The Return of Bedside Rounds: An Educational Intervention

PubMed Central

Gonzalo, Jed D.; Chuang, Cynthia H.; Huang, Grace

2010-01-01

Background Bedside rounds have decreased in frequency on teaching services. Perceived barriers toward bedside rounds are inefficiency and patient and house staff lack of preference for this mode of rounding. Objectives To evaluate the impact of a bedside rounding intervention on the frequency of bedside rounding, duration of patient encounters and rounding sessions, and patient and resident attitudes toward bedside rounds. Design A pre- and postintervention design, with a bedside rounding workshop midway through two consecutive internal medicine rotations, with daily resident interviews, patient surveys, and an end-of-the-year survey given to all Medicine house staff. Participants Medicine house staff and medicine patients. Measures Frequency of bedside rounds, duration of new patient encounters and rounding sessions, and patient and house staff attitudes regarding bedside rounds. Results Forty-four residents completed the bedside rounding workshop. Comparing the preintervention and postintervention phases, bedside rounds increased from <1% to 41% (p < 0.001). The average duration of walk rounding encounters was 16 min, and average duration of bedside rounding encounters was 15 min (p = 0.42). Duration of rounds was 95 and 98 min, respectively (p = 0.52). Patients receiving bedside rounds preferred bedside rounds (99% vs. 83%, p = 0.03) and perceived more time spent at the bedside by their team (p < 0.001). One hundred twelve house staff (71%) responded, with 73% reporting that bedside rounds are better for patient care. House staff performing bedside rounds were less likely to believe that bedside rounds were more educational (53% vs. 78%, p = 0.01). Conclusions Bedside rounding increased after an educational intervention, and the time to complete bedside rounding encounters was similar to alternative forms of rounding. Patients preferred bedside rounds and perceived more time spent at the bedside when receiving bedside rounds. Medicine

Implementing Year-Round School--Monroe Style.

ERIC Educational Resources Information Center

Cruz, John

Planning for conversion to a year-round school in James Monroe School, Madera, California, began in 1984 as educators and community faced the fact that continued enrollment increases had reached a critical point. This report describes program development and implementation; an appendix with program worksheets comprises over one-half of the…

Year-Round versus Traditional Schools

ERIC Educational Resources Information Center

Lyttle, LeighAnne

2011-01-01

This document serves as a literature review for the practicality and cost effectiveness of traditional versus year-round school systems. The differences in year-round and traditional schools are many, as the debate lingers on which type is best for students' learning. Generally conclusive, the literature indicates that year-round schools' benefits…

Effects of Year-Round Education on Texas Middle School Student Performance

ERIC Educational Resources Information Center

Coopersmith, Michael

2011-01-01

This study was designed to investigate the effects of the year-round calendar on student performance in Texas middle schools as measured by achievement on the Texas Assessment of Knowledge and Skills (TAKS) test. In the State of Texas, 15 schools served students in grades six through eight using the year-round calendar in 2009-2010. The 15…

A Focus Group Study of Community Members' Perceptions about Year-Round Education in Michigan's Copper Country

ERIC Educational Resources Information Center

Trewartha, Mollie Louise

2007-01-01

Restructuring of schools by means of revising the school calendar from the traditional 9-month calendar to a year-round calendar is one reform idea proposed to meet the diverse abilities and needs of students. Considering the sweeping changes influenced by No Child Left Behind and the trend toward excellence in education, this research focused…

Year-Round School. Research Brief

ERIC Educational Resources Information Center

Walker, Karen

2009-01-01

Despite the numerous advantages of a year-round schedule, there are significant political hurdles to its implementation. The most successful year-round schools are those where leaders worked closely with staff and families to maximize the benefits, minimize the costs, and build support for modifying the traditional school calendar. The research on…

Leading Instructional Rounds in Education: A Facilitator?'s Guide. Instructional Rounds Series

ERIC Educational Resources Information Center

Fowler-Finn, Thomas

2013-01-01

Instructional rounds is a powerful form of professional learning aimed at helping schools and systems develop the capacity to educate all children to high levels. In this practical book, Thomas Fowler-Finn, an experienced consultant who has worked closely with the Harvard team that pioneered instructional rounds, discusses how facilitators can…

Policy Considerations in Conversion to Year-Round Schools. Policy Briefs of the Education Policy Studies Laboratory, No. 92-01.

ERIC Educational Resources Information Center

Glass, Gene V.

Increasing enrollments and budget problems have prompted many school districts nationwide to experiment with year-round school schedules. Year-round school schedules allow districts to serve more students without constructing more buildings. As in traditional 9-month schools, students in year-round schools attend classes about 180 days a year. The…

ESSA's Well-Rounded Education. Special Report

ERIC Educational Resources Information Center

Jones, Scott D.; Workman, Emily

2016-01-01

As questions regarding the Every Student Succeeds Act (ESSA) flow in to Education Commission of the States, one frequent inquiry is about the concept of a "well-rounded education," referenced more than 20 times and included within the majority of Titles in the Act. State education leaders want to know what constitutes a well-rounded…

Quality Teaching Rounds in Mathematics Teacher Education

ERIC Educational Resources Information Center

Prieto, Elena; Howley, Peter; Holmes, Kathryn; Osborn, Judy-anne; Roberts, Malcolm; Kepert, Andrew

2015-01-01

The purpose of the study reported in this paper is to evaluate the effectiveness of an implementation of teaching rounds as a practice-based approach to pre-service teacher education in mathematics. The teaching rounds implemented in the study utilised the NSW Quality Teaching model pedagogical framework as a tool for learning about and reflecting…

What Do Teachers Do When They Say They Are Doing Learning Rounds? Scotland's Experience of Instructional Rounds

ERIC Educational Resources Information Center

Philpott, Carey; Oates, Catriona

2015-01-01

This paper reports on research into the practice of learning rounds in Scotland. Learning rounds are a form of collaborative professional development for teachers based on the instructional rounds practice developed in the USA. In recent years learning rounds have gained high profile official support within education in Scotland. The research…

Missouri School Superintendent Perceptions of Year-Round School Calendars

ERIC Educational Resources Information Center

Cook, Becca Christine

2016-01-01

The purpose of this study is to synthesize perceptions of Missouri superintendents with regards to year-round school calendars and correlate them to the four themes of Time, Student Learning and Achievement, District Cost, and Family Cost and Support. The idea behind year-round school calendars is that by going to school throughout the year with…

Rebound Body Mass Index Growth in Year-Round Elementary Education Students of Largely Hispanic Descent Undergoing Obesity Interventions

ERIC Educational Resources Information Center

Alexander, Andrew G.; Lyons, Paul E.

2016-01-01

Background: Body mass index (BMI) increases when students are away on summer vacation. Evaluation of serial BMI measurements on year-round students allows new insight into the reasons children gain weight seasonally. Methods: The 206 first and second graders of 2-year-round elementary schools with obesity intervention programs were weighed and…

Prevent Heartworms in Pets Year-Round

MedlinePlus

... Home For Consumers Consumer Updates Prevent Heartworms in Dogs, Cats, and Ferrets Year-Round Share Tweet Linkedin ... bad news: Heartworm disease can be fatal to dogs, cats, and ferrets. The good news: You can ...

School Crowding, Year-Round Schooling, and Mobile Classroom Use: Evidence from North Carolina

ERIC Educational Resources Information Center

McMullen, Steven C.; Rouse, Kathryn E.

2012-01-01

This study exploits a unique policy environment and a large panel dataset to evaluate the impact of school crowding on student achievement in Wake County, NC. We also estimate the effects of two education policy initiatives that are often used to address crowding: multi-track year-round calendars and mobile classrooms. We estimate a multi-level…

Clinical Immersion and Biomedical Engineering Design Education: "Engineering Grand Rounds".

PubMed

Walker, Matthew; Churchwell, André L

2016-03-01

Grand Rounds is a ritual of medical education and inpatient care comprised of presenting the medical problems and treatment of a patient to an audience of physicians, residents, and medical students. Traditionally, the patient would be in attendance for the presentation and would answer questions. Grand Rounds has evolved considerably over the years with most sessions being didactic-rarely having a patient present (although, in some instances, an actor will portray the patient). Other members of the team, such as nurses, nurse practitioners, and biomedical engineers, are not traditionally involved in the formal teaching process. In this study we examine the rapid ideation in a clinical setting to forge a system of cross talk between engineers and physicians as a steady state at the praxis of ideation and implementation.

Legionella species in year-round vs. seasonal accommodation water supply systems.

PubMed

Rakić, Anita; Perić, Jelena; Štambuk-Giljanović, Nives; Mikrut, Antonija; Bakavić, Ana-Spomenka

2011-12-01

The purpose of this study was to compare the quality of hot water between eleven hotels in the Split-Dalmatia County, Croatia that are open year round and 10 summer season hotels and retirement homes with irregular use of water. We took 122 samples between May and December 2009. Water temperature and free residual chlorine were measured in situ. Physical and chemical analysis included pH, electrical conductivity, and concentrations of iron, manganese, copper, zinc, calcium, and magnesium that were measured using atomic absorption spectrophotometry, while the Legionella species were determined using a cultivation method on buffered charcoal yeast extract agar. Differences in metal concentrations between the seasonal and year-round accommodation facilities were negligible, save for zinc that was higher in year-round (0.341 mg L(-1)) than in seasonal facilities (0.130 mg L(-1)). Samples from all year-round and six summer season hotels were negative to the Legionella species, but four seasonal facilities turned up with positive samples to Legionella pneumophila. Our study has demonstrated that water quality differs between year-round and seasonal accommodation facilities. These findings suggest that metal plumbing components and associated corrosion products are important factors in the survival and growth of Legionella species in water distribution systems.

Is Year-Round Schooling on Track?

ERIC Educational Resources Information Center

Dessoff, Alan

2011-01-01

For administrators, teachers, students and their families in some districts, summer isn't what it used to be. Trying to stem a "summer slide" of learning loss by students and also to avoid having to build more schools to cope with overcrowding, districts are operating on year-round schedules that shorten the traditional summer vacation…

Bringing Rounds Back to the Patient: A One-Year Evaluation of the Chiefs' Service Model for Inpatient Teaching.

PubMed

Bennett, Nadia L; Flesch, Judd D; Cronholm, Peter; Reilly, James B; Ende, Jack

2017-04-01

The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design. Its first year (January 2013-January 2014) was evaluated with a mixed-methods approach. Residents completed end-of-rotation evaluation questionnaires; 20 CS and 10 traditional service (TS) residents were interviewed. Measures of resident agreement on questionnaire items were compared across groups using independent sample t testing. A modified grounded theory approach was used to assess CS residents' perspectives on the CS elements and identify emergent themes. The questionnaires were completed by 183/188 residents (response rate 97%). Compared with TS residents, CS residents reported significantly greater satisfaction in the domains of resident education and patient care, and they rated the overall value of the rotation significantly higher. The majority of CS residents found the CS elements to be effective. CS residents described the CS as focused on resident education, patient-centered care, and collaboration with an interdisciplinary team. The CS approach to inpatient rounding is seen by residents as valuable and is associated with positive outcomes in terms of residents' perceptions of learning, interdisciplinary communication, and patient care.

Seasonal atmospheric deposition and air-sea gas exchange of polycyclic aromatic hydrocarbons over the Yangtze River Estuary, East China Sea: Implications for source-sink processes

NASA Astrophysics Data System (ADS)

Jiang, Yuqing; Lin, Tian; Wu, Zilan; Li, Yuanyuan; Li, Zhongxia; Guo, Zhigang; Yao, Xiaohong

2018-04-01

In this work, air samples and surface seawater samples covering four seasons from March 2014 to January 2015 were collected from a background receptor site in the YRE to explore the seasonal fluxes of air-sea gas exchange and dry and wet deposition of 15 polycyclic aromatic hydrocarbons (PAHs) and their source-sink processes at the air-sea interface. The average dry and wet deposition fluxes of 15 PAHs were estimated as 879 ± 1393 ng m-2 d-1 and 755 ± 545 ng m-2 d-1, respectively. Gaseous PAH release from seawater to the atmosphere averaged 3114 ± 1999 ng m-2 d-1 in a year round. The air-sea gas exchange of PAHs was the dominant process at the air-sea interface in the YRE as the magnitude of volatilization flux of PAHs exceeded that of total dry and wet deposition. The gas PAH exchange flux was dominated by three-ring PAHs, with the highest value in summer and lowest in winter, indicating a marked seasonal variation owing to differences in Henry's law constants associated with temperature, as well as wind speed and gaseous-dissolved gradient among seasons. Based on the simplified mass balance estimation, a net 11 tons y-1 of PAHs (mainly three-ring PAHs) were volatilized from seawater to the atmosphere in a ∼20,000 km2 area in the YRE. Other than the year-round Yangtze River input and ocean ship emissions, the selective release of low-molecular-weight PAHs from bottom sediments in winter due to resuspension triggered by the East Asian winter monsoon is another potential source of PAHs. This work suggests that the source-sink processes of PAHs at the air-sea interface in the YRE play a crucial role in regional cycling of PAHs.

A Nurse-Led Innovation in Education: Implementing a Collaborative Multidisciplinary Grand Rounds.

PubMed

Matamoros, Lisa; Cook, Michelle

2017-08-01

Multidisciplinary grand rounds provides an opportunity to promote excellence in patient care through scholarly presentations and interdisciplinary collaboration with an innovative approach. In addition, multidisciplinary grand rounds serves to recognize expertise of staff, mentor and support professional development, and provide a collaborative environment across all clinical disciplines and support services. This article describes a process model developed by nurse educators for implementing a multidisciplinary grand rounds program. The components of the process model include topic submissions, coaching presenters, presentations, evaluations, and spreading the work. This model can be easily implemented at any organization. J Contin Educ Nurs. 2017;48(8):353-357. Copyright 2017, SLACK Incorporated.

Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies.

PubMed

Shoeb, Marwa; Khanna, Raman; Fang, Margaret; Sharpe, Brad; Finn, Kathleen; Ranji, Sumant; Monash, Brad

2014-04-01

The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees' competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies. We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model. We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills. HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies. © 2014 Society of Hospital Medicine.

Teacher Job Satisfaction in a Year-Round School.

ERIC Educational Resources Information Center

Haser, Shelly Gismondi; Nasser, Ilham

2003-01-01

Describes reasons for teacher job satisfaction at a year-round elementary school (Timber Lane) in Fairfax County, Virginia, such as flexible work schedules, reduced stress, and time for professional planning. (PKP)

Round-the-table teaching: a novel approach to resuscitation education.

PubMed

McGarvey, Kathryn; Scott, Karen; O'Leary, Fenton

2014-10-01

Effective cardiopulmonary resuscitation saves lives. Health professionals who care for acutely unwell children need to be prepared to care for a child in arrest. Hospitals must ensure that their staff have the knowledge, confidence and ability to respond to a child in cardiac arrest. RESUS4KIDS is a programme designed to teach paediatric resuscitation to health care professionals who care for acutely unwell children. The programme is delivered in two components: an e-learning component for pre-learning, followed by a short, practical, face-to-face course that is taught using the round-the-table teaching approach. Round-the-table teaching is a novel, evidence-based small group teaching approach designed to teach paediatric resuscitation skills and knowledge. Round-the-table teaching uses a structured approach to managing a collapsed child, and ensures that each participant has the opportunity to practise the essential resuscitation skills of airway manoeuvres, bag mask ventilation and cardiac compressions. Round-the-table teaching is an engaging, non-threatening approach to delivering interdisciplinary paediatric resuscitation education. The methodology ensures that all participants have the opportunity to practise each of the different essential skills associated with the Danger, Response, Send for help, Airway, Breathing, Circulation, Defibrillation or rhythm recognition (DRSABCD) approach to the collapsed child. Round-the-table teaching is based on evidence-based small group teaching methods. The methodology of round-the-table teaching can be applied to any topic where participants must demonstrate an understanding of a sequential approach to a clinical skill. Round-the-table teaching uses a structured approach to managing a collapsed child. © 2014 The Authors. The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.

IFLA General Conference, 1990. Division of Education and Research: Section of Education and Training; Section of Library Theory and Research; Library History, Round Table; Research in Reading, Round Table; Editors of Library Journals, Round Table; and Continuing Professional Education, Round Table; Joint Workshop Papers. Booklet 7.

ERIC Educational Resources Information Center

International Federation of Library Associations, The Hague (Netherlands).

The 21 papers in this collection were presented at the meetings of two sections and three round tables of the Division of Education and Research: (1) "Library and Information Services in Culturally Diverse Communities" (Cheryl Metoyer-Duran); (2) "Library Education in a Pluralistic Society" (Shmuel Sever); (3) "Each One an Individual:…

A Study of Year-Round Schools. Volume III: Handbook for Conducting Cost Analysis of Year-Round School Programs.

ERIC Educational Resources Information Center

Burnett, Robert W.

This manual is intended for use by district officials undertaking analysis of the costs of year-round school (YRS) programs. To analyze the budgetary impact of YRS, it is necessary to determine the actual costs incurred with the YRS program and to compare these costs to expenses that would be incurred without the YRS program. A simulated…

Outdoor Cultivation of Marine Diatoms for Year-Round Production of Biofuels.

PubMed

Matsumoto, Mitsufumi; Nojima, Daisuke; Nonoyama, Tomomi; Ikeda, Kiichi; Maeda, Yoshiaki; Yoshino, Tomoko; Tanaka, Tsuyoshi

2017-03-25

Biofuel production using microalgae is believed to have the advantage of continuous year-round production over crop plants, which have strong seasonality. However, actual year-round production of microalgal lipids using outdoor mass cultivation has rarely been demonstrated. In our previous study, it was demonstrated that the oleaginous diatom, Fistulifera solaris , was culturable in outdoor bioreactors from spring to autumn, whereas biomass and lipid production in winter failed because F. solaris did not grow below 15 °C. Therefore, another candidate strain that is culturable in winter is required. In this study, a cold-tolerant diatom, Mayamaea sp. JPCC CTDA0820, was selected as a promising candidate for biofuel production in winter. Laboratory-scale characterization revealed that this diatom was culturable at temperatures as low as 10 °C. Subsequently, F. solaris (April-October) and Mayamaea sp. JPCC CTDA0820 (November-March) were cultured in outdoor open-pond bioreactors, wherein year-round production of diatom lipids was successfully demonstrated. The maximal values of areal productivities of biomass and lipids reached to 9.79 and 1.80 g/(m² day) for F. solaris , and 8.62 and 0.92 g/(m² day) for Mayamaea sp. JPCC CTDA0820, respectively. With the combined use of these two diatom species, stable year-round production of microalgal lipids became possible.

Interprofessional resuscitation rounds: a teamwork approach to ACLS education.

PubMed

Dagnone, Jeffrey Damon; McGraw, Robert C; Pulling, Cheryl A; Patteson, Ann K

2008-01-01

We developed and implemented a series of interprofessional resuscitation rounds targeting fourth year nursing and medical students, and junior residents from a variety of specialty programs. Each two hour session was conducted in our patient simulation lab, and was held weekly during the academic year. Students were given specific instruction on the roles and responsibilities of resuscitation team members, and then teams of five worked through pre-defined Advanced Cardiac Life Support (ACLS) scenarios on a high fidelity patient simulator. At the end of each session students completed an anonymous evaluation of the program via a standardized questionnaire using Likert rating scales. A total of 222 evaluations (101 nursing students, 42 medical students, and 79 junior residents) were submitted from October 2005 to April 2006. Mean scores reflected a strong consensus that these rounds were valuable for their training, provided a vehicle for understanding team roles in resuscitation, and that these rounds should be mandatory for all medical and nursing trainees. Participants also expressed a desire for additional interprofessional training. Despite challenges inherent in teaching a diverse group of learners, these interprofessional resuscitation rounds were rated highly by nursing and medical trainees as valuable learning experiences.

The Irony of Year-Round Schools: Mexican Migrant Resistance in a California Community during the Civil Rights Era.

ERIC Educational Resources Information Center

Donato, Ruben

1996-01-01

Examines the politics of year-round education in Brownfield, California, in the 1970s. Findings showed that Mexican Americans challenged the proposed 45-15 plan because they were excluded from the decision-making process and because the plan conflicted with migrant workers' employment patterns. Formal mechanisms must be activated to guard all…

Effects of efforts to optimise morbidity and mortality rounds to serve contemporary quality improvement and educational goals: a systematic review.

PubMed

Smaggus, Andrew; Mrkobrada, Marko; Marson, Alanna; Appleton, Andrew

2018-01-01

The quality and safety movement has reinvigorated interest in optimising morbidity and mortality (M&M) rounds. We performed a systematic review to identify effective means of updating M&M rounds to (1) identify and address quality and safety issues, and (2) address contemporary educational goals. Relevant databases (Medline, Embase, PubMed, Education Resource Information Centre, Cumulative Index to Nursing and Allied Health Literature, Healthstar, and Global Health) were searched to identify primary sources. Studies were included if they (1) investigated an intervention applied to M&M rounds, (2) reported outcomes relevant to the identification of quality and safety issues, or educational outcomes relevant to quality improvement (QI), patient safety or general medical education and (3) included a control group. Study quality was assessed using the Medical Education Research Study Quality Instrument and Newcastle-Ottawa Scale-Education instruments. Given the heterogeneity of interventions and outcome measures, results were analysed thematically. The final analysis included 19 studies. We identified multiple effective strategies (updating objectives, standardising elements of rounds and attaching rounds to a formal quality committee) to optimise M&M rounds for a QI/safety purpose. These efforts were associated with successful integration of quality and safety content into rounds, and increased implementation of QI interventions. Consistent effects on educational outcomes were difficult to identify, likely due to the use of methodologies ill-fitted for educational research. These results are encouraging for those seeking to optimise the quality and safety mission of M&M rounds. However, the inability to identify consistent educational effects suggests the investigation of M&M rounds could benefit from additional methodologies (qualitative, mixed methods) in order to understand the complex mechanisms driving learning at M&M rounds. © Article author(s) (or their

Requiem for the grand round.

PubMed

Stanyon, Maham; Khan, Shahid Anis

2015-02-01

The time-honoured tradition of Grand Round is firmly rooted in medical education, but has little evidence for its effectiveness or its impact on patient management. A mode of didactic teaching, Grand Round has lost its appeal in modern medical education with dwindling attendance at Grand Rounds worldwide. Once a platform for eminence-based medicine and a cross fertilisation of medical ideas, emphasis on sub-specialisation and clinical governance, combined with rota, trainee engagement and attendance failures has made Grand Round obsolete. To survive, Grand Round must have evidence for its effectiveness in medical education. It must be able to compete with other forms of teaching and adapt by using technology to reach trainees. Engaging the audience and encouraging participation needs to be woven into the fabric of the modern Grand Round, alongside learning clinical skills and developing clinical reasoning. Understanding the needs of today's trainees and their involvement in formulating the Grand Round programme is vital. Attendance at Grand Round is a recognised measure of its success and will be used in its evaluation. Questions still remain regarding the future of Grand Round. Its survival will depend upon its ability to change with time and reclaim its place as a credible tool to promote learning. © 2015 Royal College of Physicians.

Round-the-table teaching: a novel approach to resuscitation education

PubMed Central

McGarvey, Kathryn; Scott, Karen; O'Leary, Fenton

2014-01-01

Background Effective cardiopulmonary resuscitation saves lives. Health professionals who care for acutely unwell children need to be prepared to care for a child in arrest. Hospitals must ensure that their staff have the knowledge, confidence and ability to respond to a child in cardiac arrest. RESUS4KIDS is a programme designed to teach paediatric resuscitation to health care professionals who care for acutely unwell children. The programme is delivered in two components: an e–learning component for pre-learning, followed by a short, practical, face-to-face course that is taught using the round-the-table teaching approach. Context Round-the-table teaching is a novel, evidence-based small group teaching approach designed to teach paediatric resuscitation skills and knowledge. Round-the-table teaching uses a structured approach to managing a collapsed child, and ensures that each participant has the opportunity to practise the essential resuscitation skills of airway manoeuvres, bag mask ventilation and cardiac compressions. Innovation Round-the-table teaching is an engaging, non-threatening approach to delivering interdisciplinary paediatric resuscitation education. The methodology ensures that all participants have the opportunity to practise each of the different essential skills associated with the Danger, Response, Send for help, Airway, Breathing, Circulation, Defibrillation or rhythm recognition (DRSABCD) approach to the collapsed child. Implications Round-the-table teaching is based on evidence-based small group teaching methods. The methodology of round-the-table teaching can be applied to any topic where participants must demonstrate an understanding of a sequential approach to a clinical skill. Round-the-table teaching uses a structured approach to managing a collapsed child PMID:25212931

Rounding the Regression

ERIC Educational Resources Information Center

Marland, Eric; Bossé, Michael J.; Rhoads, Gregory

2018-01-01

Rounding is a necessary step in many mathematical processes. We are taught early in our education about significant figures and how to properly round a number. So when we are given a data set and asked to find a regression line, we are inclined to offer the line with rounded coefficients to reflect our model. However, the effects are not as…

Learning from Instructional Rounds

ERIC Educational Resources Information Center

City, Elizabeth A.

2011-01-01

Instructional rounds are a disciplined way for educators to work together to improve a school's instructional core. The practice combines three common elements of improvement: classroom observation, an improvement strategy, and a network. Instructional rounds differ from supervision and evaluation in that people doing rounds learn something…

Evaluating the Promise of Single-Track Year-Round Schools.

ERIC Educational Resources Information Center

Haenn, Joseph F.

1996-01-01

Describes two single-track year-round elementary schools in Durham, North Carolina, established in discrete attendance zones. Remediation and enrichment activities were provided during intersession. Low-SES students were overrepresented in remediation sessions. Student outcomes data (end-of-grade reading and math test scores) suggest that…

Reviving post-take surgical ward round teaching.

PubMed

Force, Jade; Thomas, Ian; Buckley, Frances

2014-04-01

Learning in the clinical environment is an important feature of medical education. Ward-round teaching leads to relevant, applied and lasting learning of knowledge, skills and attitudes; however, on fast-paced ward rounds in specialties such as general surgery, the student experience is often suboptimal, and teaching can be overlooked. Clinical teaching fellows (CTFs) are postgraduate doctors ranging from foundation year-2 (FY2) level through to specialty trainees, who have elected to spend up to 2 years out of the programme to teach medical undergraduates. This article explores whether CTFs can successfully support the regular delivery of undergraduate medical teaching on the busy post-take surgical ward round (PTSWR). The CTFs at Raigmore Hospital, Inverness, planned and facilitated weekly, structured teaching sessions to accompany the PTSWR. This educational intervention was evaluated using pre- and post-intervention student questionnaires. The questionnaires focused on student enjoyment and depth of learning using Likert scales and free-text components. Students were also asked about barriers to learning on typical PTSWRs. The consultant surgeons leading on these rounds were issued separate questionnaires, to gauge their evaluation of CTF support. The main barrier to effective undergraduate ward round teaching was a lack of time on the part of clinical staff. Ward rounds accompanied by CTF support significantly increased student enjoyment (p < 0.0001) and perceived learning (p < 0.0001). Consultant surgeons were supportive of the teaching initiative. Support from CTFs on busy PTSWRs optimised student satisfaction, and was welcomed by clinical staff. CTF support could be widened to other busy ward rounds, e.g. acute medical takes, to enhance student learning and reduce the teaching burden on clinical faculty staff. © 2014 John Wiley & Sons Ltd.

Engineering challenges of operating year-round portable seismic stations at high-latitude

NASA Astrophysics Data System (ADS)

Beaudoin, Bruce; Carpenter, Paul; Hebert, Jason; Childs, Dean; Anderson, Kent

2017-04-01

Remote portable seismic stations are, in most cases, constrained by logistics and cost. High latitude operations introduce environmental, technical and logistical challenges that require substantially more engineering work to ensure robust, high quality data return. Since 2006, IRIS PASSCAL has been funded by NSF to develop, deploy, and maintain a pool of polar specific seismic stations. Here, we describe our latest advancements to mitigate the challenges of high-latitude, year-round station operation. The IRIS PASSCAL program has supported high-latitude deployments since the late 1980s. These early deployments were largely controlled source, summer only experiments. In early 2000 PASSCAL users began proposing year-round deployments of broadband stations in some of the harshest environments on the planet. These early year-round deployments were stand-alone (no telemetry) stations largely designed to operate during summer months and then run as long as possible during the winter with hopes the stations would revive come following summer. In 2006 and in collaboration with UNAVCO, we began developing communications, power systems, and enclosures to extend recording to year-round. Since this initial effort, PASSCAL continued refinement to power systems, enclosure design and manufacturability, and real-time data communications. Several sensor and data logger manufacturers have made advances in cold weather performance and delivered newly designed instruments that have furthered our ability to successfully run portable stations at high-latitude with minimal logistics - reducing size and weight of instruments and infrastructure. All PASSCAL polar engineering work is openly shared through our website: www.passcal.nmt.edu/content/polar

The evaluation of a framework for measuring the non-technical ward round skills of final year nursing students: An observational study.

PubMed

Murray, Kara; McKenzie, Karen; Kelleher, Michael

2016-10-01

The importance of non-technical skills (NTS) to patient outcomes is increasingly being recognised, however, there is limited research into how such skills can be taught and evaluated in student nurses in relation toward rounds. This pilot study describes an evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses. The study used an observational design. Potential key NTS were identified from existing literature and NTS taxonomies. The proposed framework was then used to evaluate whether the identified NTS were evident in a series of ward round simulations that final year general nursing students undertook as part of their training. Finally, the views of a small group of qualified nurse educators, qualified nurses and general nursing students were sought about whether the identified NTS were important and relevant to practice. The proposed NTS framework included seven categories: Communication, Decision Making, Situational Awareness, Teamwork and Task Management, Student Initiative and Responsiveness to Patient. All were rated as important and relevant to practice. The pilot study suggests that the proposed NTS framework could be used as a means of evaluating student nurse competencies in respect of many non-technical skills required for a successful ward round. Further work is required to establish the validity of the framework in educational settings and to determine the extent to which it is of use in a non-simulated ward round setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Final screening round of the NELSON lung cancer screening trial: the effect of a 2.5-year screening interval.

PubMed

Yousaf-Khan, Uraujh; van der Aalst, Carlijn; de Jong, Pim A; Heuvelmans, Marjolein; Scholten, Ernst; Lammers, Jan-Willem; van Ooijen, Peter; Nackaerts, Kristiaan; Weenink, Carla; Groen, Harry; Vliegenthart, Rozemarijn; Ten Haaf, Kevin; Oudkerk, Matthijs; de Koning, Harry

2017-01-01

In the USA annual lung cancer screening is recommended. However, the optimal screening strategy (eg, screening interval, screening rounds) is unknown. This study provides results of the fourth screening round after a 2.5-year interval in the Dutch-Belgian Lung Cancer Screening trial (NELSON). Europe's largest, sufficiently powered randomised lung cancer screening trial was designed to determine whether low-dose CT screening reduces lung cancer mortality by ≥25% compared with no screening after 10 years of follow-up. The screening arm (n=7915) received screening at baseline, after 1 year, 2 years and 2.5 years. Performance of the NELSON screening strategy in the final fourth round was evaluated. Comparisons were made between lung cancers detected in the first three rounds, in the final round and during the 2.5-year interval. In round 4, 46 cancers were screen-detected and there were 28 interval cancers between the third and fourth screenings. Compared with the second round screening (1-year interval), in round 4 a higher proportion of stage IIIb/IV cancers (17.3% vs 6.8%, p=0.02) and higher proportions of squamous-cell, bronchoalveolar and small-cell carcinomas (p=0.001) were detected. Compared with a 2-year interval, the 2.5-year interval showed a higher non-significant stage distribution (stage IIIb/IV 17.3% vs 5.2%, p=0.10). Additionally, more interval cancers manifested in the 2.5-year interval than in the intervals of previous rounds (28 vs 5 and 28 vs 19). A 2.5-year interval reduced the effect of screening: the interval cancer rate was higher compared with the 1-year and 2-year intervals, and proportion of advanced disease stage in the final round was higher compared with the previous rounds. ISRCTN63545820. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Elusiveness of Equity: Evolution of Instructional Rounds in a Superintendent's Network

ERIC Educational Resources Information Center

Roegman, Rachel; Allen, David; Hatch, Thomas

2017-01-01

The practice of instructional rounds is a recent innovation in educational administration, intended to support administrators' understanding of instruction through the development of common language. This longitudinal study examines the rounds practice of a network of superintendents over 6 years to understand how rounds serves as a vehicle for…

Evaluation and Follow-Up of Policies, Plans and Reforms of Education: Round Table V.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France). Div. of Educational Policy and Planning.

The proceedings from a round table held at an international symposium focuses on the planning and management of educational development. The following papers are included in this document: "Overall View on the Evaluation of Educational Plans and Reforms (Ingemar Fagerlind); "Evaluation and Research Capacity-Building in Education Meeting…

Modified round block mastopexy versus traditional round block mastopexy.

PubMed

Sterodimas, A; Nicaretta, B; Boriani, F

2015-01-01

Breast ptosis may be caused by several factors, including significant weight loss, pregnancy, long breastfeeding periods, and involution of the postmenopausal breast tissue. The authors performed a prospective study to evaluate patient satisfaction and the rate of complications after modified round block mastopexy versus traditional round block mastopexy. Forty-four patients fulfilled the inclusion criteria for undergoing round block mastopexy in a prospective randomized controlled study performed from 2007 to 2008. All the patients received polyurethane silicone implants. Group A included patients who underwent the traditional round block technique described by Benelli. Group B included patients who underwent the traditional round block and 4 cardinal glando-glandular permanent sutures. The overall satisfaction with body appearance after breast mastopexy was rated on a scale of 1 (poor), 2 (fair), 3 (good), 4 (very good), and 5 (excellent). Group A patient ages ranged from 28 to 52 years and in Group B ranged from 29 to 49 years. The mean implant volume was 215 cc in both Groups. The complication and satisfaction rates for both Groups are reported. The combination of the cardinal glandulo-glandular sutures along with the traditional round block appears to be key to preventing the areolar enlargement and persistent breast ptosis. The satisfaction rates in patients who underwent the modified round mastopexy appear superior when compared to the traditional round block mastopexy. Furhter long-term follow-up need to be performed in order to confirm the favorable results seen in this series of cases.

Ten-year results of quality assurance in radiotherapy chart round.

PubMed

Taghavi Bayat, Bardia; Gill, Suki; Siva, Shankar; Tai, Keen Hun; Joon, Michael Lim; Foroudi, Farshad

2013-04-23

The Royal Australian and New Zealand College of Radiologists (RANZCR) initiated a unique instrument to audit the quality of patient notes and radiotherapy prescriptions. We present our experience collected over ten years from the use of the RANZCR audit instrument. In this study, the results of data collected prospectively from January 1999 to June 2009 through the audit instrument were assessed. Radiotherapy chart rounds were held weekly in the uro-oncology tumour stream and real time feedback was provided. Electronic medical records were retrospectively assessed in September 2009 to see if any omissions were subsequently corrected. In total 2597 patients were audited. One hundred and thirty seven (5%) patients had one hundred and ninety nine omissions in documentation or radiotherapy prescription. In 79% of chart rounds no omissions were found at all, in 12% of chart rounds one omission was found and in 9% of chart rounds two or more omissions were found. Out of 199 omissions, 95% were of record keeping and 2% were omissions in the treatment prescription. Of omissions, 152 (76%) were unfiled investigation results of which 77 (51%) were subsequently corrected. Real-time audit with feedback is an effective tool in assessing the standards of radiotherapy documentation in our department, and also probably contributed to the high level of attentiveness. A large proportion of omissions were investigation results, which highlights the need for an improved system of retrieval of investigation results in the radiation oncology department.

Playing Doctor with Education: Considerations in Using Medical Rounds as a Model for Instructional Rounds

ERIC Educational Resources Information Center

Roegman, Rachel; Riehl, Carolyn

2012-01-01

This article examines the literature on medical rounds to inform the recent move toward instructional rounds as a practice of districtwide improvement and professional learning for superintendents and administrators. Based on the practice of medical rounds as a method for creating shared norms and understandings about medicine and patient care,…

Year-round School Makes Good Business Sense, Says This Boardman-Businessman

ERIC Educational Resources Information Center

Howe, Paul H.

1973-01-01

Argues that year-round schools make good business sense by providing (1) a more efficient use of capital investments, (2) an alleviation of uneconomical and undesirable peaks in working and recreation, and (3) a more sensible way of looking at teacher salaries. (JF)

Simulated ward round: reducing costs, not outcomes.

PubMed

Ford, Helen; Cleland, Jennifer; Thomas, Ian

2017-02-01

Distractions and interruptions on the ward pose substantial patient safety risks, but medical students receive little training on their management. Although there is some evidence that medical students can be taught how to manage distractions and interruptions in a simulated ward environment, the only model to date is based on individual feedback, which is resource-expensive, mitigating curricular integration. Our aim was to assess the educational utility of a cost-efficient approach to a patient safety-focused simulated ward round. Twenty-three of 55 final-year medical students took part in a cost-reduced simulated ward round. Costs were minimised by providing group rather than individualised feedback, thereby shortening the duration of each simulation and reducing the number of interruptions. The utility of the simulation was assessed via student evaluation and performance on a patient safety station of an objective structured clinical examination (OSCE). The direct costs of the simulation were more than 50 per cent lower per student compared with the original study, mostly as a result of a reduction in the time that faculty members took to give feedback. Students managed distractions better and received higher scores in the OSCE station than those who had not undergone the ward round. Group feedback was evaluated positively by most participants: 94 per cent of those who provided feedback agreed or strongly agreed that the simulation would make them a safer doctor and would improve their handling of distractions. Our aim was to assess the educational utility of a cost-efficient approach to a patient safety-focused simulated ward round DISCUSSION: The costs of a simulated ward round can be significantly reduced whilst maintaining educational utility. These findings should encourage medical schools to integrate ward simulation into curricula. © 2016 John Wiley & Sons Ltd.

Longer School Years: Reform or Illusion? Policy Studies in Education.

ERIC Educational Resources Information Center

Smith, Edward C.

The advantages and disadvantages of the year-round school fall into three major categories: financial, educational, and professional. Financial advantages are based on the postponement of construction costs and the use of existing school facilities and equipment to serve a larger number of students. Financial disadvantages include a rise in…

Effects of an Educational Workshop on Pediatric Nurses' Attitudes and Beliefs About Family-Centered Bedside Rounds.

PubMed

Montgomery, Lara; Benzies, Karen; Barnard, Chantelle

2016-01-01

This pilot study evaluated the effects of an educational workshop on nurses' (N=36) attitudes and beliefs toward family-centered bedside rounds (FBR) using a single group, pretest/posttest design on two pediatric inpatient units at an academic tertiary-care center in Western Canada. The theory of planned behavior was used to develop the Nurses Attitudes and Behaviors about Rounds (NABAR) questionnaire. There were statistically significant increases between pretest and posttest scores on nurses' intentions, subjective norms and perceived behavioral control related to FBR, and on providing education to families about FBR. A brief, educational workshop can positively affect nurses' attitudes and beliefs about FBR. Future research should include additional psychometric evaluation of the NABAR. Copyright © 2016 Elsevier Inc. All rights reserved.

Instructional Rounds in Action

ERIC Educational Resources Information Center

Roberts, John E.

2012-01-01

"Instructional Rounds in Action" is an invaluable guide for those involved in implementing instructional rounds as the foundation and framework for systemic improvement in schools. Over the past few years, districts across the United States, Canada, and Australia have begun implementing "instructional rounds," a set of ideas…

Maximizing efficiency on trauma surgeon rounds.

PubMed

Ramaniuk, Aliaksandr; Dickson, Barbara J; Mahoney, Sean; O'Mara, Michael S

2017-01-01

Rounding by trauma surgeons is a complex multidisciplinary team-based process in the inpatient setting. Implementation of lean methodology aims to increase understanding of the value stream and eliminate nonvalue-added (NVA) components. We hypothesized that analysis of trauma rounds with education and intervention would improve surgeon efficacy. Level 1 trauma center with 4300 admissions per year. Average non-intensive care unit census was 55. Five full-time attending trauma surgeons were evaluated. Value-added (VA) and NVA components of rounding were identified. The components of each patient interaction during daily rounds were documented. Summary data were presented to the surgeons. An action plan of improvement was provided at group and individual interventions. Change plans were presented to the multidisciplinary team. Data were recollected 6 mo after intervention. The percent of interactions with NVA components decreased (16.0% to 10.7%, P = 0.0001). There was no change between the two periods in time of evaluation of individual patients (4.0 and 3.5 min, P = 0.43). Overall time to complete rounds did not change. There was a reduction in the number of interactions containing NVA components (odds ratio = 2.5). The trauma surgeons were able to reduce the NVA components of rounds. We did not see a decrease in rounding time or individual patient time. This implies that surgeons were able to reinvest freed time into patient care, or that the NVA components were somehow not increasing process time. Direct intervention for isolated improvements can be effective in the rounding process, and efforts should be focused upon improving the value of time spent rather than reducing time invested. Copyright © 2016 Elsevier Inc. All rights reserved.

Student Scheduling in a Year-Round Middle School. A Simulation Notebook.

ERIC Educational Resources Information Center

Whitley, Alfred C.

This paper presents a model of a successful student scheduling pattern for a 45-15 year-round middle school (grades 6-8). The model allows for scheduling 100 percent of resource lab teaching time for all the student population in attendance at any one time, and formulates a house design and team teaching structure that facilitates smooth ingress…

Rounds Today: A Qualitative Study of Internal Medicine and Pediatrics Resident Perceptions.

PubMed

Rabinowitz, Raphael; Farnan, Jeanne; Hulland, Oliver; Kearns, Lisa; Long, Michele; Monash, Bradley; Bhansali, Priti; Fromme, H Barrett

2016-10-01

Attending rounds is a key component of patient care and education at teaching hospitals, yet there is an absence of studies addressing trainees' perceptions of rounds. To determine perceptions of pediatrics and internal medicine residents about the current and ideal purposes of inpatient rounds on hospitalist services. In this multi-institutional qualitative study, the authors conducted focus groups with a purposive sample of internal medicine and pediatrics residents at 4 teaching hospitals. The constant comparative method was used to identify themes and codes. The study identified 4 themes: patient care, clinical education, patient/family involvement, and evaluation. Patient care included references to activities on rounds that forwarded care of the patient. Clinical education pertained to teaching/learning on rounds. Patient/family involvement encompassed comments about incorporating patients and families on rounds. Evaluation described residents demonstrating skill for attendings. Resident perceptions of the purposes of rounds aligned with rounding activities described by prior observational studies of rounds. The influence of time pressures and the divergent needs of participants on today's rounds placed these identified purposes in tension, and led to resident dissatisfaction in the achievement of all of them. Suboptimal congruency exists between perceived resident clinical education and specialty-specific milestones. These findings suggest a need for education of multiple stakeholders by (1) enhancing faculty teaching strategies to maximize clinical education while minimizing inefficiencies; (2) informing residents about the value of patient interactions and family-centered rounds; and (3) educating program directors in proper alignment of inpatient rotational objectives to the milestones.

The Effects of Year-Round Schools on the Hospitality Industry's Seasonal Labor Force in the State of Tennessee.

ERIC Educational Resources Information Center

Pickeral, Lyn M.; Hubbard, Susan

2002-01-01

Data collected from 66 managers in Tennessee tourist attractions indicate that 53 percent of seasonal workers in Tennessee come from the school system. The proposal to implement year-round schools would drastically increase the tourism industry's labor shortage. An alternative labor force needs to be identified and the issue of year-round schools…

The Final Stretch: An Analysis of the Race to the Top Round 2 Finalists

ERIC Educational Resources Information Center

National Council on Teacher Quality, 2010

2010-01-01

The U.S. Department of Education recently announced the finalists for the second round of the Race to the Top (RTT) competition, with the winners to be announced in September. Round one of the competition yielded just two awards earlier this year, with Delaware and Tennessee claiming approximately $600 million of the available funds. Thirty-five…

Patterns of interaction during rounds: implications for work-based learning.

PubMed

Walton, Jennifer M; Steinert, Yvonne

2010-06-01

OBJECTIVES In-patient rounds are a major educational and patient care-related activity in teaching hospitals. This exploratory study was conducted to gain better understanding of team interactions during rounds and to assess student and resident perceptions of the utility of this activity. METHODS Data were collected by a non-participant observer using a novel, personal digital assistant (PDA)-based data collection system. Medical students and residents completed surveys related to the utility of rounds for patient care, education and ward administration. Analyses included descriptive and correlational statistics and the use of social network analysis to describe and measure patterns of interaction. RESULTS Eighteen different rounds were observed. On average, rounds were 106 minutes long and included discussion of 22.1 patients. Three different patterns of verbal interaction were observed. In most cases, the attending physician was most talkative and many students and residents spoke infrequently. More time was devoted to patients discussed earlier in the round, regardless of diagnosis. Observed teaching was primarily factual and teacher-centred. Attending physician-dominated sessions were rated more highly for educational utility than those that were more interactive. CONCLUSIONS In-patient rounds are an example of an opportunity for powerful work-based learning. In this study, we used a novel method of observational data collection and analysis to examine this activity and found that it may not always live up to its educational potential. Rounds are time-consuming and are generally dominated by the attending physician. Individuals who are not directly involved in a case are often minimally involved. Participants felt that rounds were most useful for patient care and, contrary to expectations, students and residents viewed attending physician-dominated sessions as more educational. To improve the educational impact of rounds, the order of patient discussion should

The European Round Table of Industrialists and the Restructuring of European Higher Education

ERIC Educational Resources Information Center

Kauppinen, Ilkka

2014-01-01

The restructuring of European higher education (EHE) since the 1980s is a widely studied subject. However, this paper argues that previous studies have paid insufficient attention to the role of transnational policy-making groups in this complex and multilevel process. This argument is supported by focusing on how the European Round Table of…

Natrelle round silicone breast implants: Core Study results at 10 years.

PubMed

Spear, Scott L; Murphy, Diane K

2014-06-01

Allergan's Natrelle round silicone-filled breast implants were approved by the U.S. Food and Drug Administration in 2006 based on interim results from the Core Study; final 10-year study results are now available. Seven hundred fifteen subjects were implanted with smooth and Biocell textured Natrelle round silicone implants and attended clinic visits at 0 to 4 weeks, 6 months, 1 year, and annually through 10 years. Approximately one-third of subjects underwent magnetic resonance imaging at years 1, 3, 5, 7, and 9 to assess rupture. Complication rates showed modest increases over the previously published 6-year rates. The Kaplan-Meier capsular contracture rate was 18.9 percent for augmentation, 28.7 percent for revision-augmentation, and 24.6 percent for reconstruction. Among augmentation subjects, capsular contracture was significantly lower (p = 0.023) for submuscular (15.7 percent) versus subglandular (26.3 percent) placement. The overall rupture rate in the magnetic resonance imaging cohort was 13.0 percent for subjects and 7.7 percent for implants. By the end of the study, 81.8 percent of augmentation subjects still had an original implant in place. Using a five-point scale, 94.2 percent of augmentation, 83.8 percent of revision-augmentation, and 90.7 percent of reconstruction subjects reported being satisfied or definitely satisfied with their implants. Significant improvement over baseline was also seen in overall breast satisfaction and satisfaction with breast size, shape, feel, and how well they matched. The 10-year data from the Natrelle Core Study, which can guide surgeons and patients in decision-making, demonstrate safety and high levels of patient satisfaction. Therapeutic, III.

Barriers and facilitators to providing undergraduate physiotherapy clinical education in the primary care setting: a three-round Delphi study.

PubMed

McMahon, S; Cusack, T; O'Donoghue, G

2014-03-01

With the global shift in health care from secondary to primary care, employment opportunities for newly qualified physiotherapists are likely to be in the primary care setting. However, to date, undergraduate physiotherapy clinical education has been centred around secondary care, focusing on acute services in large teaching hospitals. For contemporary physiotherapists to become effective first-contact primary care providers, they need to be exposed to the primary care environment during their undergraduate education. To explore the concept and identify perceived barriers and facilitators to providing physiotherapy undergraduate clinical placements in the primary healthcare setting A three-round Delphi survey was used. Participants were asked to answer open-ended questions with regard to: (i) student preparation for and (ii) provision of primary care placements (Round 1). Content analysis was employed to identify key themes. These themes generated statements for Round 2. In Round 2, participants were asked to rate their level of agreement/disagreement with the generated statements. In Round 3, a final rating process was conducted. Level of consensus was established as ≥70% agreement, with an interquartile range of ≤1. One hundred and ninety-eight primary care physiotherapy staff. Barriers identified included shortage of resources (e.g. staff) and a lack of tradition; in other words, students are not traditionally educated in the primary care setting. Response rates were 60% (120/198), 70% (84/120) and 76% (64/84) for Rounds 1, 2 and 3, respectively. All seven key facilitators identified reached consensus. They included additional support for staff taking students and motivated students. This study revealed that there is support for the provision of physiotherapy clinical education in the primary care setting. Through careful consideration with clear planning and collaboration with all stakeholders, it may be possible to convert the main barriers identified into

Year-Round Use Of Thermography In House Doctoring

NASA Astrophysics Data System (ADS)

Gadsby, Kenneth J.; Harrje, David T.; Dutt, Gautam S.

1983-03-01

There have been many presentations of thermographic residential building analyses at the past ThermosInse conferences. A number of these papers have dealt with evaluation of insulation voids and more recently a few have described air leakage detection 2,3 during the colder winter months. This paper will focus on the thermographic application in the House Doctor instrumented energy analysis approach as developed by Princeton University. The central theme will be the application to a year-round research or commercial activity. Some of the conditions that could create thermographic problems, as well as techniques that may be used to lessen these difficulties, thereby extending the thermographic "season" is discussed. Our experiences in summer thermography with and without the use of a building pressurization system is also covered.

Teacher Perceptions Regarding the Relationship of Modified Year-Round School Calendars with Student Achievement, Student Behavior, and Teacher Efficacy

ERIC Educational Resources Information Center

Huffman, George Eugene

2013-01-01

The purpose of this study was to analyze demographic and school data, as well as data on the perceptions of teachers regarding the impact that a modified year-round school calendar has on student achievement, student behavior, and teacher efficacy. Prior research and literature examined the impact of year-round school calendars on student…

Enhanced inpatient rounds, appointment reminders, and patient education improved HIV care engagement following hospital discharge.

PubMed

Khawcharoenporn, Thana; Damronglerd, Pansachee; Chunloy, Krongtip; Sha, Beverly E

2018-06-01

Human immunodeficiency virus (HIV) care engagement post hospital discharge is often suboptimal. Strategies to improve follow-up are needed. A quasi-experimental study was conducted among hospitalized HIV-infected patients between the period from 1 January 2013 to 30 June 2014 (preintervention period) and 1 July 2014 to 31 December 2015 (intervention period). During the intervention period, an HIV care team consisting of an Infectious Diseases physician, a nurse, a pharmacist, a social worker, and an HIV-infected volunteer made daily inpatient rounds. Prior to discharge, patients received a structured HIV education session and an outpatient appointment was scheduled for them with two telephone reminder calls following discharge. There were 240 HIV-infected patients enrolled (120 in each study period), of which the median age was 37 years (interquartile range [IQR] 28-44 years), 58% were male, 39% were newly diagnosed with HIV infection, 46% were hospitalized because of AIDS-related conditions, and the median CD4 cell count on admission was 158 cells/µl (IQR 72-382 cells/µl). The rate of HIV care engagement within 30 days after discharge was significantly higher in the intervention period compared to the preintervention period (95% versus 69%; P < 0.001). Independent factors associated with no care engagement within 30 days were patients in the preintervention period (adjusted odds ratio [aOR] 6.36; P < 0.001) and new diagnosis of HIV infection (aOR 2.77; P = 0.009). The study findings suggest that enhanced inpatient rounds, appointment reminders, and patient education were shown to be associated with improved HIV care engagement after hospital discharge. Patients with a new diagnosis of HIV infection benefit from more intense outreach. ClinicalTrials.gov Identifier: NCT02578654.

Palliative medicine Death Rounds: small group learning on a vital subject.

PubMed

Kitzes, Judith A; Kalishman, Summers; Kingsley, Darra D; Mines, Jan; Lawrence, Elizabeth

The medical student's experience with patients' dying and death has profound impact on personal and professional development. Death Rounds at the University of New Mexico School of Medicine is a small group educational model that promotes student self-reflection, metacognition, professional growth, and collegial support. To describe the implementation and evaluation activities of a third year clerkship Death Rounds which are a structured, institutionally supported resource for helping students to understand the clinical, ethical, legal, professional, cultural, and spiritual aspects of death. Medical students attend 2 to 3 small group palliative medicine Death Rounds sessions, facilitated by the attending clerkship director, chief residents, and a palliative care physician. The students' assessment of their palliative medicine knowledge and skills in 5 categories before and after participation in Death Rounds rated their skills after Death Rounds higher with effect sizes ranging from 0.9 to 1.9. Evidence from both the Death Rounds Questionnaire and Facilitators' Logs demonstrates that multiple issues and topics were addressed and all associated with the School of Medicine's 6 core competencies. Death Rounds minimally affect on clerkship time and faculty resources.

Sustaining Nursing and Midwifery Grand Rounds in a Regional Australian Health Service.

PubMed

Smyth, Wendy; Abernethy, Gail

2016-07-01

This article reports the success, or otherwise, of strategies implemented to sustain nursing grand rounds in a large regional health service in North Queensland, Australia. Nursing grand rounds had been introduced in late 2010 to increase nurses' engagement with research and evidence-based practice. Although the format, topics, and purpose of grand rounds have changed, attendees continue to positively evaluate each presentation. However, after 5 years, the initiative has expanded and somewhat modified its focus. This article describes these changes and proposes options for the future progression of this professional development activity. J Contin Educ Nurs. 2016;47(7):316-320. Copyright 2016, SLACK Incorporated.

Creating a Cycle of Continuous Improvement through Instructional Rounds

ERIC Educational Resources Information Center

Meyer-Looze, Catherine L.

2015-01-01

Instructional Rounds is a continuous improvement strategy that focuses on the technical core of educational systems as well as educators collaborating side-by-side. Concentrating on collective learning, this process only makes sense within an overall strategy of improvement. This case study examined the Instructional Rounds process in a northern…

Nursing students' viewpoints toward two methods of clinical conference and clinical nursing round.

PubMed

Gheidanzadeh, Maryam; Baghersad, Zahra; Abazari, Parvaneh

2017-01-01

Clinical education provides a chance to combine theoretical knowledge and clinical skills. Students are the key elements in the evaluation of clinical education efficacy. The present study was aimed to define nursing students' viewpoints concerning conformity to the characteristics of clinical conference and clinical round. This descriptive analytical study was conducted on the bachelor's students of the 4 th -6 th semester of nursing. Sampling was conducted using census sampling method during the 2 nd semester of 2014-2015 school year. Data collection tool was a three-section researcher-made questionnaire containing demographic, nursing round, and clinical conference characteristics. Descriptive and inferential statistical tests (independent t -test, ANOVA, and Spearman and Pearson correlation coefficients) were used for data analysis. Participants were 134 bachelor's students of the 4 th -6 th semester of nursing. According to half of the participants, conformity to the characteristics of clinical conference (45.5%, 53%) and clinical round (44%, 51.5%) were poor and medium, respectively. Paired t -test showed a significant difference between students' viewpoints toward the planning of clinical conference and clinical nursing round ( P = 0.006, t = 2.77). According to the results of the present study on students' viewpoints, clinical education faces a serious challenge with regard to clinical education methods. Considering the necessity and importance of clinical education, more investigation should be conducted to detect its relevant factors and plan for its improvement.

Building and using our sun-heated greenhouse. Grow vegetables all year-round

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

Nearing, H.; Nearing, S.

1977-01-01

Experience with unheated greenhouses in Maine and Vermont is described from the viewpoint of vegetarian, homesteading organic gardeners. The necessity of extending the growing season in the north in order to have fresh vegetables year round is discussed. Locating, building, and maintaining soil and growing conditions in the greenhouse are included. Plants for each season in the greenhouse are discussed. (MHR)

Does Year Round Schooling Affect the Outcome and Growth of California's API Scores?

ERIC Educational Resources Information Center

Wu, Amery D.; Stone, Jake E.

2010-01-01

This paper examined whether year round schooling (YRS) in California had an effect upon the outcome and growth of schools' Academic Performance Index (API) scores. While many previous studies had examined the connection between YRS and academic achievement, most had lacked the statistical rigour required to provide reliable interpretations. As a…

Mesothelial Cysts of the Round Ligament of the Uterus in 9 Patients: a 15-year experience.

PubMed

Tirnaksiz, Mehmet; Erkan, Arman; Dogrul, Ahmet Bulent; Abbasoglu, Osman

2016-04-04

Aim of this study was to evaluate the characteristic features of patients with mesothelial cyst of the round ligament of the uterus and the incidence of this entity. This was a retrospective review of 3065 patients who underwent inguinal exploration for groin mass from 1998 to 2013. Clinical, radiological and histopathological features of patients with a diagnosis of mesothelial cyst of the round ligament were analyzed. Of the 405 female patients reviewed 9 mesothelial cysts of the round ligament were identified (2.2%). The median age was 37 (range 19-82 years). In all patients the groin mass was manually irreducible on physical examination. The lesions were on the right side in 6 (66.6%) patients. These were identified before surgery in 4 (all by groin ultrasonography). Three were misidentified as a hernia before surgery. The remaining 2 (22%) had both hernia and the mesothelial cyst of the round ligament. The cysts were identified after surgery at the time of histopathological examination in these two patients. In all patients histopathological examination revealed multilobular cystic lesion lined by a single layer of mesothelial cells. Cystic lesions arising from the round ligament were identified and excised along with the round ligament in 7 patients. In the remaining 2, a hernia repair was also performed. There was no recurrence at follow-up. Mesothelial cysts of the round ligament are rare. They are easily misidentified as groin hernia. An accurate diagnosis requires a high index of suspicion and is greatly aided by preoperative imaging studies.

Parent Attitudes Toward the Virginia Beach Year-Round School Pilot Project. Final Report.

ERIC Educational Resources Information Center

Schlechty, Phillip C.

Part of the Virginia Beach year-round school program evaluation, this final report contains a detailed analysis of parental attitudes, beliefs, and perceptions. The data leads to the following conclusions: a majority (53.3 percent) of parents are dubious or negative toward the 45-15 pilot project; a slight majority of parents in the pilot schools…

The Continuous School Year. The Cranston Quadricycle Plan for a Continuous School Year. Project Pacesetter.

ERIC Educational Resources Information Center

Cranston School Dept., RI.

Acting on instructions from the Cranston School Committee, a committee comprised of educational professional staff, community leaders, citizens, and students was organized to consider the methods and feasibility of year-round schools. The year round concept and its application in various plans throughout the country was the subject of…

Multi-Track Year-Round Schooling as Cost Saving Reform: Not Just a Matter of Time

ERIC Educational Resources Information Center

Graves, Jennifer; McMullen, Steven; Rouse, Kathryn

2013-01-01

In the face of school crowding and fears about inequality-inducing summer learning loss, many schools have started to adopt multitrack year-round school calendars, which keep the same number of school days, but spread them more evenly across the calendar year. This change allows schools to support a larger student population by rotating which…

The Asia-Pacific Academy of Ophthalmology's Grand Rounds Around the World-An Online Educational Program Freely Accessible to All.

PubMed

Lam, Dennis; Leung, Christopher; He, Mingguang; Tham, Clement; Liu, Yizhi; Pang, Calvin; Martin, Frank

2012-01-01

Grand rounds are excellent learning platforms for physicians and other health care professionals to keep up with important evolving areas in the management and treatment models of various diseases. However, there are hardly any freely accessible grand rounds in ophthalmology to meet the need for ophthalmic education in the Asia-Pacific region and beyond. The Asia-Pacific Academy of Ophthalmology would like to meet the need by sponsoring a new initiative "Grand Rounds Around the World" so that ophthalmologists and eye care professionals in the Asia-Pacific region and beyond can benefit from the program, leading to improved patient care and the elimination of learning barriers.

Mesa Verde--A Year-Round High School. A Descriptive Report of 1980-81.

ERIC Educational Resources Information Center

Housden, Terry; Holmes, Lynda

Mesa Verde High School was constructed in 1974 and is the last high school built in the San Juan (California) Unified District. It serves students in grades 9 through 12 and has an open enrollment policy. Mesa Verde operates on a year-round schedule with students divided into three tracks. Basically, each track is in session for 9 weeks and then…

Students' medical ethics rounds: a combinatorial program for medical ethics education.

PubMed

Beigy, Maani; Pishgahi, Ghasem; Moghaddas, Fateme; Maghbouli, Nastaran; Shirbache, Kamran; Asghari, Fariba; Abolfat-H Zadeh, Navid

2016-01-01

It has long been a common goal for both medical educators and ethicists to develop effective methods or programs for medical ethics education. The current lecture-based courses of medical ethics programs in medical schools are demonstrated as insufficient models for training "good doctors''. In this study, we introduce an innovative program for medical ethics education in an extra-curricular student-based design named Students' Medical Ethics Rounds (SMER). In SMER, a combination of educational methods, including theater-based case presentation, large group discussion, expert opinions, role playing and role modeling were employed. The pretest-posttest experimental design was used to assess the impact of interventions on the participants' knowledge and attitude regarding selected ethical topics. A total of 335 students participated in this study and 86.57% of them filled the pretest and posttest forms. We observed significant improvements in the knowledge (P < 0.0500) and attitude (P < 0.0001) of participants. Interestingly, 89.8% of participants declared that their confidence regarding how to deal with the ethical problems outlined in the sessions was increased. All of the applied educational methods were reported as helpful. We found that SMER might be an effective method of teaching medical ethics. We highly recommend the investigation of the advantages of SMER in larger studies and interdisciplinary settings.

A montane Mediterranean climate supports year-round photosynthesis and high forest biomass.

PubMed

Kelly, Anne E; Goulden, Michael L

2016-04-01

The mid-elevation forest of California's Sierra Nevada poses a bioclimatic paradox. Mid-elevation trees experience a montane Mediterranean climate, with near-freezing winter days and rain-free summers. The asynchrony between warmth and water input suggests low primary production, limited by photosynthetic dormancy in winter cold, and again in summer and early autumn with drought, yet this forest is characterized by tall trees and high biomass. We used eddy covariance in a mid-elevation Sierra stand to understand how winter cold and summer drought limit canopy photosynthesis and production. The trees exhibited canopy photosynthesis year-round. Trees avoided winter dormancy, and daytime CO2uptake continued despite a deep snowpack and near-freezing temperatures. Photosynthesis on sunny days continued at half of maximum rates when air temperature was 0 °C. Likewise, the vegetation avoided summer drought dormancy, and high rates of daytime CO2uptake and transpiration continued despite a 5-month period with only negligible water input. We attribute this drought avoidance to deep rooting and availability of deep soil water. Year-round photosynthesis helps explain the large biomass observed in the Sierra Nevada, and implies adaptive strategies that may contribute to the resiliency or vulnerability of Sierran vegetation to climate change. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effects of Year-Round Schooling on Disadvantaged Students and the Distribution of Standardized Test Performance

ERIC Educational Resources Information Center

Graves, Jennifer

2011-01-01

Using detailed longitudinal data for the state of California, this paper estimates the effect of year-round school calendars on nationally standardized test performance of traditionally disadvantaged students. The student subgroups studied in this paper are: low socioeconomic status, limited English proficiency, Hispanic and Latino, and African…

Medical Student Self-Efficacy with Family-Centered Care during Bedside Rounds

PubMed Central

Young, Henry N.; Schumacher, Jayna B.; Moreno, Megan A.; Brown, Roger L.; Sigrest, Ted D.; McIntosh, Gwen K.; Schumacher, Daniel J.; Kelly, Michelle M.; Cox, Elizabeth D.

2012-01-01

Purpose Factors that support self-efficacy must be understood in order to foster family-centered care (FCC) during rounds. Based on social cognitive theory, this study examined (1) how 3 supportive experiences (observing role models, having mastery experiences, and receiving feedback) influence self-efficacy with FCC during rounds and (2) whether the influence of these supportive experiences was mediated by self-efficacy with 3 key FCC tasks (relationship building, exchanging information, and decision making). Method Researchers surveyed 184 students during pediatric clerkship rotations during the 2008–2011 academic years. Surveys assessed supportive experiences and students’ self-efficacy with FCC during rounds and with key FCC tasks. Measurement models were constructed via exploratory and confirmatory factor analyses. Composite indicator structural equation (CISE) models evaluated whether supportive experiences influenced self-efficacy with FCC during rounds and whether self-efficacy with key FCC tasks mediated any such influences. Results Researchers obtained surveys from 172 eligible students who were 76% (130) White and 53% (91) female. Observing role models and having mastery experiences supported self-efficacy with FCC during rounds (each p<0.01), while receiving feedback did not. Self-efficacy with two specific FCC tasks, relationship building and decision making (each p < 0.05), mediated the effects of these two supportive experiences on self-efficacy with FCC during rounds. Conclusions Observing role models and having mastery experiences foster students’ self-efficacy with FCC during rounds, operating through self-efficacy with key FCC tasks. Results suggest the importance of helping students gain self-efficacy in key FCC tasks before the rounds experience and helping educators implement supportive experiences during rounds. PMID:22534602

Students’ medical ethics rounds: a combinatorial program for medical ethics education

PubMed Central

Beigy, Maani; Pishgahi, Ghasem; Moghaddas, Fateme; Maghbouli, Nastaran; Shirbache, Kamran; Asghari, Fariba; Abolfat-h Zadeh, Navid

2016-01-01

It has long been a common goal for both medical educators and ethicists to develop effective methods or programs for medical ethics education. The current lecture-based courses of medical ethics programs in medical schools are demonstrated as insufficient models for training “good doctors’’. In this study, we introduce an innovative program for medical ethics education in an extra-curricular student-based design named Students’ Medical Ethics Rounds (SMER). In SMER, a combination of educational methods, including theater-based case presentation, large group discussion, expert opinions, role playing and role modeling were employed. The pretest-posttest experimental design was used to assess the impact of interventions on the participants’ knowledge and attitude regarding selected ethical topics. A total of 335 students participated in this study and 86.57% of them filled the pretest and posttest forms. We observed significant improvements in the knowledge (P < 0.0500) and attitude (P < 0.0001) of participants. Interestingly, 89.8% of participants declared that their confidence regarding how to deal with the ethical problems outlined in the sessions was increased. All of the applied educational methods were reported as helpful. We found that SMER might be an effective method of teaching medical ethics. We highly recommend the investigation of the advantages of SMER in larger studies and interdisciplinary settings. PMID:27471586

It is the time for oceanic seabirds: Tracking year-round distribution of gadfly petrels across the Atlantic Ocean

USGS Publications Warehouse

Ramos, Raul; Carlile, Nicholas; Madeiros, Jeremy; Ramirez, Ivan; Paiva, Vitor H.; Dinis, Herculano A.; Zino, Francis; Biscoito, Manuel; Leal, Gustavo R.; Bugoni, Leandro; Jodice, Patrick G.R.; Ryan, Peter G.; Gonzalez-Solis, Jacob

2017-01-01

AimAnthropogenic activities alter and constrain the structure of marine ecosystems with implications for wide-ranging marine vertebrates. In spite of the environmental importance of vast oceanic ecosystems, most conservation efforts mainly focus on neritic areas. To identify relevant oceanic areas for conservation, we assessed the year-round spatial distribution and spatio-temporal overlap of eight truly oceanic seabird species of gadfly petrels (Pterodroma spp.) inhabiting the Atlantic Ocean.LocationAtlantic Ocean.MethodsUsing tracking data (mostly from geolocators), we examined year-round distributions, the timing of life-cycle events, and marine habitat overlap of eight gadfly petrel species that breed in the Atlantic Ocean.ResultsWe compiled 125 year-round tracks. Movement strategies ranged from non-migratory to long-distance migrant species and from species sharing a common non-breeding area to species dispersing among multiple non-breeding sites. Gadfly petrels occurred throughout the Atlantic Ocean but tended to concentrate in subtropical regions. During the boreal summer, up to three species overlapped spatio-temporally over a large area around the Azores archipelago. During the austral summer, up to four species coincided in a core area in subtropical waters around Cape Verde, and three species shared habitat over two distinct areas off Brazil. The petrels used many national Exclusive Economic Zones, although they also exploited offshore international waters.Main conclusionsTracking movements of highly mobile vertebrates such as gadfly petrels can provide a powerful tool to evaluate and assess the potential need for and location of protected oceanic areas. As more multispecies, year-round data sets are collected from wide-ranging vertebrates, researchers and managers will have greater insight into the location of biodiversity hotspots. These can subsequently inform and guide marine spatial planning efforts that account for both conservation and

Patient Safety Leadership WalkRounds.

PubMed

Frankel, Allan; Graydon-Baker, Erin; Neppl, Camilla; Simmonds, Terri; Gustafson, Michael; Gandhi, Tejal K

2003-01-01

In the WalkRounds concept, a core group, which includes the senior executives and/or vice presidents, conducts weekly visits to different areas of the hospital. The group, joined by one or two nurses in the area and other available staff, asks specific questions about adverse events or near misses and about the factors or systems issues that led to these events. ANALYSIS OF EVENTS: Events in the Walkrounds are entered into a database and classified according to the contributing factors. The data are aggregated by contributing factors and priority scores to highlight the root issues. The priority scores are used to determine QI pilots and make best use of limited resources. Executives are surveyed quarterly about actions they have taken as a direct result of WalkRounds and are asked what they have learned from the rounds. As of September 2002, 47 Patient Safety Leadership WalkRounds visited a total of 48 different areas of the hospital, with 432 individual comments. The WalkRounds require not only knowledgeable and invested senior leadership but also a well-organized support structure. Quality and safety personnel are needed to collect data and maintain a database of confidential information, evaluate the data from a systems approach, and delineate systems-based actions to improve care delivery. Comments of frontline clinicians and executives suggested that WalkRounds helps educate leadership and frontline staff in patient safety concepts and will lead to cultural changes, as manifested in more open discussion of adverse events and an improved rate of safety-based changes.

A pilot study of team learning on in-patient rounds.

PubMed

Colbert, James; Pelletier, Stephen; Xavier-Depina, Francisca; Shields, Helen

2016-02-01

Medical trainees often do not receive structured teaching during in-patient rounds. To assess whether the addition of a collaborative team learning technique would improve the learning experience on a general medicine in-patient team. Eight learners participated in this pilot study. Learning teams consisted of internal medicine residents and third-year medical students on a general medicine in-patient rotation. The experimental curriculum covered four common topics: cardiac stress testing; syncope; pneumonia; and valvular heart disease. Sessions had the following format: (1) each learner answered five self-assessment questions using an immediate feedback technique; (2) learners were divided into groups of two or three to discuss their answers; (3) the teaching doctor led a discussion to clarify and summarise, and also distributed a handout delineating key learning points. Control sessions consisted of the usual teaching rounds. Learners were e-mailed a daily online survey asking them to rate the rounds and handouts on a Likert scale. Medical trainees often do not receive structured teaching during in-patient rounds All of the learners rated the collaborative team learning intervention as either 'excellent' or 'very good'. Learners also indicated that they found the take-away handout valuable, and positive responses were also noted in the survey comments. A novel collaborative team learning technique resulted in high ratings of teaching rounds by medical residents and medical students. Learners found the sessions engaging, high yield, and educationally valuable. This interactive discussion-based teaching method could be used to enhance the learning experience during teaching rounds on medical, surgical and subspecialty services. © 2015 John Wiley & Sons Ltd.

Ward round template: enhancing patient safety on ward rounds.

PubMed

Gilliland, Niall; Catherwood, Natalie; Chen, Shaouyn; Browne, Peter; Wilson, Jacob; Burden, Helena

2018-01-01

Concerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety. These parameters were based on Trust patient safety guidance and CQUIN targets. The quality improvement technique of plan-do-study-act (PDSA) was used in this project. We retrospectively reviewed ward round entries to record baseline measurements, based on the above described parameters, prior to making any changes. Following this, the change applied was the introduction of a ward round template to include the highlighted important baseline parameters. Monthly PDSA cycles are performed, and baseline measurements are re-examined, then relevant changes were made to the ward round template. Documentation of baseline measurements was poor prior to introduction of the ward round template; this improved significantly following introduction of a standardised ward round template. Following three cycles, documentation of VTE risk assessments increased from 14% to 92%. Antibiotic stewardship documentation went from 0% to 100%. Use of the TEP form went from 29% to 78%. Following introduction of the ward round template, compliance improved significantly in all safety parameters. Important safety measures being discussed on ward rounds will lead to enhanced patient safety and will improve compliance to Trust guidance and comissioning for quality and innovation (CQUIN) targets. Ongoing change implementation will focus on improving compliance with usage of the template on all urology ward rounds.

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.

A Comparative Analysis of Texas Grade Five Student Achievement between Year-Round and Traditional School Calendars

ERIC Educational Resources Information Center

Wilmore-Dafonte, Christy N.

2013-01-01

Purpose: The purpose of this dissertation was to determine the extent to which school instructional calendar configuration (i.e., year-round or traditional) influenced Grade 5 student academic performance as reflected on the Texas Assessment of Knowledge and Skills (TAKS) test as a function of student ethnicity (i.e., Hispanic, White, and Black)…

Year-Round Daylight Saving Time Study : Volume 1. Interim Report on the Operation and Effects of Daylight Saving Time

DOT National Transportation Integrated Search

1975-06-01

The analyses of the effects of Year-Round Daylight Saving Time were not conslusive because they could not be reliablyseparated from other changes occuring simultaneously including fuel availability constraints, speed limit reductions, Sunday gasoline...

Round pneumonia in an adult.

PubMed

Zhang, Yi; Yu, Yong-Sheng; Tang, Zheng-Hao; Chen, Xiao-Hua; Zang, Guo-Qing

2014-01-01

Round pneumonia is an uncommon form of pulmonary infection usually found in children. It may resemble pulmonary neoplasm on radiographs. We present a case of round pneumonia in a 43-year-old male with a history of smoking and a family history of lung cancer. The patient was treated with antibiotics for more than two weeks, after which the infection resolved completely both clinically and radiologically. Clinicians should consider this uncommon type of pneumonia in the differential diagnosis of spherical pulmonary masses to avoid unnecessary diagnostic tests.

Development of Electronic Medical Record-Based "Rounds Report" Results in Improved Resident Efficiency, More Time for Direct Patient Care and Education, and Less Resident Duty Hour Violations.

PubMed

Ham, Phillip B; Anderton, Toby; Gallaher, Ryan; Hyrman, Mike; Simmerman, Erika; Ramanathan, Annamalai; Fallaw, David; Holsten, Steven; Howell, Charles Gordon

2016-09-01

Surgeons frequently report frustration and loss of efficiency with electronic medical record (EMR) systems. Together, surgery residents and a programmer at Augusta University created a rounds report (RR) summarizing 24 hours of vitals, intake/output, labs, and other values for each inpatient that were previously transcribed by hand. The objective of this study was to evaluate the RR's effect on surgery residents. Surgery residents were queried to assess the RR's impact. Outcome measures were time spent preparing for rounds, direct patient care time, educational activity time, rates of incorrect/incomplete data on rounds, and rate of duty hour violations. Hospital wide, 17,200 RRs were generated in the 1-month study. Twenty-three surgery residents participated. Time spent preparing for rounds decreased per floor patient (15.6 ± 3.0 vs 6.0 ± 1.2, P < 0.0001) and per intensive care unit patient (19.9 ± 2.9 vs 7.5 ± 1.2 P < 0.0001). The work day spent in direct patient care increased from 45.1 ± 5.6 to 54.0 ± 5.7 per cent (P = 0.0044). Educational activity time increased from 35.2 ± 5.4 to 54.7 ± 7.1 minutes per resident per day (P = 0.0004). Reported duty hour violations decreased 58 per cent (P < 0.0001). American Board of Surgery in Training exam scores trended up, and estimates of departmental annual financial savings range from $66,598 to $273,141 per year. Significant improvements occur with surgeon designed EMR tools like the RR. Hospitals and EMR companies should pair interested surgeons with health information technology developers to facilitate EMR enhancements. Improvements like RRs can have broad ranging, multidisciplinary impact and should be standard in all EMRs used for inpatient care at academic medical centers.

Developing non-technical ward-round skills.

PubMed

Harvey, Rachel; Mellanby, Edward; Dearden, Effie; Medjoub, Karima; Edgar, Simon

2015-10-01

Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform. There is evidence that newly qualified doctors are not adequately prepared by their undergraduate experiences for this task. The aim of this study was to analyse the challenges pertaining to non-technical skills that students would face during ward rounds, and to create a model that facilitates the transition from medical student to doctor. A total of 217 final-year medical students completed a simulated ward round. Free-text responses were analysed using template analysis applying an a priori template developed from the literature by the research team. This drew on the generic categories of non-technical skills suggested by Flin et al. Ninety-seven per cent of students agreed or strongly agreed that the simulated ward round improved their insight into the challenges of ward rounds and their perceived ability to work efficiently as an active member of the ward round. The responding students (206) submitted written feedback describing the learning that they planned to use: 800 learning points were recorded, and all could be categorised into one of seven non-technical skills. Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform We believe that improved task efficiency and insight into the challenges of the ward round gained by medical students will lead to an enhancement in performance during clinical rounds, and will have a positive impact on patient safety. We would suggest that undergraduate medical schools consider this model in the preparation for the clinical practice element of the curriculum. © 2015 John Wiley & Sons Ltd.

Choroidal Round Hyporeflectivities in Geographic Atrophy.

PubMed

Corbelli, Eleonora; Sacconi, Riccardo; De Vitis, Luigi Antonio; Carnevali, Adriano; Rabiolo, Alessandro; Querques, Lea; Bandello, Francesco; Querques, Giuseppe

2016-01-01

In geographic atrophy (GA), choroidal vessels typically appear on structural optical coherence tomography (OCT) as hyperreflective round areas with highly reflective borders. We observed that some GA eyes show choroidal round hyporeflectivities with highly reflective borders beneath the atrophy, and futher investigated the charcteristcs by comparing structural OCT, indocyanine green angiography (ICGA) and OCT angiography (OCT-A). Round hyporeflectivities were individuated from a pool of patients with GA secondary to non-neovascular age-related macular degeneration consecutively presenting between October 2015 and March 2016 at the Medical Retina & Imaging Unit of the University Vita-Salute San Raffaele. Patients underwent a complete ophthalmologic examination including ICGA, structural OCT and OCT-A. The correspondence between choroidal round hyporeflectivities beneath GA on structural OCT and ICGA and OCT-A imaging were analyzed. Fifty eyes of 26 consecutive patients (17 females and 9 males; mean age 76.8±6.2 years) with GA were included. Twenty-nine round hyporeflectivities have been found by OCT in choroidal layers in 21 eyes of 21 patients (42.0%; estimated prevalence of 57.7%). All 29 round hyporeflectivities showed constantly a hyperreflective border and a backscattering on structural OCT, and appeared as hypofluorescent in late phase ICGA and as dark foci with non detectable flow in the choroidal segmentation of OCT-A. Interestingly, the GA area was greater in eyes with compared to eyes without round hyporeflectivities (9.30±5.74 and 5.57±4.48mm2, respectively; p = 0.01). Our results suggest that most round hyporeflectivities beneath GA may represent non-perfused or hypo-perfused choroidal vessels with non-detectable flow.

Integration of Mobile Devices to Facilitate Patient Care and Teaching During Family-Centered Rounds.

PubMed

Byrd, Angela S; McMahon, Pamela M; Vath, Richard J; Bolton, Michael; Roy, Melissa

2018-01-01

The increasing prevalence of mobile devices in clinical settings has the potential to improve both patient care and education. The benefits are particularly promising in the context of family-centered rounds in inpatient pediatric settings. We aimed to increase mobile device usage by inpatient rounding teams by 50% in 6 months. We hoped to demonstrate that use of mobile devices would improve access to patient care and educational information and to determine if use would improve efficiency and perceptions of clinical teaching. We designed a mixed-methods study involving pre- and post-implementation surveys to residents, families, and faculty as well as direct observations of family-centered rounds. We conducted rapid cycles of continual quality improvement by using the Plan-Do-Study-Act framework involving 3 interventions. Pre-intervention, the mobile computing cart was used for resident education on average 3.3 times per rounding session. After cycle 3, teaching through the use of mobile devices increased by ∼79% to 5.9 times per rounding session. On the basis of survey data, we determined there was a statistically significant increase in residents' perception of feeling prepared for rounds, receiving teaching on clinical care, and ability to teach families. Additionally, average time spent per patient on rounds decreased after implementation of mobile devices. Integration of mobile devices into a pediatric hospital medicine teaching service can facilitate patient care and perception of resident teaching by extending the utility of electronic medical records in care decisions and by improving access to knowledge resources. Copyright © 2018 by the American Academy of Pediatrics.

Relationships, Instruction, Understandings: One District's Implementation of Rounds

ERIC Educational Resources Information Center

Roegman, Rachel; Hatch, Thomas; Hill, Kathryn; Kniewel, Victoria S.

2015-01-01

Purpose: The purpose of this paper is to show how instructional rounds contributes to shared understandings and facilitates the development of relationships among administrators. Design/methodology/approach: This mixed methods study draws on three years of data in a district engaged in rounds. Administrators annually completed a social network…

Association Between ICU Admission During Morning Rounds and Mortality

PubMed Central

Gajic, Ognjen; Morales, Ian J.; Keegan, Mark T.; Peters, Steve G.; Hubmayr, Rolf D.

2009-01-01

Background: No previous study has evaluated the association between admission to ICUs during round time and patient outcome. The objective of this study was to determine the association between round-time ICU admission and patient outcome. Methods: This retrospective study included 49,844 patients admitted from October 1994 to December 2007 to four ICUs (two surgical, one medical, and one multispecialty) of an academic medical center. Of these patients, 3,580 were admitted to the ICU during round time (8:00 am to 10:59 am) and 46,264 were admitted during nonround time (from 1:00 pm to 6:00 am). The medical ICU had 24-h/7-day per week intensivist coverage during the last 2 years of the study. We compared the baseline characteristics and outcome of patients admitted to the ICU between the two groups. Data were abstracted from the acute physiology and chronic health evaluation (APACHE) III database. Results: The round-time and non-round-groups were similar in gender, ethnicity, and age. The predicted hospital mortality rate of the round time group was higher (17.4% vs 12.3% predicted, respectively; p < 0.001). The hospital length of stay was similar between the two groups. The round-time group had a higher hospital mortality rate (16.2% vs 8.8%, respectively; p < 0.001). Most of the round-time ICU admissions and deaths occurred in the medical ICU. Round-time admission was an independent risk factor for hospital death (odds ratio, 1.321; 95% CI, 1.178 to 1.481). This independent association was present for the whole study period except for the last 2 years. Conclusions: Patients admitted to the ICU during morning rounds have higher severity of illness and mortality rates. PMID:19505985

Interprofessional rhetoric and operational realities: an ethnographic study of rounds in four intensive care units.

PubMed

Paradis, Elise; Leslie, Myles; Gropper, Michael A

2016-10-01

Morning interprofessional rounds (MIRs) are used in critical care medicine to improve team-based care and patient outcomes. Given existing evidence of conflict between and dissatisfaction among rounds participants, this study sought to better understand how the operational realities of care delivery in the intensive care unit (ICU) impact the success of MIRs. We conducted a year-long comparative ethnographic study of interprofessional collaboration and patient and family involvement in four ICUs in tertiary academic hospitals in two American cities. The study included 576 h of observation of team interactions, 47 shadowing sessions and 40 clinician interviews. In line with best practices in ethnographic research, data collection and analysis were done iteratively using the constant comparative method. Member check was conducted regularly throughout the project. MIRs were implemented on all units with the explicit goals of improving team-based and patient-centered care. Operational conditions on the units, despite interprofessional commitment and engagement, appeared to thwart ICU teams from achieving these goals. Specifically, time constraints, struggles over space, and conflicts between MIRs' educational and care-plan-development functions all prevented teams from achieving collaboration and patient-involvement. Moreover, physicians' de facto control of rounds often meant that they resembled medical rounds (their historical predecessors), and sidelined other providers' contributions. This study suggests that the MIRs model, as presently practiced, might not be well suited to the provision of team-based, patient-centered care. In the interest of interprofessional collaboration, of the optimization of clinicians' time, of high-quality medical education and of patient-centered care, further research on interprofessional rounds models is needed.

The Reconstruction of Condition-Specific Transcriptional Modules Provides New Insights in the Evolution of Yeast AP-1 Proteins

PubMed Central

Goudot, Christel; Etchebest, Catherine

2011-01-01

AP-1 proteins are transcription factors (TFs) that belong to the basic leucine zipper family, one of the largest families of TFs in eukaryotic cells. Despite high homology between their DNA binding domains, these proteins are able to recognize diverse DNA motifs. In yeasts, these motifs are referred as YRE (Yap Response Element) and are either seven (YRE-Overlap) or eight (YRE-Adjacent) base pair long. It has been proposed that the AP-1 DNA binding motif preference relies on a single change in the amino acid sequence of the yeast AP-1 TFs (an arginine in the YRE-O binding factors being replaced by a lysine in the YRE-A binding Yaps). We developed a computational approach to infer condition-specific transcriptional modules associated to the orthologous AP-1 protein Yap1p, Cgap1p and Cap1p, in three yeast species: the model yeast Saccharomyces cerevisiae and two pathogenic species Candida glabrata and Candida albicans. Exploitation of these modules in terms of predictions of the protein/DNA regulatory interactions changed our vision of AP-1 protein evolution. Cis-regulatory motif analyses revealed the presence of a conserved adenine in 5′ position of the canonical YRE sites. While Yap1p, Cgap1p and Cap1p shared a remarkably low number of target genes, an impressive conservation was observed in the YRE sequences identified by Yap1p and Cap1p. In Candida glabrata, we found that Cgap1p, unlike Yap1p and Cap1p, recognizes YRE-O and YRE-A motifs. These findings were supported by structural data available for the transcription factor Pap1p (Schizosaccharomyces pombe). Thus, whereas arginine and lysine substitutions in Cgap1p and Yap1p proteins were reported as responsible for a specific YRE-O or YRE-A preference, our analyses rather suggest that the ancestral yeast AP-1 protein could recognize both YRE-O and YRE-A motifs and that the arginine/lysine exchange is not the only determinant of the specialization of modern Yaps for one motif or another. PMID:21695268

A time-motion study of inpatient rounds using a family-centered rounds model.

PubMed

Bhansali, Priti; Birch, Sarah; Campbell, Joyce K; Agrawal, Dewesh; Hoffner, Wendy; Manicone, Paul; Shah, Kyle; Krieger, Evelina; Ottolini, Mary

2013-01-01

Family-centered rounds (FCR) have become increasingly prevalent in pediatric hospital settings. The objective of our study was to describe time use and discrete events during pediatric inpatient rounds by using a FCR model. We conducted a prospective observational study at Children's National Medical Center between September 2010 and February 2011. Investigators directly observed rounds on hospitalist and neurology services. Events were timed, and key features were recorded by using a Microsoft Access-based program. Associations with increased time spent during rounds were determined by using regression analyses. One hundred fifty-nine rounding encounters were observed. Rounds lasted 7.9 minutes on average per patient. An average of 1.3 minutes was spent between patients during rounds. Eighty-six (54%) encounters occurred outside the patient's room, 3% of the time because of the family's request. Infectious isolation was associated with rounds occurring outside the room (P<.0001). Participation of the parent, location of rounds inside or outside the patient's room, most teaching behaviors, and interruptions were not significantly associated with increased time spent during rounds. Teaching physical examination techniques by allowing multiple trainees to examine the patient was associated with increased rounding time (P= .02). The majority of rounds occurred outside the patient's room, yet rarely at the parent's request. Patients on infectious isolation were more likely to have rounds occur outside the patient's room. Neither parental participation nor most teaching behaviors were associated with increased time spent on rounds. These findings will enrich the evidence base needed to establish FCR best practices.

Seasonal atmospheric deposition and air-sea gaseous exchange of polycyclic aromatic hydrocarbons over the Yangtze River Estuary, East China Sea: Implication for the source-sink processes

NASA Astrophysics Data System (ADS)

Jiang, Y.; Guo, Z.

2017-12-01

As the home of the largest port in the world, the Yangtze River Estuary (YRE) in the East China Sea (ECS) is adjacent to the largest economic zone in China with more than 10% of Chinese population and provides one-fifth of national GDP. The YRE is under the path of contaminated East Asian continental outflow. These make the YRE unique for the pollutant biogeochemical cycling in the world. In this work, 94 pairs of air samples and 20 surface seawater samples covering four seasons were collected from a remote receptor site in the YRE from March 2014 to January 2015, in order to explore the seasonal fluxes of air-sea gaseous exchange and atmospheric dry and wet deposition of 15 polycyclic aromatic hydrocarbons (PAHs) and their source-sink processes at the air-sea interface. The average dry and wet deposition fluxes of 15 PAHs were estimated as 879 ± 1393 ng m-2 d-1 and 755 ± 545 ng m-2 d-1, respectively. The gaseous PAHs were released from seawater to atmosphere during the whole year with an average of 3039 ± 2030 ng m-2 d-1. The gaseous exchange of PAHs was referred as the dominant process at the air-sea interface in the YRE as the magnitude of volatilization flux of PAHs exceeded that of the total dry and wet deposition. The gaseous PAH exchange flux was dominated by 3-ring PAHs, with the highest value in summer while lowest in winter, depicting a strong seasonal variation due to temperature, wind speed and air-sea concentration gradient difference among seasons. Based on the simplified mass balance estimation, net 9.6 tons/y of PAHs was volatilized from seawater to atmosphere with an area of approximately 20000 km2 in the YRE. Apart from Yangtze River input and ocean ship emissions in the entire year, the selective release of low molecular weight PAHs from sediments in winter due to re-suspension triggered by the East Asian winter monsoon could be another possible source for dissolved PAHs. This work suggests that the source-sink processes of PAHs at air

What makes Alpine swift ascend at twilight? Novel geolocators reveal year-round flight behaviour.

PubMed

Meier, Christoph M; Karaardıç, Hakan; Aymí, Raül; Peev, Strahil G; Bächler, Erich; Weber, Roger; Witvliet, Willem; Liechti, Felix

2018-01-01

Studying individual flight behaviour throughout the year is indispensable to understand the ecology of a bird species. Recent development in technology allows now to track flight behaviour of small long-distance bird migrants throughout its annual cycle. The specific flight behaviour of twilight ascents in birds has been documented in a few studies, but only during a short period of the year, and never quantified on the individual level. It has been suggested that twilight ascents might be a role in orientation and navigation. Previous studies had reported the behaviour only near the breeding site and during migration. We investigated year-round flight behaviour of 34 individual Alpine swifts ( Apus melba ) of four different populations in relation to twilight ascents. We recorded twilight ascents all around the year and found a twofold higher frequency in ascents during the non-breeding residence phase in Africa compared to all other phases of the year. Dawn ascents were twice as common as dusk ascents and occurred mainly when atmospheric conditions remained stable over a 24-h period. We found no conclusive support that twilight ascents are essential for recalibration of compass cues and landmarks. Data on the wing flapping intensity revealed that high activity at twilight occurred more regularly than the ascents. We therefore conclude that alpine swift generally increase flight activity-also horizontal flight-during the twilight period and we suppose that this increased flight activity, including ascents, might be part of social interactions between individuals. Year-round flight altitude tracking with a light-weight multi-sensor tag reveals that Alpine swifts ascend several hundred meters high at twilight regularly. The reason for this behaviour remains unclear and the low-light conditions at this time of the day preclude foraging as a possibility. The frequency and altitude of twilight ascents were highest during the non-breeding period, intermediate during

Blue and Fin Whale Habitat Modeling from Long-Term Year-Round Passive Acoustic Data from the Southern California Bight

DTIC Science & Technology

2014-09-30

be used for habitat modeling include sea surface temperature (SST), sea surface height (SSH), chlorophyll a concentration, and primary production...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Blue and Fin Whale Habitat Modeling from Long-Term Year...predictive, year-round habitat models of the presence of calling blue and fin whales in the Southern California Bight, to facilitate Navy’s operational

Consensus statement on round window vibroplasty.

PubMed

Beltrame, Achille M; Todt, Ingo; Sprinzl, Georg; Profant, Milan; Schwab, Burkhard

2014-10-01

This study aimed to review current knowledge regarding implantation of the Vibrant Soundbridge floating mass transducer (FMT) at the round window (round window vibroplasty) as well as to form a consensus on steps for a reliable, stable surgical procedure. Review of the literature and experimental observations by the authors. Round window (RW) vibroplasty has been established as a reliable procedure that produces good and stable results for patients with conductive or mixed hearing loss. The experience gained over the past few years of the authors' more than 200 implantations has led to consensus on several key points: (1) a wide and bloodless access to the middle ear with facial nerve monitoring, (2) the careful and correct identification and exposure of the round window membrane, (3) a good setup for efficient energy transition of the FMT, namely, perpendicular placement of the FMT with no contact to bone and the placement of cartilage behind the FMT to create a preloaded "spring" function, and (4) 4 points of FMT fixation: a rim of the round window bony overhang left intact both anterior and posterior to the FMT, conductor link stabilization, and cartilage behind the FMT. In addition, the FMT should be covered with soft tissue. © The Author(s) 2014.

Learners' decisions for attending Pediatric Grand Rounds: a qualitative and quantitative study.

PubMed

Dolcourt, Jack L; Zuckerman, Grace; Warner, Keith

2006-04-27

Although grand rounds plays a major educational role at academic medical centers, there has been little investigation into the factors influencing the learners' decision to attend. Greater awareness of attendees' expectations may allow grand rounds planners to better accommodate the learners' perspective, potentially making continuing education activities more attractive and inviting. We used both qualitative (part A) and quantitative (part B) techniques to investigate the motivators and barriers to grand rounds attendance. Part A investigated contextual factors influencing attendance as expressed through attendee interviews. Transcripts of the interviews were analyzed using grounded theory techniques. We created a concept map linking key factors and their relationships. In part B we quantified the motivators and barriers identified during the initial interviews through a survey of the grand rounds audience. Sixteen persons voluntarily took part in the qualitative study (part A) by participating in one of seven group interview sessions. Of the 14 themes that emerged from these sessions, the most frequent factors motivating attendance involved competent practice and the need to know. All sessions discussed intellectual stimulation, social interaction, time constraints and convenience, licensure, content and format, and absence of cost for attending sessions. The 59 respondents to the survey (part B) identified clinically-useful topics (85%), continuing education credit (46%), cutting-edge research (27%), networking (22%), and refreshments (8%) as motivators and non-relevant topics (44%) and too busy to attend (56%) as barriers. Greater understanding of the consumers' perspective can allow planners to tailor the style, content, and logistics to make grand rounds more attractive and inviting.

The Wheels of Stress Go 'Round and 'Round

ERIC Educational Resources Information Center

Brey, Rebecca A.; Clark, Susan E.

2012-01-01

"The Wheels of Stress Go Round and Round" teaching idea uses three activity wheels to reinforce stress-related content and concepts. After presenting a definition of stress, the instructor assists students in identifying stressors, and aids in formulating a list of negative, reactive behaviors and a list of positive coping mechanisms. Using…

Are family characteristics associated with attendance at family centered rounds in the PICU?.

PubMed

Drago, Matthew J; Aronson, Paul L; Madrigal, Vanessa; Yau, Jennifer; Morrison, Wynne

2013-02-01

The objective of this study was to identify if family characteristics or opinions affected participation in family centered rounds. Observational study of 431 patient encounters on daily work rounds, followed by 100 questionnaires completed by family members of patients in the unit during observation. PICU at a tertiary care, academic, free-standing children's hospital. Patients and families admitted to the PICU during the observation period. None. The most frequent family members present for rounds were mothers (40%). Race, educational level, age of the family member, age of the child, whether the admission was expected, and whether the family member was a medical professional had no association with whether the family member attended rounds. Both family members who were present and those who were not present felt being at rounds would improve the care of their child (87% vs. 100%, p = 0.57). A family's response that they preferred to attend rounds was the only factor associated with a higher likelihood of attending rounds (odds ratio 3.4, 95% confidence interval 1.1-10.8, p = 0.03). Families feel that participating in family centered rounds improves the care of their children. Those that like attending rounds are more likely to participate in family centered rounds, but family demographic characteristics were not associated with rounds attendance. Future studies are needed to identify barriers to family participation in family centered rounds.

Utilization of year round data in the estimation of genetic parameters for internal parasite resistance traits in Dorper sheep

USDA-ARS?s Scientific Manuscript database

The objective of this study was to evaluate the effect on the estimates of heritability and permanent environmental effects as a proportion of phenotypic variance when year round records are used. Records from 1,008 Dorper sheep in a private South African flock comprised 17,711 FAMACHA scores, 3,758...

Year-round Application of Water Curtain for Environmental Control in Greenhouse

NASA Astrophysics Data System (ADS)

Ibuki, R.; Sugita, E.

2011-12-01

In large area of Japan needs forced environmental control to cultivate yields in hard temperature condition. Water Curtain is applied in Japan for night time air temperature control of small greenhouse, making strawberry and covered by plastic film. Water is splayed on extended plastic film, located above strawberry and below roof film. Underground water is utilized for cooling in summer, and warming in winter. Heat exchange between water and ground, and also water and air in the greenhouse is occurring in this system. Furthermore, heat transfer by radiation effect is also controlled by water membrane. In winter night, infrared radiation through plastic film is reduced by water membrane because of its high absorption coefficient on wave length of infrared. Besides water has a high transparency on wave length of visible light. These features are useful on the daytime radiation control of greenhouse to maintain visible light level for photosynthesis and to reduce excess infrared, damages yields in summer. Also in daytime of sunny day in winter season, temperature is too high to cultivate yields in closed greenhouse. Under this situation, water curtain is useful to storage from broad area in greenhouse excess heat from air in the circulation water. Warm water is useful to maintain temperature in greenhouse. On the contrary, in summer season, water can storage heat in daytime and release in night time. Water curtain system will contribute to be a sustainable and low energy consumption system to maintain comfortable environment for yields growth. For this reason we are considering to use water curtain in year-round. At the first step of the year-round application, day time use in summer is experimentally investigated. General water curtain splays water on plastic film extended on metal pipe. In this situation water is gathered at valley part of the film. Then water membrane is partially made and radiation control is not effective at large area. Therefore we applied new

Spatial anatomy of the round ligament, gallbladder, and intrahepatic vessels in patients with right-sided round ligament of the liver.

PubMed

Ibukuro, Kenji; Takeguchi, Takaya; Fukuda, Hozumi; Abe, Shoko; Tobe, Kimiko

2016-11-01

To analyze the vascular structure of the liver in patients with a right-sided round ligament. We reviewed 16 patients with a right-sided round ligament and 3 polysplenia and situs inversus patients with a left-sided round ligament who underwent multidetector row CT with contrast media. The patient population consisted of 13 men and 6 women (mean 62 years). We analyzed the axial and volume-rendered images for the location of the round ligament, gallbladder, portal veins, hepatic veins, and hepatic artery. The following imaging findings for the patients with polysplenia and situs inversus were horizontally reversed. The prevalence of a right-sided round ligament with and without polysplenia was 75 and 0.11 %, respectively. The gallbladder was located to the right, below, and left of the round ligament in 27.7, 38.8 and 33.3 %, respectively. Independent branching of the right posterior portal vein was noted in 57.8 %. PV4 was difficult to identify in 36.8 %. The middle hepatic vein was located to the left of the round ligament. Two branching patterns for the lateral and medial branches of the right anterior hepatic artery were noted: the common (44.4 %) and separated types (55.5 %). Both of the right anterior hepatic artery and portal vein ramified into two segments; the lateral segment with many branches and the medial segment with a few branches. The right-sided round ligament divided the right anterior section into the lateral and medial segments based on the portal vein and hepatic artery anatomy.

Colorectal cancer in a second round after a negative faecal immunochemical test.

PubMed

Bujanda, Luis; Sarasqueta, Cristina; Castells, Antoni; Pellisé, María; Cubiella, Joaquín; Gil, Inés; Cosme, Angel; Arana-Arri, Eunate; Mar, Izaskun; Idigoras, Isabel; Portillo, Isabel

2015-07-01

The faecal immunochemical test is one of the tests recommended by scientific societies for colorectal cancer (CRC) screening in average-risk populations. Our aim was to evaluate the characteristics of CRC detected in a second round of screening after negative results in a first round. We studied patients in whom CRC was detected in a screening programme. This programme included asymptomatic individuals between 50 and 69 years old and offered tests every 2 years. A total of 363,792 individuals were invited to participate in the first round of faecal immunochemical test screening and 100,135 individuals in the second round after a first negative result. The screening strategy consisted of faecal testing of a single sample using an automated semiquantitative kit, with a cut-off of 20 μg haemoglobin (Hb)/g faeces. The rate of positive results was 6.9% (16,467/238,647) in the first round and 4.8% (3359/69,193) in the second round (P < 0.0005). Overall, 860 (0.36%) cases of CRC were detected in the first round and 100 (0.14%) in the second round (P < 0.005). The location of the cancer was proximal in 12.5 and 24% of cases detected in the first and second rounds, respectively (P = 0.008). Hb concentrations were higher in the first round (211 vs. 109 μg Hb/g faeces in the second round; P = 0.002). Multivariate analysis confirmed that, in the second round, CRC diagnosed was more often proximal (hazard ratio vs. first round, 2.4; 95% confidence interval, 1.3-4.4; P = 0.003) and the concentration of Hb/g faeces was lower (hazard ratio vs. first round, 2.1; 95% confidence interval, 1.3-3.5; P = 0.003). The CRC detection rate is lower in the second round of screening. Further, in the second round, CRC detected is more often in a proximal location and Hb concentrations are lower.

Migratory monarchs wintering in California experience low infection risk compared to monarchs breeding year-round on non-native milkweed.

PubMed

Satterfield, Dara A; Villablanca, Francis X; Maerz, John C; Altizer, Sonia

2016-08-01

Long-distance migration can lower infection risk for animal populations by removing infected individuals during strenuous journeys, spatially separating susceptible age classes, or allowing migrants to periodically escape from contaminated habitats. Many seasonal migrations are changing due to human activities including climate change and habitat alteration. Moreover, for some migratory populations, sedentary behaviors are becoming more common as migrants abandon or shorten their journeys in response to supplemental feeding or warming temperatures. Exploring the consequences of reduced movement for host-parasite interactions is needed to predict future responses of animal pathogens to anthropogenic change. Monarch butterflies (Danaus plexippus) and their specialist protozoan parasite Ophryocystis elektroscirrha (OE) provide a model system for examining how long-distance migration affects infectious disease processes in a rapidly changing world. Annual monarch migration from eastern North America to Mexico is known to reduce protozoan infection prevalence, and more recent work suggests that monarchs that forego migration to breed year-round on non-native milkweeds in the southeastern and south central Unites States face extremely high risk of infection. Here, we examined the prevalence of OE infection from 2013 to 2016 in western North America, and compared monarchs exhibiting migratory behavior (overwintering annually along the California coast) with those that exhibit year-round breeding. Data from field collections and a joint citizen science program of Monarch Health and Monarch Alert showed that infection frequency was over nine times higher for monarchs sampled in gardens with year-round milkweed as compared to migratory monarchs sampled at overwintering sites. Results here underscore the importance of animal migrations for lowering infection risk and motivate future studies of pathogen transmission in migratory species affected by environmental change. © The

Virtual Simulated Care Coordination Rounds for Nursing Students.

PubMed

Badowski, Donna M

Implementation of the Affordable Care Act has nursing education reflecting on paradigm shifts in order to prepare nursing students for the evolving health care environment. The traditional focus of nursing education on nursing care in acute care settings does not provide learning experiences in care coordination and transitional care management skills. Virtual simulated care coordination rounds, using the National League for Nursing Advancing Care Excellence resources, offer nursing students an innovative experience in care coordination and transition care management.

Race to Top Round Two Heating Up

ERIC Educational Resources Information Center

McNeil, Michele

2010-01-01

With the second-round deadline for federal Race to the Top Fund grants less than six weeks away, states are rushing to raise the stakes on their education reform plans as they fight over the remaining $3.4 billion in prize money. But in doing so, states from Massachusetts to Colorado are tangling with their teachers' unions as they test how far…

Pay for Performance Proposals in Race to the Top Round II Applications. Briefing Memo

ERIC Educational Resources Information Center

Rose, Stephanie

2010-01-01

The Education Commission of the States reviewed all 36 Race to the Top (RttT) round II applications. Each of the 36 states that applied for round II funding referenced pay for performance under the heading of "Improving teacher and principal effectiveness based on performance." The majority of states outlined pay for performance…

Assessment of bridge scour in the lower, middle, and upper Yangtze River estuary with riverbed sonar profiling techniques.

PubMed

Zheng, Shuwei; Xu, Y Jun; Cheng, Heqin; Wang, Bo; Lu, Xuejun

2017-12-12

Riverbed scour of bridge piers can cause rapid loss in foundation strength, leading to sudden bridge collapse. This study used multi-beam echo sounders (Seabat 7125) to map riverbed surrounding the foundations of four major bridges in the lower, middle, and upper reaches of the 700-km Yangtze River Estuary (YRE) during June 2015 and September 2016. The high-resolution data were utilized to analyze the morphology of the bridge scour and the deformation of the wide-area riverbed (i.e., 5-18 km long and 1.3-8.3 km wide). In addition, previous bathymetric measurements collected in 1998, 2009, and 2013 were used to determine riverbed erosion and deposition at the bridge reaches. Our study shows that the scour depth surrounding the bridge foundations progressed up to 4.4-19.0 m in the YRE. Over the past 5-15 years, the total channel erosion in some river reaches was up to 15-17 m, possessing a threat to the bridge safety in the YRE. Tide cycles seemed to have resulted in significant variation in the scour morphology in the lower and middle YRE. In the lower YRE, the riverbed morphology displayed one long erosional ditch on both sides of the bridge foundations and a long-strip siltation area distributed upstream and downstream of the bridge foundations; in the middle YRE, the riverbed morphology only showed erosional morphology surrounding the bridge foundations. Large dunes caused deep cuts and steeper contours in the bridge scour. Furthermore, this study demonstrates that the high-resolution grid model formed by point cloud data of multi-beam echo sounders can clearly display the morphology of the bridge scour in terms of wide areas and that the sonar technique is a very useful tool in the assessment of bridge scours.

Assessment of parental presence during bedside pediatric intensive care unit rounds: effect on duration, teaching, and privacy.

PubMed

Phipps, Lorri M; Bartke, Cheryl N; Spear, Debra A; Jones, Linda F; Foerster, Carolyn P; Killian, Marie E; Hughes, Jennifer R; Hess, Joseph C; Johnson, David R; Thomas, Neal J

2007-05-01

There is a paucity of literature evaluating the effects of family member presence during bedside medical rounds in the pediatric intensive care unit. We hypothesized that, when compared with rounds without family members, parental presence during morning medical rounds would increase time spent on rounds, decrease medical team teaching/education, increase staff dissatisfaction, create more stress in family members, and violate patient privacy in our open unit. Prospective, blinded, observational study. Academic pediatric intensive care unit with 12 beds. A total of 105 admissions were studied, 81 family members completed a survey, and 187 medical team staff surveys were completed. Investigators documented parental presence and time allocated for presentation, teaching, and answering questions. Surveys related to perception of goals, teaching, and privacy of rounds were distributed to participants. Time spent on rounds, time spent teaching on rounds, and medical staff and family perception of the effects of parental presence on rounds. There was no significant difference between time spent on rounds in the presence or absence of family members (p = NS). There is no significant difference between the time spent teaching by the attending physician in the presence or absence of family members (p = NS). Overall, parents reported that the medical team spent an appropriate amount of time discussing their child and were not upset by this discussion. Parents did not perceive that their own or their child's privacy was violated during rounds. The majority of medical team members reported that the presence of family on rounds was beneficial. Parental presence on rounds does not seem to interfere with the educational and communication process. Parents report satisfaction with participation in rounds, and privacy violations do not seem to be a concern from their perspective.

Psychiatry Morbidity and Mortality Rounds: Implementation and Impact

ERIC Educational Resources Information Center

Goldman, Stuart; Demaso, David R.; Kemler, Beth

2009-01-01

Objective: This study assessed the implementation of psychiatry morbidity and mortality rounds (M&Ms) on the clinical and educational practice in a children's hospital. Methods: Attendees to monthly M&Ms between July 2005 and May 2007 included staff and trainees from psychiatry, psychology, nursing, and social work. Cases were selected based on a…

Analysis of Math and Reading Achievement Scores of Students Attending Year-Round Calendar Schools and Traditional Calendar Schools in Tennessee

ERIC Educational Resources Information Center

Abakwue, Chimaeze Ikechi

2011-01-01

The purpose of this study was to determine if there were a significant difference in math and reading academic achievement scores between eighth-grade students attending year-round calendar schools and eighth-grade students attending traditional calendar schools based on the TCAP. In addition, this study investigated math and reading achievement…

Lipoma of round ligament on the intraperitoneal portion (abdominal site): a case report.

PubMed

Ozdemır, Ozhan; Sarı, Mustafa Erkan; Sakar, Vefa Selimova; Nebıoglu, Mehriban; Atalay, Cemal Resat

2017-09-01

Primary tumors of round ligament are rare, and when found are typically leiomyomas. Endometrioma, and mesothelial cysts are the benign lesions recognized as involving the round ligament. We report a case of lipoma of the round ligament in a 48-year-old premenopausal woman. Round ligament lipoma on the intraperitoneal portion (abdominal site) is very rare and it should be kept in the differential diagnosis of ovarian and abdominal masses.

Weathering a Dynamic Seascape: Influences of Wind and Rain on a Seabird’s Year-Round Activity Budgets

PubMed Central

Pistorius, Pierre A.; Hindell, Mark A.; Tremblay, Yann; Rishworth, Gavin M.

2015-01-01

How animals respond to varying environmental conditions is fundamental to ecology and is a question that has gained impetus due to mounting evidence indicating negative effects of global change on biodiversity. Behavioural plasticity is one mechanism that enables individuals and species to deal with environmental changes, yet for many taxa information on behavioural parameters and their capacity to change are lacking or restricted to certain periods within the annual cycle. This is particularly true for seabirds where year-round behavioural information is intrinsically challenging to acquire due to their reliance on the marine environment where they are difficult to study. Using data from over 13,000 foraging trips throughout the annual cycle, acquired using new-generation automated VHF technology, we described sex-specific, year-round activity budgets in Cape gannets. Using these data we investigated the role of weather (wind and rain) on foraging activity and time allocated to nest attendance. Foraging activity was clearly influenced by wind speed, wind direction and rainfall during and outside the breeding season. Generally, strong wind conditions throughout the year resulted in relatively short foraging trips. Birds spent longer periods foraging when rainfall was moderate. Nest attendance, which was sex-specific outside of the breeding season, was also influenced by meteorological conditions. Large amounts of rainfall (> 2.5 mm per hour) and strong winds (> 13 m s-1) resulted in gannets spending shorter amounts of time at their nests. We discuss these findings in terms of life history strategies and implications for the use of seabirds as bio-indicators. PMID:26581108

Optimal coupling and feasibility of a solar-powered year-round ejector air conditioner

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

Sokolov, M.; Hershgal, D.

1993-06-01

An ejector refrigeration system that uses a conventional refrigerant (R-114) is introduced as a possible mechanism for providing solar-based air-conditioning. Optimal coupling conditions between the collectors' energy output and energy requirements of the cooling system, are investigated. Operation at such optimal conditions assures maximized overall efficiency. Procedures leading to the evaluation of the performance of a real system are disclosed. Design curves for such a system with R-114 as refrigerant are provided. A multi-ejectors arrangement that provides an efficient adjustment for variations of ambient conditions, is described. Year-round air-conditioning is facilitated by rerouting the refrigerant flow through a heating modemore » of the system. Calculations are carried out for illustrative configurations in which relatively low condensing temperature (water reservoirs, cooling towers, or moderate climate) can be maintained.« less

Year-round Regional CO2 Fluxes from Boreal and Tundra Ecosystems in Alaska

NASA Astrophysics Data System (ADS)

Commane, R.; Lindaas, J.; Benmergui, J. S.; Luus, K. A.; Chang, R. Y. W.; Daube, B. C.; Euskirchen, E. S.; Henderson, J.; Karion, A.; Miller, J. B.; Miller, S. M.; Parazoo, N.; Randerson, J. T.; Sweeney, C.; Tans, P. P.; Thoning, K. W.; Veraverbeke, S.; Miller, C. E.; Wofsy, S. C.

2016-12-01

High-latitude ecosystems could release large amounts of carbon dioxide (CO2) to the atmosphere in a warmer climate. We derive temporally and spatially resolved year-round CO2 fluxes in Alaska from a synthesis of airborne and tower CO2 observations in 2012-2014. We find that tundra ecosystems were net sources of atmospheric CO2. We discuss these flux estimates in the context of long-term CO2 measurements at Barrow, AK, to asses the long term trend in carbon fluxes in the Arctic. Many Earth System Models incorrectly simulate net carbon uptake in Alaska presently. Our results imply that annual net emission of CO2 to the atmosphere may have increased markedly in this region of the Arctic in response to warming climate, supporting the view that climate-carbon feedback is strongly positive in the high Arctic.

Qualities Required of Education Today To Meet Foreseeable Demands in the Twenty-first Century. International Symposium and Round Table Proceedings (Beijing, China, November 27-December 2, 1989).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

This report contains proceedings of a United Nations Education, Scientific, and Cultural Organization (UNESCO) international symposium and round table. The main objective of the meeting was to debate long-term goals of education and its role in preparing young people to face the demands of the 21st century. Papers presented include: (1) "Young…

An Investigation on Teacher Retention and Teachers' Perceptions of Cultural Leadership in Selected North Carolina Year Round and Traditional Elementary Schools

ERIC Educational Resources Information Center

Council, Ve-Lecia Selene

2010-01-01

The purpose of this study was to investigate teacher retention and teachers' perceptions of cultural leadership in select North Carolina elementary year round and traditional elementary schools. The participants in this study were North Carolina elementary teachers that participated in the 2008 North Carolina Teacher Working Conditions Survey…

Students' Perceptions on an Interprofessional Ward Round Training - A Qualitative Pilot Study.

PubMed

Nikendei, C; Huhn, D; Pittius, G; Trost, Y; Bugaj, T J; Koechel, A; Schultz, J-H

2016-01-01

Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students', nurses' as well as physiotherapists' views on a simulation-based interprofessional ward round training. In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second) volunteered to participate in two standardized patient ward round scenarios: (1) patient with myocardial infarction, and (2) patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups. Focus group based feedback contained two main categories (A) ward round training benefits and (B) difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups. The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.

Do antibody responses to the influenza vaccine persist year-round in the elderly? A systematic review and meta-analysis.

PubMed

Young, Barnaby; Zhao, Xiahong; Cook, Alex R; Parry, Christopher M; Wilder-Smith, Annelies; I-Cheng, Mark Chen

2017-01-05

The influenza vaccine is less immunogenic in older than younger adults, and the duration of protection is unclear. Determining if protection persists beyond a typical seasonal epidemic is important for climates where influenza virus activity is year-round. A systematic review protocol was developed and registered with PROSPERO [CRD42015023847]. Electronic databases were searched systematically for studies reporting haemagglutination-inhibition (HI) titres 180-360days following vaccination with inactivated trivalent seasonal influenza vaccine, in adults aged ⩾65years. Geometric mean titre (GMT) and seroprotection (HI titre ⩾1:40) at each time point was extracted. A Bayesian model was developed of titre trajectories from pre-vaccination to Day 360. In the meta-analysis, studies were aggregated using a random-effects model to compare pre-vaccination with post-vaccination HI titres at Day 21-42 ('seroconversion'), Day 180 and Day 360. Potential sources of bias were systematically assessed, and heterogeneity explored. 2864 articles were identified in the literature search, of which nineteen met study inclusion/exclusion criteria. Sixteen studies contained analysable data from 2565 subjects. In the Bayesian model, the proportion of subjects seroprotected increased from 41-51% pre-vaccination to 75-78% at seroconversion. Seroprotection subsequently fell below 60% for all serotypes by Day 360: A/H1 42% (95% CI 38-46), A/H3 59% (54-63), B 47% (42-52). The Bayesian model of GMT trajectories revealed a similar pattern. By Day 360, titres were similar to pre-vaccination levels. In the meta-analysis, no significant difference in proportion of subjects seroprotected, 0 (-0.11, 0.11) or in log 2 GMT 0.30 (-0.02, 0.63) was identified by Day 360 compared with pre-vaccination. The quality of this evidence was limited to moderate on account of significant participant dropout. The review found consistent evidence that HI antibody responses following influenza vaccination do not

Linguistics, Language, and the Professions: Education, Journalism, Law, Medicine, and Technology. Georgetown University Round Table on Languages and Linguistics (Washington, DC, May 4-6, 2000).

ERIC Educational Resources Information Center

Alatis, James E., Ed.; Hamilton, Heidi E., Ed.; Tan, Ai-Hui, Ed.

This volume contains the published version of selected papers from the 2000 Georgetown University Round Table on Languages and Linguistics (GURT). Plenary speeches include the following: "The Talk of Learning Professional Work" (Shirley Brice Heath); "Linguistics, Education, and the Ebonics Firestorm" (John R. Rickford);…

Age and growth of round gobies in Lake Huron: Implications for food web dynamics

USGS Publications Warehouse

Duan, You J.; Madenjian, Charles P.; Xie, Cong X.; Diana, James S.; O'Brien, Timothy P.; Zhao, Ying M.; He, Ji X.; Farha, Steve A.; Huo, Bin

2016-01-01

Although the round goby (Neogobius melanostomus) has become established throughout the Laurentian Great Lakes, information is scarce on spatial variation in round goby growth between and within lakes. Based on a sample of 754 specimens captured in 2014, age, growth, and mortality of round gobies at four locations in Lake Huron were assessed via otolith analysis. Total length (TL) of round gobies ranged from 44 to 111 mm for Saginaw Bay, from 45 to 115 mm for Rockport, from 50 to 123 mm for Hammond Bay, and from 51 to 118 mm for Thunder Bay. Estimated ages of round gobies ranged from 2 to 5 years for Saginaw Bay, from 2 to 6 years for Rockport, and from 2 to 7 years for Hammond Bay and Thunder Bay. Sex-specific, body–otolith relationships were used to back-calculate total lengths at age, which were then fitted to von Bertalanffy growth models. For each sex, round goby growth showed significant spatial variation among the four locations within Lake Huron. At all four locations in Lake Huron, males grew significantly faster than females and attained a larger asymptotic length than females. Annual mortality rate estimates were high (62 to 85%), based on catch-curve analysis, suggesting that round gobies may be under predatory control in Lake Huron.

Patient-Centered Collaborative Care: The Impact of a New Approach to Postpartum Rounds on Residents' Perception of Their Work Environment

PubMed Central

Baldwin, Maureen; Hashima, Jason; Guise, Jeanne-Marie; Gregory, William Thomas; Edelman, Alison; Segel, Sally

2010-01-01

Objective At our institution, traditional postpartum rounds consisted of separate visits from all members of the obstetric team. This led to patient care inefficiencies and miscommunication. In an effort to improve patient care, patient-centered collaborative care (PCCC) was established, whereby physicians, residents, medical students, nurses, case managers, and social workers conduct rounds as a team. The goal of this observational study was to evaluate how PCCC rounds affected resident physicians' assessment of their work environment. Methods Obstetrics and gynecology residents completed a 13-question written survey designed to assess their sense of workflow, education, and workplace cohesion. Surveys were completed before and 6 months after the implementation of PCCC. Responses were compared in aggregate for preintervention and postintervention with Pearson χ2 test. Results Ninety-two percent of the obstetrics residents (n  =  23) completed the preintervention survey, and 79% (n  =  19) completed the postintervention survey. For most measures, there was no difference in resident perception between the 2 time points. After implementation of PCCC rounds, fewer residents felt that rounds were educational (preintervention  =  39%, postintervention  =  7%; P  =  .03). Conclusion Residents did not report negative impacts on workflow, cohesion, or general well-being after the implementation of PCCC rounds. However, there was a perception that PCCC rounds negatively impacted the educational value of postpartum rounds. This information will help identify ways to improve the resident physician experience in the obstetric service while optimizing patient care. PMID:21975886

FACS selection of valuable mutant mouse round spermatids and strain rescue via round spermatid injection.

PubMed

Zhu, Lian; Zhou, Wei; Kong, Peng-Cheng; Wang, Mei-Shan; Zhu, Yan; Feng, Li-Xin; Chen, Xue-Jin; Jiang, Man-Xi

2015-06-01

Round spermatid injection (ROSI) into mammalian oocytes can result in the development of viable embryos and offspring. One current limitation to this technique is the identification of suitable round spermatids. In the current paper, round spermatids were selected from testicular cells with phase contrast microscopy (PCM) and fluorescence-activated cell sorting (FACS), and ROSI was performed in two strains of mice. The rates of fertilization, embryonic development and offspring achieved were the same in all strains. Significantly, round spermatids selected by PCM and FACS were effectively used to rescue the infertile Pten-null mouse. The current results indicate that FACS selection of round spermatids can not only provide high-purity and viable round spermatids for use in ROSI, but also has no harmful effects on the developmental capacity of subsequently fertilized embryos. It was concluded that round spermatids selected by FACS are useful for mouse strain rederivation and rescue of infertile males; ROSI should be considered as a powerful addition to the armamentarium of assisted reproduction techniques applicable in the mouse.

Fast round-trip Mars trajectories

NASA Technical Reports Server (NTRS)

Wilson, Sam

1990-01-01

This paper is concerned with the effect of limiting the overall duration or else the one-way flight time of a round trip to Mars, as reflected in the sum of impulsive velocity increments required of the spacecraft propulsion system. Ignition-to-burnout mass ratios for a hypothetical single stage spacecraft, obtained from the rocket equation by combining these delta-V sums with appropriate values of specific impulse, are used to evaluate the relative effectiveness of four high-thrust propulsion alternatives. If the flight crew goes to the surface of Mars and stays there for the duration of their stopover, it is much cheaper (in terms of delta-V) to minimize their zero-g exposure by limiting the interplanetary transit time of a conjunction-class mission (round trip time = 800-1000 days, Mars stopover = 450-700 days) than to impose the same limit on an opposition-class mission (round trip time less than 600 days, stopover = 40 days). Using solid-core nuclear thermal propulsion to fly a conjunction-class mission, for a moderate mass penalty the interplanetary transit time (each way) probably could be limited to something in the range of 4 to 6 months, depending on the launch year.

Why Are So Many Things in the Solar System Round?

ERIC Educational Resources Information Center

Heilig, Steven J.

2010-01-01

Several years ago a student asked why so many things in the solar system were round. He noted that many objects in the solar system, although not all, are round. The standard answer, which he knew, is that the mutual gravitational attraction of the molecules pulls them into the shape that gets them as close to each other as possible: a sphere.…

Applying Alternative Teaching Methods to Impart a Rounded, Liberal Arts and Sciences (LAS) Education: Students' Reflections on the Role of Magazines as Instructional Tools

ERIC Educational Resources Information Center

Sithole, Alec; Kibirige, Joachim; Mupinga, Davison M.; Chiyaka, Edward T.

2016-01-01

In a constantly and rapidly changing social world, students from all disciplines ought to attain a rounded education within the tradition of a "Liberal Arts and Sciences" (LAS) context. Students outside of the natural sciences must be encouraged to appreciate the place of those sciences in their lives. Conversely, students in the natural…

Geographical and temporal variation in environmental conditions affects nestling growth but not immune function in a year-round breeding equatorial lark.

PubMed

Ndithia, Henry K; Bakari, Samuel N; Matson, Kevin D; Muchai, Muchane; Tieleman, B Irene

2017-01-01

Variation in growth and immune function within and among populations is often associated with specific environmental conditions. We compared growth and immune function in nestlings of year-round breeding equatorial Red - capped Lark Calandrella cinerea from South Kinangop, North Kinangop and Kedong (Kenya), three locations that are geographically close but climatically distinct. In addition, we studied growth and immune function of lark nestlings as a function of year - round variation in breeding intensity and rain within one location. We monitored mass, wing, and tarsus at hatching (day 1) and at 4, 7, and 10 days post - hatch, and we quantified four indices of immune function (haptoglobin, agglutination, lysis and nitric oxide) using blood samples collected on day 10. Nestling body mass and size at hatching, which presumably reflect the resources that females allocated to their eggs, were lowest in the most arid location, Kedong. Contrary to our predictions, nestlings in Kedong grew faster than nestlings in the two other cooler and wetter locations of South and North Kinangop. During periods of peak reproduction within Kedong, nestlings were heavier at hatching, but they did not grow faster over the first 10 days post - hatch. In contrast, rainfall, which did not relate to timing of breeding, had no effect on hatching mass, but more rain did coincide with faster growth post - hatch. Finally, we found no significant differences in nestling immune function, neither among locations nor with the year - round variation within Kedong. Based on these results, we hypothesize that female body condition determines nestling mass and size at hatching, but other independent environmental conditions subsequently shape nestling growth. Overall, our results suggest that environmental conditions related to food availability for nestlings are relatively unimportant to the timing of breeding in equatorial regions, while these same conditions do have consequences for nestling

Round Cell Tumors: Classification and Immunohistochemistry.

PubMed

Sharma, Shweta; Kamala, R; Nair, Divya; Ragavendra, T Raju; Mhatre, Swapnil; Sabharwal, Robin; Choudhury, Basanta Kumar; Rana, Vivek

2017-01-01

Round cell tumors as the name suggest are comprised round cells with increased nuclear-cytoplasmic ratio. This group of tumor includes entities such as peripheral neuroectodermal tumor, rhabdomyosarcoma, synovial sarcoma, non-Hodgkin's lymphoma, neuroblastoma, hepatoblastoma, Wilms' tumor, and desmoplastic small round cell tumor. These round cells tumors are characterized by typical histological pattern, immunohistochemical, and electron microscopic features that can help in differential diagnosis. The present article describes the classification and explains the histopathology and immunohistochemistry of some important round cell tumors.

Age and growth of round gobies in Lake Michigan, with preliminary mortality estimation

USGS Publications Warehouse

Huo, Bin; Madenjian, Charles P.; Xie, Cong X.; Zhao, Yingming; O'Brien, Timothy P.; Czesny, Sergiusz J.

2015-01-01

The round goby (Neogobius melanostomus) is a prevalent invasive species throughout Lake Michigan, as well as other Laurentian Great Lakes, yet little information is available on spatial variation in round goby growth within one body of water. Age and growth of round goby at three areas of Lake Michigan were studied by otolith analysis from a sample of 659 specimens collected from 2008 to 2012. Total length (TL) ranged from 48 to 131 mm for Sturgeon Bay, from 50 to 125 mm for Waukegan, and from 54 to 129 mm for Sleeping Bear Dunes. Ages ranged from 2 to 7 years for Sturgeon Bay, from 2 to 5 years for Waukegan, and from 2 to 6 years for Sleeping Bear Dunes. Area-specific and sex-specific body–otolith relationships were used to back-calculate estimates of total length at age, which were fitted to von Bertalanffy models to estimate growth rates. For both sexes, round gobies at Sleeping Bear Dunes and Waukegan grew significantly faster than those at Sturgeon Bay. However, round goby growth did not significantly differ between Sleeping Bear Dunes and Waukegan for either sex. At all three areas of Lake Michigan, males grew significantly faster than females. Based on catch curve analysis, estimates of annual mortality rates ranged from 0.79 to 0.84. These relatively high mortality rates suggested that round gobies may be under predatory control in Lake Michigan.

9+ The Year-Round School.

ERIC Educational Resources Information Center

American Association of School Administrators, Washington, DC.

The 9-month school year with a 3-month summer vacation had its origin in our earlier agrarian life. Today's teacher shortages, overcrowded schools, and pressures to learn demand extensions of the school year. This publication analyzes five programs: (1) a staggered-vacation school year for all, (2) a full 48-week school year for all, (3) a…

Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study.

PubMed

Kimbrough, Tiffany N; Heh, Victor; Wijesooriya, N Romesh; Ryan, Michael S

2016-01-01

Objective To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. Methods A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from 'traditional' rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Results Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=-0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56-0.77) for all years. Conclusions Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.

Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study.

PubMed

Kimbrough, Tiffany N; Heh, Victor; Wijesooriya, N Romesh; Ryan, Michael S

2016-01-01

To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from 'traditional' rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=-0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56-0.77) for all years. Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.

Ward rounds, participants, roles and perceptions: literature review.

PubMed

Walton, Victoria; Hogden, Anne; Johnson, Julie; Greenfield, David

2016-05-09

Purpose - The purpose of this paper is to classify and describe the purpose of ward rounds, who attends each round and their role, and participants' perception of each other's role during the respective ward rounds. Design/methodology/approach - A literature review of face-to-face ward rounds in medical wards was conducted. Peer reviewed journals and government publications published between 2000 and 2014 were searched. Articles were classified according to the type of round described in the study. Purposes were identified using keywords in the description of why the round was carried out. Descriptions of tasks and interactions with team members defined participant roles. Findings - Eight round classifications were identified. The most common were the generalised ward; multidisciplinary; and consultant rounds. Multidisciplinary rounds were the most collaborative round. Medical officers were the most likely discipline to attend any round. There was limited reference to allied health clinicians and patient involvement on rounds. Perceptions attendees held of each other reiterated the need to continue to investigate teamwork. Practical implications - A collaborative approach to care planning can occur by ensuring clinicians and patients are aware of different ward round processes and their role in them. Originality/value - Analysis fulfils a gap in the literature by identifying and analysing the different ward rounds being undertaken in acute medical wards. It identifies the complexities in the long established routine hospital processes of the ward round.

A rare case of recurrent ovarian cancer presenting as a round ligament metastasis.

PubMed

Togami, Shinichi; Kato, Tomoyasu; Oi, Takateru; Ishikawa, Mitsuya; Onda, Takashi; Ikeda, Shun-ichi; Kasamatsu, Takahiro

2011-11-07

We report a rare case of recurrent ovarian cancer presenting as a round ligament metastasis. A 44-year-old woman presented with a lower abdominal mass. Computed tomography showed a pelvic mass. Primary surgery was performed. A histopathological examination showed an ovarian serous adenocarcinoma of Stage IIIb. The patient received 6 cycles of paclitaxel and carboplatin. Almost 2 years after the initial operation, the patient noticed a left inguinal mass. Computed tomography showed a left inguinal mass, 18 mm in size. An excisional biopsy was performed and the tumor was found to originate in the left round ligament. A histopathological examination showed serous adenocarcinoma and there was no evidence of lymph node tissue. Recurrence of ovarian cancer in the round ligament is extremely rare. This unique case suggests, however, that the round ligament in rare cases may be a recurrence site for ovarian cancer, and that accurate differentiation including confirmation by diagnostic imaging and excisional biopsy, is necessary for a definitive pathological diagnosis.

Measuring ward round quality in urology.

PubMed

Darbyshire, Daniel; Barrett, Charlotte; Ross, David; Shackley, David

2015-01-01

Ward rounds are the traditional process by which clinical information is interpreted and management plans made in the inpatient setting and the only time during which patient-doctor interaction can reliably occur. Efforts to improve quality and safety have started looking at the ward round but this has mainly been in the acute medical setting. To begin the quality improvement process for Urological ward rounds. Twenty indicators thought to relate to quality were recorded for every weekday ward round by the Urology team for one month. Twenty ward rounds, 93 patient encounters, were reviewed. A consultant was present for 37% of the patient encounters. 84% of observation charts were reviewed; drug charts 28% and antibiotics 70%. Plans were communicated to the doctors, patient and nursing staff. All notes were typed directly onto the electronic system, 20% of notes were checked by the lead clinician. Mean time per patient was 6 minutes. By starting a discussion about ward rounds we aim to align the process with the broader values of the organisation. Ward rounds can be the cornerstone of delivering safe, clean and personal care and measuring this process is vital to understanding efforts to improve them.

Distribution and risk assessment of trace metals in sediments from Yangtze River estuary and Hangzhou Bay, China.

PubMed

Li, Feipeng; Mao, Lingchen; Jia, Yubao; Gu, Zhujun; Shi, Weiling; Chen, Ling; Ye, Hua

2018-01-01

The Yangtze River estuary (YRE) and Hangzhou Bay (HZB) is of environmental significance because of the negative impact from industrial activities and rapid development of aquaculture on the south bank of HZB (SHZB) in recent years. This study investigated the distribution and risk assessments of trace metals (Cr, Cu, Zn, Hg, Pb, and Cd) accumulated in surface sediments by sampling in YRE, outer and south HZB. Copper and Zn concentration (avg. 35.4 and 98.7 mg kg -1 , respectively) in surface sediments were generally higher than the background suggesting a widespread of Cu and Zn in the coastal area of Yangtze River Delta. High concentrations of Cu (~ 42 mg kg -1 ), Zn (~ 111 mg kg -1 ), Cd (~ 0.27 mg kg -1 ), and Hg (~ 0.047 mg kg -1 ) were found in inner estuary of YRE and decreased offshore as a result of terrestrial input and dilution effect of total metal contents by "cleaner" sediments from the adjacent sea. In outer HZB, accumulation of terrestrial derived metal has taken place near the Zhoushan Islands. Increase in sediment metal concentration from the west (inner) to the east (outer) of SHZB gave rise to the input of fine-grained sediments contaminated with metals from outer bay. According the results from geoaccumulation index, nearly 75% of samples from YRE were moderately polluted (1.0 < I geo  < 2.0) by Cd. Cadmium and Hg contributed for 80~90% to the potential ecological risk index in the YRE and HZB, with ~ 72% sites in HZB under moderate risk (150 ≤ RI < 300) especially near Zhoushan Islands.

Returning Fourth-Year Students to the Classroom/Laboratory.

ERIC Educational Resources Information Center

Markert, Ronald J.; Ogilvie, Charles D.

1980-01-01

The Eighth Semester Program of the Texas College of Osteopathic Medicine reintroduces classroom-laboratory activities into the medical students' clinical years in an attempt to "round out" students' education. Topics include development of a medical practice, government and the physician, counseling skills, and nutrition inpatient care.…

A Proposal to the President to Establish a Year-Round Operation and an Annual Assignment System for Omega College, Beginning Summer 1974.

ERIC Educational Resources Information Center

Reda, Mario R.

The purpose of this paper is the presentation of a proposal for a year-round operation and an annual assignment system (YRO/AAS) to the administrative officers of the College of DuPage, Glen Ellyn, Illinois. The proposal is comprised of four chapters. The first chapter deals with the significance of the study in terms of the College of DuPage's…

Performance and economic analyses of year-round forage systems for forage-fed beef production in the Gulf Coast.

PubMed

Scaglia, G; Rodriguez, J; Gillespie, J; Bhandari, B; Wang, J J; McMillin, K W

2014-12-01

On a global scale, most beef is produced from grazing pastures or rangelands. Certain limitations exist, however, such as not having adequate animal rates of gain for marbling and availability of adequate forage nutritional value and quantity for constant animal weight gains. In the last 20 yr, there has been an increased interest in forage-fed beef for multiple reasons (health related, environmental concerns, and welfare issues). Starting on June 5, 13, 14, and 8 in 4 consecutive yr, 54 steers (initial BW=259±5.6 kg; average of 9 mo of age) were randomly allotted to 3 yr-round forage systems. Each system occupied 6 ha/replicate and had the same stocking rate. System 1 had annual ryegrass (Lolium multiflorum) for winter grazing and bermudagrass (Cynodon dactylon) for summer grazing; while Systems 2 and 3 added rye and a clover mix to the ryegrass and diversified the use of pastures in the fall (dallisgrass [Paspalum dilatatum] and clovers [Trifolium spp.]). System 3 added the use of annual summer forages. During their respective growing season for each forage or forage mix, mass and height did not limit animal performance; however, there was a sampling date effect (P<0.05) for nutritive value variables since it decreased as forages became mature. The ADG observed (0.44 kg) for all systems (P=0.78) during summer was lower than expected and might have been limited by the observed temperature as well as forage nutritive value. Systems 1 and 2 had more grazing days (P=0.03) during summer (155 and 146 d, respectively) compared to System 3 (132 d) due to the greater pasture area of bermudagrass in those systems. Steers in System 3 were fed more hay for a longer period of time (P<0.05) than on the other 2 systems. System 1 and 2 produced more hay per hectare than System 3 (P<0.05). No differences (P>0.05) were detected between systems in ADG year round, during the winter season, or carcass characteristics. Return over total direct costs and total specified expenses were

Differences by Ending Rounds and Other Rounds in Time-Motion Analysis of Mixed Martial Arts: Implications for Assessment and Training.

PubMed

Miarka, Bianca; Brito, Ciro J; Moreira, Danilo G; Amtmann, John

2018-02-01

Miarka, B, Brito, CJ, Moreira, DG, and Amtmann, J. Differences by ending rounds and other rounds in time-motion analysis of mixed martial arts: implications for assessment and training. J Strength Cond Res 32(2): 534-544, 2018-This study aimed to support training program development through the comparison of performance analysis of professionals mixed martial art (MMA) athletes in the bouts that were not finished by points. Using digital recordings of each bout, we analyzed 1,564 rounds (678 bouts) which were separated by ending and other rounds. Our results indicated that knockout/technical knockout is the main outcome that defines the ending round (≈60%); however, there is a higher frequency of ending by submission on the first and second rounds (>30%). Bouts ending during the first or second rounds had shorter total time and standing combat with low intensity than ending in the third round (91.5 ± 71.4, 93.4 ± 67.5, and 143.2 ± 87.4; for low intensity in the first, second, and third rounds, respectively; p ≤ 0.05), whereas standing combat time with high intensity was longer in the last round in comparison to bouts that finished in the first or second rounds (7.4 ± 9.2, 9.7 ± 18.0, and 17.7 ± 29.1 for high intensity in the first, second, and third rounds, respectively; p ≤ 0.05). The lower time dedicated to low-intensity stand-up combat actions, regardless of round, and forcefulness of the actions in groundwork in the first and second rounds seem to be elements that increase the probability of success in professional MMA bouts; these factors have essential implications related to training program design.

The Role of READ (Rural Education and Development) Foundation in Quality Education of Pakistan

ERIC Educational Resources Information Center

Farooq, Muhammad Sabil; Kai, Yuan Tong

2016-01-01

Education means all round development, this all round development means intellectual, social and emotional development. It is only education that can mould the behavior of an individual. READ (Rural Education and Development) Foundation is not-for-profit organization established in 1994 to address the dire need for education and literacy in…

Evaluation of Educational Programs for Young Children: The Minnesota Round Table on Early Childhood Education II.

ERIC Educational Resources Information Center

Weinberg, Richard A., Ed.; Moore, Shirley G., Ed.

This is a collection of papers based on presentations made by participants in the Minnesota Round Table II sponsored by the University of Minnesota and the Child Development Associate Consortium in 1974. Included are an introduction to the conference (Richard A. Weinberg and Shirley G. Moore) and the following articles: (1) Planning Evaluation…

Implementing iRound: A Computer-Based Auditing Tool.

PubMed

Brady, Darcie

Many hospitals use rounding or auditing as a tool to help identify gaps and needs in quality and process performance. Some hospitals are also using rounding to help improve patient experience. It is known that purposeful rounding helps improve Hospital Consumer Assessment of Healthcare Providers and Systems scores by helping manage patient expectations, provide service recovery, and recognize quality caregivers. Rounding works when a standard method is used across the facility, where data are comparable and trustworthy. This facility had a pen-and-paper process in place that made data reporting difficult, created a silo culture between departments, and most audits and rounds were completed differently on each unit. It was recognized that this facility needed to standardize the rounding and auditing process. The tool created by the Advisory Board called iRound was chosen as the tool this facility would use for patient experience rounds as well as process and quality rounding. The success of the iRound tool in this facility depended on several factors that started many months before implementation to current everyday usage.

Shaped versus Round Implants in Breast Reconstruction: A Multi-Institutional Comparison of Surgical and Patient-Reported Outcomes.

PubMed

Khavanin, Nima; Clemens, Mark W; Pusic, Andrea L; Fine, Neil A; Hamill, Jennifer B; Kim, H Myra; Qi, Ji; Wilkins, Edwin G; Kim, John Y S

2017-05-01

Since the 2012 approval of shaped implants, their use in breast reconstruction has increased in the United States. However, large-scale comparisons of complications and patient-reported outcomes are lacking. The authors endeavored to compare surgical and patient-reported outcomes across implant types. The Mastectomy Reconstruction Outcomes Consortium database was queried for expander/implant reconstructions with at least 1-year postexchange follow-up (mean, 18.5 months). Outcomes of interest included postoperative complications, 1-year revisions, and patient-reported outcomes. Bivariate and mixed-effects regression analyses evaluated the effect of implant type on patient outcomes. Overall, 822 patients (73.5 percent) received round and 297 patients (26.5 percent) received shaped implants. Patients undergoing unilateral reconstructions with round implants underwent more contralateral symmetry procedures, including augmentations (round, 18.7 percent; shaped, 6.8 percent; p = 0.003) and reductions (round, 32.2 percent; shaped, 20.5 percent; p = 0.019). Shaped implants were associated with higher rates of infection (shaped, 6.1 percent; round, 2.3 percent; p = 0.002), that remained significant after multivariable adjustment. Other complication rates did not differ significantly between cohorts. Round and shaped implants experienced similar 2-year patient-reported outcome scores. This prospective, multicenter study is the largest evaluating outcomes of shaped versus round implants in breast reconstruction. Although recipients of round implants demonstrated lower infection rates compared with shaped implants, these patients were more likely to undergo contralateral symmetry procedures. Both implant types yielded comparable patient-reported outcome scores. With appropriate patient selection, both shaped and round implants can provide acceptable outcomes in breast reconstruction. Therapeutic, III.

Desmoplastic small round cell tumor of the lung.

PubMed

Muramatsu, Takashi; Shimamura, Mie; Furuichi, Motohiko; Nishii, Tatsuhiko; Takeshita, Shinji; Shiono, Motomi

2010-12-01

We report a rare case of desmoplastic small round cell tumor, which arose from the left lung. A 25-year-old man was found to have an abnormal shadow during a routine physical examination and was admitted to our hospital. A thoracoscopic tumor biopsy was performed under general anesthesia. According to the histopathologic findings of permanent sections, the tumor was composed of sharply outlined nests, clusters, and trabeculae of small round to oval cells separated by a spindle-shaped desmoplastic stroma. A gene analysis revealed chimera genes of Ewing's sarcoma and Wilms' tumor by reverse transcription polymerase chain reaction. Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Pollution levels and risks of polycyclic aromatic hydrocarbons in surface sediments from two typical estuaries in China.

PubMed

Wang, Chenglong; Zou, Xinqing; Li, Yali; Zhao, Yifei; Song, Qiaochu; Yu, Wenwen

2017-01-30

To assess the environmental risks of polycyclic aromatic hydrocarbons (PAHs), 48 and 45 sediments were collected from the Yangtze River Estuary (YRE) and Pearl River Estuary (PRE), respectively. The toxicity equivalency concentration (TEQ) in the YRE and PRE were ranged from 1.68 to 76.13 and 9.28 to 129.24ngTEQg -1 , respectively. Results of risk quotient suggest that ecological risks of two estuaries are at a moderate level, but are higher in the PRE than YRE. The increment lifetime cancer risks (ILCR) from the YRE via ingestion and dermal contact were 1×10 -6 to 5.6×10 -5 and 4×10 -6 to 1.6×10 -4 , and ranged from 7×10 -6 to 9.4×10 -5 and 2×10 -5 to 2.8×10 -4 in the PRE. ILCR results suggest that some low and moderate cancer risk exists in the YRE and PRE. Therefore, monitoring and control measures should be carried out immediately to reduce or eliminate the risks to human health from environmental exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.

Investigating the prevention of hospital-acquired infection through standardized teaching ward rounds in clinical nursing.

PubMed

Zhang, R

2015-04-22

This study aimed to explore the effect of standardized teaching ward rounds in clinical nursing on preventing hospital-acquired infection. The experimental group comprised 120 nursing students from our hospital selected between June 2010 and June 2012. The control group consisted of 120 nursing students selected from May 2008 to May 2010. Traditional teaching ward rounds for nursing education were carried out with the control group, while a standardized teaching ward round was carried out with the experimental group. The comprehensive application of nursing abilities and skills, the mastering of situational infection knowledge, and patient satisfaction were compared between the two groups. The applied knowledge of nursing procedures and the pass rate on comprehensive skill tests were significantly higher in the experimental group than in the control group (P < 0.05). The rate of mastery of sterilization and hygiene procedures was also higher in the experimental group than in the control group (P < 0.05). The patient satisfaction rate with infection control procedures in the experimental group time period was 98.09%, which was significantly higher than patient satisfaction in the control group time period (93.05%, P < 0.05). Standardized teaching ward rounds for nursing education expanded the knowledge of the nursing staff in controlling hospital-acquired infection and enhanced the ability of comprehensive application and awareness of infection control procedures.

Adherence to colorectal cancer screening: four rounds of faecal immunochemical test-based screening.

PubMed

van der Vlugt, Manon; Grobbee, Esmée J; Bossuyt, Patrick Mm; Bongers, Evelien; Spijker, Wolfert; Kuipers, Ernst J; Lansdorp-Vogelaar, Iris; Essink-Bot, Marie-Louise; Spaander, Manon C W; Dekker, Evelien

2017-01-03

The effectiveness of faecal immunochemical test (FIT)-based screening programs is highly dependent on consistent participation over multiple rounds. We evaluated adherence to FIT screening over four rounds and aimed to identify determinants of participation behaviour. A total of 23 339 randomly selected asymptomatic persons aged 50-74 years were invited for biennial FIT-based colorectal cancer screening between 2006 and 2014. All were invited for every consecutive round, except for those who had moved out of the area, passed the upper age limit, or had tested positive in a previous screening round. A reminder letter was sent to non-responders. We calculated participation rates per round, response rates to a reminder letter, and differences in participation between subgroups defined by age, sex, and socioeconomic status (SES). Over the four rounds, participation rates increased significantly, from 60% (95% CI 60-61), 60% (95% CI 59-60), 62% (95% CI 61-63) to 63% (95% CI 62-64; P for trend<0.001) with significantly higher participation rates in women in all rounds (P<0.001). Of the 17 312 invitees eligible for at least two rounds of FIT screening, 12 455 (72%) participated at least once, whereas 4857 (28%) never participated; 8271 (48%) attended all rounds when eligible. Consistent participation was associated with older age, female sex, and higher SES. Offering a reminder letter after the initial invite in the first round increased uptake with 12%; in subsequent screening rounds this resulted in an additional uptake of up to 10%. In four rounds of a pilot biennial FIT-screening program, we observed a consistently high and increasing participation rate, whereas sending reminders remain effective. The substantial proportion of inconsistent participants suggests the existence of incidental barriers to participation, which, if possible, should be identified and removed.

[Intra-abdominal desmoplastic small round cell tumour].

PubMed

Briseño-Hernández, Andrés Alejandro; Quezada-López, Deissy Roxana; Corona-Cobián, Lilia Edith; Castañeda-Chávez, Agar; Duarte-Ojeda, Alfonso Tonatiuh; Macías-Amezcua, Michel Dassaejv

2015-01-01

The desmoplastic small round cell tumour is a rare and aggressive intra-abdominal neoplasia, with only 200 cases reported, and a higher incidence in men and predilection for the second decade of life. Histologically characterized by the presence of small nests of undifferentiated tumour cells, wrapped in fibrous desmoplastic stroma. A 24 year old male started with abdominal pain of 4 weeks onset in the right upper quadrant, colic type, sporadic, self-limiting and accompanied by early satiety, decreased appetite, and involuntary weight loss of 10 kg in 3 months. At the time of admission the abdomen was globular, with decreased peristalsis, soft, depressible. Computed tomography of the abdomen showed multiple enlarged lymph nodes in the abdominal-pelvic cavity. A laparotomy was performed, with a subsequent omentum resection due to the presence of multiple tumours, which microscopically were characterised by groups of small, round, blue cells, separated by a desmoplastic stroma. The immunohistochemistry was positive for desmin (> 75%), epithelial membrane antigen (> 75%), CD99 (> 50%), and S100 (25%), concluding with an abdominal tumour of small, round, blue cells as a diagnosis. Chemotherapy treatment was initiated based on IMAP plus GM-CSF. The desmoplastic small round cell tumour is a rare neoplasia, with diagnostic complexity and a lethal course. Its clinical presentation is unspecific. Histologically, it is classified as an aggressive soft tissue sarcoma that shares similar characteristics with the family of the small and blue cells tumours. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Mechanical grading of round timber beams

Treesearch

David W. Green; Thomas M. Gorman; James W. Evans; Joseph F. Murphy

2006-01-01

Current procedures used to sort round timber beams into structural grades rely on visual grading methods and property assignments based on modification of clear wood properties. This study provides the technical basis for mechanical grading of 228 mm (9 in.) diameter round timbers. Test results on 225 round Engelmann spruce–alpine fir–lodgepole pine beams demonstrate...

Clinical physiology grand rounds.

PubMed

Richards, Jeremy; Schwartzstein, Richard; Irish, Julie; Almeida, Jacqueline; Roberts, David

2013-04-01

Clinical Physiology Grand Rounds (CPGR) is an interactive, case-based conference for medical students designed to: (1) integrate preclinical and clinical learning; (2) promote inductive clinical reasoning; and (3) emphasise students as peer teachers. CPGR specifically encourages mixed learning level student interactions and emphasises the use of concept mapping. We describe the theoretical basis and logistical considerations for an interactive, integrative, mixed-learner environment such as CPGR. In addition, we report qualitative data regarding students' attitudes towards and perceptions of CPGR. Medical students from first to fourth year participate in a monthly, interactive conference. The CPGR was designed to bridge gaps and reinforce linkages between basic science and clinical concepts, and to incorporate interactive vertical integration between preclinical and clinical students. Medical education and content experts use Socratic, interactive teaching methods to develop real-time concept maps to emphasise the presence and importance of linkages across curricula. Student focus groups were held to assess attitudes towards and perceptions of the mixed-learner environment and concept maps in CPGR. Qualitative analyses of focus group transcripts were performed to develop themes and codes describing the students' impressions of CPGR. CPGR is a case-based, interactive conference designed to help students gain an increased appreciation of linkages between basic science and clinical medicine concepts, and an increased awareness of clinical reasoning thought processes. Success is dependent upon explicit attention being given to goals for students' integrated learning. © Blackwell Publishing Ltd 2013.

Comparison of student learning in the out-patient clinic and ward round.

PubMed

Davis, M H; Dent, J A

1994-05-01

In undergraduate medical education there is a trend away from ward-based teaching towards out-patient and community-based teaching. To study the potential effects of this altered emphasis on student learning, a pilot group of final-year medical students at the University of Dundee was asked to keep individual structured log-books. These contained details of patients seen during their 3-week orthopaedic attachment in both a ward and out-patient setting. A comparison of perceived learning in the two settings showed that students learned more from attending an out-patient clinic than a ward round, but did not make full use of the learning potential of either. The setting did not particularly influence the balance of learning as categorized here but only the ward round supplied experience of surgical complications. The amount of learning taking place in an out-patient clinic was influenced by student ability, measured by examination performance, but not by clinic work-load. The implications of increased use of out-patient clinics and the advantages and disadvantages of the approach employed are discussed. It is concluded that in the situation studied student learning in the outpatient setting is as good as or superior to the ward setting but should not totally replace it.

Why Are Buckyonions Round?

NASA Technical Reports Server (NTRS)

Bates, Kevin R.; Scuseria, Gustavo E.

1997-01-01

Multi-layered round carbon particles (onions) containing tens to hundreds of thousands of atoms form during electron irradiation of graphite carbon. However, theoretical models of large icosahedral fullerenes predict highly faceted shapes for molecules with more than a few hundred atoms. This discrepancy in shape may be explained by the presence of defects during the formation of carbon onions. Here, we use the semi-empirical tight-binding method for carbon to simulate the incorporation of pentagon-heptagon defects on to the surface of large icosahedral fullerenes. We show a simple mechanism that results in energetically competitive derivative structures and a global change in molecular shape from faceted to round. Our results provide a plausible explanation of the apparent discrepancy between experimental observations of round buckyonions and theoretical predictions of faceted icosahedral fullerenes.

Why are Buckyonions Round?

NASA Technical Reports Server (NTRS)

Bates, Kevin R.; Scuseria, Gustavo E.

1998-01-01

Multi-layered round carbon particles (onions) containing tens to hundreds of thousands of atoms form during electron irradiation of graphite. However. theoretical models or large icosahedral fullerenes predict highly faceted shapes for molecules with more than a few hundred atoms. This discrepancy in shape may be explained by the presence of defects during the formation of carbon onions. Here, we use the semi-empirical tight-binding method for carbon to simulate the incorporation of pentagon-heptagon defects on to the surface of large icosahedral fullerenes. We show a simple mechanism that results in energetically competitive derivative structures and a global change in molecular shape from faceted to round. Our results provide a plausible explanation of the apparent discrepancy between experimental observations or round buckyonions and theoretical predictions of faceted icosahedral fullerenes.

Perspective: a business school view of medical interprofessional rounds: transforming rounding groups into rounding teams.

PubMed

Bharwani, Aleem M; Harris, G Chad; Southwick, Frederick S

2012-12-01

An effective interprofessional medical team can efficiently coordinate health care providers to achieve the collective outcome of improving each patient's health. To determine how current teams function, four groups of business students independently observed interprofessional work rounds on four different internal medicine services in a typical academic hospital and also interviewed the participants. In all instances, caregivers had formed working groups rather than working teams. Participants consistently exhibited parallel interdependence (individuals working alone and assuming their work would be coordinated with other caregivers) rather than reciprocal interdependence (individuals working together to actively coordinate patient care), the hallmark of effective teams. With one exception, the organization was hierarchical, with the senior attending physician possessing the authority. The interns exclusively communicated with the attending physician in one-on-one conversations that excluded all other members of the team. Although nurses and pharmacists were often present, they never contributed their ideas and rarely spoke.The authors draw on these observations to form recommendations for enhancing interprofessional rounding teams. These are to include the bedside nurse, pharmacist, and case manager as team members, begin with a formal team launch that encourages active participation by all team members, use succinct communication protocols, conduct work rounds in a quiet, distraction-free environment, have teams remain together for longer durations, and receive teamwork training and periodic coaching. High-performing businesses have effectively used teams for decades to achieve their goals, and health care professionals should follow this example.

Round ligament leiomyoma: a rare manifestation of a common entity.

PubMed

Deol, Madhvi; Arleo, Elizabeth Kagan

A 68-year-old woman with a history of multifocal uterine leiomyomas presented with left groin pain and was referred for cross-sectional imaging to assess for the presence of an inguinal hernia. In this patient, MRI demonstrated a round ligament leiomyoma encased in the proximal left inguinal canal. Leiomyomas are the most common benign gynecologic tumors, however round ligament leiomyomas are very rare. The purpose of this case report is to highlight a rare manifestation of a common entity. Copyright © 2016 Elsevier Inc. All rights reserved.

Medical Student Outcomes after Family-Centered Bedside Rounds

PubMed Central

Cox, Elizabeth D.; Schumacher, Jayna B.; Young, Henry N.; Evans, Michael D.; Moreno, Megan A.; Sigrest, Ted D.

2011-01-01

Objective Family-centered bedside rounds (FCBR) are recommended to improve trainee education, patient outcomes, and family satisfaction. However, bedside teaching has waned in recent years, potentially leading to less teaching and more concern for trainees. We examined medical students’ concerns, teaching evaluations, and attitudes after experiencing FCBR during the pediatric clerkship. Methods Data are both cross-sectional and pre- and post-clerkship surveys for 113 (89%) of 127 students. Students reported frequencies of post-clerkship concerns (14 items) and teaching experiences (17 items), with five response options (1=never, 2=rarely, 3=occasionally, 4=usually, 5=always, dichotomized with “frequent” being usually or occasionally). Students reported pre- and post-clerkship attitudes for 4 items on a 7-point scale (1=strongly disagree, 7=strongly agree). Analyses included adjusted means or proportions. Results The most commonly endorsed concern was presenting information in a way that was understandable to patients and families with 34.5% of students having this concern frequently. The majority of students frequently experienced 12 of the 17 teaching items. Effective teaching of physical exam skills was the teaching item least often experienced frequently by students (20.3%). Student attitudes about the benefits of FCBR for families were significantly more positive post-clerkship (mean change 0.37 pts, p<0.001), but they remained neutral in their preference for FCBR over traditional rounds without the family present (mean change −0.14 pts, p>0.05). Conclusions Although students demonstrate positive attitudes toward FCBR and report frequent occurrence of inpatient teaching elements, findings suggest opportunities for easing student concerns and for using this venue to teach exam skills. PMID:21393084

Round-trip mission requirements for Asteroids 1976 AA and 1973 EC

NASA Technical Reports Server (NTRS)

Niehoff, J. C.

1977-01-01

The feasibility of manned or unmanned missions to two recently discovered asteroids is assessed. Characteristics of a likely target for a round-trip exploratory excursion include: a period close to one year; and an orbit that is nearly circular and nearly coplanar with the ecliptic. Mass requirements and optimal times of launch are investigated for unmanned and manned missions to Asteroids 1976 AA and 1973 EC (recently numbered 1943); 365-day round-trip trajectories in the first half of the 1990s are proposed. However, since neither of the two targets considered entirely fulfills all the necessary orbital characteristics, neither can offer the opportunity for a fast low-energy round-trip mission; nevertheless, other minor planets crossing earth's orbit may be found to meet the requirements.

Adaptation of a hospital electronic referral system for antimicrobial stewardship prospective audit and feedback rounds.

PubMed

Rawlins, Matthew D M; Raby, Edward; Sanfilippo, Frank M; Douglass, Rae; Chambers, Jonathan; McLellan, Duncan; Dyer, John R

2018-05-04

To evaluate the impact of the adaptation of an existing electronic referral application for use in antimicrobial stewardship prospective audit and feedback rounds (antimicrobial rounds). Retrospective, single-centre observational study between March 2015 and February 2016. A new quaternary referral centre. Adults referred for antimicrobial rounds outside of the intensive care and haematology units. Adaptation of an electronic referral application used by medical and allied health staff. A questionnaire-style referral form was designed to capture patient clinical details using a combination of free text and dropdown menus. Clinical pharmacists were educated and granted access to the system. The proportion of completed electronic referrals of total round reviews by month for the 12 months after implementation. The time from request to completion of reviews. The impact on adherence to advice provided on rounds. The impact on the institutional usage of broad-spectrum antibiotics: glycopeptides, carbapenems, third and fourth generation cephalosporins, fluoroquinolones and piperacillin/tazobactam. Over the study period, the proportion of electronic referrals of completed antimicrobial round reviews increased from 59% to 88% (P < 0.001); 75.7% of accepted electronic referrals were seen within 48 h of request. The proportion of advice ignored fell from 18% to 8.5% (P < 0.001). Piperacillin/tazobactam, fluoroquinolone and glycopeptide usage decreased. The adaptation of an electronic referral application for antimicrobial rounds was associated with increased adherence to advice and reduction in use in target antibiotics. Our model is now used at other institutions.

A Case of Desmoplastic Small Round Cell Tumor.

PubMed

Reisner, David; Brahee, Deborah; Patel, Shweta; Hartman, Matthew

2015-08-01

Desmoplastic small round cell tumor is a rare, aggressive tumor primarily affecting young males. It is considered a childhood cancer, and is characterized by a unique chromosomal translocation which leads to failure to suppress tumor growth. It is classified as a soft tissue sarcoma, sharing some features with other small round cell tumors such as Ewing's Sarcoma and primitive neuroectodermal tumor. Typical imaging findings include multiple heterogeneous, lobular abdominal masses, which can grow very large. Often there is a dominant mass with additional peritoneal, omental, retroperitoneal and retrovesical masses. Prognosis is relatively poor with a 3 year survival rate of 50% in those treated aggressively with surgical resection, chemotherapy, and radiation therapy. The clinical presentation, imaging characteristics and pathology are discussed in regards to a recent case.

Associations between seasonal meteorological conditions and the daily step count of adults in Yokohama, Japan: Results of year-round pedometer measurements in a large population.

PubMed

Hino, Kimihiro; Lee, Jung Su; Asami, Yasushi

2017-12-01

People's year-round interpersonal step count variations according to meteorological conditions are not fully understood, because complete year-round data from a sufficient sample of the general population are difficult to acquire. This study examined the associations between meteorological conditions and objectively measured step counts using year-round data collected from a large cohort ( N  = 24,625) in Yokohama, Japan from April 2015 to March 2016. Two-piece linear regression analysis was used to examine the associations between the monthly median daily step count and three meteorological indices (mean values of temperature, temperature-humidity index (THI), and net effective temperature (NET)). The number of steps per day peaked at temperatures between 19.4 and 20.7 °C. At lower temperatures, the increase in steps per day was between 46.4 and 52.5 steps per 1 °C increase. At temperatures higher than those at which step counts peaked, the decrease in steps per day was between 98.0 and 187.9 per 1 °C increase. Furthermore, these effects were more obvious in elderly than non-elderly persons in both sexes. A similar tendency was seen when using THI and NET instead of temperature. Among the three meteorological indices, the highest R 2 value with step counts was observed with THI in all four groups. Both high and low meteorological indices discourage people from walking and higher values of the indices adversely affect step count more than lower values, particularly among the elderly. Among the three indices assessed, THI best explains the seasonal fluctuations in step counts.

HRCT Correlation with Round Window Identification during Cochlear Implantation in Children.

PubMed

Pendem, Sai Kiran; Rangasami, Rajeswaran; Arunachalam, Ravi Kumar; Mohanarangam, Venkata Sai Pulivadulu; Natarajan, Paarthipan

2014-01-01

To determine the accuracy of High Resolution Computer Tomography (HRCT) temporal bone measurements in predicting the actual visualization of round window niche as viewed through posterior tympanotomy (i.e. facial recess). This is a prospective study of 37 cochlear implant candidates, aged between 1and 6 years, who were referred for HRCT temporal bone during the period December 2013 to July 2014. Cochlear implantation was done in 37 children (25 in the right ear and 12 in the left ear). The distance between the short process of incus and the round window niche and the distance between the oval window and the round window niche were measured preoperatively on sub-millimeter (0.7 mm) HRCT images. We classified the visibility of round window niche based on the surgical view (i.e. through posterior tympanotomy) during surgery into three types: 1) Type 1- fully visible, 2) Type 2- partially visible, and 3) Type 3- difficult to visualize. The preoperative HRCT measurements were used to predict the type of visualization of round window niche before surgery and correlated with the findings during surgery. The mean and standard deviation for the distance between the short process of incus and the round window niche and for the distance between the oval window and the round window niche for Types 1, 2, and 3 were 8.5 ± 0.2 mm and 3.2 ± 0.2 mm, 8.0 ± 0.4 mm and 3.8 ± 0.2 mm, 7.5 ± 0.2 mm and 4.4 ± 0.2 mm respectively, and showed statistically significant difference (P < 0.01) between them. The preoperative HRCT measurements had a sensitivity and specificity of 92.3% and 96.2%, respectively, in determining the actual visualization of round window niche. This study shows preoperative HRCT temporal bone measurements are useful in predicting the actual visualization of round window niche as viewed through posterior tympanotomy.

In the Round: Supporting Teachers' Authentic Professional Learning

ERIC Educational Resources Information Center

Strand, Matt

2013-01-01

This is a study of teachers' authentic professional learning at a public school in Poudre School District in northern Colorado. At Polaris Expeditionary Learning School, teachers and administrators have developed a form of school-based instructional rounds referred to herein as PLC rounds (professional learning community rounds). In PLC rounds,…

Diet shift of double-crested cormorants in eastern Lake Ontario associated with the expansion of the invasive round goby

USGS Publications Warehouse

Johnson, James H.; Ross, Robert M.; McCullough, Russell D.; Mathers, Alastair

2010-01-01

The proliferation of the invasive round goby (Apollonia melanostoma) in the Great Lakes has caused shifts in the trophic ecology in some areas. We examined the diet of double-crested cormorants (Phalacrocorax auritas) prior to, and immediately after, round goby population expansion at two colonies, Pigeon and Snake Islands, in eastern Lake Ontario from 1999 to 2007. Cormorant diet was determined from the examination of 10,167 pellets collected over the nine-year period. By the second year round gobies were found in the diet (2002 at Snake Island and 2003 at Pigeon Island) they were the main species consumed by cormorants at each colony. The dominance of round goby in cormorant diets had a significant effect on both daily fish consumption and seasonal trends in fish consumption compared to the pre-goby years. Seasonal differences that were observed during the pre-goby years were lost once gobies became the main diet component of cormorants. The rapid switch to a benthic prey such as round goby, from a largely limnetic fish diet demonstrates the adaptive foraging ability of cormorants. Round goby may act as a buffer for yellow perch and smallmouth bass, two sport fish impacted by cormorant predation in eastern Lake Ontario.

Extended School Year Programs: The Effects on Achievement and Other Phases of Student's Lives.

ERIC Educational Resources Information Center

Crim, Roger D.

Reasons for the present emphasis on all-year operation of schools differ from those prevailing 30-40 years ago. During the depression emphasis was on economy. Recently, a more sensible reason for an extended school year is coming into focus--the year-round school has educational value. It is not just something to be considered in order to save…

Ethics rounds: An appreciated form of ethics support.

PubMed

Silén, Marit; Ramklint, Mia; Hansson, Mats G; Haglund, Kristina

2016-03-01

Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection. The aim of this study was to gain a deeper understanding of how the ethics rounds were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff. An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews. A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed. The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards. The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work. A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care. By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. © The Author(s) 2014.

Collaborative Care for Children: A Grand Rounds Presentation

ERIC Educational Resources Information Center

Foley, Michele; Dunbar, Nancy; Clancy, Jeanne

2014-01-01

At the end of the 2011-2012 school year, two collaborative initiatives took place in Springfield, MA, between the public school system and Baystate Medical Center, an affiliate of Tufts University. The success of these initiatives was highlighted during grand rounds that featured academic medical center physicians and nurses as well as public…

Year-round simulated methane emissions from a permafrost ecosystem in Northeast Siberia

NASA Astrophysics Data System (ADS)

Castro-Morales, Karel; Kleinen, Thomas; Kaiser, Sonja; Zaehle, Sönke; Kittler, Fanny; Kwon, Min Jung; Beer, Christian; Göckede, Mathias

2018-05-01

Wetlands of northern high latitudes are ecosystems highly vulnerable to climate change. Some degradation effects include soil hydrologic changes due to permafrost thaw, formation of deeper active layers, and rising topsoil temperatures that accelerate the degradation of permafrost carbon and increase in CO2 and CH4 emissions. In this work we present 2 years of modeled year-round CH4 emissions into the atmosphere from a Northeast Siberian region in the Russian Far East. We use a revisited version of the process-based JSBACH-methane model that includes four CH4 transport pathways: plant-mediated transport, ebullition and molecular diffusion in the presence or absence of snow. The gas is emitted through wetlands represented by grid cell inundated areas simulated with a TOPMODEL approach. The magnitude of the summertime modeled CH4 emissions is comparable to ground-based CH4 fluxes measured with the eddy covariance technique and flux chambers in the same area of study, whereas wintertime modeled values are underestimated by 1 order of magnitude. In an annual balance, the most important mechanism for transport of methane into the atmosphere is through plants (61 %). This is followed by ebullition ( ˜ 35 %), while summertime molecular diffusion is negligible (0.02 %) compared to the diffusion through the snow during winter ( ˜ 4 %). We investigate the relationship between temporal changes in the CH4 fluxes, soil temperature, and soil moisture content. Our results highlight the heterogeneity in CH4 emissions at landscape scale and suggest that further improvements to the representation of large-scale hydrological conditions in the model will facilitate a more process-oriented land surface scheme and better simulate CH4 emissions under climate change. This is especially necessary at regional scales in Arctic ecosystems influenced by permafrost thaw.

An unusual abdominal cystic mass in the round ligament of the uterus: a case report.

PubMed

Açmaz, Gökhan; Aksoy, Hüseyin; Aksoy, Ülkü; Özyurt, Sezin; Esin, Erkan; Gökahmetoğlu, Günhan

2014-10-01

Cystic tumor of the round ligament is extremely rare. To our knowledge, this is the first case reported in the literature of a round ligament giant serous cystadenoma. A 17-year-old adolescent who presented with massive abdominal swelling and was later identified as a serous cystadenomas of the round ligament with a size of approximately 50 cm. A multidisciplinary team including gynecologist, surgeon, and urologist performed the surgical cyst excision and she has recovered well without any complications. Round ligament serous cystadenomas could grow to any size when there is a diagnosis. In addition, even in unusual locations, round ligament serous cysts should be kept in the differential diagnosis of abdominal masses. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Purposes, Diversities, and Futures in MFT Doctoral Education

ERIC Educational Resources Information Center

Woolley, Scott R.

2010-01-01

Doctoral education in marital and family therapy (MFT) plays a crucial role in the future of the field. In this article, I write about the purposes, diversities, and futures of MFT doctoral education from the perspective of having hired 18 full-time MFT faculty over the last 13 years. I argue that the field needs well-rounded doctoral-level…

16 CFR 460.11 - Rounding off R-values.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Rounding off R-values. 460.11 Section 460.11... INSULATION § 460.11 Rounding off R-values. R-values shown in labels, fact sheets, ads, or other promotional materials must be rounded to the nearest tenth. However, R-values of 10 or more may be rounded to the...

A Year-round Observation of Size Distribution of Aerosol Particles at the Cape Ochiishi, Japan

NASA Astrophysics Data System (ADS)

Miura, K.; Mukai, H.; Hashimoto, S.; Uematsu, M.

2010-12-01

New particle formation by nucleation of gas-phase compounds emitted from marine biogenic sources is very important for climate change. To clarify the mechanism of the formation, size distributions of submicron aerosols have been measured at the Cape Ochiishi, facing the North Western Pacific Ocean where primary productivity is high. A test observation was done from 22nd May to 18th June 2008 and a year-round observation has been performed from 16th October 2009 to 7th September 2010. The size distribution from 10 nm to 487 nm in diameter was measured with a scanning mobility particle sizer (SMPS, TSI 3034). Sample air was dried to lower than 40%. Transport of sulfate, organic carbon (OC), and black carbon (BC) was estimated with Chemical weather FORecasting System (CFORS), developed by Prof. Uno, Kyushu University, Japan. Existence of inversion layer was estimated with temperature profile measured at surface, 10m, 30m, and 50m in altitude. The burst of the particles smaller than 20nm in diameter continuing longer than 3 hrs was observed ten times until 3rd November 2009. Two were observed in early summer and the other was in autumn. Banana shape was faintly observed five times. Transport of sulfate, OC, and BC was observed 3, 8, 9 times, respectively. Source of air mass was estimated with these elements, weather map, and wind direction. Five air masses were estimated to continental. Clearly nucleation related to marine sources was not observed. The size distribution of burst evens of maritime and continental air mass showed the shift of mode to larger diameter. Strong inversion of temperature was observed once. The value of size distribution did not show high. Minimum value of size distribution was observed in the strong rain on 27th October. Acknowledgments This study was partly supported by the Grant-in-Aids for Scientific Research on Priority Areas from the Ministry of Education, Culture, Sports, Science and Technology, Japan (18067005). The observation was

Why Are So Many Things in the Solar System Round?

NASA Astrophysics Data System (ADS)

Heilig, Steven J.

2010-09-01

Several years ago a student asked why so many things in the solar system were round. He noted that many objects in the solar system, although not all, are round. The standard answer, which he knew, is that the mutual gravitational attraction of the molecules pulls them into the shape that gets them as close to each other as possible: a sphere. This argument works fine for fluid bodies such as the Sun or Jupiter, but it isn't so simple for a solid object-we have all seen rocks that are not round. There is still a gravitational attraction acting between the rock's molecules, butfor small rocks that force does not overcome the strength of the bonds holding those molecules in their relative positions. Since the strength of the gravitational force grows with the size of the object, a large enough rock will have a strong enough gravitational attraction to force a deformation into a round shape. But how large is that? A simple model gives an answer to this question. There is also renewed interest in this topic as a result of the new definition of a planet approved by the International Astronomical Union, which says in part, ``A `planet' is a celestial body that... has sufficient mass for its self-gravity to overcome rigid body forces so that it assumes a hydrostatic equilibrium (nearly round) shape.''1 What size object is large enough to satisfy this criterion? Where does Pluto fall regarding this question?

Investigating First Year Education Students' Stress Level

ERIC Educational Resources Information Center

Geng, Gretchen; Midford, Richard

2015-01-01

This paper investigated the stress levels of first-year education students who undertake teaching practicum and theory units during their first year of teacher education program. First, 139 first-year and 143 other years' education students completed the PSS-10 scale, which measures perceived level of stress. Then, 147 first-year education…

Anesthesiology leadership rounding: identifying opportunities for improvement.

PubMed

Gravenstein, Dietrich; Ford, Susan; Enneking, F Kayser

2012-01-01

Rounding that includes participation of individuals with authority to implement changes has been advocated as important to the transformation of an institution into a high-quality and safe organization. We describe a Department of Anesthesiology's experience with leadership rounding. The Department Chair or other senior faculty designate, a quality coordinator, up to four residents, the ward charge nurse, and patient nurses participated in rounds at bedsides. During a 23-month period, 14 significant opportunities to improve care were identified. Nurses identified 5 of these opportunities, primary team physicians 2, the rounding team 4, and patients or their family members another 3. The anesthesiology service had sole or shared responsibility for 10 improvements. A variety of organizations track specific measures across all phases of the patient experience to gauge quality of care. Chart auditing tools for detecting threats to safety are often used. These measures and tools missed opportunities for improvement that were discovered only through rounding. We conclude that the introduction of leadership rounding by an anesthesiology service can identify opportunities for improving quality that are not captured by conventional efforts.

Summary of Round Table Session and Appendixes

Treesearch

1992-01-01

The round table session was designed for interaction between the presenters and other round table participants. Twelve round tables, each capable of holding 10 participants were set up in one room. Presenters for the sessions were encouraged to lead discussions on one of many topics in these areas: a research idea that the presenter was just formulating; an unpublished...

Playground Physics: Determining the Moment of Inertia of a Merry-Go-Round

ERIC Educational Resources Information Center

Van Hook, Stephen; Lark, Adam; Hodges, Jeff; Celebrezze, Eric; Channels, Lindsey

2007-01-01

A playground can provide a valuable physics education laboratory. For example, Taylor et al. describe bringing teachers in a workshop to a playground to examine the physics of a seesaw and slide, and briefly suggest experiments involving a merry-go-round. In this paper, we describe an experiment performed by students from a Society of Physics…

Ball mounting fixture for a roundness gage

DOEpatents

Gauler, Allen L.; Pasieka, Donald F.

1983-01-01

A ball mounting fixture for a roundness gage is disclosed. The fixture includes a pair of chuck assemblies oriented substantially transversely with respect to one another and mounted on a common base. Each chuck assembly preferably includes a rotary stage and a wobble plate affixed thereto. A ball chuck affixed to each wobble plate is operable to selectively support a ball to be measured for roundness, with the wobble plate permitting the ball chuck to be tilted to center the ball on the axis of rotation of the rotary stage. In a preferred embodiment, each chuck assembly includes a vacuum chuck operable to selectively support the ball to be measured for roundness. The mounting fixture enables a series of roundness measurements to be taken with a conventional rotating gagehead roundness instrument, which measurements can be utilized to determine the sphericity of the ball.

Novel round cells in urine sediment and their clinical implications.

PubMed

Shukuya, Kenichi; Ogura, Sayoko; Tokuhara, Yasunori; Okubo, Shigeo; Yatomi, Yutaka; Tozuka, Minoru; Shimosawa, Tatsuo

2016-06-01

Voided urine contains a variety of cells from the kidney and urinary tract and urinalysis provides us various information by investigating cellular components. We investigated urine sediment from renal impaired patients. We found 'round cell' to be distinct from known cells in sediment and is close to proximal convoluted tubule-derived cells based on morphology and molecular marker expression (GGT1 but not podocalyxin). Also it was positive for undifferentiated cell markers, including PAX2, WT1, OSR1, and SIX2. They were observed in end-stage renal failure patients and the number of cells was correlated with the severity of chronic kidney disease. A prospective analysis revealed that patients who had more round cells were more likely to require hemodialysis within a year. Round cells are a novel marker that can be used to predict the need for hemodialysis. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Planetary Taxonomy: Label Round Bodies "Worlds"

NASA Astrophysics Data System (ADS)

Margot, Jean-Luc; Levison, H. F.

2009-05-01

The classification of planetary bodies is as important to Astronomy as taxonomy is to other sciences. The etymological, historical, and IAU definitions of planet rely on a dynamical criterion, but some authors prefer a geophysical criterion based on "roundness". Although the former criterion is superior when it comes to classifying newly discovered objects, the conflict need not exist if we agree to identify the subset of "round" planetary objects as "worlds". This addition to the taxonomy would conveniently recognize that "round" objects such as Earth, Europa, Titan, Triton, and Pluto share some common planetary-type processes regardless of their distance from the host star. Some of these worlds are planets, others are not. Defining how round is round and handling the inevitable transition objects are non-trivial tasks. Because images at sufficient resolution are not available for the overwhelming majority of newly discovered objects, the degree of roundness is not a directly observable property and is inherently problematic as a basis for classification. We can tolerate some uncertainty in establishing the "world" status of a newly discovered object, and still establish its planet or satellite status with existing dynamical criteria. Because orbital parameters are directly observable, and because mass can often be measured either from orbital perturbations or from the presence of companions, the dynamics provide a robust and practical planet classification scheme. It may also be possible to determine which bodies are dynamically dominant from observations of the population magnitude/size distribution.

Workplace Education Initiative: Year Two Observations.

ERIC Educational Resources Information Center

Sperazi, Laura; Astrein, Bruce

Site visits to 17 workplace education projects funded in the second year of the Massachusetts Workplace Education Initiative are reported for year 1 and year 2 projects. The year one projects are as follows: EASCO Handtool Company (Springfield), T.J. Maxx Distribution Center (Worcester), laundry workers (Boston/Lynn), AT&T (Lawrence), and…

Grand Rounds: A Method for Improving Student Learning and Client Care Continuity in a Student-Run Physical Therapy Pro Bono Clinic

ERIC Educational Resources Information Center

Black, Jill D.; Bauer, Kyle N.; Spano, Georgia E.; Voelkel, Sarah A.; Palombaro, Kerstin M.

2017-01-01

Background and Purpose: Grand Rounds is a teaching methodology that has existed in various forms in medical education for centuries. When a student-run pro bono clinic identified a growing challenge of providing continuity of care for clients and a lack of preparedness in students, they implemented a Grand Rounds model of case presentation within…

Cultural Diversity in Outdoor Education

ERIC Educational Resources Information Center

Thompson, Graham; Horvath, Erin

2007-01-01

At first glance Sioux Lookout is a typical northern Ontario town, situated within an intricate lake and river system, socially focused on year-round outdoor activities, and enveloped by kilometres and more kilometres of undomesticated Canadian Shield landscape. One might think this would be an ideal spot for outdoor education, just as these…

Understanding Key Education Issues: How We Got Here and Where We Go from Here

ERIC Educational Resources Information Center

Lynch, Matthew

2017-01-01

In this age of education innovation and reform, schools must evolve and react to current policy trends. This accessible book offers research-based insights into six key educational trends and issues that are impacting K-12 learning today: year-round schooling, assessments, educating minorities, anti-intellectualism, issues of social promotion and…

Patient-Centered Bedside Rounds and the Clinical Examination.

PubMed

Lichstein, Peter R; Atkinson, Hal H

2018-05-01

Bedside hospital rounds promote patient-centered care in teaching and nonteaching settings. Patients and families prefer bedside rounds and provider acceptance is increasing. Efficient bedside rounds with an interprofessional team or with learners requires preparation of the patient and the rounding team. Bedside "choreography" provides structure and sets expectations for time spent in the room. By using relationship-centered communication, rounds can be both patient proximate and patient centered. The clinical examination can be integrated into the flow of the presentation and case discussion. Patient and provider experience can be enhanced through investing time at the bedside. Copyright © 2018 Elsevier Inc. All rights reserved.

Ball mounting fixture for a roundness gage

DOEpatents

Gauler, A.L.; Pasieka, D.F.

1983-11-15

A ball mounting fixture for a roundness gage is disclosed. The fixture includes a pair of chuck assemblies oriented substantially transversely with respect to one another and mounted on a common base. Each chuck assembly preferably includes a rotary stage and a wobble plate affixed thereto. A ball chuck affixed to each wobble plate is operable to selectively support a ball to be measured for roundness, with the wobble plate permitting the ball chuck to be tilted to center the ball on the axis of rotation of the rotary stage. In a preferred embodiment, each chuck assembly includes a vacuum chuck operable to selectively support the ball to be measured for roundness. The mounting fixture enables a series of roundness measurements to be taken with a conventional rotating gagehead roundness instrument, which measurements can be utilized to determine the sphericity of the ball. 6 figs.

THE DISTRIBUTION OF ROUNDS FIRED IN STOCHASTIC DUELS

DTIC Science & Technology

This paper continues the development of the theory of Stochastic Duels to include the distribution of the number of rounds fired. Most generally...the duel between two contestants who fire at each other with constant kill probabilities per round is considered. The time between rounds fired may be...at the beginning of the duel may be limited and is a discrete random variable. Besides the distribution of rounds fired, its first two moments and

Primary desmoplastic small round cell tumor in the left orbit: a case report and literature review.

PubMed

He, Xue-Rui; Liu, Zheng; Wei, Jing; Li, Wan-Jun; Liu, Tao

2018-01-30

Desmoplastic small round cell tumor is a rare malignant neoplasm that most often occurs in the abdomen or pelvis of young men. We herein describe a rare case of desmoplastic small round cell tumor arising from the left orbit in a 16-year-old male. A biopsy was performed and the histology showed the nests of tumor cells with small round cell morphology. The tumor cells showed immunopositivity for desmin, CD99, CD56, SMA, NSE, CgA, SYN, Ki67 and vimentin. Fluorescence in situ hybridization study using EWSR1 break-apart probe was positive for EWSR1 gene rearrangement. After complete surgical resection of the tumor, we did not find tumor recurrence or metastasis with one-year follow-up. Furthermore, a review of the relevant English literature has been discussed. In the present study, for the first time, we report a case of desmoplastic small round cell tumor which is located in the orbital region.

Improving nurse-physician teamwork through interprofessional bedside rounding.

PubMed

Henkin, Stanislav; Chon, Tony Y; Christopherson, Marie L; Halvorsen, Andrew J; Worden, Lindsey M; Ratelle, John T

2016-01-01

Teamwork between physicians and nurses has a positive association with patient satisfaction and outcomes, but perceptions of physician-nurse teamwork are often suboptimal. To improve nurse-physician teamwork in a general medicine inpatient teaching unit by increasing face-to-face communication through interprofessional bedside rounds. From July 2013 through October 2013, physicians (attendings and residents) and nurses from four general medicine teams in a single nursing unit participated in bedside rounding, which involved the inclusion of nurses in morning rounds with the medicine teams at the patients' bedside. Based on stakeholder analysis and feedback, a checklist for key patient care issues was created and utilized during bedside rounds. To assess the effect of bedside rounding on nurse-physician teamwork, a survey of selected items from the Safety Attitudes Questionnaire (SAQ) was administered to participants before and after the implementation of bedside rounds. The number of pages to the general medicine teams was also measured as a marker of physician-nurse communication. Participation rate in bedside rounds across the four medicine teams was 58%. SAQ response rates for attendings, residents, and nurses were 36/36 (100%), 73/73 (100%), and 32/73 (44%) prior to implementation of bedside rounding and 36 attendings (100%), 72 residents (100%), and 14 (19%) nurses after the implementation of bedside rounding, respectively. Prior to bedside rounding, nurses provided lower teamwork ratings (percent agree) than residents and attendings on all SAQ items; but after the intervention, the difference remained significant only on SAQ item 2 ("In this clinical area, it is not difficult to speak up if I perceive a problem with patient care", 64% for nurses vs 79% for residents vs 94% for attendings, P=0.02). Also, resident responses improved on SAQ item 1 ("Nurse input is well received in this area", 62% vs 82%, P=0.01). Increasing face-to-face communication through

Rounded atelectasis of the lung: A pictorial review

PubMed Central

Sobocińska, Magdalena; Sobociński, Bartosz; Jarzemska, Agnieszka; Serafin, Zbigniew

2014-01-01

Summary Rounded atelectasis of the lung is well described in medical literature, but still difficult to diagnose. Since lesions give no clinical symptoms in patients, radiologists are often the first to recognize the round lesion in an X-ray picture or a CT scan. Rounded atelectasis is an atypical form of lung collapse that usually occurs adjacent to scarred pleura and can be mistaken for lung cancer. Patients with rounded atelectasis have a history of asbestos exposure or pleural effusion due to various causes. When characteristic imaging findings are present, the diagnosis is rarely dubious and no further investigation is necessary. However, differential diagnosis of rounded atelectasis poses a challenge to pulmonary specialists and radiologists. PMID:25045412

Medical academia clinical experiences of Ward Round Teaching curriculum.

PubMed

Haghani, Fariba; Arabshahi, Seyed Kamran Soltani; Bigdeli, Shoaleh; Alavi, Mousa; Omid, Athar

2014-01-01

Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members' experience on Ward Round Teaching content. This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

Medical academia clinical experiences of Ward Round Teaching curriculum

PubMed Central

Haghani, Fariba; Arabshahi, Seyed Kamran Soltani; Bigdeli, Shoaleh; Alavi, Mousa; Omid, Athar

2014-01-01

Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members’ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners. PMID:24627858

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

7 CFR 1405.7 - Uruguay Round Agreements Act.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Uruguay Round Agreements Act. 1405.7 Section 1405.7... Uruguay Round Agreements Act. In the event the outlays by the United States for domestic support measures will exceed, in any required reporting period, the allowable levels under the Uruguay Round Agreements...

Year-round behaviour of soil microarthropod communities under plant protection product application.

PubMed

Vaj, Claudia; Van Gestel, Cornelis A M; Vighi, Marco

2014-07-01

The use of plant protection products (PPPs) in agro-environments can lead to undesired exposure of non-target organisms in non-target compartments. A year-round field survey was conducted in a vineyard in Northern Italy, for monitoring the changes in the structure of soil microarthropod communities under the application of PPPs, focusing on springtails and mites, both inside and 4 and 10 m outside the vineyard. Exposure to PPPs was estimated as time-weighted average soil concentrations. The fluctuations in the abundances of the different organisms after the application of PPPs, especially insecticides, were recorded. A recovery in abundances was observed at the end of the productive season outside the field and at the beginning of the next spring within the vineyard. Using multivariate statistical tools, the behaviour of each taxon in relation to the stressors was assessed. Some organisms were affected by the stressors, while others were favoured because of low vulnerability to PPPs and the indirect effect of the absence of other taxa. The principal response curves (PRC) method was the most sensitive tool for assessing PPP effects on soil arthropod communities. Strong differences were evident in the structure of the communities inside and outside the vineyard, with the communities sampled 4 and 10 m outside the vineyard being fairly similar, the latter considered as control. The role of physical stressors on community composition is recognised. However, chemical stressors, and in particular PPP exposure seemed to have larger effects on structural and functional characteristics of soil arthropod communities than physical stressors.

Learner Autonomy as an Element in Chinese Education Reform: A Case of English Language Subject

ERIC Educational Resources Information Center

Lu, Jinjin; Liu, Yingliang

2016-01-01

Enhancing students' learning autonomy has been emphasized in the current round of English curriculum reforms by the Ministry of Education (MOE) in China. The initial aim of the new guidelines was developed to enhance students' English proficiency to better fulfil their basic education (Nine-year compulsory education). However, up until now, very…

Out of Round

NASA Image and Video Library

2011-10-26

This unnamed crater in Terra Cimmeria is not as round in shape as other craters. Major landslides have occurred on the crater rim, resulting in the final shape as seen by NASA 2001 Mars Odyssey spacecraft.

Hearing and the round goby: Understanding the auditory system of the round goby (Neogobius melanostomus)

NASA Astrophysics Data System (ADS)

Belanger, Andrea J.; Higgs, Dennis M.

2005-04-01

The round goby (Neogobius melanostomus), is an invasive species in the Great Lakes watershed. Adult round gobies show behavioral responses to conspecific vocalizations but physiological investigations have not yet been conducted to quantify their hearing abilities. We have been examining the physiological and morphological development of the auditory system in the round goby. Various frequencies (100 Hz to 800 Hz and conspecific sounds), at various intensities (120 dB to 170 dB re 1 Pa) were presented to juveniles and adults and their auditory brain-stem responses (ABR) were recorded. Round gobies only respond physiologically to tones from 100-600 Hz, with threshold varying between 145 to 155 dB re 1 Pa. The response threshold to conspecific sounds was 140 dB re 1 Pa. There was no significant difference in auditory threshold between sizes of fish for either tones or conspecific sounds. Saccular epithelia were stained using phalloidin and there was a trend towards an increase in both hair cell number and density with an increase in fish size. These results represent a first attempt to quantify auditory abilities in this invasive species. This is an important step in understanding their reproductive physiology, which could potentially aid in their population control. [Funded by NSERC.

Military Base Closures: Observations on Prior and Current BRAC Rounds

EPA Pesticide Factsheets

DOD indicates that recommendations from the previous BRAC rounds were implemented within the 6-year period mandated by law. As a result, DOD estimated that it reduced its domestic infrastructure by about 20 percent; about 90 percent of unneeded BRAC property is now available for reuse.

Auditor recommendations resulting from three clinical audit rounds in Finnish radiology units.

PubMed

Miettunen, Kirsi; Metsälä, Eija

2017-06-01

Background The purpose of clinical audits performed in radiology units is to reduce the radiation dose of patients and staff and to implement evidence-based best practices. Purpose To describe auditor recommendations in three Finnish clinical audit rounds performed in 2002-2014, and to determine if auditor recommendations have had any impact on improving medical imaging practice. Material and Methods The retrospective observational study was performed in radiology units holding a radiation safety license issued by the Finnish Radiation and Nuclear Safety Authority. The data comprised a systematic sample (n = 120) of auditor reports produced in three auditing rounds in these units during the years 2002-2014. The data were analyzed by descriptive methods and by using the Friedman two-way ANOVA test. Results The number of auditor recommendations given varied between clinical audit rounds and according to the type of imaging unit, as well as according to calculation method. Proportionally, the most recommendations in all three clinical audit rounds were given about defining and using quality assurance functions and about guidelines and practices for carrying out procedures involving radiation exposure. Demanding radiology units improved their practices more than basic imaging units towards the third round. Conclusion Auditor recommendations help to address the deficiencies in imaging practices. There is a need to develop uniform guidelines and to provide tutoring for clinical auditors in order to produce comparable clinical audit results.

PAs reduce rounding interruptions in the pediatric intensive care unit.

PubMed

Hascall, Rebecca L; Perkins, R Serene; Kmiecik, Lauren; Gupta, Priya R; Shelak, Carolyn F; Demirel, Shaban; Buchholz, Mark T

2018-06-01

We investigated the proportion of encounters that were interrupted during family-centered rounds in the pediatric intensive care unit (PICU) to determine whether the use of a physician assistant (PA) significantly affected the proportion of interrupted encounters. We evaluated 2,657 rounding encounters in our 24-bed regional referral unit. The duration of each rounding encounter and total rounding duration were recorded. The presence or absence of a PA during each rounding encounter, the occurrence of an interruption, and other potential predictors of interruptions were recorded. The presence of a PA during PICU rounds was significantly associated (P < .001) with a 35.4% lower likelihood of an interruption. Family-centered rounds in the PICU are less likely to be interrupted when a PA is present. PAs help physicians and improve rounding efficiency by safely and effectively handling certain interruptions.

Design of Round-trip Trajectories to Near-Earth Asteroids Utilizing a Lunar Flyby

NASA Technical Reports Server (NTRS)

Hernandez, Sonia; Barbee, Brent W.

2011-01-01

There are currently over 7,700 known Near-Earth Asteroids (NEAs), and more are being discovered on a continual basis. Current models predict that the actual order of magnitude of the NEA population may range from 10' to 10 6 . The close proximity of NEA orbits to Earth's orbit makes it possible to design short duration round-trip trajectories to NEAs under the proper conditions. In previous work, 59 potentially accessible NEAs were identified for missions that depart Earth between the years 2016 and 2050 and have round-trip flight times of a year or less. We now present a new method for designing round-trip trajectories to NEAs in which the Moon's gravity aids the outbound trajectory via a lunar flyby. In some cases this gravity assist can reduce the overall spacecraft propellant required for the mission, which in turn can allow NEAs to be reached which would otherwise be inaccessible to a given mission architecture. Results are presented for a specific case study on NEA 2003 LN6.

Evidence for predatory control of the invasive round goby

USGS Publications Warehouse

Madenjian, C.P.; Stapanian, M.A.; Witzel, L.D.; Einhouse, D.W.; Pothoven, S.A.; Whitford, H.L.

2011-01-01

We coupled bioenergetics modeling with bottom trawl survey results to evaluate the capacity of piscivorous fish in eastern Lake Erie to exert predatory control of the invading population of round goby Neogobius melanostomus. In the offshore (>20 m deep) waters of eastern Lake Erie, burbot Lota lota is a native top predator, feeding on a suite of prey fishes. The round goby invaded eastern Lake Erie during the late 1990s, and round goby population size increased dramatically during 1999–2004. According to annual bottom trawl survey results, round goby abundance in offshore waters peaked in 2004, but then declined during 2004–2008. Coincidentally, round goby became an important component of burbot diet beginning in 2003. Using bottom trawling and gill netting, we estimated adult burbot abundance and age structure in eastern Lake Erie during 2007. Diet composition and energy density of eastern Lake Erie burbot were also determined during 2007. This information, along with estimates of burbot growth, burbot mortality, burbot water temperature regime, and energy densities of prey fish from the literature, were incorporated into a bioenergetics model application to estimate annual consumption of round goby by the adult burbot population. Results indicated that the adult burbot population in eastern Lake Erie annually consumed 1,361 metric tons of round goby. Based on the results of bottom trawling, we estimated the biomass of yearling and older round goby in offshore waters eastern Lake Erie during 2007–2008 to be 2,232 metric tons. Thus, the adult burbot population was feeding on round goby at an annual rate equal to 61% of the estimated round goby standing stock. We concluded that the burbot population had high potential to exert predatory control on round goby in offshore waters of eastern Lake Erie.

26 CFR 49.4264(e)-1 - Round trips.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 16 2011-04-01 2011-04-01 false Round trips. 49.4264(e)-1 Section 49.4264(e)-1... TAXES FACILITIES AND SERVICES EXCISE TAXES Transportation of Persons § 49.4264(e)-1 Round trips. (a) In general. For purposes of the regulations in this subpart, a round trip shall be considered to consist of...

26 CFR 49.4264(e)-1 - Round trips.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Round trips. 49.4264(e)-1 Section 49.4264(e)-1... TAXES FACILITIES AND SERVICES EXCISE TAXES Transportation of Persons § 49.4264(e)-1 Round trips. (a) In general. For purposes of the regulations in this subpart, a round trip shall be considered to consist of...

26 CFR 49.4264(e)-1 - Round trips.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 16 2012-04-01 2012-04-01 false Round trips. 49.4264(e)-1 Section 49.4264(e)-1... TAXES FACILITIES AND SERVICES EXCISE TAXES Transportation of Persons § 49.4264(e)-1 Round trips. (a) In general. For purposes of the regulations in this subpart, a round trip shall be considered to consist of...

Creative Writing and Schiller's Aesthetic Education

ERIC Educational Resources Information Center

Howarth, Peter

2007-01-01

For academics committed to the idea of an all-round aesthetic education, one of the great successes of the last thirty years has been the tremendous expansion of creative writing classes. Despite the dramatic expansion of creative writing as an academic discipline, the methods, ideals, and values of creative writing workshops have very often been…

Roundness calibration standard

DOEpatents

Burrus, Brice M.

1984-01-01

A roundness calibration standard is provided with a first arc constituting the major portion of a circle and a second arc lying between the remainder of the circle and the chord extending between the ends of said first arc.

The West Virginia Special Education Technology Integration Specialist (SETIS) Program: 2012-2014 Evaluation Report

ERIC Educational Resources Information Center

Stohr, Amber D.

2015-01-01

The Special Education Technology Integration Specialist (SETIS) program provides professional development for special education teachers to assist them in achieving proficiency with 21st Century Technology Tools. The program completed its eighth and ninth rounds during the 2012-2013 and 2013-2014 school years, training more than 30 special…

Educational Vouchers and Social Cohesion: A Statistical Analysis of Student Civic Attitudes in Sweden, 1999-2009

ERIC Educational Resources Information Center

Shafiq, M. Najeeb; Myers, John P.

2014-01-01

This study examines the Swedish national educational voucher scheme and changes in social cohesion. We conduct a statistical analysis using data from the 1999 and 2009 rounds of the International Association for the Evaluation of Educational Achievement's civic education study of 14-year-old students and their attitudes toward the rights of ethnic…

Not Round Crater

NASA Image and Video Library

2012-08-07

Not all images are round as shown by NASA 2001 Mars Odyssey spacecraft. Here, the surface likely had fractures or preexisting tectonic features that diverted some of the impact stresses along those features and resulted in the straighter east and north

Generalised Pareto distribution: impact of rounding on parameter estimation

NASA Astrophysics Data System (ADS)

Pasarić, Z.; Cindrić, K.

2018-05-01

Problems that occur when common methods (e.g. maximum likelihood and L-moments) for fitting a generalised Pareto (GP) distribution are applied to discrete (rounded) data sets are revealed by analysing the real, dry spell duration series. The analysis is subsequently performed on generalised Pareto time series obtained by systematic Monte Carlo (MC) simulations. The solution depends on the following: (1) the actual amount of rounding, as determined by the actual data range (measured by the scale parameter, σ) vs. the rounding increment (Δx), combined with; (2) applying a certain (sufficiently high) threshold and considering the series of excesses instead of the original series. For a moderate amount of rounding (e.g. σ/Δx ≥ 4), which is commonly met in practice (at least regarding the dry spell data), and where no threshold is applied, the classical methods work reasonably well. If cutting at the threshold is applied to rounded data—which is actually essential when dealing with a GP distribution—then classical methods applied in a standard way can lead to erroneous estimates, even if the rounding itself is moderate. In this case, it is necessary to adjust the theoretical location parameter for the series of excesses. The other solution is to add an appropriate uniform noise to the rounded data ("so-called" jittering). This, in a sense, reverses the process of rounding; and thereafter, it is straightforward to apply the common methods. Finally, if the rounding is too coarse (e.g. σ/Δx 1), then none of the above recipes would work; and thus, specific methods for rounded data should be applied.

Nebraska Reading First: Year Six of Implementation--2009-2010. Annual Report

ERIC Educational Resources Information Center

Trainin, Guy; Wilson, Kathryn

2010-01-01

Reading First has been implemented in Nebraska since the 2004-5 academic year. In two rounds of funding and participation, schools have transformed the way they trained their teachers, measured student progress, and taught. This transformation is one of the hardest tasks in education and it has taken the considerable dedication of school personnel…

Round cell sarcoma with CIC-DUX4 gene fusion: Discussion of the distinctive cytomorphologic, immunohistochemical, and molecular features in the differential diagnosis of round cell tumors.

PubMed

Chebib, Ivan; Jo, Vickie Y

2016-05-01

Undifferentiated round cell sarcomas are a heterogeneous group, and include tumors that resemble the Ewing sarcoma family. Although a subset defined by recurrent CIC-DUX4 gene fusion has been recently characterized, data regarding the cytomorphologic features are currently limited. Two recent fine-needle aspiration (FNA) cases prompted review of the spectrum of round cell tumors in the differential diagnosis to determine distinctive diagnostic features. Two genetically confirmed FNA cases were identified. Cytomorphologic features were evaluated on FNA smears and hematoxylin and eosin-stained cell block and concurrent needle biopsy sections, and immunohistochemical studies performed on cell block and biopsy sections were reviewed. The 2 patients were a 24-year-old man with a posterior mediastinal mass and a 69-year-old woman with a gluteal mass. FNA smears were cellular with tumor cells present in large groups and singly dispersed. Tumor cells had large, round-to-ovoid, hyperchromatic nuclei with irregular membranes, frequent large nucleoli, and a moderate amount of vacuolated cytoplasm. Both cases demonstrated necrosis, and one case had prominent myxoid stroma. Immunohistochemistry demonstrated focal-to-multifocal CD99 positivity and diffuse nuclear staining for WT1; staining for cytokeratin, desmin, S-100, CD34, CD45, and TdT were negative. Fluorescence in situ hybridization demonstrated CIC-DUX4 fusion in both cases. CIC-DUX4 round cell sarcoma differs from Ewing sarcoma in that it has more atypical cytologic features and lacks the diffuse membranous CD99 staining pattern characteristic of Ewing sarcoma. The differential diagnosis is broad, and requires the judicious use of ancillary studies. Focal-to-multifocal CD99 immunoreactivity and diffuse nuclear WT1 positivity is characteristic of CIC-DUX4 sarcoma, and should prompt molecular testing. Cancer Cytopathol 2016;124:350-61. © 2016 American Cancer Society. © 2016 American Cancer Society.

Rounding, work intensification and new public management.

PubMed

Willis, Eileen; Toffoli, Luisa; Henderson, Julie; Couzner, Leah; Hamilton, Patricia; Verrall, Claire; Blackman, Ian

2016-06-01

In this study, we argue that contemporary nursing care has been overtaken by new public management strategies aimed at curtailing budgets in the public hospital sector in Australia. Drawing on qualitative interviews with 15 nurses from one public acute hospital with supporting documentary evidence, we demonstrate what happens to nursing work when management imposes rounding as a risk reduction strategy. In the case study outlined rounding was introduced across all wards in response to missed care, which in turn arose as a result of work intensification produced by efficiency, productivity, effectiveness and accountability demands. Rounding is a commercially sponsored practice consistent with new public management. Our study illustrates the impact that new public management strategies such as rounding have on how nurses work, both in terms of work intensity and in who controls their labour. © 2015 John Wiley & Sons Ltd.

Minimum impulse trajectories for Mars round trip missions

NASA Technical Reports Server (NTRS)

Horvat, Glen M.; Alexander, Stephen W.

1992-01-01

Data are presented for minimum-impulse earth-Mars round-trip trajectories for the 2010 to 2027 Mars launch opportunities. Round-trip mission times from 120 to 600 days, including a 30-day rendezvous at Mars, for direct trajectories and trajectories utilizing a Venus gravitational assist are considered. Optimal planetary launch and arrival dates and total impulse requirements are based on all maneuvers being performed propulsively with no finite burn or other losses. Direct trajectories have the lowest impulse requirements for shorter mission times and Venus gravitational assist trajectories have the lowest impulse requirements for longer mission times. It is shown that one can depart on trajectories to Mars, beginning with lower energy trajectories to the moon. The fuel savings varies, depending on the final energy level required and on the swingby procedure used. Procedures discussed include single lunar swingbys, double-powered or unpowered lunar swingbys, third lunar flybys a year later, and gravity assists by Venus and earth after the final lunar swingby.

Identification of competencies for patient education in physiotherapy using a Delphi approach.

PubMed

Forbes, Roma; Mandrusiak, Allison; Smith, Michelle; Russell, Trevor

2018-06-01

Patient education is a critical part of physiotherapy practice however an empirically derived set of competencies for its use does not exist. This study aimed to generate a set of competencies for patient education in physiotherapy using a consensus approach. A Delphi study with two rounds using a panel of expert physiotherapists within Australia was undertaken. In the first round, the panel of 12 specialist physiotherapists identified competencies required for patient education in the physiotherapy setting. Framework analysis was applied to develop a set of competencies that were assessed in the second round where ≥80% agreement of importance from the panel indicated consensus. Response rates of specialist physiotherapists agreeing to participate were 67% for the first round and 100% for the second round. Analysis following the first round produced 25 competencies. The second round resulted in agreement on a final set of 22 competencies. This study developed a concise list of competencies for patient education with a high level of expert agreement. By identifying the key competencies in this area, there is potential to benchmark patient education training and assessment of physiotherapists for improved educational and professional outcomes. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

[Academic origin of round magnetic needle and standardization operation].

PubMed

Cheng, Yan-Ting; Zhang, Tian-Sheng; Meng, Li-Qiang; Shi, Rui-Qi; Ji, Lai-Xi

2014-07-01

The origin and development of round magnetic needle was explored, and the structure of round magnetic needle was introduced in detail, including the handle, the body and the tip of the needle. The clinical opera tion of round magnetic needle were standardized from the aspects of the methods of holding needle, manipulation skill, tapping position, strength of manipulation, application scope and matters needing attention, which laid foundation for the popularization and application of round magnetic needle.

Local quantum transformations requiring infinite rounds of classical communication.

PubMed

Chitambar, Eric

2011-11-04

In this Letter, we investigate the number of measurement and communication rounds needed to implement certain tasks by local quantum operations and classical communication (LOCC), a relatively unexplored topic. To demonstrate the possible strong dependence on the round number, we consider the problem of converting three-qubit entanglement into two-qubit form, specifically in the random distillation setting of [Phys. Rev. Lett. 98, 260501 (2007)]. We find that the number of LOCC rounds needed for a transformation can depend on the amount of entanglement distilled. In fact, for a wide range of transformations, the required number of rounds is infinite (unbounded). This represents the first concrete example of a task needing an infinite number of rounds to implement.

The Cost and Quality of Full Day, Year-Round Early Care and Education in Massachusetts: Preschool Classrooms [with] Executive Summary.

ERIC Educational Resources Information Center

Marshall, Nancy L.; Creps, Cindy L.; Burstein, Nancy R.; Glantz, Frederic B.; Robeson, Wendy Wagner; Barnett, Steve

There are an estimated 167,000 children in early care and education programs in Massachusetts. In 2000, the state department of education commissioned a study of the cost and quality of early care and education in the state. This report and executive summary are the first from the study, addressing early care and education for preschool-aged…

Leadership line care rounds: Application of the engage, educate, execute, and evaluate improvement model for the prevention of central line-associated bloodstream infections in children with cancer.

PubMed

Owings, Angie; Graves, JoBeth; Johnson, Sherry; Gilliam, Craig; Gipson, Mike; Hakim, Hana

2018-02-01

To prevent central line-associated bloodstream infections (CLABSIs), leadership line care rounds (LLCRs) used the engage, educate, execute, and evaluate improvement model to audit compliance, identify barriers and opportunities, empower patients and families, and engage leadership. Findings of excellence and improvement opportunities were communicated to unit staff and managers. LLCRs contributed to compliance with CLABSI prevention interventions. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Using Disciplinary Literacy to Develop Coherence in History Teacher Education: The Clinical Rounds Project

ERIC Educational Resources Information Center

Bain, Robert B.

2012-01-01

Since 2005, the author and Elizabeth Moje have been engaged in a project to create a more coherent and cohesive program to prepare secondary teachers at the University of Michigan, a project they call the Clinical Rounds Project. Central to this effort has been their use of "disciplinary literacy" to build connections and enhance…

Year-round influenza immunisation during pregnancy in Nepal: a phase 4, randomised, placebo-controlled trial.

PubMed

Steinhoff, Mark C; Katz, Joanne; Englund, Janet A; Khatry, Subarna K; Shrestha, Laxman; Kuypers, Jane; Stewart, Laveta; Mullany, Luke C; Chu, Helen Y; LeClerq, Steven C; Kozuki, Naoko; McNeal, Monica; Reedy, Adriana M; Tielsch, James M

2017-09-01

Influenza immunisation during pregnancy is recommended but not widely implemented in some low-income regions. We assessed the safety and efficacy in mothers and infants of year-round maternal influenza immunisation in Nepal, where influenza viruses circulate throughout the year. In this phase 4, randomised, placebo-controlled trial, we enrolled two consecutive sequential annual cohorts of pregnant women from the Sarlahi district in southern Nepal. We randomised mothers 1:1 to receive seasonally recommended trivalent inactivated influenza vaccine or saline placebo in blocks of eight, stratified by gestational age at enrolment (17-25 weeks vs 26-34 weeks). Women were eligible if they were married, 15-40 years of age, 17-34 weeks' gestation at enrolment, and had not previously received any influenza vaccine that season. We collected serum samples before and after immunisation, and cord blood from a subset of women and infants. Staff masked to allocation made home visits every week from enrolment to 6 months after delivery. Midnasal swabs for respiratory virus PCR testing were collected during maternal acute febrile respiratory infections, and from infants with any respiratory symptom. We assessed vaccine immunogenicity, safety, and three primary outcomes: the incidence of maternal influenza-like illness in pregnancy and 0-180 days postpartum, the incidence of low birthweight (<2500 g), and the incidence of laboratory-confirmed infant influenza disease from 0 to 180 days. This trial is registered with ClinicalTrials.gov, number NCT01034254. From April 25, 2011, to Sept 9, 2013, we enrolled 3693 women in two cohorts of 2090 (1041 assigned to placebo and 1049 to vaccine) and 1603 (805 assigned to placebo and 798 to vaccine), with 3646 liveborn infants (cohort 1, 999 in placebo group and 1010 in vaccine group; cohort 2, 805 in placebo group and 798 in vaccine group). Immunisation reduced maternal febrile influenza-like illness with an overall efficacy of 19% (95% CI 1 to

'Take Ten' improving the surgical post-take ward round: a quality improvement project.

PubMed

Banfield, Danielle Alice; Adamson, Carly; Tomsett, Amy; Povey, James; Fordham, Tony; Richards, Sarah Kathryn

2018-01-01

The surgical post-take ward round is a complex multidisciplinary interaction in which new surgical patients are reviewed and management plans formulated. Its fast-paced nature can lead to poor communication and inaccurate or incomplete documentation with potential detriment to patient safety. Junior team members often do not fully understand the diagnosis and management plan. The aims of this project were to improve both communication and documentation on the surgical post-take ward round, influencing patient safety. The ward round was deconstructed to identify individual roles and determine where intervention would have the most impact. Ten important points were identified that should be documented in the management of an acute surgical patient; observations, examination, impression, investigations, antibiotics, intravenous fluids, VTE assessment, nutrition status, estimated length of stay and ceiling of treatment. A 'Take Ten' checklist was devised with these items to be used as a 'time out' after each patient with the whole team for discussion, clarification and clear documentation. Four plan do study act cycles were completed over a period of a year. A retrospective review of post-take documentation preintervention and postintervention was performed, and the percentage of points that were accurately documented was calculated. For further clarification, 2 weekends were compared-one where the checklist was used and one where it was not. Results showed documentation postintervention varied between categories but there was improvement in documentation of VTE assessment, fluids, observations and investigations. On direct comparison of weekends the checklist showed improved documentation in all categories except length of stay. Junior team members found the checklist improved understanding of diagnosis and management plan, and encouraged a more effective ward round. The 'Take Ten' checklist has been well received. Three years on from its inception, the checklist

No difference in the graft shift between a round and a rounded rectangular femoral tunnel for anterior cruciate ligament reconstruction: an experimental study.

PubMed

Takata, Yasushi; Nakase, Junsuke; Oshima, Takeshi; Shimozaki, Kengo; Asai, Kazuki; Tsuchiya, Hiroyuki

2018-05-16

We developed a novel technique of creating a rounded rectangular femoral bone tunnel for anatomical, single-bundle, autologous hamstring tendon anterior cruciate ligament (ACL) reconstruction. Although this tunnel has many advantages, its non-circular shape has raised concerns regarding excessive graft shift within the bone tunnel. This study aimed to compare the graft shift between round and rounded rectangular tunnels using a graft diameter tester for simulating the femoral bone tunnel. Seven semitendinosus tendon grafts harvested from fresh-frozen cadavers were prepared by removing all excess soft tissue. The two ends of a double-fold hamstring tendon were sutured using a baseball stitch and then looped over a TightRope (Arthrex Co., Ltd., Naples, Florida, USA) to make a fourfold graft. The diameter of the graft was standardized to 8 mm using a round graft diameter tester. A round and an original rounded rectangular graft diameter tester were used for simulating the respective femoral bone tunnels. The graft was inserted into the tunnel, with the TightRope positioned on the outside of the tunnel. The distal end of the graft was tensioned to 40 N at an angle of 75° to reproduce the most severe graft bending angle. Digital photographs of the tunnel aperture taken at each simulated tunnel and the range of graft shift in the simulated tunnel were analyzed by ImageJ software. Statistical analyses were performed using the Tukey test. P < 0.05 was considered to be significant. There were no significant differences between the round and the rounded rectangular tunnel groups (P > 0.05) in terms of graft shift, gap area, and graft shift ratio. In a simulated ACL reconstruction, there is no difference in the graft shift between a round and a rounded rectangular bone tunnel.

A rare case of leiomyosarcoma originating from the left round ligament of the uterus.

PubMed

Kaba, Metin; Tokmak, Aytekin; Timur, Hakan; Özdal, Bülent; Şirvan, Levent; Güngör, Tayfun

2016-07-01

Uterine leiomyosarcomas (LMS) are rare malignancies with a poor prognosis. The incidence is reported to be 3-7/100.000 per year. Preoperative and intraoperative differentiation between LMS and large leiomyoma is always challenging. Therefore, LMS are often diagnosed during postoperative histologic evaluation of hysterectomy or myomectomy specimens. LMS of the round ligament of the uterus which can represent as an inguinal or pelvic mass is extremely rare. To our knowledge, there is only one case report of LMS arising from the round ligament available in the literature. Herein, we aimed to present the second case of LMS originating from the left round ligament of the uterus in a premenopausal woman initially misdiagnosed as an ovarian tumor. © 2016 Old City Publishing, Inc.

Phage display screening without repetitious selection rounds.

PubMed

't Hoen, Peter A C; Jirka, Silvana M G; Ten Broeke, Bradley R; Schultes, Erik A; Aguilera, Begoña; Pang, Kar Him; Heemskerk, Hans; Aartsma-Rus, Annemieke; van Ommen, Gertjan J; den Dunnen, Johan T

2012-02-15

Phage display screenings are frequently employed to identify high-affinity peptides or antibodies. Although successful, phage display is a laborious technology and is notorious for identification of false positive hits. To accelerate and improve the selection process, we have employed Illumina next generation sequencing to deeply characterize the Ph.D.-7 M13 peptide phage display library before and after several rounds of biopanning on KS483 osteoblast cells. Sequencing of the naive library after one round of amplification in bacteria identifies propagation advantage as an important source of false positive hits. Most important, our data show that deep sequencing of the phage pool after a first round of biopanning is already sufficient to identify positive phages. Whereas traditional sequencing of a limited number of clones after one or two rounds of selection is uninformative, the required additional rounds of biopanning are associated with the risk of losing promising clones propagating slower than nonbinding phages. Confocal and live cell imaging confirms that our screen successfully selected a peptide with very high binding and uptake in osteoblasts. We conclude that next generation sequencing can significantly empower phage display screenings by accelerating the finding of specific binders and restraining the number of false positive hits. Copyright © 2011 Elsevier Inc. All rights reserved.

Leadership rounds to reduce health care-associated infections.

PubMed

Knobloch, Mary Jo; Chewning, Betty; Musuuza, Jackson; Rees, Susan; Green, Christopher; Patterson, Erin; Safdar, Nasia

2018-03-01

Evidence-based guidelines exist to reduce health care-associated infections (HAIs). Leadership rounds are one tool leaders can use to ensure compliance with guidelines, but have not been studied specifically for the reduction of HAIs. This study examines HAI leadership rounds at one facility. We explored unit-based HAI leadership rounds led by 2 hospital leaders at a large academic hospital. Leadership rounds were observed on 19 units, recorded, and coded to identify themes. Themes were linked to the Consolidated Framework for Implementation Research and used to guide interviews with frontline staff members. Staff members disclosed unit-specific problems and readily engaged in problem-solving with top hospital leaders. These themes appeared over 350 times within 22 rounds. Findings revealed that leaders used words that demonstrated fallibility and modeled curiosity, 2 factors associated with learning climate and psychologic safety. These 2 themes appeared 115 and 142 times, respectively. The flexible nature of the rounds appeared to be conducive for reflection and evaluation, which was coded 161 times. Each interaction between leaders and frontline staff can foster psychologic safety, which can lead to open problem-solving to reduce barriers to implementation. Discovering specific communication and structural factors that contribute to psychologic safety may be powerful in reducing HAIs. Published by Elsevier Inc.

Triatomine Infestation in Guatemala: Spatial Assessment after Two Rounds of Vector Control

PubMed Central

Manne, Jennifer; Nakagawa, Jun; Yamagata, Yoichi; Goehler, Alexander; Brownstein, John S.; Castro, Marcia C.

2012-01-01

In 2000, the Guatemalan Ministry of Health initiated a Chagas disease program to control Rhodnius prolixus and Triatoma dimidiata by periodic house spraying with pyrethroid insecticides to characterize infestation patterns and analyze the contribution of programmatic practices to these patterns. Spatial infestation patterns at three time points were identified using the Getis-Ord Gi*(d) test. Logistic regression was used to assess predictors of reinfestation after pyrethroid insecticide administration. Spatial analysis showed high and low clusters of infestation at three time points. After two rounds of spray, 178 communities persistently fell in high infestation clusters. A time lapse between rounds of vector control greater than 6 months was associated with 1.54 (95% confidence interval = 1.07–2.23) times increased odds of reinfestation after first spray, whereas a time lapse of greater than 1 year was associated with 2.66 (95% confidence interval = 1.85–3.83) times increased odds of reinfestation after first spray compared with localities where the time lapse was less than 180 days. The time lapse between rounds of vector control should remain under 1 year. Spatial analysis can guide targeted vector control efforts by enabling tracking of reinfestation hotspots and improved targeting of resources. PMID:22403315

Observational Study Using the Tools of Lean Six Sigma to Improve the Efficiency of the Resident Rounding Process

PubMed Central

Chand, David V.

2011-01-01

Background Recent focus on resident work hours has challenged residency programs to modify their curricula to meet established duty hour restrictions and fulfill their mission to develop the next generation of clinicians. Simultaneously, health care systems strive to deliver efficient, high-quality care to patients and families. The primary goal of this observational study was to use a data-driven approach to eliminate examples of waste and variation identified in resident rounding using Lean Six Sigma methodology. A secondary goal was to improve the efficiency of the rounding process, as measured by the reduction in nonvalue-added time. Methods We used the “DMAIC” methodology: define, measure, analyze, improve, and control. Pediatric and family medicine residents rotating on the pediatric hospitalist team participated in the observation phase. Residents, nurses, hospitalists, and parents of patients completed surveys to gauge their attitudes toward rounds. The Mann-Whitney test was used to test for differences in the median times measured during the preimprovement and postimprovement phases, and the Student t test was used for comparison of survey data. Results and Discussion Collaborative, family-centered rounding with elimination of the “prerounding” process, as well as standard work instructions and pacing the process to meet customer demand (takt time), were implemented. Nonvalue-added time per patient was reduced by 64% (P  =  .005). Survey data suggested that team members preferred the collaborative, family-centered approach to the traditional model of rounding. Conclusions Lean Six Sigma provides tools, a philosophy, and a structured, data-driven approach to address a problem. In our case this facilitated an effort to adhere to duty hour restrictions while promoting education and quality care. Such approaches will become increasingly useful as health care delivery and education continue to transform. PMID:22655134

Observational study using the tools of lean six sigma to improve the efficiency of the resident rounding process.

PubMed

Chand, David V

2011-06-01

Recent focus on resident work hours has challenged residency programs to modify their curricula to meet established duty hour restrictions and fulfill their mission to develop the next generation of clinicians. Simultaneously, health care systems strive to deliver efficient, high-quality care to patients and families. The primary goal of this observational study was to use a data-driven approach to eliminate examples of waste and variation identified in resident rounding using Lean Six Sigma methodology. A secondary goal was to improve the efficiency of the rounding process, as measured by the reduction in nonvalue-added time. We used the "DMAIC" methodology: define, measure, analyze, improve, and control. Pediatric and family medicine residents rotating on the pediatric hospitalist team participated in the observation phase. Residents, nurses, hospitalists, and parents of patients completed surveys to gauge their attitudes toward rounds. The Mann-Whitney test was used to test for differences in the median times measured during the preimprovement and postimprovement phases, and the Student t test was used for comparison of survey data. Collaborative, family-centered rounding with elimination of the "prerounding" process, as well as standard work instructions and pacing the process to meet customer demand (takt time), were implemented. Nonvalue-added time per patient was reduced by 64% (P  =  .005). Survey data suggested that team members preferred the collaborative, family-centered approach to the traditional model of rounding. Lean Six Sigma provides tools, a philosophy, and a structured, data-driven approach to address a problem. In our case this facilitated an effort to adhere to duty hour restrictions while promoting education and quality care. Such approaches will become increasingly useful as health care delivery and education continue to transform.

Hanging A "round."

ERIC Educational Resources Information Center

Stewart, Barbara

2000-01-01

Discusses an art project for fifth and sixth grade that was inspired by a Laurel Burch plate with a jungle motif. Explains that students choose a project name, make lists of images associated with their chosen name, and use those images in their round designs. (CMK)

Secondary Education Systems and the General Skills of Less- and Intermediate-Educated Adults: A Comparison of 18 Countries

ERIC Educational Resources Information Center

Heisig, Jan Paul; Solga, Heike

2015-01-01

We investigate the impact of external differentiation and vocational orientation of (lower and upper) secondary education on country variation in the mean numeracy skills of, and skills gaps between, adults with low and intermediate formal qualifications. We use data on 30- to 44-year-olds in 18 countries from the 2011-12 round of the Program for…

Clinical reasoning and knowledge management in final year medical students: the role of Student-led Grand Rounds.

PubMed

Kandiah, David Arumaisingam

2017-01-01

The development of clinical reasoning and decision-making skills is often limited in medical school curricula. In reality, medical graduates acquire these skills during their first few years of residency. For many, this can be stressful as they may be working under limited supervision as a part of their rotations. Student-led Grand Rounds was developed to transfer both explicit and tacit knowledge to final year medical students. This pilot project was to apply the principles of knowledge management to allow students to be exposed to the reasoning and decision making of common clinical presentations. Student feedback through questionnaires was collated at the end of the program. Based on feedback and focus groups, modifications were made to produce a stable program in subsequent clinical rotations. Formal feedback was collated from all the 76 students who participated in the first year. This represented 100% of the cohort for this clinical school for that year. There was a 100% response rate as the feedback forms were given and collected at the end of the last session per block. The student responses were both in ratings defined in a feedback forms and in written comments. A total of 74 of the 76 students rated the program highly. They enjoyed the nonthreatening interactions. The remaining two students preferred more didactic teaching. This initiative allows an efficient transfer and utilization of knowledge. This could maximize the acquisition of practical knowledge by medical students as they finish their course in the transition to graduate medical practice.

Lifestyle predictors for non-participation and outcome in the second round of faecal immunochemical test in colorectal cancer screening.

PubMed

Knudsen, Markus Dines; Berstad, Paula; Hjartåker, Anette; Gulichsen, Elisabeth Haagensen; Hoff, Geir; de Lange, Thomas; Bernklev, Tomm; Botteri, Edoardo

2017-08-08

To reduce colorectal cancer (CRC) mortality through population-based screening programmes using faecal tests, it is important that individuals continue to participate in the repeated rounds of screening. We aimed to identify lifestyle predictors for discontinuation of faecal immunochemical test (FIT) screening after the first round, as well as lifestyle predictors for colorectal neoplasia detected in the second-round FIT screening. In this longitudinal study, we invited 6959 individuals aged 50-74 years from south-east Norway for a first round of FIT screening and to complete a self-reported lifestyle questionnaire on demographic factors, body mass index (BMI, kg m -2 ), smoking habits, physical activity, consumption of alcohol and dietary items. Two years later, we estimated the associations between these factors, non-participation and screening results in the second round of FIT screening using adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Of the 3114 responders to the questionnaire who completed the first-round FIT and who were invited to participate in second-round FIT screening, 540 (17%) did not participate. The OR and (95% CI) for discontinuation of FIT screening after the first round was 1.61 (1.24-2.10) for current smoking compared with non-smoking; 2.01 (1.25-3.24) for BMI⩾35 kg m -2 compared with BMI 16.9-24.9 kg m -2 and 0.70 (0.52-0.94) for physical activity in the third quartile vs the first. Among participants, smoking, high BMI and high alcohol consumption were associated with an increased odds of detecting colorectal neoplasia (n=107). These results may indicate that Norwegian FIT screening participants who discontinue after the first round have lifestyle behaviours associated with increased risk of CRC.

Discretization vs. Rounding Error in Euler's Method

ERIC Educational Resources Information Center

Borges, Carlos F.

2011-01-01

Euler's method for solving initial value problems is an excellent vehicle for observing the relationship between discretization error and rounding error in numerical computation. Reductions in stepsize, in order to decrease discretization error, necessarily increase the number of steps and so introduce additional rounding error. The problem is…

Australia: round module handling and cotton classing

USDA-ARS?s Scientific Manuscript database

Round modules of seed cotton produced via on-board module building harvesters are the reality of the cotton industry, worldwide. Although round modules have been available to the industry for almost a decade, there is still no consensus on the best method to handle the modules, particularly when th...

A case study of healthcare providers' goals during interprofessional rounds.

PubMed

Prystajecky, Michael; Lee, Tiffany; Abonyi, Sylvia; Perry, Robert; Ward, Heather

2017-07-01

Daily interprofessional rounds enhance collaboration among healthcare providers and improve hospital performance measures. However, it is unclear how healthcare providers' goals influence the processes and outcomes of interprofessional rounds. The purpose of this case study was to explore the goals of healthcare providers attending interprofessional rounds in an internal medicine ward. The second purpose was to explore the challenges encountered by healthcare providers while pursuing these goals. Three focus groups were held with healthcare providers of diverse professional backgrounds. Focus group field notes and transcripts were analysed using thematic analysis. The data indicated that there was no consensus among healthcare providers regarding the goals of interprofessional rounds. Discharge planning and patient care delivery were perceived as competing priorities during rounds, which limited the participation of healthcare providers. Nevertheless, study participants identified goals of rounds that were relevant to most care providers: developing shared perspectives of patients through direct communication, promoting collaborative decision making, coordinating care, and strengthening interprofessional relationships. Challenges in achieving the goals of interprofessional rounds included inconsistent attendance, exchange of irrelevant information, variable participation by healthcare providers, and inconsistent leadership. The findings of this study underscore the importance of shared goals in the context of interprofessional rounding.

IFLA General Conference, 1989. Division of Education and Research. Section on Education and Training; Round Table on Library History; Round Table on Research in Reading; Round Table on Continuing Professional Education. Booklet 70.

ERIC Educational Resources Information Center

International Federation of Library Associations, The Hague (Netherlands).

There are 10 papers in this collection from the Division of Education and Research: (1) "The Importance of Basic Training in Marketing for Librarians and Information Professionals" (French and English versions; Rejean Savard); (2) "Information Management Education: Some Interdisciplinary Approaches" (Marianne Broadbent); (3) "Educational…

"Walking" Along a Free Rotating Bicycle Wheel (Round and Round)

ERIC Educational Resources Information Center

Güémez, J.; Fiolhais, M.

2015-01-01

We describe the kinematics, dynamics, and also some energy issues related to Marta mouse's motion when she walks on top of a horizontal bicycle wheel, which is free to rotate like a merry-go-round, as presented recently by Paul Hewitt in the "Figuring Physics" section of this journal. The situation is represented in Fig. 1, which was…

Fifty Years of Promoting Library History: A Chronology of the ALA (American) Library History Round Table, 1947-1997.

ERIC Educational Resources Information Center

Wertheimer, Andrew B.; Marshall, John David

2000-01-01

Presents a chronology of the Library History Round Table of the American Library Association. Includes topics and presenters of programs; awards, including the Justin Winsor Prize and the Phyllis Dain Library Dissertation Award; and leadership. (LRW)

The Effect of Family Presence on Rounding Duration in the PICU.

PubMed

Gupta, Priya R; Perkins, R Serene; Hascall, Rebecca L; Shelak, Carolyn F; Demirel, Shaban; Buchholz, Mark T

2017-02-01

The incorporation of family-centered rounds has become standard in PICUs across the United States. We compared rounding times in our institution, with and without family members present, to determine the effect on total rounding time and work flow. This observational study of a convenience sample was conducted over a 17-month period (May 2014-October 2015), accounting for typical seasonal variation in the PICU. The individual patient rounding times for 2657 encounters were recorded. The presence of family members, intubation status, physician assistant participation, interruptions during rounds, attending physician's full- or part-time status, and patient census were documented. The effect of family presence on per-patient rounding time was analyzed, while controlling for influential variables. Family members were present during 1743 of 2657 (66%) rounding encounters. The average per-patient rounding time with and without family members present was 8.6 minutes and 7.3 minutes, respectively, a difference of 1.3 minutes per patient. In statistical models that accounted for other influential variables, the presence of family members was associated with a highly significant (20.4%, P < .001) increase in the per-patient rounding time. The presence of family members increases per-patient rounding times in the PICU. Family presence on rounds may have benefits that outweigh the additional time required to complete each patient interaction. Copyright © 2017 by the American Academy of Pediatrics.

Age, growth, and maturity of round whitefish of the Apostle Islands and Isle Royale Regions, Lake Superior

USGS Publications Warehouse

Bailey, Merryll M.

1963-01-01

The round whitefish has been of some commercial importance in the upper Great Lakes but production in Lake Superior has generally been small; the United States average was 26,600 pounds for 1929-59. This study is based on 1,173 fish collected in the Apostle Islands in 1958-60 and 103 collected at Isle Royale in 1958 and 1960. The average age of 6.0 years at Isle Royale was concluded to be significantly higher than the mean of 4.2 years in the Apostle Islands. The body-scale relation is a straight line with an intercept of 1.1 inches on the length axis. Weight of Apostle Islands round whitefish captured in several months increased as the 3.22 power of the length. Growth in length was relatively slow; nearly or fully 7 years were required to reach an acceptable commercial length of 14 inches in both the Apostle Islands and at Isle Royale. The calculated weights at the end of the seventh year were 12.6 ounces in the Apostle Islands and 13.8 ounces at Isle Royale. Minimum length at maturity of male round whitefish (7.0-7.4 inches) was less than that of females (8.5-8.9 inches). At age-group II, 11.1 percent of male round whitefish, but only 1.5 percent of the females were mature. All males were mature as age-group V and all females as age-group VI. Males dominated the younger age groups but females were more numerous in the older ones. Estimates of the number of eggs in 37 round whitefish ovaries yielded an average of 5,330 eggs for fish 10.5-17.4 inches long.

Our Choice to Homeschool: Stepping off the Merry-Go-Round

ERIC Educational Resources Information Center

Rivero, Lisa

2004-01-01

Today's after-school programs and sports are often year-round activities, and children are pressured to focus on one activity to the exclusion of others. Homework for students who attend highly competitive high schools can take three to five hours per night. Not only schools, but the whole culture is different. People listen to music through…

Validation of the Nurses' Perception of Patient Rounding Scale: An Exploratory Study of the Influence of Shift Work on Nurses' Perception of Patient Rounding.

PubMed

Neville, Kathleen; DiBona, Courtney; Mahler, Maureen

2016-01-01

Hourly rounds have re-emerged as standard practice among nurses in acute care settings, and there is the need to identify nurses' perceptions regarding this practice. Further use of the Nurses' Perception of Patient Rounding Scale (NPPRS) is needed to further validate this new instrument. In addition, there exists a dearth of literature that examines the impact of hours worked and shift on nurses' perceptions of patient rounding. The purpose of this descriptive study was to explore nurses' perception of the required practice of patient rounding, to examine the influence of nurses' shift on nurses' perception of rounding practice, and to provide additional psychometric support for the NPPRS. The NPPRS, a 42-item scale in 5-point Likert format, and a demographic information sheet were used in the study. The NPPRS yields three subscales: communication, patient benefits, and nurse benefits. Using a convenience sample of anonymous nurse participants, 76 nurses from five medical-surgical units at a medical center in the northeast corridor of the United States participated in the study. Further psychometric support for the NPPRS was demonstrated. Excellent reliability coefficients via Cronbach's alpha for the total scale (0.91) and each of the subscales were obtained. A statistically significant difference was noted among nurses working 8 hours versus 12 hours or combined 8- and 12-hour workloads. Perceptions of nurse benefits were statistically significantly higher for nurses working 8 hours. In addition, results indicated that nurses perceived rounding to be more beneficial to their own practice than to patients. Analyses revealed that leadership support was instrumental in successful rounding practice. Further support for the NPPRS was obtained through this study. Strong nursing leadership, supportive of rounding, is essential for successful rounding. Further research should examine the efficacy of nurse rounding-developed protocols specific to the shift and unit of

75 FR 67392 - Notice of Availability: HUD's Fiscal Year (FY) NOFA for the Choice Neighborhoods Initiative-Round...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

..., HUD. ACTION: Notice extension of deadline. SUMMARY: On August 26, 2010, HUD posted on http://www...--Round 1. Today's Federal Register notice announces that HUD has posted on http://www.Grants.gov a... to the Mapping Tool used to determine neighborhood eligibility. HUD will post on http://www.Grants...

The History and Progression of Manual Rounds: A Structured Peer Observation Process for Teachers in Urban School Settings

ERIC Educational Resources Information Center

Hunzicker, Jana; Tripses, Jenny; Wolffe, Robert; Jenkins, Taunya; Ewan-Skorczewski, Martha; Chrosniak, Patricia

2017-01-01

Research shows that half of all teachers working in urban school settings leave the profession within five years, and many who choose to leave are the ones who are most effective (Coggins & Diffenbaugh, 2013.) Manual Rounds, a structured peer observation process based on the established practice of instructional rounds, was implemented at…

Strength of small-diameter round and tapered bending members

Treesearch

Ron Wolfe; Joe Murphy

2005-01-01

An early focus on structural use of processed rather than round timber resulted in an underestimation of the structural advantages of retaining the natural form of small-diameter round timber. In the round and tapered form, timbers are not susceptible to the strength-reducing effects of diving grain and exposed juvenile wood. Fiber continuity around knots on the...

Strategies for improving family engagement during family-centered rounds.

PubMed

Kelly, Michelle M; Xie, Anping; Carayon, Pascale; DuBenske, Lori L; Ehlenbach, Mary L; Cox, Elizabeth D

2013-04-01

Family-centered rounds (FCR) are recommended as standard practice in the pediatric inpatient setting; however, limited data exist on best practices promoting family engagement during rounds. To identify strategies to enhance family engagement during FCR using a recognized systems engineering approach. In this qualitative study, stimulated recall interviews using video-recorded rounding sessions were conducted with participants representing the various stakeholders on rounds (15 parents/children and 22 healthcare team [HCT] members) from 4 inpatient services at a children's hospital in Wisconsin. On video review, participants were asked to provide strategies that would increase family engagement on FCR. Qualitative content analysis of interview transcripts was performed in an iterative process. We identified 21 categories of strategies corresponding to 2 themes related to the structure and process of FCR. Strategies related to the structure of FCR were associated with all five recognized work system elements: people (HCT composition), tasks (HCT roles), organization (scheduling of rounds and HCT training), environment (location of rounds and HCT positioning), and tools and technologies (computer use). Strategies related to the FCR process were associated with three rounding phases: before (HCT and family preparation), during (eg, introductions, presentation content, communication style), and after (follow-up) FCR. We identified a range of strategies to enhance family engagement during FCR. These strategies both confirm prior work on the importance of the content and style of communication on rounds and highlight other factors within the hospital work system, like scheduling and computer use, which may affect family engagement in care. Copyright © 2013 Society of Hospital Medicine.

General Education in Two-Year Colleges.

ERIC Educational Resources Information Center

Johnson, B. Lamar, Ed.

1982-01-01

Issues in defining and conceptualizing general education in the two-year college are examined in this collection of essays. After introductory remarks, B. Lamar Johnson reviews the findings of the 1952 California Study of General Education and discusses their current applicability. Next, K. Patricia Cross reviews trends in general education from…

Usefulness of a 50-meter round walking test for fall prediction in the elderly requiring long-term care

PubMed Central

Hachiya, Mizuki; Murata, Shin; Otao, Hiroshi; Ihara, Takehiko; Mizota, Katsuhiko; Asami, Toyoko

2015-01-01

[Purpose] This study aimed to verify the usefulness of a 50-m round walking test developed as an assessment method for walking ability in the elderly. [Subjects] The subjects were 166 elderly requiring long-term care individuals (mean age, 80.5 years). [Methods] In order to evaluate the factors that had affected falls in the subjects in the previous year, we performed the 50-m round walking test, functional reach test, one-leg standing test, and 5-m walking test and measured grip strength and quadriceps strength. [Results] The 50-m round walking test was selected as a variable indicating fall risk based on the results of multiple logistic regression analysis. The cutoff value of the 50-m round walking test for determining fall risk was 0.66 m/sec. The area under the receiver operating characteristic curve was 0.64. The sensitivity of the cutoff value was 65.7%, the specificity was 63.6%, the positive predictive value was 55.0%, the negative predictive value was 73.3%, and the accuracy was 64.5%. [Conclusion] These results suggest that the 50-m round walking test is a potentially useful parameter for the determination of fall risk in the elderly requiring long-term care. PMID:26834327

Usefulness of a 50-meter round walking test for fall prediction in the elderly requiring long-term care.

PubMed

Hachiya, Mizuki; Murata, Shin; Otao, Hiroshi; Ihara, Takehiko; Mizota, Katsuhiko; Asami, Toyoko

2015-12-01

[Purpose] This study aimed to verify the usefulness of a 50-m round walking test developed as an assessment method for walking ability in the elderly. [Subjects] The subjects were 166 elderly requiring long-term care individuals (mean age, 80.5 years). [Methods] In order to evaluate the factors that had affected falls in the subjects in the previous year, we performed the 50-m round walking test, functional reach test, one-leg standing test, and 5-m walking test and measured grip strength and quadriceps strength. [Results] The 50-m round walking test was selected as a variable indicating fall risk based on the results of multiple logistic regression analysis. The cutoff value of the 50-m round walking test for determining fall risk was 0.66 m/sec. The area under the receiver operating characteristic curve was 0.64. The sensitivity of the cutoff value was 65.7%, the specificity was 63.6%, the positive predictive value was 55.0%, the negative predictive value was 73.3%, and the accuracy was 64.5%. [Conclusion] These results suggest that the 50-m round walking test is a potentially useful parameter for the determination of fall risk in the elderly requiring long-term care.

Bridging Theory to Practice with Classroom Rounds

ERIC Educational Resources Information Center

Bowman, Connie L.; Herrelko, Janet M.

2014-01-01

Pre-service candidates' perceptions of how to teach were challenged after going through the process of Classroom Rounds, the process that was used in this study. Classroom Rounds consisted of a pre-conference meeting with an inservice teacher, followed by a classroom observation of that teacher, and finally a discussion focusing on proven…

Challenges of the ward round teaching based on the experiences of medical clinical teachers.

PubMed

Arabshahi, Kamran Soltani; Haghani, Fariba; Bigdeli, Shoaleh; Omid, Athar; Adibi, Peyman

2015-03-01

Holding educational sessions in a clinical environment is a major concern for faculty members because of its special difficulties and restrictions. This study attempts to recognize the challenges of the ward round teaching through investigating the experiences of clinical teachers in 2011. This qualitative research is carried out through purposive sampling with maximum variation from among the clinical teachers of major departments in Isfahan University of Medical Sciences (9 persons). The sampling continued until data saturation. Data were collected through semi-structured interview and analyzed through Collaizzi method. Data reliability and validity was confirmed through the four aspects of Lincoln and Guba method (credibility, conformability, transferability, and dependability). Three major themes and their related sub-themes (minor themes) were found out including the factors related to the triad of clinical teaching (patient, learner, and clinical teacher) (concern about patient's welfare, poor preparation, lack of motivation, ethical problems), factors related to the educational environment (stressful environment, humiliating environment and poor communication) and the factors related to the educational system of the clinical environment (poor organizing and arrangement of resources, poor system's monitoring, bad planning and inadequate resource). Ward round teaching has many concerns for teachers, and this should be recognized and resolved by authorities and teachers. If these problems are not resolved, it would affect the quality of clinical teaching.

Challenges of the ward round teaching based on the experiences of medical clinical teachers

PubMed Central

Arabshahi, Kamran Soltani; Haghani, Fariba; Bigdeli, Shoaleh; Omid, Athar; Adibi, Peyman

2015-01-01

Background: Holding educational sessions in a clinical environment is a major concern for faculty members because of its special difficulties and restrictions. This study attempts to recognize the challenges of the ward round teaching through investigating the experiences of clinical teachers in 2011. Materials and Methods: This qualitative research is carried out through purposive sampling with maximum variation from among the clinical teachers of major departments in Isfahan University of Medical Sciences (9 persons). The sampling continued until data saturation. Data were collected through semi-structured interview and analyzed through Collaizzi method. Data reliability and validity was confirmed through the four aspects of Lincoln and Guba method (credibility, conformability, transferability, and dependability). Results: Three major themes and their related sub-themes (minor themes) were found out including the factors related to the triad of clinical teaching (patient, learner, and clinical teacher) (concern about patient's welfare, poor preparation, lack of motivation, ethical problems), factors related to the educational environment (stressful environment, humiliating environment and poor communication) and the factors related to the educational system of the clinical environment (poor organizing and arrangement of resources, poor system's monitoring, bad planning and inadequate resource). Conclusion: Ward round teaching has many concerns for teachers, and this should be recognized and resolved by authorities and teachers. If these problems are not resolved, it would affect the quality of clinical teaching. PMID:26109975

Use of electrical barriers to deter movement of round goby

USGS Publications Warehouse

Savino, Jacqueline F.; Jude, David J.; Kostich, Melissa J.; Coutant, Charles C.

2001-01-01

An electrical barrier was chosen as a possible means to deter movement of round goby Neogobius melanostomus. Feasibility studies in a 2.1-m donut-shaped tank determined the electrical parameters necessary to inhibit round goby from crossing the 1-m stretch of the benthic, electrical barrier. Increasing electrical pulse duration and voltage increased effectiveness of the barrier in deterring round goby movement through the barrier. Differences in activity of round goby during daytime and nocturnal tests did not change the effectiveness of the barrier. In field verification studies, an electrical barrier was placed between two blocking nets in the Shiawassee River, Michigan. The barrier consisted of a 6-m wide canvas on which were laid four cables carrying the electrical current. Seven experiments were conducted, wherein 25 latex paint-marked round goby were introduced upstream of the electrical barrier and recovered 24 h later upstream, on, and downstream of the barrier. During control studies, round goby moved across the barrier within 20 min from release upstream. With the barrier on and using the prescribed electrical settings shown to inhibit passage in the laboratory, the only marked round goby found below the barrier were dead. At reduced pulse durations, a few round goby (mean one/test) were found alive, but debilitated, below the barrier. The electrical barrier could be incorporated as part of a program in reducing movement of adult round goby through artificial connections between watersheds.

Response of Biological Soil Crust Diazotrophs to Season, Altered Summer Precipitation, and Year-Round Increased Temperature in an Arid Grassland of the Colorado Plateau, USA

DOE PAGES

Yeager, Chris M.; Kuske, Cheryl R.; Carney, Travis D.; ...

2012-01-01

Biological soil crusts (biocrusts), which supply significant amounts of fixed nitrogen into terrestrial ecosystems worldwide (~33 Tg y -1), are likely to respond to changes in temperature and precipitation associated with climate change. Using nifH gene-based surveys, we explored variation in the diazotrophic community of biocrusts of the Colorado Plateau, USA in response to season (autumn vs. spring), as well as field manipulations that increased the frequency of small volume precipitation events and year-round soil temperature. Abundance of nifH genes in biocrusts ranged from 3 × 10 6 to 1 × 108 g -1 soil, and nifH from heterocystous cyanobacteriamore » closely related to Scytonema hyalinum, Spirirestis rafaelensis, and Nostoc commune comprised >98% of the total. Although there was no apparent seasonal effect on total nifH gene abundance in the biocrusts, T-RFLP analysis revealed a strong seasonal pattern in nifH composition. Spirirestis nifH abundance was estimated to oscillate 1 to >2 orders of magnitude between autumn (low) and spring (high). A year-round increase of soil temperature (2–3°C) had little effect on the diazotroph community structure over 2 years. Altered summer precipitation had little impact on diazotroph community structure over the first 1.5 years of the study, when natural background patterns across years and seasons superseded any treatment effects. However, after the second summer of treatments, nifH abundance was 2.6-fold lower in biocrusts receiving altered precipitation. Heterocystous cyanobacteria were apparently more resilient to altered precipitation than other cyanobacteria. The results demonstrate that diazotrophic community composition of biocrusts in this semi-arid grassland undergoes strong seasonal shifts and that the abundance of its dominant members decreased in response to more frequent, small volume precipitation events.« less

Response of biological soil crust diazotrophs to season, altered summer precipitation, and year-round increased temperature in an arid grassland of the Colorado Plateau, USA

USGS Publications Warehouse

Yeager, Chris M.; Kuske, Cheryl R.; Carney, Travis D.; Johnson, Shannon L.; Ticknor, Lawrence O.; Belnap, Jayne

2012-01-01

Biological soil crusts (biocrusts), which supply significant amounts of fixed nitrogen into terrestrial ecosystems worldwide (~33Tg y-1), are likely to respond to changes in temperature and precipitation associated with climate change. Using nifH gene-based surveys, we explored variation in the diazotrophic community of biocrusts of the Colorado Plateau, USA in response to season (autumn vs. spring), as well as field manipulations that increased the frequency of small volume precipitation events and year-round soil temperature. Abundance of nifH genes in biocrusts ranged from 3×106 to 1×8 g-1 soil, and nifH from heterocystous cyanobacteria closely related to Scytonema hyalinum, Spirirestis rafaelensis, and Nostoc commune comprised >98% of the total. Although there was no apparent seasonal effect on total nifH gene abundance in the biocrusts, T-RFLP analysis revealed a strong seasonal pattern in nifH composition. Spirirestis nifH abundance was estimated to oscillate 1 to >2 orders of magnitude between autumn (low) and spring (high). A year-round increase of soil temperature (2–3°C) had little effect on the diazotroph community structure over 2 years. Altered summer precipitation had little impact on diazotroph community structure over the first 1.5years of the study, when natural background patterns across years and seasons superseded any treatment effects. However, after the second summer of treatments, nifH abundance was 2.6-fold lower in biocrusts receiving altered precipitation. Heterocystous cyanobacteria were apparently more resilient to altered precipitation than other cyanobacteria. The results demonstrate that diazotrophic community composition of biocrusts in this semi-arid grassland undergoes strong seasonal shifts and that the abundance of its dominant members decreased in response to more frequent, small volume precipitation events.

Response of biological soil crust diazotrophs to season, altered summer precipitation, and year-round increased temperature in an arid grassland of the colorado plateau, USA.

PubMed

Yeager, Chris M; Kuske, Cheryl R; Carney, Travis D; Johnson, Shannon L; Ticknor, Lawrence O; Belnap, Jayne

2012-01-01

Biological soil crusts (biocrusts), which supply significant amounts of fixed nitrogen into terrestrial ecosystems worldwide (∼33 Tg y(-1)), are likely to respond to changes in temperature and precipitation associated with climate change. Using nifH gene-based surveys, we explored variation in the diazotrophic community of biocrusts of the Colorado Plateau, USA in response to season (autumn vs. spring), as well as field manipulations that increased the frequency of small volume precipitation events and year-round soil temperature. Abundance of nifH genes in biocrusts ranged from 3 × 10(6) to 1 × 10(8) g(-1) soil, and nifH from heterocystous cyanobacteria closely related to Scytonema hyalinum, Spirirestis rafaelensis, and Nostoc commune comprised >98% of the total. Although there was no apparent seasonal effect on total nifH gene abundance in the biocrusts, T-RFLP analysis revealed a strong seasonal pattern in nifH composition. SpirirestisnifH abundance was estimated to oscillate 1 to >2 orders of magnitude between autumn (low) and spring (high). A year-round increase of soil temperature (2-3°C) had little effect on the diazotroph community structure over 2 years. Altered summer precipitation had little impact on diazotroph community structure over the first 1.5 years of the study, when natural background patterns across years and seasons superseded any treatment effects. However, after the second summer of treatments, nifH abundance was 2.6-fold lower in biocrusts receiving altered precipitation. Heterocystous cyanobacteria were apparently more resilient to altered precipitation than other cyanobacteria. The results demonstrate that diazotrophic community composition of biocrusts in this semi-arid grassland undergoes strong seasonal shifts and that the abundance of its dominant members decreased in response to more frequent, small volume precipitation events.

The Cost and Quality of Full-Day Year-Round Early Care and Education in Massachusetts: Infant and Toddler Classrooms

ERIC Educational Resources Information Center

Marshall, Nancy L.; Creps, Cindy L.; Burstein, Nancy R.; Roberts, Joanne; Glantz, Frederic B.; Robeson, Wendy Wagner

2004-01-01

The Massachusetts Cost and Quality Study assessed the quality and costs of early care and education services in Massachusetts, the relationship between quality and costs, and the relationship between the family income of children served and the quality of care provided by early care and education programs. This report presents the findings from…

Year-round record of Dry Valley soil CO2 flux provides insights into Antarctic soil dynamics

NASA Astrophysics Data System (ADS)

Risk, D. A.; Lee, C.; Macintyre, C. M.; Cary, C.

2012-12-01

The McMurdo Dry Valleys of Antarctica host extreme soil microbial communities that have been extensively studied within the past decade. Activity of microbial communities is routinely measured via soil CO2 flux, and some useful Antarctic measurements have been made during short Austral summers. These studies are mostly spatial in nature, but temporal patterns are also valuable and may provide insights into critical thresholds and the interplay between various mechanisms that drive CO2 flux and its variation. New membrane-based Forced Diffusion (FD) soil efflux techniques offer promise for this application. The purpose of this study was to use a specially designed FD instrument in Hidden Valley of the Antarctic Dry Valleys to evaluate hardware performance in year-round deployments, and to identify features of interest with respect to soil CO2 flux variation. Overall, the deployment was successful. Small but sustained positive fluxes were present only twice during the year. The first such event was small but consistent and of long duration, occurring in the Austral winter. The second was more volatile and likely of microbial origin, and appeared for roughly a month at the end of the calendar year within the Austral summer. The observed patterns suggest that Hidden Valley soil CO2 fluxes are not solely biological in nature, but likely modulated by a combination of biological, geological, and physical processes, which will be discussed in this presentation. In future studies, additional measurement locations, and simultaneous subsurface and lower atmospheric gradient concentration measurements (power-permitting) would be extremely valuable for interpreting measured fluxes, to help identify advective depletion events, the depth source of fluxes, and changes in soil and atmospheric diffusivities.

Comparative analysis of fabrication methods for achieving rounded microchannels in PDMS

NASA Astrophysics Data System (ADS)

Bartlett, Nicholas W.; Wood, Robert J.

2016-11-01

Many microfluidic applications demand control over channel cross-sectional geometry. In particular, rounded microchannels are essential to the function of microfluidic valves, which have played an integral part in the success of microfluidics over the past fifteen years. Here we investigate the relative strengths and weaknesses of different strategies for fabricating rounded microchannels in PDMS, systematically examining five common strategies. We consider the appropriateness of the fabrication strategies for microchannels of differing sizes and aspect ratios, and evaluate these various strategies on a number of metrics ranging from microchannel resolution to fabrication difficulty. We discuss the merits of the different strategies for a range of applications, and make recommendations on which strategy to use based on the driving constraints of the device.

Chargemaster maintenance: think 'spring cleaning' all year round.

PubMed

Barton, Shawn; Lancaster, Dani; Bieker, Mike

2008-11-01

Steps toward maintaining a standardized chargemaster include: Building a corporate chargemaster maintenance team. Developing a core research function. Designating hospital liaisons. Publishing timely reports on facility compliance. Using system codes to identify charges. Selecting chargemaster maintenance software. Developing a standard chargemaster data repository. Educating staff.

The Schwartz Center Rounds: evaluation of an interdisciplinary approach to enhancing patient-centered communication, teamwork, and provider support.

PubMed

Lown, Beth A; Manning, Colleen F

2010-06-01

To assess the impact of Schwartz Center Rounds, an interdisciplinary forum where attendees discuss psychosocial and emotional aspects of patient care. The authors investigated changes in attendees' self-reported behaviors and beliefs about patient care, sense of teamwork, stress, and personal support. In 2006-2007, researchers conducted retrospective surveys of attendees at six sites offering Schwartz Center Rounds ("the Rounds") for > or =3 years and prospective surveys of attendees at 10 new Rounds sites that have held > or =7 Rounds. Most of the retrospective survey respondents indicated that attending Rounds enhanced their likelihood of attending to psychosocial and emotional aspects of care and enhanced their beliefs about the importance of empathy. Respondents reported better teamwork, including heightened appreciation of the roles and contributions of colleagues. There were significant decreases in perceived stress (P < .001) and improvements in the ability to cope with the psychosocial demands of care (P < .05). In the prospective study, after control for presurvey differences, the more Rounds one attended, the greater the impact on postsurvey insights into psychosocial aspects of care and teamwork (both: P < .05). Respondents to both retrospective and prospective surveys described changes in institutional culture and greater focus on patient-centered care and institution-specific initiatives. Schwartz Center Rounds may foster enhanced communication, teamwork, and provider support. The impact on measured outcomes increased with the number of Rounds attended. The Rounds represent an effective strategy for providing support to health care professionals and for enhancing relationships among them and with their patients.

Use of foreslope rounding by departments of transportation.

DOT National Transportation Integrated Search

2011-09-11

"To enhance driver safety, departments of transportation sometimes round the foreslopes of highway shoulders at the : intersection of the shoulder and its side slope. WisDOT was interested in learning about foreslope rounding practices : used by othe...

Medical ward round competence in internal medicine - an interview study towards an interprofessional development of an Entrustable Professional Activity (EPA).

PubMed

Wölfel, Teresa; Beltermann, Esther; Lottspeich, Christian; Vietz, Elisa; Fischer, Martin R; Schmidmaier, Ralf

2016-07-11

The medical ward round is a central but complex activity that is of relevance from the first day of work. However, difficulties for young doctors have been reported. Instruction of ward round competence in medical curricula is hampered by the lack of a standardized description of the procedure. This paper aims to identify and describe physicians' tasks and relevant competences for conducting a medical ward round on the first day of professional work. A review of recent literature revealed known important aspects of medical ward rounds. These were used for the development of a semi-structured interview schedule. Medical ward round experts working at different hospitals were interviewed. The sample consisted of 14 ward physicians (M = 8.82 years of work experience) and 12 nurses (M = 14.55 years of work experience) working in different specializations of internal medicine. All interviews were audiotaped, fully transcribed, and analyzed using an inductive-deductive coding scheme. Nine fields of competences with 18 related sub-competences and 62 observable tasks were identified as relevant for conducting a medical ward round. Over 70 % of the experts named communication, collaborative clinical reasoning and organization as essential competences. Deeper analysis further unveiled the importance of self-management, management of difficult situations, error management and teamwork. The study is the first to picture ward round competences and related tasks in detail and to define an EPA "Conducting an internal medicine ward round" based on systematic interprofessional expert interviews. It thus provides a basis for integration of ward round competences in the medical curricula in an evidence based manner and gives a framework for the development of instructional intervention studies and comparative studies in other medical fields.

Electronic Printed Ward Round Proformas: Freeing Up Doctors' Time.

PubMed

Fernandes, Darren; Eneje, Philip

2017-01-01

The role of a junior doctor involves preparing for the morning ward round. At a time when there are gaps on rotas and doctors' time is more stretched, this can be a source of significant delay and thus a loss of working time. We therefore looked at ways in which we could make the ward round a more efficient place by introducing specific electronic, printed ward round proformas. We used the average time taken to write proformas per patient and the average time taken per patient on the ward round. This would then enable us to make fair comparisons with future changes that were made using the plan, do, study, and act principles of quality improvement. Our baseline measurement found that the average time taken to write up the proforma for each patient was 1 minute 9 seconds and that the average time taken per patient on the ward round was 8 minutes 30 seconds. With the changes we made during our 3 PDSA cycles and the implementation of an electronic, printed ward round proforma, we found that we were able to reduce the average time spent per patient on the ward round to 6 minutes 32 seconds, an improvement of 1 min 58 seconds per patient. The project has thus enabled us to reduce the time taken per patient during the ward round. This improved efficiency will enable patients to be identified earlier for discharge. It will also aid in freeing up the time of junior doctors, allowing them to complete discharge letters sooner, order investigations earlier and enable them to complete their allocated tasks within contracted hours.

Using an Audience Response System Smartphone App to Improve Resident Education in the Pediatric Intensive Care Unit.

PubMed

Chung, Hoyoung; Kallay, Tom; Anas, Nick; Bruno, Diana; Decamps, Jose; Evans, Darci; Vilasagar, Niveditha; Mink, Richard B

2018-01-01

In the Pediatric Intensive Care Unit (PICU), most teaching occurs during bedside rounds, but technology now provides new opportunities to enhance education. Specifically, smartphone apps allow rapid communication between instructor and student. We hypothesized that using an audience response system (ARS) app can identify resident knowledge gaps, guide teaching, and enhance education in the PICU. Third-year pediatric residents rotating through the PICU participated in ARS-based education or received traditional teaching. Before rounds, experimental subjects completed an ARS quiz using the Socrative app. Concomitantly, the fellow leading rounds predicted quiz performance. Then, discussion points based on the incorrect answers were used to guide instruction. Scores on the pre-rotation test were similar between groups. On the post-rotation examination, ARS participants did not increase their scores more than controls. The fellow's prediction of performance was poor. Residents felt that the method enhanced their education whereas fellows reported that it improved their teaching efficiency. Although there was no measurable increase in knowledge using the ARS app, it may still be a useful tool to rapidly assess learners and help instructors provide learner-centered education.

19 CFR 159.3 - Rounding of fractions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Rounding of fractions. 159.3 Section 159.3 Customs... (CONTINUED) LIQUIDATION OF DUTIES General Provisions § 159.3 Rounding of fractions. (a) Value. In the... cents or more, the lower fractions shall be dropped, and if it is necessary to take up as whole dollars...

Powder-driven-nail connections for round timber

Treesearch

Ronald W. Wolfe; KugBo Shim; Marshall Begel

2003-01-01

In an effort to encourage the development of value-added engineered applications for small diameter round timber, research is being conducted at the US Forest Products Laboratory to develop and verify design guidelines for connections with specific application to round timbers. The objective of this work is to provide potential users with a number of viable connection...

International Technical Working Group Round Robin Tests

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

Dudder, Gordon B.; Hanlen, Richard C.; Herbillion, Georges M.

The goal of nuclear forensics is to develop a preferred approach to support illicit trafficking investigations. This approach must be widely understood and accepted as credible. The principal objectives of the Round Robin Tests are to prioritize forensic techniques and methods, evaluate attribution capabilities, and examine the utility of database. The HEU (Highly Enriched Uranium) Round Robin, and previous Plutonium Round Robin, have made tremendous contributions to fulfilling these goals through a collaborative learning experience that resulted from the outstanding efforts of the nine participating internal laboratories. A prioritized list of techniques and methods has been developed based on thismore » exercise. Current work is focused on the extent to which the techniques and methods can be generalized. The HEU Round Robin demonstrated a rather high level of capability to determine the important characteristics of the materials and processes using analytical methods. When this capability is combined with the appropriate knowledge/database, it results in a significant capability to attribute the source of the materials to a specific process or facility. A number of shortfalls were also identified in the current capabilities including procedures for non-nuclear forensics and the lack of a comprehensive network of data/knowledge bases. The results of the Round Robin will be used to develop guidelines or a ''recommended protocol'' to be made available to the interested authorities and countries to use in real cases.« less

Ethical Grand Rounds: Teaching Ethics at the Point of Care.

PubMed

Airth-Kindree, Norah M M; Kirkhorn, Lee-Ellen C

2016-01-01

We offer an educational innovation called Ethical Grand Rounds (EGR) as a teaching strategy to enhance ethical decision-making. Nursing students participate in EGR-flexible ethical laboratories, where they take stands on ethical dilemmas, arguing for--or against--an ethical principle. This process provides the opportunity to move past normative ethics, that is, an ideal ethical stance in accord with ethical conduct codes, to applied ethics, what professional nurses would do in actual clinical practice, given the constraints that exist in contemporary care settings. EGR serves as a vehicle to translate "what ought to be" into "what is."

Effectiveness of piscicides for controlling round gobies (Neogobius melanostomus)

USGS Publications Warehouse

Schreier, Theresa M.; Dawson, V.K.; Larson, W.

2008-01-01

Round gobies (Neogobius melanostomus) were introduced to the Great Lakes presumably as a result of ballast water releases from seagoing freighters returning from European water bodies. These unwelcome fish have become established in the Great Lakes region and are expanding their range to suitable portions of other interior drainage basins including the Mississippi River traversing the central United States and the Trent-Severn waterway spanning south-central Ontario. If the invasion continues, use of chemical toxicants as a control measure may be necessary. Toxicity tests of the currently registered piscicides antimycin, rotenone, 3-trifluoromethyl-4-nitrophenol (TFM), and Bayluscide?? were conducted with three fish species native to the Great Lakes and round gobies collected from the Illinois Waterway. Tests indicated that round gobies are sensitive to all of the piscicides, however, the level of sensitivity is similar to that of the native fish species tested. Therefore, currently registered piscicides have limited potential to selectively remove round gobies. Bottom-release formulations of Bayluscide?? and antimycin were also evaluated as control agents for the normally bottom-dwelling round goby. Avoidance behavior tests demonstrated that the round goby did not react to the presence of either chemical. Therefore, the bottom-release formulations may have some application for the selective removal of round gobies, and may be one of the few tools presently available to fishery managers to help limit the range expansion of this invasive fish.

Outdoor Recreation and Education for the Mentally Retarded.

ERIC Educational Resources Information Center

Grosse, Reg

A year-round outdoor recreation and education program for the moderately and severely retarded begun in 1972 at Craig State School in Sonyea, New York, is summarized in this report of development of the program, its success, and recommendations for the future. The program builds progressively from a nature trail hike to a day camping program one…

Invasion strategies in round goby (Neogobius melanostomus): Is bigger really better?

PubMed Central

Schliewen, Ulrich K.

2018-01-01

Few studies have systematically investigated mid- or long-term temporal changes of biological characteristics in invasive alien species considering the different phases of an invasion. We studied the invasion performance of one of the most invasive species worldwide, the round goby Neogobius melanostomus, from total absence over first occurrence until establishment from 2010 to 2015 in the upper Danube River. After an upstream movement of the invasion front of about 30 river km within four years, the pattern that round goby pioneering populations significantly differ from longer established ones has been confirmed: Pioneering populations at the invasion front comprised more females than males, and adult specimens with a larger body size compared to those at longer inhabited areas. On the population-level, the proportion of juveniles increased with time since invasion. The results of this study provide support for the previously postulated ´bigger is better´ and ´individual trait utility´ hypotheses explaining invasion success in round goby. Pioneering invaders with their greater exploratory behavior, highly adaptive phenotypic plasticity and increased competitive ability seem to act as prime emperors of new habitats, strongly following and benefiting from man-made river-bank structures. PMID:29304159

Earning a Living Wage: Metro Differences in Opportunity and Inequality for Adult Males with Low Education Levels. Working Papers on Regional Economic Opportunities.

ERIC Educational Resources Information Center

Foster-Bey, John; Rubin, Mark; Temkin, Kenneth

This paper measures the relationship between employment growth and employment opportunities for noncollege-educated males, examining variations across metropolitan areas in the living-wage employment ratio for prime-aged males with at most a high school education (less educated). Living-wage employment is full-time, year-round employment yielding…

Medical student appraisal: electronic resources for inpatient pre-rounding.

PubMed

Sampognaro, P J; Mitchell, S L; Weeks, S R; Khalifian, S; Markman, T M; Uebel, L W; Dattilo, J R

2013-01-01

Pre-rounding is essential to preparing for morning rounds. Despite its importance, pre-rounding is rarely formally taught within the medical school curriculum and more often informally learned by modeling residents. The evolution of mobile applications provides opportunities to optimize this process. To evaluate three options available to medical students while pre-rounding and promote adoption of mobile resources in clinical care. Six medical students formed the evaluation cohort. Students were surveyed to assess pre-rounding practices. Participants utilized paper-based pre-rounding templates for two weeks followed by two weeks of the electronic note-taking service Evernote. A review of mobile applications on the iTunes and Google Play stores was performed, with each application informally reviewed by a single student. The application Scutsheet was selected for formal review by all students. Data was collected from narrative responses supplied by students throughout the evaluation periods and aggregated to assess strengths and limitations of each application. Pre-study responses demonstrated two consistent processes: verbal sign-out of overnight events and template use to organize patient information. The paper-based template was praised for its organization and familiarity amongst residents, but perceived as limited by the requirement of re-copying data into the hospital's electronic medical record (EMR). Evernote excelled due to compatibility across multiple operating systems, including accessibility from clinical workstations and ability to copy notes into the hospital's EMR. Scutsheet allowed for retention of data across multiple hospital days, but was limited by inability to export data or modify the electronic template. Aggregated user feedback identified the abilities to customize templates and copy information into the EMR as two prevailing characteristics that enhanced the efficiency of pre-rounding. Mobile devices offer the potential to enhance pre-rounding

Environmental heterogeneity associated with European perch (Perca fluviatilis) predation on invasive round goby (Neogobius melanostomus).

PubMed

Liversage, Kiran; Nurkse, Kristiina; Kotta, Jonne; Järv, Leili

2017-12-01

Spatiotemporal environmental variation affects fish feeding behaviour and capacity for piscivorous control of prey populations, which is important for management when prey include invasive species causing ecosystem impacts. We assessed gut-contents of an important piscivore (European perch Perca fluviatilis) over two years, and analysed variables affecting initiation and amounts of feeding, focusing on an important invasive prey species, round goby (Neogobius melanostomus). We show that predation is primarily controlled by variation of physical and habitat characteristics surrounding perch. Fish prey began being incorporated in diets of perch that were >150 mm, with temperature conditions controlling initiation of their feeding. Total amounts of fish in perch diets, and amounts of round goby individually, were strongly affected by macrophyte cover; seldom were fish present in perch stomachs when macrophyte cover was >40%. Environmental densities of round goby were related to multivariate diet composition in ways that suggest predation of some native species may be relaxed in areas of dense round goby populations. There was evidence that perch predation is unlikely to limit populations of the invader, as there was only a weak relationship between round goby densities and amounts in gut contents. The results have ecosystem management implications, because some variables found to be important could be manipulated to control round goby or other similar invaders e.g. fisheries management of native piscivore stock-density and body-size, or modification of benthic environment structure. Copyright © 2017 Elsevier Ltd. All rights reserved.

A new way to experience the International Gastric Cancer Association Congress: the Web Round Tables.

PubMed

Morgagni, Paolo; Verlato, Giuseppe; Marrelli, Daniele; Roviello, Franco; de Manzoni, Giovanni

2014-10-01

In an attempt to attract a wider diversity of professionals to the 10th International Gastric Cancer Association Congress (IGCC) held in June 2013, the Scientific Committee of the conference organized a number of pre-congress Web Round Tables to discuss cutting-edge topics relating to gastric cancer treatment. Twenty Web Round Tables, each coordinated by a different chairman, were proposed on the IGCC Website 1 year before the congress. Each chairman identified a number of studies related to the theme of his/her Round Table and invited corresponding authors to send an update of their conclusions in light of their subsequent experience, which would then form the basis of discussion of the Web Round Tables. The chairmen posted several questions regarding these updates on the web and opened a forum for a period of 1-2 months. The forum was free and specifically intended for congress participants. Fifty-one (9.9 %) of the 516 authors contacted took part in the initiative. Two hundred fifty participants from 21 countries joined the forum discussion and posted 671 comments. The Web Round Tables were viewed 15,810 times while the forum was open. Overall, the Web Round Tables aroused considerable interest, especially among young professionals working in the area of gastric cancer who had the opportunity to contact and interact with experts in what often turned out to be an interesting and lively exchange of views. All the discussions are now freely available for consultation on the IGCC website. The Web Round Table experience was presented, with great success, during the conference at special afternoon sessions.

Status and Evolution of the Journal of Astronomy & Earth Science Education's First Year

NASA Astrophysics Data System (ADS)

Slater, Timothy F.

2016-01-01

The Journal of Astronomy & Earth Science Education (JAESE.org) is a recently created, peer-reviewed journal designed to serve the discipline-based astronomy, planetary, and geo-sciences education research community. JAESE's first issue was published on December 31, 2014 and has published two volumes and three issues since that time, encompassing 15 peer-reviewed articles. By far, the median article topic has been focused on planetarium education research, while there has only been one article on solid Earth geosciences education research. Although there is not yet an even distribution of topics across the field, there is a relatively even distribution among author demographics. Authors include a range of both junior and senior members of the field. There have been slightly female authors than male authors. Submissions are distributed to two or three reviewers with authors' names redacted from the manuscript. The average time to complete the first round of peer-review reviewers is 6.2-weeks. There have been too few manuscripts to reliably publish a "percentage acceptance rate." Finally, the majority of recently completed astronomy education research doctoral dissertations have been published in JAESE. Taken together, JAESE's guiding Editorial Advisory Board judges this to be a successful first year. In a purposeful effort to make JAESE authors' scholarly works as widely accessible as possible, JAESE adopted an open-access business model. JAESE articles are available to read free-of-charge over the Internet, delivered as PDFs. To date, the most common way articles are downloaded by readers is through Google Scholar. Instead of charging readers and libraries recurring subscription fees, JAESE charges authors a nominal submission fee and a small open-access fee, averaging about $500 USD. These charges are similar to the traditional page charges typically charged to authors or their institutions by scientific journals, making JAESE an attractive publishing venue for

The Nature of Primary Students' Conversation in Technology Education

ERIC Educational Resources Information Center

Fox-Turnbull, Wendy H.

2016-01-01

Classroom conversations are core to establishing successful learning for students. This research explores the nature of conversation in technology education in the primary classroom and the implications for teaching and learning. Over a year, two units of work in technology were taught in two primary classrooms. Most data was gathered in Round 2…

Investigating Discourses for Administrators' Learning within Instructional Rounds

ERIC Educational Resources Information Center

Allen, David; Roegman, Rachel; Hatch, Thomas

2016-01-01

Instructional rounds is a professional learning practice for supporting school and district leaders' understanding of the instructional core, the interaction among curricular content, instruction, and student learning, which is a foundation for instructional leadership practices. This article examines instructional rounds visits within a network…

School-Based Instructional Rounds: Improving Teaching and Learning across Classrooms

ERIC Educational Resources Information Center

Teitel, Lee

2013-01-01

In "School-Based Instructional Rounds," Teitel offers detailed case studies of five different models of school-based rounds and investigates critical learning from each. Instructional rounds--one of the most innovative and powerful approaches to improving teaching and learning--has been taken up by districts across the country and around…

Incorporating metacognition into morbidity and mortality rounds: The next frontier in quality improvement.

PubMed

Katz, David; Detsky, Allan S

2016-02-01

This Perspective proposes the introduction of metacognition (thinking about thinking) into the existing format of hospital-based morbidity and mortality rounds. It is placed in the context of historical movements to advance quality improvement by expanding the spectrum of the causes of medical error from systems-based issues to flawed human decision-making capabilities. We suggest that the current approach that focuses on systems-based issues can be improved by exploiting the opportunities to educate physicians about predictable errors committed by reliance on cognitive heuristics. In addition, because the field of educating clinicians about cognitive heuristics has shown mixed results, this proposal represents fertile ground for further research. Educating clinicians about cognitive heuristics may improve metacognition and perhaps be the next frontier in quality improvement. © 2015 Society of Hospital Medicine.

Round window closure affects cochlear responses to suprathreshold stimuli.

PubMed

Cai, Qunfeng; Whitcomb, Carolyn; Eggleston, Jessica; Sun, Wei; Salvi, Richard; Hu, Bo Hua

2013-12-01

The round window acts as a vent for releasing inner ear pressure and facilitating basilar membrane vibration. Loss of this venting function affects cochlear function, which leads to hearing impairment. In an effort to identify functional changes that might be used in clinical diagnosis of round window atresia, the current investigation was designed to examine how the cochlea responds to suprathreshold stimuli following round window closure. Prospective, controlled, animal study. A rat model of round window occlusion (RWO) was established. With this model, the thresholds of auditory brainstem responses (ABR) and the input/output (IO) functions of distortion product otoacoustic emissions (DPOAEs) and acoustic startle responses were examined. Round window closure caused a mild shift in the thresholds of the auditory brainstem response (13.5 ± 9.1 dB). It also reduced the amplitudes of the distortion product otoacoustic emissions and the slope of the input/output functions. This peripheral change was accompanied by a significant reduction in the amplitude, but not the threshold, of the acoustic startle reflex, a motor response to suprathreshold sounds. In addition to causing mild increase in the threshold of the auditory brainstem response, round window occlusion reduced the slopes of both distortion product otoacoustic emissions and startle reflex input/output functions. These changes differ from those observed for typical conductive or sensory hearing loss, and could be present in patients with round window atresia. However, future clinical observations in patients are needed to confirm these findings. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Variations in early life history traits of Japanese anchovy Engraulis japonicus in the Yangtze River Estuary.

PubMed

Liu, Chunlong; Xian, Weiwei; Liu, Shude; Chen, Yifeng

2018-01-01

Resources of Japanese anchovy ( Engraulis japonicus Temminck & Schlegel, 1846) are undergoing dramatic recessions in China as the consequence of intensifying anthropogenic activities. Elucidating the influences of local-scale environmental factors on early life history traits is of great importance to design strategies conserving and restoring the declining anchovy resources. In this research, we studied hatching date and early growth of anchovy in the Yangtze River Estuary (YRE) using information obtained from otolith microstructure. Onset of hatching season and growth rates of anchovy was compared to populations in Japan and Taiwan. In YRE, the hatching date of anchovy ranged from February 26th to April 6th and mean growth rate ranged from 0.27 to 0.77 mm/d. Anchovies hatching later had higher growth rates than individuals hatching earlier before the 25th day. Among populations, hatching onsets of anchovy from the higher latitude were later than populations in the lower latitude, and growth rates of anchovy in YRE were much lower than populations in Japan and Taiwan. Variations in hatching onsets and early growth patterns of anchovy thus provide important knowledge on understanding the adaptation of anchovy in YRE and designing management strategies on conserving China's anchovy resources.

Lower antibiotic costs attributable to clinical microbiology rounds.

PubMed

Huang, Richard S P; Guervil, David J; Hunter, Robert L; Wanger, Audrey

2015-09-01

At our institution, our microbiologist, pharmacist, and infectious disease (ID) team meet to discuss ID patients, and this meeting is referred to as microbiology rounds. We hypothesized that our microbiology rounds reduce antibiotic costs. The study involved a review of 80 patients with an ID consultation order at each of the 3 hospitals: hospital A (HA) (only HA has microbiology rounds), hospital B (HB), and hospital C (HC). Of this population, we included patients with a positive blood culture. Thirty-six patients who met the above criteria were included in the study. The average antibiotic cost/patient/day at HA, HB, and HC were $66.0, $123, and $109, respectively. Also, we found that change in antibiotics was appropriate when compared to the final microbiology results in 90%, 44%, and 40% of the time at HA, HB, and HC, respectively. Herein, we found an association between conducting microbiology rounds and reduction of antibiotic cost. Copyright © 2015 Elsevier Inc. All rights reserved.

Round versus rectangular: Does the plot shape matter?

NASA Astrophysics Data System (ADS)

Iserloh, Thomas; Bäthke, Lars; Ries, Johannes B.

2016-04-01

Field rainfall simulators are designed to study soil erosion processes and provide urgently needed data for various geomorphological, hydrological and pedological issues. Due to the different conditions and technologies applied, there are several methodological aspects under review of the scientific community, particularly concerning design, procedures and conditions of measurement for infiltration, runoff and soil erosion. Extensive discussions at the Rainfall Simulator Workshop 2011 in Trier and the Splinter Meeting at EGU 2013 "Rainfall simulation: Big steps forward!" lead to the opinion that the rectangular shape is the more suitable plot shape compared to the round plot. A horizontally edging Gerlach trough is installed for sample collection without forming unnatural necks as is found at round or triangle plots. Since most research groups did and currently do work with round plots at the point scale (<1m²), a precise analysis of the differences between the output of round and square plots are necessary. Our hypotheses are: - Round plot shapes disturb surface runoff, unnatural fluvial dynamics for the given plot size such as pool development especially directly at the plot's outlet occur. - A square plot shape prevent these problems. A first comparison between round and rectangular plots (Iserloh et al., 2015) indicates that the rectangular plot could indeed be the more suitable, but the rather ambiguous results make a more elaborate test setup necessary. The laboratory test setup includes the two plot shapes (round, square), a standardised silty substrate and three inclinations (2°, 6°, 12°). The analysis of the laboratory test provide results on the best performance concerning undisturbed surface runoff and soil/water sampling at the plot's outlet. The analysis of the plot shape concerning its influence on runoff and erosion shows that clear methodological standards are necessary in order to make rainfall simulation experiments comparable. Reference

[Desmoplastic small round cell tumor in children, adolescents and young adults].

PubMed

de Marcellus, Charles; Sarnacki, Sabine; Pierron, Gaëlle; Ranchère-Vince, Dominique; Scalabre, Aurélien; Bolle, Stéphanie; Minard-Colin, Véronique; Corradini, Nadège; Fayard, Cindy; Orbach, Daniel

2018-05-01

Desmoplastic small round cell tumor (DSRCT) is a rare sarcoma that typically affects pediatric and young adult patients with a median age in the general and in the pediatric population of 24.6 years (range 4-58 years) and 15.0 years (range 0-21 years) respectively, with a strong male predominance. This tumor is characterized by a specific t(11;22)(p13;q12) that results in fusion of EWS and WT1 genes which can be demonstrated by RT-PCR or by FISH. DSRCT most frequently presents as an intra-abdominal primary mass associated with peritoneal seeding and a highly aggressive pattern of spread. Generally, all tumors showed the typical histologic findings of variably sized clusters of poly-phenotypic small, round, or spindled cells lying in a desmoplastic stroma. Treatment of this malignancy remains a challenge. The combination of polychemotherapy regimens and aggressive surgery followed by whole abdomen radiation therapy represents nowadays a classical protocol for DSRCT. The survival rate of DSRCT patients is still disappointing around 20 %. However, the survival of patients who had complete resection of the tumor appears better. Hopes are turning to targeted therapeutics against this simple genomic sarcoma. Authors summarize medical knowledge of this rare tumor. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

The Importance of Situational Awareness: A Qualitative Study of Family Members' and Nurses' Perspectives on Teaching During Family-Centered Rounds.

PubMed

Beck, Jimmy; Meyer, Rebecca; Kind, Terry; Bhansali, Priti

2015-10-01

Family-centered rounds (FCR) has become a leading model for pediatric inpatient rounding. During FCR, faculty must balance trainees' educational needs with patient care priorities. Investigators have examined trainees' views on effective teaching during FCR, but none have evaluated what family members and nurses consider to be effective teaching behaviors of attending physicians. The authors sought to explore family members' and nurses' perspectives on effective teaching behaviors during FCR. The authors conducted (2012-2013) a qualitative study of families and nurses at an academic children's hospital where FCR is the standard model for inpatient rounds. Nurses and families familiar with FCR participated in separate focus groups. The authors reviewed focus group transcripts using techniques of qualitative content analysis; they generated codes and developed categories, supported by illustrative quotations. Fifteen nurses and 13 family members participated in the focus groups. The unifying theme was that situational awareness on behalf of the attending physician is essential for FCR to be educational for all participants. The authors identified four categories of awareness-(1) cognitive factors, (2) logistics and time management, (3) physical environment, (4) emotional state-and developed a set of effective teaching strategies based on participants' comments. The findings of this study support previous work identifying effective FCR teaching strategies, but this study is the first to include the perspectives of families and nurses. The inclusion of these participants provides a framework for faculty development and training to improve the educational value of FCR.

Recommended Protocol for Round Robin Studies in Additive Manufacturing

PubMed Central

Moylan, Shawn; Brown, Christopher U.; Slotwinski, John

2016-01-01

One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST’s experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed. PMID:27274602

Recommended Protocol for Round Robin Studies in Additive Manufacturing.

PubMed

Moylan, Shawn; Brown, Christopher U; Slotwinski, John

2016-03-01

One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST's experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed.

Surgical anatomy of the round window-Implications for cochlear implantation.

PubMed

Luers, J C; Hüttenbrink, K B; Beutner, D

2018-04-01

The round window is an important portal for the application of active hearing aids and cochlear implants. The anatomical and topographical knowledge about the round window region is a prerequisite for successful insertion for a cochlear implant electrode. To sum up current knowledge about the round window anatomy and to give advice to the cochlear implant surgeon for optimal placement of an electrode. Systematic Medline search. Search term "round window[Title]" with no date restriction. Only publications in the English Language were included. All abstracts were screened for relevance, that is a focus on surgical anatomy of the round window. The search results were supplemented with hand searching of selected reviews and reference lists from included studies. Subjective assessment. There is substantial variability in size and shape of the round window. The round window is regarded as the most reliable surgical landmark to safely locate the scala tympani. Factors affecting the optimal trajectory line for atraumatic electrode insertion are anatomy of the round window, the anatomy of the intracochlear hook region and the variable orientation and size of the cochlea's basal turn. The very close relation to the sensitive inner ear structures necessitates a thorough anatomic knowledge and careful insertion technique, especially when implanting patients with residual hearing. In order to avoid electrode migration between the scalae and to achieve protect the modiolus and the basilar membrane, it is recommended to aim for an electrode insertion vector from postero-superior to antero-inferior. © 2017 John Wiley & Sons Ltd.

Entrepreneurial Education in Nigeria Tertiary Institutions and Sustainable Development

ERIC Educational Resources Information Center

Agboola, B. M.

2010-01-01

The higher education in Nigeria has witnessed a tremendous growth in the last 50 years in terms of producing manpower that could bring about development. However, the problem of Nigeria today is not about human and natural resources, but how to translate the human potentials to meet the realization of its all round development and sustain economic…

Nine-Year Core Study Data for Sientra's FDA-Approved Round and Shaped Implants with High-Strength Cohesive Silicone Gel.

PubMed

Stevens, W Grant; Calobrace, M Bradley; Harrington, Jennifer; Alizadeh, Kaveh; Zeidler, Kamakshi R; d'Incelli, Rosalyn C

2016-04-01

Since approval in March 2012, data on Sientra's (Santa Barbara, CA) silicone gel implants have been updated and published regularly to provide immediate visibility to the continued safety and performance of these devices. The 9 year follow-up data support the previously published data confirming the ongoing safety and efficacy of Sientra silicone gel breast implants. The authors provide updated 9 year study data for Sientra's round and shaped silicone gel breast implants. The Core Study is an ongoing 10 year study that enrolled 1788 patients with 3506 Sientra implants across four indications (primary augmentation, revision-augmentation, primary reconstruction, and revision-reconstruction). For the safety analysis, Kaplan-Meier risk rates were calculated to evaluate postoperative complications, including all breast implant-related adverse effects. For the effectiveness analyses, results were presented through 8 years as patient satisfaction scores were assessed at even years. Through 9 years, the overall risk of capsular contracture was 12.6%. Smooth devices (16.6%, 95% CI, 14.2%, 19.5%) had a statistically significantly higher rate of capsular contracture compared to textured devices (8.0%, 95% CI, 6.2%, 10.4%). Out of the 610 reoperations in 477 patients, over half of all reoperations were due to cosmetic reasons (n = 315; 51.6%). Patient satisfaction remains high through 8 years, with 90% of primary augmentation patients indicating their breast implants look natural and feel soft. The 9-year follow-up data from the ongoing Core Study of the Sientra portfolio of HSC and HSC+ silicone gel breast implants reaffirm the very strong safety profile as well as continued patient satisfaction. 2 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

38 CFR 3.29 - Rounding.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., Compensation, and Dependency and Indemnity Compensation General § 3.29 Rounding. (a) Annual rates. Where the... countable income, and parents' dependency and indemnity compensation benefit rates and annual income...

38 CFR 3.29 - Rounding.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., Compensation, and Dependency and Indemnity Compensation General § 3.29 Rounding. (a) Annual rates. Where the... countable income, and parents' dependency and indemnity compensation benefit rates and annual income...

38 CFR 3.29 - Rounding.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Compensation, and Dependency and Indemnity Compensation General § 3.29 Rounding. (a) Annual rates. Where the... countable income, and parents' dependency and indemnity compensation benefit rates and annual income...

38 CFR 3.29 - Rounding.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Compensation, and Dependency and Indemnity Compensation General § 3.29 Rounding. (a) Annual rates. Where the... countable income, and parents' dependency and indemnity compensation benefit rates and annual income...

38 CFR 3.29 - Rounding.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., Compensation, and Dependency and Indemnity Compensation General § 3.29 Rounding. (a) Annual rates. Where the... countable income, and parents' dependency and indemnity compensation benefit rates and annual income...

Rounds Process: Puts Teachers in Charge of Learning

ERIC Educational Resources Information Center

Troen, Vivian; Boles, Katherine C.

2014-01-01

Most people are familiar with the practice of medical rounds, in which interns and mentoring physicians visit patients in an institutional setting, observe their various conditions, discuss what they observed, and analyze possible treatment options and outcomes. In the medical profession, making these rounds is viewed as a significant and highly…

Desmoplastic small round cell tumor of the middle ear: A case report.

PubMed

Xu, Jing; Yao, Mengwei; Yang, Xinxin; Liu, Tao; Wang, Shaohua; Ma, Dengdian; Li, Xiaoyu

2018-04-01

Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive and malignant tumor. This report describes a case involving DSRCT of the middle ear which no case has been reported in the literature till date. A 59-year-old Chinese man with a 40-year history of repeated suppuration of his right ear and 1-year history of drooping of the angle of mouth. The CT of the middle ear and brain scan and enhanced MRI showed space occupying lesion in the right middle ear. Desmoplastic small round cell tumor of the middle ear. After relevant examinations, radical mastoidectomy and subtotal temporal bone resection were performed on the right ear under general anesthesia. The patient underwent postoperative adjuvant chemoradiation therapy. The patient was counterchecked regularly,there was norecurrence of DSRCT of the middle ear. Four years after surgery, the CT and MRI of the middle ear mastoid showed right middle ear soft tissue shadow,but postoperative pathological results showed proliferative fibrous and vascular tissues with chronic inflammatory cell infiltration and necrosis. DSRCT is a relatively aggressive, malignant mesenchymal tumor, with a very poor prognosis.The diagnosis of DSRCT relies on immunohistological data. Early diagnosis, radical surgery, chemotherapy, and radiotherapy are considered a reasonable way to prolong survival.

Round window chamber and fustis: endoscopic anatomy and surgical implications.

PubMed

Marchioni, Daniele; Soloperto, Davide; Colleselli, Elena; Tatti, Maria Fatima; Patel, Nirmal; Jufas, Nicholas

2016-11-01

The round window region is of critical importance in the anatomy of the middle ear. The aim of this paper is to describe its anatomy from an endoscopic point of view, emphasizing structures that have important surgical implications, in particular the fustis and the subcochlear canaliculus. The fustis, a smooth bony structure that forms the floor of the round window region, is a constant and important structure. It seems to indicate the round window membrane and the correct position of scala tympani. A structure connecting the round window region to the petrous apex, named the subcochlear canaliculus, is also described. A retrospective review of video recordings of endoscopic dissection and surgical procedures, carried out between June 2014 and February 2015, was conducted across two Tertiary university referral centers. A total of 42 dissections were analyzed in the study. We observed the fustis in all the cases and we identify two different anatomical conformations. The subcochlear canaliculus was found in 81.0 %, with a pneumatization direct to the petrous apex in 47.7 %. Conformation and limits of the round window niche may influence the surgical view of the round window membrane. Endoscopic approaches allow a very detailed view, which enables a comprehensive exploration of the round window region. Accurate knowledge of the anatomical relationships of this region has important advantages during middle ear surgery.

Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women

PubMed Central

Haghighat, Shahpar; Akbari, Mohammad Esmaeil; Yavari, Parvin; Javanbakht, Mehdi; Ghaffari, Shahram

2016-01-01

Background Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease. Objectives We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer. Patients and Methods This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years (QALY) and lifetime costs. Results The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int. $ 37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int. $ 141,641 and Int. $ 389,148 respectively. Conclusions Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making. PMID:27366315

Rounding Technique for High-Speed Digital Signal Processing

NASA Technical Reports Server (NTRS)

Wechsler, E. R.

1983-01-01

Arithmetic technique facilitates high-speed rounding of 2's complement binary data. Conventional rounding of 2's complement numbers presents problems in high-speed digital circuits. Proposed technique consists of truncating K + 1 bits then attaching bit in least significant position. Mean output error is zero, eliminating introducing voltage offset at input.

ASBESTOS-CONTAINING MATERIALS IN SCHOOL BUILDINGS: BULK SAMPLE ANALYSIS QUALITY ASSURANCE PROGRAM-BULK SAMPLE ROUNDS 9, 10, 11 AND BLIND ROUND 2

EPA Science Inventory

The report presents the results of laboratories participating in the nineth, tenth, eleventh and second blind round(s) of the bulk sample analysis quality assurance program sponsored by the U.S. Environmental Protection Agency. Two hundred fifty-four, 320, 318, and 50 laboratorie...

Contrasting responses of male and female foraging effort to year-round wind conditions.

PubMed

Lewis, Sue; Phillips, Richard A; Burthe, Sarah J; Wanless, Sarah; Daunt, Francis

2015-11-01

There is growing interest in the effects of wind on wild animals, given evidence that wind speeds are increasing and becoming more variable in some regions, particularly at temperate latitudes. Wind may alter movement patterns or foraging ability, with consequences for energy budgets and, ultimately, demographic rates. These effects are expected to vary among individuals due to intrinsic factors such as sex, age or feeding proficiency. Furthermore, this variation is predicted to become more marked as wind conditions deteriorate, which may have profound consequences for population dynamics as the climate changes. However, the interaction between wind and intrinsic effects has not been comprehensively tested. In many species, in particular those showing sexual size dimorphism, males and females vary in foraging performance. Here, we undertook year-round deployments of data loggers to test for interactions between sex and wind speed and direction on foraging effort in adult European shags Phalacrocorax aristotelis, a pursuit-diving seabird in which males are c. 18% heavier. We found that foraging time was lower at high wind speeds but higher during easterly (onshore) winds. Furthermore, there was an interaction between sex and wind conditions on foraging effort, such that females foraged for longer than males when winds were of greater strength (9% difference at high wind speeds vs. 1% at low wind speeds) and when winds were easterly compared with westerly (7% and 4% difference, respectively). The results supported our prediction that sex-specific differences in foraging effort would become more marked as wind conditions worsen. Since foraging time is linked to demographic rates in this species, our findings are likely to have important consequences for population dynamics by amplifying sex-specific differences in survival rates. © 2015 The Authors. Journal of Animal Ecology published by John Wiley & Sons Ltd on behalf of the British Ecological Society.

The role of immunohistochemistry in the analysis of the spectrum of small round cell tumours at a tertiary care centre.

PubMed

D'cruze, Lawrence; Dutta, Ruma; Rao, Shalinee; R, Anuradha; Varadarajan, Suresh; Kuruvilla, Sarah

2013-07-01

The term, "Small Round - Cell Tumours" (SRCT) describes a group of highly aggressive malignant neoplasms which are composed predominantly of small and monotonous undifferentiated cells with high nucleocytoplasmic ratios. Immunohistochemistry (IHC) plays a crucial role in catagorizing the small round - cell tumours. This study was done to analyse the spectrum of small round cell tumours over a period of five years at a tertiary care centre and to study the relevance of immunohistochemistry in making precise diagnoses of the small round cell tumours. Formalin - fixed, paraffin - embedded sections of tumours which were diagnosed as small round cell tumours on small biopsies and resected specimens were retrieved from the files of the Department of Pathology of Sri Ramachandra Medical College and Research institute, in the period from January 2005 to December 2009. This study was confined to the bone and the soft tissues. Decalcification was performed on the bony tissues before the routine processing was done. The patients belonging to all age groups were included in this study. The small round cell tumours of the bone marrow, the spleen and the lymph node was excluded from our study. Immunohistochemical stains were performed to differentiate and categorise the small round blue cell tumours. The immunomarkers which were utilised in this study included CD45/LCA (the lymphocyte common antigen), CD20, CD3, CD99 (cluster of differentiation 99 also known as MIC2), desmin, EMA (epithelial membrane antigen), CK(cytokeratin), synaptophysin, chromogranin and GFAP (Glial fibrillary acidic protein). Forty three cases of small round cell tumours were analysed, which included 19 cases of NHL (non Hodgkin's lymphoma), 6 cases of Ewing/PNETs (primitive neuroectodermal tumours), 3 cases of atypical carcinoid, 3 cases of olfactory neuroblastoma, 2 cases each of rhabdomyosarcoma, Wilms tumour, neuroblastoma and synovial sarcoma and 1 case each of small cell osteosarcoma, small (oat) cell

The value of case-based teaching vignettes in clinical microbiology rounds.

PubMed

Spicer, Jennifer O; Kraft, Colleen S; Burd, Eileen M; Armstrong, Wendy S; Guarner, Jeannette

2014-03-01

To describe the implementation and evaluation of a case-based microbiology curriculum during daily microbiology rounds. Vignettes consist of short cases with images and questions that facilitate discussion among microbiologists, pathologists, infectious disease physicians, and trainees (residents and fellows). We performed a survey to assess the value of these vignettes to trainees. Motivation to come to rounds on time increased from 60% to 100%. Trainees attending rounds after implementation of the vignettes perceived the value of microbiology rounds to be significantly higher compared with those who attended rounds before implementation (P = .04). Pathology residents found that vignettes were helpful for retaining knowledge (8.3 of 10 points). The vignettes have enhanced the value of microbiology rounds by serving as a formalized curriculum exposing trainees from multiple specialties to various microbiology topics. Emphasis on interdisciplinary interactions between clinical and laboratory personnel was highlighted with this case-based curriculum.

Transient Three-Dimensional Side Load Analysis of Out-of-Round Film Cooled Nozzles

NASA Technical Reports Server (NTRS)

Wang, Ten-See; Lin, Jeff; Ruf, Joe; Guidos, Mike

2010-01-01

The objective of this study is to investigate the effect of nozzle out-of-roundness on the transient startup side loads at a high altitude, with an anchored computational methodology. The out-of-roundness could be the result of asymmetric loads induced by hardware attached to the nozzle, asymmetric internal stresses induced by previous tests, and deformation, such as creep, from previous tests. The rocket engine studied encompasses a regeneratively cooled thrust chamber and a film cooled nozzle extension with film coolant distributed from a turbine exhaust manifold. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and a transient inlet history based on an engine system simulation. Transient startup computations were performed with the out-of-roundness achieved by four different degrees of ovalization: one perfectly round, one slightly out-of-round, one more out-of-round, and one significantly out-of-round. The results show that the separation-line-jump is the peak side load physics for the round, slightly our-of-round, and more out-of-round cases, and the peak side load increases as the degree of out-of-roundness increases. For the significantly out-of-round nozzle, however, the peak side load reduces to comparable to that of the round nozzle and the separation line jump is not the peak side load physics. The counter-intuitive result of the significantly out-of-round case is found to be related to a side force reduction mechanism that splits the effect of the separation-line-jump into two parts, not only in the circumferential direction and most importantly in time.

Summary of the ACAT Round Table Discussion: Open-source, knowledge sharing and scientific collaboration

NASA Astrophysics Data System (ADS)

Carminati, Federico; Perret-Gallix, Denis; Riemann, Tord

2014-06-01

Round table discussions are in the tradition of ACAT. This year's plenary round table discussion was devoted to questions related to the use of scientific software in High Energy Physics and beyond. The 90 minutes of discussion were lively, and quite a lot of diverse opinions were spelled out. Although the discussion was, in part, controversial, the participants agreed unanimously on several basic issues in software sharing: • The importance of having various licensing models in academic research; • The basic value of proper recognition and attribution of intellectual property, including scientific software; • The user respect for the conditions of use, including licence statements, as formulated by the author. The need of a similar discussion on the issues of data sharing was emphasized and it was recommended to cover this subject at the conference round table discussion of next ACAT. In this contribution, we summarise selected topics that were covered in the introductory talks and in the following discussion.

Quality assessment program for EuroFlow protocols: summary results of four-year (2010-2013) quality assurance rounds.

PubMed

Kalina, Tomas; Flores-Montero, Juan; Lecrevisse, Quentin; Pedreira, Carlos E; van der Velden, Vincent H J; Novakova, Michaela; Mejstrikova, Ester; Hrusak, Ondrej; Böttcher, Sebastian; Karsch, Dennis; Sędek, Łukasz; Trinquand, Amelie; Boeckx, Nancy; Caetano, Joana; Asnafi, Vahid; Lucio, Paulo; Lima, Margarida; Helena Santos, Ana; Bonaccorso, Paola; van der Sluijs-Gelling, Alita J; Langerak, Anton W; Martin-Ayuso, Marta; Szczepański, Tomasz; van Dongen, Jacques J M; Orfao, Alberto

2015-02-01

Flow cytometric immunophenotyping has become essential for accurate diagnosis, classification, and disease monitoring in hemato-oncology. The EuroFlow Consortium has established a fully standardized "all-in-one" pipeline consisting of standardized instrument settings, reagent panels, and sample preparation protocols and software for data analysis and disease classification. For its reproducible implementation, parallel development of a quality assurance (QA) program was required. Here, we report on the results of four consecutive annual rounds of the novel external QA EuroFlow program. The novel QA scheme aimed at monitoring the whole flow cytometric analysis process (cytometer setting, sample preparation, acquisition and analysis) by reading the median fluorescence intensities (MedFI) of defined lymphocytes' subsets. Each QA participant applied the predefined reagents' panel on blood cells of local healthy donors. A uniform gating strategy was applied to define lymphocyte subsets and to read MedFI values per marker. The MedFI values were compared with reference data and deviations from reference values were quantified using performance score metrics. In four annual QA rounds, we analyzed 123 blood samples from local healthy donors on 14 different instruments in 11 laboratories from nine European countries. The immunophenotype of defined cellular subsets appeared sufficiently standardized to permit unified (software) data analysis. The coefficient of variation of MedFI for 7 of 11 markers performed repeatedly below 30%, average MedFI in each QA round ranged from 86 to 125% from overall median. Calculation of performance scores was instrumental to pinpoint standardization failures and their causes. Overall, the new EuroFlow QA system for the first time allowed to quantify the technical variation that is introduced in the measurement of fluorescence intensities in a multicentric setting over an extended period of time. EuroFlow QA is a proficiency test specific for

Mesothelial cyst in the liver round ligament: A case report and review of the literature.

PubMed

Feo, Claudio F; Ginesu, Giorgio C; Cherchi, Giuseppe; Fancellu, Alessandro; Cossu, M Laura; Porcu, Alberto

2017-01-01

Cysts of the liver round ligament are rare and they are benign in the majority of cases. Current literature has been reviewed on this subject. A 22-year-old woman with a history of epigastric pain was admitted at our institution. Computed tomography (CT) of the abdomen showed a 14-mm cystic lesion in the epigastrium. A large cyst of the liver round ligament was successfully removed during exploratory laparoscopy and histopathology revealed a benign mesothelial cyst. Mesothelial cysts of the liver round ligament are rare entities and we found a total of 5 cases from the literature. Diameter varies from 5 to 14cm. Most patients were asymptomatic or may complain abdominal pain in the upper quadrants. Ultrasonography and CT scan are the most useful diagnostic tools, however differential diagnosis between various abdominal cystic lesions can be difficult. Treatment is usually surgical excision. Mesothelial cysts of the liver round ligament are extremely rare but should be taken in consideration in the differential diagnosis of intra-abdominal cystic lesions. We stress the importance of exploratory laparoscopy that can allow both diagnosis and radical surgical excision. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Pros and Cons: Compulsory 12 Year Education Reform in Turkey

ERIC Educational Resources Information Center

Kasa, Basak; Ersöz, Yasemin

2016-01-01

Turkey has undergone two significant education reforms in the last two decades. In 1997, the compulsory education period was increased from five years to eight years with the unification of primary school (five years) and middle school (three years) and vocational middle schools were dismissed. In 2012, compulsory education was increased from…

Introduction of a new ward round approach in a cardiothoracic critical care unit.

PubMed

Shaughnessy, Liz; Jackson, Jo

2015-07-01

Francis (2013) described inconsistent ward rounds and failures to conduct ward rounds properly as contributing factors to the poor care seen at the Mid Staffordshire Foundation Trust. He suggested that the absence of a nurse at the bedside had clear consequences for communication, ward round efficiency and patient safety. He recommended that nurses should be actively involved in ward rounds and linked this to high quality patient care. To share an experience of introducing a ward round checklist, a bedside nurse verbal summary and the development of standard operating procedure for Ward Rounds in cardiothoracic critical care unit to improve patient safety and care. Semi structured interviews of six registered nurses. A questionnaire to 69 registered nurses. An electronic questionnaire sent to 23 members of the MDT. An observational audit of seven ward rounds reviewing 69 patients. 97% of nurses agreed that verbal summarizing had improved clarity and 90% felt that it had improved patient care. 87% of the MDT respondents stated that they had noticed an improvement in the attendance of the bedside nurse at the ward round review. The ward round checklist reduced omissions. Communication with patients during ward rounds was an area which needed to be improved. The introduction of a new ward round approach and audit of its practice has enabled an improvement in the quality of patient care by: Giving more opportunity for the nurse to participate and feel part of the ward round. Reduction of omissions through the use of a ward round checklist. Improved clarity among the MDT by the use of bedside nurse verbal summarizing of the plan of care. Nurses' full participation in ward rounds is essential to ensure effective communication and enhance patient safety. © 2015 British Association of Critical Care Nurses.

Attitudes of nursing staff toward interprofessional in-patient-centered rounding.

PubMed

Sharma, Umesh; Klocke, David

2014-09-01

Historically, medicine and nursing has had a hierarchical and patriarchal relationship, with physicians holding monopoly over knowledge-based practice of medical care, thus impeding interprofessional collaboration. Power gradient prevents nurses from demanding cooperative patient rounding. We surveyed attitudes of nursing staff at our tertiary care community hospital, before and after implementation of a patient-centered interprofessional (hospitalist-nurse) rounding process for patients. There was a substantial improvement in nursing staff satisfaction related to the improved communication (7%-54%, p < 0.001) and rounding (3%-49%, p < 0.001) by hospitalist providers. Patient-centered rounding also positively impacted nursing workflow (5%-56%, p < 0.001), nurses' perceptions of value as a team member (26%-56%, p = 0.018) and their job satisfaction (43%-59%, p = 0.010). Patient-centered rounding positively contributed to transforming the hospitalist-nurse hierarchical model to a team-based collaborative model, thus enhancing interprofessional relationships.

Stabilization of flow past a rounded cylinder

NASA Astrophysics Data System (ADS)

Samtaney, Ravi; Zhang, Wei

2016-11-01

We perform global linear stability analysis on low-Re flow past a rounded cylinder. The cylinder corners are rounded with a radius R, normalized as R+ = R / D where D is the cylinder diameter, and its effect on the flow stability characteristics is investigated. We compute the critical Reynolds number (Recr) for the onset of first instability, and quantify the perturbation growth rate for the super-critical flows. It is found that the flow can be stabilized by partially rounding the cylinder. Compared with the square and circular cylinders, the partially rounded cylinder has a higher Recr , attaining a maximum at around R+ = 0 . 30 , and the perturbation growth rate of the super-critical flows is reduced for Re <= 100 . We perform sensitivity analysis to explore the source of the stabilization. The growth rate sensitivity to base flow modification has two different spatial structures: the growth rate is sensitive to the wake backflow in a large region for square-like cylinders (R+ -> 0 . 00), while only the near-wake backflow is crucial for circular-like cylinders (R+ -> 0 . 50). The stability analysis results are also verified with those of the direct simulations and very good agreement is achieved. Supported by the KAUST Office of Competitive Research Funds under Award No. URF/1/1394-01. The supercomputer Shaheen at KAUST was utilized for the simulations.

Development and Early Piloting of a CanMEDS Competency-Based Feedback Tool for Surgical Grand Rounds.

PubMed

Fahim, Christine; Bhandari, Mohit; Yang, Ilun; Sonnadara, Ranil

2016-01-01

Grand rounds offer an excellent opportunity for the evaluation of medical expertise, and other competencies, such as communication and professionalism. The purpose of this study was to develop a tool that would facilitate the provision of formative feedback for grand rounds to improve learning. The resulting CanMEDS-based evaluation tool was piloted in an academic surgical department. This study employed the use of a 3-phase, qualitatively-focused, embedded mixed methods approach. In Phase 1, an intrinsic case study was conducted to identify preliminary themes. These findings were crystallized using a quantitative survey. Following interpretation of these data, a grand rounds evaluation tool was developed in Phase 2. The tool was piloted in the Phase 3 focus group. This study was piloted at an academic surgical center among members of the Department of Surgery, McMaster University, Ontario, Canada. Purposive sampling was used for this study. A total of n = 7 individuals participated in the Phase 1 interviews, and n = 24 participants completed the Phase 1 survey. Participants included a representative sample of medical students, residents, fellows, and staff. The tool was piloted among n = 19 participants. The proposed evaluation tool contains 13 Likert-scale questions and 2 open-ended questions. The tool outlines specific questions to assess grand rounds presenters within the structure of the 7 CanMEDS competency domains. "Evaluation fatigue" was identified as a major barrier in the willingness to provide effective feedback. Further, a number of factors regarding the preferred content, structure, and format of surgical grand rounds were identified. This pilot study presents a CanMEDS-specific evaluation tool that can be applied to surgical grand rounds. With the increasing adoption of competency-based medical education, comprehensive evaluation of surgical activities is required. This form provides a template for the development of competency-based evaluation tools

Developing Canadian oncology education goals and objectives for medical students: a national modified Delphi study.

PubMed

Tam, Vincent C; Ingledew, Paris-Ann; Berry, Scott; Verma, Sunil; Giuliani, Meredith E

2016-01-01

Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives. Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives. Through a systematic process, we created a comprehensive, consensus-based set of oncology goals and objectives to

Fourteen babies born after round spermatid injection into human oocytes

PubMed Central

Tanaka, Atsushi; Nagayoshi, Motoi; Takemoto, Youichi; Tanaka, Izumi; Kusunoki, Hiroshi; Watanabe, Seiji; Kuroda, Keiji; Takeda, Satoru; Ito, Masahiko; Yanagimachi, Ryuzo

2015-01-01

During the human in vitro fertilization procedure in the assisted reproductive technology, intracytoplasmic sperm injection is routinely used to inject a spermatozoon or a less mature elongating spermatid into the oocyte. In some infertile men, round spermatids (haploid male germ cells that have completed meiosis) are the most mature cells visible during testicular biopsy. The microsurgical injection of a round spermatid into an oocyte as a substitute is commonly referred to as round spermatid injection (ROSI). Currently, human ROSI is considered a very inefficient procedure and of no clinical value. Herein, we report the birth and development of 14 children born to 12 women following ROSI of 734 oocytes previously activated by an electric current. The round spermatids came from men who had been diagnosed as not having spermatozoa or elongated spermatids by andrologists at other hospitals after a first Micro-TESE. A key to our success was our ability to identify round spermatids accurately before oocyte injection. As of today, all children born after ROSI in our clinic are without any unusual physical, mental, or epigenetic problems. Thus, for men whose germ cells are unable to develop beyond the round spermatid stage, ROSI can, as a last resort, enable them to have their own genetic offspring. PMID:26575628

Fourteen babies born after round spermatid injection into human oocytes.

PubMed

Tanaka, Atsushi; Nagayoshi, Motoi; Takemoto, Youichi; Tanaka, Izumi; Kusunoki, Hiroshi; Watanabe, Seiji; Kuroda, Keiji; Takeda, Satoru; Ito, Masahiko; Yanagimachi, Ryuzo

2015-11-24

During the human in vitro fertilization procedure in the assisted reproductive technology, intracytoplasmic sperm injection is routinely used to inject a spermatozoon or a less mature elongating spermatid into the oocyte. In some infertile men, round spermatids (haploid male germ cells that have completed meiosis) are the most mature cells visible during testicular biopsy. The microsurgical injection of a round spermatid into an oocyte as a substitute is commonly referred to as round spermatid injection (ROSI). Currently, human ROSI is considered a very inefficient procedure and of no clinical value. Herein, we report the birth and development of 14 children born to 12 women following ROSI of 734 oocytes previously activated by an electric current. The round spermatids came from men who had been diagnosed as not having spermatozoa or elongated spermatids by andrologists at other hospitals after a first Micro-TESE. A key to our success was our ability to identify round spermatids accurately before oocyte injection. As of today, all children born after ROSI in our clinic are without any unusual physical, mental, or epigenetic problems. Thus, for men whose germ cells are unable to develop beyond the round spermatid stage, ROSI can, as a last resort, enable them to have their own genetic offspring.

Personal Development in Secondary Education: The Irish Transition Year

ERIC Educational Resources Information Center

Clerkin, Aidan

2012-01-01

Secondary education in Ireland includes an optional Transition Year (TY) between the junior and senior examination cycles, when students are typically about 15 years old. Transition Year is an innovative programme, unique to Irish education, which is intended as a non-academic year devoted to personal and social development in the absence of…

Ten Years of Federal Statistics on Vocational Education.

ERIC Educational Resources Information Center

Barnes, Robert E.

An examination was made of Federal program statistics on vocational education during the past 10 years by the Bureau of Occupational and Adult Education of the U. S. Office of Education and the National Center for Education Statistics of the U. S. Department of Education. The study found that despite a mandate for reform, the National Center's…

Transient Three-Dimensional Side Load Analysis of Out-of-Round Film Cooled Nozzles

NASA Technical Reports Server (NTRS)

Wang, Ten-See; Lin, Jeff; Ruf, Joe; Guidos, Mike

2010-01-01

The objective of this study is to investigate the effect of nozzle out-of-roundness on the transient startup side loads. The out-of-roundness could be the result of asymmetric loads induced by hardware attached to the nozzle, asymmetric internal stresses induced by previous tests and/or deformation, such as creep, from previous tests. The rocket engine studied encompasses a regeneratively cooled thrust chamber and a film cooled nozzle extension with film coolant distributed from a turbine exhaust manifold. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and a transient inlet history based on an engine system simulation. Transient startup computations were performed with the out-of-roundness achieved by four degrees of ovalization of the nozzle: one perfectly round, one slightly out-of-round, one more out-of-round, and one significantly out-of-round. The computed side load physics caused by the nozzle out-of-roundness and its effect on nozzle side load are reported and discussed.

NEA Higher Education: 150 Years and Growing

ERIC Educational Resources Information Center

Maitland, Christine

2007-01-01

In this article, the author reviews the history of the National Education Association (NEA), which celebrated its 150th year in 2007. Over that time, NEA has been a driving force in education at all levels. The story of NEA is about the building of a unique American school system and the articulation of three levels of education into a unified…

Prevalence of newly isolated, cytopathic small round virus (Aichi strain) in Japan.

PubMed Central

Yamashita, T; Sakae, K; Ishihara, Y; Isomura, S; Utagawa, E

1993-01-01

Cytopathic small round virus (Aichi strain), isolated from a patient with oyster-associated gastroenteritis, showed no reaction in the polymerase chain reaction method for enteroviruses or in the enzyme-linked immunosorbent assay (ELISA) for the five serotypes of astroviruses. Our ELISA was sensitive in detecting the Aichi strain antigen in stool samples, but there was no reaction in this ELISA with any non-Aichi strains of enteric viruses, with such origins as enterovirus, rotavirus, Norwalk virus, calicivirus, or astrovirus. In the ELISA, 13 of 47 stool samples from adult patients in five of nine oyster-associated gastroenteritis outbreaks were positive, but only 1 of 397 pediatric stool samples in Aichi Prefecture was positive. The prevalence rate for Aichi strain antibody was found to be 7.2% for persons aged 7 months to 4 years. The prevalence rate for antibody to Aichi strain increased with age, to about 80% in persons 35 years old. On the basis of the results of the present study, it was hypothesized that Aichi strain could be a new type of small round virus that mainly produces diarrhea in patients in the 15- to 34-year-old age group, 50 to 76% of whom possess neutralizing antibody. Images PMID:8263178

CT features of rounded atelectasis of the lung

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

Doyle, T.C.; Lawler, G.A.

1984-08-01

Rounded atelectasis is an uncommon but increasingly recognized benign form of peripheral lung collapse. The three patients described here had pleural-based lung masses considered initially to represent carcinoma. On computed tomography, a characteristics appearance of eight major and five minor signs of rounded atelectasis of the lung were found. In conjunction with other radiologic evaluations, these allowed the patients to be confidently managed without exploratory thoracotomy.

Do "trainee-centered ward rounds" help overcome barriers to learning and improve the learning satisfaction of junior doctors in the workplace?

PubMed

Acharya, Vikas; Reyahi, Amir; Amis, Samuel M; Mansour, Sami

2015-01-01

Ward rounds are widely considered an underutilized resource with regard to medical education, and therefore, a project was undertaken to assess if the initiation of "trainee-centered ward rounds" would help improve the confidence, knowledge acquisition, and workplace satisfaction of junior doctors in the clinical environment. Data were collated from junior doctors, registrar grade doctors, and consultants working in the delivery suite at Luton and Dunstable University Hospital in Luton over a 4-week period in March-April 2013. A review of the relevant literature was also undertaken. This pilot study found that despite the reservations around time constraints held by both junior and senior clinicians alike, feedback following the intervention was largely positive. The junior doctors enjoyed having a defined role and responsibility during the ward round and felt they benefited from their senior colleagues' feedback. Both seniors and junior colleagues agreed that discussing learning objectives prior to commencing the round was beneficial and made the round more learner-orientated; this enabled maximal learner-focused outcomes to be addressed and met. The juniors were generally encouraged to participate more during the round and the consultants endeavored to narrate their decision-making, both were measures that led to greater satisfaction of both parties. This was in keeping with the concept of "Legitimate peripheral participation" as described by Lave and Wenger. Overall, trainee-centered ward rounds did appear to be effective in overcoming some of the traditional barriers to teaching in the ward environment, although further work to formalize and quantify these findings, as well as using greater sample sizes from different hospital departments and the inclusion of a control group, is needed.

Beyond the Core: Advancing Student Success through the Arts. Education Trends

ERIC Educational Resources Information Center

Workman, Emily

2017-01-01

The Every Student Succeeds Act (ESSA), which passed in late 2015, is the first major federal law in more than 30 years offering states a significant degree of flexibility to broaden--rather than narrow--curricula, and strongly encourages states to ensure all students have access to a well-rounded education, which includes the arts and music. Armed…

Firearm equipped with live round inhibiting means and method of making same

DOEpatents

Baehr, Donald G.

1990-01-01

A firearm is disclosed having live round inhibiting means mounted in the barrel of the firearm which permits a blank cartridge to be loaded into a firearm and fired while preventing the loading and firing of a live round. The live round inhibiting means comprise shaft means mounted in the barrel of the firearm and which extends a sufficient length into the barrel at a point just beyond the chamber portion of the firearm to engage the bullet portion of a live round to prevent it from properly chambering, while permitting a blank cartridge to be loaded into the firearm and fired without engaging the live round-inhibiting shaft means.

Developing Attitudinal Metrics for Induction-Year Agricultural Education Teachers

ERIC Educational Resources Information Center

Rayfield, John; McKim, Billy R.; Lawrence, Shannon; Stair, Kristin

2014-01-01

This study was part of a larger regional study of induction-year agricultural education teachers in three Western states. Studies have purported that attitude toward teaching is important for understanding and helping induction-year teachers. Thus, developing an instrument to assess induction-year agricultural education teachers' attitudes toward…

Educational affairs plan: A five-year strategy

NASA Technical Reports Server (NTRS)

1987-01-01

A five-year plan is presented to guide the use of NASA resources in administering a focused and consistent set of aeronautics and space science education programs. Major initiatives outlined in this plan fall into two categories: programmatic priorities and institutional priorities. Programmatic priorities for this plan include elementary education, teacher education, underrepresented minority participation, educational technology and the Aerospace Education Services Project (AESP). Institutional priorities highlighted in this plan include university programs, educational publications and their distribution, educational partnerships with public and private organizations, educational research and evaluation, and activities of the educational affairs administration. The plan's aim is to directly and indirectly help to ensure an adequate pool of talented scientists, engineers and technical personnel to keep NASA at the forefront of advancements for the 21st century.

Round timbers and ties

Treesearch

Ronald W. Wolfe

1999-01-01

Round timbers and ties represent some of the most efficient uses of our forest resources. They require a minimum of processing between harvesting the tree and marketing the structural commodity. Poles and piles are debarked or peeled, seasoned, and often treated with preservative prior to use as structural members. Construction logs are usually shaped to facilitate...

40 CFR 86.1837-01 - Rounding of emission measurements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... subpart to one additional significant figure, in accordance with the Rounding-Off Method specified in ASTM E29-93a, Standard Practice for Using Significant Digits in Test Data to Determine Conformance with... credits generated or needed as follows: manufacturers must round to the same number of significant figures...

40 CFR 86.1837-01 - Rounding of emission measurements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... subpart to one additional significant figure, in accordance with the Rounding-Off Method specified in ASTM E29-93a, Standard Practice for Using Significant Digits in Test Data to Determine Conformance with... credits generated or needed as follows: manufacturers must round to the same number of significant figures...

40 CFR 86.1837-01 - Rounding of emission measurements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... subpart to one additional significant figure, in accordance with the Rounding-Off Method specified in ASTM E29-93a, Standard Practice for Using Significant Digits in Test Data to Determine Conformance with... credits generated or needed as follows: manufacturers must round to the same number of significant figures...

40 CFR 86.1837-01 - Rounding of emission measurements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... subpart to one additional significant figure, in accordance with the Rounding-Off Method specified in ASTM E29-93a, Standard Practice for Using Significant Digits in Test Data to Determine Conformance with... credits generated or needed as follows: manufacturers must round to the same number of significant figures...

Weapon Performance Testing and Analysis: The MODI-PAC Round, the Number 4 Lead-Shot Round, and the Flying Baton

DTIC Science & Technology

1976-01-01

items. The items tested were the MODI-PAC, a proprietary item of Reming)on Arms Company, a standard 12 - gauge round of No. 4 lead shot, and an...to refrain from testing this item. Therefore, the final selection of items for testing were (1) the MODI-PAC, (2) a standard 12 - gauge shotgun round of...The first item evaluated was the MODI-PAC5. The MOQ1-PAC which standsfor “modified impact “ is a 12 - gauge shotgun shell loaded with approximately 320

Solitary Fibrous Tumor in the Round Ligament of the Liver: A Fortunate Intraoperative Discovery

PubMed Central

Beyer, Laura; Delpero, Jean-Robert; Chetaille, Bruno; Sarran, Anthony; Perrot, Delphine; Moureau-Zabotto, Laurence; Guiramand, Jérôme; Bertucci, François

2012-01-01

Solitary fibrous tumors (SFTs) are mesenchymal neoplasms of fibroblastic origin, most commonly found in the pleura. Numerous extrathoracic locations have been reported during the last 2 decades. Herein, we report the first case of an SFT in the round ligament of the liver. A 46-year-old Caucasian man presented with a 12-month history of abdominal pain. An ultrasonography-guided microbiopsy first revealed a desmoid tumor. After failure of first- and second-line medical treatments (celecoxib and tamoxifen, then imatinib), histological reexamination was suspicious for a low-grade sarcoma. MRI was also suspicious for a malignant process. Hence, surgery was decided. Laparotomy found a huge and well-limited tumor that, unexpectedly, was appended to the round ligament of the liver and free from any other intra-abdominal contact. The tumor was easily removed. Excision was monobloc and macroscopically complete. Histological analysis diagnosed an SFT arising from the round ligament of the liver. No adjuvant treatment was given. Ten months after surgery, the patient is alive without any signs or symptoms of relapse. This is the first report of SFT arising from the round ligament of the liver. It illustrates the difficulty in diagnosing such tumors. Whilst diagnosis of SFT is rare, it should be kept in mind to allow early diagnosis and complete surgical resection, which provide the best chance for recovery. PMID:22666211

Solitary fibrous tumor in the round ligament of the liver: a fortunate intraoperative discovery.

PubMed

Beyer, Laura; Delpero, Jean-Robert; Chetaille, Bruno; Sarran, Anthony; Perrot, Delphine; Moureau-Zabotto, Laurence; Guiramand, Jérôme; Bertucci, François

2012-01-01

Solitary fibrous tumors (SFTs) are mesenchymal neoplasms of fibroblastic origin, most commonly found in the pleura. Numerous extrathoracic locations have been reported during the last 2 decades. Herein, we report the first case of an SFT in the round ligament of the liver. A 46-year-old Caucasian man presented with a 12-month history of abdominal pain. An ultrasonography-guided microbiopsy first revealed a desmoid tumor. After failure of first- and second-line medical treatments (celecoxib and tamoxifen, then imatinib), histological reexamination was suspicious for a low-grade sarcoma. MRI was also suspicious for a malignant process. Hence, surgery was decided. Laparotomy found a huge and well-limited tumor that, unexpectedly, was appended to the round ligament of the liver and free from any other intra-abdominal contact. The tumor was easily removed. Excision was monobloc and macroscopically complete. Histological analysis diagnosed an SFT arising from the round ligament of the liver. No adjuvant treatment was given. Ten months after surgery, the patient is alive without any signs or symptoms of relapse. This is the first report of SFT arising from the round ligament of the liver. It illustrates the difficulty in diagnosing such tumors. Whilst diagnosis of SFT is rare, it should be kept in mind to allow early diagnosis and complete surgical resection, which provide the best chance for recovery.

Virtual rounds: simulation-based education in procedural medicine

NASA Astrophysics Data System (ADS)

Shaffer, David W.; Meglan, Dwight A.; Ferrell, Margaret; Dawson, Steven L.

1999-07-01

Computer-based simulation is a goal for training physicians in specialties where traditional training puts patients at risk. Intuitively, interactive simulation of anatomy, pathology, and therapeutic actions should lead to shortening of the learning curve for novice or inexperienced physicians. Effective transfer of knowledge acquired in simulators must be shown for such devices to be widely accepted in the medical community. We have developed an Interventional Cardiology Training Simulator which incorporates real-time graphic interactivity coupled with haptic response, and an embedded curriculum permitting rehearsal, hypertext links, personal archiving and instructor review and testing capabilities. This linking of purely technical simulation with educational content creates a more robust educational purpose for procedural simulators.

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

47 CFR 73.31 - Rounding of nominal power specified on applications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... power of an existing station shall specify nominal power rounded to two significant figures as follows: Nominal power (kW) Rounded down to nearest figure (kW) Below 0.25 0.001 0.25 to 0.99 0.01 1 to 9.9 0.1 10... shall be adjusted accordingly. If rounding upward to the nearest figure would result in objectionable...

Organized colorectal cancer screening in Serbia - the first round within 2013-2014.

PubMed

Banković Lazarević, Dušica; Krivokapić, Zoran; Barišić, Goran; Jovanović, Verica; Ilić, Dragan; Veljković, Marko

2016-04-01

The National Organized Colorectal Cancer Screening Program was conducted in the Republic of Serbia during 2013-2014 covering the population of both genders, aged 50 to 74 years, in 28 municipalities out of 180, with the target population of 651,445 people. This organized colorectal cancer screening aims to reduce mortality from colorectal cancer in the target population. The aim of this study was to show the results of organized screening for colorectal cancer during the first biannual round in Serbia. General practitioners from the primary health centers, invited target population by letters and by phone to perform immunochemical fecal occult blood test. Persons with a positive test results were referred to the colonoscopy. The database of health insurance and other citizens of the target population was used for invitation for screening in primary health centers. Descriptive statistical analysis of the results in organized colorectal cancer screening in the first round was performed for the key screening indicators. In the first round, a total of 99,592 persons were invited. The participation rate was 62.5%. Colonoscopy was performed in 1,554 persons. Adenomas were found in 586 persons (0.9% of all the tested), e.g. 37.7 % of all colonoscopied. In 129 persons colorectal cancer was diagnosed (0.2% of all the tested), e.g. 8.3% of all the colonoscopied. In the left half of the colon (rectum, sigmoid and descending colon) there were 70.4% diagnosed polyps and 77.3% carcinomas, while 29.6% of polyps and 22.7% carcinomas were found in the proximal parts of the colon. In the first round of the organized colorectal cancer screening in Serbia the participation rate of the targeted population was high and gave encouraging result. It was expected that in the forthcoming rounds even higher coverage of the target population would be accomplished. A positive predictive value of the completed colonoscopies showed that further work on observing the stages of diagnosed adenomas

Spatial distribution and pollution evaluation of heavy metals in Yangtze estuary sediment.

PubMed

Liu, Ruimin; Men, Cong; Liu, Yongyan; Yu, Wenwen; Xu, Fei; Shen, Zhenyao

2016-09-15

To analyze the spatial distribution patterns and ecological risks of heavy metals, 30 sediment samples were taken in the Yangtze River Estuary (YRE) in May 2011. The content of Al, As, Cr, Cu, Fe, Mn, Ni and Pb increased as follows: inner-regionYRE. In Tucker 3, considering the fractions of metals, Mn turned to be the severest pollutant and As did not contribute too much to the contamination of the YRE. That was most probably because that Mn was closely related to the carbonate-associated (CARB) and As was related to organic-associated (OM) which is more stable than CARB. The fractions played an important role in the contamination assessment of heavy metals. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Association Between Sensemaking During Physician Team Rounds and Hospitalized Patients' Outcomes.

PubMed

Leykum, Luci K; Chesser, Hannah; Lanham, Holly J; Carla, Pezzia; Palmer, Ray; Ratcliffe, Temple; Reisinger, Heather; Agar, Michael; Pugh, Jacqueline

2015-12-01

Sensemaking is the social act of assigning meaning to ambiguous events. It is recognized as a means to achieve high reliability. We sought to assess sensemaking in daily patient care through examining how inpatient teams round and discuss patients. Our purpose was to assess the association between inpatient physician team sensemaking and hospitalized patients' outcomes, including length of stay (LOS), unnecessary length of stay (ULOS), and complication rates. Eleven inpatient medicine teams' daily rounds were observed for 2 to 4 weeks. Rounds were audiotaped, and field notes taken. Four patient discussions per team were assessed using a standardized Situation, Task, Intent, Concern, Calibrate (STICC) framework. Inpatient physician teams at the teaching hospitals affiliated with the University of Texas Health Science Center at San Antonio participated in the study. Outcomes of patients admitted to the teams were included. Sensemaking was assessed based on the order in which patients were seen, purposeful rounding, patient-driven rounding, and individual patient discussions. We assigned teams a score based on the number of STICC elements used in the four patient discussions sampled. The association between sensemaking and outcomes was assessed using Kruskal-Wallis sum rank and Dunn's tests. Teams rounded in several different ways. Five teams rounded purposefully, and four based rounds on patient-driven needs. Purposeful and patient-driven rounds were significantly associated with lower complication rates. Varying the order in which patients were seen and purposefully rounding were significantly associated with lower LOS, and purposeful and patient-driven rounds associated with lower ULOS. Use of a greater number of STICC elements was associated with significantly lower LOS (4.6 vs. 5.7, p = 0.01), ULOS (0.3 vs. 0.6, p = 0.02), and complications (0.2 vs. 0.5, p = 0.0001). Improving sensemaking may be a strategy for improving patient outcomes, fostering a

1. HISTORIC PHOTOGRAPH, VIEW OF ROUND HILL ROAD BRIDGE, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. HISTORIC PHOTOGRAPH, VIEW OF ROUND HILL ROAD BRIDGE, LOOKING WEST, CA. 1940. CONNECTICUT DEPARTMENT OF TRANSPORTATION. - Merritt Parkway, Round Hill Road Bridge, Spanning Merritt Parkway at 3.5 mile mark, Greenwich, Fairfield County, CT

Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction.

PubMed

Katz-Sidlow, Rachel J; Ludwig, Allison; Miller, Scott; Sidlow, Robert

2012-10-01

While there are numerous benefits of smartphone use for physicians, little is known about the negative effects of using these devices in the context of patient care. To assess resident and faculty smartphone use during inpatient attending rounds and its potential as a source of distraction during transfer of clinical information. Cross-sectional survey. University-affiliated public teaching hospital. All housestaff and inpatient faculty in the departments of Medicine and Pediatrics. Participants were asked about smartphone ownership, usage patterns during attending rounds, and whether team members had ever missed important data during rounds due to distraction from smartphones. Attendings were asked whether policies should be established for smartphone use during rounds. The overall response rate was 73%. Device ownership was prevalent (89% residents, 98% faculty), as was use of smartphones during inpatient rounds (57% residents, 28% attendings). According to self-reports, smartphones were used during rounds for patient care (85% residents, 48% faculty), reading/responding to personal texts/e-mails (37% residents, 12% faculty), and other non-patient care uses (15% residents, 0% faculty). Nineteen percent of residents and 12% of attendings believed they had missed important information because of distraction from smartphones. Residents and faculty agreed that smartphones "can be a serious distraction during attending rounds," and nearly 80% of faculty believed that smartphone policies should be established. Smartphone use during attending rounds is prevalent and can distract users during important information transfer. Attendings strongly favored the institution of formal policies governing appropriate smartphone use during inpatient rounds. Copyright © 2012 Society of Hospital Medicine.

Firearm equipped with live round inhibiting means and method of making same

DOEpatents

Baehr, D.G.

1990-11-13

A firearm is disclosed having live round inhibiting means mounted in the barrel of the firearm which permits a blank cartridge to be loaded into a firearm and fired while preventing the loading and firing of a live round. The live round inhibiting means comprise shaft means mounted in the barrel of the firearm and which extends a sufficient length into the barrel at a point just beyond the chamber portion of the firearm to engage the bullet portion of a live round to prevent it from properly chambering, while permitting a blank cartridge to be loaded into the firearm and fired without engaging the live round-inhibiting shaft means. 9 figs.

Tanzania Higher Education--Fifty Years after Independence

ERIC Educational Resources Information Center

Mnubi, Godfrey M.

2013-01-01

As Tanzania celebrates fifty years of independence at the crossroads of globalization, the country has experienced a changing landscape and a major transformation in higher learning education with spectacular expansion in student enrollment rates. This requires its higher education institutions, particularly universities, to function effectively…

1. Entrance to Heintooga Round Bottom Road and sign looking ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Entrance to Heintooga Round Bottom Road and sign looking N. - Great Smoky Mountains National Park Roads & Bridges, Heintooga Round Bottom Road & Balsam Mountain Road, Between Blue Ridge Parkway & Big Cove Road, Gatlinburg, Sevier County, TN

The impact of a lean rounding process in a pediatric intensive care unit.

PubMed

Vats, Atul; Goin, Kristin H; Villarreal, Monica C; Yilmaz, Tuba; Fortenberry, James D; Keskinocak, Pinar

2012-02-01

Poor workflow associated with physician rounding can produce inefficiencies that decrease time for essential activities, delay clinical decisions, and reduce staff and patient satisfaction. Workflow and provider resources were not optimized when a pediatric intensive care unit increased by 22,000 square feet (to 33,000) and by nine beds (to 30). Lean methods (focusing on essential processes) and scenario analysis were used to develop and implement a patient-centric standardized rounding process, which we hypothesize would lead to improved rounding efficiency, decrease required physician resources, improve satisfaction, and enhance throughput. Human factors techniques and statistical tools were used to collect and analyze observational data for 11 rounding events before and 12 rounding events after process redesign. Actions included: 1) recording rounding events, times, and patient interactions and classifying them as essential, nonessential, or nonvalue added; 2) comparing rounding duration and time per patient to determine the impact on efficiency; 3) analyzing discharge orders for timeliness; 4) conducting staff surveys to assess improvements in communication and care coordination; and 5) analyzing customer satisfaction data to evaluate impact on patient experience. Thirty-bed pediatric intensive care unit in a children's hospital with academic affiliation. Eight attending pediatric intensivists and their physician rounding teams. Eight attending physician-led teams were observed for 11 rounding events before and 12 rounding events after implementation of a standardized lean rounding process focusing on essential processes. Total rounding time decreased significantly (157 ± 35 mins before vs. 121 ± 20 mins after), through a reduction in time spent on nonessential (53 ± 30 vs. 9 ± 6 mins) activities. The previous process required three attending physicians for an average of 157 mins (7.55 attending physician man-hours), while the new process required two

Mass Treatment with Azithromycin for Trachoma: When Is One Round Enough? Results from the PRET Trial in The Gambia

PubMed Central

Harding-Esch, Emma M.; Sillah, Ansumana; Edwards, Tansy; Burr, Sarah E.; Hart, John D.; Joof, Hassan; Laye, Mass; Makalo, Pateh; Manjang, Ahmed; Molina, Sandra; Sarr-Sissoho, Isatou; Quinn, Thomas C.; Lietman, Tom; Holland, Martin J.; Mabey, David; West, Sheila K.; Bailey, Robin

2013-01-01

Background The World Health Organization has recommended three rounds of mass drug administration (MDA) with antibiotics in districts where the prevalence of follicular trachoma (TF) is ≥10% in children aged 1–9 years, with treatment coverage of at least 80%. For districts at 5–10% TF prevalence it was recommended that TF be assessed in 1–9 year olds in each community within the district, with three rounds of MDA provided to any community where TF≥10%. Worldwide, over 40 million people live in districts whose TF prevalence is estimated to be between 5 and 10%. The best way to treat these districts, and the optimum role of testing for infection in deciding whether to initiate or discontinue MDA, are unknown. Methods In a community randomized trial with a factorial design, we randomly assigned 48 communities in four Gambian districts, in which the prevalence of trachoma was known or suspected to be above 10%, to receive annual mass treatment with expected coverage of 80–89% (“Standard”), or to receive an additional visit in an attempt to achieve coverage of 90% or more (“Enhanced”). The same 48 communities were randomised to receive mass treatment annually for three years (“3×”), or to have treatment discontinued if Chlamydia trachomatis (Ct) infection was not detected in a sample of children in the community after mass treatment (stopping rule(“SR”)). Primary outcomes were the prevalence of TF and of Ct infection in 0–5 year olds at 36 months. Results The baseline prevalence of TF and of Ct infection in the target communities was 6.5% and 0.8% respectively. At 36 months the prevalence of TF was 2.8%, and that of Ct infection was 0.5%. No differences were found between the arms in TF or Ct infection prevalence either at baseline (Standard-3×: TF 5.6%, Ct 0.7%; Standard-SR: TF 6.1%, Ct 0.2%; Enhanced-3×: TF 7.4%, Ct 0.9%; and Enhanced-SR: TF 6.2%, Ct 1.2%); or at 36 months (Standard-3×: TF 2.3%, Ct 1.0%; Standard-SR TF 2.5%, Ct 0

CADNA: a library for estimating round-off error propagation

NASA Astrophysics Data System (ADS)

Jézéquel, Fabienne; Chesneaux, Jean-Marie

2008-06-01

The CADNA library enables one to estimate round-off error propagation using a probabilistic approach. With CADNA the numerical quality of any simulation program can be controlled. Furthermore by detecting all the instabilities which may occur at run time, a numerical debugging of the user code can be performed. CADNA provides new numerical types on which round-off errors can be estimated. Slight modifications are required to control a code with CADNA, mainly changes in variable declarations, input and output. This paper describes the features of the CADNA library and shows how to interpret the information it provides concerning round-off error propagation in a code. Program summaryProgram title:CADNA Catalogue identifier:AEAT_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEAT_v1_0.html Program obtainable from:CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions:Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.:53 420 No. of bytes in distributed program, including test data, etc.:566 495 Distribution format:tar.gz Programming language:Fortran Computer:PC running LINUX with an i686 or an ia64 processor, UNIX workstations including SUN, IBM Operating system:LINUX, UNIX Classification:4.14, 6.5, 20 Nature of problem:A simulation program which uses floating-point arithmetic generates round-off errors, due to the rounding performed at each assignment and at each arithmetic operation. Round-off error propagation may invalidate the result of a program. The CADNA library enables one to estimate round-off error propagation in any simulation program and to detect all numerical instabilities that may occur at run time. Solution method:The CADNA library [1] implements Discrete Stochastic Arithmetic [2-4] which is based on a probabilistic model of round-off errors. The program is run several times with a random rounding mode generating different results each

Uncovering paradoxes from physicians' experiences of patient-centered ward-round.

PubMed

Bååthe, Fredrik; Ahlborg, Gunnar; Edgren, Lars; Lagström, Annica; Nilsson, Kerstin

2016-05-03

Purpose The purpose of this paper is to uncover paradoxes emerging from physicians' experiences of a patient-centered and team-based ward round, in an internal medicine department. Design/methodology/approach Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings. Findings This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician's professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician's professional identity was centered. Physicians with more of a We-perspective experienced challenges with the new round, while physicians with more of an I-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered. Practical implications For change processes affecting physicians' professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure. Originality/value This paper provides increased understanding about how physicians' professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement.

Year-round spatiotemporal distribution of harbour porpoises within and around the Maryland wind energy area

PubMed Central

O’Brien, Michael; Lyubchich, Vyacheslav; Roberts, Jason J.; Halpin, Patrick N.; Rice, Aaron N.; Bailey, Helen

2017-01-01

Offshore windfarms provide renewable energy, but activities during the construction phase can affect marine mammals. To understand how the construction of an offshore windfarm in the Maryland Wind Energy Area (WEA) off Maryland, USA, might impact harbour porpoises (Phocoena phocoena), it is essential to determine their poorly understood year-round distribution. Although habitat-based models can help predict the occurrence of species in areas with limited or no sampling, they require validation to determine the accuracy of the predictions. Incorporating more than 18 months of harbour porpoise detection data from passive acoustic monitoring, generalized auto-regressive moving average and generalized additive models were used to investigate harbour porpoise occurrence within and around the Maryland WEA in relation to temporal and environmental variables. Acoustic detection metrics were compared to habitat-based density estimates derived from aerial and boat-based sightings to validate the model predictions. Harbour porpoises occurred significantly more frequently during January to May, and foraged significantly more often in the evenings to early mornings at sites within and outside the Maryland WEA. Harbour porpoise occurrence peaked at sea surface temperatures of 5°C and chlorophyll a concentrations of 4.5 to 7.4 mg m-3. The acoustic detections were significantly correlated with the predicted densities, except at the most inshore site. This study provides insight into previously unknown fine-scale spatial and temporal patterns in distribution of harbour porpoises offshore of Maryland. The results can be used to help inform future monitoring and mitigate the impacts of windfarm construction and other human activities. PMID:28467455

Year-round spatiotemporal distribution of harbour porpoises within and around the Maryland wind energy area.

PubMed

Wingfield, Jessica E; O'Brien, Michael; Lyubchich, Vyacheslav; Roberts, Jason J; Halpin, Patrick N; Rice, Aaron N; Bailey, Helen

2017-01-01

Offshore windfarms provide renewable energy, but activities during the construction phase can affect marine mammals. To understand how the construction of an offshore windfarm in the Maryland Wind Energy Area (WEA) off Maryland, USA, might impact harbour porpoises (Phocoena phocoena), it is essential to determine their poorly understood year-round distribution. Although habitat-based models can help predict the occurrence of species in areas with limited or no sampling, they require validation to determine the accuracy of the predictions. Incorporating more than 18 months of harbour porpoise detection data from passive acoustic monitoring, generalized auto-regressive moving average and generalized additive models were used to investigate harbour porpoise occurrence within and around the Maryland WEA in relation to temporal and environmental variables. Acoustic detection metrics were compared to habitat-based density estimates derived from aerial and boat-based sightings to validate the model predictions. Harbour porpoises occurred significantly more frequently during January to May, and foraged significantly more often in the evenings to early mornings at sites within and outside the Maryland WEA. Harbour porpoise occurrence peaked at sea surface temperatures of 5°C and chlorophyll a concentrations of 4.5 to 7.4 mg m-3. The acoustic detections were significantly correlated with the predicted densities, except at the most inshore site. This study provides insight into previously unknown fine-scale spatial and temporal patterns in distribution of harbour porpoises offshore of Maryland. The results can be used to help inform future monitoring and mitigate the impacts of windfarm construction and other human activities.

Project Copernicus: Cooperation Programme in Europe on Nature and Industry through Coordinated University Study. Round Table. Unesco-Standing Conference of Rectors, Presidents, and Vice Chancellors of the European Universities (CRE) (Catania, Sicily, April 5-8, 1989). Number 32. Papers on Higher Education.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

This Project COPERNICUS (Cooperation Programme in Europe for Research on Nature and Industry through Coordinated University Studies) Round Table report considers efforts to identify priorities and objectives of the new alliance between the higher education community, industry, and international organizations in addressing today's environmental…

Medieval Round Churches and the Shape of the Earth.

PubMed

Haagensen, Erling; Lind, Niels C

2015-12-01

There is a unique cluster of four medieval round churches, linked by a simple geometry, on Bornholm Island in the Baltic Sea. Why so many and why so close together? Immediate simple answers are "Just by chance" and "For no reason." Why are the churches round? "Defense." This essay proposes another hypothesis for this unique situation: the churches are astronomical observatories, meant to solve a scientific problem (Is the Earth really spherical?) and a practical problem (How far is it to sail west to the Orient?). The capacity and desire to find answers, together with other practical needs related to astronomy, can better explain these round churches' special architecture. The geometry that connects them fits the ideal pattern with an angular accuracy of 1 minute of a degree. The round churches may be the earliest astronomical observatories in Christian Europe; other hypotheses have been shown to be untenable. Their location provides for a good method to estimate the Earth's extent in the east-west direction, seemingly the earliest such measurements.

An international Delphi study examining health promotion and health education in nursing practice, education and policy.

PubMed

Whitehead, Dean

2008-04-01

To arrive at an expert consensus in relation to health promotion and health education constructs as they apply to nursing practice, education and policy. Nursing has often been maligned and criticized, both inside and outside of the profession, for its ability to understand and conduct effective health promotion and health education-related activities. In the absence of an expert-based consensus, nurses may find it difficult to progress beyond the current situation. In the absence of any previously published nursing-related consensus research, this study seeks to fill that knowledge-gap. A two-round Delphi technique via email correspondence. A first-round qualitative questionnaire used open-ended questions for defining health promotion and health education. This was both in general terms and as participants believed these concepts related to the clinical, theoretical (academic/educational) and the policy (political) setting in nursing. Line-by-line qualitative content and thematic analysis of the first-round data generated 13 specific categories. These categories contained 134 statement items. The second-round questionnaire comprised the identified 134 statements. Using a five-point Likert scale (ranging from 1 = strongly disagree to 5 = strongly agree) participants scored and rated their level of agreement/disagreement against the listed items. Data from the second-round was descriptively analysed according to distribution and central tendency measures. An expert consensus was reached on 65 of the original 134 statements. While some minor contradiction was demonstrated, strong consensus emerged around the issues of defining health promotion and health education and the emergence of a wider health promotion and health education role for nursing. No consensus was reached on only one of the 13 identified topic categories - that of 'nurses working with other disciplines and agencies in a health education and health promotion role.' This study provides a hitherto

Effect of Round Window Reinforcement on Hearing: A Temporal Bone Study With Clinical Implications for Surgical Reinforcement of the Round Window.

PubMed

Wegner, Inge; Eldaebes, Mostafa M A S; Landry, Thomas G; Adamson, Robert B; Grolman, Wilko; Bance, Manohar L

2016-06-01

Round window reinforcement leads to conductive hearing loss. The round window is stiffened surgically as therapy for various conditions, including perilymphatic fistula and superior semicircular canal dehiscence. Round window reinforcement reduces symptoms in these patients. However, it also reduces fluid displacement in the cochlea and might therefore increase conductive hearing loss. Perichondrium was applied to the round window membrane in nine fresh-frozen, nonpathologic temporal bones. In four temporal bones cartilage was applied subsequently. Acoustic stimuli in the form of frequency sweeps from 250 to 8000 Hz were generated at 110 dB sound pressure level. A total of 16 frequencies in a 1/3-octave series were used. Stapes velocities in response to the acoustic stimuli were measured at equally spaced multiple points covering the stapes footplate using a scanning laser Doppler interferometry system. Measurements were made at baseline, after applying perichondrium, and after applying cartilage. At frequencies up to 1000 Hz perichondrium reinforcement decreased stapes velocities by 1.5 to 2.9 dB compared with no reinforcement (p value = 0.003). Reinforcement with cartilage led to a further deterioration of stapes velocities by 2.6 to 4.2 dB at frequencies up to 1000 Hz (p value = 0.050). The higher frequencies were not affected by perichondrium reinforcement (p value = 0.774) or cartilage reinforcement (p value = 0.644). Our results seem to suggest a modest, clinically negligible effect of reinforcement with perichondrium. Placing cartilage on the round window resulted in a graded effect on stapes velocities in keeping with the increased stiffness of cartilage compared with perichondrium. Even so, the effect was relatively small.

The WTO and the Millennium Round: What Is at Stake for Public Education? Common Concerns for Workers in Education and the Public Sector.

ERIC Educational Resources Information Center

Education International, Brussels (Belgium).

On the eve of the year 2000, global public spending on education tops one trillion dollars. Against the backdrop of globalization, public education is currently being subjected to attacks by proponents of privatization and deregulation. The process is already underway, as is apparent from an important agreement reached by the World Trade…

Mechanisms of Cochlear Stimulation Through the Round Window

NASA Astrophysics Data System (ADS)

Lukashkin, Andrei N.; Weddell, Thomas; Russell, Ian J.

2011-11-01

The round window membrane (RW) functions as a pressure relief valve in conventional hearing allowing structures of the middle ear to move. Investigations in recent years have shown that middle ear implants can be used to stimulate the cochlea via the RW. Isolated clinical uses of this technique have been applied but more thorough theoretical and empirical studies are required. Using guinea pigs as test subjects we have investigated physiological effects of RW stimulation using a simulation of active middle ear prosthesis, a cylindrical neodymium iron boron disk magnet placed upon the RW which can be stimulated by an electromagnetic coil positioned in close proximity to the magnet.

Teacher Competencies in Health Education: Results of a Delphi Study

PubMed Central

Moynihan, Sharon; Paakkari, Leena; Välimaa, Raili; Jourdan, Didier; Mannix-McNamara, Patricia

2015-01-01

Objective The aim of this research study was to identify the core competencies for health education teachers in supporting the development of health literacy among their students. Method/Results A three round Delphi method was employed. Experts in health education were asked to identify core competencies for school health educators. Twenty six participants from the academic field were invited to participate in the study. Twenty participants completed the first round of the Delphi, while eighteen took part in round two and fifteen participated in the final round. Data were collected using an electronic questionnaire. The first round contained an open ended question in which participants were asked to name and define all the competencies they perceived were important. Thematic analysis was undertaken on these data. A list of 36 competencies was created from this round. This list was then returned to the same participants and they were asked to rate each competency on a 7 point semantic differential scale in terms of importance. The resulting data were then analysed. For the final round, participants were presented with a list of 33 competencies and were asked to rank them again, in order of importance. Conclusion Twelve core competencies emerged from the analysis and these competencies comprised of a mixture of knowledge, attitude and skills. The authors suggest that how these competencies are achieved and operationalised in the school context can be quite complex and multi-faceted. While the authors do not seek to generalise from the study they suggest that these competencies are an important input for all stakeholders, in order to question national and international teacher guidelines. In addition the competencies identified may provide a useful starting point for others to undertake deeper analysis of what it means to be an effective health educator in schools. PMID:26630180

Year Book of Adult Education in Scotland, 1972-73.

ERIC Educational Resources Information Center

Shearer, J. G. S., Ed.

The Year Book of Adult Education in Scotland for 1972-73 contains: (1) next [new] business; (2) directory of organizations--Scottish Institute of Adult Education, education authorities, the universities, the Workers' Educational Association, Newbattle Abbey College, the Open University, university contribution to adult education H.M. Forces, radio…

Individualized Cooperative Education (Second Year). Teacher Edition.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This instructor's guide is designed to direct and support instruction for advanced business and office, home economics, and agriculture and marketing education students across Oklahoma who are in their second year of individualized cooperative education programs. The following topics are covered in the 12 competency-based instructional units…

Effect of Several Negative Rounds of Human Papillomavirus and Cytology Co-testing on Safety Against Cervical Cancer: An Observational Cohort Study.

PubMed

Castle, Philip E; Kinney, Walter K; Xue, Xiaonan; Cheung, Li C; Gage, Julia C; Zhao, Fang-Hui; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas S; Wentzensen, Nicolas; Katki, Hormuzd A; Schiffman, Mark

2018-01-02

Current U.S. cervical cancer screening and management guidelines do not consider previous screening history, because data on multiple-round human papillomavirus (HPV) and cytology "co-testing" have been unavailable. To measure cervical cancer risk in routine practice after successive negative screening co-tests at 3-year intervals. Observational cohort study. Integrated health care system (Kaiser Permanente Northern California, Oakland, California). 990 013 women who had 1 or more co-tests from 2003 to 2014. 3- and 5-year cumulative detection of (risk for) cervical intraepithelial neoplasia grade 3, adenocarcinoma in situ, and cervical cancer (≥CIN3) in women with different numbers of negative co-tests, overall and within subgroups defined by previous co-test results or baseline age. Five-year ≥CIN3 risks decreased after each successive negative co-test screening round (0.098%, 0.052%, and 0.035%). Five-year ≥CIN3 risks for an HPV-negative co-test, regardless of the cytology result, nearly matched the performance (reassurance) of a negative co-test for each successive round of screening (0.114%, 0.061%, and 0.041%). By comparison, ≥CIN3 risks for the cytology-negative co-test, regardless of the HPV result, also decreased with each successive round, but 3-year risks were as high as 5-year risks after an HPV-negative co-test (0.199%, 0.065%, and 0.043%). No interval cervical cancer cases were diagnosed after the second negative co-test. Independently, ≥CIN3 risks decreased with age. Length of previous screening interval did not influence future ≥CIN3 risks. Interval-censored observational data. After 1 or more negative cervical co-tests (or HPV tests), longer screening intervals (every 5 years or more) might be feasible and safe. National Cancer Institute Intramural Research Program.

200 Years of Vocational Education, 1776-1976

ERIC Educational Resources Information Center

Barlow, Melvin L.

1976-01-01

The introduction to a series of articles on the 200-year history of vocational education in the United States summarizes major achievements during 50-year periods: 1776-1826, 1826-1876, 1876-1926, and 1926-1976. (EC)

Short Round Sub-Linear Zero-Knowledge Argument for Linear Algebraic Relations

NASA Astrophysics Data System (ADS)

Seo, Jae Hong

Zero-knowledge arguments allows one party to prove that a statement is true, without leaking any other information than the truth of the statement. In many applications such as verifiable shuffle (as a practical application) and circuit satisfiability (as a theoretical application), zero-knowledge arguments for mathematical statements related to linear algebra are essentially used. Groth proposed (at CRYPTO 2009) an elegant methodology for zero-knowledge arguments for linear algebraic relations over finite fields. He obtained zero-knowledge arguments of the sub-linear size for linear algebra using reductions from linear algebraic relations to equations of the form z = x *' y, where x, y ∈ Fnp are committed vectors, z ∈ Fp is a committed element, and *' : Fnp × Fnp → Fp is a bilinear map. These reductions impose additional rounds on zero-knowledge arguments of the sub-linear size. The round complexity of interactive zero-knowledge arguments is an important measure along with communication and computational complexities. We focus on minimizing the round complexity of sub-linear zero-knowledge arguments for linear algebra. To reduce round complexity, we propose a general transformation from a t-round zero-knowledge argument, satisfying mild conditions, to a (t - 2)-round zero-knowledge argument; this transformation is of independent interest.

The Solar Dynamics Observatory Education and Public Outreach Program: The First Years

NASA Astrophysics Data System (ADS)

Wawro, M.; Drobnes, E.; van Doren, A.; Scherrer, D. K.

2010-12-01

The Solar Dynamics Observatory (SDO) Education and Public Outreach (E/PO) program began as a series of discrete programs implemented by each of the instrument teams and has evolved into a well-rounded program with a full suite of national and international programs: student, teacher, and journalist workshops, international research programs, family programs, etc. In this presentation, we provide an overview of our philosophy and approach and of some of the programs developed and implemented prior to launch. In conclusion we will summarize our successes, our failures, our lessons learned, and present guiding principles in the hope that future missions will use our platform as a guide to build upon for future programs, incorporating their own content to enhance the public's appreciation of the science that NASA does and its benefit to society.

Still "Unfinished Education": Latino Students Forty Years after the Mexican American Education Study

ERIC Educational Resources Information Center

Madrigal-Gonzalez, Lizely

2012-01-01

The onus of this dissertation was to evaluate the educational conditions of Mexican American students forty years after the "Mexican American Education Study" published a six-volume study detailing the findings of the "Mexican American Education Study" (1970-1974). The "MAES" study focused on five southwest states…

Reconstruction of Bile Duct Injury and Defect with the Round Ligament.

PubMed

Dokmak, Safi; Aussilhou, Béatrice; Ragot, Emilia; Tantardini, Camille; Cauchy, François; Ponsot, Philippe; Belghiti, Jacques; Sauvanet, Alain; Soubrane, Olivier

2017-09-01

Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. The vascularized round ligament is completely mobilized until its origin and used for lateral reconstruction of the bile duct to cover the defect. T tube was inserted and removed after few months. Patency of the bile duct was assessed by cholangiography, the liver function test and magnetic resonance imaging (MRI). Two patients aged 33 and 59 years old underwent lateral reconstruction of the bile duct for defects secondary to choledocotomy for stone extraction or during dissection for Mirizzi syndrome. The defects measured 2 and 3 cm and occupied half of the bile duct circumference. The postoperative course was marked by low output biliary fistula resolved spontaneously. In one patient, the T tube was removed at 3 months after surgery and MRI at 9 months showed strictly normal aspect of the bile duct with normal liver function test. The second patient is going very well 2 months after surgery and the T tube is closed. Lateral reconstruction of the bile duct can be safely achieved with the vascularized round ligament. We will extend our indications to tubular reconstruction.

Applied anatomy of round window and adjacent structures of tympanum related to cochlear implantation.

PubMed

Jain, Shraddha; Gaurkar, Sagar; Deshmukh, Prasad T; Khatri, Mohnish; Kalambe, Sanika; Lakhotia, Pooja; Chandravanshi, Deepshikha; Disawal, Ashish

2018-04-19

Various aspects of the round window anatomy and anatomy of posterior tympanum have relevant implications for designing cochlear implant electrodes and visualizing the round window through facial recess. Preoperative information about possible anatomical variations of the round window and its relationships to the adjacent neurovascular structures can help reduce complications in cochlear implant surgery. The present study was undertaken to assess the common variations in round window anatomy and the relationships to structures of the tympanum that may be relevant for cochlear implant surgery. Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of round window and its relation to facial nerve, carotid canal, jugular fossa and other structures of posterior tympanum. The dissected bones were photographed by a digital camera of 18 megapixels, which were then imported to a computer to determine various parameters using ScopyDoc 8.0.0.22 version software, after proper calibration and at 1× magnification. When the round window niche is placed posteriorly and inferiorly, the distance between round window and vertical facial nerve decreases, whereas that with horizontal facial nerve increases. In such cases, the distance between oval window and round window also increases. Maximum height of the round window in our study ranged from 0.51-1.27mm (mean of 0.69±0.25mm). Maximum width of round window ranged from 0.51 to 2.04mm (mean of 1.16±0.47mm). Average minimum distance between round window and carotid canal was 3.71±0.88mm (range of 2.79-5.34mm) and that between round window and jugular fossa was 2.47±0.9mm (range of 1.24-4.3mm). The distances from the round window to the oval window and facial nerve are important parameters in identifying a difficult round window niche. Modification of the electrode may be a better option than drilling off the round window margins for insertion of cochlear implant electrodes. Copyright © 2018

Family-centered rounds in Pakistani pediatric intensive care settings: non-randomized pre- and post-study design.

PubMed

Ladak, Laila Akbar; Premji, Shahirose Sadrudin; Amanullah, Muhammad Muneer; Haque, Anwarul; Ajani, Khairulnissa; Siddiqui, Fahad Javaid

2013-06-01

Involvement of family in bedside rounds is one strategy to implement family-centered care to help families get clear information about their child, and be actively involved in decision-making about care. However in developing countries such as Pakistan, daily bedside rounds include the physician, residents, medical students and a nurse/technician. Parents are not currently a part of these rounds. To assess whether family-centered rounds improve parents' and health care professionals' satisfaction, decrease patient length of stay, and improve time utilization when compared to traditional practice rounds in a population with a low literacy rate, socioeconomic status, and different cultural values and beliefs. A non-randomized before-after study design. A private hospital in Karachi, Pakistan. A convenience sample of 82 parents, whose children were hospitalized for a minimum of 48h, and 25 health care professionals able to attend two consecutive rounds. During the before phase, traditional bedside rounds were practiced; and during after phase, family-centered rounds were practiced. Parents and health care professionals completed a questionnaire on the second day of rounds. An observational form facilitated data collection on length of stay and time utilization during. Parents' ratings during the family-centered rounds were significantly higher for some parental satisfaction items: evidence of team work (p=0.007), use of simple language during the rounds (p=0.002), feeling of inclusion in discussion at rounds (p=0.03), decision making (p=0.01), and preference for family-centered rounds (p=<0.001). No significant differences were found in health care professionals' satisfaction between rounds. Patient length of stay was significantly reduced in the family-centered rounds group, while no significant difference was found in the duration of rounds. Family-centered rounds served as an opportunity for parents to correct/add to patient history or documentation. Parents were

Rethinking Field Observations: Strengthening Teacher Education through INFORM

ERIC Educational Resources Information Center

Hoyt, Kristin; Terantino, Joe

2015-01-01

This article introduces the Instructional Field Observation Rounds Model (INFORM), drawn from the medical profession where resident interns make rounds with experienced physicians, as an alternative approach for conducting classroom observations in pre-service teacher education methods courses. INFORM centers on structured group observations in…

25 Years of Teamwork for Adult Education in Iowa.

ERIC Educational Resources Information Center

Stacy, W. H.

This silver anniversary report reviews the history of the Iowa Adult Education Association (IAEA) since its founding on April 7, 1945. IAEA conferences, meetings, workshops, and publications are covered year by year, with particular reference to such activities and concerns as leadership training, professional continuing education, educational…

Experience with Round Beam Operation at The Advanced Photon Source

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

Xiao, A.; Emery, L.; Sajaev, V.

2015-01-01

Very short Touschek lifetime becomes a common issue for next-generation ultra-low emittance storage ring light sources. In order to reach a longer beamlifetime, such amachine often requires operating with a vertical-to-horizontal emittance ratio close to an unity, i.e. a “round beam”. In tests at the APS storage ring, we determined how a round beam can be reached experimentally. Some general issues, such as beam injection, optics measurement and corrections, and orbit correction have been tested also. To demonstrate that a round beam was achieved, the beam size ratio is calibrated using beam lifetime measurement.

Knights of the Round-Table.

ERIC Educational Resources Information Center

Teagarden, Jim; Koppes, Peggy

This document describes a classroom learning activity that brings together role playing, learning about the Middle Ages, and working for rewards. In the course of the activity, entitled "Knights of the Round Table," students advance by completing assignments and amassing points. Players move upwards through the beginning or…

WHEN DID ROUND DISK GALAXIES FORM?

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

Takeuchi, T. M.; Ohta, K.; Yuma, S.

2015-03-01

When and how galaxy morphology, such as the disk and bulge seen in the present-day universe, emerged is still not clear. In the universe at z ≳ 2, galaxies with various morphologies are seen, and star-forming galaxies at z ∼ 2 show the intrinsic shape of bar-like structures. Then, when did the round disk structure form? Here we take a simple and straightforward approach to see the epoch when a round disk galaxy population emerged by constraining the intrinsic shape statistically based on the apparent axial ratio distribution of galaxies. We derived the distributions of the apparent axial ratios inmore » the rest-frame optical light (∼5000 Å) of star-forming main-sequence galaxies at 2.5 > z > 1.4, 1.4 > z > 0.85, and 0.85 > z > 0.5, and found that their apparent axial ratios show peaky distributions at z ≳ 0.85, while a rather flat distribution at the lower redshift. By using a tri-axial model (A > B > C) for the intrinsic shape, we found that the best-fit models give the peaks of the B/A distribution of 0.81 ± 0.04, 0.84 ± 0.04, and 0.92 ± 0.05 at 2.5 > z > 1.4, 1.4 > z > 0.85, and 0.85 > z > 0.5, respectively. The last value is close to the local value of 0.95. Thickness (C/A) is ∼0.25 at all the redshifts and is close to the local value (0.21). The results indicate that the shape of the star-forming galaxies in the main sequence changes gradually, and that the round disk is established at around z ∼ 0.9. The establishment of the round disk may be due to the cessation of a violent interaction between galaxies or the growth of a bulge and/or a supermassive black hole residing at the center of a galaxy that dissolves the bar structure.« less

Rheumatology Research Foundation Clinician Scholar Educator Award: Fifteen Years Promoting Rheumatology Educators and Education.

PubMed

Berman, Jessica R; O'Rourke, Kenneth S; Kolasinski, Sharon L; Aizer, Juliet; Wheatley, Mary J; Battistone, Michael J; Siaton, Bernadette C; Criscione-Schreiber, Lisa; Pillinger, Michael H; Lazaro, Deana M

2016-11-01

The Rheumatology Research Foundation's Clinician Scholar Educator (CSE) award is a 3-year career development award supporting medical education research while providing opportunities for mentorship and collaboration. Our objective was to document the individual and institutional impact of the award since its inception, as well as its promise to strengthen the subspecialty of rheumatology. All 60 CSE Award recipients were surveyed periodically. Fifty-six of those 60 awardees (90%) responded to requests for survey information that included post-award activities, promotions, and further funding. Data were also collected from yearly written progress reports for each grant. Of the total CSE recipients to date, 48 of 60 (80%) are adult rheumatologists, 11 of 60 (18%) are pediatric rheumatologists, and 1 is an adult and pediatric rheumatologist. Two-thirds of survey respondents spend up to 30% of their total time in educational activities, and one-third spend greater than 30%. Thirty-one of the 60 CSE recipients (52%) have published a total of 86 medical education papers. Twenty-six of 52 (50%) had received an academic promotion following the award. Eleven awardees earned advanced degrees. We describe the creation and evolution of a grant program from a medical subspecialty society foundation and the impact on producing education research, individual identity formation, and ongoing support for educators. This community of rheumatology scholar educators now serves as an important resource at the national level for the American College of Rheumatology and its membership. We believe that this grant may serve as a model for other medical societies that want to promote education scholarship and leadership within their specialties. © 2016, American College of Rheumatology.

Review of the Year's Publications for 2008: Social Justice Education

ERIC Educational Resources Information Center

Adams, Maurianne; Brigham, Elaine; Whitlock, Elaine R. Cook; Johnson, Julie

2009-01-01

This article offers an annotated bibliographical review of the preceding year's publications in the field of social justice education. In this Year in Review for 2008 (YIR '08), the authors present the work of two Social Justice Education doctoral students and the editors of "Equity & Excellence in Education (EEE)," who together have…

Review of the Year's Publication for 2006: Social Justice Education

ERIC Educational Resources Information Center

Dolan, Jen; Ehrlich, Rachel; McIntosh, Donique R.; Whitlock, Elaine R.; Adams, Maurianne

2007-01-01

This paper offers an annotated bibliographical review of the preceding year's publications in the fields of social justice education. In this Year in Review for 2006, the authors present the work of three advanced Social Justice Education graduate students and the Editors of "Equity & Excellence in Education (EEE), who together have selected…

PHOX2B reliably distinguishes neuroblastoma among small round blue cell tumours.

PubMed

Hung, Yin P; Lee, John P; Bellizzi, Andrew M; Hornick, Jason L

2017-11-01

Neuroblastoma shows considerable histological overlap with other small round blue cell tumours. PHOX2B, a transcription factor that is essential for autonomic nervous system development, has been reported as an immunohistochemical marker for neuroblastoma. The aim of this study was to validate the specificity and diagnostic utility of PHOX2B for peripheral neuroblastic tumours. We evaluated 240 cases (133 in whole-tissue sections; 107 in tissue microarrays), including 76 peripheral neuroblastic tumours (median age 2 years; including four adults) and 164 other tumours: 44 Wilms tumours; 20 Ewing sarcomas; 10 each of CIC-rearranged round cell sarcomas, poorly differentiated synovial sarcomas, lymphoblastic lymphomas, alveolar rhabdomyosarcomas, embryonal rhabdomyosarcomas, mesenchymal chondrosarcomas, Merkel cell carcinomas, olfactory neuroblastomas, and melanomas; and five each of NUT midline carcinomas and desmoplastic small round cell tumours. Immunohistochemistry for PHOX2B was performed with a rabbit monoclonal antibody. PHOX2B positivity was defined as the presence of nuclear immunoreactivity in ≥5% of cells. PHOX2B was positive in 70 (92%) peripheral neuroblastic tumours, including 68 of 72 (94%) paediatric and two of four (50%) adult cases. Furthermore, PHOX2B was consistently negative in all non-peripheral neuroblastic tumours, with staining being absent in 160 cases and limited in four cases. PHOX2B is a highly sensitive and specific immunohistochemical marker for peripheral neuroblastic tumours, including neuroblastoma. PHOX2B reliably distinguishes neuroblastoma from histological mimics such as Wilms tumour, Ewing sarcoma, and CIC-rearranged round cell sarcoma. PHOX2B negativity in two of four adult neuroblastoma cases raises the possibility that some adult neuroblastomas are of a different lineage than paediatric cases. © 2017 John Wiley & Sons Ltd.

All-Round Marketing Increases Hospital Popularity.

PubMed

Ziqi, Tao

2015-06-01

Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.

The Last 40 Years in Finnish Teacher Education

ERIC Educational Resources Information Center

Tirri, Kirsi

2014-01-01

This article sets out to identify and discuss the changes that have taken place in Finnish teacher education during the last 40 years (1974-2014). A brief history of teacher education in Finland is presented, followed by the goals and aims of current research-based teacher education in Finland. Finally, the major changes in Finnish teacher…

Comprehensive Education Plan, School Year 1986-87.

ERIC Educational Resources Information Center

District of Columbia Public Schools, Washington, DC. Research Information Center.

The Board of Education and the administration of the District of Columbia Public Schools cooperated to compose a five-year plan for the 1983-87 school years. Long range and intermediate objectives of the plan are described and the offices accountable for them are indicated. The program for the 1986-87 school year is extracted from those…

Atmospheric deposition and air-sea gas exchange fluxes of DDT and HCH in the Yangtze River Estuary, East China Sea

NASA Astrophysics Data System (ADS)

Li, Zhongxia; Lin, Tian; Li, Yuanyuan; Jiang, Yuqing; Guo, Zhigang

2017-07-01

The Yangtze River Estuary (YRE) is strongly influenced by the Yangtze River and lies on the pathway of the East Asian Monsoon. This study examined atmospheric deposition and air-sea gas exchange fluxes of dichlorodiphenyltrichloroethane (DDT) and hexachlorocyclohexane (HCH) to determine whether the YRE is a sink or source of selected pesticides at the air-water interface under the influences of river input and atmospheric transport. The air-sea gas exchange of DDT was characterized by net volatilization with a marked difference in its fluxes between summer (140 ng/m2/d) and the other three seasons (12 ng/m2/d), possibly due to the high surface seawater temperatures and larger riverine input in summer. However, there was no obvious seasonal variation in the atmospheric HCH deposition, and the air-sea gas exchange reached equilibrium because of low HCH levels in the air and seawater after the long-term banning of HCH and the degradation. The gas exchange flux of HCH was comparable to the dry and wet deposition fluxes at the air-water interface. This suggests that the influences from the Yangtze River input and East Asian continental outflow on the fate of HCH in the YRE were limited. The gas exchange flux of DDT was about fivefold higher than the total dry and wet deposition fluxes. DDT residues in agricultural soil transported by enhanced riverine runoff were responsible for sustaining such a high net volatilization in summer. Moreover, our results indicated that there were fresh sources of DDT from the local environment to sustain net volatilization throughout the year.

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 4 2014-10-01 2014-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 4 2012-10-01 2012-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

47 CFR 73.812 - Rounding of power and antenna heights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 4 2013-10-01 2013-10-01 false Rounding of power and antenna heights. 73.812... RADIO BROADCAST SERVICES Low Power FM Broadcast Stations (LPFM) § 73.812 Rounding of power and antenna...) Antenna radiation center, antenna height above average terrain (HAAT), and antenna supporting structure...

Medication communication during ward rounds on medical wards: Power relations and spatial practices.

PubMed

Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

2013-03-01

Communication plays a crucial role in the management of medications. Ward rounds are sites where health professionals from different disciplines and patients come together to exchange medication information and make treatment decisions. This article examines power relations and spatial practices surrounding medication communication between patients and health professionals including doctors, nurses and pharmacists during ward rounds. Data were collected in two medical wards of a metropolitan teaching hospital in Melbourne, Australia. Data collection methods involved participant observations, field interviews, video-recordings, together with individual and group reflexive interviews. A critical discourse analysis was undertaken to identify the location sites where power relations were reproduced or challenged in ward rounds. Findings demonstrated that traditional medical hierarchies constructed the ways in which doctors communicated about medications during ward rounds. Nurses and pharmacists ventured into the ward round space by using the discourse of preparation and occupying a peripheral physical position. Doctors privileged the discourse of medication rationalization in their ward round discussions, competing with the discourse of inquiry taken up by patients and families. Ward rounds need to be restructured to provide opportunities for nurses and pharmacists to speak at dedicated times and in strategic locations. By critically reflecting upon the complex process of medication communication during ward rounds, greater opportunities exist for enhanced team communication among health professionals.

Enhance ONE Year of Education.

ERIC Educational Resources Information Center

Longhurst, Max L.; Smith, Geoffrey G.; Sorenson, Blaine L.

Substitute teachers are responsible for over 1 full year of every child's education, but research shows that only 10 percent of school districts provide more than 2 hours of substitute teacher training, and 53 percent of school districts provide no training. There is a tremendous need to implement effective training programs that will ultimately…

Transient Side Load Analysis of Out-of-Round Film-Cooled Nozzle Extensions

NASA Technical Reports Server (NTRS)

Wang, Ten-See; Lin, Jeff; Ruf, Joe; Guidos, Mike

2012-01-01

There was interest in understanding the impact of out-of-round nozzle extension on the nozzle side load during transient startup operations. The out-of-round nozzle extension could be the result of asymmetric internal stresses, deformation induced by previous tests, and asymmetric loads induced by hardware attached to the nozzle. The objective of this study was therefore to computationally investigate the effect of out-of-round nozzle extension on the nozzle side loads during an engine startup transient. The rocket engine studied encompasses a regeneratively cooled chamber and nozzle, along with a film cooled nozzle extension. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and transient inlet boundary flow properties derived from an engine system simulation. Six three-dimensional cases were performed with the out-of-roundness achieved by three different degrees of ovalization, elongated on lateral y and z axes: one slightly out-of-round, one more out-of-round, and one significantly out-of-round. The results show that the separation line jump was the primary source of the peak side loads. Comparing to the peak side load of the perfectly round nozzle, the peak side loads increased for the slightly and more ovalized nozzle extensions, and either increased or decreased for the two significantly ovalized nozzle extensions. A theory based on the counteraction of the flow destabilizing effect of an exacerbated asymmetrical flow caused by a lower degree of ovalization, and the flow stabilizing effect of a more symmetrical flow, created also by ovalization, is presented to explain the observations obtained in this effort.

Round Robin Analyses of the Steel Containment Vessel Model

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

Costello, J.F.; Hashimote, T.; Klamerus, E.W.

A high pressure test of the steel containment vessel (SCV) model was conducted on December 11-12, 1996 at Sandia National Laboratories, Albuquerque, NM, USA. The test model is a mixed-scaled model (1:10 in geometry and 1:4 in shell thickness) of an improved Mark II boiling water reactor (BWR) containment. Several organizations from the US, Europe, and Asia were invited to participate in a Round Robin analysis to perform independent pretest predictions and posttest evaluations of the behavior of the SCV model during the high pressure test. Both pretest and posttest analysis results from all Round Robin participants were compared tomore » the high pressure test data. This paper summarizes the Round Robin analysis activities and discusses the lessons learned from the collective effort.« less

In-vitro maturation of round spermatids using co-culture on Vero cells.

PubMed

Cremades, N; Bernabeu, R; Barros, A; Sousa, M

1999-05-01

In an attempt to determine whether co-culture could promote sperm maturation, three patients with non-obstructive azoospermia, two with maturation arrest at the level of primary spermatocytes and one patient with <1% tubules showing complete spermatogenesis, and one patient with total globozoospermia, gave consent to experimentally co-culture round spermatids retrieved from the testicle on Vero cell monolayers. In all azoospermic patients elongating spermatids could be obtained from round spermatids. In one case of maturation arrest, of 37 round spermatids co-cultured for up to 5 days, 30% developed flagella, 46% matured to elongating and 19% to elongated spermatids, with one mature spermatozoon also obtained (3%). In the same patient, primary cultures of three round spermatids with flagella enabled development of one further mature spermatozoon. In the case with total globozoospermia, of six round spermatids co-cultured for up to 5 days, one mature spermatozoon was obtained, with a flagellum and normal head morphology. These preliminary findings suggest that it may be possible to overcome the round spermatid block, and even the triggering of morphological abnormalities arising at the spermiogenic level, by in-vitro maturation under special environmental conditions.

Patterns of participation over four rounds of annual fecal immunochemical test-based screening for colorectal cancer: what predicts rescreening?

PubMed

Osborne, Joanne M; Wilson, Carlene; Duncan, Amy; Cole, Stephen R; Flight, Ingrid; Turnbull, Deborah; Hughes, Donna L; Young, Graeme P

2017-08-01

Participation at the recommended intervals is critical for screening to be effective in reducing colorectal cancer (CRC) incidence. This study describes patterns of screening participation over four rounds of fecal immunochemical testing (FIT) to identify whether demographic variables and prior screening satisfaction are significantly associated with patterns of re-participation. Baseline surveys were mailed to 4000 South Australians randomly selected from the electoral-roll. Respondents (n = 1928/48.2%) were offered four annual FIT rounds. Screening participation and satisfaction at each round were recorded. Study participation was 58.5, 66.9, 73.1 and 71.4% respectively over four rounds. Three participation patterns were described: consistent participation (43.1%), consistent non-participation (26.4%) and inconsistent participation (changeable; 30.5%), including intermittent and sustained change patterns. Sustained change described those who changed participatory behavior and then maintained for at least two rounds (n = 375/19.5%). Older people, and those not working were most likely to sustain participation. Younger invitees, especially men, were more likely to change participatory behavior and sustain the change. People with higher disadvantage, less education, not working and with no prior (pre-trial) screening experience were more likely to start participating and drop out. People dissatisfied with a prior screening test, including finding aspects embarrassing or unpleasant, were also more likely not to participate in annual screening or to drop out. The findings identify those at risk of non- or inconsistent participation in rescreening. They should aid targeting of interventions for demographic groups at risk and ensuring screening experiences are not perceived as unpleasant or difficult.

Improved targeted immunization strategies based on two rounds of selection

NASA Astrophysics Data System (ADS)

Xia, Ling-Ling; Song, Yu-Rong; Li, Chan-Chan; Jiang, Guo-Ping

2018-04-01

In the case of high degree targeted immunization where the number of vaccine is limited, when more than one node associated with the same degree meets the requirement of high degree centrality, how can we choose a certain number of nodes from those nodes, so that the number of immunized nodes will not exceed the limit? In this paper, we introduce a new idea derived from the selection process of second-round exam to solve this problem and then propose three improved targeted immunization strategies. In these proposed strategies, the immunized nodes are selected through two rounds of selection, where we increase the quotas of first-round selection according the evaluation criterion of degree centrality and then consider another characteristic parameter of node, such as node's clustering coefficient, betweenness and closeness, to help choose targeted nodes in the second-round selection. To validate the effectiveness of the proposed strategies, we compare them with the degree immunizations including the high degree targeted and the high degree adaptive immunizations using two metrics: the size of the largest connected component of immunized network and the number of infected nodes. Simulation results demonstrate that the proposed strategies based on two rounds of sorting are effective for heterogeneous networks and their immunization effects are better than that of the degree immunizations.

[Prediction of round window visibility in cochlear implantation with temporal bone high resolution computed tomography].

PubMed

Sun, S P; Lu, W; Lei, Y B; Men, X M; Zuo, B; Ding, S G

2017-08-07

Objective: To discuss the prediction of round window(RW) visibility in cochlear implantation(CI) with temporal bone high resolution computed tomography(HRCT). Methods: From January 2013 to January 2017, 130 cases underwent both HRCT and CI in our hospital were analyzed. The distance from facial nerve to posterior canal wall(FWD), the angle between facial nerve and inner margin of round window(FRA), and the angle between facial nerve and tympanic anulus to inner margin of round window(FRAA) were detected at the level of round window on axial temporal bone HRCT. A line parallel to the posterior wall of ear canal was drawn from the anterior wall of facial nerve at the level of round window on axial temporal bone HRCT and its relationship with round window was detected (facial-round window line, FRL): type0-posterior to the round window, type1-between the round window, type2-anterior to the round window. Their(FWD, FRA, FRAA, FRL) relationships with intra-operative round window visibility were analyzed by SPSS 17.0 software. Results: FWD( F =18.76, P =0.00), FRA( F =34.57, P =0.00), FRAA ( F =14.24, P =0.00) could affect the intra-operative RW visibility significantly. RW could be exposed completely during CI when preoperative HRCT showing type0 FRL. RW might be partly exposed and not exposed when preoperative HRCT showing type1 and type2 FRL respectively. Conclusion: FWD, FRA, FRAA and FRL of temporal bone HRCT can predict intra-operative round window visibility effectively in CI surgery.

Virtual nursing grand rounds and shared governance: how innovation and empowerment are transforming nursing practice at Thanh Nhan Hospital, Hanoi, Vietnam.

PubMed

Crow, Gregory L; Nguyen, Thanh; DeBourgh, Gregory A

2014-01-01

The Vietnam Nurse Project has been operating in Hanoi since 2007. Its primary purpose is to improve nursing education through curriculum development, faculty development, and the introduction of a more student-centric teaching and learning environment. The Virtual Nursing Grand Rounds component of the project is an academic-practice partnership between the Vietnam Nurse Project at the University of San Francisco School of Nursing and Health Professions and the Thanh Nhan Hospital intensive care unit. Its goal is to improve nursing practice in the Thanh Nhan Hospital intensive care unit. The Virtual Nursing Grand Rounds is a fully interactive real-time synchronous computer technology-assisted point-to-point program that provides ongoing evidence-based staff development and consultative services.

Impact of near-peer teaching rounds on student satisfaction in the basic surgical clerkship.

PubMed

Lin, Joseph A; Farrow, Norma; Lindeman, Brenessa M; Lidor, Anne O

2017-06-01

Teaching rounds are rarely featured in the surgery clerkship. Senior students interested in surgery are suited to precept teaching rounds. Near-peer teaching can provide benefits to both learners and preceptors. Near-peer teaching rounds consisted of senior student-precetors leading groups of 3 clerkship students on teaching rounds once during the clerkship. We prospectively surveyed student satisfaction before and after instituting near-peer teaching rounds. We retrospectively gathered qualitative narratives from student-preceptors. The survey response rate was 93% before near-peer teaching rounds were instituted and 85% after. Satisfaction with the learning environment and the quality and amount of small-group teaching were significantly higher after the institution of near-peer teaching rounds (P ≤ .001 for all 3). Satisfaction with the overall clerkship and baseline interest in surgery were not significantly different. Student-preceptors reported gaining valuable experience for future roles in academia as residents and attending surgeons. Student satisfaction with small-group teaching and the learning environment increased after the institution of near-peer teaching rounds in the surgery clerkship. Student-preceptors gained early experience for careers in academic surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Integrated Doppler Correction to TWSTFT Using Round-Trip Measurement

DTIC Science & Technology

2010-11-01

42 nd Annual Precise Time and Time Interval (PTTI) Meeting 251 INTEGRATED DOPPLER CORRECTION TO TWSTFT USING ROUND-TRIP MEASUREMENT Yi...Frequency Transfer ( TWSTFT ) data. It is necessary to correct the diurnal variation for comparing the time-scale difference. We focus on the up-/downlink...delay difference caused by satellite motion. In this paper, we propose to correct the TWSTFT data by using round-trip delay measurement. There are

The round window region and contiguous areas: endoscopic anatomy and surgical implications.

PubMed

Marchioni, Daniele; Alicandri-Ciufelli, Matteo; Pothier, David D; Rubini, Alessia; Presutti, Livio

2015-05-01

The round window region is a critical area of the middle ear; the aim of this paper is to describe its anatomy from an endoscopic perspective, emphasizing some structures, the knowledge of which could have important implications during surgery, as well as to evaluate what involvement cholesteatoma may have with these structures. Retrospective review of video recordings of endoscopic ear surgeries and retrospective database review were conducted in Tertiary university referral center. Videos from endoscopic middle ear procedures carried out between June 2010 and September 2012 and stored in a shared database were reviewed retrospectively. Surgeries in which an endoscopic magnification of the round window region and the inferior retrotympanum area was performed intraoperatively were included in the study. Involvement by cholesteatoma of those regions was also documented based on information obtained from the surgical database. Conformation of the tegmen of the round window niche may influence the surgical view of round window membrane. A structure connecting the round window area to the petrous apex, named the subcochlear canaliculus, is described. Cholesteatoma can invade the round window areas in some patients. Endoscopic approaches can guarantee a very detailed view and allow the exploration of the round window region. Exact anatomical knowledge of this region can have important advantages during surgery, since some pathology can invade inside cavities or tunnels otherwise not seen by instrumentation that produces a straight-line view (e.g. microscope).

Missouri Coordinating Board for Higher Education Fiscal Year 2007 Annual Report

ERIC Educational Resources Information Center

Missouri Department of Higher Education, 2007

2007-01-01

The Coordinating Board for Higher Education (CBHE) and the Missouri Department of Higher Education (MDHE) present this report on Missouri higher education for fiscal year 2007. 2007 is an exciting year. The omnibus higher education bill, which was signed in May and became law in August 2007, represents a major transformation in the structure of…

Missouri Coordinating Board for Higher Education Fiscal Year 2005 Annual Report

ERIC Educational Resources Information Center

Fitch, Gregory G.; Stein, Robert; Matchefts, Jim; Peterson, Dan; Imhoff, Donna; Miner, Brenda; Fennewald, Amy

2005-01-01

The Coordinating Board for Higher Education and the Missouri Department of Higher Education present this fiscal year 2005 Annual Report to inform individuals of the state's status and progress in higher education. The Coordinating Board for Higher Education (CBHE) began the 2005 calendar year with a number of significant changes. The board and its…

Moving House for Education in the Pre-School Years

ERIC Educational Resources Information Center

Hansen, Kirstine

2014-01-01

This paper uses data from the Millennium Cohort Study (MCS) to examine house moves that take place in the pre-school years, focusing on families who move for the education of their children. We present results showing that education- related house moves do indeed occur in the pre-school years with particular types of parents making these…

Early Years Education and the Value for Money Folklore

ERIC Educational Resources Information Center

Campbell-Barr, Verity

2012-01-01

This article is intended as a contribution to the debate on the role of human capital in determining value for money in early years education. The article explores how the idea that early years education offers value for money has become folklore amongst policymakers and more widely. However, drawing on both interview data and existing literature…

Early Years Education Resource Guide. Early Education Support Series.

ERIC Educational Resources Information Center

Dunlop, Aline-Wendy, Comp.

The aim of this resource guide is to provide practitioners in preschool settings with information to help them plan, implement, augment with resources, and review practice based on the "Curriculum Framework for Children in Their Pre-School Year" issued by the Scottish Office Education and Industry Department. The guide presents a…

Helicopter noise analysis : round-robin test

DOT National Transportation Integrated Search

1981-08-01

This report documents the results of an international round robin test on the analysis of helicopter noise. Digital spectral noise data of a 3.5-second simulated helicopter flyover and identical analog test tapes containing helicopter noise data, ref...

A core subunit of the RNA-processing/degrading exosome specifically influences cuticular wax biosynthesis in Arabidopsis.

PubMed

Hooker, Tanya S; Lam, Patricia; Zheng, Huanquan; Kunst, Ljerka

2007-03-01

The cuticle is an extracellular matrix composed of cutin polyester and waxes that covers aerial organs of land plants and protects them from environmental stresses. The Arabidopsis thaliana cer7 mutant exhibits reduced cuticular wax accumulation and contains considerably lower transcript levels of ECERIFERUM3/WAX2/YORE-YORE (CER3/WAX2/YRE), a key wax biosynthetic gene. We show here that CER7 protein is a putative 3'-5' exoribonuclease homologous to yeast Ribonuclease PH45 (RRP45p), a core subunit of the RNA processing and degrading exosome that controls the expression of CER3/WAX2/YRE. We propose that CER7 acts by degrading a specific mRNA species encoding a negative regulator of CER3/WAX2/YRE transcription. A second RRP45p homolog found in Arabidopsis, designated At RRP45a, is partially functionally redundant with CER7, and complete loss of RRP45 function in Arabidopsis is lethal. To our knowledge, CER7 is currently the only example of a core exosomal subunit specifically influencing a cellular process.

Round-Robin approach to data flow optimization

NASA Technical Reports Server (NTRS)

Witt, J.

1978-01-01

A large data base, circular in structure, was required (for the Voyager Mission to Jupiter/Saturn) with the capability to completely update the data every four hours during high activity periods. The data is stored in key ordered format for retrieval but is not input in key order. Existing access methods for large data bases with rapid data replacement by keys become inefficient as the volume of data being replaced grows. The Round-Robin method was developed to alleviate this problem. The Round-Robin access method allows rapid updating of the data with continuous self cleaning where the oldest data (by key) is deleted and the newest data (by key) is kept regardless of the order of input.

2. HISTORIC PHOTOGRAPH, MERRITT PARKWAY UNDER CONSTRUCTION,LOOKING WEST TO ROUND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. HISTORIC PHOTOGRAPH, MERRITT PARKWAY UNDER CONSTRUCTION,LOOKING WEST TO ROUND HILL ROAD BRIDGE, CA. 1936. COLLECTION OF GEORGE L. LARNED. - Merritt Parkway, Round Hill Road Bridge, Spanning Merritt Parkway at 3.5 mile mark, Greenwich, Fairfield County, CT

The effect of embedded bonus rounds on slot machine preference.

PubMed

Belisle, Jordan; Owens, Kelti; Dixon, Mark R; Malkin, Albert; Jordan, Sam D

2017-04-01

Twenty-three university students completed a simulated slot machine task involving the concurrent presentation of two slot machines that were varied both in win density and the inclusion of a bonus round feature to evaluate the effect of embedded bonus rounds on participant response allocation. The results suggest that participants allocated a greater percentage of responses to machines with embedded bonus rounds across both dense (Bonus: M = 68.4, SD = 19.2; No Bonus: M = 51.2; 9.6) and lean (Bonus: M = 48.8, SD = 9.6; No Bonus: M = 31.6, SD = 19.2) reinforcement schedules, in which the overall reinforcement rate across all machines was held constant. © 2016 Society for the Experimental Analysis of Behavior.

Divergent life histories of invasive round gobies (Neogobius melanostomus) in Lake Michigan and its tributaries

USGS Publications Warehouse

Kornis, Matthew; Weidel, Brian C.; Vander Zanden, M. Jake

2017-01-01

Round gobies (Neogobius melanostomus) have invaded benthic habitats of the Laurentian Great Lakes and connected tributary streams. Although connected, these two systems generally differ in temperature (Great Lakes are typically colder), food availability (Dreissenid mussels are more prevalent in Great Lakes), and system size and openness. Here, we compare round goby life histories from inshore Lake Michigan and adjacent tributary systems—an uncommon case study of life-history differences between connected systems. Tributary round gobies grew much faster (average length-at-age of 122.3 vs. 65.7 mm for Age 2 +  round gobies), appeared to have shorter life spans (maximum observed age of 2 vs. 5) and had lower age-at-50% maturity (1.6 vs. 2.4 years; females only) compared to gobies from Lake Michigan. In addition, tributary gobies had greater fecundity at Ages 1–2 than lake gobies, but had fewer eggs for a given body size prior to the first spawning event of the summer. We were not able to determine the cause of the observed life-history differences. Nonetheless, the observed differences in growth, maturation and longevity were consistent with known effects of water temperature, as well as predictions of life-history theory for animals at invasion fronts exposed to novel environmental conditions. The high degree of phenotypic plasticity in connected populations of this invasive species has implications for our understanding of invasive species impacts in different habitats.

Delaying the Academy: A Gap Year Education

ERIC Educational Resources Information Center

O'Shea, Joseph

2011-01-01

This investigation serves as one of the first empirical analyses to examine the international volunteering gap year from an educational perspective, concluding an in-depth case study of a prominent gap year organisation in the UK. Contrary to widespread industry promotion of international development, the findings suggest that the experience can…

Quantum dots for a high-throughput Pfu polymerase based multi-round polymerase chain reaction (PCR).

PubMed

Sang, Fuming; Zhang, Zhizhou; Yuan, Lin; Liu, Deli

2018-02-26

Multi-round PCR is an important technique for obtaining enough target DNA from rare DNA resources, and is commonly used in many fields including forensic science, ancient DNA analysis and cancer research. However, multi-round PCR is often aborted, largely due to the accumulation of non-specific amplification during repeated amplifications. Here, we developed a Pfu polymerase based multi-round PCR technique assisted by quantum dots (QDs). Different PCR assays, DNA polymerases (Pfu and Taq), DNA sizes and GC amounts were compared in this study. In the presence of QDs, PCR specificity could be retained even in the ninth-round amplification. Moreover, the longer and more complex the targets were, the earlier the abortion happened in multi-round PCR. However, no obvious enhancement of specificity was found in multi-round PCR using Taq DNA polymerase. Significantly, the fidelity of Pfu polymerase based multi-round PCR was not sacrificed in the presence of QDs. Besides, pre-incubation at 50 °C for an hour had no impact on multi-round PCR performance, which further authenticated the hot start effect of QDs modulated in multi-round PCR. The findings of this study demonstrated that a cost-effective and promising multi-round PCR technique for large-scale and high-throughput sample analysis could be established with high specificity, sensibility and accuracy.

The cross-sectional shape of the fourfold semitendinosus tendon is oval, not round.

PubMed

Oshima, Takeshi; Nakase, Junsuke; Numata, Hitoaki; Takata, Yasushi; Tsuchiya, Hiroyuki

2016-12-01

The looped side of the semitendinosus tendon (ST) graft (i.e., the side inserted into the femoral tunnel during anterior cruciate ligament reconstruction) appears to be oval rather than round. The purpose of this study was to investigate the cross section of the fourfold semitendinosus tendon graft and, more specifically, the differences in pressure exerted by a rounded rectangular tunnel versus a round femoral tunnel. Seven STs were harvested from cadaveric knees and a fourfold ST graft was made. Aluminum cubes with round or rectangular tunnels containing four-way pressure-sensitive conductive sensors (vertically and bilaterally) were used. The area of both cubes was the same. The graft was inserted into the tunnels 15 mm from the looped edge. After measuring pressure, the graft was fixed using ultraviolet-curing acrylic resin and was cut at 7.5 mm and 15 mm from the lapel edge. The area, axes for the best fitting ellipse of the cross-section, and ellipticity of the axes were measured. In the round tunnel, the mean contact pressure was 287.0 ± 136.7 gf at the bilateral sensor; there was no contact pressure detected by the vertical sensor. In the rounded rectangular tunnel, the mean contact pressure was 260.9 ± 186.4 gf at the bilateral sensor and 352.9 ± 49.5 gf at the vertical sensor. Ellipticity was 1.25 ± 0.13 at 7.5 mm, and 1.17 ± 0.07 at 15 mm from the lapel edge of the graft. The cross-sectional shape of the fourfold ST graft was not round, but oval. Moreover, the rounded rectangular tunnel was more fitted to the graft than the round tunnel.

Visual search, movement behaviour and boat control during the windward mark rounding in sailing.

PubMed

Pluijms, Joost P; Cañal-Bruland, Rouwen; Hoozemans, Marco J M; Savelsbergh, Geert J P

2015-01-01

In search of key-performance predictors in sailing, we examined to what degree visual search, movement behaviour and boat control contribute to skilled performance while rounding the windward mark. To this end, we analysed 62 windward mark roundings sailed without opponents and 40 windward mark roundings sailed with opponents while competing in small regattas. Across conditions, results revealed that better performances were related to gazing more to the tangent point during the actual rounding. More specifically, in the condition without opponents, skilled performance was associated with gazing more outside the dinghy during the actual rounding, while in the condition with opponents, superior performance was related to gazing less outside the dinghy. With respect to movement behaviour, superior performance was associated with the release of the trimming lines close to rounding the mark. In addition, better performances were related to approaching the mark with little heel, yet heeling the boat more to the windward side when being close to the mark. Potential implications for practice are suggested for each phase of the windward mark rounding.

Evaluation of ADCP backscatter inversion to suspended sediment concentration in estuarine environments

NASA Astrophysics Data System (ADS)

Lee, G. H.; Park, H. B.

2014-12-01

Acoustic Doppler Current Profiler (ADCP), designed for measuring velocity profile, is now widely used for the estimation of suspended sediment concentration from acoustic backscatter intensity, but its application to estuarine environments has not been vigorously tested. In this study, we examined the inversion capability of two ADCPs with 600 and 1200 kHz at three Korean estuaries: macrotidal Han river estuary (HRE), microtidal Nakdong river estuary (NRE), and anthropogenically altered macrotidal Yeongsan river estuary (YRE). In particular, we examined the relative importance of the sound attenuations due to water (aw) and sediment (as) in response to sediment characteristics (size and concentration) as well as changing salinity and temperature. The inverted concentration was compared with reference concentrations obtained either water samples or Optical Backscatter Sensors. In NRE and YRE, where suspended sediment concentrations were smaller than 0.2 kg/m3, the acoustic inversion performed poorly only with as (R2 = 0.05 and 0.39 for NRE and YRE, respectively), but well with aw (R2 = 0.70 and 0.64 for NRE and YRE, respectively). Thus, it is important to accurately constrain aw in low-concentration estuarine environments. However, we did not find that the varying aw performed considerably better than the constant aw. On the other hand, the acoustic inversion was poorest at HRE regardless of aw and as (R2 = 0.58 and mean relative error =45%). The large discrepancy appears to result from the poorly constrained, spatially and temporally varying sediment characteristics (grain size, density and concentration) due to non-local sediment transport at macrotidal HRE.

Evaluation of ADCP backscatter inversion to suspended sediment concentration in estuarine environments

NASA Astrophysics Data System (ADS)

Lee, Guan-hong; Park, Hyo-Bong

2015-04-01

Acoustic Doppler Current Profiler (ADCP), designed for measuring velocity profile, is now widely used for the estimation of suspended sediment concentration from acoustic backscatter strength, but its application to estuarine environments has still room for improvement. In this study, we examinedthe inversion capability of two ADCPs with 600 and 1200 kHz at three Korean estuaries: macrotidalHan river estuary (HRE), microtidalNakdong river estuary (NRE), and anthropogenically altered macrotidalYeongsan river estuary (YRE). In particular, we examined the relative importance of the sound attenuations due to water (αw) and sediment (αs) in response to sediment characteristics (size and concentration) as well as changing salinity and temperature. The inverted concentration was compared with reference concentrations obtained either water samples or Optical Backscatter Sensors. In NRE and YRE, where suspended sediment concentrations were smaller than 0.2 g/l, the acoustic inversion performed poorly only with αs (r = 0.20and 0.38for NRE and YRE, respectively), but well with αw (r = 0.66and 0.42 for NREand YRE, respectively). Thus, it is important to accurately constrain αw in low-concentration estuarine environments. However, we did not find that the varying αw performed considerably better than the constant αw. On the other hand, the acoustic inversion was poorest at HRE regardless of αw and αs (r = 0.71 and mean relative error =45%). The large discrepancy appears to result from the poorly constrained, spatially and temporally varying sediment characteristics (grain size, density and concentration) due to non-local sediment transport at macrotidal HRE.

All-year-round aerosol chemical composition at Dome C, Antarctica

NASA Astrophysics Data System (ADS)

Udisti, Roberto; Becagli, Silvia; Frosini, Daniele; Galli, Gaia; Ghedini, Costanza; Rugi, Francesco; Severi, Mirko; Traversi, Rita

2010-05-01

Since 2005, continuous, all-year-round aerosol sampling was carried out at Dome C (Central East Antarctica, 3233 m a.s.l., about 1100 km far from the coastline), in the framework of "Station Concordia" project, an Italian PNRA - French IPEV joint program. Size-segregated aerosol samples were collected in summer and winter periods by using different low- and medium-volume systems, including pre-selected cut-off samplers (with PM10, PM2.5 and PM1 cut-off heads) and multi-stage (Andersen 8-stage and Dekati 4-stage) impactors. Sampling resolution and volumes ranged from 1 day to 1 month and from 2.3 to 12 m3/h, respectively. Aerosol study at Dome C is expected improving our knowledge on present-day source intensity, transport efficiency and pathways (including stratosphere-troposphere interchanges) of particles reaching internal sites of Antarctica. Besides, more detailed information on atmosphere-snow interactions, including depositional and post-depositional processes, as well as the effect of sublimation/condensation processes on snow surface, will be used for improving the reconstruction of past atmosphere composition from ice core chemical stratigraphies (EPICA Dome C ice core). Here we report major results from the chemical composition of the Antarctic background aerosol reaching Dome C, pointing out the seasonal pattern and the temporal trend of some ionic components used as tracers of sea spray, marine biogenic and crustal emissions. Oxidised sulfur compounds are assumed to affect the climate system by influencing the Earth's radiative budget, both directly (solar light scattering) and indirectly (acting as cloud condensation nuclei). Among these compounds, methanesulphonic acid (MSA) and H2SO4 (arising from the atmospheric oxidation of phytoplanktonic dimethylsulphide - DMS), are considered the best tracers of marine productivity. Their use as reliable markers of oceanic biogenic emissions is hindered by poorly known mechanisms (temperature and photochemistry

Exploration pace slated to pick up on 13th round acreage in Thailand

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

Not Available

This paper reports that Thailand is about to see a major surge in exploration by foreign companies the next 3 years. With the tentative award of 33 petroleum concessions this summer, 17 companies are posed to spend at least $150 million for exploration during an initial 3 year obligation period, the Prakong Polahan, deputy director general of the Department of Mineral Resources. The 13th round of bidding resulted in a flurry of interest that contrasts with a slowing of the exploration pace in Thailand in recent years. Few new companies have tried to enter the Thai exploration scene in recentmore » years, and most companies operating existing concessions had completed obligation work.« less

Hole-pin joining structure with fiber-round-hole distribution of lobster cuticle and biomimetic study.

PubMed

Chen, Bin; Fan, Jinghong; Gou, Jihua; Lin, Shiyun

2014-12-01

Observations of the cuticle of the Boston Spiny Lobster using scanning electron microscope (SEM) show that it is a natural biocomposite consisting of chitin fibers and sclerotic-protein matrix with hierarchical and helicoidal structure. The SEM images also indicate that there is a hole-pin joining structure in the cuticle. In this joining structure, the chitin fibers in the neighborhood of the joining holes continuously round the holes to form a fiber-round-hole distribution. The maximum pullout force of the fibers in the fiber-round-hole distribution, which is closely related to the fracture toughness of the cuticle, is investigated and compared with that of the fibers in non-fiber-round-hole distribution based on their representative models. It is revealed that the maximum pullout force of the fibers in the fiber-round-hole distribution is significantly larger than that of the fibers in the non-fiber-round-hole distribution, and that a larger diameter of the hole results in a larger difference in the maximum pullout forces of the fibers between the two kinds of the fiber distributions. Inspired by the fiber-round-hole distribution found in the cuticle, composite specimens with the fiber-round-hole distribution were fabricated with a special mold and process to mirror the fiber-round-hole distribution. The fracture toughness of the biomimetic composite specimens is tested and compared with that of the conventional composite specimens with the non-fiber-round-hole distribution. It is demonstrated that the fracture toughness of the biomimetic composite specimens with the fiber-round-hole distribution is significantly larger than that of the conventional composite specimens with the non-fiber-round-hole distribution. Copyright © 2014 Elsevier Ltd. All rights reserved.

The impact of HIV on children's education in eastern Zimbabwe.

PubMed

Pufall, Erica L; Nyamukapa, Constance; Eaton, Jeffrey W; Campbell, Catherine; Skovdal, Morten; Munyati, Shungu; Robertson, Laura; Gregson, Simon

2014-01-01

Little is known about how HIV impacts directly and indirectly on receiving, or particularly succeeding in, education in sub-Saharan Africa. To address this gap, we used multivariable logistic regression to determine the correlation between education outcomes in youth (aged 15-24) (being in the correct grade-for-age, primary school completion and having at least five "O" level passes) and being HIV-positive; having an HIV-positive parent; being a young carer; or being a maternal, paternal or double orphan, in five rounds (1998-2011) of a general population survey from eastern Zimbabwe. The fifth survey round (2009-2011) included data on children aged 6-17, which were analysed for the impacts of the above risk factors on regular attendance in primary and secondary schools and being in the correct grade-for-age. For data pooled over all rounds, being HIV-positive had no association with primary school completion, "O" level passes, or being in the correct grade-for-age in adolescents aged 16-17 years. Additionally, HIV status had no significant association with any education outcomes in children aged 6-17 surveyed in 2009-2011. In 2009-2011, being a young carer was associated with lower attendance in secondary school (69% vs. 85%, AOR: 0.44; p=0.02), whilst being a maternal (75% vs. 83%, AOR: 0.67; p<0.01), paternal (76% vs. 83%, AOR: 0.67; p=0.02) or double (75% vs. 83%, AOR: 0.68; p=0.02) orphan was associated with decreased odds of being in the correct grade-for-age. All forms of orphanhood also significantly decreased the odds of primary school completion in youths surveyed from 1998 to 2011 (all p<0.01). We found no evidence that HIV status affects education but further evidence that orphans do experience worse education outcomes than other children. Combination approaches that provide incentives for children to attend school and equip schools with tools to support vulnerable children may be most effective in improving education outcomes and should be developed

Year-round methane emissions from permafrost in a North-east Siberian region

NASA Astrophysics Data System (ADS)

Castro-Morales, Karel; Kaiser, Sonja; Kleinen, Thomas; Kwon, Min Jung; Kittler, Fanny; Zaehle, Sönke; Beer, Christian; Göckede, Mathias

2017-04-01

In recent decades, permafrost regions in northern latitudes are thawing as a response of climate warming. Soils in permafrost areas contain vast amounts of organic material that is released into the environment after thaw, providing new labile material for bacterial decomposition. As a result, higher production of methane in the anoxic soil layers and within anaerobic wetlands is anticipated, and this will be further released to the atmosphere. In order to assess the current large-scale methane emissions from a wetland permafrost-thaw affected area, we present results of year-round simulated methane emissions at regional scale for a section at the Russian far Northeast in Siberia, located in the low Arctic tundra and characterized by continuous permafrost. For this we use a newly developed process-based methane model built in the framework of the land surface model JSBACH. The model contains explicit permafrost processes and an improved representation of the horizontal extent of wetlands with a hydrological model (TOPMODEL). Model simulated distribution and horizontal extent of wetlands is evaluated against high-resolution remote sensing data. Total and individual regional methane emissions by ebullition, molecular diffusion, plant-mediated and emissions through snow are presented for 2014 and 2015. The model shows a reasonable seasonal transition between the individual methane emission paths. Most of the methane emissions to the atmosphere occur in summer (July, August, September), with the peak of the emissions during August. In this month, plant-mediated transport is the dominant emission path with about 15 mg CH4 m-2 d-1 in 2014, followed by ebullition (7 mg CH4 m-2 d-1) accounting for about half of the emissions thorough plants. Molecular diffusion is a minor contributor with only 0.006 mg CH4 m-2 d-1 at the peak of the summer emissions. Methane emissions through snow occur only during spring, fall and winter months, with higher emissions in spring and autumn

Higher Education Cooperation Act: Fiscal Year 1997 Grant Allocations.

ERIC Educational Resources Information Center

Illinois State Board of Higher Education, Springfield.

This publication provides individual descriptions of grants allocated by the state of Illinois for aid to higher education for fiscal year 1997 under the provisions of the State Higher Education Cooperation Act. The Act provides funds for interinstitutional grants, minority educational achievement grants, minority articulation program grants,…

Parental presence on neonatal intensive care unit clinical bedside rounds: randomised trial and focus group discussion

PubMed Central

Boswell, Danette; Broom, Margaret; Smith, Judith; Davis, Deborah

2015-01-01

Background There are limited data to inform the choice between parental presence at clinical bedside rounds (PPCBR) and non-PPCBR in neonatal intensive care units (NICUs). Methods We performed a single-centre, survey-based, crossed-over randomised trial involving parents of all infants who were admitted to NICU and anticipated to stay >11 days. Parents were randomly assigned using a computer-generated stratified block randomisation protocol to start with PPCBR or non-PPCBR and then crossed over to the other arm after a wash-out period. At the conclusion of each arm, parents completed the ‘NICU Parental Stressor Scale’ (a validated tool) and a satisfaction survey. After completion of the trial, we surveyed all healthcare providers who participated at least in one PPCBR rounding episode. We also offered all participating parents and healthcare providers the opportunity to partake in a focus group discussion regarding PPCBR. Results A total of 72 parents were enrolled in this study, with 63 parents (87%) partially or fully completing the trial. Of the parents who completed the trial, 95% agreed that parents should be allowed to attend clinical bedside rounds. A total of 39 healthcare providers’ surveys were returned and 35 (90%) agreed that parents should be allowed to attend rounds. Nine healthcare providers and 8 parents participated in an interview or focus group, augmenting our understanding of the ways in which PPCBR was beneficial. Conclusions Parents and healthcare providers strongly support PPCBR. NICUs should develop policies allowing PPCBR while mitigating the downsides and concerns of parents and healthcare providers such as decreased education opportunity and confidentiality concerns. Trial registration number Australia and New Zealand Clinical Trials Register number, ACTRN12612000506897. PMID:25711125

First-Year University Students of Educational Sciences on Inclusive Education: Attitudes and Convictions in Flanders.

ERIC Educational Resources Information Center

Vanderfaeillie, Johan; De Fever, Frank; Lombaerts, Koen

2003-01-01

Assessed the attitudes toward inclusive education of college students at a Flemish college that had a new curriculum designed to familiarize first year educational psychology and special education students with inclusive education. Surveys of students who took introductory courses on inclusion indicated that students neither advocated for nor…

Rounding Behavior in the Reporting of Headache Frequency Complicates Headache Chronification Research

PubMed Central

Houle, Timothy T.; Turner, Dana P.; Houle, Thomas A.; Smitherman, Todd A.; Martin, Vincent; Penzien, Donald B.; Lipton, Richard B.

2013-01-01

Objectives To characterize the extent of measurement error arising from rounding in headache frequency reporting (days per month) in a population sample of headache sufferers. Background When reporting numerical health information, individuals tend to round their estimates. The tendency to round to the nearest 5 days when reporting headache frequency can distort distributions and engender unreliability in frequency estimates in both clinical and research contexts. Methods This secondary analysis of the 2005 American Migraine Prevalence and Prevention study (AMPP) survey characterized the population distribution of 30-day headache frequency among community headache sufferers and determined the extent of numerical rounding (“heaping”) in self-reported data. Headache frequency distributions (days per month) were examined using a simplified version of Wang and Heitjan’s (2008) approach to heaping to estimate the probability that headache sufferers round to a multiple of 5 when providing frequency reports. Multiple imputation was used to estimate a theoretical “true” headache frequency. Results Of the 24,000 surveys, headache frequency data were available for 15,976 respondents diagnosed with migraine (68.6%), probable migraine (8.3%), or episodic tension-type headache (10.0%); the remainder had other headache types. The mean number of headaches days/month was 3.7 (SD = 5.6). Examination of the distribution of headache frequency reports revealed a disproportionate number of responses centered on multiples of 5 days. The odds that headache frequency was rounded to 5 increased by 24% with each one-day increase in headache frequency (OR: 1.24, 95% CI: 1.23 to 1.25), indicating that heaping occurs most commonly at higher headache frequencies. Women were more likely to round than men, and rounding decreased with increasing age and increased with symptoms of depression. Conclusions Because of the coarsening induced by rounding, caution should be used when

Advanced transportation concept for round-trip space travel

NASA Technical Reports Server (NTRS)

Yen, Chen-Wan L.

1988-01-01

A departure from the conventional concept of round-trip space travel is introduced. It is shown that a substantial reduction in the initial load required of the Shuttle or other launch vehicle can be achieved by staging the ascent orbit and leaving fuel for the return trip at each stage of the orbit. Examples of round trips from a low-inclination LEO to a high-inclination LEO and from an LEO to a GEO are used to show the merits of the new concept. Potential problem areas and research needed for the development of an efficient space transportation network are discussed.