribal Hatchery Facilities and productionmore » areas within Nez Perce Treaty lands. The NPTH program was designed to rear and release 1.4 million fall and 625,000 spring Chinook salmon. Construction of the central incubation and rearing facility NPTH and spring Chinook salmon acclimation facilities were completed in 2003 and the first full term NPTH releases occurred in 2004 (Brood Year 03). Monitoring and evaluation plans (Steward, 1996; Hesse and Cramer, 2000) were established to determine whether the Nez Perce Tribal Hatchery program is achieving its stated goals. The monitoring and evaluation action plan identifies the need for annual data collection and annual reporting. In addition, recurring 5-year program reviews will evaluate emerging trends and aid in the determination of the effectiveness of the NPTH program with recommendations to improve the program's implementation. This report covers the Migratory Year (MY) 2007 period of the NPTH Monitoring & Evaluation (M&E) program. There are three NPTH spring Chinook salmon treatment streams: Lolo Creek, Newsome Creek, and Meadow Creek. In 2007, Lolo Creek received 140,284 Brood Year (BY) 2006 acclimated pre-smolts at an average weight of 34.9 grams per fish, Newsome Creek received 77,317 BY 2006 acclimated pre-smolts at an average of 24.9 grams per fish, and Meadow Creek received 53,425 BY 2006 direct stream release parr at an average of 4.7 grams per fish. Natural and hatchery origin spring Chinook salmon pre-smolt emigrants were monitored from September - November 2006 and smolts from March-June 2007. Data on adult returns were collected from May-September. A suite of performance measures were calculated including total adult and spawner escapement, juvenile production, and survival probabilities. These measures were used to evaluate the effectiveness of supplementation and provide information on the capacity of the natural environment to assimilate and support supplemented salmon populations.« less

Alaska Dental Health Aide Program.

PubMed

Shoffstall-Cone, Sarah; Williard, Mary

2013-01-01

In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

Alaska Dental Health Aide Program

PubMed Central

Shoffstall-Cone, Sarah; Williard, Mary

2013-01-01

Background In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. Objectives This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. Results The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Conclusions Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities. PMID:23984306

Teddy and I Get a Check-Up: A Pilot Educational Intervention Teaching Children Coping Strategies for Managing Procedure-Related Pain and Fear.

PubMed

Dalley, Jessica S; McMurtry, C Meghan

2016-01-01

Background. Pediatric medical information provision literature focuses on hospitalization and surgical procedures, but children would also benefit from an educational program regarding more commonly experienced medical procedures (e.g., needles, general check-up). Objective. To determine whether an evidence-based educational program reduced children's ratings of fear of and expected pain from medical stimuli and increased their knowledge of procedural coping strategies. Methods. An educational, interactive, developmentally appropriate Teddy Bear Clinic Tour was developed and delivered at a veterinary clinic. During this tour, 71 5-10-year-old children (Mage = 6.62 years, SD = 1.19) were taught about medical equipment, procedures, and coping strategies through modelling and rehearsal. In a single-group, pretest posttest design, participants reported their fear of and expected pain from medical and nonmedical stimuli. Children were also asked to report strategies they would use to cope with procedural fear. Results. Children's ratings for expected pain during a needle procedure were reduced following the intervention. No significant change occurred in children's fear of needles. Children reported more intervention-taught coping strategies at Time 2. Conclusions. The results of this study suggest that an evidence-based, interactive educational program can reduce young children's expectations of needle pain and may help teach them procedural coping strategies.

Effects of Reproductive Health Education on Knowledge and Attitudes Among Female Adolescents in Saudi Arabia.

PubMed

Tork, Hanan Mohamed Mohamed; Al Hosis, Khalid Fahad

2015-09-01

For many girls, the onset of puberty that occurs during adolescence marks a time of heightened vulnerability to early pregnancy, with its attendant complications and heightened risk of maternal mortality. National and international forums have recognized the need to address these problems through reproductive health education. This article assesses the reproductive-health-related knowledge and attitudes of female adolescents aged between 14 and 19 years. In addition, the authors assess the effectiveness of a reproductive health education program in improving the related knowledge of female adolescents. The study was conducted on female students in three secondary schools and in the preparatory year at Qassim University (N = 309). A 59-item structured questionnaire was used to test the knowledge and attitudes of all participants regarding reproductive health before and after the intervention program. Data collection was carried out between September and November 2012. A significant increase for the total sample in knowledge regarding puberty and menstruation was observed (p < .001) postintervention. Differences in overall knowledge regarding pregnancy and antenatal care were statistically significant. Knowledge regarding contraceptive intrauterine devices improved from 27.2% preintervention to 67.6% postintervention. This study clearly showed that the reproductive health education program improves knowledge among adolescent girls regarding reproductive health.

Fetal programming and early identification of newborns at high risk of free radical-mediated diseases.

PubMed

Perrone, Serafina; Santacroce, Antonino; Picardi, Anna; Buonocore, Giuseppe

2016-05-08

Nowadays metabolic syndrome represents a real outbreak affecting society. Paradoxically, pediatricians must feel involved in fighting this condition because of the latest evidences of developmental origins of adult diseases. Fetal programming occurs when the normal fetal development is disrupted by an abnormal insult applied to a critical point in intrauterine life. Placenta assumes a pivotal role in programming the fetal experience in utero due to the adaptive changes in structure and function. Pregnancy complications such as diabetes, intrauterine growth restriction, pre-eclampsia, and hypoxia are associated with placental dysfunction and programming. Many experimental studies have been conducted to explain the phenotypic consequences of fetal-placental perturbations that predispose to the genesis of metabolic syndrome, obesity, diabetes, hyperinsulinemia, hypertension, and cardiovascular disease in adulthood. In recent years, elucidating the mechanisms involved in such kind of process has become the challenge of scientific research. Oxidative stress may be the general underlying mechanism that links altered placental function to fetal programming. Maternal diabetes, prenatal hypoxic/ischaemic events, inflammatory/infective insults are specific triggers for an acute increase in free radicals generation. Early identification of fetuses and newborns at high risk of oxidative damage may be crucial to decrease infant and adult morbidity.

Big Explosions, Strong Gravity: Making Girl Scouts ACEs of Space through Chandra Outreach

NASA Astrophysics Data System (ADS)

Hornschemeier, A. E.; Lochner, J. C.; Ganguly, R.; Feaga, L. M.; Ford, K. E. S.

2005-12-01

Thanks to two years of Chandra E/PO funding we have carried out a number of successful activities with the Girl Scouts of Central Maryland, focusing on girls in the 11-17 year age range. Our reasons for targeting this age range include the general decline in interest in math and science that occurs at or after children reach this critical age (meaning that we reach them early enough to have a positive effect). We initially target girls due to their underrepresentation in science, but the actitivities are all gender-neutral and highly adaptable to other groups. The program includes two components, in collaboration with Girl Scouts of Central Maryland. The first component is a well-established one-day Girl Scout patch activity entitled Big Explosions and Strong Gravity (BESG) where the girls earn a patch for their badge sash. The four BESG activities, mostly adapted from existing E/PO material, are available on the World Wide Web for use by others. The activities cover the electromagnetic spectrum as a tool for astronomy, the cosmic abundance of the elements and the supernova origin of many of the elements, black holes and their detection, and supernova explosions/stellar evolution. Thus far approximately 200 girls and their parents have participated in BESG and it has now become part of the council culture. The second activity is new and is part of the relatively new Girl Scout Studio 2B program, which is a girl-led program for the 11-17 year age range. Based on several meetings with small groups of girls and adults, we have formed a Studio 2B "club" called the ACE of Space Club (Astronomical Cosmic Exploration). We'll describe our experiences interacting with the Girl Scouts in this girl-led program.

Seven Q-Tracks monitors of laboratory quality drive general performance improvement: experience from the College of American Pathologists Q-Tracks program 1999-2011.

PubMed

Meier, Frederick A; Souers, Rhona J; Howanitz, Peter J; Tworek, Joseph A; Perrotta, Peter L; Nakhleh, Raouf E; Karcher, Donald S; Bashleben, Christine; Darcy, Teresa P; Schifman, Ron B; Jones, Bruce A

2015-06-01

Many production systems employ standardized statistical monitors that measure defect rates and cycle times, as indices of performance quality. Clinical laboratory testing, a system that produces test results, is amenable to such monitoring. To demonstrate patterns in clinical laboratory testing defect rates and cycle time using 7 College of American Pathologists Q-Tracks program monitors. Subscribers measured monthly rates of outpatient order-entry errors, identification band defects, and specimen rejections; median troponin order-to-report cycle times and rates of STAT test receipt-to-report turnaround time outliers; and critical values reporting event defects, and corrected reports. From these submissions Q-Tracks program staff produced quarterly and annual reports. These charted each subscriber's performance relative to other participating laboratories and aggregate and subgroup performance over time, dividing participants into best and median performers and performers with the most room to improve. Each monitor's patterns of change present percentile distributions of subscribers' performance in relation to monitoring durations and numbers of participating subscribers. Changes over time in defect frequencies and the cycle duration quantify effects on performance of monitor participation. All monitors showed significant decreases in defect rates as the 7 monitors ran variously for 6, 6, 7, 11, 12, 13, and 13 years. The most striking decreases occurred among performers who initially had the most room to improve and among subscribers who participated the longest. All 7 monitors registered significant improvement. Participation effects improved between 0.85% and 5.1% per quarter of participation. Using statistical quality measures, collecting data monthly, and receiving reports quarterly and yearly, subscribers to a comparative monitoring program documented significant decreases in defect rates and shortening of a cycle time for 6 to 13 years in all 7 ongoing clinical laboratory quality monitors.

Mortality audit of the Finnish cervical cancer screening program.

PubMed

Lönnberg, Stefan; Nieminen, Pekka; Luostarinen, Tapio; Anttila, Ahti

2013-05-01

Incidence-based evaluations of cervical cancer screening programs have suggested age-specific impacts and there is uncertainty regarding the effectiveness of screening outside the ages of 30-60 years. We audited the screening histories of cervical cancer deaths and conducted a case-control evaluation of the effectiveness of organized screening in different ages with mortality as outcome. We included all 506 cervical cancer deaths in Finland in 2000-2009 due to cancers diagnosed in 1990 or later, and 3,036 controls matched by age at diagnosis to the cases. Squamous cell carcinoma constituted 59% of the cases, adenocarcinomas 29%, and the remaining 12% were other specified and unspecified cervical malignancies. Most deaths (54%) were due to cancers diagnosed more than 5 years after last screening invitation, 24% were diagnosed among nonattenders and only 14% of deaths occurred among women who had attended invitational screening. The risk reduction associated with attending a single program screen at an age below 40 was nonsignificant (OR 0.70; 95% CI 0.33-1.48), while clear risk reductions were observed after screening at the age of 40-54 (OR 0.33; CI 0.20-0.56) and 55-69 (OR 0.29; CI 0.16-0.54). This study also provides some indication of a long-lasting additional effect of screening at the age of 65. Possible avenues for improving the effectiveness of the Finnish screening program include efforts to increase attendance and an extension of the target ages to include 65-to 69-year-old women. The potential benefit of increasing the sensitivity of the screening test or shortening the screening interval is smaller. Copyright © 2012 UICC.

[Evaluation of the program "Strong families: love and limits" in families with teenagers aged 10 to 14 years].

PubMed

Corea V, M Loreto; Zubarew G, Tamara; Valenzuela M, M Teresa; Salas P, Francisca

2012-06-01

"Strong Families" is a family program aimed at preventing risk behaviors in adolescents from 10 to 14 years of age. It has been developed by the Pan American Health Organization (PAHO/WHO) and is based on the Iowa Strengthening Families Program. This program has been certified and has been proven to effectively prevent adolescent drug and alcohol abuse in several countries around the globe. To evaluate the Strong Families Program toward adjusting current parenting styles, aiming to decrease risk behaviors in Chilean adolescents. A quasi-experimental study involving 120 families, selected from 6 schools within the Metropolitan Region of Santiago, Chile. A group of 129 adolescents and 124 parents were chosen by convenience to be intervened. A control group of 223 adolescents and 165 parents were not intervened. The families that underwent intervention attended to 7 educational sessions. The intervened and control groups were evaluated before intervention as well as 6 months after intervention, by means of self-administered evaluation tools. The intervened parents showed significant parenting changes six months after intervention, which resulted in less yelling (p = 0.007), insults (p = 0.002) and lack of control when their children misbehaved (p = 0.008). Regarding the risk behaviors in the intervened and control adolescents, no changes were observed in terms of the consumption rate of tobacco, alcohol or illegal drug use, or in sexual risk behaviors. After six months of intervention, the Program proved to be effective in modifying parenting styles. However, no changes were observed in risk behaviors among adolescents, which could occur within a longer period of time, as reported in other studies.

Intentional Excellence in the Baldwin Wallace University Neuroscience Program

PubMed Central

Morris, Jacqueline K.; Peppers, Kieth; Mickley, G. Andrew

2015-01-01

The Society for Neuroscience recognized Baldwin Wallace University’s (BWU) undergraduate Neuroscience program as their Program of the Year for 2012. This award acknowledged the “accomplishments of a neuroscience department or program for excellence in educating neuroscientists and providing innovative models to which other programs can aspire.” The Neuroscience program grew out of students interested in studying the biological basis of behavior. BWU’s neuroscience major is research-intensive, and all students are required to produce an empirically-based senior thesis. This requirement challenges program resources, and the demand for faculty attention is high. Thus, we developed an intentional 3-step peer mentoring system that encourages our students to collaborate with and learn from, not only faculty, but each other. Peer mentoring occurs in the curriculum, faculty research labs, and as students complete their senior theses. As the program has grown with over 80 current majors, we have developed a new Neuroscience Methods course to train students on the safety, ethics, and practice of research in the neuroscience laboratory space. Students in this course leave with the skills and knowledge to assist senior level students with their theses and to begin the process of developing their own projects in the laboratory. Further, our students indicate that their “peer mentorship was excellent,” “helped them gain confidence,” and “allowed them to be more successful in their research.” PMID:26240522

Anaphylaxis in Schools: Results of the EPIPEN4SCHOOLS Survey Combined Analysis.

PubMed

White, Martha V; Hogue, Susan L; Odom, Dawn; Cooney, Darryl; Bartsch, Jennifer; Goss, Diana; Hollis, Kelly; Herrem, Christopher; Silvia, Suyapa

2016-09-01

A pilot survey described the characteristics of anaphylactic events occurring in an initial set of participating U.S. schools during the 2013-2014 school year. This survey was subsequently readministered to large school districts, which were underrepresented in initial results. A cross-sectional survey was administered to the U.S. schools that were participating in the EPIPEN4SCHOOLS ® program (Mylan Specialty L.P., Canonsburg, PA) to assess characteristics of anaphylactic events. Data from large school districts were added to initial findings in this comprehensive combined analysis. A total of 1,140 anaphylactic events were reported among 6,574 responding schools. Of 1,063 anaphylactic events with data on who experienced the event, it was observed that it occurred mostly in students (89.5%, 951/1,063). For students, anaphylactic events were reported across all grades, with 44.9% (400/891) occurring in high school students, 18.9% (168/891) in middle school students, and 32.5% (290/891) in elementary school students. Food was identified as the most common trigger (60.1%, 622/1,035). A majority of schools (55.0%, 3,332/6,053) permitted only the school nurse and select staff to administer epinephrine to treat anaphylaxis. The unpredictability of anaphylaxis is emphasized by its high occurrence in individuals with no known allergies (25.0%). A majority of schools permitted only the school nurse and select staff to treat anaphylaxis. Thus, individuals experiencing an anaphylactic event may frequently encounter staff members not being permitted to administer potentially life-saving epinephrine. Epinephrine auto-injectors provided by the EPIPEN4SCHOOLS program were used to treat 38.0% of events. Anaphylaxis can occur in children with no previously known allergies, illustrating the importance of public access to epinephrine.

Strategies for safe motherhood.

PubMed

Chatterjee, A

1995-02-01

The Safe Motherhood Initiative was launched in 1988 as a global effort to halve maternal mortality and morbidity by the year 2000. The program uses a combination of health and nonhealth strategies to emphasize the need for maternal health services, extend family planning services, and improve the status of women. The maternal mortality rate (per 100,000 live births) is 390 for the world, 20-30 for developed countries, 450 for developing countries, and 420 for Asia. This translates into 308,000 maternal deaths in Asia, of which 100,000 occur in India. The direct causes of maternal mortality include sepsis, hemorrhage, eclampsia, and ruptured uterus. Indirect causes occur when associated medical conditions, such as anemia and jaundice, are exacerbated by pregnancy. Underlying causes are ineffective health services, inadequate obstetric care, unregulated fertility, infections, illiteracy, early marriage, poverty, malnutrition, and ignorance. India's Child Survival and Safe Motherhood Program seeks to achieve immediate improvements by improving health care. Longterm improvements will occur as nutrition, income, education, and the status of women improve. Improvements in health care will occur in through the provision of 1) essential obstetric care for all women (which will be essentially designed for low-risk women), 2) early detection of complications during pregnancy and labor, and 3) emergency services. Services will be provided to pregnant women at their door by field staff, at a first referral hospital, perhaps at maternity villages where high risk cases can be housed in the latter part of their pregnancies, and through the continual accessibility of government vehicles. In addition, family planning services will be improved so that fertility regulation can have its expected beneficial effect on the maternal mortality rate. The professional health organizations in India will also play a vital role in the success of this effort to reduce maternal mortality.

Baseline evaluation of nutritional status and government feeding programs in Chiclayo, Peru.

PubMed

Gross, Rainer; Lechtig, Aarón; López de Romaña, Daniel

2006-01-01

Because of the rapid growth of the urban population in Peru, food and nutrition insecurity will occur increasingly in this population. For appropriate policy setting and programming, the food and nutrition situation of the urban poor requires better understanding. To gain information about the nature, magnitude, severity, and causes of the nutritional problems of the population in low-income areas of the city of Chiclayo, Peru. A cross-sectional nutrition survey was conducted in 1,604 households, covering children under 5 years of age and their parents. The prevalence rates of stunting, wasting, overweight. and anemia in children were 15.4%, 1.3%, 4.6%, and 65.7%, respectively; one third of adults were overweight, and one tenth were obese; 2.1% of the mothers were underweight; and 34.3% of mothers and 12.2% of fathers had anemia. Governmental feeding programs did not address these problems adequately. Interventions must have adequate targeting; address appropriate responses at the household, community, and national levels; and reduce stunting, obesity, and iron-deficiency anemia.

Don't Mess with the NEST

NASA Astrophysics Data System (ADS)

Larson, Michael

2012-03-01

This presentation will describe the history of the Nuclear Emergency Support Team (NEST) and its evolution over the years. NEST was formed due to a number of nuclear extortion threats received in the early 1970s. From the beginning NEST developed an extensive exercise program to test and expand capabilities. The Nuclear Assessment Program (NAP) was developed, in part, to determine if NEST deployments were required. A major revamp of the NEST program occurred in 1994. Many other organizations work in conjunction with NEST in particular the FBI and DOD. Considerable research and development has been performed in the areas of Access, Search, Diagnostics, Device Assessment, and Disablement. Extensive searches of material appearing in the unclassified literature have been and are being performed to see what is being said about nuclear materials and devices. A comprehensive study of Improvised Nuclear Devices (IND) is ongoing to determine what a terrorist can and cannot do. NEST now consists of four phases with the latest additions of Phase III, Disposition and Phase IV, Nuclear Forensics. LLNL-ABS-521775

Methane Hydrate Field Program. Development of a Scientific Plan for a Methane Hydrate-Focused Marine Drilling, Logging and Coring Program

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

Collett, Tim; Bahk, Jang-Jun; Frye, Matt

2013-12-31

This topical report represents a pathway toward better understanding of the impact of marine methane hydrates on safety and seafloor stability and future collection of data that can be used by scientists, engineers, managers and planners to study climate change and to assess the feasibility of marine methane hydrate as a potential future energy resource. Our understanding of the occurrence, distribution and characteristics of marine methane hydrates is incomplete; therefore, research must continue to expand if methane hydrates are to be used as a future energy source. Exploring basins with methane hydrates has been occurring for over 30 years, butmore » these efforts have been episodic in nature. To further our understanding, these efforts must be more regular and employ new techniques to capture more data. This plan identifies incomplete areas of methane hydrate research and offers solutions by systematically reviewing known methane hydrate “Science Challenges” and linking them with “Technical Challenges” and potential field program locations.« less

Depression Prevention for Early Adolescent Girls

PubMed Central

Chaplin, Tara M.; Gillham, Jane E.; Reivich, Karen; Elkon, Andrea G. L.; Samuels, Barbra; Freres, Derek R.; Winder, Breanna; Seligman, Martin E. P.

2015-01-01

Given the dramatic increase in depression that occurs during early adolescence in girls, interventions must address the needs of girls. The authors examined whether a depression prevention program, the Penn Resiliency Program, was more effective for girls in all-girls groups than in co-ed groups. Within co-ed groups, the authors also tested whether there were greater effects for boys than for girls. Participants were 208 11- to 14-year-olds. Girls were randomly assigned to all-girls groups, co-ed groups, or control. Boys were assigned to co-ed groups or control. Students completed questionnaires on depressive symptoms, hopelessness, and explanatory style before and after the intervention. Girls groups were better than co-ed groups in reducing girls’hopelessness and for session attendance rates but were similar to co-ed groups in reducing depressive symptoms. Co-ed groups decreased depressive symptoms, but this did not differ by gender. Findings support prevention programs and suggest additional benefits of girls groups. PMID:26139955

NASA's Beachside Corrosion Test Site and Current Environmentally Friendly Corrosion Control Initiatives

NASA Technical Reports Server (NTRS)

Russell, Richard W.; Calle, Luz Marina; Johnston, Frederick; Montgomery, Eliza L.; Curran, Jerome P.; Kolody, Mark R.

2013-01-01

NASA began corrosion studies at the Kennedy Space Center (KSC) in 1966 during the Gemini/Apollo Programs with the evaluation of long-term corrosion protective coatings for carbon steel. KSC's Beachside Corrosion Test Site (BCTS), which has been documented by the American Society of Materials (ASM) as one of the most corrosive, naturally occurring, environments in the world, was established at that time. With the introduction of the Space Shuttle in 1981, the already highly corrosive conditions at the launch pad were rendered even more severe by the acid ic exhaust from the solid rocket boosters. In the years that followed, numerous studies have identified materials, coatings, and maintenance procedures for launch hardware and equipment exposed to the highly corrosive environment at the launch pad. This paper presents a historical overview of over 45 years of corrosion and coating evaluation studies and a description of the BCTS's current capabilities. Additionally, current research and testing programs involving chromium free coatings, environmentally friendly corrosion preventative compounds, and alternates to nitric acid passivation will be discussed.

Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System--Update for Fiscal Year Beginning October 1, 2015 (FY 2016). Final rule.

PubMed

2015-08-05

This final rule updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) (which are freestanding IPFs and psychiatric units of an acute care hospital or critical access hospital). These changes are applicable to IPF discharges occurring during fiscal year (FY) 2016 (October 1, 2015 through September 30, 2016). This final rule also implements: a new 2012-based IPF market basket; an updated IPF labor-related share; a transition to new Core Based Statistical Area (CBSA) designations in the FY 2016 IPF Prospective Payment System (PPS) wage index; a phase-out of the rural adjustment for IPF providers whose status changes from rural to urban as a result of the wage index CBSA changes; and new quality measures and reporting requirements under the IPF quality reporting program. This final rule also reminds IPFs of the October 1, 2015 implementation of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), and updates providers on the status of IPF PPS refinements.

Valuing shifts in the distribution of visibility in national parks and wilderness areas in the United States.

PubMed

Boyle, Kevin J; Paterson, Robert; Carson, Richard; Leggett, Christopher; Kanninen, Barbara; Molenar, John; Neumann, James

2016-05-15

Environmental regulations often have the objective of eliminating the lower tail of an index of environmental quality. That part of the distribution of environmental quality moves somewhere above a threshold and where in the original distribution it moves is a function of the control strategy chosen. This paper provides an approach for estimating the economic benefits of different distributional changes as the worst environmental conditions are removed. The proposed approach is illustrated by examining shifts in visibility at Class I visibility areas (National Parks and wilderness areas) that would occur with implementation of the U.S. Environmental Protection Agency's Regional Haze Program. In this application we show that people value shifts in the distribution of visibility and place a higher value on the removal of a low visibility day than on the addition of a high visibility day. We found that respondents would pay about $120 per year in the Southeast U.S. and about $80 per year in the Southwest U.S. for improvement programs that remove the 20% worst visibility days. Copyright © 2016 Elsevier Ltd. All rights reserved.

Rotarix in developing countries: paving the way for inclusion in national childhood immunization programs in Africa.

PubMed

Pawinski, Robert; Debrus, Serge; Delem, Andrée; Smolenov, Igor; Suryakiran, Pemmaraju V; Han, Htay Htay

2010-09-01

Rotavirus gastroenteritis causes more than half a million deaths annually among children aged <5 years, the great majority of which occur in Africa and Asia. Vaccination is considered to be the most effective public health strategy to prevent rotavirus disease and to reduce the significant global burden of rotavirus gastroenteritis. Rotarix (GlaxoSmithKline Biologicals) is an oral, live attenuated rotavirus vaccine derived from a human G1P[8] rotavirus strain. Results of phase III studies in Europe, Latin America, and Asia have shown that Rotarix offers sustained high protection against severe rotavirus gastroenteritis during the first 2 years of life, when disease burden is highest, with broad protection demonstrated against each of the 5 main rotavirus types that circulate globally (G1, G2, G3, G4, and G9). Coupled with the availability of local burden of disease data and promising interim efficacy data from an ongoing study in Malawi and South Africa, this further reinforces the case for introduction of this rotavirus vaccine in national childhood immunization programs in Africa, where rotavirus-related mortality is significant.

A flexible e-learning resource promoting the critical reading of scientific papers for science undergraduates.

PubMed

Letchford, Julie; Corradi, Hazel; Day, Trevor

2017-11-01

An important aim of undergraduate science education is to develop student skills in reading and evaluating research papers. We have designed, developed, and implemented an on-line interactive resource entitled "Evaluating Scientific Research literature" (ESRL) aimed at students from the first 2 years of the undergraduate program. In this article, we describe the resource, then use student data collected from questionnaire surveys to evaluate the resource within 2 years of its launch. Our results add to those reported previously and indicate that ESRL can enable students to start evaluating research articles when used during their undergraduate program. We conclude maximal learning is likely to occur when the resource can be embedded in the curriculum such that students have a clearly articulated context for the resource's activities, can see their relevance in relation to assessed assignments and can be encouraged to think deeply about the activities in conversation with one another and/or with staff. © 2017 by The International Union of Biochemistry and Molecular Biology, 45(6):483-490, 2017. © 2017 The International Union of Biochemistry and Molecular Biology.

Faculty Perceptions of Online Teaching Effectiveness and Indicators of Quality.

PubMed

Frazer, Christine; Sullivan, Debra Henline; Weatherspoon, Deborah; Hussey, Leslie

2017-01-01

Online education programs in nursing are increasing rapidly. Faculty need to be competent in their role and possess the skills necessary to positively impact student outcomes. Existing research offers effective teaching strategies for online education; however, there may be some disconnect in the application of these strategies and faculty perceptions of associated outcomes. Focus groups were formed to uncover how nursing faculty in an online program define and describe teaching effectiveness and quality indicators in an asynchronous online environment. A semistructured interview format guided group discussion. Participants ( n = 11) included nurse educators from an online university with an average of 15 years of experience teaching in nursing academia and 6 years in an online environment. Teaching effectiveness, indicators of quality, and student success were three categories that emerged from the analysis of data. What materialized from the analysis was an overarching concept of a "dance" that occurs in the online environment. Effective online teachers facilitate, connect, lead, and work in synchrony with students to obtain indicators of quality such as student success, student improvement over time, and student application of knowledge to the professional role.

Faculty Perceptions of Online Teaching Effectiveness and Indicators of Quality

PubMed Central

Sullivan, Debra Henline; Weatherspoon, Deborah; Hussey, Leslie

2017-01-01

Online education programs in nursing are increasing rapidly. Faculty need to be competent in their role and possess the skills necessary to positively impact student outcomes. Existing research offers effective teaching strategies for online education; however, there may be some disconnect in the application of these strategies and faculty perceptions of associated outcomes. Focus groups were formed to uncover how nursing faculty in an online program define and describe teaching effectiveness and quality indicators in an asynchronous online environment. A semistructured interview format guided group discussion. Participants (n = 11) included nurse educators from an online university with an average of 15 years of experience teaching in nursing academia and 6 years in an online environment. Teaching effectiveness, indicators of quality, and student success were three categories that emerged from the analysis of data. What materialized from the analysis was an overarching concept of a “dance” that occurs in the online environment. Effective online teachers facilitate, connect, lead, and work in synchrony with students to obtain indicators of quality such as student success, student improvement over time, and student application of knowledge to the professional role. PMID:28326195

Seasonal variation of copper and zinc concentrations in the oyster Saccostrea cuccullata from the Dampier Archipelago, Western Australia: implications for pollution monitoring.

PubMed

Talbot, V

1986-12-01

The intertidal rock oyster Saccostrea cuccullata, sampled at eight sites on eight occasions over a 1-year period, contained mean Cu and Zn concentrations ranging between 34 and 267 and 206 and 4078 mg kg-1 dry weight, respectively. In the study area, Cu and Zn emanate from sewage and boat slips (antifouling paints), while Zn probably also originates from coolant water from an electricity power generating station and iron ore exporting facilities. Highest oyster wet weight, Cu and Zn concentrations and loads occurred in January (spawning period), indicating that metal variation was not reciprocating wet weight. Lowest metal concentrations and loads occurred in October (period of onset of gametogenesis), while lowest wet weight occurred in April (post-spawning period). No significant (P less than 0.001) variation in the wet to dry weight ratio was noted temporally. However, significant, though slight, variation was noted between polluted and unpolluted oysters. Results of this study indicate that pollution control monitoring programs should consider: seasonal variation of metal concentrations; portion of the year during which standards are exceeded; oyster size and availability for human consumption; suitability of standards where shellfish are not consumed as a staple diet; appropriate size indicies which can be used for selecting specimens for intersite comparisons; wet to dry weight calculations: techniques, spatial and temporal variations; and the physical dynamics of sites used.

Pediatric fluoroquinolone prescription in South Korea before and after a regulatory intervention: A nationwide study, 2007-2015.

PubMed

Song, Seung Yeon; Shin, Joo Hee; Hyeon, Su Yeong; Kim, Donguk; Kang, Won Ku; Choi, Soo-Han; Kim, Yae-Jean; Kim, Eun Young

2017-01-01

To investigate the impact of national implementation of age restriction on fluoroquinolone prescription in children and adolescents. Data collected from the database of Health Insurance Review and Assessment Service in South Korea, a national health insurance system to analyze fluoroquinolone prescribing practice in children and adolescents younger than 18 years, between 2007 and 2015. The age restriction was implemented in December 2009. The annual prescription rate of FQ per 100,000 person-years was calculated and an autoregressive model was used to predict the prescription pattern if an intervention had not occurred. A total of 505,859 children received systemic fluoroquinolone during the study period-297,054 ciprofloxacin, and 208,805 levofloxacin. After implementation of the drug utilization review program, the annual prescription rate for ciprofloxacin declined by 97.5% (from 840 to 21 per 100,000 person-years, P < 0.001), and for levofloxacin by 96.4% (from 598 to 11 per 100,000 person-years, P < 0.001). The decline was more dramatic in the outpatient setting than in the inpatient setting for both drugs. The dramatic and sustained decline in prescription number and change in prescription pattern after the regulatory action suggests that the implementation under drug utilization review program was successful in controlling excessive and inappropriate use of fluoroquinolones in children, possibly guiding towards more judicious and selective prescription behavior.

Pediatric fluoroquinolone prescription in South Korea before and after a regulatory intervention: A nationwide study, 2007-2015

PubMed Central

Hyeon, Su Yeong; Kim, Donguk; Kang, Won Ku; Choi, Soo-Han; Kim, Yae-Jean

2017-01-01

Objective To investigate the impact of national implementation of age restriction on fluoroquinolone prescription in children and adolescents. Methods Data collected from the database of Health Insurance Review and Assessment Service in South Korea, a national health insurance system to analyze fluoroquinolone prescribing practice in children and adolescents younger than 18 years, between 2007 and 2015. The age restriction was implemented in December 2009. The annual prescription rate of FQ per 100,000 person-years was calculated and an autoregressive model was used to predict the prescription pattern if an intervention had not occurred. Results A total of 505,859 children received systemic fluoroquinolone during the study period—297,054 ciprofloxacin, and 208,805 levofloxacin. After implementation of the drug utilization review program, the annual prescription rate for ciprofloxacin declined by 97.5% (from 840 to 21 per 100,000 person-years, P < 0.001), and for levofloxacin by 96.4% (from 598 to 11 per 100,000 person-years, P < 0.001). The decline was more dramatic in the outpatient setting than in the inpatient setting for both drugs. Conclusion The dramatic and sustained decline in prescription number and change in prescription pattern after the regulatory action suggests that the implementation under drug utilization review program was successful in controlling excessive and inappropriate use of fluoroquinolones in children, possibly guiding towards more judicious and selective prescription behavior. PMID:28520738

Earth observation photography: Looking back 20 years after Skylab

NASA Technical Reports Server (NTRS)

Nicholson, James H.

1992-01-01

A committee of trained classroom teachers, backed by a volunteer team of technical experts and academic advisors has developed a program for earth science based on photographs obtained from low earth orbit. In selecting targeting objectives, immediate note was made of the fact nearly one generation (20 years) has passed since the United States' ambitious SKYLAB program was conducted. A critical part of those missions was the acquisition of earth photography using a six camera, multi-spectral camera system. This objective was systematically furthered through the term of three separate crew visits to the Space Station. Not merely an exercise in randomly photographing the Earth below, the purpose of the Earth Resource Experiment Package (EREP) was to determine what kind, and how much, photographic data could be acquired of the broad variety of Earth features witnessed on the mission's ground track. The collection of 35,000 photos produced by EREP represents the most complete coverage of Earth. However, it remains under used. GAS 324 intends to revisit, and to add a tier of relevancy to this inventory. The photography of GAS 324 should allow a direct examination and comparison of the changes in the globe in the last 20 years. format in both coverage and quality. The photogra phy acquired by CAN DO should allow a direct examination and comparison of the changes that have occured to the Globe in the last twenty years.

Roles, intents, and actions: First-year teachers' uses of discourse during elementary science instruction

NASA Astrophysics Data System (ADS)

Newman, William J., Jr.

In this study, I examined how three first-year elementary teachers constructed and used classroom discourse during science instruction. The three participants, though graduates from different universities, learned to teach science through similar science methods courses, which stressed the importance of inquiry-based science instruction. The participants taught different grade levels, and two of them taught at the same school. Data sources included field notes, videotapes, audiotapes, and semi-structured teacher interviews. While monologic and dialogic discourse existed in all three classrooms, monologic discourse was more prominent, especially when the discourse was teacher controlled. Dialogic discourse occurred most often during student-centered activities. The teachers constructed discourse with authoritative function to present science content and determine student comprehension. Generative function was most likely during student-based small group discussions. Monologic character often aligned with authoritative function, and dialogic character often aligned with generative function. However, monologic/generative and dialogic/authoritative discourse events did occur, contributing to the development of a discourse theory model. The teacher explanations for discourse included classroom control, inadequate planning, time constraints, life experiences, science education standards, and assessment. The teachers relied on their texts, kits, and state science standards to determine the content and methods for science instruction. They rarely reported that their science methods courses influenced how they taught science. The observed lessons rarely aligned with science education reform descriptions of appropriate science instruction. Implications include the need for in-service programs for beginning science teachers, curricular reform for science texts and kits, and explicit instruction of discourse strategies in science methods courses and in-service programs.

Cabazitaxel for metastatic castration-resistant prostate cancer: safety data from the Spanish expanded access program.

PubMed

Castellano, Daniel; Antón Aparicio, Luis M; Esteban, Emilio; Sánchez-Hernández, Alfredo; Germà, Jose Ramón; Batista, Norberto; Maroto, Pablo; Pérez-Valderrama, Begoña; Luque, Raquel; Méndez-Vidal, María José

2014-09-01

Based on the TROPIC study results, cabazitaxel was approved for the management of metastatic castration-resistant prostate cancer (mCRPC) progressing on or after docetaxel. This multi-centre program provided early access to cabazitaxel to patients with mCRPC before its commercialization. Safety data from 153 Spanish patients receiving cabazitaxel 25 mg/m(2) i.v. Q3W, plus oral prednisone/prednisolone 10 mg daily, are reported. Median age of patients was 70 years (26.8% ≥ 75 years), 94.1 and 26.8% had bone and visceral metastasis, respectively. Most had an Eastern Cooperative Oncology Group ≤ 1 (88.9%) and had received a median of 8.0 cycles of last docetaxel treatment. The median of cabazitaxel cycles and cumulative dose were 6.0 (Interquartile range [IQR]: 4.0; 8.0) and 148.9 (IQR: 98.2; 201.4) mg/m(2), respectively. Adverse events (AEs) possibly related to cabazitaxel occurred in 143 (93.5%) patients. The most frequent grade ≥ 3 AEs were neutropenia (n = 25, 16.3%) and asthenia (n = 17, 11.1%). Febrile neutropenia and grade ≥ 3 diarrhea occurred in 5.2% of the patients each. There were five (3.3%) possibly treatment-related deaths, mainly infection-related. G-CSFs were used in 114 (74.5%) patients, generally as prophylaxis (n = 107; 69.9%). Grade ≥ 3 peripheral neuropathy and nail disorders were uncommon. Cabazitaxel administration, in a real-world setting, is tolerated by Spanish patients with mCRPC, and the AEs are manageable.

Utilization of substance abuse treatment services under Medicare, 2001-2002.

PubMed

Vandivort, Rita; Teich, Judith L; Cowell, Alexander J; Chen, Hong

2009-06-01

In 2006, the Medicare program covered 37 million elderly persons and 7 million persons younger than 65 years, but little is known about substance abuse (SA) service utilization. Using the 5% Sample of Medicare claims data, the study examines individuals who used SA detoxification ("detox") and/or rehabilitation ("rehab") services under Medicare in 2001 and 2002. SA claimants less than 65 years of age (disabled) were compared to claimants more than 65 years of age (elderly). The disabled were more likely to have a co-occurring mental disorder than elderly claimants (50% vs. 14%) and more likely to have serious mental illness (21% vs. 2.3%). Disabled claimants were more than three times as likely to receive any detox service as elderly claimants (17% vs. 6%). The rate of claimants receiving rehab services within 30 days of detox is about one third for disabled claimants and one quarter for elderly claimants.

Typhoid vaccine: a case for inclusion in national program.

PubMed

Sharma, Pragya; Taneja, Davendra K

2011-01-01

Typhoid has been reported to be a common and significant cause of morbidity in pre-school and school-age children in the endemic countries like India. The incidence of typhoid has been reported to be as high as 27.3 per 1000 person-years in children less than 5 years of age. Serious complications occur in about 10% of cases requiring hospitalization. The mean cost of treatment per episode of blood culture-confirmed typhoid fever has been calculated as INR 3,597 (1996 prices) in an outdoor setting, whereas in case of hospitalization, the cost of illness increases by several folds (INR 18,131). Vi polysaccharide vaccine is safe, efficacious and affordable for use as a cost-effective public health tool to protect children from typhoid and related complications, when given at 2 and 5 years of age as a part of National Immunization Schedule.

Financial effect of bovine Johne's disease in beef cattle herds in Australia.

PubMed

Webb Ware, J K; Larsen, J W A; Kluver, P

2012-04-01

To assess the financial effect of programs for controlling bovine Johne's disease (BJD) in beef herds. A spreadsheet simulation model of a self-replacing beef herd in south-eastern Australia selling 400-kg steers at 15 months old. The model calculated the monthly cash flow, and net present value (NPV) of cumulative cash flow, over 10 years. Four main control options were compared: (1) a base herd (no action to control the disease), (2) test and cull, and (3) partial and (4) total destocking. It was assumed that BJD was eradicated after 3 and 5 years with total and partial destocking, respectively, and not eradicated with a test and cull program. Scenarios were compared for both commercial and stud enterprises. If there was no discount on the sale price of cattle in commercial herds, deaths from BJD had to exceed 5% before the NPV of partial or total destocking was similar to taking no action to control the disease over a 10-year period. When cattle sales incurred a 10% discount, deaths had to exceed 1% before the destocking strategies would break even after 10 years. Control options for BJD should be carefully planned on an individual herd basis, as significant production and financial risks accompany destocking programs. Eradication will only be more profitable in the longer term, compared with living with the disease, when discounts on the sale of stock from infected herds are high. This can occur with the selling of store cattle or breeders. In stud herds, BJD will usually cause the total failure of the business. © 2012 The Authors. Australian Veterinary Journal © 2012 Australian Veterinary Association.

Surface-water-quality assessment of the Yakima River basin, Washington; project description

USGS Publications Warehouse

McKenzie, S.W.; Rinella, J.F.

1987-01-01

In April 1986, the U.S. Geological Survey began the National Water Quality Assessment program to: (1) provide a nationally consistent description of the current status of water quality, (2) define water quality trends that have occurred over recent decades, and (3) relate past and present water quality conditions to relevant natural features, the history of land and water use, and land management and waste management practices. At present (1987), The National Water Quality Assessment program is in a pilot studies phase, in which assessment concepts and approaches are being tested and modified to prepare for possible full implementation of the program. Seven pilot projects (four surface water projects and three groundwater projects) have been started. The Yakima River basin in Washington is one of the pilot surface water project areas. The Yakima River basin drains in area of 6,155 sq mi and contains about 1,900 river mi of perennial streams. Major land use activities include growing and harvesting timber, dryland pasture grazing, intense farming and irrigated agriculture, and urbanization. Water quality issues that result from these land uses include potentially large concentrations of suspended sediment, bacteria, nutrients, pesticides, and trace elements that may affect water used for human consumption, fish propagation and passage, contact recreation, livestock watering, and irrigation. Data will be collected in a nine year cycle. The first three years of the cycle will be a period of concentrated data acquisition and interpretation. For the next six years, sample collection will be done at a much lower level of intensity to document the occurrence of any gross changes in water quality. This nine year cycle would then be repeated. Three types of sampling activities will be used for data acquisition: fixed location station sampling, synoptic sampling, and intensive reach studies. (Lantz-PTT)

Characterization of mortality in children with sickle cell disease diagnosed through the Newborn Screening Program.

PubMed

Sabarense, Alessandra P; Lima, Gabriella O; Silva, Lívia M L; Viana, Marcos Borato

2015-01-01

To characterize the deaths of 193 children with sickle cell disease screened by a neonatal program from 1998 to 2012 and contrast the initial years with the final years. Deaths were identified by active surveillance of children absent to scheduled appointments in Blood Bank Clinical Centers (Hemominas). Clinical and epidemiological data came from death certificates, neonatal screening database, medical records, and family interviews. Between 1998 and 2012, 3,617,919 children were screened and 2,591 had sickle cell disease (1:1,400). There were 193 deaths (7.4%): 153 with SS/Sβ(0)-thalassemia, 34 SC and 6 Sβ(+)thalassemia; 76.7% were younger than five years; 78% died in the hospital and 21% at home or in transit. The main causes of death were infection (45%), indeterminate (28%), and acute splenic sequestration (14%). In 46% of death certificates, the term "sickle cell" was not recorded. Seven-year death rate for children born between 1998 and 2005 was 5.43% versus 5.12% for those born between 2005 and 2012 (p = 0.72). Medical care was provided to 75% of children; 24% were unassisted. Medical care was provided within 6 hours of symptom onset in only half of the interviewed cases. In 40.5% of cases, death occurred within the first 24 hours. Low family income was recorded in 90% of cases, and illiteracy in 5%. Although comprehensive and effective, neonatal screening for sickle cell disease was not sufficient to significantly reduce mortality in a newborn screening program. Economic and social development and increase of the knowledge on sickle cell disease among health professionals and family are needed to overcome excessive mortality. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Usage patterns and 1-year outcomes with the TAXUS Liberté stent: results of the TAXUS OLYMPIA registry.

PubMed

Ahmed, Waqar H; Mendiz, Oscar A; Thomas, Martyn R

2011-06-01

The TAXUS OLYMPIA registry is a prospective, global, post-approval program designed to collect clinical outcome data through 1 year from patients receiving the TAXUS Liberté paclitaxel-eluting stent in routine interventional cardiology practice. The thin-strut TAXUS Liberté stent has been studied in ongoing clinical trials with specific inclusion/exclusion criteria. Between September 2005 and April 2007, a total of 21,954 patients from 365 sites in 57 countries eligible to receive a TAXUS Liberté stent were enrolled in the TAXUS OLYMPIA registry. Baseline characteristics and procedure patterns were collected and clinical follow-up is available for 1 year. The primary endpoint was the composite cardiac event (cardiac death, MI, and reintervention of the target vessel) rate related to the TAXUS Liberté stent at 1 year. All cardiac events were monitored and all endpoints were independently adjudicated. Complex patients and lesions were prevalent, including: 27% medically-treated diabetes, 58% ACC/AHA type B2/C lesions, 32% multiple stenting, 13% long lesions (>28 mm), and 10% small vessels (<2.5 mm). At 1 year, the composite cardiac event rate was 4.4%, including 1.4% cardiac death, 1.0% MI, and 3.2% TVR. Stent thrombosis (ST, angiographically confirmed) occurred in 0.8% of patients, with 0.4% ST occurring >30 days postprocedure. The composite cardiac event rate related to the TAXUS Liberté stent was 3.8% at 1 year. Low 1-year cardiac event rates were reported with TAXUS Liberté in a broad spectrum of patients, thereby confirming the technical and clinical performance of this stent in a "real-world" setting. Copyright © 2010 Wiley-Liss, Inc.

Postdoctoral pharmacy industry fellowships: a descriptive analysis of programs and postgraduate positions.

PubMed

Melillo, Stephanie; Gangadharan, Amy; Johnson, Hiliary; Schleck, Patrick; Steinberg, Michael; Alexander, James G

2012-01-01

Postdoctoral pharmacy industry fellowship programs and the employment of fellowship graduates are described. A list of postgraduate industry fellowships was gathered from the 2009 ASHP Midyear Clinical Meeting. Data regarding program characteristics were collected using the Personnel Placement Service database and program-specific brochures. After data compilation, a standardized survey was sent in January 2010 via e-mail to the point of contact for all programs to confirm the accuracy of the program's characteristics. Only academically affiliated industry fellowship programs were analyzed. Retrospective data were collected regarding the first position of employment for all fellows who graduated from the program between 2005 and 2009 and the position of those same individuals at the time of survey completion. Surveys were sent to 64 postgraduate industry fellowship programs affiliated with a school of pharmacy, 56 (87.5%) of whom responded. The departmental breakdown for positions offered (n = 75) across all academically affiliated industry fellowship programs (including nonresponders) was as follows: medical affairs (38.7%, n = 29), clinical research (32.0%, n = 24), regulatory affairs (9.3%, n = 7), commercial (8.0%, n = 6), health economics and outcomes research (8.0%, n = 6), and pharmacovigilance (4.0%, n = 3). Data from fellows during years 1-5 after completion of the industry fellowship indicated that 90.5% of former fellows remained in the industry (n = 238). The postgraduate industry fellowship programs surveyed indicated that the majority of fellowship graduates continued to hold positions in industry after program completion. The majority of industry fellowships and subsequent job placements occurred in the areas of medical affairs, clinical research, and regulatory affairs.

7 CFR 1940.302 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... flood—A flood of a magnitude that occurs once every 100 years on the average. Within any one-year period... a magnitude that occurs once every 500 years on the average. (Within any one-year period there is... that occurs once every 100 years on the average (the flood having a one-percent chance of being...

7 CFR 1940.302 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... flood—A flood of a magnitude that occurs once every 100 years on the average. Within any one-year period... a magnitude that occurs once every 500 years on the average. (Within any one-year period there is... that occurs once every 100 years on the average (the flood having a one-percent chance of being...

Shaping oral feeding in a gastronomy tube-dependent child in natural settings.

PubMed

Gutentag, S; Hammer, D

2000-07-01

A 3-year-old medically fragile girl who refused to eat after prolonged and frequent hospitalizations was started on a feeding program in the home and school settings. She exhibited food aversions and received all nourishment via a gastronomy tube. Preevaluation observations of her feeding behavior revealed that she refused all presented drinks and foods. Treatment was two-fold. First, food acceptance was followed by social praise and access to preferred toy play, and second, food refusal and disruptive behaviors were ignored. Gagging, vomiting, and crying occurred periodically during initial feedings. In addition, there were medical complications during the course of treatment necessitating continuous modifications of the program. Results of a multiple-phase design showed marked increases in the amount of food consumed at home, which then generalized to the school setting.

Cognitive behavioral group therapy for anxiety: recent developments.

PubMed

Wolgensinger, Laure

2015-09-01

Anxiety disorders occur frequently, and can have a negative impact on the quality of people's lives. They often begin at an early age and can have some serious consequences. This article is an overview of the recent studies concerning group cognitive-behavioral interventions for anxiety disorders. In the last few years, anxiety disorder prevention for children and adolescents has become an important focus of research work. Group prevention programs are based on standard cognitive behavioral therapy (CBT) strategies and are aimed at preventing anxiety disorders as early as possible. Numerous cognitive behavioral group therapies for children as well as adults have been well studied. There are many CBT protocols that have been developed for treating specific anxiety disorders. Now, specialized CBT programs are available for individuals who suffer from different anxiety disorders, enabling them to be treated together in groups.

78 FR 47859 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

...This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2014 (for discharges occurring on or after October 1, 2013 and on or before September 30, 2014) as required by the statute. This final rule also revised the list of diagnosis codes that may be counted toward an IRF's ``60 percent rule'' compliance calculation to determine ``presumptive compliance,'' update the IRF facility-level adjustment factors using an enhanced estimation methodology, revise sections of the Inpatient Rehabilitation Facility-Patient Assessment Instrument, revise requirements for acute care hospitals that have IRF units, clarify the IRF regulation text regarding limitation of review, update references to previously changed sections in the regulations text, and revise and update quality measures and reporting requirements under the IRF quality reporting program.

Mentoring doctoral students for qualitative research: interviews with experienced nursing faculty in Japan.

PubMed

Kayama, Mami; Gregg, Misuzu F; Asahara, Kiyomi; Yamamoto-Mitani, Noriko; Okuma, Keiko; Ohta, Kikuko; Kinoshita, Yasuhito

2013-05-01

This study aimed to describe the process of mentoring doctoral students for qualitative research in Japanese graduate programs in nursing. Nine experienced faculty-seven nurse researchers and two sociologists-were interviewed. Participants were asked about their process of mentoring students for qualitative nursing dissertations. Data analysis was conducted using a qualitative descriptive method. Participants' age ranged from 48 to 60 years. The first theme in the mentoring process is about the individualized, one-on-one mentorship process. The second theme occurs in a group process. The third theme is coordinating mentors and establishing a network to support the evaluation system. The mentoring processes identified in this study will be useful for future faculty development. The study elucidated much room for improvement in doctoral education programs for qualitative research methods in nursing science. Copyright 2013, SLACK Incorporated.

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

Haspel, A.E.

The program for leasing federal lands for oil and gas drilling brought the federal government over $1 billion in revenues in 1983 from lands that are estimated to contain one-sixth of the country's undiscovered oil and gas resources. In a policy debate over the leasing program, all parties agree that leasing should occur, but differ in how it should be done. The author reviews the two systems followed for onshore leases: a lottery system for parcels with proven oil and gas reserves and a first-come first-served basis for other parcels. Policy debate over the years has focused on the lossmore » of revenue from not using the lottery ticket sales for all leases and the need to increase competitive bidding. The author proposes a flexible multi-tier system that combines competitive and noncompetitive leasing in a way that will increase production and revenues.« less

The declining rates of hepatitis B carriage among adolescents and young people in the Eastern region of Saudi Arabia

PubMed Central

Al-Jubran, Khalid. M.; Al-Dossary, Mohamed. A.; Elsafi, Salah H.

2016-01-01

Objectives: To study age specific rates of hepatitis B virus (HBV) carriage in the eastern region of Saudi Arabia following a 24 year immunization program. Methods: Hepatitis B surveillance data between January 2004 and December 2013 were analyzed in a retrospective study, which included 24,504,914 patients. Seropositive cases of hepatitis B were reported by laboratory personnel as part of various investigations. Hepatitis B cases including acute and chronic carriers were identified upon serological positivity of hepatitis B surface antigen (HBsAg). Results: The study shows that the overall prevalence rate decreased from 18.8 to 9.9/100,000 population between 2004 and 2013 (p=0.01). It was also found that the prevalence rate increased with age. For instance, the highest prevalence of hepatitis B was seen among patients >15 years of age and the lowest was seen among children <15 years of age. Over the period, the prevalence rate decreased in all age groups with the greatest decline among the age groups <4 years old. However, this was statistically insignificant (p>0.05). Another significant reduction in the prevalence rate occurred among age groups 5-14 years old (p=0.00). An insignificant decrease in the rate by 43% was also seen among older patients of 15-44 years old and 35% in >45 years old. The overall prevalence of hepatitis B is significantly higher in men than in women (p=0.00). Conclusion: There is a particular decreased trend in the prevalence of HBV infection in different age groups over a decade of surveillance following more than 20 years of the universal HBV vaccination program. PMID:27464863

Cardiometabolic Mortality by Supplemental Nutrition Assistance Program Participation and Eligibility in the United States

PubMed Central

Rehm, Colin D.; Wilde, Parke; Mozaffarian, Dariush

2017-01-01

Objectives. To investigate total and cause-specific cardiometabolic mortality among Supplemental Nutrition Assistance Program (SNAP) participants, SNAP-eligible nonparticipants, and SNAP-ineligible individuals overall and by age, gender, race/ethnicity, and other characteristics. Methods. We performed a prospective study with nationally representative survey data from the National Health Interview Survey (2000–2009), merged with subsequent Public-Use Linked Mortality Files (2000–2011). We used survey-weighted Cox proportional hazards models adjusted for age and gender to estimate hazard ratios of total and cause-specific cardiometabolic mortality for 499 741 US adults aged 25 years or older. Results. Over a mean of 6.8 years of follow-up (maximum 11.9 years), 39 293 deaths occurred, including 7408 heart disease, 2185 stroke, and 1376 diabetes deaths. Individuals participating in SNAP exhibited higher total and cardiovascular disease mortality, largely limited to non-Hispanic Whites and non-Hispanic Blacks, than both SNAP-eligible nonparticipants and SNAP-ineligible individuals, and higher diabetes mortality across races/ethnicities (P < .01). Conclusions. Participants in SNAP require greater focus to understand and further address their poor health outcomes. Public Health Implications. Low-income Americans require even greater efforts to improve their health than they currently receive, and such efforts should be a priority for public health policymakers. PMID:28103061

Estimating the costs of cervical cancer screening in high-burden Sub-Saharan African countries.

PubMed

Mvundura, Mercy; Tsu, Vivien

2014-08-01

To estimate the capital investment and recurrent costs of national cervical cancer screening and precancer treatment programs in 23 high-incidence countries in Sub-Saharan Africa in order to provide estimates of the investment required to tackle the burden of cervical cancer in this region. These 23 countries account for 64% of the annual cervical cancer deaths in this region. Secondary data were used to estimate the financial costs of equipment purchases and economic costs of screening and treating eligible women over a 10-year period. Screening would be by visual inspection with acetic acid and treatment by cryotherapy or loop electrosurgical excision procedure. Approximately US $59 million would be required to purchase treatment equipment if cryotherapy were placed at every screening facility. Approximately 20 million women would be screened over 10 years. Cost per woman screened in a screen-and-treat program was either US $3.33 or US $7.31, and cost per woman treated was either US $38 or US $71 depending on the location of cryotherapy equipment. It would take less than US $10 per woman screened to significantly decrease the cervical cancer deaths that will occur in Sub-Saharan Africa over the next 10 years. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Exploring the mathematical confidence of Indigenous preservice teachers in a remote teacher education program

NASA Astrophysics Data System (ADS)

Thornton, Steve; Giles, Wendy; Prescott, Debbie; Rhodes, David

2011-06-01

This paper reports on the efficacy of an accelerated teacher education program ( Growing Our Own) focused in remote Indigenous communities in the Northern Territory. The program is a joint initiative of Charles Darwin University and the Northern Territory Catholic Education Office, providing an intensive two-year program designed to educate Indigenous Teacher Assistants to full teacher status. We describe the growth in knowledge and confidence that has occurred through the program using the story of one of the students in the project, Philomena, as an evocative representation of the experiences of the participants in the program. This growth is particularly evident in one lesson that Philomena taught towards the end of the program in which she was able to challenge her previously accepted role as subservient to the non-Indigenous teacher. Our discussion highlights some key issues for improving outcomes for Indigenous children, including the potential mismatch between Western and Aboriginal ways of thinking in mathematics and developing the mathematical capacity of Indigenous teacher assistants in remote settings. We suggest that the mutual respect of the participants at various levels of Growing Our Own, the situated and purposeful nature of the learning, and the capacity of students to engage in that learning without abandoning their community responsibilities have been pivotal in enhancing educational outcomes in remote communities and in providing opportunities for Indigenous people.

Urban household food security, Madagascar.

PubMed

Balachander, J

1997-12-01

This article discusses the success of the Madagascar Food Security and Nutrition project in decreasing malnutrition and monitoring child health. Success has occurred in the following realms: effective collaboration between government and nongovernmental organizations (NGOs), capacity building through investment in training of community workers, increased quality of services provided by community nutrition workers, community involvement, government commitment, and a flexible program design. NGOs were able to respond to community concerns by adding program inputs without losing the focus on core nutrition interventions. Community workers were selected from a group of mothers. Women were trained to monitor the growth of all children under age 5. Children who were severely malnourished were identified and referred to rehabilitation centers for treatment lasting up to 3 weeks. The program offered support and nutrition education for mothers of sick children. One drawback of the treatment program was the inability of mothers to stay for long periods of time during the duration of treatment. The program offers distribution of iodine capsules as part of a long-term salt iodization program that is supported by UNICEF and the World Bank. The program also offers microcredit. Since 1993, 28,000 children under age 5 have been weighed each month. These children came from two provinces and belonged to 300,000 families. The monitored children were 66% of the total number of children aged under 5 years. Malnutrition rates decreased from 46% to 37%.

The meteorology and chemistry of high nitrogen oxide concentrations in the stable boundary layer at the South Pole

NASA Astrophysics Data System (ADS)

Neff, William; Crawford, Jim; Buhr, Marty; Nicovich, John; Chen, Gao; Davis, Douglas

2018-03-01

Four summer seasons of nitrogen oxide (NO) concentrations were obtained at the South Pole (SP) during the Sulfur Chemistry in the Antarctic Troposphere (ISCAT) program (1998 and 2000) and the Antarctic Tropospheric Chemistry Investigation (ANTCI) in (2003, 2005, 2006-2007). Together, analyses of the data collected from these studies provide insight into the large- to small-scale meteorology that sets the stage for extremes in NO and the significant variability that occurs day to day, within seasons, and year to year. In addition, these observations reveal the interplay between physical and chemical processes at work in the stable boundary layer of the high Antarctic plateau. We found a systematic evolution of the large-scale wind system over the ice sheet from winter to summer that controls the surface boundary layer and its effect on NO: initially in early spring (Days 280-310) the transport of warm air and clouds over West Antarctica dominates the environment over the SP; in late spring (Days 310-340), the winds at 300 hPa exhibit a bimodal behavior alternating between northwest and southeast quadrants, which is of significance to NO; in early summer (Days 340-375), the flow aloft is dominated by winds from the Weddell Sea; and finally, during late spring, winds aloft from the southeast are strongly associated with clear skies, shallow stable boundary layers, and light surface winds from the east - it is under these conditions that the highest NO occurs. Examination of the winds at 300 hPa from 1961 to 2013 shows that this seasonal pattern has not changed significantly, although the last twenty years have seen an increasing trend in easterly surface winds at the SP. What has also changed is the persistence of the ozone hole, often into early summer. With lower total ozone column density and higher sun elevation, the highest actinic flux responsible for the photolysis of snow nitrate now occurs in late spring under the shallow boundary layer conditions optimum for high accumulation of NO. This may occur via the non-linear HOX-NOx chemistry proposed after the first ISCAT field programs and NOx recycling to the surface where quantum yields may be large under the low-snow-accumulation regime of the Antarctic plateau. During the 2003 field program a sodar made direct measurements of the stable boundary layer depth (BLD), a key factor in explaining the chemistry of the high NO concentrations. Because direct measurements were not available in the other years, we developed an estimator for BLD using direct observations obtained in 2003 and step-wise linear regression with meteorological data from a 22 m tower (that was tested against independent data obtained in 1993). These data were then used with assumptions about the column abundance of NO to estimate surface fluxes of NOx. These results agreed in magnitude with results at Concordia Station and confirmed significant daily, intraseasonal and interannual variability in NO and its flux from the snow surface. Finally, we found that synoptic to mesoscale eddies governed the boundary layer circulation and accumulation pathways for NO at the SP rather than katabatic forcing. It was the small-scale features of the circulation including the transition from cloudy to clear conditions that set the stage for short-term extremes in NO, whereas larger-scale features were associated with more moderate concentrations.

Towards a Property-Based Testing Environment With Applications to Security-Critical Software

DTIC Science & Technology

1994-01-01

4 is a slice of the MINIX [Tan87] login program with respect to the setuid system call. The original program contains 337 lines, the slice only 20...demonstrat- ing the e ectiveness of slicing in this case5. The mapping of the abstract concept of au- thentication to source code in the MINIX login...Slice of MINIX login with respect to setuid(). occurs. If no incorrect execution occurs, slices of the program are examined for their data ow coverage

Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

PubMed

Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

2017-07-01

Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

Molecular and mathematical modeling analyses of inter-island transmission of rabies into a previously rabies-free island in the Philippines.

PubMed

Tohma, Kentaro; Saito, Mariko; Demetria, Catalino S; Manalo, Daria L; Quiambao, Beatriz P; Kamigaki, Taro; Oshitani, Hitoshi

2016-03-01

Rabies is endemic in the Philippines and dog bites are a major cause of rabies cases in humans. The rabies control program has not been successful in eliminating rabies because of low vaccination coverage among dogs. Therefore, more effective and feasible strategies for rabies control are urgently required in the country. To control rabies, it is very important to know if inter-island transmission can occur because rabies can become endemic once the virus is introduced in areas that previously had no reported cases. Our molecular epidemiological study suggests that inter-island transmission events can occur; therefore, we further investigated these inter-island transmission using phylogenetic and modeling approaches. We investigate inter-island transmission between Luzon and Tablas Islands in the Philippines. Phylogenetic analysis and mathematical modeling demonstrate that there was a time lag of several months to a year from rabies introduction to initial case detection, indicating the difficulties in recognizing the initial rabies introductory event. There had been no rabies cases reported in Tablas Island; however, transmission chain was sustained on this island after the introduction of rabies virus because of low vaccination coverage among dogs. Across the islands, a rabies control program should include control of inter-island dog transportation and rabies vaccination to avoid viral introduction from the outside and to break transmission chains after viral introduction. However, this program has not yet been completely implemented and transmission chains following inter-island virus transmission are still observed. Local government units try to control dog transport; however, it should be more strictly controlled, and a continuous rabies control program should be implemented to prevent rabies spread even in rabies-free areas. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial.

PubMed

Trombetti, Andrea; Hars, Mélany; Herrmann, François R; Kressig, Reto W; Ferrari, Serge; Rizzoli, René

2011-03-28

Falls occur mainly while walking or performing concurrent tasks. We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk in elderly individuals. We conducted a 12-month randomized controlled trial involving 134 community-dwelling individuals older than 65 years, who are at increased risk of falling. They were randomly assigned to an intervention group (n = 66) or a delayed intervention control group scheduled to start the program 6 months later (n = 68). The intervention was a 6-month multitask exercise program performed to the rhythm of piano music. Change in gait variability under dual-task condition from baseline to 6 months was the primary end point. Secondary outcomes included changes in balance, functional performances, and fall risk. At 6 months, there was a reduction in stride length variability (adjusted mean difference, -1.4%; P < .002) under dual-task condition in the intervention group, compared with the delayed intervention control group. Balance and functional tests improved compared with the control group. There were fewer falls in the intervention group (incidence rate ratio, 0.46; 95% confidence interval, 0.27-0.79) and a lower risk of falling (relative risk, 0.61; 95% confidence interval, 0.39-0.96). Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention. The benefit of the intervention on gait variability persisted 6 months later. In community-dwelling older people at increased risk of falling, a 6-month music-based multitask exercise program improved gait under dual-task condition, improved balance, and reduced both the rate of falls and the risk of falling. Trial Registration clinicaltrials.gov Identifier: NCT01107288.

Notes from the Field: Splenomegaly of Unknown Etiology in Congolese Refugees Applying for Resettlement to the United States - Uganda, 2015.

PubMed

Goers, Matthew; Ope, Maurice O; Samuels, Aaron; Gitu, Natalia; Akandwanaho, Saul; Nabwami, Gladys; Nyoka, Raymond; Cetron, Martin S; Dalal, Warren; Conroy, Andrea L; Cantey, Paul; John, Chandy; Naoum, Marwan; Weinberg, Michelle; Marano, Nina; Stauffer, William

2016-09-09

Approximately 70,000-90,000 refugees are resettled to the United States each year, and during the next 5 years, 50,000 Congolese refugees are expected to arrive in the United States. The International Organization for Migration (IOM) performs refugee medical examinations overseas for the U.S. Refugee Resettlement Program. In 2014, IOM reported that a large number of U.S.-bound Congolese refugees from Uganda had spleens that were enlarged on examination. During two evaluations of refugee populations in western Uganda in March and July 2015, refugees with splenomegaly on physical examination were offered additional assessment and treatment, including abdominal ultrasonography and laboratory testing. Among 987 persons screened, 145 (14.7%) had splenomegaly and received further testing. Among the 145 patients with splenomegaly, 63.4% were aged 5-17 years (median = 14.8 years). There was some evidence of family clustering, with 33 (22.7%) of the 145 cases occurring in families.

Melting ice

NASA Astrophysics Data System (ADS)

Benedetto, Elmo

2018-01-01

In this brief frontline, we want to describe the well-known fact that, when freshwater ice melts, the freshwater liquid level does not change. In the Italian Ministerial programs, fluid statics is introduced in the three years of middle school (students of 11-13 years) and during the first two years of high school (14-15 years). The Italian textbooks do not clearly explain why the abovementioned phenomenon occurs. The explanations are qualitative and they may lead to misinterpretation. I have noted that the students are very curious about this phenomenon. They sought a demonstration from books and from the web; and when they do not find it they asked me. Moreover, they have allowed me to observe that there are contradictory statements about the melting of icebergs. Some authors claim that they would not raise the sea-level, others say the opposite. Honestly speaking, I had never thought about this phenomenon and in classroom I tried to give them proof, expressing my opinion about the melting of icebergs.

Mars Exploration Architecture

NASA Technical Reports Server (NTRS)

Jordan, James F.; Miller, Sylvia L.

2000-01-01

The architecture of NASA's program of robotic Mars exploration missions received an intense scrutiny during the summer months of 1998. We present here the results of that scrutiny, and describe a list of Mars exploration missions which are now being proposed by the nation's space agency. The heart of the new program architecture consists of missions which will return samples of Martian rocks and soil back to Earth for analysis. A primary scientific goal for these missions is to understand Mars as a possible abode of past or present life. The current level of sophistication for detecting markers of biological processes and fossil or extant life forms is much higher in Earth-based laboratories than possible with remotely deployed instrumentation, and will remain so for at least the next decade. Hence, bringing Martian samples back to Earth is considered the best way to search for the desired evidence. A Mars sample return mission takes approximately three years to complete. Transit from Earth to Mars requires almost a single year. After a lapse of time of almost a year at Mars, during which orbital and surface operations can take place, and the correct return launch energy constraints are met, a Mars-to-Earth return flight can be initiated. This return leg also takes approximately one year. Opportunities to launch these 3-year sample return missions occur about every 2 years. The figure depicts schedules for flights to and from Mars for Earth launches in 2003, 2005, 2007 and 2009. Transits for less than 180 deg flight angle, measured from the sun, and more than 180 deg are both shown.

Descriptive Correlates of Urban Pediatric Violent Injury Using Emergency Medical Service Patient-Level Data.

PubMed

Walthall, Jennifer D H; Burgess, Aaron; Weinstein, Elizabeth; Miramonti, Charles; Arkins, Thomas; Wiehe, Sarah

2018-02-01

This study aimed to describe spatiotemporal correlates of pediatric violent injury in an urban community. We performed a retrospective cohort study using patient-level data (2009-2011) from a novel emergency medical service computerized entry system for violent injury resulting in an ambulance dispatch among children aged 0 to 16 years. Assault location and patient residence location were cleaned and geocoded at a success rate of 98%. Distances from the assault location to both home and nearest school were calculated. Time and day of injury were used to evaluate temporal trends. Data from the event points were analyzed to locate injury "hotspots." Seventy-six percent of events occurred within 2 blocks of the patient's home. Clusters of violent injury correlated with areas with high adult crime and areas with multiple schools. More than half of the events occurred between 3:00 PM and 11:00 PM. During these peak hours, Sundays had significantly fewer events. Pediatric violent injuries occurred in identifiable geographic and temporal patterns. This has implications for injury prevention programming to prioritize highest-risk areas.

Addressing sexual and relationship violence in the LGBT community using a bystander framework.

PubMed

Potter, Sharyn J; Fountain, Kim; Stapleton, Jane G

2012-01-01

Sexual and relationship violence are two major public health issues that affect an alarming number of undergraduate students. As a result, many colleges and universities have protocols to serve victims of these forms of violence. Despite federal legislation stating that all students should have equitable experiences, current protocols and programs focus primarily on heterosexual students. College student victims of sexual and relationship violence who identify as lesbian, gay, bisexual, or transgender can face particular challenges, including disclosure of their sexual and gender orientations, and revictimization when seeking services. In recent years an increasing number of campuses have adopted bystander prevention strategies to address sexual and relationship violence. These strategies seek to engage community members in the prevention of sexual and relationship violence by training them to identify and safely intervene in situations where sexual or relationship violence is about to occur, is occurring, or has occurred. In this article we review published bystander prevention strategies that focus on preventing sexual and relationship violence in the campus community, and discuss how bystander strategies are addressing or can address relationship and sexual violence in the LGBT community.

Occupational exposures to blood in a dental teaching environment: results of a ten-year surveillance study.

PubMed

Younai, F S; Murphy, D C; Kotelchuck, D

2001-05-01

Evaluation of occupational exposures can assist with practice modifications, redesign of equipment, and targeted educational efforts. The data presented in this report has been collected as part of a ten-year surveillance program of occupational exposures to blood or other potentially infectious materials in a large dental teaching institution. From 1987 to 1997, a total of 504 percutaneous/non-intact skin and mucous membrane exposures were documented. Of these, 494 (98 percent) were percutaneous, and 10 (2 percent) were mucosal, each involving a splash to the eye of the dental care worker (DCW). Among the 504 exposures, 414 (82.1 percent) occurred among dental students, 60 (11.9 percent) among staff, and 30 (6 percent) among faculty. One hundred ninety-one (37.9 percent) exposures were superficial (no bleeding), 260 (51.6 percent) were moderate (some bleeding), and 53 (10.5 percent) were deep (heavy bleeding). Regarding the circumstances of exposure, 279 (54.5 percent) of the injuries occurred post-operatively (after the use of the device), and most were related to instrument clean-up; 210 (41.0 percent) occurred intra-operatively (during the use of the device); and 23 (4.5 percent) occurred when a DCW collided with a sharp object in the dental operatory (eight cases involved more than one circumstance). The overall exposure rate for the college was 2.46+/-0.11 SD per 10,000 patient visits. The average rate for the student population was 4.02+/-0.20 SD per 100 person-years, with the highest rates being observed among junior year students. The observed rates of occupational exposures to blood and body fluids in this report are consistent with published reports from several other educational settings. Dental teaching institutions are faced with the unique challenge of protecting the student and patient populations against bloodborne infections. Educational efforts must go beyond mere teaching of universal precautions and should include the introduction of safer products and clinical procedures that can minimize the risks associated with the hands-on aspects of the students' learning process.

Recruiting Older Adults into a Physical Activity Promotion Program: "Active Living Every Day" Offered in a Naturally Occurring Retirement Community

ERIC Educational Resources Information Center

Hildebrand, Mary; Neufeld, Peggy

2009-01-01

Purpose: This article explores recruitment strategies based on the transtheoretical model (TTM) with older adults living in a naturally occurring retirement community (NORC) to encourage enrollment in a physical activity promotion program, "Active Living Every Day" (ALED). Reasons for participation or nonparticipation are identified. Design and…

The Positive Impact of Early Intervention for Children with Developmental Delays, Gestational Cocaine Exposure, and Co-Occurring Risk Factors

ERIC Educational Resources Information Center

Ullery, Mary Anne; Katz, Lynne

2017-01-01

This article examined transition rates of young children (n = 102) from an early intervention program at the Linda Ray Intervention Program (LRIP) who had documented developmental delays and co-occurring prenatal drug exposure often coupled with verified child maltreatment. Findings indicated that there was significant group improvement from…

Where the rubber meets the road: long-term in-stream data collection to inform regional land management monitoring in the Pacific Northwest

NASA Astrophysics Data System (ADS)

Hirsch, C.

2017-12-01

The initiation of the Northwest Forest Plan (NWFP) in 1994 brought a sea change to federal land management agencies of the Pacific Northwest. The NWFP was developed in response to the listing of the Northern Spotted Owl and concern about declining populations of Pacific Salmon. The Aquatic and Riparian Effectiveness Monitoring Program (AREMP) was developed to track changes that occurred as a result of active and passive management on the landscape. A significant management change affecting riparian areas was the creation of buffers around fish bearing and non-fish bearing streams. Two monitoring arms of the AREMP program focus on upslope and in-stream conditions in order to capture watershed-scale effects of land management changes. Field data to support the in-stream monitoring mission of AREMP began in 2002 with a study design based on an 8-year re-survey rotation. The sampling design was intended to capture watershed-scale variability across the broad and diverse study area in western Washington, western Oregon, and northwest California. 2017 marks repeat visits of every site and opens the door to more detailed assessments of changes that have occurred at local and regional extents over this time period. Results so far show improving trends in characteristics such as water temperature and macroinvertebrate community diversity. Maintaining an ongoing and relevant monitoring program over time has required a strong commitment to quality control in terms of data collection and analysis, and an openness to how AREMP can provide management relevant information as new challenges occur. AREMP's mandated role as the aquatic monitoring arm of the NWFP provides the overarching framework within which the program operates. However, new emerging topics of relevance to aquatic managers such as climate change and aquatic invasive species have been rolled into the mission over time. By being responsive to new challenges, and providing consistent feedback, AREMP has been able to evolve over time. AREMP is now poised to provide relevant feedback on changes to date, while also informing the emerging challenges faced by federal land managers in the west.

Status of trauma quality improvement programs in the Andean region: What foundation do we have to build on.

PubMed

LaGrone, Lacey N; Romaní Pozo, Diego A; Figueroa, Juan F; Artunduaga, Maria A; Huaman Egoavil, Eduardo; Rodriguez Castro, Manuel J A; Foianini, Jorge Esteban; Rubiano, Andrés M; Rodas, Edgar B; Mock, Charles N

2017-09-01

Trauma quality improvement (QI) programs have been shown to improve outcomes and decrease cost. These are high priorities in low- and middle-income countries (LMICs), where 2,000,000 deaths due to survivable injuries occur each year. We sought to define areas for improvement in trauma QI programs in four LMICs. We conducted a survey among trauma care providers in four Andean middle-income countries: Bolivia, Colombia, Ecuador, and Peru. 336 physicians, medical students, nurses, administrators and paramedical professionals responded to the cross-sectional survey with a response rate greater than 90% in all included countries except Bolivia, where the response rate was 14%. Eighty-seven percent of respondents reported morbidity and mortality (M&M) conferences occur at their hospital. Conferences were often reported as infrequent - 45% occurred less than every three months and poorly attended - 63% had five or fewer staff physicians present. Only 23% of conferences had standardized selection criteria, most lacked documentation - notes were taken at only 35% of conferences. Importantly, only 13% of participants indicated that discussions were routinely followed-up with any sort of corrective action. Multivariable analysis revealed the presence of standardized case selection criteria (OR 3.48, 95% CI 1.16-10.46), written documentation of the M&M conferences (OR 5.73, 95% CI 1.73-19.06), and a clear plan for follow-up (OR 4.80, 95% CI 1.59-14.50) to be associated with effective M&M conferences. Twenty-two percent of respondents worked at hospitals with a trauma registry. Fifty-two percent worked at institutions where autopsies were conducted, but only 32% of those reported the autopsy results to ever be used to improve hospital practice. M&M conferences are frequently practiced in the Andean region of Latin America but often lack methodologic rigor and thus effectiveness. Next steps in the maturation of QI programs include optimizing use of data from autopsies and registries, and systematic follow-up of M&M conferences with corrective action to ensure that these activities result in appreciable changes in clinical care. Copyright © 2017 Elsevier Ltd. All rights reserved.

The trend of road traffic crashes at urban signalised intersection

NASA Astrophysics Data System (ADS)

Farhana Nasarrudin, Nurul; Razelan, Intan Suhana Mohd

2018-04-01

Road traffic crash is one of the main contributing factors for deaths in the world. Intersection is listed as the second road type which road crashes occurred frequently. Hence, the traffic light was installed to minimise the road crashes at intersection. However, the crashes are still occurring and arising. The objective of this study was to exhibit the trend of road crashes at the signalised intersections. The data of road crashes for the past 6 years were analysed using descriptive analysis. The results showed that the road traffic crashes at three- and four-legged signalised intersection recorded the increasing trend. In conclusion, this finding shows that the road traffic crashes for these types of signalised intersection in Malaysia is rising. It is also one the contributors to the increasing number of crashes in Malaysia. This finding will encourage the local authority to conduct awareness programs on the safety at the signalised intersection.

Clinical challenges in the treatment of patients with posttraumatic stress disorder and substance abuse.

PubMed

Schäfer, Ingo; Najavits, Lisa M

2007-11-01

The aim of this article is to review the current literature on co-occuring posttraumatic stress disorder and substance-use disorder, with an emphasis on clinical aspects and emerging treatments. In clinical populations (focusing on either disorder), about 25-50% have a lifetime dual diagnosis of posttraumatic stress disorder and substance-use disorder. Patients with both disorders have a more severe clinical profile than those with either disorder alone, lower functioning, poorer well being, and worse outcomes across a variety of measures. In recent years, several promising treatment programs have been developed specifically for co-occuring posttraumatic stress disorder and substance-use disorder, with one model having been established as effective thus far. Comorbid posttraumatic stress disorder/substance-use disorder is a frequent diagnosis in clinical populations that severely affects course and outcome. Treatment approaches appropriate for this vulnerable population need to be evaluated further and implemented in routine practice.

America in Space: The First Decade - NASA Spacecraft

NASA Technical Reports Server (NTRS)

1969-01-01

It is ten years since the National Aeronautics and Space Administration was created to explore space and to continue the American efforts that had already begun with the launch of Explorer 1 on January 31, 1958. Many changes have occurred since that tumbling, 31 -pound cylinder went into an Earth orbit. "NASA Spacecraft" represents one of the broad avenues selected by NASA as an approach to its objective of making widely known the progress that has taken place in its program of space exploration. This report is a vivid illustration of the changes that have occurred and the complexities that have developed. Here one finds descriptions of the present family of spacecraft some small, some large; some spinoriented, some accurately attitude-controlled; some manned, some automated; some in low orbits, some in trajectories to the Moon and the planets; some free in space until they expire, others commanded to return to the Earth or to land on the Moon

NASA Environmental Control and Life Support Technology Development and Maturation for Exploration: 2015 to 2016 Overview

NASA Technical Reports Server (NTRS)

Schneider, Walter F.; Gatens, Robyn L.; Anderson, Molly S.; Broyan, James L.; MaCatangay, Ariel V.; Shull, Sarah A.; Perry, Jay L.; Toomarian, Nikzad

2016-01-01

Over the last year, the National Aeronautics and Space Administration (NASA) has continued to refine the understanding and prioritization of technology gaps that must be closed in order to achieve Evolvable Mars Campaign objectives and near term objectives in the cislunar proving ground. These efforts are reflected in updates to the technical area roadmaps released by NASA in 2015 and have guided technology development and maturation tasks that have been sponsored by various programs. This paper provides an overview of the refined Environmental Control and Life Support (ECLS) strategic planning, as well as a synopsis of key technology and maturation project tasks that occurred in 2014 and early 2015 to support the strategic needs. Plans for the remainder of 2015 and subsequent years are also described.

Reducing juvenile delinquency with automated cell phone calls.

PubMed

Burraston, Bert O; Bahr, Stephen J; Cherrington, David J

2014-05-01

Using a sample of 70 juvenile probationers (39 treatment and 31 controls), we evaluated the effectiveness of a rehabilitation program that combined cognitive-behavioral training and automated phone calls. The cognitive-behavioral training contained six 90-min sessions, one per week, and the phone calls occurred twice per day for the year following treatment. Recidivism was measured by whether they were rearrested and the total number of rearrests during the 1st year. To test the impact of the phone calls, those who received phone calls were divided into high and low groups depending on whether they answered more or less than half of their phone calls. Those who completed the class and answered at least half of their phone calls were less likely to have been arrested and had fewer total arrests.