Yoga Meditation Practitioners Exhibit Greater Gray Matter Volume and Fewer Reported Cognitive Failures: Results of a Preliminary Voxel-Based Morphometric Analysis

Directory of Open Access Journals (Sweden)

Brett Froeliger

2012-01-01

Full Text Available Hatha yoga techniques, including physical postures (asanas, breathing exercises (pranayama, and meditation, involve the practice of mindfulness. In turn, yoga meditation practices may induce the state of mindfulness, which, when evoked recurrently through repeated practice, may accrue into trait or dispositional mindfulness. Putatively, these changes may be mediated by experience-dependent neuroplastic changes. Though prior studies have identified differences in gray matter volume (GMV between long-term mindfulness practitioners and controls, no studies to date have reported on whether yoga meditation is associated with GMV differences. The present study investigated GMV differences between yoga meditation practitioners (YMP and a matched control group (CG. The YMP group exhibited greater GM volume in frontal, limbic, temporal, occipital, and cerebellar regions; whereas the CG had no greater regional greater GMV. In addition, the YMP group reported significantly fewer cognitive failures on the Cognitive Failures Questionnaire (CFQ, the magnitude of which was positively correlated with GMV in numerous regions identified in the primary analysis. Lastly, GMV was positively correlated with the duration of yoga practice. Results from this preliminary study suggest that hatha yoga practice may be associated with the promotion of neuroplastic changes in executive brain systems, which may confer therapeutic benefits that accrue with repeated practice.

THE PRACTICAL SIGNIFICANCE OF GLAUCOMA INVESTIGATIONS

African Journals Online (AJOL)

more reliable and the more practical ones in a short, concise manner ... pathological changes in the affected eye'" This definition makes it clear ... having glaucoma; clear-cut clinical cases are excluded. So often ... be remembered that the provocative tests are helpful, but ... Make sure your Schiotz tonometer is standardized.

Prevalence of gastrointestinal helminths and management practices for dogs in the Greater Accra region of Ghana

Directory of Open Access Journals (Sweden)

Sherry Ama Mawuko Johnson

2015-09-01

Full Text Available Toxocariosis and ancylostomosis remain the most important parasitic infections affecting companion animals worldwide and pose a risk to animal and human health. Information on these infections in dogs in Ghana is inadequate. A cross sectional study was undertaken to determine the occurrence of gastrointestinal helminths infections and management practices of dogs in the Greater Accra Region (GAR of Ghana. Faecal samples were obtained from 380 dogs from communities in 11 out of 16 districts in the GAR. Coprological examination of the samples was performed using the modified McMaster technique. Management practices for control of helminths in dogs were assessed through questionnaire interviews of the dog owners. Most dogs (70.7% were kept for security reasons and were not housed (61.8%. Prevalence of gastrointestinal helminths was 62.6%. Hookworm eggs were found in 178 (46.8% dogs, Toxocara canis eggs in 22 (5.8% and mixed infections of hookworms and T. canis in 38 (10.0%. Dipylidium caninum was found in 51 (13.4% dogs, while Isospora species was in 33 (8.5% dogs. Most households (68%; 133/194 of the sampled dogs had at least a child below the age of 5 years. Hookworm, T. canis and D. caninum were the zoonotic gastrointestinal helminths prevalent in dogs in the study area. Lack of housing for dogs creates ideal conditions for infection and spread of the zoonotic parasites.

Multiple-land use practices in transfrontier conservation areas: the case of Greater Mapungubwe straddling parts of Botswana, South Africa and Zimbabwe

Directory of Open Access Journals (Sweden)

Sinthumule Ndidzulafhi Innocent

2016-12-01

Full Text Available Transfrontier Conservation Areas (TFCAs have recently emerged as the 21st century approach to managing protected areas in southern Africa. Unlike national parks and other protected areas that place emphasis only on the protection of plant and animal species within their borders, transfrontier conservation areas promote conservation beyond the borders of protected areas. Consequently, this mega-conservation initiative encourage multiple land-use practices with the purpose of improving rural livelihoods whilst promoting biodiversity conservation. Thus, land parcels under different forms of tenure are brought together into a common nature conservation project. This study argues that the integration of various land-use practices within one area benefits conservation goals at the expense of local communities and irrigation farmers. To substantiate this argument, the study draws on fieldwork material collected in the Greater Mapungubwe Transfrontier Conservation Area spanning parts of Botswana, South Africa and Zimbabwe. The study concludes that multiple-land use practices in transfrontier conservation areas is only promoted by wildlife managers to gain access to extra land.

How Often Is the Misfit of Item Response Theory Models Practically Significant?

Science.gov (United States)

Sinharay, Sandip; Haberman, Shelby J.

2014-01-01

Standard 3.9 of the Standards for Educational and Psychological Testing ([, 1999]) demands evidence of model fit when item response theory (IRT) models are employed to data from tests. Hambleton and Han ([Hambleton, R. K., 2005]) and Sinharay ([Sinharay, S., 2005]) recommended the assessment of practical significance of misfit of IRT models, but…

Predictive performance of three practical approaches for grapefruit juice-induced 2-fold or greater increases in AUC of concomitantly administered drugs.

Science.gov (United States)

Takahashi, M; Onozawa, S; Ogawa, R; Uesawa, Y; Echizen, H

2015-02-01

Clinical pharmacists have a challenging task when answering patients' question about whether they can take specific drugs with grapefruit juice (GFJ) without risk of drug interaction. To identify the most practicable method for predicting clinically relevant changes in plasma concentrations of orally administered drugs caused by the ingestion of GFJ, we compared the predictive performance of three methods using data obtained from the literature. We undertook a systematic search of drug interactions associated with GFJ using MEDLINE and the Metabolism & Transport Drug Interaction Database (DIDB version 4.0). We considered an elevation of the area under the plasma concentration-time curve (AUC) of 2 or greater relative to the control value [AUC ratio (AUCR) ≥ 2.0] as a clinically significant interaction. The data from 74 drugs (194 data sets) were analysed. When the reported information of CYP3A involvement in the metabolism of a drug of interest was adopted as a predictive criterion for GFJ-drug interaction, the performance assessed by positive predictive value (PPV) was low (0.26), but that assessed by negative predictive value (NPV) and sensitivity was high (1.00 for both). When the reported oral bioavailability of ≤ 0.1 was used as a criterion, the PPV improved to 0.50 with an acceptable NPV of 0.81, but sensitivity was reduced to 0.21. When the reported AUCR was ≥ 10 after co-administration of a typical CYP3A inhibitor, the corresponding values were 0.64, 0.79 and 0.19, respectively. We consider that an oral bioavailability of ≤ 0.1 or an AUCR of ≥ 10 caused by a CYP3A inhibitor of a drug of interest may be a practical prediction criterion for avoiding significant interactions with GFJ. Information about the involvement of CYP3A in their metabolism should also be taken into account for drugs with narrow therapeutic ranges. © 2014 John Wiley & Sons Ltd.

Culture, Leadership, and Activism: Translating Fink's Taxonomy of Significant Learning into Pedagogical Practice

Science.gov (United States)

Jenkins, Toby S.

2016-01-01

Through the article, I share the theoretical foundations, structure, knowledge acquisition, and outcomes of a cultural leadership course. The process for course development integrates several theories and research methods into practice: L. Dee Fink's Taxonomy of Significant Learning, Feminist Theory, Critical Race Theory, and…

The development and significance of vesicular-arbuscular mycorrhizas as influenced by agricultural practices

NARCIS (Netherlands)

Ruissen, M.A.

1982-01-01

The development and significance of vesicular- arbuscular mycorrhizas (VAM) in wheat and potatoes have been studied in relation to various farming systems and agricultural practices. The effects of farming systems on VAM have been observed on three neighbouring experimental farms in the vicinity of

Effective admissions practices to achieve greater student diversity in dental schools.

Science.gov (United States)

Price, Shelia S; Grant-Mills, Donna

2010-10-01

In this chapter we describe the institutional and policy-level strategies that dental schools in the Pipeline, Profession, and Practice: Community-Based Dental Education program used to modify their admissions practices to increase the diversity of their student bodies. Schools developed and used clear statements recognizing the value of diversity. They incorporated recent U.S. Supreme Court rulings regarding educational diversity into their revised admissions practices; these rulings cited diversity as both a "compelling interest" and its use in only "narrowly tailored" circumstances. We make a case for admissions decisions based on a comprehensive evaluation that balances the quantitative and qualitative qualities of a candidate. It refutes the practice of overreliance on standardized tests by detailing the whole-file review process to measure merit and professional promise. Also described is a range of noncognitive variables (e.g., leadership, ability to sustain academic achievement with competing priorities, volunteerism, communication, social background, and disadvantaged status) that schools can take into consideration in admissions decisions. Admissions committees can tie this comprehensive review of candidates into the case for promoting cross-cultural understanding and enhanced competence to provide care to patients from diverse backgrounds. In addition, the chapter reviews the challenges schools face in developing admissions policies and procedures that reflect the university's mission for diversity. It addresses the importance of a diverse composition of the admissions committee. It also describes how tailored workshops and technical assistance for admissions committees can help schools improve their student diversity and how admissions committees can engage in a process of periodic review of their diversity objectives in relationship to the school's mission.

Distinguishing between statistical significance and practical/clinical meaningfulness using statistical inference.

Science.gov (United States)

Wilkinson, Michael

2014-03-01

Decisions about support for predictions of theories in light of data are made using statistical inference. The dominant approach in sport and exercise science is the Neyman-Pearson (N-P) significance-testing approach. When applied correctly it provides a reliable procedure for making dichotomous decisions for accepting or rejecting zero-effect null hypotheses with known and controlled long-run error rates. Type I and type II error rates must be specified in advance and the latter controlled by conducting an a priori sample size calculation. The N-P approach does not provide the probability of hypotheses or indicate the strength of support for hypotheses in light of data, yet many scientists believe it does. Outcomes of analyses allow conclusions only about the existence of non-zero effects, and provide no information about the likely size of true effects or their practical/clinical value. Bayesian inference can show how much support data provide for different hypotheses, and how personal convictions should be altered in light of data, but the approach is complicated by formulating probability distributions about prior subjective estimates of population effects. A pragmatic solution is magnitude-based inference, which allows scientists to estimate the true magnitude of population effects and how likely they are to exceed an effect magnitude of practical/clinical importance, thereby integrating elements of subjective Bayesian-style thinking. While this approach is gaining acceptance, progress might be hastened if scientists appreciate the shortcomings of traditional N-P null hypothesis significance testing.

Practical Significance of Basin Water Market Construction on Agricultural Production

Institute of Scientific and Technical Information of China (English)

2011-01-01

On the basis of introducing the concept of water market and the water market research in cluding both domestic market and foreign market,the system design features of water market are analyzed.The features include the prior distribution of agricultural water right,the close construction of market structure,reasonable price of water obtaining right and water pollution-discharge right and scientific stipulation of total volume of water use and total volume of pollution drainage.The practical significances of basin water market construction on Chinese agricultural production are revealed,which clover safeguarding the safety of agricultural water;effectively alleviating agricultural drought;saving the agricultural production water and improving the quality of agricultural products.

Greater Confinement Disposal trench and borehole operations status

International Nuclear Information System (INIS)

Harley, J.P. Jr.; Wilhite, E.L.; Jaegge, W.J.

1987-01-01

Greater Confinement Disposal (GCD) facilities have been constructed within the operating burial ground at the Savannah River Plant (SRP) to dispose of the higher activity fraction of SRP low-level waste. GCD practices of waste segregation, packaging, emplacement below the root zone, and waste stabilization are being used in the demonstration. 2 refs., 2 figs., 2 tabs

[Autoerotic fatalities in Greater Dusseldorf].

Science.gov (United States)

Hartung, Benno; Hellen, Florence; Borchard, Nora; Huckenbeck, Wolfgang

2011-01-01

Autoerotic fatalities in the Greater Dusseldorf area correspond to the relevant medicolegal literature. Our results included exclusively young to middle-aged, usually single men who were found dead in their city apartments. Clothing and devices used showed a great variety. Women's or fetish clothing and complex shackling or hanging devices were disproportionately frequent. In most cases, death occurred due to hanging or ligature strangulation. There was no increased incidence of underlying psychiatric disorders. In most of the deceased no or at least no remarkable alcohol intoxication was found. Occasionally, it may be difficult to reliably differentiate autoerotic accidents, accidents occurring in connection with practices of bondage & discipline, dominance & submission (BDSM) from natural death, suicide or homicide.

Impact of preoperative patient characteristics on posturethroplasty recurrence: The significance of stricture length and prior treatments

Directory of Open Access Journals (Sweden)

Jibril Oyekunle Bello

2016-01-01

Full Text Available Introduction: Urethral strictures are common in urologic practice of Sub-Saharan Africa including Nigeria. We determine the rate of stricture recurrence following urethroplasty for anterior urethral strictures and evaluate preoperative variables that predict of stricture recurrence in our practice. Subjects and Methods: Thirty-six men who had urethroplasty for proven anterior urethral stricture disease between February 2012 and January 2015 were retrospectively analyzed. Preoperative factors including age, socioeconomic factors, comorbidities, etiology of strictures, stricture location, stricture length, periurethral spongiofibrosis, and prior stricture treatments were assessed for independent predictors of stricture recurrence. Results: The median age was 49.5 years (range 21-90, median stricture length was 4 cm (range 1-18 cm and the overall recurrence rate was 27.8%. Postinfectious strictures, pan urethral strictures or multiple strictures involving the penile and bulbar urethra were more common. Most patients had penile circular fasciocutaneous flap urethroplasty. Following univariate analysis of potential preoperative predictors of stricture recurrence, stricture length, and prior treatments with dilations or urethrotomies were found to be significantly associated with stricture recurrence. On multivariate analysis, they both remained statistically significant. Patients who had prior treatments had greater odds of having a recurrent stricture (odds ratio 18, 95% confidence interval [CI] 1.4-224.3. Stricture length was dichotomized based on receiver operating characteristic (ROC analysis, and strictures of length ≥5 cm had significantly greater recurrence (area under ROC curve of 0.825, 95% CI 0.690-0.960, P = 0.032. Conclusion: Patients who had prior dilatations or urethrotomies and those with long strictures particularly strictures ≥5 cm have significantly greater odds of developing a recurrence following urethroplasty in Nigerian

Validity of Medical Student Questionnaire Data in Prediction of Rural Practice Choice and Its Association With Service Orientation.

Science.gov (United States)

Shannon, C Ken; Jackson, Jodie

2015-01-01

The validity of medical student projection of, and predictors for, rural practice and the association of a measure of service orientation, projected practice accessibility to the indigent, were investigated. West Virginia (WV) medical student online pre- and postrural rotation questionnaire data were collected during the time period 2001-2009. Of the 1,517 respondent students, submissions by 1,271 met the time interval criterion for inclusion in analyses. Subsequent WV licensing data were available for 461 in 2013. These 2 databases were used to assess for validity of projection of rural practice, for predictors of rural practice, and for student projected accessibility of the future practice to indigent patients. There were statistically significant associations between both pre- and postrotation projections of rural practice and subsequent rural practice. The most significant independent predictors of rural practice were student rural background, reported primary care intent, prediction of rural practice and projection of greater accessibility of the future practice to indigent patients. For scoring of practice access, there were trends for higher scoring by rural students and rural practitioners, with greater pre-post increases for those with urban hometowns. This study demonstrates the utility of medical student questionnaires for projections of numbers of future rural physicians. It suggests that students with a rural background, rural practice intent, or greater service orientation are more likely to enter rural practice. It also suggests that students, particularly those with urban hometowns, are influenced by rural rotation experiences in forecasting greater practice accessibility and in entering rural practice. © 2015 National Rural Health Association.

Practice Location Characteristics of Non-Traditional Dental Practices.

Science.gov (United States)

Solomon, Eric S; Jones, Daniel L

2016-04-01

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

Quality of life during orthopaedic training and academic practice: part 2: spouses and significant others.

Science.gov (United States)

Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

2012-10-03

Orthopaedic residents and attending physicians who report having a supportive spouse show lower levels of burnout and psychological distress than those without supportive spouses. However, little is known about the experiences of the spouses. This nationwide study examines burnout, psychological distress, and marital satisfaction of the spouses and significant others (collectively referred to hereafter as spouses) of orthopaedists in training and in orthopaedic practice in an academic setting. Employing previously reported methodology, 259 spouses of orthopaedic residents and 169 spouses of full-time orthopaedic faculty completed a voluntary, anonymous survey. The survey included three validated instruments (the Maslach Burnout Inventory, the General Psychological Health Questionnaire-12, and the Revised Dyadic Adjustment Scale) and three novel question sets addressing demographic information, relationship issues, stress, and work/life balance. Psychological distress was noted in 18% of resident spouses compared with only 10% of faculty spouses (p = 0.014). Resident spouses reported greater loneliness (p < 0.0009) and stress (p = 0.03) than faculty spouses. Among working spouses, 30% of resident spouses and 13% of faculty spouses showed high levels of emotional exhaustion (p < 0.003). Twenty-eight percent of employed resident spouses and 5% of employed faculty spouses showed problematic levels of depersonalization (p < 0.0001). Twenty-six percent of employed resident spouses and 12% of employed faculty spouses showed a diminished sense of personal accomplishment (p = 0.012). Marital satisfaction was high for both resident and faculty spouses. Decreased satisfaction correlated with excessive mate irritability and fatigue that precluded their mate's involvement in family activities. A gratifying sex life, full-time work outside the home, and spending more than ninety minutes a day with their mate correlated significantly with marital satisfaction. Many orthopaedic

Optimal wildlife management in the greater Yellowstone ecosystem: A spatiotemporal model of disease risk

Science.gov (United States)

South of Yellowstone National Park there are twenty-three sites where elk herds are provided supplementary feeding during the winter and spring months. Supplementary feeding of elk in the Greater Yellowstone Ecosystem (GYE) has been practiced since the early twentieth century, but the practice has b...

Preliminary Evidence That Yoga Practice Progressively Improves Mood and Decreases Stress in a Sample of UK Prisoners

Directory of Open Access Journals (Sweden)

Amy C. Bilderbeck

2015-01-01

Full Text Available Objectives. In the first randomized controlled trial of yoga on UK prisoners, we previously showed that yoga practice was associated with improved mental wellbeing and cognition. Here, we aimed to assess how class attendance, self-practice, and demographic factors were related to outcome amongst prisoners enrolled in the 10-week yoga intervention. Methods. The data of 55 participants (52 male, 3 female who completed a 10-week yoga course were analysed. Changes in pre- and postyoga measures of affect, perceived stress, and psychological symptoms were entered into linear regression analyses with bias-corrected and accelerated bootstrap confidence intervals. Class attendance, self-practice, demographic variables, and baseline psychometric variables were included as regressors. Results. Participants who attended more yoga classes and those who engaged in frequent (5 times or more self-practice reported significantly greater decreases in perceived stress. Decreases in negative affect were also significantly related to high frequency self-practice and greater class attendance at a near-significant level. Age was positively correlated with yoga class attendance, and higher levels of education were associated with greater decreases in negative affect. Conclusions. Our results suggest that there may be progressive beneficial effects of yoga within prison populations and point to subpopulations who may benefit the most from this practice.

Interprofessional Communities of Practice in Continuing Medical Education for Promoting and Sustaining Practice Change: A Prospective Cohort Study.

Science.gov (United States)

Barker, Megan; Lecce, Julia; Ivanova, Anna; Zawertailo, Laurie; Dragonetti, Rosa; Selby, Peter

2018-01-01

Standard knowledge delivery formats for CME may have limited impact on long-term practice change. A community of practice (CoP) is one tool that may enhance competencies and support practice change. This study explores the utility of an interprofessional CoP as an adjunct to a CME program in tobacco addiction treatment (Training Enhancement in Applied Counselling and Health [TEACH] Project) to promote and sustain practice change. A prospective cohort design was utilized to examine the long-term impact of the TEACH CoP on practice change. An online survey was administered to TEACH-trained practitioners to assess perceived feasibility, importance, and confidence related to course competencies, involvement in TEACH CoP activities, engagement in knowledge transfer (KT), and implementation of new programming. Chi-square tests were used to detect differences in KT and program development associated with CoP participation. Course competency scores from immediate postcourse surveys and long-term follow-up surveys were compared. No significant differences in participant characteristics were found between those who did (n = 300) and did not (n = 122) participate in the TEACH CoP. Mean self-perceived competency scores were greater immediately after course than at long-term follow-up; however, self-ratings of competency in pharmacological interventions and motivational interviewing were higher at follow-up. TEACH CoP participation was associated with significantly greater engagement in KT and implementation of new programming after training. The findings from this evaluation suggest the value of interprofessional CoPs offered posttraining as a mechanism to enhance practice. CME providers should consider offering CoPs as a component of training programs to promote and sustain practice change.

Greater Cortical Thickness in Elderly Female Yoga Practitioners—A Cross-Sectional Study

Directory of Open Access Journals (Sweden)

Rui F. Afonso

2017-06-01

Full Text Available Yoga, a mind-body activity that requires attentional engagement, has been associated with positive changes in brain structure and function, especially in areas related to awareness, attention, executive functions and memory. Normal aging, on the other hand, has also been associated with structural and functional brain changes, but these generally involve decreased cognitive functions. The aim of this cross-sectional study was to compare brain cortical thickness (CT in elderly yoga practitioners and a group of age-matched healthy non-practitioners. We tested 21 older women who had practiced hatha yoga for at least 8 years and 21 women naive to yoga, meditation or any mind-body interventions who were matched to the first group in age, years of formal education and physical activity level. A T1-weighted MPRAGE sequence was acquired for each participant. Yoga practitioners showed significantly greater CT in a left prefrontal lobe cluster, which included portions of the lateral middle frontal gyrus, anterior superior frontal gyrus and dorsal superior frontal gyrus. We found greater CT in the left prefrontal cortex of healthy elderly women who trained yoga for a minimum of 8 years compared with women in the control group.

Education, training, and practice among nordic neuropsychologists. Results from a professional practices survey

DEFF Research Database (Denmark)

Norup, A; Egeland, Jens; Løvstad, Marianne

2017-01-01

disability were the most common conditions seen by neuropsychologists. A mean income of 53,277 Euros was found. Neuropsychologists expressed greater job satisfaction than income satisfaction. Significant differences were found between the Nordic countries. Finnish neuropsychologists were younger and worked......OBJECTIVE: To investigate sociodemographic characteristics, clinical and academic training, work setting and salary, clinical activities, and salary and job satisfaction among practicing neuropsychologists in four Nordic countries. METHODS: 890 neuropsychologists from Denmark, Finland, Norway...

Fractures of the greater trochanter following total hip replacement.

Science.gov (United States)

Brun, Ole-Christian L; Maansson, Lukas

2013-01-01

We studied the incidence of greater trochanteric fractures at our department following THR. In all we examined 911 patients retrospectively and found the occurance of a greater trochanteric fracture to be 3%. Patients with fractures had significantly poorer outcome on Oxford Hip score, Pain VAS, Satisfaction VAS and EQ-5D compared to THR without fractures. Greater trochanteric fracture following THR is one of the most common complications following THR. It has previously been thought to have little impact on the overall outcome following THR, but our study suggests otherwise.

Impact significance determination-Pushing the boundaries

International Nuclear Information System (INIS)

Lawrence, David P.

2007-01-01

Impact significance determination practice tends to be highly variable. Too often insufficient consideration is given to good practice insights. Also, impact significance determinations are frequently narrowly defined addressing, for example, only individual, negative impacts, focusing on bio-physical impacts, and not seeking to integrate either the Precautionary Principle or sustainability. This article seeks to extend the boundaries of impact significance determination practice by providing an overview of good general impact significance practices, together with stakeholder roles and potential methods for addressing significance determination challenges. Relevant thresholds, criteria, contextual considerations and support methods are also highlighted. The analysis is then extended to address how impact significance determination practices change for positive as compared with negative impacts, for cumulative as compared with individual impacts, for socio-economic as compared with bio-physical impacts, when the Precautionary Principle is integrated into the process, and when sustainability contributions drive the EIA process and related impact significance determinations. These refinements can assist EIA practitioners in ensuring that the scope and nature of impact significance determinations reflect the broadened scope of emerging EIA requirements and practices. Suggestions are included for further refining and testing of the proposed changes to impact significance determination practice

Significant Structuring Resources in the Reading Practices of a Digital Classroom

Directory of Open Access Journals (Sweden)

Annika Lantz-Andersson

2016-06-01

Full Text Available Since reading and writing digitally demand partially different competencies, there is a change in some of the premises of related educational practices. This study aims to contribute to the knowledge of educational reading practices by scrutinizing how literacy events evolve in a digital classroom where each student has a personal digital device (1:1, iPads in this study. Our study is grounded in sociocultural theories of learning and focuses on the structuring resources utilized by students, namely the notion of multiple ongoing activities and the ways in which specific resources take precedence in shaping these activities. One class of 13–14 year-old students was studied for a week across several subjects through video-recordings and observations. The findings imply that the students moved among vast array of reading practices. However, the main structuring resource is a strong focus on task-solving and the practice of schooling, which mainly builds on principles emanating from traditional text. It is only occasionally that structuring resources that also include the opportunities associated with digital technology are utilized. This indicates the importance of further studies on how educational practices could be organized to scaffold the basis of traditional reading comprehension as well as other approaches required in digital environments.

Associations between demographic characteristics and physical activity practices in Nevada schools.

Science.gov (United States)

Monnat, Shannon M; Lounsbery, Monica A F; McKenzie, Thomas L; Chandler, Raeven Faye

2017-02-01

Schools are important settings for not only providing and promoting children's physical activity (PA) but also for reducing PA disparities. We investigated associations between school-level demographic characteristics (racial/ethnic and socioeconomic composition, urban-rural status, and student-to-teacher ratio) and 16 PA-promoting practices in 347 Nevada public elementary, middle, and high schools in 2014. We found that low-cost and easy-to-implement practices are most prevalent. There is relative demographic equity in ten of 16 PA practices and significant differences in six PA practices in Nevada schools. Schools with comparatively larger percentages of Black students are the most disadvantaged, as they have the fewest PA-supportive practices in place. Higher percent black was associated with lower odds of providing classroom activity breaks (AOR=0.632, 95% CI=0.453-0.881) and bike racks (AOR=0.60, 95% CI=0.362-0.996), greater odds of withholding recess/PE for disciplinary reasons (AOR=1.377, 95% CI=1.006-1.885), and lower odds of having recess supervisors who are trained to promote PA (AOR=0.583, 95% CI=0.374-0.909). Schools with greater percentages of Hispanic students have lower odds of providing before-school PA programs (AOR=0.867, 95% CI=0.761-0.987), whereas schools with greater percentages of low-SES students have greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Higher student-to-teacher ratio was also associated with greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Urban-rural status was unrelated to all PA practices. Copyright © 2016 Elsevier Inc. All rights reserved.

Evidence for the functional significance of diazotroph community structure in soil.

Science.gov (United States)

Hsu, Shi-Fang; Buckley, Daniel H

2009-01-01

Microbial ecologists continue to seek a greater understanding of the factors that govern the ecological significance of microbial community structure. Changes in community structure have been shown to have functional significance for processes that are mediated by a narrow spectrum of organisms, such as nitrification and denitrification, but in some cases, functional redundancy in the community seems to buffer microbial ecosystem processes. The functional significance of microbial community structure is frequently obscured by environmental variation and is hard to detect in short-term experiments. We examine the functional significance of free-living diazotrophs in a replicated long-term tillage experiment in which extraneous variation is minimized and N-fixation rates can be related to soil characteristics and diazotroph community structure. Soil characteristics were found to be primarily impacted by tillage management, whereas N-fixation rates and diazotroph community structure were impacted by both biomass management practices and interactions between tillage and biomass management. The data suggest that the variation in diazotroph community structure has a greater impact on N-fixation rates than do soil characteristics at the site. N-fixation rates displayed a saturating response to increases in diazotroph community diversity. These results show that the changes in the community structure of free-living diazotrophs in soils can have ecological significance and suggest that this response is related to a change in community diversity.

Discovering the Significance of Scientific Design Practice

DEFF Research Database (Denmark)

Pries-Heje, Jan; Baskerville, Richard

2016-01-01

This paper discusses and defines the achievement of significance in design science research. We review the values and processes of old-science and how this mode of science attacks the complexity of scientific knowledge production through analysis. We then explain how new-science attacks...... the complexity of scientific knowledge production through synthesis. The work argues that significance of the new-science contribution in design science can be obfuscated when wrapped in old-science. This understanding helps reveal how new-science, such as design science research, constitutes its significance...

Greater happiness for a greater number: Is that possible in Austria?

NARCIS (Netherlands)

R. Veenhoven (Ruut)

2011-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the happiness of the great number could not be measured

Greater happiness for a greater number: Is that possible in Germany?

NARCIS (Netherlands)

R. Veenhoven (Ruut)

2009-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the Happiness of the great number could not be measured

The practice brochure: a patient's guide to team care.

OpenAIRE

Marsh, G N

1980-01-01

A practice brochure describing the primary health care team was given to 262 new and established patients in a group practice. Most liked it, and thought it helpful, and improved their knowledge of team care. When asked how they would respond to certain hypothetical health problems and clinical situations, there was a significantly greater use of non-doctor members of the team than by a matched sample who had not read the brochure. Inappropriate use of members of the team was not engendered.

The contribution of human agricultural activities to increasing evapotranspiration is significantly greater than climate change effect over Heihe agricultural region.

Science.gov (United States)

Zou, Minzhong; Niu, Jun; Kang, Shaozhong; Li, Xiaolin; Lu, Hongna

2017-08-18

Evapotranspiration (ET) is a major component linking the water, energy, and carbon cycles. Understanding changes in ET and the relative contribution rates of human activity and of climate change at the basin scale is important for sound water resources management. In this study, changes in ET in the Heihe agricultural region in northwest China during 1984-2014 were examined using remotely-sensed ET data with the Soil and Water Assessment Tool (SWAT). Correlation analysis identified the dominant factors that influence change in ET per unit area and those that influence change in total ET. Factor analysis identified the relative contribution rates of the dominant factors in each case. The results show that human activity, which includes factors for agronomy and irrigation, and climate change, including factors for precipitation and relative humidity, both contribute to increases in ET per unit area at rates of 60.93% and 28.01%, respectively. Human activity, including the same factors, and climate change, including factors for relative humidity and wind speed, contribute to increases in total ET at rates of 53.86% and 35.68%, respectively. Overall, in the Heihe agricultural region, the contribution of human agricultural activities to increased ET was significantly greater than that of climate change.

Greater confinement disposal of radioactive wastes

International Nuclear Information System (INIS)

Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.

1985-01-01

Low-level radioactive waste (LLW) includes a broad spectrum of different radionuclide concentrations, half-lives, and hazards. Standard shallow-land burial practice can provide adequate protection of public health and safety for most LLW. A small volume fraction (approx. 1%) containing most of the activity inventory (approx. 90%) requires specific measures known as greater-confinement disposal (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics

The perceptions of inquiry held by greater Houston area science supervisors

Science.gov (United States)

Aoki, Jon Michael

The purpose of this study was to describe the perceptions of inquiry held by responding greater Houston area science supervisors. Leading science organizations proposed that students might be better served if students are mentally and physically engaged in the process of finding out about natural phenomena rather than by didactic modes of teaching and learning. During the past fifty years, inquiry-based instruction has become a significant theme of new science programs. Students are more likely to make connections between classroom exercises and their personal lives through the use of inquiry-based instruction. Learning becomes relevant to students. Conversely, traditional science instruction often has little or no connection to students' everyday lives (Papert, 1980). In short, inquiry-based instruction empowers students to become independent thinkers. The utilization of inquiry-based instruction is essential to a successful reform in science education. However, a reform's success is partly determined by the extent to which science supervisors know and understand inquiry and consequently promote its integration in the district's science curricula. Science supervisors have the role of providing curriculum and instructional support to science teachers and for implementing science programs. There is a fundamental need to assess the perceptions of inquiry held by greater Houston area science supervisors. Science supervisor refers to a class of job titles that include department chairperson, science specialist, science consultant, and science coordinator. The target population was greater Houston area science supervisors in Texas. This study suggests that there are three major implications for educational practice. First, there is the implication that responding greater Houston area science supervisors need an inclusive perception of inquiry. Second, responding greater Houston area science supervisors' perception of inquiry may affect the perceptions and understandings

Effects of practice variability on unimanual arm rotation.

Science.gov (United States)

James, Eric G; Conatser, Phillip

2014-01-01

High variability practice has been found to lead to a higher rate of motor learning than low variability practice in sports tasks. The authors compared the effects of low and high levels of practice variability on a simple unimanual arm rotation task. Participants performed rhythmic unimanual internal-external arm rotation as smoothly as possible before and after 2 weeks of low (LV) or high (HV) variability practice and after a 2-week retention interval. Compared to the pretest, the HV group significantly decreased hand, radioulnar, and shoulder rotation jerk on the retention test and shoulder jerk on the posttest. After training the LV group had lower radioulnar and shoulder jerk on the posttest but not the retention test. The results supported the hypothesis that high variability practice would lead to greater learning and reminiscence than low variability practice and the theoretical prediction of a bifurcation in the motor learning dynamics.

The Impact of Desired Family Size Upon Family Planning Practices in Rural East Pakistan

Science.gov (United States)

Mosena, Patricia Wimberley

1971-01-01

Results indicated that women whose desired family size is equal to or less than their actual family size have significantly greater frequencies practicing family planning than women whose desired size exceeds their actual size. (Author)

Greater-confinement disposal of low-level radioactive wastes

International Nuclear Information System (INIS)

Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.

1985-01-01

Low-level radioactive wastes include a broad spectrum of wastes that have different radionuclide concentrations, half-lives, and physical and chemical properties. Standard shallow-land burial practice can provide adequate protection of public health and safety for most low-level wastes, but a small volume fraction (about 1%) containing most of the activity inventory (approx.90%) requires specific measures known as ''greater-confinement disposal'' (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics. This paper presents an overview of the factors that must be considered in planning the application of methods proposed for providing greater confinement of low-level wastes. 27 refs

What is the Significance of Research for Music Education in Practice?

DEFF Research Database (Denmark)

Nielsen, Frede V.

2009-01-01

these types of relationship are considered necessary. The distinctive task of music pedagogical research is to question, explore, and develop issues, conditions, and potentialities within the practice of music education by rendering them accessible to consciousness and conceptual thought in verbal terms....... Consequently, it has to do its utmost not to degenerate into ideology. The role of teacher education is discussed. Examples show how research may matter to practical music teaching and learning. An overall conclusion is that the relationship in question should be marked by closeness and distance at the same...

Safe delivery practices: experience from cross-sectional data of Bangladeshi women.

Science.gov (United States)

Kabir, M A; Goh, Kim-Leng; Khan, M M H; Al-Amin, Abul Quasem; Azam, Mohammad Nurul

2015-03-01

This study examines the safe delivery practices of Bangladeshi women using data on 4905 ever-married women aged 15 to 49 years from the 2007 Bangladesh Demographic and Health Survey. Variables that included age, region of origin, education level of respondent and spouse, residence, working status, religion, involvement in NGOs, mass media exposure, and wealth index were analyzed to find correlates of safe delivery practices. More than 80% of the deliveries took place at home, and only 18% were under safe and hygienic conditions. The likelihood of safe deliveries was significantly lower among younger and older mothers than middle-aged mothers and higher among educated mothers and those living in urban areas. Economically better-off mothers and those with greater exposure to mass media had a significantly higher incidence of safe delivery practices. A significant association with religion and safe delivery practices was revealed. Demographic, socioeconomic, cultural, and programmatic factors that are strongly associated with safe delivery practices should be considered in the formulation of reproductive health policy. © 2012 APJPH.

A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester.

Science.gov (United States)

Humphreys, John; Harvey, Gill; Coleiro, Michelle; Butler, Brook; Barclay, Anna; Gwozdziewicz, Maciek; O'Donoghue, Donal; Hegarty, Janet

2012-08-01

Research has demonstrated a knowledge and practice gap in the identification and management of chronic kidney disease (CKD). In 2009, published data showed that general practices in Greater Manchester had a low detection rate for CKD. A 12-month improvement collaborative, supported by an evidence-informed implementation framework and financial incentives. 19 general practices from four primary care trusts within Greater Manchester. Number of recorded patients with CKD on practice registers; percentage of patients on registers achieving nationally agreed blood pressure targets. The collaborative commenced in September 2009 and involved three joint learning sessions, interspersed with practice level rapid improvement cycles, and supported by an implementation team from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Greater Manchester. At baseline, the 19 collaborative practices had 4185 patients on their CKD registers. At final data collection in September 2010, this figure had increased by 1324 to 5509. Blood pressure improved from 34% to 74% of patients on practice registers having a recorded blood pressure within recommended guidelines. Evidence-based improvement can be implemented in practice for chronic disease management. A collaborative approach has been successful in enabling teams to test and apply changes to identify patients and improve care. The model has proved to be more successful for some practices, suggesting a need to develop more context-sensitive approaches to implementation and actively manage the factors that influence the success of the collaborative.

Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study.

Science.gov (United States)

Walker, Judith H; Dewitt, Dawn E; Pallant, Julie F; Cunningham, Christine E

2012-01-01

Health workforce shortages are a major problem in rural areas. Australian medical schools have implemented a number of rural education and training interventions aimed at increasing medical graduates' willingness to work in rural areas. These initiatives include recruiting students from rural backgrounds, delivering training in rural areas, and providing all students with some rural exposure during their medical training. However there is little evidence regarding the impact of rural exposure versus rural origin on workforce outcomes. The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools (RCS) Program. Questionnaires were distributed to 166 medical students who had completed their RCS term in 2006; 125 (75%) responded. Medical students were asked about their preferred location and specialty for future practice, their beliefs about rural work and life, and the impact of the RCS experience on their future rural training and practice preferences. Almost half the students (47%; n=58) self-reported a 'rural background'. Significantly, students from rural backgrounds were 10 times more likely to prefer to work in rural areas when compared with other students (ppreferring general practice, 80% (n=24) wished to do so rurally. Eighty-five per cent (n=105) of students agreed that their RCS experience increased their interest in rural training and practice with 62% (n=75) of students indicating a preference for rural internship/basic training after their RCS experience. A substantial percentage (86%; n=108) agreed they would consider rural practice after their RCS experience. This baseline study provides significant evidence to support rural medical recruitment and retention through education and training, with important insights into the factors affecting preference for future rural practice. By far the most significant predictor of rural practice

Velocity Drives Greater Power Observed During Back Squat Using Cluster Sets.

Science.gov (United States)

Oliver, Jonathan M; Kreutzer, Andreas; Jenke, Shane C; Phillips, Melody D; Mitchell, Joel B; Jones, Margaret T

2016-01-01

This investigation compared the kinetics and kinematics of cluster sets (CLU) and traditional sets (TRD) during back squat in trained (RT) and untrained (UT) men. Twenty-four participants (RT = 12, 25 ± 1 year, 179.1 ± 2.2 cm, 84.6 ± 2.1 kg; UT = 12, 25 ± 1 year, 180.1 ± 1.8 cm, 85.4 ± 3.8 kg) performed TRD (4 × 10, 120-second rest) and CLU (4 × (2 × 5) 30 seconds between clusters; 90 seconds between sets) with 70% one repetition maximum, randomly. Kinematics and kinetics were sampled through force plate and linear position transducers. Resistance-trained produced greater overall force, velocity, and power; however, similar patterns were observed in all variables when comparing conditions. Cluster sets produced significantly greater force in isolated repetitions in sets 1-3, while consistently producing greater force due to a required reduction in load during set 4 resulting in greater total volume load (CLU, 3302.4 ± 102.7 kg; TRD, 3274.8 ± 102.8 kg). Velocity loss was lessened in CLU resulting in significantly higher velocities in sets 2 through 4. Furthermore, higher velocities were produced by CLU during later repetitions of each set. Cluster sets produced greater power output for an increasing number of repetitions in each set (set 1, 5 repetitions; sets 2 and 3, 6 repetitions; set 4, 8 repetitions), and the difference between conditions increased over subsequent sets. Time under tension increased over each set and was greater in TRD. This study demonstrates greater power output is driven by greater velocity when back squatting during CLU; therefore, velocity may be a useful measure by which to assess power.

Greater saphenous vein anomaly and aneurysm with subsequent pulmonary embolism

OpenAIRE

Ma, Truong; Kornbau, Craig

2017-01-01

Abstract Venous aneurysms often present as painful masses. They can present either in the deep or superficial venous system. Deep venous system aneurysms have a greater risk of thromboembolism. Though rare, there have been case reports of superficial aneurysms and thrombus causing significant morbidity such as pulmonary embolism. We present a case of an anomalous greater saphenous vein connection with an aneurysm and thrombus resulting in a pulmonary embolism. This is the only reported case o...

Greater happiness for a greater number: Is that possible? If so how? (Arabic)

NARCIS (Netherlands)

R. Veenhoven (Ruut); E. Samuel (Emad)

2012-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time, the happiness of the great number could not be

Greater Occipital Nerve Treatment in the Management of Spontaneous Intracranial Hypotension Headache: A Case Report.

Science.gov (United States)

Niraj, G; Critchley, Peter; Kodivalasa, Mahesh; Dorgham, Mohammed

2017-06-01

Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life. Magnetic resonance imaging revealed bilateral convexity subdural collections. Post gadolinium scan revealed pachymeningeal enhancement with reduced pontomesencephalic angle below 50 degrees. The patient was offered an epidural blood patch and greater occipital nerve block with corticosteroids. The patient chose occipital nerve block. The patient reported significant short-term benefit lasting 4 months. Thereafter, the patient underwent pulsed radiofrequency treatment to bilateral greater occipital nerves. He reported significant benefit lasting 10 months. Greater occipital nerve treatment may have a role in management of SIHH. © 2017 American Headache Society.

Greater support and debriefing may help student midwives to process traumatic birth experiences

OpenAIRE

Kitson-Reynolds, Ellen

2015-01-01

Implications for practice and researchIncorporating resilience training and a multidisciplinary debriefing approach within clinical and academic environments would develop a culture of support and compassion for the workforce and ultimately effective care for women using maternity services. Further research surrounding the effectiveness of resilience education for student midwives is required to elicit greater understanding of the effect on woman-centred care.

Evaluation of cardiovascular demands of game play and practice in women's ice hockey.

Science.gov (United States)

Spiering, Barry A; Wilson, Meredith H; Judelson, Daniel A; Rundell, Kenneth W

2003-05-01

Preparation for the physical demands of competition often involves game simulation during practice. This paradigm is thought to promote physiological adaptations that enhance maximal performance. However, a mismatch between practice intensity and actual competition intensity may not provide adequate training to achieve optimal game-play fitness. The purpose of this study was to evaluate the effectiveness of practice in meeting the cardiovascular demands of a women's ice hockey game. Heart rate (HR) data from 11 U.S. National Women's Ice Hockey team members were collected (5-second intervals) during a game and a typical practice session. Data was normalized to individual HRmax determined during Vo(2)max testing. Working time was defined as a game shift or practice-working interval. Mean working HR was greater during the game than the practice, 90 +/- 2% and 76 +/- 3% of HRmax, respectively (p game or practice) >90% HRmax was also longer during the game than the practice, 10.5 +/- 4.1% and 5.6 +/- 3.5% (p 80% HRmax, and mean resting HR were not different between game and practice (68 +/- 7% vs. 69 +/- 5%, 23.2 +/- 5.3% vs. 26.1 +/- 9.2%, and 59 +/- 8% vs. 56 +/- 5%, respectively). Elite women hockey players experience significantly greater cardiovascular load during game play than during practice. This mismatch in cardiovascular demand may prevent players from achieving "game shape," thus affecting competition play.

Survey of DOE NDA practices for CH-Tru waste certification--illustrated with a greater than 10,000 drum NDA data base

International Nuclear Information System (INIS)

Schultz, F.J.; Caldwell, J.T.; Smith, J.R.

1988-01-01

We have compiled a greater than 10,000 CH-TRU waste drum data base from seven DOE sites which have utilized such multiple NDA measurements within the past few years. Most of these nondestructive assay (NDA) technique assay result comparisons have been performed on well-characterized, segregated waste categories such as cemented sludges, combustibles, metals, graphite residues, glasses, etc., with well-known plutonium isotopic compositions. Waste segregation and categorization practices vary from one DOE site to another. Perhaps the most systematic approach has been in use for several years at the Rocky Flats Plant (RFP), operated by Rockwell International, and located near Golden, Colorado. Most of the drum assays in our data base result from assays of RFP wastes, with comparisons available between the original RFP assays and PAN assays performed independently at the Idaho National Engineering Laboratory (INEL) Solid Waste Examination Pilot Plant (SWEPP) facility. Most of the RFP assays were performed with hyperpure germanium (HPGe)-based SGS assay units. However, at least one very important waste category, processed first-stage sludges, is assayed at RFP using a sludge batch-sampling procedure, prior to filling of the waste drums. 5 refs., 5 figs

Meaningful and Purposeful Practice

Science.gov (United States)

Clementi, Donna

2014-01-01

This article describes a graphic, designed by Clementi and Terrill, the authors of "Keys to Planning for Learning" (2013), visually representing the components that contribute to meaningful and purposeful practice in learning a world language, practice that leads to greater proficiency. The entire graphic is centered around the letter…

Associations Between Positive Body Image, Sexual Liberalism, and Unconventional Sexual Practices in U.S. Adults.

Science.gov (United States)

Swami, Viren; Weis, Laura; Barron, David; Furnham, Adrian

2017-11-01

While studies have documented robust relationships between body image and sexual health outcomes, few studies have looked beyond sexual functioning in women. Here, we hypothesized that more positive body image would be associated with greater sexual liberalism and more positive attitudes toward unconventional sexual practices. An online sample of 151 women and 164 men from the U.S. completed measures of sexual liberalism, attitudes toward unconventional sexual practices, and indices of positive body image (i.e., body appreciation, body acceptance by others, body image flexibility, and body pride), and provided their demographic details. Regression analyses indicated that, once the effects of sexual orientation, relationship status, age, and body mass index had been accounted for, higher body appreciation was significantly associated with greater sexual liberalism in women and men. Furthermore, higher body appreciation and body image flexibility were significantly associated with more positive attitudes toward unconventional sexual practices in women and men. These results may have implications for scholars working from a sex-positive perspective, particularly in terms of understanding the role body image plays in sexual attitudes and behaviors.

Primary care practice organization influences colorectal cancer screening performance.

Science.gov (United States)

Yano, Elizabeth M; Soban, Lynn M; Parkerton, Patricia H; Etzioni, David A

2007-06-01

To identify primary care practice characteristics associated with colorectal cancer (CRC) screening performance, controlling for patient-level factors. Primary care director survey (1999-2000) of 155 VA primary care clinics linked with 38,818 eligible patients' sociodemographics, utilization, and CRC screening experience using centralized administrative and chart-review data (2001). Practices were characterized by degrees of centralization (e.g., authority over operations, staffing, outside-practice influence); resources (e.g., sufficiency of nonphysician staffing, space, clinical support arrangements); and complexity (e.g., facility size, academic status, managed care penetration), adjusting for patient-level covariates and contextual factors. Chart-based evidence of CRC screening through direct colonoscopy, sigmoidoscopy, or consecutive fecal occult blood tests, eliminating cases with documented histories of CRC, polyps, or inflammatory bowel disease. After adjusting for sociodemographic characteristics and health care utilization, patients were significantly more likely to be screened for CRC if their primary care practices had greater autonomy over the internal structure of care delivery (pmanagement and referral procedures are associated with significantly lower CRC screening performance. Competition with hospital resource demands may impinge on the degree of internal organization of their affiliated primary care practices.

Discovering the Significance of Scientific Design Practice

DEFF Research Database (Denmark)

Pries-Heje, Jan; Baskerville, Richard

This paper aims at discussing and defining what it is that makes design science research significant. First it reviews the values and processes of old science and how this attacks complexity through analysis. It then shows how new science attacks complexity through synthesis. Then the paper argue...

Professional performance attributes according to accounting entrepreneurs from greater São Paulo

OpenAIRE

Ivam Ricardo Peleias; Rafael Augusto Lourenço; Marcos Reinaldo Severino Peters; Carlos Eduardo Farcin Lavarda

2015-01-01

Accounting has a broad activity universe, which requires skilled professionals who are prepared to practice the profession. One possibility is to be an accounting entrepreneur, whose profile requires specific attributes and attitudes. The results reported on in this paper derive from a research developed using the oral history technique, concerning the identification and analysis of attributes valued in the performance of the profession by accounting entrepreneurs from greater São Paulo. A fi...

Explanation of Significant Differences Between Models used to Assess Groundwater Impacts for the Disposal of Greater-Than-Class C Low-Level Radioactive Waste and Greater-Than-Class C-Like Waste Environmental Impact Statement (DOE/EIS-0375-D) and the

Energy Technology Data Exchange (ETDEWEB)

Annette Schafer; Arthur S. Rood; A. Jeffrey Sondrup

2011-08-01

Models have been used to assess the groundwater impacts to support the Draft Environmental Impact Statement for the Disposal of Greater-Than-Class C (GTCC) Low-Level Radioactive Waste and GTCC-Like Waste (DOE-EIS 2011) for a facility sited at the Idaho National Laboratory and the Environmental Assessment for the INL Remote-Handled Low-Level Waste Disposal Project (INL 2011). Groundwater impacts are primarily a function of (1) location determining the geologic and hydrologic setting, (2) disposal facility configuration, and (3) radionuclide source, including waste form and release from the waste form. In reviewing the assumptions made between the model parameters for the two different groundwater impacts assessments, significant differences were identified. This report presents the two sets of model assumptions and discusses their origins and implications for resulting dose predictions. Given more similar model parameters, predicted doses would be commensurate.

Immediate effects of adding mental practice to physical practice on the gait of individuals with Parkinson's disease: Randomized clinical trial.

Science.gov (United States)

Santiago, Lorenna Marques de Melo; de Oliveira, Daniel Antunes; de Macêdo Ferreira, Louise Gabriella Lopes; de Brito Pinto, Hyanne Yasmim; Spaniol, Ana Paula; de Lucena Trigueiro, Larissa Coutinho; Ribeiro, Tatiana Souza; de Sousa, Angélica Vieira Cavalcanti; Piemonte, Maria Elisa Pimentel; Lindquist, Ana Raquel Rodrigues

2015-01-01

Mental practice has shown benefits in the rehabilitation of neurological patients, however, there is no evidence of immediate effects on gait of individuals with Parkinson's disease. Determine the effects of mental practice activity added to physical practice on the gait of individuals with Idiopathic Parkinson's Disease (IPD). 20 patients classified with stage 2 and 3, according to the Hoehn and Yahr scale were randomized into 2 groups. The experimental group (N = 10) was submitted to a single session of mental practice and physical practice gait protocol and the control group (N = 10) only to physical practice. The primary outcomes were stride length and total stance and swing time. Secondary outcomes were hip range of motion, velocity and mobility. Subjects were reassessed 10 minutes, 1 day and 7 days after the end of the session. There was no statistically significant difference between the groups. An intragroup difference was observed in velocity, stride length, hip range of motion, and mobility, as well as total stance and swing time. These results were also observed on follow-ups. Mental practice did not have a greater effect on the gait of individuals with IPD than physical practice, after a single session.

The degree of horizontal violence in RNs practicing in New York State.

Science.gov (United States)

Sellers, Kathleen F; Millenbach, Linda; Ward, Kathy; Scribani, Melissa

2012-10-01

This study examined the degree of horizontal violence (HV) among RNs practicing in New York State (NYS). The objective was to determine the knowledge of HV and the degree of being a victim among practicing RNs. A descriptive survey using Briles' Sabotage Savvy Questionnaire, measuring occurrences of HV and nurses' knowledge of HV, was conducted among 2659 RNs in NYS hospitals. Findings demonstrate a significantly greater (P leadership, and individual interventions to address HV helps create a culture of safety.

Greater Confinement Disposal Program at the Savannah River Plant

International Nuclear Information System (INIS)

Towler, O.A.; Cook, J.R.; Peterson, D.L.

1983-01-01

Plans for improved LLW disposal at the Savannah River Plant include Greater Confinement Disposal (GCD) for the higher activity fractions of this waste. GCD practices will include waste segregation, packaging, emplacement below the root zone, and stabilizing the emplacement with cement. Statistical review of SRP burial records showed that about 95% of the radioactivity is associated with only 5% of the waste volume. Trigger values determined in this study were compared with actual burials in 1982 to determine what GCD facilities would be needed for a demonstration to begin in Fall 1983. Facilities selected include 8-feet-diameter x 30-feet-deep boreholes to contain reactor scrap, tritiated waste, and selected wastes from offsite

Oversize/overweight permitting practices review : phase II.

Science.gov (United States)

2013-02-01

This study explores a more detailed analysis of the permitting process in the Mid-Atlantic Region and : delves into operational practice, and theory and history of the practice among states. The states : practices examined in greater detail include C...

Calculating Clinically Significant Change: Applications of the Clinical Global Impressions (CGI) Scale to Evaluate Client Outcomes in Private Practice

Science.gov (United States)

Kelly, Peter James

2010-01-01

The Clinical Global Impressions (CGI) scale is a therapist-rated measure of client outcome that has been widely used within the research literature. The current study aimed to develop reliable and clinically significant change indices for the CGI, and to demonstrate its application in private psychological practice. Following the guidelines…

The Greater Involvement of People Living with AIDS principle: theory versus practice in Ontario's HIV/AIDS community-based research sector.

Science.gov (United States)

Travers, R; Wilson, M G; Flicker, S; Guta, A; Bereket, T; McKay, C; van der Meulen, A; Cleverly, S; Dickie, M; Globerman, J; Rourke, S B

2008-07-01

Drawing on the Greater Involvement of People with HIV/AIDS (GIPA) principle, the HIV/AIDS movement began to "democratize" research in Canada in the mid-1990s. To date, there is little evidence about the success of the community-based research (CBR) movement in relation to the implementation of GIPA. We draw on findings from a larger study examining barriers and facilitating factors in relation to HIV-related CBR in Ontario, Canada. An online survey was completed by 39 senior managers in Ontario AIDS service organizations (ASOs). Twenty-five in-depth, semi-structured interviews were then conducted to further explore the survey findings. Survey respondents reported that, compared to researchers and frontline service providers, people living with HIV/AIDS (PLWHA) tended to be the least involved in all stages (input, process and outcome) of CBR projects. AIDS service organizations with a mandate that included serving rural and urban communities reported even lower levels of PLWHA involvement in CBR. Qualitative data reveal complex barriers that make meaningful PLWHA engagement in CBR difficult, including: HIV-related stigma; health-related challenges; "credentialism"; lack of capacity to engage in research; other issues taking priority; and mistrust of researchers. Facilitating factors included valuing lived experience; training and mentoring opportunities; financial compensation; trust building; and accommodating PLWHA's needs. While there is strong support for the GIPA principles in theory, practice lags far behind.

Improving greater trochanteric reattachment with a novel cable plate system.

Science.gov (United States)

Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan

2013-03-01

Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

Mindfulness and personal identity in the Western cultural context: A plea for greater cosmopolitanism.

Science.gov (United States)

Panaïoti, Antoine

2015-08-01

In the psychological sciences, mindfulness practices are increasingly being used, studied, and theorized, but their indigenous theoretical foundations in Buddhist accounts of the dynamics and psychology of personal identity tend to be overlooked. This situation is mirrored in the discipline of philosophy: here, Buddhist views on personal identity are beginning to draw attention, but almost invariably in a way which entirely blanks out the role of mindfulness practices in cultivating Buddhist insights on selfhood. The aggregate result is a failure, in the West, to reflect upon and seriously consider Buddhist theory and Buddhist practice in an integrated, holistic fashion. In its effort to overcome the compartmentalization of Buddhist theory (in philosophy) versus Buddhist practice (in psychology) and to embrace the challenges this might pose to fundamental Western beliefs about the self, this paper is intended both as a plea for and an exercise in greater, more venturesome cosmopolitanism. © The Author(s) 2015.

Facilitators of transforming primary care: a look under the hood at practice leadership.

Science.gov (United States)

Donahue, Katrina E; Halladay, Jacqueline R; Wise, Alison; Reiter, Kristin; Lee, Shoou-Yih Daniel; Ward, Kimberly; Mitchell, Madeline; Qaqish, Bahjat

2013-01-01

This study examined how characteristics of practice leadership affect the change process in a statewide initiative to improve the quality of diabetes and asthma care. We used a mixed methods approach, involving analyses of existing quality improvement data on 76 practices with at least 1 year of participation and focus groups with clinicians and staff in a 12-practice subsample. Existing data included monthly diabetes or asthma measures (clinical measures) and monthly practice implementation, leadership, and practice engagement scores rated by an external practice coach. Of the 76 practices, 51 focused on diabetes and 25 on asthma. In aggregate, 50% to 78% made improvements within in each clinical measure in the first year. The odds of making practice changes were greater for practices with higher leadership scores (odds ratios = 2.41-4.20). Among practices focused on diabetes, those with higher leadership scores had higher odds of performing nephropathy screening (odds ratio = 1.37, 95% CI, 1.08-1.74); no significant associations were seen for the intermediate outcome measures of hemoglobin A1c, blood pressure, and cholesterol. Focus groups revealed the importance of a leader, typically a physician, who believed in the transformation work (ie, a visionary leader) and promoted practice engagement through education and cross-training. Practices with greater change implementation also mentioned the importance of a midlevel operational leader who helped to create and sustain practice changes. This person communicated and interacted well with, and was respected by both clinicians and staff. In the presence of a vision for transformation, operational leaders within practices can facilitate practice changes that are associated with clinical improvement.

Impact significance determination-Back to basics

International Nuclear Information System (INIS)

Lawrence, David P.

2007-01-01

Impact significance determination is widely recognized as a vital and critical EIA activity. But impact significance related concepts are poorly understood. And the quality of approaches for impact significance determination in EIA practice remains highly variable. This article seeks to help establish a sound and practical conceptual foundation for formulating and evaluating impact significance determination approaches. It addresses the nature (what is impact significance?), the core characteristics (what are the major properties of significance determination?), the rationale (why are impact significance determinations necessary?), the procedural and substantive objectives (what do impact significance determinations seek to achieve?), and the process for making impact significance judgments (how is impact significance determination conducted?). By identifying fundamental attributes and key distinctions associated with impact significance determinations, a basis is provided for designing and evaluating impact significance determination procedures at both the regulatory and applied levels

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

Science.gov (United States)

Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle

2016-05-01

This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. © 2016 Pharmacotherapy Publications, Inc.

Economic and geographic factors affecting the development of Greater Baku

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Vusat AFANDIYEV

2014-12-01

Full Text Available Globally, the responsible factors for the ongoing development of urbanization are the high speed of population growth, and the mass migration of humans to cities and large urban areas. In most countries, this process resulted in the emergence of ‘pseudo-urbanization’ which is difficult to be regulated. The purpose of the carried researches to determine the development priorities in the territory of Greater Baku – the capital city of the Republic of Azerbaijan; to define the problems that take place in this connection; and to develop ways of elimination of these problems. The reason of taking Baku as a research area is connected with some of the factors. Firstly, studies on Baku have been conducted based on the Soviet geographical and urban planning school and their methods for a long period. In this regard, it is necessary to carry out research in this field based on the principles adopted in most countries. Secondly, since 1992, the intensive accumulation of population in the territory of the capital city and the surrounding areas is being observed because of socio-economic problems. As a result, the process of pseudo-urbanization intensified, entailing a densely-populated area. Thirdly, low-rise buildings still continue to exist in the large areas within the territory of Baku, and they are not associated with the functional structure of the city. This situation creates many challenges, particularly in terms of density growth and effective use of the city’s territory. Finally, numerous new buildings have been constructed in the residential areas of Baku in recent years, and this may entailserious problems in water supply, energy provision, and utilities. The study is carried out referring to previous works of researchers, statistic data, and the results of the population census conducted in 1959-2009.The practical significance of the scientific work is that positive and negative factors affecting the further development of Greater Baku

Are family practice trainers and their host practices any better? Comparing practice trainers and non-trainers and their practices.

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van den Hombergh, Pieter; Schalk-Soekar, Saskia; Kramer, Anneke; Bottema, Ben; Campbell, Stephen; Braspenning, Jozé

2013-02-21

Family Physician (FP) trainees are expected to be provided with high quality training in well organized practice settings. This study examines differences between FP trainers and non-trainers and their practices to see whether there are differences in trainers and non-trainers and in how their practices are organized and their services are delivered. 203 practices (88 non-training and 115 training) with 512 FPs (335 non-trainers and 177 trainers) were assessed using the "Visit Instrument Practice organization (VIP)" on 369 items (142 FP-level; 227 Practice level). Analyses (ANOVA, ANCOVA) were conducted for each level by calculating differences between FP trainees and non-trainees and their host practices. Trainers scored higher on all but one of the items, and significantly higher on 47 items, of which 13 remained significant after correcting for covariates. Training practices scored higher on all items and significantly higher on 61 items, of which 23 remained significant after correcting for covariates. Trainers (and training practices) provided more diagnostic and therapeutic services, made better use of team skills and scored higher on practice organization, chronic care services and quality management than non-training practices. Trainers reported more job satisfaction and commitment and less job stress than non-trainers. There are positive differences between FP trainers and non-trainers in both the level and the quality of services provided by their host practices. Training institutions can use this information to promote the advantages of becoming a FP trainer and training practice as well as to improve the quality of training settings for FPs.

Use of care management practices in small- and medium-sized physician groups: do public reporting of physician quality and financial incentives matter?

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Alexander, Jeffrey A; Maeng, Daniel; Casalino, Lawrence P; Rittenhouse, Diane

2013-04-01

To examine the effect of public reporting (PR) and financial incentives tied to quality performance on the use of care management practices (CMPs) among small- and medium-sized physician groups. Survey data from The National Study of Small and Medium-sized Physician Practices were used. Primary data collection was also conducted to assess community-level PR activities. The final sample included 643 practices engaged in quality reporting; about half of these practices were subject to PR. We used a treatment effects model. The instrumental variables were the community-level variables that capture the level of PR activity in each community in which the practices operate. (1) PR is associated with increased use of CMPs, but the estimate is not statistically significant; (2) financial incentives are associated with greater use of CMPs; (3) practices' awareness/sensitivity to quality reports is positively related to their use of CMPs; and (4) combined PR and financial incentives jointly affect CMP use to a greater degree than either of these factors alone. Small- to medium-sized practices appear to respond to PR and financial incentives by greater use of CMPs. Future research needs to investigate the appropriate mix and type of incentive arrangements and quality reporting. © Health Research and Educational Trust.

Greater-confinement disposal

International Nuclear Information System (INIS)

Trevorrow, L.E.; Schubert, J.P.

1989-01-01

Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

MR Neurography of Greater Occipital Nerve Neuropathy: Initial Experience in Patients with Migraine.

Science.gov (United States)

Hwang, L; Dessouky, R; Xi, Y; Amirlak, B; Chhabra, A

2017-11-01

MR imaging of peripheral nerves (MR neurography) allows improved assessment of nerve anatomy and pathology. The objective of this study was to evaluate patients with unilateral occipital neuralgia using MR neurography and to assess the differences in greater occipital nerve signal and size between the symptomatic and asymptomatic sides. In this case-control evaluation using MR neurography, bilateral greater occipital nerve caliber, signal intensity, signal-to-noise ratios, and contrast-to-noise ratios were determined by 2 observers. Among 18 subjects with unilateral occipital migraines, the average greater occipital nerve diameter for the symptomatic side was significantly greater at 1.77 ± 0.4 mm than for the asymptomatic side at 1.29 ± 0.25 mm ( P = .001). The difference in nerve signal intensity between the symptomatic and asymptomatic sides was statistically significant at 269.06 ± 170.93 and 222.44 ± 170.46, respectively ( P = .043). The signal-to-noise ratios on the symptomatic side were higher at 15.79 ± 4.59 compared with the asymptomatic nerve at 14.02 ± 5.23 ( P = .009). Contrast-to-noise ratios were significantly higher on the symptomatic side than on the asymptomatic side at 2.57 ± 4.89 and -1.26 ± 5.02, respectively ( P = .004). Intraobserver performance was good to excellent (intraclass coefficient correlation, 0.68-0.93), and interobserver performance was fair to excellent (intraclass coefficient correlation, 0.54-0.81). MR neurography can be reliably used for the diagnosis of greater occipital nerve neuropathy in patients with unilateral occipital migraines with a good correlation of imaging findings to the clinical presentation. © 2017 by American Journal of Neuroradiology.

ADR characteristics and corporate governance in the Greater China region

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Lee-Hsien Pan

2012-04-01

Full Text Available We examine the relationship between firm valuation and governance mechanisms, firm characteristics, and institutional factors of the American Depository Receipts (ADRs domiciled in the Greater China region. We find that China ADRs have the highest market-to-book value ratio followed by Hong Kong and Taiwan ADRs. It appears that Chinese firms with the poorest external governance environment stand to benefit the most from cross listing under the ADR programs. Listing in the U.S. that requires more stringent regulations and disclosure rules may strengthen the firms’ governance practices and thereby enhance their firm value. Among the internal governance mechanisms, institutional ownership and insider ownership are important for firm value.

Use of renewable energy in the greater metropolitan area

International Nuclear Information System (INIS)

Arias Garcia, Rocio; Castro Gomez, Gustavo; Fallas Cordero, Kenneth; Grant Chaves, Samuel; Mendez Parrales, Tony; Parajeles Fernandez, Ivan

2012-01-01

A study is conducted on different renewable energy within the larger metropolitan area, selecting the most suitable for the area and the implementation for distributed generation. A research methodology is practiced type pretending gather the necessary information to make proposals selected of different type of energy. The geography of the greater metropolitan area is studied along with the different existing renewable energy: distributed generation, remote measurement of energy which is one of the elements of the concept of intelligent networks (Smart Grid) in the electricity sector, legislation of Costa Rica regarding the generation of renewable energy and environmental impact. An analysis of economic feasibility is covered for each of the proposals estimating current rates for leading distributors of a future value, concluding with the viability of projects for possible execution of the same. (author) [es

The effects of husband's alcohol consumption on married women in three low-income areas of Greater Mumbai.

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Berg, Marlene J; Kremelberg, David; Dwivedi, Purva; Verma, Supriya; Schensul, Jean J; Gupta, Kamla; Chandran, Devyani; Singh, S K

2010-08-01

Gender-based violence rooted in norms, socialization practices, structural factors, and policies that underlie men's abusive practices against married women in India is exacerbated by alcohol. The intersection of domestic violence, childhood exposure to alcohol and frustration, which contribute to drinking and its consequences including forced sex is explored through analysis of data obtained from 486 married men living with their wives in a low-income area of Greater Mumbai. SEM shows pathways linking work-related stress, greater exposure to alcohol as a child, being a heavy drinker, and having more sexual partners (a proxy for HIV risk). In-depth ethnographic interviews with 44 married women in the study communities reveal the consequences of alcohol on women's lives showing how married women associate alcohol use and violence with different patterns of drinking. The study suggests ways alcohol use leads from physical and verbal abuse to emotional and sexual violence in marriage. Implications for gendered multi-level interventions addressing violence and HIV risk are explored.

Mentor-guided self-directed learning affects resident practice.

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Aho, Johnathon M; Ruparel, Raaj K; Graham, Elaina; Zendejas-Mummert, Benjamin; Heller, Stephanie F; Farley, David R; Bingener, Juliane

2015-01-01

Self-directed learning (SDL) can be as effective as instructor-led training. It employs less instructional resources and is potentially a more efficient educational approach. Although SDL is encouraged among residents in our surgical training program via 24-hour access to surgical task trainers and online modules, residents report that they seldom practice. We hypothesized that a mentor-guided SDL approach would improve practice habits among our residents. From 2011 to 2013, 12 postgraduate year (PGY)-2 general surgery residents participated in a 6-week minimally invasive surgery (MIS) rotation. At the start of the rotation, residents were asked to practice laparoscopic skills until they reached peak performance in at least 3 consecutive attempts at a task (individual proficiency). Trainees met with the staff surgeon at weeks 3 and 6 to evaluate progress and review a graph of their individual learning curve. All trainees subsequently completed a survey addressing their practice habits and suggestions for improvement of the curriculum. By the end of the rotation, 100% of participants improved in all practiced tasks (p mentor-guided SDL. Additionally, 6 (50%) residents reported that their skill level had improved relative to their peers. Some residents (n = 3) felt that the curriculum could be improved by including task-specific goals and additional practice sessions with the staff surgeon. Mentor-guided SDL stimulated surgical residents to practice with greater frequency. This repeated deliberate practice led to significantly improved MIS skills without significantly increasing the need for faculty-led instruction. Some residents preferred more discrete goal setting and increased mentor guidance. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Simultaneous bilateral isolated greater trochanter fracture

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Maruti Kambali

2013-01-01

Full Text Available A 48-year-old woman sustained simultaneous isolated bilateral greater trochanteric fracture, following a road traffic accident. The patient presented to us 1 month after the injury. She presented with complaints of pain in the left hip and inability to walk. Roentgenograms revealed displaced comminuted bilateral greater trochanter fractures. The fracture of the left greater trochanter was reduced and fixed internally using the tension band wiring technique. The greater trochanter fracture on the right side was asymptomatic and was managed conservatively. The patient regained full range of motion and use of her hips after a postoperative follow-up of 6 months. Isolated fractures of the greater trochanter are unusual injuries. Because of their relative rarity and the unsettled controversy regarding their etiology and pathogenesis, several methods of treatment have been advocated. Furthermore, the reports of this particular type of injury are not plentiful and the average textbook coverage afforded to this entity is limited. In our study we discuss the mechanism of injury and the various treatment options available.

Breast Feeding And Its Significance In Infant Feeding Practices In India

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Belavady Bhavani

1987-01-01

Full Text Available Surveys on breast-feeding practices have revealed a satisfactory situation in many parts of the country. However, adequacy in terms of quality and quantity of breast milk has not been studied much. Reports available indicate secretion of adequate amount of milk by the mother. This however should not be equated with adequacy of nutrients to this growing child. Concentrations of vitamins are low. The immunologica factors, proteins, minerals and calorie content are in the normal ranges observed in milk samples obtained from well-nourished mother. Breast-feeding should be recommended for as long as possible with adequate supplements. This will have a salubrious effect on the infant and help mothers in spacing births of children. Growth of infants fed soley on breast milk is satisfactory during the first 4 to 5 months. Proper time and type of supplements to be recommended for the community in general need to be studied. Effect of work outside the house on the mother and child, if any, has not received the attention it deserves. High priority has to be a corded to this study, in the present context of dynamic change occurring in the country in relation to the working status of women. Indian is considered a developing country and Indians are conservative by nature. Attitude of the community to infant feeding has not change much except in the educated urban elite and a small section of the poor who consider practice among the former as ideal. The concern and anxiety expressed with regard to breast-feeding by health personnel in foreign countries have not evoked the same response in our country. Reasons are many but if any single reason is to be assigned, it is the popularity of breast-feeding in a vast majority of our mothers. This article will highlight the findings of selected surveys on breast-feeding in the context of our present infant and pre-school feeding practices and refers to the quality and quantity of breast milk briefly.

Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature.

Science.gov (United States)

Ohkura, Yu; Haruta, Shusuke; Shindoh, Junichi; Tanaka, Tsuyoshi; Ueno, Masaki; Udagawa, Harushi

2017-05-25

For proximal gastric cancer invading the greater curvature, concomitant splenectomy is frequently performed to secure the clearance of lymph node metastases. However, prognostic impact of prophylactic splenectomy remains unclear. The aim of this study was to clarify the oncological significance of prophylactic splenectomy for advanced proximal gastric cancer invading the greater curvature. Retrospective review of 108 patients who underwent total or subtotal gastrectomy for advanced proximal gastric cancer involving the greater curvature was performed. Short-term and long-term outcomes were compared between the patients who underwent splenectomy (n = 63) and those who did not (n = 45). Patients who underwent splenectomy showed higher amount of blood loss (538 vs. 450 mL, p = 0.016) and morbidity rate (30.2 vs. 13.3, p = 0.041) compared with those who did not undergo splenectomy. In particular, pancreas-related complications were frequently observed among patients who received splenectomy (17.4 vs. 0%, p = 0.003). However, no significant improvement of long-term outcomes were confirmed in the cases with splenectomy (5-year recurrence-free rate, 60.2 vs. 67.3%; p = 0.609 and 5-year overall survival rates, 63.7 vs. 73.6%; p = 0.769). On the other hand, splenectomy was correlated with marginally better survival in patients with Borrmann type 1 or 2 gastric cancer (p = 0.072). For advanced proximal gastric cancer involving the greater curvature, prophylactic splenectomy may have no significant prognostic impact despite the increased morbidity rate after surgery. Such surgical procedure should be avoided as long as lymph node involvement is not evident.

Labour intensity of guidelines may have a greater effect on adherence than GPs' workload

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Westert Gert P

2009-11-01

Full Text Available Abstract Background Physicians' heavy workload is often thought to jeopardise the quality of care and to be a barrier to improving quality. The relationship between these has, however, rarely been investigated. In this study quality of care is defined as care 'in accordance with professional guidelines'. In this study we investigated whether GPs with a higher workload adhere less to guidelines than those with a lower workload and whether guideline recommendations that require a greater time investment are less adhered to than those that can save time. Methods Data were used from the Second Dutch National survey of General Practice (DNSGP-2. This nationwide study was carried out between April 2000 and January 2002. A multilevel logistic-regression analysis was conducted of 170,677 decisions made by GPs, referring to 41 Guideline Adherence Indicators (GAIs, which were derived from 32 different guidelines. Data were used from 130 GPs, working in 83 practices with 98,577 patients. GP-characteristics as well as guideline characteristics were used as independent variables. Measures include workload (number of contacts, hours spent on continuing medical education, satisfaction with available time, practice characteristics and patient characteristics. Outcome measure is an indicator score, which is 1 when a decision is in accordance with professional guidelines or 0 when the decision deviates from guidelines. Results On average, 66% of the decisions GPs made were in accordance with guidelines. No relationship was found between the objective workload of GPs and their adherence to guidelines. Subjective workload (measured on a five point scale was negatively related to guideline adherence (OR = 0.95. After controlling for all other variables, the variation between GPs in adherence to guideline recommendations showed a range of less than 10%. 84% of the variation in guideline adherence was located at the GAI-level. Which means that the differences in

Factors associated with emergency medical services scope of practice for acute cardiovascular events.

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Williams, Ishmael; Valderrama, Amy L; Bolton, Patricia; Greek, April; Greer, Sophia; Patterson, Davis G; Zhang, Zefeng

2012-01-01

To examine prehospital emergency medical services (EMS) scope of practice for acute cardiovascular events and characteristics that may affect scope of practice; and to describe variations in EMS scope of practice for these events and the characteristics associated with that variability. In 2008, we conducted a telephone survey of 1,939 eligible EMS providers in nine states to measure EMS agency characteristics, medical director involvement, and 18 interventions authorized for prehospital care of acute cardiovascular events by three levels of emergency medical technician (EMT) personnel. A total of 1,292 providers responded to the survey, for a response rate of 67%. EMS scope of practice interventions varied by EMT personnel level, with the proportion of authorized interventions increasing as expected from EMT-Basic to EMT-Paramedic. Seven of eight statistically significant associations indicated that EMS agencies in urban settings were less likely to authorize interventions (odds ratios department-based EMS agencies were two to three times more likely to authorize interventions for EMT-Intermediate personnel. Volunteer EMS agencies were more than twice as likely as nonvolunteer agencies to authorize interventions for EMT-Basic and EMT-Intermediate personnel but were less likely to authorize any one of the 11 interventions for EMT-Paramedics. Greater medical director involvement was associated with greater likelihood of authorization of seven of the 18 interventions for EMT-Basic and EMT-Paramedic personnel but had no association with EMT-Intermediate personnel. We noted statistically significant variations in scope of practice by rural vs. urban setting, medical director involvement, and type of EMS service (fire department-based/non-fire department-based; volunteer/paid). These variations highlight local differences in the composition and capacity of EMS providers and offer important information for the transition towards the implementation of a national scope of

Clobazam and its active metabolite N-desmethylclobazam display significantly greater affinities for α₂- versus α₁-GABA(A-receptor complexes.

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Henrik Sindal Jensen

Full Text Available Clobazam (CLB, a 1,5-benzodiazepine (BZD, was FDA-approved in October 2011 for the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome (LGS in patients 2 years and older. BZDs exert various CNS effects through allosteric modulation of GABAA receptors. The structurally distinct, 1,4-BZD clonazepam (CLN is also approved to treat LGS. The precise mechanisms of action and clinical efficacy of both are unknown. Data show that the GABAA α₁-subunit-selective compound zolpidem [ZOL] exhibits hypnotic/sedative effects. Conversely, data from knock-in mice carrying BZD binding site mutations suggest that the α₂ subunit mediates anticonvulsant effects, without sedative actions. Hence, the specific pattern of interactions across the GABAA receptor complexes of BZDs might be reflected in their clinical efficacies and adverse effect profiles. In this study, GABAA-receptor binding affinities of CLB, N-desmethylclobazam (N-CLB, the major metabolite of CLB, CLN, and ZOL were characterized with native receptors from rat-brain homogenates and on cloned receptors from HEK293 cells transfected with combinations of α (α₁, α₂, α₃, or α₅, β₂, and γ₂ subtypes. Our results demonstrate that CLB and N-CLB have significantly greater binding affinities for α₂- vs. α₁-receptor complexes, a difference not observed for CLN, for which no distinction between α₂ and α₁ receptors was observed. Our experiments with ZOL confirmed the high preference for α₁ receptors. These results provide potential clues to a new understanding of the pharmacologic modes of action of CLB and N-CLB.

Multilevel linear modelling of the response-contingent learning of young children with significant developmental delays.

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Raab, Melinda; Dunst, Carl J; Hamby, Deborah W

2018-02-27

The purpose of the study was to isolate the sources of variations in the rates of response-contingent learning among young children with multiple disabilities and significant developmental delays randomly assigned to contrasting types of early childhood intervention. Multilevel, hierarchical linear growth curve modelling was used to analyze four different measures of child response-contingent learning where repeated child learning measures were nested within individual children (Level-1), children were nested within practitioners (Level-2), and practitioners were nested within the contrasting types of intervention (Level-3). Findings showed that sources of variations in rates of child response-contingent learning were associated almost entirely with type of intervention after the variance associated with differences in practitioners nested within groups were accounted for. Rates of child learning were greater among children whose existing behaviour were used as the building blocks for promoting child competence (asset-based practices) compared to children for whom the focus of intervention was promoting child acquisition of missing skills (needs-based practices). The methods of analysis illustrate a practical approach to clustered data analysis and the presentation of results in ways that highlight sources of variations in the rates of response-contingent learning among young children with multiple developmental disabilities and significant developmental delays. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Call to action: Better care, better health, and greater value in college health.

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Ciotoli, Carlo; Smith, Allison J; Keeling, Richard P

2018-03-05

It is time for action by leaders across higher education to strengthen quality improvement (QI) in college health, in pursuit of better care, better health, and increased value - goals closely linked to students' learning and success. The size and importance of the college student population; the connections between wellbeing, and therefore QI, and student success; the need for improved standards and greater accountability; and the positive contributions of QI to employee satisfaction and professionalism all warrant a widespread commitment to building greater capacity and capability for QI in college health. This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring QI to the forefront of college health practice - and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.

Health-damaging policing practices among persons who inject drugs in Mexico: Are deported migrants at greater risk?

Science.gov (United States)

Pinedo, Miguel; Beletsky, Leo; Alamillo, Nathan; Ojeda, Victoria D

2017-08-01

Evidence-based public health and criminal justice policies aimed at addressing the structurally vulnerable population of persons who inject drugs (PWID) and who are involved in the immigrant enforcement and deportation system are lacking. Policing practices are critical structural determinants of HIV among PWID. PWID in Mexico who have been deported from the US are at elevated risk of HIV. From 2011 to 2013, 733 PWID were recruited to complete structured questionnaires, including past 6-month experiences with police. Eligible PWID were 18 years or older, had injected in the past month, and resided in Tijuana, Mexico with no intentions of moving. To determine if deportation status was associated with experiences of arrests and problematic policing practices, we conducted separate multivariate logistic regression models for independent policing variables. In multivariate analyses, deportation status was independently associated with higher odds of being arrested (Adjusted Odds Ratio (AOR): 1.45; 95% Confidence Interval (CI): 1.02-2.05), being asked for a bribe (AOR: 1.39; 95% CI: 1.05-2.04), and being forced to leave a place of residence (AOR: 2.00; 95% CI: 1.08-3.70) in the past 6 months. Results highlight a previously poorly understood elements of the US-deportation experience: migrants' experiences with law enforcement post-deportation and the role of deportation policies and practices as structural drivers of public health risk in destination countries. We provide policy recommendations for Mexico and the US based on our findings, which have potential application in other countries seeking to improve enforcement and related policing practices from a public health perspective. Copyright © 2017. Published by Elsevier B.V.

Sex inequalities in HIV-related practices in the Brazilian population aged 15 to 64 years old, 2008

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Ana Roberta Pati Pascom

2011-01-01

Full Text Available The objective of this study is to analyze gender differences in HIV-related practices in the Brazilian population. A national survey was carried out in 2008 with a sample size of 8,000 individuals aged 15-64 years old. The sampling was stratified by macro geographical region and urban/rural areas. Logistic regression models were used to investigate the main predictors of consistent condom use. The results showed that women have less sexy, start sexual life later than men, have fewer casual sexual partners, but use condom less frequently than men. On the other hand, the coverage of HIV testing is significantly greater among women. Significant differences by gender were seen in all HIV-related risky practices. The greater vulnerability was always associated with women, with exception of HIV testing. The low proportion of condom use in infidelity situations was a problem for box sexes and deserves special consideration when developing prevention strategies.

Conservation buffer distance estimates for Greater Sage-Grouse: a review

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Manier, Daniel J.; Bowen, Zachary H.; Brooks, Matthew L.; Casazza, Michael L.; Coates, Peter S.; Deibert, Patricia A.; Hanser, Steven E.; Johnson, Douglas H.

2014-01-01

This report was prepared at the request of the U.S. Department of the Interior and is a compilation and summary of published scientific studies that evaluate the influence of anthropogenic activities and infrastructure on Greater Sage-Grouse(Centrocercus urophasianus; hereafter, sage-grouse) populations. The purpose of this report is to provide a convenient reference for land managers and others who are working to develop biologically relevant and socioeconomically practical buffer distances around sage-grouse habitats. The framework for this summary includes (1) addressing the potential effects of anthropogenic land use and disturbances on sage-grouse populations, (2) providing ecologically based interpretations of evidence from the scientific literature, and (3) informing implementation of conservation buffers around sage-grouse communal breeding locations—known as leks.

Greater confinement disposal program at the Savannah River Plant

International Nuclear Information System (INIS)

Cook, J.R.; Towler, O.A.; Peterson, D.L.; Johnson, G.M.; Helton, B.D.

1984-01-01

The first facility to demonstrate Greater Confinement Disposal (GCD) in a humid environment in the United States has been built and is operating at the Savannah River Plant. GCD practices of waste segregation, packaging, emplacement below the root zone, and waste stabilization are being used in the demonstration. Activity concentrations to select wastes for GCD are based on a study of SRP burial records, and are equal to or less than those for Class B waste in 10CFR61. The first disposal units to be constructed are 9-foot diameter, thirty-foot deep boreholes which will be used to dispose of wastes from production reactors, tritiated wastes, and selected wastes from off-site. In 1984 an engineered GCD trench will be constructed for disposal of boxed wastes and large bulky items. 2 figures, 1 table

Low Carbon Rice Farming Practices in the Mekong Delta Yield Significantly Higher Profits and Lower Greenhouse Gas Emissions

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Rudek, J.; Van Sanh, N.; Tinh, T. K.; Tin, H. Q.; Thu Ha, T.; Pha, D. N.; Cui, T. Q.; Tin, N. H.; Son, N. N.; Thanh, H. H.; Kien, H. T.; Kritee, K.; Ahuja, R.

2014-12-01

The Vietnam Low-Carbon Rice Project (VLCRP) seeks to significantly reduce GHG emissions from rice cultivation, an activity responsible for more than 30% of Vietnam's overall GHG emissions, while improving livelihoods for the rice farmer community by decreasing costs and enhancing yield as well as providing supplemental farmer income through the sale of carbon credits. The Mekong Delta makes up 12% of Vietnam's land area, but produces more than 50% of the country's rice, including more than 90% of the rice for export. Rice cultivation is the main source of income for 80% of farmers in the Mekong Delta. VLCRP was launched in late 2012 in the Mekong Delta in two major rice production provinces, Kien Giang and An Giang. To date, VLCRP has completed 11 crop seasons (in Kien Giang and An Giang combined), training over 400 farmer households in applying VLCRP's package of practices (known as 1 Must - 6 Reductions) and building technical capacity to its key stakeholders and rice farmer community leaders. By adopting the 1 Must- 6 Reductions practices (including reduced seeding density, reduced fertilizer and pesticide application, and alternative wetting and drying water management), rice farmers reduce their input costs while maintaining or improving yields, and decreasing greenhouse gas emissions. The VLCRP package of practices also deliver other environmental and social co-benefits, such as reduced water pollution, improved habitat for fishery resources and reduced health risks for farmers through the reduction of agri-chemicals. VLCRP farmers use significantly less inputs (50% reduction in seed, 30% reduction in fertilizer, 40-50% reduction in water) while improving yields 5-10%, leading to an increase in profit from 10% to as high as 60% per hectare. Preliminary results indicate that the 1 Must- 6 Reductions practices have led to approximately 40-65% reductions in greenhouse gas emissions, equivalent to 4 tons of CO2e/ha/yr in An Giang and 35 tons of CO2e/ha/yr in Kien

Replacing gasoline with corn ethanol results in significant environmental problem-shifting.

Science.gov (United States)

Yang, Yi; Bae, Junghan; Kim, Junbeum; Suh, Sangwon

2012-04-03

Previous studies on the life-cycle environmental impacts of corn ethanol and gasoline focused almost exclusively on energy balance and greenhouse gas (GHG) emissions and largely overlooked the influence of regional differences in agricultural practices. This study compares the environmental impact of gasoline and E85 taking into consideration 12 different environmental impacts and regional differences among 19 corn-growing states. Results show that E85 does not outperform gasoline when a wide spectrum of impacts is considered. If the impacts are aggregated using weights developed by the National Institute of Standards and Technology (NIST), overall, E85 generates approximately 6% to 108% (23% on average) greater impact compared with gasoline, depending on where corn is produced, primarily because corn production induces significant eutrophication impacts and requires intensive irrigation. If GHG emissions from the indirect land use changes are considered, the differences increase to between 16% and 118% (33% on average). Our study indicates that replacing gasoline with corn ethanol may only result in shifting the net environmental impacts primarily toward increased eutrophication and greater water scarcity. These results suggest that the environmental criteria used in the Energy Independence and Security Act (EISA) be re-evaluated to include additional categories of environmental impact beyond GHG emissions.

Biological variability in biomechanical engineering research: Significance and meta-analysis of current modeling practices.

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Cook, Douglas; Julias, Margaret; Nauman, Eric

2014-04-11

Biological systems are characterized by high levels of variability, which can affect the results of biomechanical analyses. As a review of this topic, we first surveyed levels of variation in materials relevant to biomechanics, and compared these values to standard engineered materials. As expected, we found significantly higher levels of variation in biological materials. A meta-analysis was then performed based on thorough reviews of 60 research studies from the field of biomechanics to assess the methods and manner in which biological variation is currently handled in our field. The results of our meta-analysis revealed interesting trends in modeling practices, and suggest a need for more biomechanical studies that fully incorporate biological variation in biomechanical models and analyses. Finally, we provide some case study example of how biological variability may provide valuable insights or lead to surprising results. The purpose of this study is to promote the advancement of biomechanics research by encouraging broader treatment of biological variability in biomechanical modeling. Copyright © 2014 Elsevier Ltd. All rights reserved.

Monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma (SMM): a practical guide to management.

Science.gov (United States)

Maciocia, Nicola; Wechalekar, Ashutosh; Yong, Kwee

2017-12-01

Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma are precursor conditions of symptomatic multiple myeloma (MM). Diagnostic principles are aimed at excluding MM requiring therapy, other conditions associated with paraproteins that may require different management, and risk stratifying patients for the purposes of tailored follow-up and investigation. The International Myeloma Working Group have recently published a revised definition of MM, which singles out a small group of patients with smoldering multiple myeloma who are at very high risk of progression and organ damage; such patients are now included under the definition of MM and recommended to start anti-myeloma treatment. Furthermore, the recently published National Institute of Health and Care Excellence guideline recommends cross-sectional imaging techniques in place of skeletal survey. These recent recommendations are discussed, and practical guidance for investigation and management are presented. Copyright © 2016 John Wiley & Sons, Ltd.

Sagebrush, greater sage-grouse, and the occurrence and importance of forbs

Science.gov (United States)

Pennington, Victoria E.; Schlaepfer, Daniel R.; Beck, Jeffrey L.; Bradford, John B.; Palmquist, Kyle A.; Lauenroth, William K.

2016-01-01

Big sagebrush (Artemisia tridentata Nutt.) ecosystems provide habitat for sagebrush-obligate wildlife species such as the Greater Sage-Grouse (Centrocercus urophasianus). The understory of big sagebrush plant communities is composed of grasses and forbs that are important sources of cover and food for wildlife. The grass component is well described in the literature, but the composition, abundance, and habitat role of forbs in these communities is largely unknown. Our objective was to synthesize information about forbs and their importance to Greater Sage-Grouse diets and habitats, how rangeland management practices affect forbs, and how forbs respond to changes in temperature and precipitation. We also sought to identify research gaps and needs concerning forbs in big sagebrush plant communities. We searched for relevant literature including journal articles and state and federal agency reports. Our results indicated that in the spring and summer, Greater Sage-Grouse diets consist of forbs (particularly species in the Asteraceae family), arthropods, and lesser amounts of sagebrush. The diets transition to sagebrush in fall and winter. Forbs provide cover for Greater Sage-Grouse individuals at their lekking, nesting, and brood-rearing sites, and the species has a positive relationship with arthropod presence. The effect of grazing on native forbs may be compounded by invasion of nonnative species and differs depending on grazing intensity. The effect of fire on forbs varies greatly and may depend on time elapsed since burning. In addition, chemical and mechanical treatments affect annual and perennial forbs differently. Temperature and precipitation influence forb phenology, biomass, and abundance differently among species. Our review identified several uncertainties and research needs about forbs in big sagebrush ecosystems. First, in many cases the literature about forbs is reported only at the genus or functional type level. Second, information about forb

Examination of weight control practices in a non-clinical sample of college women.

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Hayes, S; Napolitano, M A

2012-09-01

The current study examined healthy weight control practices among a sample of college women enrolled at an urban university (N=715; age=19.87±1.16; 77.2% Caucasian; 13.4% African American, 7.2% Asian, 2.2% other races). Participants completed measures as part of an on-line study about health habits, behaviors, and attitudes. Items from the Three Factor Eating Questionnaire were selected and evaluated with exploratory factor analysis to create a healthy weight control practices scale. Results revealed that college women, regardless of weight status, used a comparable number (four of eight) of practices. Examination of racial differences between Caucasian and African American women revealed that normal weight African American women used significantly fewer strategies than Caucasian women. Of note, greater use of healthy weight control practices was associated with higher cognitive restraint, drive for thinness, minutes of physical activity, and more frequent use of compensatory strategies. Higher scores on measures of binge and disinhibited eating, body dissatisfaction, negative affect, and depressive symptoms were associated with greater use of healthy weight control practices by underweight/normal weight but not by overweight/obese college women. Results suggest that among a sample of college females, a combination of healthy and potentially unhealthy weight control practices occurs. Implications of the findings suggest the need for effective weight management and eating disorder prevention programs for this critical developmental life stage. Such programs should be designed to help students learn how to appropriately use healthy weight control practices, as motivations for use may vary by weight status.

Academic Program Approval and Review Practices

Directory of Open Access Journals (Sweden)

Don G. Creamer

1999-08-01

Full Text Available This report outlines general and specific processes for both program approval and program review practices found in 50 states and eight foreign countries and regions.  Models that depict these procedures are defined and the strengths and weakness of each are discussed.  Alternatives to current practice by state agencies in the U.S. are described that might provide for greater decentralization of these practices while maintaining institutional accountability.

Trabecular microstructure and surface changes in the greater tuberosity in rotator cuff tears

International Nuclear Information System (INIS)

Jiang, Yebin; Zhao, Jenny; Ouyang, Xiaolong; Genant, Harry K.; Holsbeeck, Marnix T. van; Flynn, Michael J.

2002-01-01

Abstract Objective. When planning surgery in patients with rotator cuff tear, strength of bone at the tendon insertion and trabecular bone structure in the greater tuberosity are usually taken into consideration. We investigated radiographic changes in bone structure of the greater tuberosity in rotator cuff tears.Design. Twenty-two human cadaveric shoulders from subjects ranging from 55 to 75 years of age were obtained. The integrity of the rotator cuff was examined by sonography to determine if it is intact without any tear, or torn partially or completely. The humeral head was sectioned in 3 mm thick coronal slab sections and microradiographed. After digitization of the microradiographs and imaging processing with in-house semi-automated image processing software tools developed using software interfaces on a Sun workstation, the trabecular histomorphometrical structural parameters and connectivity in the greater tuberosity were quantified. The degenerative changes on the surface of the greater tuberosity were interpreted blindly by 2 independent readers.Results. Among the 22 shoulder specimens, the rotator cuff was found intact in 10 shoulders, partially in 7 and fully torn in 5. Statistically significant loss in apparent trabecular bone volume fraction, number of trabecular nodes, and number of trabecular branches, and a statistically significant increase in apparent trabecular separation and number of trabecular free ends were found in the greater tuberosity of the shoulders with tears. The loss was greater in association with full tear than in partial tear. Thickening of the cortical margin of the enthesis, irregularity of its surface, and calcification beyond the tidemark were observed in 2 (20%) shoulders with intact rotator cuff, in 6 (86%) shoulders with partial tear, and in 5 (100%) shoulders with full tear.Conclusions. Rotator cuff tears are associated with degenerative changes on the bone surface and with disuse osteopenia of the greater tuberosity

A pilot randomized controlled trial of D-cycloserine and distributed practice as adjuvants to constraint-induced movement therapy after stroke.

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Nadeau, Stephen E; Davis, Sandra E; Wu, Samuel S; Dai, Yunfeng; Richards, Lorie G

2014-01-01

Background. Phase III trials of rehabilitation of paresis after stroke have proven the effectiveness of intensive and extended task practice, but they have also shown that many patients do not qualify, because of severity of impairment, and that many of those who are treated are left with clinically significant deficits. Objective. To test the value of 2 potential adjuvants to normal learning processes engaged in constraint-induced movement therapy (CIMT): greater distribution of treatment over time and the coadministration of d-cycloserine, a competitive agonist at the glycine site of the N-methyl-D-aspartate glutamate receptor. Methods. A prospective randomized single-blind parallel-group trial of more versus less condensed therapy (2 vs 10 weeks) and d-cycloserine (50 mg) each treatment day versus placebo (in a 2 × 2 design), as potential adjuvants to 60 hours of CIMT. Results. Twenty-four participants entered the study, and 22 completed it and were assessed at the completion of treatment and 3 months later. Neither greater distribution of treatment nor treatment with d-cycloserine significantly augmented retention of gains achieved with CIMT. Conclusions. Greater distribution of practice and treatment with d-cycloserine do not appear to augment retention of gains achieved with CIMT. However, concentration of CIMT over 2 weeks ("massed practice") appears to confer no advantage either. © The Author(s) 2014.

The significance of clinical practice guidelines on adult varicocele detection and management

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Anand Shridharani

2016-01-01

Full Text Available Varicoceles are the most common correctable etiology of male factor infertility. However, the detection and management of varicoceles have not been standardized. This has led to decades of debate regarding the effect of varicocele on male infertility and subsequently whether repair leads to an improved fertility status. The current body of evidence investigating the role of varicocele and varicocelectomy is weak and conflicting. The stance taken by the AUA and ASRM suggests that there is insufficient outcomes data to support evidenced-based guidelines, citing evidence used to provide current recommendations are generally of a low quality level. On the other hand, the EAU Guidelines give a level 1a of evidence for management of varicoceles that are clinically palpable, associated with subnormal semen analyses and having otherwise unexplained fertility. Besides aiding with clinical varicocele detection and management, clinical practice opinion statements and guidelines aim to direct and strengthen the infrastructure of future studies. We review the current status of opinion statements and guidelines in varicocele and management detection with focus on their application in practice.

The significance of clinical practice guidelines on adult varicocele detection and management.

Science.gov (United States)

Shridharani, Anand; Owen, Ryan C; Elkelany, Osama O; Kim, Edward D

2016-01-01

Varicoceles are the most common correctable etiology of male factor infertility. However, the detection and management of varicoceles have not been standardized. This has led to decades of debate regarding the effect of varicocele on male infertility and subsequently whether repair leads to an improved fertility status. The current body of evidence investigating the role of varicocele and varicocelectomy is weak and conflicting. The stance taken by the AUA and ASRM suggests that there is insufficient outcomes data to support evidenced-based guidelines, citing evidence used to provide current recommendations are generally of a low quality level. On the other hand, the EAU Guidelines give a level 1a of evidence for management of varicoceles that are clinically palpable, associated with subnormal semen analyses and having otherwise unexplained fertility. Besides aiding with clinical varicocele detection and management, clinical practice opinion statements and guidelines aim to direct and strengthen the infrastructure of future studies. We review the current status of opinion statements and guidelines in varicocele and management detection with focus on their application in practice.

Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

Science.gov (United States)

Mohammed, Siti Asma; Yusof, Maryati Mohd

2013-04-01

Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.

Teacher coaching supported by formative assessment for improving classroom practices.

Science.gov (United States)

Fabiano, Gregory A; Reddy, Linda A; Dudek, Christopher M

2018-06-01

The present study is a wait-list controlled, randomized study investigating a teacher coaching approach that emphasizes formative assessment and visual performance feedback to enhance elementary school teachers' classroom practices. The coaching model targeted instructional and behavioral management practices as measured by the Classroom Strategies Assessment System (CSAS) Observer and Teacher Forms. The sample included 89 general education teachers, stratified by grade level, and randomly assigned to 1 of 2 conditions: (a) immediate coaching, or (b) waitlist control. Results indicated that, relative to the waitlist control, teachers in immediate coaching demonstrated significantly greater improvements in observations of behavior management strategy use but not for observations of instructional strategy use. Observer- and teacher-completed ratings of behavioral management strategy use at postassessment were significantly improved by both raters; ratings of instructional strategy use were significantly improved for teacher but not observer ratings. A brief coaching intervention improved teachers' use of observed behavior management strategies and self-reported use of behavior management and instructional strategies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The effectiveness of concept mapping and retrieval practice as learning strategies in an undergraduate physiology course.

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Burdo, Joseph; O'Dwyer, Laura

2015-12-01

Concept mapping and retrieval practice are both educational methods that have separately been reported to provide significant benefits for learning in diverse settings. Concept mapping involves diagramming a hierarchical representation of relationships between distinct pieces of information, whereas retrieval practice involves retrieving information that was previously coded into memory. The relative benefits of these two methods have never been tested against each other in a classroom setting. Our study was designed to investigate whether or not concept mapping or retrieval practice produced a significant learning benefit in an undergraduate physiology course as measured by exam performance and, if so, was the benefit of one method significantly greater than the other. We found that there was a trend toward increased exam scores for the retrieval practice group compared with both the control group and concept mapping group, and that trend achieved statistical significance for one of the four module exams in the course. We also found that women performed statistically better than men on the module exam that contained a substantial amount of material relating to female reproductive physiology. Copyright © 2015 The American Physiological Society.

The Link between Knowledge, Attitudes and Practices in Relation to Atmospheric Haze Pollution in Peninsular Malaysia

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De Pretto, Laura; Acreman, Stephen; Ashfold, Matthew J.; Mohankumar, Suresh K.; Campos-Arceiz, Ahimsa

2015-01-01

Transboundary haze episodes caused by seasonal forest fires have become a recurrent phenomenon in Southeast Asia, with serious environmental, economic, and public health implications. Here we present a cross-sectional survey conducted among people in Kuala Lumpur and surrounds to assess the links between knowledge, attitudes, and practices in relation to the transboundary haze episodes. Of 305 respondents, 125 were amateur athletes participating in a duathlon event and the remainder were surveyed in an inner-city shopping mall. Across the whole sample, people who possessed more factual information about the haze phenomenon showed significantly higher levels of concern. Duathletes were more knowledgeable than non-duathletes and also more concerned about the negative effects of haze, especially on health. For all people who regularly practice outdoor sports (including people interviewed at the shopping mall), higher levels of knowledge and concerned attitudes translated into a greater likelihood of engaging in protective practices, such as cancelling their outdoor training sessions, while those with greater knowledge were more likely to check the relevant air pollution index on a daily basis. Our results indicate that the provision of accurate and timely information about air quality to residents will translate into beneficial practices, at least among particularly exposed individuals, such as amateur athletes who regularly practice outdoor sports. PMID:26646896

The Link between Knowledge, Attitudes and Practices in Relation to Atmospheric Haze Pollution in Peninsular Malaysia.

Directory of Open Access Journals (Sweden)

Laura De Pretto

Full Text Available Transboundary haze episodes caused by seasonal forest fires have become a recurrent phenomenon in Southeast Asia, with serious environmental, economic, and public health implications. Here we present a cross-sectional survey conducted among people in Kuala Lumpur and surrounds to assess the links between knowledge, attitudes, and practices in relation to the transboundary haze episodes. Of 305 respondents, 125 were amateur athletes participating in a duathlon event and the remainder were surveyed in an inner-city shopping mall. Across the whole sample, people who possessed more factual information about the haze phenomenon showed significantly higher levels of concern. Duathletes were more knowledgeable than non-duathletes and also more concerned about the negative effects of haze, especially on health. For all people who regularly practice outdoor sports (including people interviewed at the shopping mall, higher levels of knowledge and concerned attitudes translated into a greater likelihood of engaging in protective practices, such as cancelling their outdoor training sessions, while those with greater knowledge were more likely to check the relevant air pollution index on a daily basis. Our results indicate that the provision of accurate and timely information about air quality to residents will translate into beneficial practices, at least among particularly exposed individuals, such as amateur athletes who regularly practice outdoor sports.

The Link between Knowledge, Attitudes and Practices in Relation to Atmospheric Haze Pollution in Peninsular Malaysia.

Science.gov (United States)

De Pretto, Laura; Acreman, Stephen; Ashfold, Matthew J; Mohankumar, Suresh K; Campos-Arceiz, Ahimsa

2015-01-01

Transboundary haze episodes caused by seasonal forest fires have become a recurrent phenomenon in Southeast Asia, with serious environmental, economic, and public health implications. Here we present a cross-sectional survey conducted among people in Kuala Lumpur and surrounds to assess the links between knowledge, attitudes, and practices in relation to the transboundary haze episodes. Of 305 respondents, 125 were amateur athletes participating in a duathlon event and the remainder were surveyed in an inner-city shopping mall. Across the whole sample, people who possessed more factual information about the haze phenomenon showed significantly higher levels of concern. Duathletes were more knowledgeable than non-duathletes and also more concerned about the negative effects of haze, especially on health. For all people who regularly practice outdoor sports (including people interviewed at the shopping mall), higher levels of knowledge and concerned attitudes translated into a greater likelihood of engaging in protective practices, such as cancelling their outdoor training sessions, while those with greater knowledge were more likely to check the relevant air pollution index on a daily basis. Our results indicate that the provision of accurate and timely information about air quality to residents will translate into beneficial practices, at least among particularly exposed individuals, such as amateur athletes who regularly practice outdoor sports.

[Clinical Results of Endoscopic Treatment of Greater Trochanteric Pain Syndrome].

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Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T

2017-01-01

PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of

ASSESSMENT OF GOOD PRACTICES IN HOSPITAL FOOD SERVICE BY COMPARING EVALUATION TOOLS.

Science.gov (United States)

Macedo Gonçalves, Juliana; Lameiro Rodrigues, Kelly; Santiago Almeida, Ângela Teresinha; Pereira, Giselda Maria; Duarte Buchweitz, Márcia Rúbia

2015-10-01

since food service in hospitals complements medical treatment, it should be produced in proper hygienic and sanitary conditions. It is a well-known fact that food-transmitted illnesses affect with greater severity hospitalized and immunosuppressed patients. good practices in hospital food service are evaluated by comparing assessment instruments. good practices were evaluated by a verification list following Resolution of Collegiate Directory n. 216 of the Brazilian Agency for Sanitary Vigilance. Interpretation of listed items followed parameters of RCD 216 and the Brazilian Association of Collective Meals Enterprises (BACME). Fisher's exact test was applied to detect whether there were statistically significant differences. Analysis of data grouping was undertaken with Unweighted Pair-group using Arithmetic Averages, coupled to a correlation study between dissimilarity matrixes to verify disagreement between the two methods. Good Practice was classified with mean total rates above 75% by the two methods. There were statistically significant differences between services and food evaluated by BACME instrument. Hospital Food Services have proved to show conditions of acceptable good practices. the comparison of interpretation tools based on RCD n. 216 and BACME provided similar results for the two classifications. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Exploring students' perceptions on the use of significant event analysis, as part of a portfolio assessment process in general practice, as a tool for learning how to use reflection in learning.

Science.gov (United States)

Grant, Andrew J; Vermunt, Jan D; Kinnersley, Paul; Houston, Helen

2007-03-30

Portfolio learning enables students to collect evidence of their learning. Component tasks making up a portfolio can be devised that relate directly to intended learning outcomes. Reflective tasks can stimulate students to recognise their own learning needs. Assessment of portfolios using a rating scale relating to intended learning outcomes offers high content validity. This study evaluated a reflective portfolio used during a final-year attachment in general practice (family medicine). Students were asked to evaluate the portfolio (which used significant event analysis as a basis for reflection) as a learning tool. The validity and reliability of the portfolio as an assessment tool were also measured. 81 final-year medical students completed reflective significant event analyses as part of a portfolio created during a three-week attachment (clerkship) in general practice (family medicine). As well as two reflective significant event analyses each portfolio contained an audit and a health needs assessment. Portfolios were marked three times; by the student's GP teacher, the course organiser and by another teacher in the university department of general practice. Inter-rater reliability between pairs of markers was calculated. A questionnaire enabled the students' experience of portfolio learning to be determined. Benefits to learning from reflective learning were limited. Students said that they thought more about the patients they wrote up in significant event analyses but information as to the nature and effect of this was not forthcoming. Moderate inter-rater reliability (Spearman's Rho .65) was found between pairs of departmental raters dealing with larger numbers (20-60) of portfolios. Inter-rater reliability of marking involving GP tutors who only marked 1-3 portfolios was very low. Students rated highly their mentoring relationship with their GP teacher but found the portfolio tasks time-consuming. The inter-rater reliability observed in this study should

Emergency Radiology Practice Patterns: Shifts, Schedules, and Job Satisfaction.

Science.gov (United States)

Hanna, Tarek N; Shekhani, Haris; Lamoureux, Christine; Mar, Hanna; Nicola, Refky; Sliker, Clint; Johnson, Jamlik-Omari

2017-03-01

To assess the practice environment of emergency radiologists with a focus on schedule, job satisfaction, and self-perception of health, wellness, and diagnostic accuracy. A survey drawing from prior radiology and health care shift-work literature was distributed via e-mail to national societies, teleradiology groups, and private practices. The survey remained open for 4 weeks in 2016, with one reminder. Data were analyzed using hypothesis testing and logistic regression modeling. Response rate was 29.6% (327/1106); 69.1% of respondents (n = 226) were greater than 40 years old, 73% (n = 240) were male, and 87% (n = 284) practiced full time. With regard to annual overnight shifts (NS): 36% (n = 118) did none, 24.9% (n = 81) did 182 or more, and 15.6% (n = 51) did 119. There was a significant association between average NS worked per year and both perceived negative health effects (P impact on memory (P job enjoyment and number of annual NS (P job" for radiologists who work no NS is 2.21 times greater than for radiologists who work at least 119 NS, when shift length is held constant. Radiologists with 11+ years of experience who work no NS or 1 to 100 NS annually have lower odds of feeling overwhelmed when compared with those working the same number of NS with job satisfaction and negative health self-perception. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A review of significant events analysed in general practice: implications for the quality and safety of patient care

Directory of Open Access Journals (Sweden)

Bradley Nick

2009-09-01

Full Text Available Abstract Background Significant event analysis (SEA is promoted as a team-based approach to enhancing patient safety through reflective learning. Evidence of SEA participation is required for appraisal and contractual purposes in UK general practice. A voluntary educational model in the west of Scotland enables general practitioners (GPs and doctors-in-training to submit SEA reports for feedback from trained peers. We reviewed reports to identify the range of safety issues analysed, learning needs raised and actions taken by GP teams. Method Content analysis of SEA reports submitted in an 18 month period between 2005 and 2007. Results 191 SEA reports were reviewed. 48 described patient harm (25.1%. A further 109 reports (57.1% outlined circumstances that had the potential to cause patient harm. Individual 'error' was cited as the most common reason for event occurrence (32.5%. Learning opportunities were identified in 182 reports (95.3% but were often non-specific professional issues not shared with the wider practice team. 154 SEA reports (80.1% described actions taken to improve practice systems or professional behaviour. However, non-medical staff were less likely to be involved in the changes resulting from event analyses describing patient harm (p Conclusion The study provides some evidence of the potential of SEA to improve healthcare quality and safety. If applied rigorously, GP teams and doctors in training can use the technique to investigate and learn from a wide variety of quality issues including those resulting in patient harm. This leads to reported change but it is unclear if such improvement is sustained.

Significant Published Articles for Pharmacy Nutrition Support Practice in 2014 and 2015.

Science.gov (United States)

Dickerson, Roland N; Kumpf, Vanessa J; Blackmer, Allison B; Bingham, Angela L; Tucker, Anne M; Ybarra, Joseph V; Kraft, Michael D; Canada, Todd W

2016-07-01

To assist the pharmacy clinician engaged in nutrition support in staying current with the most pertinent literature. Several experienced board-certified clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2014 and 2015 that they considered to be important to their practice. Only those articles available in print format were considered for potential inclusion. Articles available only in preprint electronic format were not evaluated. The citation list was compiled into a single spreadsheet where the author participants were asked to ascertain whether they considered the paper important to nutrition support pharmacy practice. A culled list of publications was then identified whereby the majority of author participants (at least 5 out of 8) considered the paper to be important. A total of 108 articles were identified; 36 of which were considered to be of high importance. An important guideline article published in early 2016, but not ranked, was also included. The top-ranked articles from the primary literature were reviewed. It is recommended that the informed pharmacist, who is engaged in nutrition support therapy, be familiar with the majority of these articles.

Significant Learning Experiences and Ignatian Pedagogy: A Case Study of Curricula, Academic Practices, and Graduate Outcomes in Jesuit Universities' Honors Programs

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Pampel, Robert

2017-01-01

This qualitative, multisite case study used Dee Fink's taxonomy of significant learning as a lens through which to examine the curricular structure, academic practices, and graduate outcomes for honors programs at Jesuit colleges and universities in the United States. Special attention was given to the distinctive quality of Ignatian pedagogy and…

Allergy-immunology practice parameters and strength of recommendation data: an evolutionary perspective.

Science.gov (United States)

Park, Matthew H; Banks, Taylor A; Nelson, Michael R

2016-03-01

The practice parameters for allergy and immunology (A/I) are a valuable tool guiding practitioners' clinical practice. The A/I practice parameters have evolved over time in the context of evidence-based medicine milestones. To identify evolutionary trends in the character, scope, and evidence underlying recommendations in the A/I practice parameters. Practice parameters that have guided A/I from 1995 through 2014 were analyzed. Statements and recommendations with strength of recommendation categories A and B were considered to have a basis in evidence from controlled trials. Forty-three publications and updates covering 25 unique topics were identified. There was great variability in the number of recommendations made and the proportion of statements with controlled trial evidence. The mean number of recommendations made per practice parameter has decreased significantly, from 95.8 to a mean of 38.3. There also is a trend toward an increased proportion of recommendations based on controlled trial evidence in practice parameters with fewer recommendations, with a mean of 30.7% in practice parameters with at least 100 recommendations based on controlled trial evidence compared with 48.3% in practice parameters with 30 to 100 recommendations and 51.0% in those with fewer than 30 recommendations. The A/I practice parameters have evolved significantly over time. Encouragingly, greater controlled trial evidence is associated with updated practice parameters and a recent trend of more narrowly focused topics. These findings should only bolster and inspire confidence in the utility of the A/I practice parameters in assisting practitioners to navigate through the uncertainty that is intrinsic to medicine in making informed decisions with patients. Published by Elsevier Inc.

Greater confinement disposal program at the Savannah River Plant

International Nuclear Information System (INIS)

Towler, O.A.; Cook, J.R.; Peterson, D.L.; Reddick, J.A.

1984-01-01

A facility to demonstrate Greater Confinement Disposal (GCD) of low-level solid radioactive waste in a humid environment has been built and is operating at the Savannah River Plant (SRP). GCD practices of waste segregation into high and low activity concentrations, emplacement of waste below the root zone, waste stabilization, and capping are being used in the demonstration. Activity concentrations to select wastes for GCD are based on the volume/activity distribution of low-level solid wastes as obtained from SRP burial records, and are equal to or less than those for Class B waste in 10 CFR 61. The first disposal units constructed are twenty 9-ft-diam, 30-ft-deep boreholes. These holes will be used to dispose of wastes from the production reactors, tritiated wastes, and selected wastes from offsite. In 1984, construction will begin on an engineered GCD trench for disposal of boxed waste and large bulky items that meet the activity concentration criteria. 4 references, 5 figures, 2 tables

Transregionalism: Underlying Concept of EAEU-ASEAN Cooperation and Greater Eurasian Partnership

Directory of Open Access Journals (Sweden)

Anna A. Garmash

2017-01-01

Full Text Available Nowadays the EAEU seeks to integrate itself into the global economy as one of its regional economic centers. Developing ties with other regional integration groups corresponds the EAEU’s interests and facilitates the polycentric structure of the emerging world order. In this respect, in 2016 on the sidelines of the third Russia-ASEAN Summit Russian President Vladimir Putin proposed to develop stronger relations between the EAEU and ASEAN as well as to form a greater Eurasian partnership encompassing the EAEU, the SCO and ASEAN. While geographically vast, these projects lack conceptual underpinning. It is deemed that transregionalism – an international phenomenon which is insuffi ciently explored by both Western and Russian scholars, can provide a crucial theoretical foundation for these initiatives. The author compares the mechanisms which ASEAN employs to promote transregional cooperation with the EU, MERCOSUR and the GCC as well as within the frameworks of such dialogue platforms as ASEM and FEALAC. The author suggests that EAEU-ASEAN relations should be analyzed from the viewpoint of a classic transregionalism, while a greater Eurasian partnership seen as an example of a broader one. The results of the analysis are instrumental in laying out practical recommendations for the EAEU in carrying out its transregional agenda.

Greater Strength Gains after Training with Accentuated Eccentric than Traditional Isoinertial Loads in Already Strength-Trained Men

Science.gov (United States)

Walker, Simon; Blazevich, Anthony J.; Haff, G. Gregory; Tufano, James J.; Newton, Robert U.; Häkkinen, Keijo

2016-01-01

As training experience increases it becomes more challenging to induce further neuromuscular adaptation. Consequently, strength trainers seek alternative training methods in order to further increase strength and muscle mass. One method is to utilize accentuated eccentric loading, which applies a greater external load during the eccentric phase of the lift as compared to the concentric phase. Based upon this practice, the purpose of this study was to determine the effects of 10 weeks of accentuated eccentric loading vs. traditional isoinertial resistance training in strength-trained men. Young (22 ± 3 years, 177 ± 6 cm, 76 ± 10 kg, n = 28) strength-trained men (2.6 ± 2.2 years experience) were allocated to concentric-eccentric resistance training in the form of accentuated eccentric load (eccentric load = concentric load + 40%) or traditional resistance training, while the control group continued their normal unsupervised training program. Both intervention groups performed three sets of 6-RM (session 1) and three sets of 10-RM (session 2) bilateral leg press and unilateral knee extension exercises per week. Maximum force production was measured by unilateral isometric (110° knee angle) and isokinetic (concentric and eccentric 30°.s−1) knee extension tests, and work capacity was measured by a knee extension repetition-to-failure test. Muscle mass was assessed using panoramic ultrasonography and dual-energy x-ray absorptiometry. Surface electromyogram amplitude normalized to maximum M-wave and the twitch interpolation technique were used to examine maximal muscle activation. After training, maximum isometric torque increased significantly more in the accentuated eccentric load group than control (18 ± 10 vs. 1 ± 5%, p < 0.01), which was accompanied by an increase in voluntary activation (3.5 ± 5%, p < 0.05). Isokinetic eccentric torque increased significantly after accentuated eccentric load training only (10 ± 9%, p < 0.05), whereas concentric torque

High School Teachers' Openness to Adopting New Practices: The Role of Personal Resources and Organizational Climate.

Science.gov (United States)

Johnson, Stacy R; Pas, Elise T; Loh, Deanna; Debnam, Katrina J; Bradshaw, Catherine P

2017-03-01

Although evidence-based practices for students' social, emotional, and behavioral health are readily available, their adoption and quality implementation in schools are of increasing concern. Teachers are vital to implementation; yet, there is limited research on teachers' openness to adopting new practices, which may be essential to successful program adoption and implementation. The current study explored how perceptions of principal support, teacher affiliation, teacher efficacy, and burnout relate to teachers' openness to new practices. Data came from 2,133 teachers across 51 high schools. Structural equation modeling assessed how organizational climate (i.e., principal support and teacher affiliation) related to teachers' openness directly and indirectly via teacher resources (i.e., efficacy and burnout). Teachers with more favorable perceptions of both principal support and teacher affiliation reported greater efficacy, and, in turn, more openness; however, burnout was not significantly associated with openness. Post hoc analyses indicated that among teachers with high levels of burnout, only principal support related to greater efficacy, and in turn, higher openness. Implications for promoting teachers' openness to new program adoption are discussed.

Greater autonomy at work

NARCIS (Netherlands)

Houtman, I.L.D.

2004-01-01

In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities

Variation in performance measure criteria significantly affects cardiology practice rankings: Insights from the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence Registry.

Science.gov (United States)

Eapen, Zubin J; Tang, Fengming; Jones, Phil G; Maddox, Thomas M; Oetgen, William J; Spertus, John A; Rumsfeld, John S; Heidenreich, Paul A; Peterson, Eric D; Drozda, Joseph P

2015-06-01

Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over 5 years by improving cardiovascular prevention. An important tool in the success of programs like Million Hearts is public ranking on the quality of practices, yet different measures may provide different rankings, so the true quality of practices is difficult to discern. We evaluated the quality of ambulatory cardiology care using performance measure metrics. We compared rankings of practices participating in the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence Registry using measures from (1) the physician quality reporting system and (2) the American College of Cardiology/American Heart Association/Physician Consortium for Performance Improvement. We compared achievement rates for measures between the 2 frameworks and determined correlations in rankings using Spearman correlation coefficients. From January 1, 2008 to December 31, 2012, there were 1,711,326 patients enrolled from 111 US practices. Among eligible patients, the physician quality reporting system and American College of Cardiology/American Heart Association/Physician Consortium for Performance Improvement measures were achieved in 76.1% versus 77.4% for antiplatelet prescription (P performance and failing to achieve public health goals. Copyright © 2015 Elsevier Inc. All rights reserved.

Caries treatment in a dental practice-based research network

DEFF Research Database (Denmark)

Gilbert, Gregg H; Gordan, Valeria V; Funkhouser, Ellen M

2012-01-01

OBJECTIVES: Practice-based research networks (PBRNs) provide a venue to foster evidence-based care. We tested the hypothesis that a higher level of participation in a dental PBRN is associated with greater stated change toward evidence-based practice. METHODS: A total of 565 dental PBRN practitio......OBJECTIVES: Practice-based research networks (PBRNs) provide a venue to foster evidence-based care. We tested the hypothesis that a higher level of participation in a dental PBRN is associated with greater stated change toward evidence-based practice. METHODS: A total of 565 dental PBRN......) of 36.0 (3.8) months later. A total of 224 were 'full participants' (enrolled in clinical studies and attended at least one network meeting); 181 were 'partial participants' (did not meet 'full' criteria). RESULTS: From 10% to 62% of practitioners were 'surgically invasive' at baseline, depending...

Getting to uptake: do communities of practice support the implementation of evidence-based practice?

Science.gov (United States)

Barwick, Melanie A; Peters, Julia; Boydell, Katherine

2009-02-01

Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario's children's mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. CoPs present a promising model for translating EBP knowledge and promoting practice change in children's mental health that requires further study.

Moderate Versus Light Pressure Massage Therapy Leads to Greater Weight Gain in Preterm Infants

Science.gov (United States)

Field, Tiffany; Diego, Miguel A.; Hernandez-Reif, Maria; Deeds, Osvelia; Figuereido, Barbara

2007-01-01

Sixty-eight preterm infants (M GA=3Owks.) were randomly assigned to a moderate or to a light pressure massage therapy group to receive 15 massages 3 times per day for 5 days. Behavior state, stress behaviors and heart rate were recorded for 15 minutes before and during the first 15-minute therapy session. Weight gain was recorded over the 5 day therapy period. The moderate versus light pressure massage group gained significantly more weight per day. During the behavior observations the moderate versus light pressure massage group showed significantly lower increases from the pre-session to the session recording on: 1) active sleep; 2) fussing; 3) crying; 4) movement; and 5) stress behavior (hiccupping). They also showed a smaller decrease in deep sleep, a greater decrease in heart rate and a greater increase in vagal tone. Thus, the moderate pressure massage therapy group appeared to be more relaxed and less aroused than the light pressure massage group which may have contributed to the greater weight gain of the moderate pressure massage therapy group. PMID:17138310

Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

Science.gov (United States)

Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

2016-01-01

limitations of our study include that it represents a single institution. The low number of infiltrations included in this study, for this guidance procedure, is another bias. This ultrasound-guided infiltration technique appears to be feasible, safe, non-ionizing, and fast when targeting the greater occipital nerve in its intermediate portion. This imaging guidance modality should be used in routine clinical practice. Greater occipital nerve, infiltration, ultrasound guidance, corticosteroids, occipital neuralgia, craniofacial pain syndrome.

Misinterpretation of the strategic significance of cost driver analysis: evidence from management accounting theory and practice

Directory of Open Access Journals (Sweden)

Henry T Palowski

2011-06-01

Full Text Available This paper traces the development of cost driver theory in the Strategy literature and reflects on misinterpretations of the strategic significance of the theory in related academic disciplines, notably Management Accounting. Management Accounting has largely been responsible for informing costing practice in a wide range of organizational settings. The paper considers one such application- i.e. the case of the Higher Education Funding Council’s (HEFC costing and pricing initiative for UK universities. The project was completed just under five years ago, although details of implementation are still ongoing, to a degree. The systems in place incorporate most of the theoretical flaws outlined in this paper. Rather than providing cost driver analysis to aid the strategic management process in universities, the system appears to represent little more than a compliance and reporting framework between university central administrations and the funding provider, HEFC.

Practical session assessments in human anatomy: Weightings and performance.

Science.gov (United States)

McDonald, Aaron C; Chan, Siew-Pang; Schuijers, Johannes A

2016-07-08

Assessment weighting within a given module can be a motivating factor for students when deciding on their commitment level and time given to study a specific topic. In this study, an analysis of assessment performances of second year anatomy students was performed over four years to determine if (1) students performed better when a higher weighting was given to a set of practical session assessments and (2) whether an improved performance in the practical session assessments had a carry-over effect on other assessment tasks within that anatomy module and/or other anatomy modules that follow. Results showed that increasing the weighting of practical session assessments improved the average mark in that assessment and also improved the percentage of students passing that assessment. Further, it significantly improved performance in the written end-semester examination within the same module and had a carry-over effect on the anatomy module taught in the next teaching period, as students performed better in subsequent practical session assessments as well as subsequent end-semester examinations. It was concluded that the weighting of assessments had significant influences on a student's performance in that, and subsequent, assessments. It is postulated that practical session assessments, designed to develop deep learning skills in anatomy, improved efficacy in student performance in assessments undertaken in that and subsequent anatomy modules when the weighting of these assessments was greater. These deep learning skills were also transferable to other methods of assessing anatomy. Anat Sci Educ 9: 330-336. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

Characterization of Greater-Than-Class C sealed sources. Volume 3, Sealed sources held by general licensees

International Nuclear Information System (INIS)

Harris, G.

1994-09-01

This is the third volume in a series of three volumes characterizing the population of sealed sources that may become greater-than-Class C low-level radioactive waste (GTCC LLW). In this volume, those sources possessed by general licensees are discussed. General-licensed devices may contain sealed sources with significant amounts of radioactive material. However, the devices are designed to be safe to use without special knowledge of radiological safety practices. Devices containing Am-241 or Cm-244 sources are most likely to become GTCC LLW after concentration averaging. This study estimates that there are about 16,000 GTCC devices held by general licensees; 15,000 of these contain Am-241 sources and 1,000 contain Cm-244 sources. Additionally, this study estimates that there are 1,600 GTCC devices sold to general licensees each year. However, due to a lack of available information on general licensees in Agreement States, these estimates are uncertain. This uncertainty is quantified in the low and high case estimates given in this report, which span approximately an order of magnitude

Gratitude is associated with greater levels of protective factors and lower levels of risks in African American adolescents.

Science.gov (United States)

Ma, Mindy; Kibler, Jeffrey L; Sly, Kaye

2013-10-01

The literature suggests gratitude is associated with positive youth development. The current study examined the relationship between gratitude and protective/risk factors among African American youth. Adolescents (N = 389; 50.4% males) ages 12-14 completed measures of gratitude (moral affect and life-orientation), protective factors (e.g., academic and activity engagement, family relationship), and high-risk behaviors (e.g., sexual attitudes and behaviors, drug/alcohol use). Results indicated greater moral affect gratitude was the only variable significantly associated with greater academic interest, better academic performance, and more extra-curricular activity engagement. Greater moral affect and life-orientation gratitude both significantly correlated with positive family relationship. Greater life-orientation gratitude was the only variable significantly associated with abstinence from sexual intimacy, sexual intercourse, likelihood of engaging in sex during primary school, and abstinence from drug/alcohol use. The findings suggest that moral affect gratitude may enhance protective factors while life-orientation gratitude may buffer against high-risk behaviors among African American youth. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Standard practice for examination of fiberglass reinforced plastic fan blades using acoustic emission

CERN Document Server

American Society for Testing and Materials. Philadelphia

2010-01-01

1.1 This practice provides guidelines for acoustic emission (AE) examinations of fiberglass reinforced plastic (FRP) fan blades of the type used in industrial cooling towers and heat exchangers. 1.2 This practice uses simulated service loading to determine structural integrity. 1.3 This practice will detect sources of acoustic emission in areas of sensor coverage that are stressed during the course of the examination. 1.4 This practice applies to examinations of new and in-service fan blades. 1.5 This practice is limited to fan blades of FRP construction, with length (hub centerline to tip) of less than 3 m [10 ft], and with fiberglass content greater than 15 % by weight. 1.6 AE measurements are used to detect emission sources. Other nondestructive examination (NDE) methods may be used to evaluate the significance of AE sources. Procedures for other NDE methods are beyond the scope of this practice. 1.7 Units—The values stated in either SI units or inch-pound units are to be regarded separately as sta...

SOARing Into Strategic Planning: Engaging Nurses to Achieve Significant Outcomes.

Science.gov (United States)

Wadsworth, Barbara; Felton, Fiona; Linus, Rita

2016-01-01

In 2013, a new system chief nursing officer engaged the nursing leaders and staff in an Appreciative Inquiry process utilizing strengths, opportunities, aspirations, and results (SOAR), and a Journey of Excellence to assess and understand the current environment. The ultimate goal was to engage all nurses in strategic planning and goal setting to connect their patient care to the system strategic initiatives. This work led to the creation of a nursing vision, a revised professional practice model and greater council alignment, resulting in significant positive change and ongoing advancement throughout the system. The shared decision-making structure was key to the process with a direct connection of each council's goals, leading to the successful achievement of 34 of the 36 goals in 2 years. This article outlines the process, tools, and staff engagement strategies used to achieve system-wide success. This methodology has improved the outcomes across the organization in both small and system-wide work groups. This work can easily be replicated and adapted to help disparate staffs brought together through mergers or acquisitions to become aligned as a new team. This process, model, and framework, provides structure and results in significant outcomes that recognizes and celebrates the work of individual entities while aligning future strategies and goals.

State-Granted Practice Authority: Do Nurse Practitioners Vote with Their Feet?

OpenAIRE

Perry, John J.

2012-01-01

Nurse practitioners have become an increasingly important part of the US medical workforce as they have gained greater practice authority through state-level regulatory changes. This study investigates one labor market impact of this large change in nurse practitioner regulation. Using data from the National Sample Survey of Registered Nurses and a dataset of state-level nurse practitioner prescribing authority, a multivariate estimation is performed analysing the impact of greater practice a...

Effects of an influenza prevention program using non-pharmaceutical prevention measures to improve the knowledge, attitudes and practices of elementary school students in Nakhon Phanom province, Thailand.

Science.gov (United States)

Mangklakeeree, Nutcharat; Pinitsoontorn, Somdej; Srisaenpang, Sompong

2013-07-04

We evaluated an influenza prevention educational program using educational media, e-books and cartoons conducted among students in grades 4 through 6. The course was 8 hours long. The study was conducted at 4 schools; 230 students at each school were in the experimental group and 224 students at each school were in the control group (no educational intervention). The data were analyzed using the Wilcoxon matched-pair signed-rank test. The students in the experimental group had significantly greater knowledge (p<0.001), attitudes (p<0.001) and practices (p<0.001) scores after the intervention. However, the control group also had significantly greater knowledge (p<0.001) and attitudes (p<0.001) scores but not practices scores (p = 0.326). Further studies are needed to determine the factors that influenced these differences.

Practice for use of a dichromate dosimetry system

International Nuclear Information System (INIS)

2003-01-01

This practice covers the preparation, testing, and procedure for using the acidic aqueous silver dichromate dosimetry system to measure absorbed dose in water when exposed to ionizing radiation. The system consists of a dosimeter and appropriate analytical instrumentation. For simplicity, the system will be referred to as the dichromate system. It is classified as a reference standard dosimetry system (see ISO/ASTM Guide 51261). This practice describes the spectrophotometric analysis procedures for the dichromate system. This practice applies only to γ-rays, x-rays/ bremsstrahlung, and high energy electrons. This practice applies provided the following conditions are satisfied: the absorbed dose range is from 2x10 3 to 5x10 4 Gy; the absorbed dose rate does not exceed 600 Gy/pulse (12.5 pulses per second), or does not exceed an equivalent dose rate of 7.5 kGy/s from continuous sources; for radionuclide gamma-ray sources, the initial photon energy shall be greater than 0.6 MeV. For bremsstrahlung photons, the initial energy of the electrons used to produce the bremsstrahlung photons shall be equal to or greater than 2 MeV. For electron beams, the initial electron energy shall be greater than 8 MeV; the irradiation temperature of the dosimeter shall be above 0 deg C and should be below 80 deg C

Protecting your practice.

Science.gov (United States)

Kerr, Joseph

2015-01-01

Dentists have much invested in their practices. They need to protect their practices from fraud and noncompliance. The author provides practical suggestions for how to significantly reduce the risk of fraud and theft in the practice without disrupting day-to-day operations. By adhering to nonintrusive policy and procedure changes, dental practice owners can reduce inherent risks of fraud and theft, while increasing financial and human resource knowledge regarding their practice. Practice owners with the appropriate policies and procedures benefit from significantly lower risk of loss from fraud and theft. Furthermore, they have a better understanding of their practice's finances and human resources. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Shaping Up the Practice of Null Hypothesis Significance Testing.

Science.gov (United States)

Wainer, Howard; Robinson, Daniel H.

2003-01-01

Discusses criticisms of null hypothesis significance testing (NHST), suggesting that historical use of NHST was reasonable, and current users should read Sir Ronald Fisher's applied work. Notes that modifications to NHST and interpretations of its outcomes might better suit the needs of modern science. Concludes that NHST is most often useful as…

Adolescent Literacy Practices and Positive Youth Development through Fink's Taxonomy of Significant Learning

Science.gov (United States)

Taylor-Greathouse, Paula

2013-01-01

The purpose of this study was not to disprove the effects of the current, common remedial literacy course design and the literacy practices within that help adolescent RLLs pass statewide assessment tests, but to describe the potential long-term impact of an innovative comprehensive approach to literacy (CAL) framed through an integrated course…

On-farm biosecurity practices and causes of preweaning mortality in Canadian commercial mink kits.

Science.gov (United States)

Compo, Nicole; Pearl, David L; Tapscott, Brian; Storer, Amanda; Hammermueller, Jutta; Brash, Marina; Turner, Patricia V

2017-09-08

Mink are an important animal commodity group in Canada and excessive kit mortality represents a significant loss to production. National biosecurity standards have been developed for Canadian mink farms, but it is unclear how well these standards have been implemented as there are no studies correlating management practices of mink producers with causes of death in mink kits. To that end, we surveyed Ontario mink producers on their biosecurity and management practices and conducted almost 5660 post mortem examinations on found-dead, preweaned kits to characterize mink farm biosecurity practices and causes of death in preweaned kits. We found that very few biosecurity and management practices were uniformly used by producers, despite good awareness of appropriate practices. Use of personal protective equipment was implemented by fewer than 50% of respondents, while control of mink shed access, disinfection of feed containers after use, and use of a rodent control program were the only practices implemented by greater than 70% of respondents. Only 18% of producers reported regular use of antimicrobials in feed or water, although 91% stated they used antimicrobials for treatment of bacterial diseases on a regular basis. On post mortem examination, no gross abnormalities were noted in 71% of the kits, 45% were thought to be stillborn or aborted, 27% had some form of abnormal fluid distribution in the body, and 2% had a congenital malformation. A subset of 69 gastrointestinal tract samples was submitted for bacterial culture, of which 45 samples yielded sufficient growth. Most interesting was the identification of Salmonella enterica serovar Heidelberg in 11% of samples. The results of this study will provide a benchmark for Canadian mink producers and their veterinarians, defining the areas to which greater attention should be given to ensure more rigorous biosecurity practices are in place. Ultimately, these improvements in practices may contribute to increased mink

Socio-economic considerations of cleaning Greater Vancouver's air

International Nuclear Information System (INIS)

2005-08-01

Socio-economic considerations of better air quality on the Greater Vancouver population and economy were discussed. The purpose of the study was to provide socio-economic information to staff and stakeholders of the Greater Vancouver Regional District (GVRD) who are participating in an Air Quality Management Plan (AQMP) development process and the Sustainable Region Initiative (SRI) process. The study incorporated the following methodologies: identification and review of Canadian, American, and European quantitative socio-economic, cost-benefit, cost effectiveness, competitiveness and health analyses of changes in air quality and measures to improve air quality; interviews with industry representatives in Greater Vancouver on competitiveness impacts of air quality changes and ways to improve air quality; and a qualitative analysis and discussion of secondary quantitative information that identifies and evaluates socio-economic impacts arising from changes in Greater Vancouver air quality. The study concluded that for the Greater Vancouver area, the qualitative analysis of an improvement in Greater Vancouver air quality shows positive socio-economic outcomes, as high positive economic efficiency impacts are expected along with good social quality of life impacts. 149 refs., 30 tabs., 6 appendices

Gender trends in dental practice patterns. A review of current U.S. literature.

Science.gov (United States)

Dolan, T A

1991-01-01

This paper reviews three recent reports of national gender trends in dental practice patterns. Although the three independent cross-sectional studies were conducted at different points in time, used different sampling strategies, and used similar but independent survey instruments, findings were consistent across studies. In summary: Women dentists are less likely to be married and have fewer children. Women are more likely to assume child rearing and household responsibilities. Women are less likely to be practice owners. Women worked slightly fewer hours per week and weeks per year, and were more likely to take a leave of absence for illness or child rearing. However, women dentists demonstrate a far greater professional work commitment than was previously reported in the literature. Women earn significantly less income from the practice of dentistry, even after controlling for age, practice ownership, hours worked per week, and other personal characteristics. The most current "Gender Wage Gap" estimates range from 57.7% for specialists to 75.4% for general practitioners (8). delta.

UT ARMPA Map 2.2 Biologically Significant Units

Data.gov (United States)

Department of the Interior — This data set was created to depict “biologically significant units” (BSU) from the BLM Greater Sage-Grouse Land Use Planning Strategy – Utah Sub-Region. This data...

Complex interventions required to comprehensively educate allied health practitioners on evidence-based practice

Directory of Open Access Journals (Sweden)

Dizon JM

2011-05-01

Full Text Available Janine Margarita Dizon1,2, Karen Grimmer-Somers11International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia; 2University of Santo Tomas, Manila, PhilippinesAbstract: There is currently no strong evidence regarding the most effective training approach for allied health professionals that will support them to consistently apply the best research evidence in daily practice. Current evidence-based practice training tends to be 'one size fits all', and is unlikely to be appropriate for all allied health disciplines because of the variability in their tasks and scope of practice. The scant body of evidence regarding the effectiveness of evidence-based practice training for allied health practitioners provides some support for improving knowledge and skills, but equivocal evidence about influencing behaviors and attitudes. We propose a new model of evidence-based practice training, based on the concept of complex interventions reported in the literature. We believe that by offering training in evidence-based practice based on complex interventions relevant to the needs of the attendees, using fixed and variable components, there may be greater success in significantly influencing knowledge skills, attitudes, and behaviors.Keywords: complex interventions, evidence-based practice training, allied health

Infant feeding practices in a high HIV prevalence rural district of ...

African Journals Online (AJOL)

Keywords: infant feeding practices; exclusive breast-feeding; mixed feeding; HIV. Infant feeding practices in ... HIV pandemic has fuelled further research and policy development ..... offer important nutritional benefits over breast milk. • Greater ...

Physician opportunity costs for performing practice-based research.

Science.gov (United States)

Hahn, D L

2000-11-01

An inverse association has been documented between the magnitude of patient care responsibilities (health maintenance organization penetration) and the amount of clinical research produced by academic medical centers. The output of academic family practice research is affected by this calculus. This article presents evidence that current market-place demands to increase patient care services may have an even greater impact on nonacademic family practice clinician researchers involved in practice-based research (PBR).

Greater trochanteric pain syndrome diagnosis and treatment.

Science.gov (United States)

Mallow, Michael; Nazarian, Levon N

2014-05-01

Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Nutrition strategies before and during ultra-endurance event: A significant gap between science and practice.

Science.gov (United States)

Papadopoulou, S K; Xyla, E E; Methenitis, S; Feidantsis, K G; Kotsis, Y; Pagkalos, I G; Hassapidou, M N

2018-03-01

The purpose of this study was to investigate and assess the nutritional practices of open-water swimmers, during the preparation period and the competition, as well as their implications on performance and anthropometric parameters according to their age. Twenty-four (n = 24) men open-water swimmers, twelve young (26.3 ± 4.9 years) and twelve older athletes (45.8 ± 9.7 years), participated in this study. Nutritional behavior-energy intake consumption, and anthropometric characteristics were evaluated prior to the Toroneos Gulf crossing (26 km). In addition, nutritional intakes during the race and anthropometrics after the race were also evaluated. Significant differences between the two groups were found for Toroneos Gulf crossing performance, BMI, and all variables of body composition at the preparation period (P nutritional intakes during the preparation period and the competition, and athletes' performance. In summary, this study provides strong evidence about the malnutrition of ultra-endurance swimmers prior and during their competition, with potential dangers for their health and performance as certain deficiencies in both macro- and micronutrient contents are present. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

From the "metaphysics of the individual" to the critique of society: on the practical significance of Michel Henry's phenomenology of life.

Science.gov (United States)

Staudigl, Michael

This essay explores the practical significance of Michel Henry's "material phenomenology." Commencing with an exposition of his most basic philosophical intuition, i.e., his insight that transcendental affectivity is the primordial mode of revelation of our selfhood, the essay then brings to light how this intuition also establishes our relation to both the world and others. Animated by a radical form of the phenomenological reduction, Henry's material phenomenology brackets the exterior world in a bid to reach the concrete interior transcendental experience at the base of all exteriority. The essay argues that this "counter reduction," designed as a practical orientation to the world, suspends all traditional parameters of onto(theo)logical individuation in order to rethink subjectivity in terms of its transcendental corporeality, i.e., in terms of the invisible display of "affective flesh." The development of this "metaphysics of the individual" anchors his "practical philosophy" as he developed it-under shifting accents-throughout his oeuvre. In particular, the essay brings into focus Henry's reflections on modernity, the industry of mass culture and their "barbaric" movements. The essay briefly puts these cultural and political areas of Henry's of thinking into contact with his late "theological turn," i.e., his Christological account of Life and the (inter)subjective self-realization to which it gives rise.

Blended learning with Moodle in medical statistics: an assessment of knowledge, attitudes and practices relating to e-learning.

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Luo, Li; Cheng, Xiaohua; Wang, Shiyuan; Zhang, Junxue; Zhu, Wenbo; Yang, Jiaying; Liu, Pei

2017-09-19

Blended learning that combines a modular object-oriented dynamic learning environment (Moodle) with face-to-face teaching was applied to a medical statistics course to improve learning outcomes and evaluate the impact factors of students' knowledge, attitudes and practices (KAP) relating to e-learning. The same real-name questionnaire was administered before and after the intervention. The summed scores of every part (knowledge, attitude and practice) were calculated using the entropy method. A mixed linear model was fitted using the SAS PROC MIXED procedure to analyse the impact factors of KAP. Educational reform, self-perceived character, registered permanent residence and hours spent online per day were significant impact factors of e-learning knowledge. Introversion and middle type respondents' average scores were higher than those of extroversion type respondents. Regarding e-learning attitudes, educational reform, community number, Internet age and hours spent online per day had a significant impact. Specifically, participants whose Internet age was no greater than 6 years scored 7.00 points lower than those whose Internet age was greater than 10 years. Regarding e-learning behaviour, educational reform and parents' literacy had a significant impact, as the average score increased 10.05 points (P learning KAP. Additionally, this type of blended course can be implemented in many other curriculums.

Operational technology for greater confinement disposal

International Nuclear Information System (INIS)

Dickman, P.T.; Vollmer, A.T.; Hunter, P.H.

1984-12-01

Procedures and methods for the design and operation of a greater confinement disposal facility using large-diameter boreholes are discussed. It is assumed that the facility would be located at an operating low-level waste disposal site and that only a small portion of the wastes received at the site would require greater confinement disposal. The document is organized into sections addressing: facility planning process; facility construction; waste loading and handling; radiological safety planning; operations procedures; and engineering cost studies. While primarily written for low-level waste management site operators and managers, a detailed economic assessment section is included that should assist planners in performing cost analyses. Economic assessments for both commercial and US government greater confinement disposal facilities are included. The estimated disposal costs range from $27 to $104 per cubic foot for a commercial facility and from $17 to $60 per cubic foot for a government facility. These costs are based on average site preparation, construction, and waste loading costs for both contact- and remote-handled wastes. 14 figures, 22 tables

Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease

Directory of Open Access Journals (Sweden)

Yonghyun Kim

2017-10-01

Full Text Available Background/Aims: Although the role of capsule endoscopy (CE in Crohn's disease (CD has expanded, CE is not used routinely for diagnosing and evaluating CD in Korea. We aimed to investigate current patterns of practice and evaluate the clinical significance of the use of CE in CD in Korean patients.Methods: Among 651 CE procedures performed for various indications, we retrospectively analyzed the medical records of patients who underwent CE in 57 cases of suspected CD (sCD and 14 cases of established CD (eCD.Results: In the sCD group, CE was most commonly used for the initial diagnosis of CD (54.4%. Capsule retention was found in only 1 patient in the eCD group (1/71, 1.4%. In the sCD group, 28.1% of patients were diagnosed with CD on the basis of CE findings; other diseases diagnosed included tuberculous enteritis (7.0%, non-steroidal anti-inflammatory drug-induced enteropathy (5.3%, and other enteritis (17.5%. Only 11.5% of patients with eCD (14/122 underwent CE. The indication for CE in the 14 patients with eCD was to assess disease extent and activity. The overall diagnostic yield of CE was 59.7%. Therapeutic strategies were changed in 70.2% of patients in the sCD group and 50% of those in the eCD group based on CE findings.Conclusions: In clinical practice, CE was most commonly indicated for the initial diagnosis of CD and was not generally performed in patients with eCD. CE appears to be an effective diagnostic modality for evaluating sCD and is useful for determining therapeutic strategies for patients with sCD and those with eCD.

Health Practice in Long-Term Survivors of Hodgkin's Lymphoma

International Nuclear Information System (INIS)

Ng, Andrea K.; Li Sigui; Recklitis, Christopher; Diller, Lisa R.; Neuberg, Donna; Silver, Barbara; Mauch, Peter M.

2008-01-01

Purpose: To compare the health practice of Hodgkin's lymphoma (HL) survivors and their siblings, and to assess the impact of socioeconomic status and disease history on health practice of HL survivors. Methods and Materials: We conducted a questionnaire study on long-term HL survivors and their siblings on health care utilization, health habits, and screening behavior. Results: A total of 511 HL survivors (response rate of 50%, including survivors lost to contact) and 224 siblings (response rate, 58%) participated. Median time from HL diagnosis was 15 years. Significantly more survivors than siblings had a physical examination in the past year (63% vs. 49%, p = 0.0001). Male survivors were significantly more likely than siblings to perform monthly self-testicular examinations (19% vs. 9%, p = 0.02). Among survivors, higher household income (p = 0.01) independently predicted for having had a physical examination in the past year. Lower educational level (p = 0.0004) and history of relapsed HL (p = 0.03) were independent predictors for smoking, moderate/heavy alcohol use, and/or physical inactivity. Conclusions: Compared with siblings, long-term HL survivors have a higher level of health care utilization and better screening practice. Survivors from lower socioeconomic background had lower adherence to routine health care and greater report of unhealthy habits. Survivors with history of relapsed HL were also more likely to engage in unhealthy habits

Variation in clinical practice: forests and trees revisited.

Science.gov (United States)

Wallis, Christopher J D; Naylor, C David; Detsky, Allan S

2017-09-01

Variations in clinical practice are commonly viewed as a sign of uneven quality of care and attributed to provider self-interest. However, patient preferences, physician practice patterns, and diagnostic and therapeutic uncertainty also cause variations. Greater attention to both doctor-patient interactions and limits to the available evidence might enable more effective assessment and improvement of health-care quality.

Investigating the efficacy of practical skill teaching: a pilot-study comparing three educational methods.

Science.gov (United States)

Maloney, Stephen; Storr, Michael; Paynter, Sophie; Morgan, Prue; Ilic, Dragan

2013-03-01

Effective education of practical skills can alter clinician behaviour, positively influence patient outcomes, and reduce the risk of patient harm. This study compares the efficacy of two innovative practical skill teaching methods, against a traditional teaching method. Year three pre-clinical physiotherapy students consented to participate in a randomised controlled trial, with concealed allocation and blinded participants and outcome assessment. Each of the three randomly allocated groups were exposed to a different practical skills teaching method (traditional, pre-recorded video tutorial or student self-video) for two specific practical skills during the semester. Clinical performance was assessed using an objective structured clinical examination (OSCE). The students were also administered a questionnaire to gain the participants level of satisfaction with the teaching method, and their perceptions of the teaching methods educational value. There were no significant differences in clinical performance between the three practical skill teaching methods as measured in the OSCE, or for student ratings of satisfaction. A significant difference existed between the methods for the student ratings of perceived educational value, with the teaching approaches of pre-recorded video tutorial and student self-video being rated higher than 'traditional' live tutoring. Alternative teaching methods to traditional live tutoring can produce equivalent learning outcomes when applied to the practical skill development of undergraduate health professional students. The use of alternative practical skill teaching methods may allow for greater flexibility for both staff and infrastructure resource allocation.

Simulation-Based Mastery Learning with Deliberate Practice Improves Clinical Performance in Spinal Anesthesia

Directory of Open Access Journals (Sweden)

Ankeet D. Udani

2014-01-01

Full Text Available Introduction. Properly performing a subarachnoid block (SAB is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents’ next three patients were evaluated in the operating room (OR. Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P<0.02. The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P<0.03. The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear.

Simulation-based mastery learning with deliberate practice improves clinical performance in spinal anesthesia.

Science.gov (United States)

Udani, Ankeet D; Macario, Alex; Nandagopal, Kiruthiga; Tanaka, Maria A; Tanaka, Pedro P

2014-01-01

Introduction. Properly performing a subarachnoid block (SAB) is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents' next three patients were evaluated in the operating room (OR). Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P < 0.02). The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P < 0.03). The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear.

Practice for use of a ceric-cerous sulfate dosimetry system

International Nuclear Information System (INIS)

2002-01-01

This practice covers the preparation, testing, and procedure for using the ceric-cerous sulfate dosimetry system to measure absorbed dose in water when exposed to ionizing radiation. The system consists of a dosimeter and appropriate analytical instrumentation. For simplicity, the system will be referred to as the ceric-cerous system. It is classified as a reference standard dosimetry system (see ISO/ASTM Guide 51261). Ceric-cerous dosimeters are also used as transfer-standard dosimeters or routine dosimeters. This practice describes both the spectrophotometric and the potentiometric readout procedures for the ceric-cerous systems. This practice applies only to g rays, X rays, and high energy electrons. This practice applies provided the following are satisfied: The absorbed-dose range shall be between 5x10 2 and 5x10 4 Gy. The absorbed-dose rate shall be less than 10 6 Gy/s. For radionuclide gamma-ray sources, the initial photon energy shall be greater than 0.6 MeV. For bremsstrahlung photons, the initial energy of the electrons used to produce the bremsstrahlung photons shall be equal to or greater than 2 MeV. For electron beams, the initial electron energy shall be greater than 8 MeV. The irradiation temperature of the dosimeter shall be between 0 and 62 deg C

Greater trochanteric fracture with occult intertrochanteric extension.

Science.gov (United States)

Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

2013-10-01

Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

Age-related practice effects across longitudinal neuropsychological assessments in older people with schizophrenia.

Science.gov (United States)

Granholm, Eric; Link, Peter; Fish, Scott; Kraemer, Helena; Jeste, Dilip

2010-09-01

The relationship between aging and practice effects on longitudinal neuropsychological assessments was investigated in middle-aged and older people with schizophrenia and healthy controls. Older people with schizophrenia (n = 107; M age = 56.1) and age-comparable nonpsychiatric controls (n = 107; M age = 57.7) were scheduled to receive annual assessments on a comprehensive battery of neuropsychological tests for an average of 2.5 years (range 11 months to 4 years). Mixed-model analyses were used to separately examine the effects of practice and age on test performance. Number of prior assessments (practice) was associated with significant performance improvement across assessments, whereas older age was associated with significant decline in performance. The groups did not differ significantly in extent of age-related cognitive decline, but a three-way interaction among group, age, and practice was found, such that greater age-related decline in practice effects were found for older people with schizophrenia relative to nonpsychiatric participants. This study did not find any evidence of neurodegenerative age-related decline in neuropsychological abilities in middle-aged and older people with schizophrenia, but older age was associated with diminished ability to benefit from repeated exposure to cognitive tasks in people with schizophrenia. Cognitive impairment in schizophrenia may combine with cognitive decline associated with normal aging to reduce practice effects in older patients. These findings have important implications for the design of studies examining the longitudinal trajectory of cognitive functioning across the life span of people with schizophrenia, as well as clinical trials that attempt to demonstrate cognitive enhancement in these individuals. Copyright 2010 APA, all rights reserved.

SUSTAINABLE AGRICULTURE New practices bring lasting food ...

International Development Research Centre (IDRC) Digital Library (Canada)

2010-11-16

Nov 16, 2010 ... Since 1970, IDRC-supported research has introduced sustainable agricultural practices to farmers and communities across the developing world. The result: higher productivity, less poverty, greater food security, and a healthier environment.

Power, effects, confidence, and significance: an investigation of statistical practices in nursing research.

Science.gov (United States)

Gaskin, Cadeyrn J; Happell, Brenda

2014-05-01

improvement. Most importantly, researchers should abandon the misleading practice of interpreting the results from inferential tests based solely on whether they are statistically significant (or not) and, instead, focus on reporting and interpreting effect sizes, confidence intervals, and significance levels. Nursing researchers also need to conduct and report a priori power analyses, and to address the issue of Type I experiment-wise error inflation in their studies. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Conceptual and measurement issues in early parenting practices research: an epidemiologic perspective.

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Walker, Lorraine O; Kirby, Russell S

2010-11-01

Early parenting practices are significant to public health because of their linkages to child health outcomes. This paper focuses on the current state of the science regarding conceptual frameworks that incorporate early parenting practices in epidemiologic research and evidence supporting reliability and validity of self-report measures of such practices. Guided by a provisional definition of early parenting practices, literature searches were conducted using PubMed and Sociological Abstracts. Twenty-five published studies that included parent-report measures of early parenting practices met inclusion criteria. Findings on conceptual frameworks were analyzed qualitatively, whereas evidence of reliability and validity were organized into four domains (safety, feeding and oral health, development promotion, and discipline) and summarized in tabular form. Quantitative estimates of measures of reliability and validity were extracted, where available. We found two frameworks incorporating early parenting: one a program theory and the other a predictive model. We found no reported evidence of the reliability or validity of parent-report measures of safety or feeding and oral health practices. Evidence for reliability and validity were reported with greater frequency for development promotion and discipline practices, but report of the most pertinent type of reliability estimation, test-retest reliability, was rare. Failure to examine associations of early parenting practices with any child outcomes within most studies resulted in missed opportunities to indirectly estimate validity of parenting practice measures. Stronger evidence concerning specific measurement properties of early parenting practices is important to advancing maternal-child research, surveillance, and practice.

The Greater Sekhukhune-CAPABILITY outreach project.

Science.gov (United States)

Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold

2013-07-01

The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.

Disordered eating practices in gastrointestinal disorders.

Science.gov (United States)

Satherley, R; Howard, R; Higgs, S

2015-01-01

To systematically review evidence concerning disordered eating practices in dietary-controlled gastrointestinal conditions. Three key questions were examined: a) are disordered eating practices a feature of GI disorders?; b) what abnormal eating practices are present in those with GI disorders?; and c) what factors are associated with the presence of disordered eating in those with GI disorders? By exploring these questions, we aim to develop a conceptual model of disordered eating development in GI disease. Five key databases, Web of Science with Conference Proceedings (1900-2014) and MEDLINE (1950-2014), PubMed, PsycINFO (1967-2014) and Google Scholar, were searched for papers relating to disordered eating practices in those with GI disorders. All papers were quality assessed before being included in the review. Nine papers were included in the review. The majority of papers reported that the prevalence of disordered eating behaviours is greater in populations with GI disorders than in populations of healthy controls. Disordered eating patterns in dietary-controlled GI disorders may be associated with both anxiety and GI symptoms. Evidence concerning the correlates of disordered eating was limited. The presence of disordered eating behaviours is greater in populations with GI disorders than in populations of healthy controls, but the direction of the relationship is not clear. Implications for further research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Pharmacy Service Orientation: a measure of organizational culture in pharmacy practice sites.

Science.gov (United States)

Clark, Bartholomew E; Mount, Jeanine K

2006-03-01

The importance of organizational culture in shaping everyday organizational life is well accepted, but little work has focused on organizational culture in pharmacy. Examining new pharmacists' experiences at various practice sites may help us to understand how these shape their professional ethos and practice habits. (1) Present development and assessment of the Pharmacy Service Orientation (PSO) measure, a tool for assessing pharmacists' impressions of pharmacy practice sites. (2) Use data gathered from a sample of new pharmacists to explore potential predictors of PSO, including type of practice site, type of pharmacy work experience, and type of pharmacy degree. Mail survey of randomly selected class of 1999 pharmacy graduates within 3 months of graduation (response rate: 259 of 1,850; 14%), each of whom reported on up to 6 different pharmacy practice sites for a total of 1,192 pharmacy observations. Pharmacy Service Orientation is scored on a 1-10 semantic differential scale and reliability was assessed using Cronbach's alpha. Predictors of PSO were explored using t test and ordinary least squares regression procedures. Reliability of the PSO across all observations was 0.86. When divided according to recency of experience and type of experience, reliabilities ranged from 0.78 to 0.87. Analysis of potential predictors of PSO showed that non-corporate-community sites had significantly greater pharmaceutical care-oriented cultures (mean PSOs of 7.42 and 5.13, respectively; PService Orientation is a reliable measure. Statistically significant differences in PSO comparisons by degree and by experience type are explained by significant differences between the PSOs of corporate-community and non-corporate-community sites.

Physical activity patterns across time-segmented youth sport flag football practice.

Science.gov (United States)

Schlechter, Chelsey R; Guagliano, Justin M; Rosenkranz, Richard R; Milliken, George A; Dzewaltowski, David A

2018-02-08

). Significantly greater %time was spent in low-energy stationary behavior in fitness (15.7 ± 3.4%) than gameplay (4.0 ± 2.9%) segments (p ≤ .01), and in sport-skill (17.6 ± 2.2%) than free-play (8.2 ± 4.2%), gameplay, and warm-up (10.6 ± 2.6%) segments (p time spent in low-energy stationary behavior and in MVPA differed by characteristics of task and setting demand of the segment. Restructuring the routine of YS practice to include segments conducive to MVPA could increase %time spent in MVPA during practice. As YS reaches a large number of children worldwide, increasing PA during YS has the potential to create a public health impact.

Perceptions of the role of general practice and practical support measures for carers of stroke survivors: a qualitative study

Directory of Open Access Journals (Sweden)

Harris Ruth

2011-06-01

themselves are low and teams are seen as reactive and time constrained. Both the carers and the general practice team participants emphasised the valuable role of general practice team in supporting stroke survivors. Research is needed to determine general practice teams' awareness and identification of carers and of the difficulties they encounter supporting stroke carers. Carer policy initiatives need greater specificity with greater attention to diversity in carer needs.

Integrating Science into Management of Ecosystems in the Greater Blue Mountains

Science.gov (United States)

Chapple, Rosalie S.; Ramp, Daniel; Bradstock, Ross A.; Kingsford, Richard T.; Merson, John A.; Auld, Tony D.; Fleming, Peter J. S.; Mulley, Robert C.

2011-10-01

Effective management of large protected conservation areas is challenged by political, institutional and environmental complexity and inconsistency. Knowledge generation and its uptake into management are crucial to address these challenges. We reflect on practice at the interface between science and management of the Greater Blue Mountains World Heritage Area (GBMWHA), which covers approximately 1 million hectares west of Sydney, Australia. Multiple government agencies and other stakeholders are involved in its management, and decision-making is confounded by numerous plans of management and competing values and goals, reflecting the different objectives and responsibilities of stakeholders. To highlight the complexities of the decision-making process for this large area, we draw on the outcomes of a recent collaborative research project and focus on fire regimes and wild-dog control as examples of how existing knowledge is integrated into management. The collaborative research project achieved the objectives of collating and synthesizing biological data for the region; however, transfer of the project's outcomes to management has proved problematic. Reasons attributed to this include lack of clearly defined management objectives to guide research directions and uptake, and scientific information not being made more understandable and accessible. A key role of a local bridging organisation (e.g., the Blue Mountains World Heritage Institute) in linking science and management is ensuring that research results with management significance can be effectively transmitted to agencies and that outcomes are explained for nonspecialists as well as more widely distributed. We conclude that improved links between science, policy, and management within an adaptive learning-by-doing framework for the GBMWHA would assist the usefulness and uptake of future research.

The relationship between age, rotator cuff integrity, and osseous microarchitecture of greater tuberosity: Where should we put anchor?

Science.gov (United States)

Kholinne, Erica; Lee, Hyun Joo; Kim, Sung Jung; Park, So Hyun; Jeon, In-Ho

2018-01-01

The aim of this study was to compare the microarchitecture of the greater tuberosity with or without rotator cuff tear and to obtain optimum location for anchor screw insertion for rotator cuff repair. Twenty-five humeral heads were harvested from 13 male cadavers of mean age 58.4 years, including 6 humeri with rotator cuff tear and 19 intact humeri. Six regions of interest (proximal, intermediate, and distal zones of the superficial and deep regions) were divided into the anterior (G1), middle (G2), and posterior (G3) areas of the greater tuberosity. Trabecular bone volume and cortical thickness were evaluated. Total trabecular bone volume was greater in subjects 50 years old but did not differ significantly in subjects with and without rotator cuff tear. Cortical thickness in both intact and torn rotator cuff groups was significantly greater in the proximal and intermediate zones than in the distal zone. Cortical thickness was related to anatomic location rather than age or cuff tear. The optimal location for anchor screw insertion during rotator cuff repair is either the proximal or intermediate region of the greater tuberosity. Age has more influence in terms of trabecular bone volume loss than rotator cuff integrity. Copyright © 2017. Production and hosting by Elsevier B.V.

Evidence-based practice: the importance of education and leadership.

Science.gov (United States)

Johansson, Birgitta; Fogelberg-Dahm, Marie; Wadensten, Barbro

2010-01-01

To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors. Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance. All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire. The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities. The present study highlights the value of education in research methods and the importance of supportive leadership. Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.

The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.

Science.gov (United States)

Brody, Stuart; Krüger, Tillmann H C

2006-03-01

Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.

Emergency nurses' current practices and understanding of family presence during CPR.

LENUS (Irish Health Repository)

Madden, Eilis

2012-02-03

PURPOSE: To examine emergency nurses\\' current practices and understanding of family presence during CPR in the emergency department, Cork University Hospital, Republic of Ireland. METHOD: A quantitative descriptive design was used in the study. A questionnaire developed by ENA was distributed to emergency nurses working in a level I trauma emergency department at Cork University Hospital. The total sample number was 90, including all emergency nurses with at least 6 months\\' emergency nursing experience. RESULTS: Emergency nurses often took families to the bedside during resuscitation efforts (58.9%) or would do so if the opportunity arose (17.8%). A high percentage (74.4%) of respondents would prefer a written policy allowing the option of family presence during CPR. The most significant barrier to family witnessed resuscitation (FWR) was conflicts occurring within the emergency team. The most significant facilitator to FWR was a greater understanding of health care professionals on the benefits of FWR to patients and families, indicating the need for educational development. CONCLUSION: The findings of the study and previously published studies indicate the need for development of written polices and guidelines on the practice to meet the needs of patients, families, and staff by providing consistent, safe, and caring practices for all involved in the resuscitation process. Recommendations of the study include the development of a written policy and an educational programme on the safe implementation and practices of FWR.

Social vulnerability to heat in Greater Atlanta, USA: spatial pattern of heat, NDVI, socioeconomics and household composition

Science.gov (United States)

Sim, Sunhui

2017-10-01

The purpose of the article is evaluating spatial patterns of social vulnerability to heat in Greater Atlanta in 2015. The social vulnerability to heat is an index of socioeconomic status, household composition, land surface temperature and normalized differential vegetation index (NDVI). Land surface temperature and NDVI were derived from the red, NIR and thermal infrared (TIR) of a Landsat OLI/TIRS images collected on September 14, 2015. The research focus is on the variation of heat vulnerability in Greater Atlanta. The study found that heat vulnerability is highly clustered spatially, resulting in "hot spots" and "cool spots". The results show significant health disparities. The hotspots of social vulnerability to heat occurred in neighborhoods with lower socioeconomic status as measured by low education, low income and more poverty, greater proportion of elderly people and young children. The findings of this study are important for identifying clusters of heat vulnerability and the relationships with social factors. These significant results provide a basis for heat intervention services.

Standard practice for examination of seamless, Gas-Filled, pressure vessels using acoustic emission

CERN Document Server

American Society for Testing and Materials. Philadelphia

2009-01-01

1.1 This practice provides guidelines for acoustic emission (AE) examinations of seamless pressure vessels (tubes) of the type used for distribution or storage of industrial gases. 1.2 This practice requires pressurization to a level greater than normal use. Pressurization medium may be gas or liquid. 1.3 This practice does not apply to vessels in cryogenic service. 1.4 The AE measurements are used to detect and locate emission sources. Other nondestructive test (NDT) methods must be used to evaluate the significance of AE sources. Procedures for other NDT techniques are beyond the scope of this practice. See Note 1. Note 1—Shear wave, angle beam ultrasonic examination is commonly used to establish circumferential position and dimensions of flaws that produce AE. Time of Flight Diffraction (TOFD), ultrasonic examination is also commonly used for flaw sizing. 1.5 The values stated in inch-pound units are to be regarded as the standard. The values given in parentheses are for information only. 1.6 This standa...

Effects of different irrigation practices using treated wastewater on tomato yields, quality, water productivity, and soil and fruit mineral contents.

Science.gov (United States)

Demir, Azize Dogan; Sahin, Ustun

2017-11-01

Wastewater use in agricultural irrigation is becoming a common practice in order to meet the rising water demands in arid and semi-arid regions. The study was conducted to determine the effects of the full (FI), deficit (DI), and partial root-zone drying (PRD) irrigation practices using treated municipal wastewater (TWW) and freshwater (FW) on tomato yield, water use, fruit quality, and soil and fruit heavy metal concentrations. The TWW significantly increased marketable yield compared to the FW, as well as decreased water consumption. Therefore, water use efficiency (WUE) in the TWW was significantly higher than in the FW. Although the DI and the PRD practices caused less yields, these practices significantly increased WUE values due to less irrigation water applied. The water-yield linear relationships were statistically significant. TWW significantly increased titratable acidity and vitamin C contents. Reduced irrigation provided significantly lower titratable acidity, vitamin C, and lycopene contents. TWW increased the surface soil and fruit mineral contents in response to FW. Greater increases were observed under FI, and mineral contents declined with reduction in irrigation water. Heavy metal accumulation in soils was within safe limits. However, Cd and Pb contents in fruits exceeded standard limits given by FAO/WHO. Higher metal pollution index values determined for fruits also indicated that TWW application, especially under FI, might cause health risks in long term.

Technical concept for a greater-confinement-disposal test facility

International Nuclear Information System (INIS)

Hunter, P.H.

1982-01-01

Greater confinement disposal (GCO) has been defined by the National Low-Level Waste Program as the disposal of low-level waste in such a manner as to provide greater containment of radiation, reduce potential for migration or dispersion or radionuclides, and provide greater protection from inadvertent human and biological intrusions in order to protect the public health and safety. This paper discusses: the need for GCD; definition of GCD; advantages and disadvantages of GCD; relative dose impacts of GCD versus shallow land disposal; types of waste compatible with GCD; objectives of GCD borehole demonstration test; engineering and technical issues; and factors affecting performance of the greater confinement disposal facility

Organizational attributes of practices successful at a disease management program.

Science.gov (United States)

Cloutier, Michelle M; Wakefield, Dorothy B; Tsimikas, John; Hall, Charles B; Tennen, Howard; Brazil, Kevin

2009-02-01

To assess the contribution of organizational factors to implementation of 3 asthma quality measures: enrollment in a disease management program, development of a written treatment plan, and prescription of severity-appropriate anti-inflammatory therapy. A total of 138 pediatric clinicians and 247 office staff in 13 urban clinics and 23 nonurban private practices completed questionnaires about their practice's organizational characteristics (eg, leadership, communication, perceived effectiveness, job satisfaction). 94% of the clinicians and 92% of the office staff completed questionnaires. When adjusted for confounders, greater practice activity and perceived effectiveness in meeting family needs were associated with higher rates of enrollment in the Easy Breathing program, whereas higher scores for 3 organizational characteristics--communication timeliness, decision authority, and job satisfaction--were associated with both higher enrollment and a greater number of written treatment plans. None of the organizational characteristics was associated with greater use of anti-inflammatory therapy. Three organizational characteristics predicted 2 quality asthma measures: use of a disease management program and creation of a written asthma treatment plan. If these organizational characteristics were amenable to change, then our findings could help focus interventions in areas of effective and acceptable organizational change.

The effect of badminton-specific exercise on badminton short-serve performance in competition and practice climates.

Science.gov (United States)

Duncan, Michael J; Chan, Cheryl K Y; Clarke, Neil D; Cox, Martin; Smith, Mike

2017-03-01

This study examined the effects of changes in physiological and psychological arousal on badminton short-serve performance in competitive and practice climates. Twenty competitive badminton players (10 males and 10 females) volunteered to participate in the study following ethics approval. After familiarisation, badminton short-serve performance was measured at rest, mid-way through and at the end of a badminton-specific exercise protocol in two conditions; competition vs. practice. Ratings of cognitive and somatic anxiety were assessed at three time points prior to badminton short-serve performance using the Mental Readiness Form 3. Heart rate and rating of perceived exertion (RPE) were assessed during the exercise protocol. Results indicated that better short-serve performance was evident in practice compared to competition (P = .034). RPE values were significantly higher in the competition condition compared to practice (P = .007). Cognitive anxiety intensity was significantly lower post-exercise in the practice condition compared to competition (P = .001). Cognitive anxiety direction showed greater debilitation post-exercise in the competition condition compared to practice (P = .01). Somatic anxiety intensity increased from pre-, to mid- to post-exercise (P = .001) irrespective of condition. This study suggests that badminton serve performance is negatively affected when physiological arousal, via badminton-specific exercise, and cognitive anxiety, via perceived competition, are high.

Relationship between width of greater trochanters and width of iliac wings in tronchanteric bursitis.

Science.gov (United States)

Viradia, Neal K; Berger, Alex A; Dahners, Laurence E

2011-09-01

Trochanteric bursitis is a common disorder that is characterized by inflammation of the bursa, superficial to the greater trochanter of the femur, leading to pain in the lateral hip, and often occurs because of acute trauma or repetitive friction involving the iliotibial band, the greater trochanter, and the bursa. In the study reported here, we hypothesized that the increased incidence of bursitis may be the result of the increased prominence of the trochanter in relation to the wings of the iliac crest. Distances between the outermost edges of trochanters and iliac wings were measured in 202 patients from the University of North Carolina Health Care System-101 without a known diagnosis and 101 with a clinical diagnosis of trochanteric bursitis. To determine significance, t tests for nonpaired data were used. Mean (SD) difference between trochanter and iliac wing widths was 28 (20) mm in the group diagnosed with trochanteric bursitis and 17 (18) mm in the control group. The difference between the groups in this regard was significant (Pbursitis group and 1.05 (.06) in the control group. The difference between these groups was significant (Pbursitis.

Retrieval-practice task affects relationship between working memory capacity and retrieval-induced forgetting.

Science.gov (United States)

Storm, Benjamin C; Bui, Dung C

2016-11-01

Retrieving a subset of items from memory can cause forgetting of other items in memory, a phenomenon referred to as retrieval-induced forgetting (RIF). Individuals who exhibit greater amounts of RIF have been shown to also exhibit superior working memory capacity (WMC) and faster stop-signal reaction times (SSRTs), results which have been interpreted as suggesting that RIF reflects an inhibitory process that is mediated by the processes of executive control. Across four experiments, we sought to further elucidate this issue by manipulating the way in which participants retrieved items during retrieval practice and examining how the resulting effects of forgetting correlated with WMC (Experiments 1-3) and SSRT (Experiment 4). Significant correlations were observed when participants retrieved items from an earlier study phase (within-list retrieval practice), but not when participants generated items from semantic memory (extra-list retrieval practice). These results provide important new insight into the role of executive-control processes in RIF.

Can genetically based clines in plant defence explain greater herbivory at higher latitudes?

Science.gov (United States)

Anstett, Daniel N; Ahern, Jeffrey R; Glinos, Julia; Nawar, Nabanita; Salminen, Juha-Pekka; Johnson, Marc T J

2015-12-01

Greater plant defence is predicted to evolve at lower latitudes in response to increased herbivore pressure. However, recent studies question the generality of this pattern. In this study, we tested for genetically based latitudinal clines in resistance to herbivores and underlying defence traits of Oenothera biennis. We grew plants from 137 populations from across the entire native range of O. biennis. Populations from lower latitudes showed greater resistance to multiple specialist and generalist herbivores. These patterns were associated with an increase in total phenolics at lower latitudes. A significant proportion of the phenolics were driven by the concentrations of two major ellagitannins, which exhibited opposing latitudinal clines. Our analyses suggest that these findings are unlikely to be explained by local adaptation of herbivore populations or genetic variation in phenology. Rather greater herbivory at high latitudes can be explained by latitudinal clines in the evolution of plant defences. © 2015 John Wiley & Sons Ltd/CNRS.

Interest and satisfaction of dentists in practicing periodontics: A survey based on treatment of gingival recession.

Science.gov (United States)

Grover, Vishakha; Kapoor, Anoop; Malhotra, Ranjan; Sachdeva, Sonia

2012-07-01

Gingival recession is a common occurrence and patients often report to dental clinic with associated problems such as root surface hypersensitivity, esthetic concerns, cervical root abrasions, and root caries that make it a concern for patients. Based upon the fact that gingival recession is an enigma for clinicians because of multitude of etiological factors and plethora of treatment modalities present for its treatment, a survey was conducted to assess knowledge as well as opinion about most common etiology, classification, and preferred treatment of gingival recession and to evaluate the interest and satisfaction of dentists in practicing periodontics. Study design consisted of a cross-sectional online survey, conducted among dentists practicing in state of Punjab, India, in the month of April 2011. A structured online questionnaire consisting of 17 questions evaluating the interest of dentists in periodontics based on knowledge about gingival recession (most of them giving the possibility of multiple choices of answers) was sent to about 300 dentists. Pearson Chi-Square and Mann-Whitney U tests were used for statistical analysis of data collected. P ≤ 0.05 was considered as statistically significant and P ≤ 0.01 considered as highly significant. A greater proportion of periodontists had better knowledge about etiology (P = 0.07), classification (P = 0.000), and treatment of gingival recession (P = 0.000). A greater number of periodontists opted for the surgical modalities to correct the defects produced by gingival recession as compared to non-periodontists and had better interest (P = 0.000) and satisfaction (P = 0.000) in practicing periodontics. The results elucidated that periodontists had better interest and satisfaction in practicing periodontics, and were more inclined towards surgical correction of gingival recession as compared to non-periodontists.

Laboratory Survey of Significant Bacteriuria in a Family Practice Clinic

African Journals Online (AJOL)

This study was carried out to determine the causative agents of significant bacteriuria and their antibiotic sensitivity pattern. ... high rate of antibiotic resistance suggest that many patients in this population will probably benefit more from treatment of UTI based on routine antibiotic sensitivity testing rather than empiric therapy.

Searching for Elements of Evidence-based Practices in Children’s Usual Care and Examining their Impact

Science.gov (United States)

Garland, Ann F.; Accurso, Erin C.; Haine-Schlagel, Rachel; Brookman-Frazee, Lauren; Roesch, Scott; Zhang, Jin Jin

2014-01-01

Objective Most of the knowledge generated to bridge the research - practice gap has been derived from experimental studies implementing specific treatment models. Alternatively, this study uses observational methods to generate knowledge about community-based treatment processes and outcomes. Aims are to (1) describe outcome trajectories for children with disruptive behavior problems (DBPs), and (2) test how observed delivery of a benchmark set of practice elements common in evidence-based (EB) treatments may be associated with outcome change, while accounting for potential confounding variables. Method Participants included 190 children ages 4–13 with DBPs and their caregivers, plus 85 psychotherapists, recruited from six clinics. All treatment sessions were video-taped and a random sample of four sessions in the first four months of treatment was reliably coded for intensity on 27 practice elements (benchmark set and others). Three outcomes (child symptom severity, parent discipline, and family functioning) were assessed by parent report at intake, four, and eight months. Data were collected on several potential covariates including child, parent, therapist, and service use characteristics. Multi-level modeling was used to assess relationships between observed practice and outcome slopes, while accounting for covariates. Results Children and families demonstrated improvements in all three outcomes, but few significant associations between treatment processes and outcome change were identified. Families receiving greater intensity on the benchmark practice elements did demonstrate greater improvement in the parental discipline outcome. Conclusion Observed changes in outcomes for families in community care were generally not strongly associated with the type or amount of treatment received. PMID:24555882

The Practice of Midwifery in Rural US Hospitals.

Science.gov (United States)

Kozhimannil, Katy B; Henning-Smith, Carrie; Hung, Peiyin

2016-07-01

Workforce shortages limit access to care for pregnant women in rural and remote areas. The goal of this analysis was to describe the role of certified nurse-midwives (CNMs) in providing maternity care in rural US hospitals and to examine state-level variation in rural CNM practice. We identified 306 rural hospitals with at least 10 births in 2010 using discharge data from the Statewide Inpatient Databases for 9 US states. We conducted a telephone survey of hospital maternity unit managers (N = 244) from November 2013 to March 2014 to understand their maternity care workforce and practice models. We describe the presence of CNMs attending births by hospital and state characteristics. Using logistic multivariate regression, we examined whether CNMs attend births, adjusting for hospital characteristics, practice regulations, and state. We also analyzed the content of open-ended responses about staffing plans, challenges, and opportunities that unit managers identified, with a focus on midwifery practice. CNMs attend births at one-third of rural maternity hospitals in 9 US states. Significant variability across states appears to be partially related to autonomous practice regulations: states allowing autonomous midwifery practice have a greater proportion of rural hospitals with midwives attending births (34% vs 28% without autonomous midwifery practice). In rural maternity hospitals, CNMs practice alongside obstetricians in 86%, and with family physicians in 44%, of hospitals. Fourteen percent of all respondents planned recruitment to increase the number of midwives at their hospital, although many, especially in smaller hospitals, noted challenges in doing so. CNMs play a crucial role in the maternity care workforce in rural US hospitals. The participation of CNMs in birth attendance varies by hospital birth volume and across state settings. Interprofessional practice is common for CNMs attending births in rural hospitals, and administrators hope to increase the

Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

Science.gov (United States)

Steele, Joseph R; Schomer, Don F

2009-07-01

Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.

Independent Planning System and Public Administration in Metropolitan Development: Agglomeration Strategies of Greater Chaoshan in Southern China

Directory of Open Access Journals (Sweden)

Tian Guang

2017-04-01

Full Text Available This paper examines independent planning system as a means of public administration in regional economic development. It proposes a new strategy based on the theories of public administrative resources, to agglomerate and unify the cities of Shantou, Jieyang, and Chaozhou into a new administrative entity as a metropolis with the status of independent planning and the preferred policies of a Special Economic Region to lead regional development. The optimal allocation of public administrative resources has played a key role in the fundamental economic development in China in recent years. The new administrative system of large cities (metropolises with independent planning has become an innovative format to utilize the renewable soft resources of administration, which in fact is a new attempt to reform the economic system by the Chinese government. The greater Chaoshan area needs to be agglomerated and unified to further develop the regional economy with the implementation of independent planning system. The current research conducted from a practical and political point of view is of significant value to the overall planning and strategic layout of the economic and social development of the whole eastern Guangdong region.

Circumpolar variation in morphological characteristics of Greater White-fronted Geese Anser albifrons

Science.gov (United States)

Ely, Craig R.; Fox, A.D.; Alisauskas, R.T.; Andreev, A.; Bromley, R.G.; Degtyarev, Andrei G.; Ebbinge, B.; Gurtovaya, E.N.; Kerbes, R.; Kondratyev, Alexander V.; Kostin, I.; Krechmar, A.V.; Litvin, K.E.; Miyabayashi, Y.; Moou, J.H.; Oates, R.M.; Orthmeyer, D.L.; Sabano, Yutaka; Simpson, S.G.; Solovieva, D.V.; Spindler, Michael A.; Syroechkovsky, Y.V.; Takekawa, John Y.; Walsh, A.

2005-01-01

Capsule: Greater White-fronted Geese show significant variation in body size from sampling locations throughout their circumpolar breeding range. Aims: To determine the degree of geographical variation in body size of Greater White-fronted Geese and identify factors contributing to any apparent patterns in variation. Methods: Structural measures of >3000 geese from 16 breeding areas throughout the Holarctic breeding range of the species were compared statistically. Results: Palearctic forms varied clinally, and increased in size from the smallest forms on the Kanin and Taimyr peninsulas in western Eurasia to the largest forms breeding in the Anadyr Lowlands of eastern Chukotka. Clinal variation was less apparent in the Nearctic, as both the smallest form in the Nearctic and the largest form overall (the Tule Goose) were from different breeding areas in Alaska. The Tule Goose was 25% larger than the smallest form. Birds from Greenland (A. a. flavirostris) were the second largest, although only slightly larger than geese from several North American populations. Body size was not correlated with breeding latitude but was positively correlated with temperature on the breeding grounds, breeding habitat, and migration distance. Body mass of Greater White-fronted Geese from all populations remained relatively constant during the period of wing moult. Morphological distinctness of eastern and western Palearctic forms concurs with earlier findings of complete range disjunction. Conclusions: Patterns of morphological variation in Greater White-fronted Geese across the Holarctic can be generally attributed to adaptation to variable breeding environments, migration requirements, and phylo-geographical histories. 

Significant prolongation of segmental pancreatic allograft survival in two species

Energy Technology Data Exchange (ETDEWEB)

Du Toit, D.F.; Heydenrych, J.J.

1988-06-01

A study was conducted to assess the suppression of segmental pancreatic allograft rejection by cyclosporine (CSA) alone in baboons and dogs, and subtotal marrow irradiation (TL1) alone and TL 1 in combination with CSA in baboons. Total pancreatectomy in the dog and primate provided a reliable diabetic model, induced an absolute deficiency of insulin and was uniformly lethal if not treated. Continuous administration of CSA in baboons resulted in modest allograft survival. As in baboons, dogs receiving CSA 25 mg/kg/d rendered moderate graft prolongation but a dose of 40 mg/kg/d resulted in significant graft survival (greater than 100 days) in 5 of 8 allograft recipients. Irradiation alone resulted in minimal baboon pancreatic allograft survival of 20 baboons receiving TL1 1,000 rad and CSA, 3 had graft survival greater than of 100 days. Of 15 baboons receiving TL1 800 rad and CSA, 6 had graft survival of greater than 100 days. In conclusion, CSA administration in dogs and TL1 in combination with CSA in baboons resulted in highly significant segmental pancreatic allograft survival.

Significant prolongation of segmental pancreatic allograft survival in two species

International Nuclear Information System (INIS)

Du Toit, D.F.; Heydenrych, J.J.

1988-01-01

A study was conducted to assess the suppression of segmental pancreatic allograft rejection by cyclosporine (CSA) alone in baboons and dogs, and subtotal marrow irradiation (TL1) alone and TL 1 in combination with CSA in baboons. Total pancreatectomy in the dog and primate provided a reliable diabetic model, induced an absolute deficiency of insulin and was uniformly lethal if not treated. Continuous administration of CSA in baboons resulted in modest allograft survival. As in baboons, dogs receiving CSA 25 mg/kg/d rendered moderate graft prolongation but a dose of 40 mg/kg/d resulted in significant graft survival (greater than 100 days) in 5 of 8 allograft recipients. Irradiation alone resulted in minimal baboon pancreatic allograft survival of 20 baboons receiving TL1 1,000 rad and CSA, 3 had graft survival greater than of 100 days. Of 15 baboons receiving TL1 800 rad and CSA, 6 had graft survival of greater than 100 days. In conclusion, CSA administration in dogs and TL1 in combination with CSA in baboons resulted in highly significant segmental pancreatic allograft survival

Assessing Climate Vulnerabilities of Food Distribution Center Sites in Greater Boston and Their Regional Implications: Climate Adaptation Planning in Practice

Science.gov (United States)

Teferra, A.; Watson, C.; Douglas, E. M.

2016-12-01

The Metro Boston region, an area whose civic leaders have been at the forefront of climate resilience initiatives in recent years, is finalizing a flood vulnerability assessment of food distribution center sites located north of Boston, with the support of the University of Massachusetts Boston and the American Geophysical Union's Thriving Earth Exchange program. The community-scientist collaboration emerged because of the need for more local analyses of the area to inform climate resiliency policy and planning actions for the region. A significant amount of the metro region's food supply passes through two major distribution centers in the cities of Everett and Chelsea, just north of the Mystic River. The Metropolitan Area Planning Council (MAPC), on behalf of the Metro Boston Climate Preparedness Taskforce, is working with Chris Watson and Ellen Douglas of UMass Boston to build on existing analyses of the region's food system and climate vulnerabilities and to develop a report identifying flood risk exposure to the sites. The analysis brings in dynamic modeling techniques that incorporate storm surge and sea level rise projections under different climate scenarios, and aims to align methodologies with those of other regional analyses, such as Climate Ready Boston and the City of Cambridge's Vulnerability Assessment. The study is helping to inform MAPC's and the Metro Boston Climate Preparedness Taskforce's understanding of this critical food distribution infrastructure, illustrate the larger regional implications of climate impacts on food distribution in the Greater Boston area, and guide the development of site-specific strategies for addressing identified vulnerabilities.

Developing clinical leaders: the impact of an action learning mentoring programme for advanced practice nurses.

Science.gov (United States)

Leggat, Sandra G; Balding, Cathy; Schiftan, Dan

2015-06-01

To determine whether a formal mentoring programme assists nurse practitioner candidates to develop competence in the clinical leadership competencies required in their advanced practice roles. Nurse practitioner candidates are required to show evidence of defined clinical leadership competencies when they apply for endorsement within the Australian health care system. Aiming to assist the candidates with the development or enhancement of these leadership skills, 18 nurse practitioner candidates participated in a mentoring programme that matched them with senior nurse mentors. A pre-postlongitudinal intervention study. Eighteen nurse practitioner candidates and 17 senior nurses participated in a voluntary mentoring programme that incorporated coaching and action learning over 18 months in 2012 and 2013. Participants completed a pen and paper questionnaire to document baseline measures of self-reported leadership practices prior to commencement of the programme and again at the end of the programme. The mentors and the nurse practitioner candidates qualitatively evaluated the programme as successful and quantitative data illustrated significant improvement in self-reported leadership practices among the nurse practitioner candidates. In particular, the nurse practitioner candidates reported greater competence in the transformational aspects of leadership, which is directly related to the nurse practitioner candidate clinical leadership standard. A formal, structured mentoring programme based on principles of action learning was successful in assisting Australian advanced practice nurses enhance their clinical leadership skills in preparation for formal endorsement as a nurse practitioner and for success in their advanced practice role. Mentoring can assist nurses to transition to new roles and develop knowledge and skills in clinical leadership essential for advanced practice roles. Nurse managers should make greater use of mentoring programmes to support nurses in

Practices used in Israel by nurses who care during hospitalization for older patients with dementia or who are bedridden.

Science.gov (United States)

Iecovich, Esther; Rabin, Barbara

2014-03-01

The study's purpose was to examine (a) bedside nurses' care practices when providing care to patients with dementia or those who are physically disabled and (b) the extent to which these actions vary by type of hospital, type of ward, and nurse's characteristics. The sample included 265 nurses in internal medicine and geriatric wards in 2 general hospitals in Israel. The results showed that the most prevalent practices were giving greater attention to these patients, locating them in a room near the nurses' station and asking family members to stay with the patient or to hire paid carers. Use of restraints was more prevalent in patients with dementia than those who were physically disabled. Use of specific practices significantly varied by type of ward and hospital, suggesting that nurses' care practices are more connected with organizational characteristics than other factors.

Greater rate of cephalic screw mobilisation following proximal femoral nailing in hip fractures with a tip-apex distance (TAD) and a calcar referenced TAD greater than 25 mm.

Science.gov (United States)

Aicale, Rocco; Maffulli, Nicola

2018-05-02

To ascertain whether the tip-apex distance (TAD), calcar referenced TAD (CalTAD), and the sum of both (TADcalTAD) are predictive measurements of mobilisation of the cephalic screw in patients with trochanteric hip fractures. Between 2014 and 2015, 68 patients (mean age 86 years, 45 females, 23 males) with a trochanteric hip fracture underwent intramedullary nailing. The TAD and CalTAD were measured, and for each parameter, we calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). There is evidence of a statistically significant association between a TAD and CalTAD greater than 25 mm and a TADcalTAD greater than 50 mm and mobilisation of the cephalic screw. All measurements have similar sensitivity, but the TAD presents the highest specificity (p TAD and CalTAD less than 25 mm and a TADcalTAD less than 50 mm when using intramedullary fixation.

Practicing the Test Produces Strength Equivalent to Higher Volume Training.

Science.gov (United States)

Mattocks, Kevin T; Buckner, Samuel L; Jessee, Matthew B; Dankel, Scott J; Mouser, J Grant; Loenneke, Jeremy P

2017-09-01

To determine if muscle growth is important for increasing muscle strength or if changes in strength can be entirely explained from practicing the strength test. Thirty-eight untrained individuals performed knee extension and chest press exercise for 8 wk. Individuals were randomly assigned to either a high-volume training group (HYPER) or a group just performing the one repetition maximum (1RM) strength test (TEST). The HYPER group performed four sets to volitional failure (~8RM-12RM), whereas the TEST group performed up to five attempts to lift as much weight as possible one time each visit. Data are presented as mean (90% confidence interval). The change in muscle size was greater in the HYPER group for both the upper and lower bodies at most but not all sites. The change in 1RM strength for both the upper body (difference of -1.1 [-4.8, 2.4] kg) and lower body (difference of 1.0 [-0.7, 2.8] kg for dominant leg) was not different between groups (similar for nondominant). Changes in isometric and isokinetic torque were not different between groups. The HYPER group observed a greater change in muscular endurance (difference of 2 [1,4] repetitions) only in the dominant leg. There were no differences in the change between groups in upper body endurance. There were between-group differences for exercise volume (mean [95% confidence interval]) of the dominant (difference of 11,049.3 [9254.6-12,844.0] kg) leg (similar for nondominant) and chest press with the HYPER group completing significantly more total volume (difference of 13259.9 [9632.0-16,887.8] kg). These findings suggest that neither exercise volume nor the change in muscle size from training contributed to greater strength gains compared with just practicing the test.

The impact of professional development on classroom teaching for science educators participating in a long term community of practice

Science.gov (United States)

Jensen, Aaron C.

Efforts to modify and improve science education in the United States have seen minimal success (Crawford, 2000; Borko & Putman, 1996; Puntambekar, Stylianou & Goldstein, 2007; Lustick, 2011). One important reason for this is the professional development that teachers go through in order to learn about and apply these new ideas is generally of poor quality and structured incorrectly for long-term changes in the classroom (Little, 1993; Fullen, 1996; Porter, 2000; Jeanpierre, Oberhauser, & Freeman, 2005). This grounded theory study explores a science community of practice and how the professional development achieved through participation in that community has effected the instruction of the teachers involved, specifically the incorporation of researched based effective science teaching instructional strategies. This study uses personal reflection papers written by the participants, interviews, and classroom observations to understand the influence that the science community of practice has had on the participants. Results indicate that participation in this science community of practice has significant impact on the teachers involved. Participants gained greater understanding of science content knowledge, incorporated effective science instructional strategies into their classroom, and were able to practice both content knowledge and strategies in a non-threatening environment thus gaining a greater understanding of how to apply them in the classrooms. These findings motivate continued research in the role that communities of practice may play in teacher professional develop and the effectiveness of quality professional development in attaining long-term, sustained improvement in science education.

Greater Proptosis Is Not Associated With Improved Compressive Optic Neuropathy in Thyroid Eye Disease.

Science.gov (United States)

Nanda, Tavish; Dunbar, Kristen E; Campbell, Ashley A; Bathras, Ryan M; Kazim, Michael

2018-05-18

Despite the paucity of supporting data, it has generally been held that proptosis in thyroid eye disease (TED) may provide relative protection from compressive optic neuropathy (CON) by producing spontaneous decompression. The objective of this study was to investigate this phenomenon in patients with bilateral TED-CON. We retrospectively reviewed the charts of 67 patients (134 orbits) with bilateral TED-CON at Columbia-Presbyterian Medical Center. Significant asymmetric proptosis (Hertel) was defined as ≥ 2 mm. Significant asymmetric CON was defined first, as the presence of an relative afferent pupillary defect. Those without an relative afferent pupillary defect were evaluated according to the TED-CON formula y = -0.69 - 0.31 × (motility) - 0.2 × (mean deviation) - 0.02 × (color vision) as previously established for the diagnosis of TED-CON. A difference in the formula result ≥ 1.0 between eyes was considered significant. Patients were then divided into 4 groups. Forty-one of 67 patients demonstrated asymmetric CON (29 by relative afferent pupillary defect, 12 by formula). Twenty-one of 67 patients demonstrated asymmetric proptosis. Only 5 of 12 (41.6%) of the patients who had both asymmetric proptosis and asymmetric CON (group 1) showed greater proptosis in the eye with less CON. Twenty-nine patients (group 2) showed that asymmetric CON occurred despite symmetrical proptosis. Seventeen patients (group 3), showed the inverse, that asymmetric differences in proptosis occurred with symmetrical CON. Despite commonly held assumptions, our results suggest that greater proptosis is not associated with improved TED-CON. Combining groups 1 to 3-all of which demonstrated asymmetry of either proptosis, CON, or both-91.4% of patients did not show a relationship between greater proptosis and improved CON.

Aspartame intake is associated with greater glucose intolerance in individuals with obesity.

Science.gov (United States)

Kuk, Jennifer L; Brown, Ruth E

2016-07-01

This study examined whether sucrose, fructose, aspartame, and saccharin influences the association between obesity and glucose tolerance in 2856 adults from the NHANES III survey. Aspartame intake significantly influenced the association between body mass index (BMI) and glucose tolerance (interaction: P = 0.004), wherein only those reporting aspartame intake had a steeper positive association between BMI and glucose tolerance than those reporting no aspartame intake. Therefore, consumption of aspartame is associated with greater obesity-related impairments in glucose tolerance.

Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions

Directory of Open Access Journals (Sweden)

Morteza Safi

2017-07-01

Full Text Available Introduction: The present study aimed at assessing the role of lesion length in predicting Fractional Flow Reserve (FFR value for physiological evaluation of intermediate coronary lesions.Methods: In the current study, 68 patients with 83 coronary lesions were enrolled. All of the patients in this study underwent routine coronary angiography, according to appropriate indications. To evaluate physiologically significant intermediate coronary stenosis (defined between 40% and 70% on visual estimation, the Fractional Flow Reserve (FFR study was performed and the Quantitative Coronary Angiography (QCA data were also assessed for measurement of lesion length. The correlation between QCA data and FFR values was also examined.Results: Eighty-three lesions were evaluated from 68 patients. Stenosis was considered physiologically significant when FFR was lower than 0.75. The FFR was significant in twelve lesions (14.5%. There was a negative correlation between FFR value and lesion length (r = -0.294 and P = 0.013. Moreover, lesion length in physiologically significant FFR group (21.07  ± 6.9 was greater than that of the non-significant FFR group (15.23 ± 6.5 (P value < 0.05. Furthermore, the correlation between QCA data and FFR values was also investigated, yet, there was only a positive correlation between FFR and Minimum Luminal Diameter (MLD values (r = 0.248 and P value = 0.04. The Receiver Operating Characteristic (ROC curve analysis for predicting the significant FFR value demonstrated that a lesion length greater than 17.5 mm was the best cut-off point for prediction of the significant FFR value with acceptable sensitivity and specificity of 83.3% and 68.8%, respectively.Conclusions: There is a negative correlation between lesion length and FFR value in intermediate coronary lesions. In addition, a lesion length greater than 17.5 mm is the best cut- off point for prediction of significant FFR values.

Prevalence and risk factors for hyperthyroidism in Irish cats from the greater Dublin area.

Science.gov (United States)

Bree, Laura; Gallagher, Barbara A; Shiel, Robert E; Mooney, Carmel T

2018-01-01

Hyperthyroidism is common in older cats. Prevalence varies geographically, but is anecdotally considered low in Ireland. The aim of this study was to document prevalence of hyperthyroidism in older cats in the greater Dublin area of Ireland and to assess environmental and clinical associations for development and identification of the disease. Primary-care veterinary practices were requested to select cats aged 10 years or older where blood sampling was being performed for health screening or clinical investigations. Surplus serum/plasma samples were submitted to University College Dublin Diagnostic Endocrine Laboratory for total thyroxine (T 4 ) measurement. Cats were classified as hyperthyroid, equivocal or euthyroid based on a total T 4 concentration (reference interval, 15-60 nmol/L), of >60 nmol/L, 30-60 nmol/L or hyperthyroidism were excluded. A questionnaire completed by the client and veterinarian detailing historical and physical information was also required. Associations between categorical variables were analysed by Chi-square or Fisher's exact test and odds ratio (OR) calculated. A P value of hyperthyroid, 54 (10.6%) equivocal and 346 (68.2%) euthyroid. The presence of goitre ( P  weight loss ( P  hyperthyroidism. Cats with goitre were more likely to be diagnosed as hyperthyroid [OR 2.85, (95% CI 1.75-4.62] compared to those without. However, goitre was only palpated in 40 of 102 (39.2%) hyperthyroid cats. Increasing age was the only significant ( P  hyperthyroidism. A relationship between hyperthyroidism and sex, breed, lifestyle, parasite control, vaccination status or feeding habits was not identified. Hyperthyroidism is not uncommon in Irish cats. Age was the only significant risk factor for its development. The high proportion of hyperthyroid cats without palpable goitre (> 60%) may reflect failure to detect goitre and account for the perceived low prevalence of this condition in Ireland.

Fractionation of Palliative Radiation Therapy for Bone Metastases in Ontario: Do Practice Guidelines Guide Practice?

Energy Technology Data Exchange (ETDEWEB)

Ashworth, Allison [Division of Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Queen' s University, Kingston, Ontario (Canada); Cancer Center of Southeastern Ontario, Kingston, Ontario (Canada); Kong, Weidong [Division of Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Queen' s University, Kingston, Ontario (Canada); Chow, Edward [Sunnybrook Regional Cancer Centre, Toronto, Ontario (Canada); Mackillop, William J., E-mail: william.mackillop@krcc.on.ca [Division of Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Queen' s University, Kingston, Ontario (Canada); Cancer Center of Southeastern Ontario, Kingston, Ontario (Canada)

2016-01-01

Purpose: To evaluate the effect of a provincial practice guideline on the fractionation of palliative radiation therapy for bone metastases (PRT.B) in Ontario. Methods and Materials: The present retrospective study used electronic treatment records linked to Ontario's population-based cancer registry. Hierarchical multivariable regression analysis was used to evaluate temporal trends in the use of single fractions (SFs), controlling for patient-related factors associated with the use of SFs. Results: From 1984 to 2012, 43.9% of 161,835 courses of PRT.B were administered as SFs. The percentage of SF courses was greater for older patients (age <50 years, 39.8% vs age >80 years, 52.5%), those with a shorter life expectancy (survival >12 months, 36.9% vs < 1 month, 53.6%), and those who lived farther from a radiation therapy center (<10 km, 42.1% vs > 50 km, 47.3%). The percentage of SFs to spinal fields was lower than that to other skeletal sites (31.5% vs 57.1%). The percentage of SFs varied among the cancer centers (range, 26.0%-67.8%). These differences were all highly significant in the multivariable analysis (P<.0001). In 2004, Cancer Care Ontario released a practice guideline endorsing the use of SFs for uncomplicated bone metastases. The rate of use of SFs increased from 42.3% in the pre-guideline period (1999-2003) to 52.6% in the immediate post-guideline period (2004-2007). However, it subsequently decreased again to 44.0% (2009-2012). These temporal trends were significant after controlling for patient-related factors in the multivariable analysis (P<.0001). Large intercenter variations in the use of SFs persisted after publication of the guideline. Conclusions: The publication of an Ontario practice guideline endorsing the use of SF PRT.B was associated with only a transient increase in the use of SFs in Ontario and did little to reduce intercenter variations in fractionation.

Cold Water Mediates Greater Reductions in Limb Blood Flow than Whole Body Cryotherapy.

Science.gov (United States)

Mawhinney, Chris; Low, David A; Jones, Helen; Green, Daniel J; Costello, Joseph T; Gregson, Warren

2017-06-01

Cold-water immersion (CWI) and whole body cryotherapy (WBC) are widely used recovery methods in an attempt to limit exercise-induced muscle damage, soreness, and functional deficits after strenuous exercise. The aim of this study was to compare the effects of ecologically valid CWI and WBC protocols on postexercise lower limb thermoregulatory, femoral artery, and cutaneous blood flow responses. Ten males completed a continuous cycle exercise protocol at 70% maximal oxygen uptake until a rectal temperature of 38°C was attained. Participants were then exposed to lower-body CWI (8°C) for 10 min, or WBC (-110°C) for 2 min, in a randomized crossover design. Rectal and thigh skin, deep, and superficial muscle temperatures, thigh, and calf skin blood flow (laser Doppler flowmetry), superficial femoral artery blood flow (duplex ultrasound), and arterial blood pressure were measured before, and for 40 min post, cooling interventions. Greater reductions in thigh skin (CWI, -5.9°C ± 1.8°C; WBC, 0.2°C ± 0.5°C; P < 0.001) and superficial (CWI, -4.4°C ± 1.3°C; WBC, -1.8°C ± 1.1°C; P < 0.001) and deep (CWI, -2.9°C ± 0.8°C; WBC, -1.3°C ± 0.6°C; P < 0.001) muscle temperatures occurred immediately after CWI. Decreases in femoral artery conductance were greater after CWI (CWI, -84% ± 11%; WBC, -59% ± 21%, P < 0.02) and thigh (CWI, -80% ± 5%; WBC, -59% ± 14%, P < 0.001), and calf (CWI, -73% ± 13%; WBC, -45% ± 17%, P < 0.001) cutaneous vasoconstriction was greater after CWI. Reductions in rectal temperature were similar between conditions after cooling (CWI, -0.6°C ± 0.4°C; WBC, -0.6°C ± 0.3°C; P = 0.98). Greater reductions in blood flow and tissue temperature were observed after CWI in comparison with WBC. These novel findings have practical and clinical implications for the use of cooling in the recovery from exercise and injury.

REGENERATIVE DESIGN PRACTICES IN NIGERIA: A CASE ...

African Journals Online (AJOL)

User

2017-07-01

Jul 1, 2017 ... a view to effectively implement the concept within the study area. ... REGENERATIVE DESIGN PRACTICES IN NIGERIA: A CASE STUDY OF NGOZIKA HOUSING .... could mean greater acceptance of new development by the public and .... human/environment relations based on the Cartesian separation of ...

Greater temperature sensitivity of plant phenology at colder sites

DEFF Research Database (Denmark)

Prevey, Janet; Vellend, Mark; Ruger, Nadja

2017-01-01

Warmer temperatures are accelerating the phenology of organisms around the world. Temperature sensitivity of phenology might be greater in colder, higher latitude sites than in warmer regions, in part because small changes in temperature constitute greater relative changes in thermal balance...

Greater Somalia, the never-ending dream?

DEFF Research Database (Denmark)

Zoppi, Marco

2015-01-01

This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...

Quantifying Arabia-Eurasia convergence accommodated in the Greater Caucasus by paleomagnetic reconstruction

Science.gov (United States)

van der Boon, A.; van Hinsbergen, D. J. J.; Rezaeian, M.; Gürer, D.; Honarmand, M.; Pastor-Galán, D.; Krijgsman, W.; Langereis, C. G.

2018-01-01

Since the late Eocene, convergence and subsequent collision between Arabia and Eurasia was accommodated both in the overriding Eurasian plate forming the Greater Caucasus orogen and the Iranian plateau, and by subduction and accretion of the Neotethys and Arabian margin forming the East Anatolian plateau and the Zagros. To quantify how much Arabia-Eurasia convergence was accommodated in the Greater Caucasus region, we here provide new paleomagnetic results from 97 volcanic sites (∼500 samples) in the Talysh Mountains of NW Iran, that show ∼15° net clockwise rotation relative to Eurasia since the Eocene. We apply a first-order kinematic restoration of the northward convex orocline that formed to the south of the Greater Caucasus, integrating our new data with previously published constraints on rotations of the Eastern Pontides and Lesser Caucasus. This suggests that north of the Talysh ∼120 km of convergence must have been accommodated. North of the Eastern Pontides and Lesser Caucasus this is significantly more: 200-280 km. Our reconstruction independently confirms previous Caucasus convergence estimates. Moreover, we show for the first time a sharp contrast of convergence between the Lesser Caucasus and the Talysh. This implies that the ancient Paleozoic-Mesozoic transform plate boundary, preserved between the Iranian and East-Anatolian plateaus, was likely reactivated as a right-lateral transform fault since late Eocene time.

Marketing the dental practice: eight steps toward success.

Science.gov (United States)

McGuigan, Patrick J; Eisner, Alan B

2006-10-01

The authors provide a suggested framework for completing a comprehensive evaluation of practice processes and routines. Their approach focuses on improving the professional image of dentists and the methods they use to market themselves. A practice can benefit by implementing a program to understand the strengths and weaknesses of the practice and how these strengths and weaknesses affect patients' experiences. A word-of-mouth marketing campaign relies on the cultivation of opinion leaders, but opinion leaders cannot be cultivated until they have been identified. Dental practice marketing campaigns cannot be based on assumptions; they must be based on facts. Practice Implications. Improving relationships with patients will lead to increased patient retention, reduced marketing costs and greater personal satisfaction. By focusing on strengths, clinicians will improve patients' experiences in the dental office.

Physician Perception of Pay Fairness and its Association with Work Satisfaction, Intent to Leave Practice, and Personal Health.

Science.gov (United States)

Kao, Audiey C; Jager, Andrew J; Koenig, Barbara A; Moller, Arlen C; Tutty, Michael A; Williams, Geoffrey C; Wright, Scott M

2018-06-01

Primary care physicians generally earn less than specialists. Studies of other occupations have identified perception of pay fairness as a predictor of work- and life-related outcomes. We evaluated whether physicians' pay fairness perceptions were associated with their work satisfaction, turnover intention, and personal health. Three thousand five hundred eighty-nine physicians were surveyed. Agreement with "my total compensation is fair" was used to assess pay fairness perceptions. Total compensation was self-reported, and we used validated measures of work satisfaction, likelihood of leaving current practice, and health status. Hierarchical logistic regressions were used to assess the associations between pay fairness perceptions and work/life-related outcomes. A total of 2263 physicians completed surveys. Fifty-seven percent believed their compensation was fair; there was no difference between physicians in internal medicine and non-primary care specialties (P = 0.58). Eighty-three percent were satisfied at work, 70% reported low likelihood of leaving their practice, and 77% rated their health as very good or excellent. Higher compensation levels were associated with greater work satisfaction and lower turnover intention, but most associations became statistically non-significant after adjusting for pay fairness perceptions. Perceived pay fairness was associated with greater work satisfaction (OR, 4.90; 95% CI, 3.94-6.08; P pay was fair reported greater work satisfaction, lower likelihood of leaving their practice, and better overall health. Addressing pay fairness perceptions may be important for sustaining a satisfied and healthy physician workforce, which is necessary to deliver high-quality care.

The operation of a Research and Development (R&D) program and its significance for practice change in community pharmacy.

Science.gov (United States)

Hermansyah, Andi; Sainsbury, Erica; Krass, Ines

2017-01-01

Community pharmacy practice in Australia is changing and Research and Development (R&D) in community pharmacy plays an important role in contributing to the changes. A range of Cognitive Pharmacy Services (CPS) were developed from R&D programs, yet their implementation has been minimal indicating slow practice change within community pharmacy. Given the vital role of R&D, little is known about the operation and the extent to which it has been effective in supporting practice change in community pharmacy. In depth, semi-structured interviews were conducted with 27 key stakeholders in the pharmacy and healthcare system in Australia. All interviews were audio-recorded, transcribed ad verbatim and analysed using an inductive approach. Participants perceived that the R&D program has played an important role in the advent of CPS. Furthermore, they considered that evidence generated by the R&D projects is a critical influence on policy formulation, funding and implementation of CPS into practice. However, policy decisions and subsequent implementation are also influenced by other factors associated with context and facilitation which in turn foster or inhibit effective Knowledge Translation (KT) in the community pharmacy sector. While R&D programs have been viewed as essential for supporting changes in community pharmacy practice through development and funding of CPS, the overall impact has been small, as contemporary practice continues to be predominantly a dispensing model. Given the complexity and dynamic nature of the community pharmacy system, stakeholders must take into account the inter-relationship between context, evidence and facilitation for successful KT in community pharmacy practice.

Assessing Human Impacts on the Greater Akaki River, Ethiopia ...

African Journals Online (AJOL)

We assessed the impacts of human activities on the Greater Akaki River using physicochemical parameters and macroinvertebrate metrics. Physicochemical samples and macroinvertebrates were collected bimonthly from eight sites established on the Greater Akaki River from February 2006 to April 2006. Eleven metrics ...

Feminist Social Work: Practice and Theory of Practice.

Science.gov (United States)

Eyal-Lubling, Roni; Krumer-Nevo, Michal

2016-07-01

Although feminist social work has been practiced in Israel since the 1970s, little has been written about it. This qualitative study aims to fill this gap by documenting and conceptualizing feminist theory of practice and actual practice based on interviews with 12 feminist social workers. Findings reveal that the interviewees perceive feminist practice as significantly different from traditional social work practice based on four analytical principles: (1) gender analysis, (2) awareness of power relations, (3) analysis of welfare services as structures of oppression, and (4) utilization of feminist language, as well as 10 principles of action. The principles are discussed in the context of feminist social work in Israel and in light of feminist principles described in international literature.

Molecular insights into the biology of Greater Sage-Grouse

Science.gov (United States)

Oyler-McCance, Sara J.; Quinn, Thomas W.

2011-01-01

Recent research on Greater Sage-Grouse (Centrocercus urophasianus) genetics has revealed some important findings. First, multiple paternity in broods is more prevalent than previously thought, and leks do not comprise kin groups. Second, the Greater Sage-Grouse is genetically distinct from the congeneric Gunnison sage-grouse (C. minimus). Third, the Lyon-Mono population in the Mono Basin, spanning the border between Nevada and California, has unique genetic characteristics. Fourth, the previous delineation of western (C. u. phaios) and eastern Greater Sage-Grouse (C. u. urophasianus) is not supported genetically. Fifth, two isolated populations in Washington show indications that genetic diversity has been lost due to population declines and isolation. This chapter examines the use of molecular genetics to understand the biology of Greater Sage-Grouse for the conservation and management of this species and put it into the context of avian ecology based on selected molecular studies.

Rapid gene expression changes in peripheral blood lymphocytes upon practice of a comprehensive yoga program.

Directory of Open Access Journals (Sweden)

Su Qu

Full Text Available One of the most common integrative medicine (IM modalities is yoga and related practices. Previous work has shown that yoga may improve wellness in healthy people and have benefits for patients. However, the mechanisms of how yoga may positively affect the mind-body system are largely unknown. Here we have assessed possible rapid changes in global gene expression profiles in the peripheral blood mononuclear cells (PBMCs in healthy people that practiced either a comprehensive yoga program or a control regimen. The experimental sessions included gentle yoga postures, breathing exercises, and meditation (Sudarshan Kriya and Related Practices--SK&P compared with a control regimen of a nature walk and listening to relaxing music. We show that the SK&P program has a rapid and significantly greater effect on gene expression in PBMCs compared with the control regimen. These data suggest that yoga and related practices result in rapid gene expression alterations which may be the basis for their longer term cell biological and higher level health effects.

INDUSTRIAL LAND DEVELOPMENT AND MANUFACTURING DECONCENTRATION IN GREATER JAKARTA

NARCIS (Netherlands)

Hudalah, Delik; Viantari, Dimitra; Firman, Tommy; Woltjer, Johan

2013-01-01

Industrial land development has become a key feature of urbanization in Greater Jakarta, one of the largest metropolitan areas in Southeast Asia. Following Suharto's market-oriented policy measures in the late 1980s, private developers have dominated the land development projects in Greater Jakarta.

Single versus double row suture anchor fixation for greater tuberosity fractures - a biomechanical study.

Science.gov (United States)

Seppel, Gernot; Saier, Tim; Martetschläger, Frank; Plath, Johannes E; Guevara-Alvarez, Alberto; Henschel, Julia; Winkler, Martin; Augat, Peter; Imhoff, Andreas B; Buchmann, Stefan

2017-12-01

Fractures of the humeral greater tuberosity (GT) are a frequent injury progressively treated with arthroscopic suture anchor repair. Yet, no biomechanical study has been performed comparing fixation strength of arthroscopic single- (SR) vs. double row (DR) fixation. Standardized fractures of the greater tuberosity were created in 12 fresh frozen proximal humeri. After random assignation to the SR or DR group the fixed humeri were tested applying cyclic loading to the supraspinatus and infraspinatus tendon. Load to failure and fragment displacement were assessed by means of an electrodynamic material testing machine using an optical tracking system. Load to failure values were higher in the DR group (649 N; ±176) than in the SR group (490 N; ±145) however without statistical significance (p = .12). In greater tuberosity displacement of 3-5 mm surgical treatment is recommended. The fixing constructs in this study did not reach displacement landmarks of 3 or 5 mm before construct failure as shown in previous studies. Thus the applied traction force (N) at 1 mm displacement was analyzed. In the SR group the load at 1 mm displacement was 277 N; ±46 compared to 260 N; ±62 in the DR group (p = .65). The results suggest that both techniques are viable options for refixation of greater tuberosity fractures. Laboratory study.

Standard filtration practices may significantly distort planktonic microbial diversity estimates

Directory of Open Access Journals (Sweden)

Cory Cruz Padilla

2015-06-01

Full Text Available Fractionation of biomass by filtration is a standard method for sampling planktonic microbes. It is unclear how the taxonomic composition of filtered biomass changes depending on sample volume. Using seawater from a marine oxygen minimum zone, we quantified the 16S rRNA gene composition of biomass on a prefilter (1.6 μm pore-size and a downstream 0.2 μm filter over sample volumes from 0.05 to 5 L. Significant community shifts occurred in both filter fractions, and were most dramatic in the prefilter community. Sequences matching Vibrionales decreased from ~40-60% of prefilter datasets at low volumes (0.05-0.5 L to less than 5% at higher volumes, while groups such at the Chromatiales and Thiohalorhabdales followed opposite trends, increasing from minor representation to become the dominant taxa at higher volumes. Groups often associated with marine particles, including members of the Deltaproteobacteria, Planctomycetes and Bacteroidetes, were among those showing the greatest increase with volume (4 to 27-fold. Taxon richness (97% similarity clusters also varied significantly with volume, and in opposing directions depending on filter fraction, highlighting potential biases in community complexity estimates. These data raise concerns for studies using filter fractionation for quantitative comparisons of aquatic microbial diversity, for example between free-living and particle-associated communities.

Frequency of satisfaction and dissatisfaction with practice among rural-based, group-employed physicians and non-physician practitioners.

Science.gov (United States)

Waddimba, Anthony C; Scribani, Melissa; Krupa, Nicole; May, John J; Jenkins, Paul

2016-10-22

Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition. We linked administrative data about practice units with cross-sectional data from a self-administered multi-dimensional questionnaire that contained practitioner demographics plus valid scales assessing autonomy/relatedness needs, risk aversion, tolerance for uncertainty/ambiguity, meaningfulness of patient care, and workload. We targeted medical professionals on the institutional payroll for inclusion. We excluded those who retired, resigned or were fired during the study launch, plus members of the advisory board and research team. Fixed-effects beta regressions were performed to test univariate associations between each factor and the percent of time a provider was dis/satisfied. Factors that manifested significant fixed effects were entered into multivariate, inflated beta regression models of the proportion of time that practitioners were dis/satisfied, incorporating clustering by practice unit as a random effect. Of the 473 eligible participants. 308 (65.1 %) completed the questionnaire. 59.1 % of respondents were doctoral-level; 40.9 % mid-level practitioners. Practitioners with heavier workloads and/or greater uncertainty intolerance were less likely to enjoy top-quintile satisfaction; those deriving greater meaning from practice were more likely. Higher meaningfulness and gratified relational needs increased one's likelihood of

Do financial incentives linked to ownership of specialty hospitals affect physicians' practice patterns?

Science.gov (United States)

Mitchell, Jean M

2008-07-01

Although physician-owned specialty hospitals have become increasingly prevalent in recent years, little research has examined whether the financial incentives linked to ownership influence physicians' referral rates for services performed at the specialty hospital. We compared the practice patterns of physician owners of specialty hospitals in Oklahoma, before and after ownership, to the practice patterns of physician nonowners who treated similar cases over the same time period in Oklahoma markets without physician-owned specialty hospitals. We constructed episodes of care for injured workers with a primary diagnosis of back/spine disorders. We used pre-post comparisons and difference-in-differences analysis to evaluate changes in practice patterns for physician owners and nonowners over the time period spanned by the entry of the specialty hospital. Findings suggest the introduction of financial incentives linked to ownership coincided with a significant change in the practice patterns of physician owners, whereas such changes were not evident among physician nonowners. After physicians established ownership interests in a specialty hospital, the frequency of use of surgery, diagnostic, and ancillary services used in the treatment of injured workers with back/spine disorders increased significantly. Physician ownership of specialty hospitals altered the frequency of use for an array of procedures rendered to patients treated at these hospitals. Given the growth in physician-owned specialty hospitals, these findings suggest that health care expenditures will be substantially greater for patients treated at these institutions relative to persons who obtain care from nonself-referral providers.

Patient-reported outcomes (PROs): the significance of using humanistic measures in clinical trial and clinical practice.

Science.gov (United States)

Refolo, P; Minacori, R; Mele, V; Sacchini, D; Spagnolo, A G

2012-10-01

Patient-reported outcome (PRO) is an "umbrella term" that covers a whole range of potential types of measurement but it is used specifically to refer to all measures quantifying the state of health through the evaluation of outcomes reported by the patient himself/herself. PROs are increasingly seen as complementary to biomedical measures and they are being incorporated more frequently into clinical trials and clinical practice. After considering the cultural background of PROs - that is the well known patient-centered model of medicine -, their historical profile (since 1914, the year of the first outcome measure) and typologies, the paper aims at debating their methodological complexity and implementation into practice. Some clinical trials and therapeutic managements utilizing patient-centered measures will be also analyzed.

Characterization of Greater Middle Eastern genetic variation for enhanced disease gene discovery.

Science.gov (United States)

Scott, Eric M; Halees, Anason; Itan, Yuval; Spencer, Emily G; He, Yupeng; Azab, Mostafa Abdellateef; Gabriel, Stacey B; Belkadi, Aziz; Boisson, Bertrand; Abel, Laurent; Clark, Andrew G; Alkuraya, Fowzan S; Casanova, Jean-Laurent; Gleeson, Joseph G

2016-09-01

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia, has resulted in an elevated burden of recessive disease. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized 'genetic purging'. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics.

Effects of mental practice on performance are moderated by cognitive anxiety as measured by the Sport Competition Anxiety Test.

Science.gov (United States)

Halvari, H

1996-12-01

45 subjects were assessed for cognitive anxiety on the Sport Competition Anxiety Test. Two months later they observed a person performing a new motor task which required high cognitive processing to be performed well. After this observation, 22 subjects were randomly assigned to a Mental Practice and 23 to a Control group. The former performed a cognitive rehearsal of the task, whereas the latter did not. None practiced the task physically before being tested. Analysis of variance showed that both errors and performance time interacted significantly with Mental Practice versus Control group scores and scores on the Sport Competition Anxiety Test. Among subjects who practiced mentally, those scoring low on cognitive anxiety performed significantly better than subjects who scored high. Further, the relationship between test scores of cognitive anxiety and performance for the total sample was analysed by different curvilinear regression models. The cubic model fitted the data better and accounted for a greater percent of variance on error performance explained by anxiety test scores (R = .39) than the linear correlation (r = .25). This cubic model formed a polynomial relationship between cognitive anxiety test scores and error in performance.

Process evaluation of a practice nurse-led smoking cessation trial in Australian general practice: views of general practitioners and practice nurses.

Science.gov (United States)

Halcomb, Elizabeth J; Furler, John S; Hermiz, Oshana S; Blackberry, Irene D; Smith, Julie P; Richmond, Robyn L; Zwar, Nicholas A

2015-08-01

Support in primary care can assist smokers to quit successfully, but there are barriers to general practitioners (GPs) providing this support routinely. Practice nurses (PNs) may be able to effectively take on this role. The aim of this study was to perform a process evaluation of a PN-led smoking cessation intervention being tested in a randomized controlled trial in Australian general practice. Process evaluation was conducted by means of semi-structured telephone interviews with GPs and PNs allocated in the intervention arm (Quit with PN) of the Quit in General Practice trial. Interviews focussed on nurse training, content and implementation of the intervention. Twenty-two PNs and 15 GPs participated in the interviews. The Quit with PN intervention was viewed positively. Most PNs were satisfied with the training and the materials provided. Some challenges in managing patient data and follow-up were identified. The Quit with PN intervention was acceptable to participating PNs and GPs. Issues to be addressed in the planning and wider implementation of future trials of nurse-led intervention in general practice include providing ongoing mentoring support, integration into practice management systems and strategies to promote greater collaboration in GPs and PN teams in general practice. The ongoing feasibility of the intervention was impacted by the funding model supporting PN employment and the competing demands on the PNs time. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pitavastatin 4 mg Provides Significantly Greater Reduction in Remnant Lipoprotein Cholesterol Compared With Pravastatin 40 mg: Results from the Short-term Phase IV PREVAIL US Trial in Patients With Primary Hyperlipidemia or Mixed Dyslipidemia.

Science.gov (United States)

Miller, P Elliott; Martin, Seth S; Joshi, Parag H; Jones, Steven R; Massaro, Joseph M; D'Agostino, Ralph B; Sponseller, Craig A; Toth, Peter P

2016-03-01

Remnants are partially hydrolyzed, triglyceride-rich lipoproteins that are implicated in atherosclerosis. We assessed the adequacy of pitavastatin 4 mg and pravastatin 40 mg in reducing atherogenic lipid parameters beyond LDL-C, in particular remnant lipoprotein cholesterol (RLP-C). From the Phase IV, multicenter, randomized, double-blind PREVAIL US (A Study of Pitavastatin 4 mg Vs. Pravastatin 40 mg in Patients With Primary Hyperlipidemia or Mixed Dyslipidemia) trial, we examined lipoprotein cholesterol subfractions using Vertical Auto Profile testing and apolipoproteins B and A-I at baseline and 12 weeks. Participants with primary hyperlipidemia or mixed dyslipidemia had LDL-C levels of 130 to 220 mg/dL and triglyceride levels ≤ 400 mg/dL. In this post hoc analysis, changes in lipid parameters were compared by using ANCOVA. Lipoprotein subfraction data were available in 312 patients (pitavastatin, n = 157; pravastatin, n = 155). Pitavastatin promoted a greater reduction in RLP-C than pravastatin (-13.6 [8.7] vs -9.3 [9.5] mg/dL). Furthermore, the pitavastatin group reported greater reductions in both components of RLP-C (both, P < 0.001): intermediate-density lipoprotein cholesterol (-9.5 [6.3] vs -6.4 [6.6] mg/dL) and very low-density lipoprotein cholesterol subfraction 3 (-4.1 [3.5] vs -2.9 [3.8] mg/dL). There were also greater reductions in the major ratios of risk (apolipoprotein B/apolipoprotein A-I and total cholesterol/HDL-C) (both, P < 0.001). There were no significant changes in HDL-C, its subfractions, or natural log lipoprotein(a)-cholesterol. The mean age was 58.8 ± 8.9 years in the pitavastatin group and 57.0 ± 10.2 years in the pravastatin group. Compared with pravastatin 40 mg daily, pitavastatin 4 mg provided superior reductions in atherogenic lipid parameters beyond LDL-C, including RLP-C. Future studies are needed investigate the clinical implications of lowering directly measured RLP-C as the principal target. ClinicalTrials.gov identifier

Social perceptions and environmental practices of the French people from 1995 to 2011

International Nuclear Information System (INIS)

2011-01-01

In this collective publication, the authors discuss the always greater sensitivity of French people to environmental issues, discuss the French environmental practices with respect to that of other countries, outline that environmental practices are mostly constrained, comment the evolution from intention to practice in these matters, highlight that the standard of living is crucial for environmental practices, comment the behaviour changes with respect to energy in housing, discuss the importance of the price factor for the change of household environmental practices

In search of joy in practice: a report of 23 high-functioning primary care practices.

Science.gov (United States)

Sinsky, Christine A; Willard-Grace, Rachel; Schutzbank, Andrew M; Sinsky, Thomas A; Margolius, David; Bodenheimer, Thomas

2013-01-01

We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life's vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice.

The Conditional Nature of High Impact/Good Practices on Student Learning Outcomes

Science.gov (United States)

Seifert, Tricia A.; Gillig, Benjamin; Hanson, Jana M.; Pascarella, Ernest T.; Blaich, Charles F.

2014-01-01

Using a multi-institutional sample of undergraduate students, this study found that the relationships between engaging in high impact/good practices and liberal arts outcomes differ based on students' precollege and background characteristics. Findings suggest that high impact/good practices are not a panacea and require a greater degree of…

Strategies for Talent Management: Greater Philadelphia Companies in Action

Science.gov (United States)

Council for Adult and Experiential Learning (NJ1), 2008

2008-01-01

Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…

Greater oil investment opportunities

International Nuclear Information System (INIS)

Arenas, Ismael Enrique

1997-01-01

Geologically speaking, Colombia is a very attractive country for the world oil community. According to this philosophy new and important steps are being taken to reinforce the oil sector: Expansion of the exploratory frontier by including a larger number of sedimentary areas, and the adoption of innovative contracting instruments. Colombia has to offer, Greater economic incentives for the exploration of new areas to expand the exploratory frontier, stimulation of exploration in areas with prospectivity for small fields. Companies may offer Ecopetrol a participation in production over and above royalties, without it's participating in the investments and costs of these fields, more favorable conditions for natural gas seeking projects, in comparison with those governing the terms for oil

The Association between Preschool Teachers' Beliefs and Practices about Developmentally Appropriate Practices

Science.gov (United States)

Mohamed, Ahmed Hassan Hemdan; Al-Qaryouti, Ibrahim Amin

2016-01-01

The purpose of this study was to explore whether preschool teachers' self-reported beliefs could predict their self-reported practices about developmentally appropriate practices (DAP). A related purpose was to examine whether classroom size and teachers' experience are significant predictors of their self-reported beliefs and practices. A total…

Response to Commentary on Cheng, Broome, Feng, and Hu (2017) Leadership behaviours play a significant role in implementing evidence-based practice. Journal of Clinical Nursing, 2018;27:e1684-e1685.

Science.gov (United States)

Cheng, Lei; Feng, Sheng; Hu, Yan; Broome, Marion E

2018-06-12

Thank you for the opportunity to respond to Hu and Gifford's comments(Hu & Gifford, 2018). We appreciated their acknowledgement of our findings about the factors influencing the successful implementation of evidence-based practice (EBP). The authors described leadership behaviors as having a significant role in implementing evidence-based practice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Holmium laser enucleation for prostate adenoma greater than 100 gm.: comparison to open prostatectomy.

Science.gov (United States)

Moody, J A; Lingeman, J E

2001-02-01

Options for treatment of large (greater than 100 gm.) prostatic adenomas have until now been limited to open surgery or transurethral resection by skilled resectionists. Considerable blood loss, morbidity, extended hospital stay and prolonged recovery occur with open surgery for large prostatic adenomas. Endoscopic surgery for benign prostatic hyperplasia has evolved during the last decade to offer the patient and surgeon significant advantages of transurethral removal of prostatic adenomas. Holmium laser enucleation of the prostate with transurethral tissue morcellation provides significant reductions in morbidity, bleeding and hospital stay for patients with large prostate adenomas. A retrospective review of data on 10 cases of holmium laser enucleation and 10 open prostatectomies for greater than 100 gm. prostatic adenomas was performed from 1998 to 1999 at our institution. Patient demographics, indication for surgery, preoperative and postoperative American Urological Association (AUA) symptom scores, operating time, serum hemoglobin, resected prostatic weight, pathological diagnosis, length of stay and complications were compared. Patient age, indications for surgery (retention, failed medical therapy, high post-void residual, bladder calculi, bladder diverticula and azotemia) and preoperative AUA symptom scores were similar in both groups. Postoperative AUA symptom scores were significantly decreased (p gm., p = 0.0003). Resected weight was greater in the holmium laser enucleation group (151 versus 106 gm., p = 0.07). Length of stay was significantly shorter in the holmium laser enucleation group (2.1 versus 6.1 days, p <0.001). Complications in the holmium laser enucleation group included stress urinary incontinence in 4 cases, prostatic perforation in 1 and urinary retention in 1. No patient treated with holmium laser enucleation was discharged home with an indwelling catheter. Complications in the open prostatectomy group included bladder neck contractures

Best practice in situ recovery uranium mining in Australia

International Nuclear Information System (INIS)

Lambert, I.B.; McKay, A.D.; Carson, L.J.

2010-01-01

The Australian Government policy is to ensure that uranium mining, milling and rehabilitation is based on world best practice standards. A best practice guide for in situ recovery (ISR) uranium mining has been developed to communicate the Australian Government's expectations with a view to achieving greater certainty that ISR mining projects meet Australian Government policy and consistency in the assessment of ISR mine proposals within multiple government regulatory processes. The guide focuses on the main perceived risks; impacts on groundwaters, disposal of mining residues, and radiation protection. World best practice does not amount to a universal template for ISR mining because the characteristics of individual ore bodies determine the best practice. (author)

Mortality in NHS Greater Glasgow and Clyde employees: 2007-2009.

Science.gov (United States)

Freer, K; Waclawski, E

2013-09-01

Just over a fifth of all deaths in Scotland occur in those under the age of 65. This study examined deaths in service in employees of the National Health Service Greater Glasgow and Clyde (NHS GG&C) Health Board over a 3-year period. To assess crude death rates by occupational group, the main causes of death and evidence of causes that could have been prevented or modified by lifestyle changes. Demographic details, occupational grouping and death certificate data were obtained for all NHS GG&C employees who died in service between 2007 and 2009. A total of 138 employees died in this period. The occupational groups in which most deaths occurred were support services (porters, domestic and catering staff; 35%) and nurses (34%). The commonest causes of death were lung cancer (15%), ischaemic heart disease (9%) and suicide (9%). The overall crude death rate was 1.2/1000 persons/year (females 1.0 and males 1.7) and was highest among support services employees (2.4) and lowest among medical staff (0.5). The relative risk of death in support services was significantly greater than the majority of occupational groups. These findings suggest health inequality within this workforce. The main causes of death identified in the support services group could potentially be modified through workplace risk factor screening and health promotion.

A survey of infection control practices of consultant anaesthesiologists in teaching hospitals of pakistan

International Nuclear Information System (INIS)

Yaqub, K.M.; Tariq, M.; Janjua, S.; Masroor, R.

2007-01-01

To determine the infection control practices of Anaesthesiologist in the teaching hospitals of Pakistan. Cross-sectional survey. The survey was closed after allowing 6 months for return of the replies. A questionnaire was distributed to 170 consultant anaesthesiologist randomly selected from all over Pakistan. Out of these, 90 (53%) were returned and analyzed. To reduce self-report bias, the forms were filled anonymously. Thirty four percent of the respondents always used masks, and only 9% used gloves in their every day practice. Only 18% of respondents stated that they always washed their hands after every patient contact and 54% reported that they always used aseptic technique for placing an indwelling cannula. Most respondents had a good knowledge of universal precautions for prevention of occupational transmission of infection. Five percent of the anaesthetists reported frequently or always reusing syringes for more than one patient. The practice of reusing syringes was significantly greater when the same consultants were anaesthetizing patients in private clinics rather than in their primary institutions (p 5, in 58% of cases. Whereas most responding anaesthesiologist exhibit appropriate infection control behaviour, there are several potentially hazardous practices that continue unabated. (author)

Body composition of young people aged 17-18 years, practicing and not practicing swimming, with the use of the bioelectrical impedance method

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Marek Jendrysek

2015-11-01

Full Text Available Purpose: Body composition evaluation of youth aged 17-18 of a different physical activity with the help of bioelectric impedance method. Material and Methods: 18 boys practicing swimming and 19 boys not practicing it took part in the study, making up a control group. Height, weight, BMI, lean body mass, the content of fat and water, Rohr factor were evaluated. Non-parametric Mann-Whitney test has been used to evaluate the differences in the range of the tissue components between the two groups. Results: Statistically significant differences were found on the p<0,05 level in % fat content. Mean body weight in experimental group was 71.5 kg, while in control group it was 69.4 kg. Minimum and maximum weight in group of swimming-practicing persons was: 56.6-92.2 kg. Increased body weight in the group of swimmers can result from greater amount of active tissue in this group compared with persons of low physical activity. Proportionally, it amounted to 64.3 kg and 61.3 kg. In the tested groups, minimal and maximal values of amount of active tissue proportionately amounted to: 54.1-78 and 49.5-72,3 kg. Conclusions: Physical activity modifies body composition. Active lifestyle is one of the methods for prevention of overweight and obesity.

BODY COMPOSITION OF YOUNG PEOPLE AGED 17-18 YEARS, PRACTICING AND NOT PRACTICING SWIMMING, WITH THE USE OF THE BIOELECTRICAL IMPEDANCE METHOD

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Jendrysek Marek

2015-11-01

Full Text Available Purpose: Body composition evaluation of youth aged 17-18 of a different physical activity with the help of bioelectric impedance method. Material and Methods: 18 boys practicing swimming and 19 boys not practicing it took part in the study, making up a control group. Height, weight, BMI, lean body mass, the content of fat and water, Rohr factor were evaluated. Non-parametric Mann-Whitney test has been used to evaluate the differences in the range of the tissue components between the two groups. Results: Statistically significant differences were found on the p<0,05 level in % fat content. Mean body weight in experimental group was 71.5 kg, while in control group it was 69.4 kg. Minimum and maximum weight in group of swimming-practicing persons was: 56.6-92.2 kg. Increased body weight in the group of swimmers can result from greater amount of active tissue in this group compared with persons of low physical activity. Proportionally, it amounted to 64.3 kg and 61.3 kg. In the tested groups, minimal and maximal values of amount of active tissue proportionately amounted to: 54.1-78 and 49.5-72,3 kg. Conclusions: Physical activity modifies body composition. Active lifestyle is one of the methods for prevention of overweight and obesity.

Retrieval practice enhances the accessibility but not the quality of memory.

Science.gov (United States)

Sutterer, David W; Awh, Edward

2016-06-01

Numerous studies have demonstrated that retrieval from long-term memory (LTM) can enhance subsequent memory performance, a phenomenon labeled the retrieval practice effect. However, the almost exclusive reliance on categorical stimuli in this literature leaves open a basic question about the nature of this improvement in memory performance. It has not yet been determined whether retrieval practice improves the probability of successful memory retrieval or the quality of the retrieved representation. To answer this question, we conducted three experiments using a mixture modeling approach (Zhang & Luck, 2008) that provides a measure of both the probability of recall and the quality of the recalled memories. Subjects attempted to memorize the color of 400 unique shapes. After every 10 images were presented, subjects either recalled the last 10 colors (the retrieval practice condition) by clicking on a color wheel with each shape as a retrieval cue or they participated in a control condition that involved no further presentations (Experiment 1) or restudy of the 10 shape/color associations (Experiments 2 and 3). Performance in a subsequent delayed recall test revealed a robust retrieval practice effect. Subjects recalled a significantly higher proportion of items that they had previously retrieved relative to items that were untested or that they had restudied. Interestingly, retrieval practice did not elicit any improvement in the precision of the retrieved memories. The same empirical pattern also was observed following delays of greater than 24 hours. Thus, retrieval practice increases the probability of successful memory retrieval but does not improve memory quality.

The Elaboration Process of Municipal Education Plans in the Greater São Paulo ABC Region

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Paulo Sérgio Garcia

2018-03-01

Full Text Available This study analyzed the elaboration process of the Municipal Education Plans (PME in Greater São Paulo ABC region (Brazil, placing the analysis in a broader framework to understand the influences made by the Lesbian, Gay, Bisexual and Transgender (LGBT movement and those practiced by the Catholic Church. A case study was used as a methodological approach. Results revealed the loosening in the drawing up of plans, the influence of the Church over the councilmen, inducing them to make alterations in final documents, ratifying the Church’s influence, which is historic in Brazil, and the education weakening regarding prejudice and discrimination, that are recognized demands of the LGBT movement. These results are important in order to provoke the debate in Education Departments and universities.

Life cycle thinking in impact assessment—Current practice and LCA gains

Energy Technology Data Exchange (ETDEWEB)

Bidstrup, Morten, E-mail: Bidstrup@plan.aau.dk

2015-09-15

It has been advocated that life cycle thinking (LCT) should be applied in impact assessment (IA) to a greater extent, since some development proposals pose a risk of significant impacts throughout the interconnected activities of product systems. Multiple authors have proposed the usage of life cycle assessment (LCA) for such analytical advancement, but little to no research on this tool application has been founded in IA practice so far. The aim of this article is to elaborate further on the gains assigned to application of LCA. The research builds on a review of 85 Danish IA reports, which were analysed for analytical appropriateness and application of LCT. Through a focus on the non-technical summary, the conclusion and the use of specific search words, passages containing LCT were searched for in each IA report. These passages were then analysed with a generic framework. The results reveal that LCT is appropriate for most of the IAs, but that LCA is rarely applied to provide such a perspective. Without LCA, the IAs show mixed performance in regard to LCT. Most IAs do consider the product provision of development proposals, but they rarely relate impacts to this function explicitly. Many IAs do consider downstream impacts, but assessments of upstream, distant impacts are generally absent. It is concluded that multiple analytical gains can be attributed to greater application of LCA in IA practice, though some level of LCT already exists. - Highlights: • Life cycle thinking is appropriate across the types and topics of impact assessment. • Yet, life cycle assessment is rarely used for adding such perspective. • Impact assessment practice does apply some degree of life cycle thinking. • However, application of life cycle assessment could bring analytical gains.

Life cycle thinking in impact assessment—Current practice and LCA gains

International Nuclear Information System (INIS)

Bidstrup, Morten

2015-01-01

It has been advocated that life cycle thinking (LCT) should be applied in impact assessment (IA) to a greater extent, since some development proposals pose a risk of significant impacts throughout the interconnected activities of product systems. Multiple authors have proposed the usage of life cycle assessment (LCA) for such analytical advancement, but little to no research on this tool application has been founded in IA practice so far. The aim of this article is to elaborate further on the gains assigned to application of LCA. The research builds on a review of 85 Danish IA reports, which were analysed for analytical appropriateness and application of LCT. Through a focus on the non-technical summary, the conclusion and the use of specific search words, passages containing LCT were searched for in each IA report. These passages were then analysed with a generic framework. The results reveal that LCT is appropriate for most of the IAs, but that LCA is rarely applied to provide such a perspective. Without LCA, the IAs show mixed performance in regard to LCT. Most IAs do consider the product provision of development proposals, but they rarely relate impacts to this function explicitly. Many IAs do consider downstream impacts, but assessments of upstream, distant impacts are generally absent. It is concluded that multiple analytical gains can be attributed to greater application of LCA in IA practice, though some level of LCT already exists. - Highlights: • Life cycle thinking is appropriate across the types and topics of impact assessment. • Yet, life cycle assessment is rarely used for adding such perspective. • Impact assessment practice does apply some degree of life cycle thinking. • However, application of life cycle assessment could bring analytical gains

Spiritual practices of taoism

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Yulia L. Butko

2016-01-01

Full Text Available In the article the spiritual practices of Taoism. Established that the spiritual path in Taoism is the main ultimate goal - achieving eternal, indestructible personality transformation through meditation and the reduction of lower mental strength to their upper classes. To achieve this, the Taoist practices, special practices that include, along with the meditative contemplation technique classes and various gymnastics, breathing exercises and the like, and (for a significant period of its history - Laboratory (“foreign” alchemy. Among the spiritual practices of Taoism is the main meditation that has little to do with certain external techniques. Taoist meditation leads people to unity, the only person that connects with the cosmos and society. The author concluded that the path of self-improvement Taoist, under the guidance of a teacher, is a series of distinct stages, gaining purely individual instruction. Spiritual practices like Taoist, were widely known in other religious and philosophical systems. However, the semantics of Taoist practices are significantly different, as well as their function in the structure of religious practices in general.

Evaluation of the genetic distinctiveness of Greater Sage-grouse in the Bi-State Planning Area

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Oyler-McCance, Sara J.; Casazza, Michael L.

2011-01-01

The purpose of this study was to further characterize a distinct population of Greater Sage-grouse: the population located along the border between Nevada and California (Bi-State Planning Area) and centered around the Mono Basin. This population was previously determined to be genetically distinct from other Greater Sage-grouse populations across their range. Previous genetic work focused on characterizing genetic variation across the species' range and thereby used a coarse sampling approach for species characterization. The goal of this study was to investigate this population further by obtaining samples from breeding locations within the population and analyzing those samples with the same mitochondrial and microsatellite loci used in previous studies. Blood samples were collected in six locations within the Bi-State Planning Area. Genetic data from subpopulations were then compared with each other and also with two populations outside of the Bi-State Planning Area. Particular attention was paid to subpopulation boundaries and internal dynamics by drawing comparisons among particular regions within the Bi-State Planning Area and regions proximal to it. All newly sampled subpopulations contained mitochondrial haplotypes and allele frequencies that were consistent with the genetically unique Bi-State (Mono Basin) Greater Sage-grouse described previously. This reinforces the fact that this group of Greater Sage-grouse is genetically unique and warrants special attention. Maintaining the genetic integrity of this population could protect the evolutionary potential of this population of Greater Sage-grouse. Additionally, the White Mountains subpopulation was found to be significantly distinct from all other Bi-State subpopulations.

Knowledge, attitudes and practices (KAP) regarding leptospirosis among residents of riverside settlements of Santa Fe, Argentina.

Science.gov (United States)

Ricardo, Tamara; Bergero, Laura C; Bulgarella, Esteban P; Previtali, M Andrea

2018-05-01

Leptospirosis is a global and re-emerging zoonotic disease caused by Leptospira spirochetes that are shed into the environment by infected animals. Humans can get infected via contact with animal hosts or contaminated environment. In Argentina, the highest annual incidences were reported in the province of Santa Fe, where epidemic outbreaks occurred during flooding events. This study examined the knowledge, attitudes and practices (KAP) regarding leptospirosis among residents of riverside slum settlements from Santa Fe after a major flood. A cross-sectional questionnaire was administered to 113 residents of 3 riverside settlements from Santa Fe. The influence of knowledge and attitudes regarding leptospirosis on the likelihood that an individual will use preventive practices were evaluated using linear mixed-effects models. The majority of respondents (83.2%) had previously heard about leptospirosis; however specific knowledge about leptospirosis was limited. The results of the modeling efforts, show that the likelihood of using preventive practices was associated with having greater knowledge score, but not with more positive attitudes. We also found that females were more likely to use safer practices than males. Even though the majority of respondents had heard about leptospirosis, a high percentage of them had limited knowledge regarding the severity of the disease and its prevalence in the region. Our results suggest that public health interventions in these riverside communities should focus on educating the public on the multiple dimensions of leptospirosis in order to attain greater adherence to preventive practices instead of intending to change the perceptions or attitudes towards the disease, which did not have a significant influence. The key challenge lies in identifying effective strategies to reach the high risk group for leptospirosis here that is male fishermen, who spend most of the time in precarious campsites on the river islands.

Practice of Environmentally Significant Behaviours in Rural China: From Being Motivated by Economic Gains to Being Motivated by Environmental Considerations.

Science.gov (United States)

Chen, Yanyan

2017-08-22

A continuous and increasing crisis that present-day China is facing is environmental degradation. The cultivation of citizens who have environmentally friendly behaviours has been deemed as a fundamental way to solve environmental crises. However, the main focus of environmentalism studies has been urban residents, whereas rare research attention was put on rural Chinese. This paper focuses on environmentally significant behaviours in rural China and aims to clarify the practice of five environmentally significant behaviours and two motivations underlying these behaviours. In total, 508 rural residents in 51 villages of Ningyang county were interviewed. Analytical results derived from survey data showed that environmentally significant behaviours are widely conducted in rural areas. However, these behaviours are mainly motivated by economic gains rather than environmental considerations. In addition, based on the norm-activation theory and considering the influences of demographic factors, the formation of environmentally motivated behaviours were quantitatively analysed. Analytical results indicated that the more people worried about environmental deterioration, the more likely they were to form environmentally motivated behaviours, and people who ascribe the most important environmental responsibility to the government are less likely to form environmentally motivated behaviours. Increasing people's anxiety towards the environment, decreasing people's dependency on the government in protecting the environment, and using females, the elderly, and people with low income and education levels as the main targets of environmental education are suggested to promote environmentally motivated behaviours in rural China.

Practice of Environmentally Significant Behaviours in Rural China: From Being Motivated by Economic Gains to Being Motivated by Environmental Considerations

Science.gov (United States)

Chen, Yanyan

2017-01-01

A continuous and increasing crisis that present-day China is facing is environmental degradation. The cultivation of citizens who have environmentally friendly behaviours has been deemed as a fundamental way to solve environmental crises. However, the main focus of environmentalism studies has been urban residents, whereas rare research attention was put on rural Chinese. This paper focuses on environmentally significant behaviours in rural China and aims to clarify the practice of five environmentally significant behaviours and two motivations underlying these behaviours. In total, 508 rural residents in 51 villages of Ningyang county were interviewed. Analytical results derived from survey data showed that environmentally significant behaviours are widely conducted in rural areas. However, these behaviours are mainly motivated by economic gains rather than environmental considerations. In addition, based on the norm-activation theory and considering the influences of demographic factors, the formation of environmentally motivated behaviours were quantitatively analysed. Analytical results indicated that the more people worried about environmental deterioration, the more likely they were to form environmentally motivated behaviours, and people who ascribe the most important environmental responsibility to the government are less likely to form environmentally motivated behaviours. Increasing people’s anxiety towards the environment, decreasing people’s dependency on the government in protecting the environment, and using females, the elderly, and people with low income and education levels as the main targets of environmental education are suggested to promote environmentally motivated behaviours in rural China. PMID:28829395

Exploring the role of educational videos in radiation oncology practice

International Nuclear Information System (INIS)

Dally, M.J.; Denham, J.W.; Boddy, G.A.

1994-01-01

Patient, staff, and medical student education are essential components of modern radiation oncology practice. Greater involvement of patients in the clinical decision-making process, and the need for other health professionals to be more informed about radiation oncology, provided further demand on resources, despite ever increasing logistic constraints. Videos made by individual departments may augment traditional teaching methods and have applications in documenting clinical practice and response. 8 refs., 1 tab

[Significant increase in the colonisation of Staphylococcus aureus among medical students during their hospital practices].

Science.gov (United States)

Rodríguez-Avial, Carmen; Alvarez-Novoa, Andrea; Losa, Azucena; Picazo, Juan J

2013-10-01

Staphylococcus aureus is a pathogen of major concern. The emergence of methicillin-resistant S. aureus (MRSA) has increasingly complicated the therapeutic approach of hospital-acquired infections. Surveillance of MRSA and control measures must be implemented in different healthcare settings, including screening programs for carriers. Our first aim was to determine the prevalence of methicillin-susceptible S. aureus (MSSA) and MRSA nasal carriage in medical students from the Clínico San Carlos Hospital (Madrid). As the MRSA carrier rate in healthcare workers is higher than in the general population, we hypothesised that carrier rate could be increased during their clinical practice in their last three years. We performed an epidemiologic al study of the prevalence of S. aureus colonisation among a group of medical students, who were sampled in 2008 in their third-year, and in 2012 when this class was in its sixth year. We have found a significant increase in MSSA carriage, from 27% to 46%. There were no MRSA colonisations in the third-year, but one was found in the sixth-year group. The large majority of strains (89%) of strains were resistant to penicillin, and 27% to erythromycin and clindamycin. As 19 coagulase-negative Staphylococcus MR were also identified, a horizontal transfer of genes, such as mecA gene to S. aureus, could have occurred. Medical students are both, at risk for acquiring, and a potential source of nosocomial pathogens, mainly MSSA. Therefore, they should take special care for hygienic precautions, such as frequent and proper hand washing, while working in the hospital. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Translating Neurodevelopmental Care Policies Into Practice: The Experience of Neonatal ICUs in France-The EPIPAGE-2 Cohort Study.

Science.gov (United States)

Pierrat, Veronique; Coquelin, Anaëlle; Cuttini, Marina; Khoshnood, Babak; Glorieux, Isabelle; Claris, Olivier; Durox, Mélanie; Kaminski, Monique; Ancel, Pierre-Yves; Arnaud, Catherine

2016-10-01

To describe the implementation of neurodevelopmental care for newborn preterm infants in neonatal ICUs in France in 2011, analyze changes since 2004, and investigate factors associated with practice. Prospective national cohort study of all births before 32 weeks of gestation. Twenty-five French regions. All neonatal ICUs (n = 66); neonates surviving at discharge (n = 3,005). None. Neurodevelopmental care policies and practices were assessed by structured questionnaires. Proportions of neonates initiating kangaroo care during the first week of life and those whose mothers expressed breast milk were measured as neurodevelopmental care practices. Multilevel logistic regression analyses were used to investigate relationships between kangaroo care or breast-feeding practices and unit policies, taking into account potential confounders. Free visiting policies, bed availability for parents, and kangaroo care encouragement significantly improved between 2004 and 2011 but with large variabilities between units. Kangaroo care initiation varied from 39% for neonates in the most restrictive units to 68% in less restrictive ones (p neurodevelopmental care significantly influenced kangaroo care initiation (odds ratio, 3.5; 95% CI, 1.8-7.0 for Newborn Individualized Developmental Care and Assessment Program implementation compared with no training). Breast milk expression by mothers was greater in units with full-time availability professionals trained for breast-feeding support (60% vs 73%; p neurodevelopmental practices occurred between 2004 and 2011, but large variabilities between units persist. Practices increased in units with supportive policies. Specific neurodevelopmental care training with multifaceted interventions strengthened the implementation of policies.

Training reduces catabolic and inflammatory response to a single practice in female volleyball players.

Science.gov (United States)

Eliakim, Alon; Portal, Shawn; Zadik, Zvi; Meckel, Yoav; Nemet, Dan

2013-11-01

We examined the effect of training on hormonal and inflammatory response to a single volleyball practice in elite adolescent players. Thirteen female, national team level, Israeli volleyball players (age 16.0 ± 1.4 years, Tanner stage 4-5) participated in the study. Blood samples were collected before and immediately after a typical 60 minutes of volleyball practice, before and after 7 weeks of training during the initial phase of the season. Training involved tactic and technical drills (20% of time), power and speed drills (25% of time), interval sessions (25% of time), endurance-type training (15% of time), and resistance training (15% of time). To achieve greater training responses, the study was performed during the early phase (first 7 weeks) of the volleyball season. Hormonal measurements included the anabolic hormones growth hormone (GH), insulin-like growth factor-I (IGF-I) and IGF-binding protein-3, the catabolic hormone cortisol, the proinflammatory marker interleukin-6 (IL-6), and the anti-inflammatory marker IL-1 receptor antagonist. Training led to a significant improvement of vertical jump, anaerobic properties (peak and mean power by the Wingate Anaerobic Test), and predicted VO2max (by the 20-m shuttle run). Volleyball practice, both before and after the training intervention, was associated with a significant increase of serum lactate, GH, and IL-6. Training resulted in a significantly reduced cortisol response ([INCREMENT]cortisol: 4.2 ± 13.7 vs. -4.4 ± 12.3 ng · ml, before and after training, respectively; p volleyball practice. The results suggest that along with the improvement of power and anaerobic and aerobic characteristics, training reduces the catabolic and inflammatory response to exercise.

Synthetic definition of biological significance

International Nuclear Information System (INIS)

Buffington, J.D.

1975-01-01

The central theme of the workshop is recounted and the views of the authors are summarized. Areas of broad agreement or disagreement, unifying principles, and research needs are identified. Authors' views are consolidated into concepts that have practical utility for the scientist making impact assessments. The need for decision-makers and managers to be cognizant of the recommendations made herein is discussed. Finally, bringing together the diverse views of the workshop participants, a conceptual definition of biological significance is synthesized

Inclusive practices in teacher training in Mexico

Directory of Open Access Journals (Sweden)

Vasthi Jocabed Flores Barrera

2017-06-01

Full Text Available Inclusive practices include diversity as a resource that favors teaching-learning processes in the classroom, although they focus on the most vulnerable people by offering them higher-quality education. This descriptive study sought to identify the inclusive practices of teachers who train teachers in an Escuela Normal (teachers’ college in Mexico. Eight teachers and 247 students participated in the study; the Guidelines for the Evaluation of Inclusive Practices in the Classroom (observation formats and students, the Learning Strategies Questionnaire, and semi-structured interviews were used. The results suggest that, although the general perception is that participating teachers have high inclusive practices, they need greater support in the physical conditions of the classroom, methodology and teacher-student relationship. It was also identified the need for a refresher program for teachers to conceptually enrich the teaching staff and encourage the implementation of inclusive education within the Escuela Normal.

WIC mothers' depressive symptoms are associated with greater use of feeding to soothe, regardless of perceived child negativity.

Science.gov (United States)

Savage, Jennifer S; Birch, Leann L

2017-04-01

Maternal symptoms of depression are related to suboptimal parenting practices and child well-being; women with elevated symptoms tend to be less responsive to their children. The objective is to explore how maternal depressive symptomatology is related to childhood obesity-promoting parenting behaviours, and whether depressive symptomatology moderates the association between perceived child negativity and the use of food to soothe among low-income mothers. There is a cross-sectional sample of 60 mothers and their formula fed infants/toddlers participating in the Special Supplemental Woman, Infants and Children Program. Measures included the Infant Behaviors Questionnaire, Baby's Basic Needs Questionnaire, the feeding problem assessment form and Center for Epidemiological Studies Depression Scale. Depressive symptoms exceeded the clinical screening cut-off for 38% of women. Mothers with depressive symptoms perceived their child to be more negative and were more likely to use food to soothe, add cereal to the bottle and put baby to bed with bottle than mothers without depressive symptoms. Generalized linear models revealed that child negativity was associated with greater use of food to soothe but that this effect was moderated by maternal depression: negativity was positively associated with food to soothe among non-depressed but not depressed mothers. A high proportion of low-income mothers reported elevated depressive symptoms; depressive symptomatology was positively associated with perceived child negativity and greater reported use of controlling feeding practices. Screening for maternal depressive symptoms may help in providing more individually tailored counselling on responsive feeding. © 2016 World Obesity Federation.

Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK Study: A study of protocols in Greater London

Directory of Open Access Journals (Sweden)

Ford Tamsin

2008-06-01

Full Text Available Abstract Background Although young people's transition from Child and Adolescent Mental Health Services (CAMHS to Adult Mental Health Services (AMHS in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. Methods A questionnaire survey (Jan-April 2005 of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Results Forty two of the 65 teams contacted (65% responded to the survey. Teams varied in type (generic/targeted/in-patient, catchment area (locality-based, wider or national and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37 was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33. In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. Conclusion At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in

Training directionally selective motion pathways can significantly improve reading efficiency

Science.gov (United States)

Lawton, Teri

2004-06-01

This study examined whether perceptual learning at early levels of visual processing would facilitate learning at higher levels of processing. This was examined by determining whether training the motion pathways by practicing leftright movement discrimination, as found previously, would improve the reading skills of inefficient readers significantly more than another computer game, a word discrimination game, or the reading program offered by the school. This controlled validation study found that practicing left-right movement discrimination 5-10 minutes twice a week (rapidly) for 15 weeks doubled reading fluency, and significantly improved all reading skills by more than one grade level, whereas inefficient readers in the control groups barely improved on these reading skills. In contrast to previous studies of perceptual learning, these experiments show that perceptual learning of direction discrimination significantly improved reading skills determined at higher levels of cognitive processing, thereby being generalized to a new task. The deficits in reading performance and attentional focus experienced by the person who struggles when reading are suggested to result from an information overload, resulting from timing deficits in the direction-selectivity network proposed by Russell De Valois et al. (2000), that following practice on direction discrimination goes away. This study found that practicing direction discrimination rapidly transitions the inefficient 7-year-old reader to an efficient reader.

Practice stories in natural resource management continuing professional education: springboards for learning

DEFF Research Database (Denmark)

Stummann, Cathy Brown

2014-01-01

in supporting professional learning of new concepts. These uses of practice stories are not evident in public natural resource management (NRM) continuing professional education. In light of greater public involvement in NRM practice over the last 20 years, however, the use of practice stories could now...... practice. Feedback from workshop participants suggests that practice stories may be able to support NRM professionals in reflecting on previous experiences, learning from colleague's practice experiences and serving as a springboard for learning by fostering linkages between social science knowledge......The use of stories from professional experience in continuing professional education has been on the rise in many fields, often aimed at bolstering capacity through sharing professional knowledge and/or supporting reflective practice. Practice stories are also suggested to be beneficial...

Stimulating Parenting Practices in Indigenous and Non-Indigenous Mexican Communities

Directory of Open Access Journals (Sweden)

Heather A. Knauer

2017-12-01

Full Text Available Parenting may be influenced by ethnicity; marginalization; education; and poverty. A critical but unexamined question is how these factors may interact to compromise or support parenting practices in ethnic minority communities. This analysis examined associations between mothers’ stimulating parenting practices and a range of child-level (age; sex; and cognitive and socio-emotional development; household-level (indigenous ethnicity; poverty; and parental education; and community-level (economic marginalization and majority indigenous population variables among 1893 children ages 4–18 months in poor; rural communities in Mexico. We also explored modifiers of associations between living in an indigenous community and parenting. Key findings were that stimulating parenting was negatively associated with living in an indigenous community or family self-identification as indigenous (β = −4.25; SE (Standard Error = 0.98; β = −1.58; SE = 0.83 respectively. However; living in an indigenous community was associated with significantly more stimulating parenting among indigenous families than living in a non-indigenous community (β = 2.96; SE = 1.25. Maternal education was positively associated with stimulating parenting only in indigenous communities; and household crowding was negatively associated with stimulating parenting only in non-indigenous communities. Mothers’ parenting practices were not associated with child sex; father’s residential status; education; or community marginalization. Our findings demonstrate that despite greater community marginalization; living in an indigenous community is protective for stimulating parenting practices of indigenous mothers.

Urban acid deposition in Greater Manchester

Energy Technology Data Exchange (ETDEWEB)

Lee, D.S.; Longhurst, J.W.S.; Gee, D.R.; Hare, S.E. (Manchester Polytechnic, Manchester (UK). Acid Rain Information Centre)

1989-08-01

Data are presented from a monitoring network of 18 bulk precipitation collectors and one wet-only collector in the urban area of Greater Manchester, in the north west of England. Weekly samples were analysed for all the major ions in precipitation along with gaseous nitrogen dioxide concentrations from diffusion tubes. Statistical analysis of the data shows significant spatial variation of non marine sulphate, nitrate, ammonium, acidity and calcium concentrations, and nitrogen dioxide concentrations. Calcium is thought to be responsible for the buffering of acidity and is of local origin. Wet deposition is the likely removal process for calcium in the atmosphere and probably by below cloud scavenging. Nitrate and ammonium concentrations and depositions show close spatial, temporal and statistical association. Examination of high simultaneous episodes of nitrate and ammonium deposition shows that these depositions cannot be explained in terms of trajectories and it is suggested that UK emissions of ammonia may be important. Statistical analysis of the relationships between nitrate and ammonium depositions, concentrations and precipitation amount suggest that ammonia from mesoscale sources reacts reversibly with nitric acid aerosol and is removed by below cloud scavenging. High episodes of the deposition of non marine sulphate are difficult to explain by trajectory analysis alone, perhaps suggesting local sources. In a comparison between wet deposition and bulk deposition, it was shown that only 15.2% of the non marine sulphur was dry deposited to the bulk precipitation collector. 63 refs., 86 figs., 31 tabs.

More features, greater connectivity.

Science.gov (United States)

Hunt, Sarah

2015-09-01

Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

A profile of solo/two-physician practices.

Science.gov (United States)

Lee, Doohee; Fiack, Kelly James; Knapp, Kenneth Michael

2014-01-01

Understanding practice behaviors of solo/dual physician ownership and associated factors at the national level is important information for policymakers and clinicians in response to the Affordable Care Act (ACA) of 2010, but poorly understood in the literature. We analyzed nationally representative data (n = 4,720). The study results reveal nearly 33% of the sample reported solo/two-physician practices. Male/minority/older physicians, psychiatrists, favor small practices. Greater market competition was perceived and less charity care was given among solo/two-physician practitioners. The South region was favored by small physician practitioners. Physicians in solo or two-person practices provided fewer services to chronic patients and were dissatisfied with their overall career in medicine. Small practices were favored by international medical graduates (IMGs) and primary care physicians (PCPs). Overall our data suggest that the role of solo/dual physician practices is fading away in the delivery of medicine. Our findings shed light on varied characteristics and practice behaviors of solo/two-physician practitioners, but more research may be needed to reevaluate the potential role of small physician practitioners and find a way to foster a private physician practice model in the context of the newly passed ACA of 2010.

Patient education about cough: effect on the consulting behaviour of general practice patients.

Science.gov (United States)

Rutten, G; Van Eijk, J; Beek, M; Van der Velden, H

1991-07-01

The aim of this general practice study was to examine how the consulting behaviour of patients with a cough was affected when the tasks and responsibilities of patients, practice nurses and general practitioners were reorganized. In four 'average' single-handed general practices the effects on the consulting behaviour of patients of a rational practice policy on cough and the provision of systematic patient education on cough were compared with patient behaviour in four matched control practices. Changes of behaviour were measured in 548 patients who consulted for cough at least twice, in two successive autumn-winter periods. Significantly more patients in the experimental practice changed their behaviour to follow the practice guidelines than did patients in the control practices (56% versus 30%, P less than 0.001). The proportion of patients who continued to consult in the approved manner was greater among patients receiving intervention (66% versus 29%, P less than 0.001). This was equally true for patients who had suffered less than four episodes of cough or more than four episodes. The more often the patients received the education, the more effective it was. All patients who consulted the general practitioner for cough during the first autumn-winter period filled in a cough diary during the second period. From this it appeared that the intervention did not result in patients delaying consultation when they had a cough lasting longer than three weeks or one with 'serious' symptoms. It would appear that a rational practice policy and the provision of patient education can stimulate patients to modify their consulting behaviour. This could result in a reduction in the costs of health care.

A different approach to the management of greater trochanter pain syndrome

Directory of Open Access Journals (Sweden)

J.C. Van Rooy

2009-01-01

Full Text Available Greater trochanter pain syndrome (GTPS, also known astrochanteric bursitis, is a regional pain syndrome that is frequently treatedby physiotherapists in private practice or out-patient departments.  It is classi -fied as an overuse injury that could become chronic in nature and frequentlyco-exists with other pathologies.This case study describes the treatment of a 61-year-old female with GTPS of her left hip. The aim was to evaluate the effectiveness of specificsoft tissue mobilisation (SSTM and eccentric strengthening of the Gluteus Medius (GM muscle in treating this condition. Particular emphasis was placed on rehabilitation of lumbar spine control in order to improve proximal stability. A nother aim was to return the patient faster to her functional activitiesthan had been reported in the literature. The patient could return to her normal daily activities after four treatment sessions and was completely pain free after 12 weeks. This case study presents a different approach to the treatment of GTPS and proposes that GTPS maypresent in a similar manner to GM tendinosis. This phenomenon could therefore possibly explain the chronic nature ofthe condition.

The Relationship Between Personality Traits, Flow-Experience, and Different Aspects of Practice Behavior of Amateur Vocal Students.

Science.gov (United States)

Heller, Katharina; Bullerjahn, Claudia; von Georgi, Richard

2015-01-01

Most of the existing studies on musical practice are concerned with instrumentalists only. Since singers are seldom considered in research, the present study is based on an online-sample of amateur vocal students (N = 120; 92 female, 28 male). The study investigated the correlations between personality traits, flow-experience and several aspects of practice characteristics. Personality was represented by the three personality dimensions extraversion, neuroticism and psychoticism, assessed by Eysenck's Personality Profiler as well as the trait form of the Positive and Negative Affect Schedule. 'Flow-experience,' 'self-congruence' and 'fear of losing control over concentration,' assessed by the Practice Flow Inventory, served as variables for flow-experience. The practice motivation was measured by the Practice Motivation Questionnaire in four categories ('self,' 'group,' 'audience,' 'teacher'). In addition, the Practice Behavior Questionnaire was used to provide an insight into the practice situation and behavior of singing students. The results show significant correlations: participants with high extraversion-scores experience significantly more flow than less extraverted persons, whereas lesser flow-experience seems to be related to high neuroticism-scores. Nevertheless, there is no influence in flow-experience concerning singing style ('classical' or 'popular'). The longer the practicing time, the more likely students are to achieve flow-experience. However, older singers tend to have less flow-experience. Consequently, singers seem to differ in their personality and practice behavior compared to other musicians. Most of the findings show that having control over one's instrument is decisive for achieving a performance of high quality, especially for singers. On the other hand, certainty in handling an instrument is essential to arouse a flow-feeling. However, flow-experience seems to be common mainly with amateur singers. In conclusion, this offers a starting

Significance of borderline personality-spectrum symptoms among adolescents with bipolar disorder.

Science.gov (United States)

Fonseka, Trehani M; Swampillai, Brenda; Timmins, Vanessa; Scavone, Antonette; Mitchell, Rachel; Collinger, Katelyn A; Goldstein, Benjamin I

2015-01-01

Little is known regarding correlates of borderline personality-spectrum symptoms (BPSS) among adolescents with bipolar disorder (BP). Participants were 90 adolescents, 13-19 years of age, who fulfilled DSM-IV-TR criteria for BP using semi-structured diagnostic interviews. BPSS status was ascertained using the Life Problems Inventory which assessed identity confusion, interpersonal problems, impulsivity, and emotional lability. Analyses compared adolescents with "high" versus "low" BPSS based on a median split. Participants with high, relative to low, BPSS were younger, and had greater current and past depressive episode severity, greater current hypo/manic episode severity, younger age of depression onset, and reduced global functioning. High BPSS participants were more likely to have BP-II, and had higher rates of social phobia, generalized anxiety disorder, conduct disorder, oppositional defiant disorder, homicidal ideation, assault of others, non-suicidal self-injury, suicidal ideation, and physical abuse. Despite greater illness burden, high BPSS participants reported lower rates of lithium use. The most robust independent predictors of high BPSS, identified in multivariate analyses, included lifetime social phobia, non-suicidal self-injury, reduced global functioning, and conduct and/or oppositional defiant disorder. The study design is cross-sectional and cannot determine causality. High BPSS were associated with greater mood symptom burden and functional impairment. Presence of high BPSS among BP adolescents may suggest the need to modify clinical monitoring and treatment practices. Future prospective studies are needed to examine the direction of observed associations, the effect of treatment on BPSS, and the effect of BPSS as a moderator or predictor of treatment response. Copyright © 2014 Elsevier B.V. All rights reserved.

Knowledge, Attitude, and Practice of Yoga in Medical Students: Assessment of Anthropometry and Lifestyle Factors.

Science.gov (United States)

Hegde, Shreelaxmi V; Rao, Swathi K; Menezes, Ritesh G; Kotian, Shashidhar M; Shetty, Sowmya

2018-03-29

Medical students often experience significant stress during their undergraduate training. Evidence has shown short-term yoga to be effective in decreasing stress in students. This study aimed to assess knowledge about, attitude toward, and practice of (KAP) yoga among medical students. A secondary objective was to analyze their dietary habits and physical activity. Participants consisted of 224 medical students aged 18-23 years in pre- and paraclinical groups. A closed-ended KAP questionnaire was used to collect data. Anthropometric measurements were taken. Results showed that paraclinical students (70.5%) favorably perceived the health benefits of yoga. Nearly three-fourths of study subjects had previously practiced yoga; greater numbers intended to practice yoga in the future. About 95.5% of the preclinical students who had done yoga had discontinued the practice. Perceived barriers to the practice of yoga were lack of time, insufficient facilities, lack of company, and lack of interest. Consideration of the undergraduates' lifestyle revealed that 50.4% of preclinical students did not exercise, and they routinely consumed more junk food with fewer servings of fresh fruits/salads. Preclinical students exhibited higher BMI and waist circumference compared to paraclinical students. Findings suggest that knowledge of and attitude regarding yoga were good among medical undergraduates.

Sell your practice to grow and compete--the synergism of vertical integration.

Science.gov (United States)

Robison, D L

1988-01-01

There are many advantages for selling a group practice to achieve vertical integration with a larger entity, including shared medical and management services, and greater efficiency, which results in greater profits. Health care in the 1990s will have a more formalized, structured system, greatly reducing freedoms enjoyed by both physicians and patients. An attractive option for smaller groups or solo practitioners is vertical integration.

Women in the Workplace and Management Practices: Theory and Evidence

OpenAIRE

Kato, Takao; Kodama, Naomi

2017-01-01

We review recent studies on management practices and their consequences for women in the workplace. First, the High Performance Work System (HPWS) is associated with greater gender diversity in the workplace while there is little evidence that the HPWS reduces the gender pay gap. Second, work-life balance practices with limited face-to-face interactions with coworkers may hamper women’s career advancement. Third, individual incentive linking pay to objective performance may enhance gender div...

Greater Sudbury fuel efficient driving handbook

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-12-15

Reducing the amount of fuel that people use for personal driving saves money, improves local air quality, and reduces personal contributions to climate change. This handbook was developed to be used as a tool for a fuel efficient driving pilot program in Greater Sudbury in 2009-2010. Specifically, the purpose of the handbook was to provide greater Sudbury drivers with information on how to drive and maintain their personal vehicles in order to maximize fuel efficiency. The handbook also provides tips for purchasing fuel efficient vehicles. It outlines the benefits of fuel maximization, with particular reference to reducing contributions to climate change; reducing emissions of air pollutants; safe driving; and money savings. Some tips for efficient driving are to avoid aggressive driving; use cruise control; plan trips; and remove excess weight. Tips for efficient winter driving are to avoid idling to warm up the engine; use a block heater; remove snow and ice; use snow tires; and check tire pressure. The importance of car maintenance and tire pressure was emphasized. The handbook also explains how fuel consumption ratings are developed by vehicle manufacturers. refs., figs.

P-Value, a true test of statistical significance? a cautionary note ...

African Journals Online (AJOL)

While it's not the intention of the founders of significance testing and hypothesis testing to have the two ideas intertwined as if they are complementary, the inconvenient marriage of the two practices into one coherent, convenient, incontrovertible and misinterpreted practice has dotted our standard statistics textbooks and ...

Effectiveness of motor practice in lucid dreams: a comparison with physical and mental practice.

Science.gov (United States)

Stumbrys, Tadas; Erlacher, Daniel; Schredl, Michael

2016-01-01

Motor practice in lucid dreams is a form of mental rehearsal where the dreamer can consciously rehearse motor skills in the dream state while being physically asleep. A previous pilot study showed that practice in lucid dreams can improve subsequent performance. This study aimed to replicate those findings with a different task (finger-tapping) and compare the effectiveness of lucid dream practice (LDP) not only to physical but also to mental practice (MP) in wakefulness. An online experiment was completed by 68 participants within four groups: LDP group, MP group, physical practice (PP) group and control (no practice) group. Pre-test was accomplished in the evening, post-test in the next morning, while the practice was done during the night. All three practice groups significantly improved their performance from pre-test to post-test, but no significant improvements were observed for the control group. Subjective sleep quality was not affected by night practice. This study thus corroborates the previous findings that practice in lucid dreams is effective in improving performance. Its effects seem to be similar to actual PP and MP in wakefulness. Future studies should establish reliable techniques for lucid dream induction and verify the effects of LDP in sleep laboratory conditions.

Prostate cancer cell lines under hypoxia exhibit greater stem-like properties.

Directory of Open Access Journals (Sweden)

Yuanyuan Ma

Full Text Available Hypoxia is an important environmental change in many cancers. Hypoxic niches can be occupied by cancer stem/progenitor-like cells that are associated with tumor progression and resistance to radiotherapy and chemotherapy. However, it has not yet been fully elucidated how hypoxia influences the stem-like properties of prostate cancer cells. In this report, we investigated the effects of hypoxia on human prostate cancer cell lines, PC-3 and DU145. In comparison to normoxia (20% O(2, 7% O(2 induced higher expressions of HIF-1α and HIF-2α, which were associated with upregulation of Oct3/4 and Nanog; 1% O(2 induced even greater levels of these factors. The upregulated NANOG mRNA expression in hypoxia was confirmed to be predominantly retrogene NANOGP8. Similar growth rates were observed for cells cultivated under hypoxic and normoxic conditions for 48 hours; however, the colony formation assay revealed that 48 hours of hypoxic pretreatment resulted in the formation of more colonies. Treatment with 1% O(2 also extended the G(0/G(1 stage, resulting in more side population cells, and induced CD44 and ABCG2 expressions. Hypoxia also increased the number of cells positive for ABCG2 expression, which were predominantly found to be CD44(bright cells. Correspondingly, the sorted CD44(bright cells expressed higher levels of ABCG2, Oct3/4, and Nanog than CD44(dim cells, and hypoxic pretreatment significantly increased the expressions of these factors. CD44(bright cells under normoxia formed significantly more colonies and spheres compared with the CD44(dim cells, and hypoxic pretreatment even increased this effect. Our data indicate that prostate cancer cells under hypoxia possess greater stem-like properties.

Gender shift in realisation of preferred type of GP practice: longitudinal survey over the last 25 years.

NARCIS (Netherlands)

Maiorova, T.; Stevens, F.; Velden, L. van der; Scherpbier, A.; Zee, J. van der

2007-01-01

Background: an increasing number of newly trained Dutch GPs prefer to work in a group practice and as a non-principal rather than in a single-handed practice. In view of the greater number of female doctors, changing practice preferences, and discussions on future workforce problems, the question is

Rural New Zealand health professionals' perceived barriers to greater use of the internet for learning.

Science.gov (United States)

Janes, Ron; Arroll, Bruce; Buetow, Stephen; Coster, Gregor; McCormick, Ross; Hague, Iain

2005-01-01

The purpose of this research was to investigate rural North Island (New Zealand) health professionals' attitudes and perceived barriers to using the internet for ongoing professional learning. A cross-sectional postal survey of all rural North Island GPs, practice nurses and pharmacists was conducted in mid-2003. The questionnaire contained both quantitative and qualitative questions. The transcripts from two open questions requiring written answers were analysed for emergent themes, which are reported here. The first open question asked: 'Do you have any comments on the questionnaire, learning, computers or the Internet?' The second open question asked those who had taken a distance-learning course using the internet to list positive and negative aspects of their course, and suggest improvements. Out of 735 rural North Island health professionals surveyed, 430 returned useable questionnaires (a response rate of 59%). Of these, 137 answered the question asking for comments on learning, computers and the internet. Twenty-eight individuals who had completed a distance-learning course using the internet, provided written responses to the second question. Multiple barriers to greater use of the internet were identified. They included lack of access to computers, poor availability of broadband (fast) internet access, lack of IT skills/knowledge, lack of time, concerns about IT costs and database security, difficulty finding quality information, lack of time, energy or motivation to learn new skills, competing priorities (eg family), and a preference for learning modalities which include more social interaction. Individuals also stated that rural health professionals needed to engage the technology, because it provided rapid, flexible access from home or work to a significant health information resource, and would save money and travelling time to urban-based education. In mid-2003, there were multiple barriers to rural North Island health professionals making greater

Mind-Body Practices in Integrative Medicine

Directory of Open Access Journals (Sweden)

Niko Kohls

2012-02-01

Full Text Available Mind-Body practices have become increasingly popular as components of psychotherapeutic and behavior medicine interventions. They comprise an array of different methods and techniques that use some sort of mental-behavioral training and involve the modulation of states of consciousness in order to influence bodily processes towards greater health, well-being and better functioning. Mind-body practices may thus be interpreted as the salutogenetic mirror image of psychosomatic medicine, where psychophysiological and health consequences of specific psychological states are studied, such as stress arousal, psychological trauma or depression. This contribution examines the empirical evidence of the most common mind-body techniques with regard to their salutogenetic potential. We concisely discuss some aspects of the mind-body problem, before we consider some historical aspects and achievements of psychosomatic medicine. We then turn to some prominent mind-body practices and their application, as well as the empirical database for them.

Relationship between parent knowledge of child sleep, and child sleep practices and problems: A pilot study in a children's hospital cohort.

Science.gov (United States)

McDowall, Philippa S; Elder, Dawn E; Campbell, Angela J

2017-08-01

To describe parent reports of sleep practices, and examine associations with parent knowledge of child sleep, and whether children's sleep practices differ between parents who underestimated, overestimated or accurately estimated children's sleep needs. Parents of children aged 2-12 years (n = 115) attending hospital inpatient or day wards were approached and asked to report child sleep routines, sleep problems, parent education, household income and parent knowledge of child sleep via questionnaire. Younger age was associated with earlier bedtimes and wake times, shorter sleep latencies, longer sleep durations and greater sleep problems (P child sleep reported earlier weekday and weekend bedtimes (r s  ≥ 0.26) and wake times (r s  ≥ 0.21) and greater consistency between their child's weekend and weekday sleep routines (P child's sleep needs: parents who underestimated reported later weekday bedtimes (on average, 46 min), and longer sleep latencies (17 min); parents who overestimated reported longer sleep latencies (22 min). These findings remained significant when controlling for child age (P Child Health Division (The Royal Australasian College of Physicians).

A systematic review of team formulation in clinical psychology practice: Definition, implementation, and outcomes.

Science.gov (United States)

Geach, Nicole; Moghaddam, Nima G; De Boos, Danielle

2017-10-03

Team formulation is promoted by professional practice guidelines for clinical psychologists. However, it is unclear whether team formulation is understood/implemented in consistent ways - or whether there is outcome evidence to support the promotion of this practice. This systematic review aimed to (1) synthesize how team formulation practice is defined and implemented by practitioner psychologists and (2) analyse the range of team formulation outcomes in the peer-reviewed literature. Seven electronic bibliographic databases were searched in June 2016. Eleven articles met inclusion criteria and were quality assessed. Extracted data were synthesized using content analysis. Descriptions of team formulation revealed three main forms of instantiation: (1) a structured, consultation approach; (2) semi-structured, reflective practice meetings; and (3) unstructured/informal sharing of ideas through routine interactions. Outcome evidence linked team formulation to a range of outcomes for staff teams and service users, including some negative outcomes. Quality appraisal identified significant issues with evaluation methods; such that, overall, outcomes were not well-supported. There is weak evidence to support the claimed beneficial outcomes of team formulation in practice. There is a need for greater specification and standardization of 'team formulation' practices, to enable a clearer understanding of any relationships with outcomes and implications for best-practice implementations. Under the umbrella term of 'team formulation', three types of practice are reported: (1) highly structured consultation; (2) reflective practice meetings; and (3) informal sharing of ideas. Outcomes linked to team formulation, including some negative outcomes, were not well evidenced. Research using robust study designs is required to investigate the process and outcomes of team formulation practice. © 2017 The British Psychological Society.

Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice: A microsimulation screening analysis.

Science.gov (United States)

Carlsson, Sigrid V; de Carvalho, Tiago M; Roobol, Monique J; Hugosson, Jonas; Auvinen, Anssi; Kwiatkowski, Maciej; Villers, Arnauld; Zappa, Marco; Nelen, Vera; Páez, Alvaro; Eastham, James A; Lilja, Hans; de Koning, Harry J; Vickers, Andrew J; Heijnsdijk, Eveline A M

2016-11-15

Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus "good practice." Microsimulation screening analysis (MISCAN) was used to evaluate the effect on quality-adjusted life-years (QALYs) if 4 recommendations were followed: limited screening in older men, selective biopsy in men with elevated PSA, active surveillance for low-risk tumors, and treatment preferentially delivered at high-volume centers. Outcomes were compared with a base model in which annual screening started at ages 55 to 69 years and were simulated using data from the European Randomized Study of Screening for Prostate Cancer. In terms of QALYs gained compared with no screening, for 1000 screened men who were followed over their lifetime, recommended good practice led to 73 life-years (LYs) and 74 QALYs gained compared with 73 LYs and 56 QALYs for the base model. In contrast, common practice led to 78 LYs gained but only 19 QALYs gained, for a greater than 75% relative reduction in QALYs gained from unadjusted LYs gained. The poor outcomes for common practice were influenced predominantly by the use of aggressive treatment for men with low-risk disease, and PSA testing in older men also strongly reduced potential QALY gains. Commonly used PSA screening and treatment practices are associated with little net benefit. Following a few straightforward clinical recommendations, particularly greater use of active surveillance for low-risk disease and reducing screening in older men, would lead to an almost 4-fold increase in the net benefit of prostate cancer screening. Cancer 2016;122:3386-3393. © 2016 American Cancer Society. © 2016 American Cancer Society.

Greater Occipital Nerve Block for Acute Treatment of Migraine Headache: A Large Retrospective Cohort Study.

Science.gov (United States)

Allen, Sorcha M; Mookadam, Farouk; Cha, Stephen S; Freeman, John A; Starling, Amaal J; Mookadam, Martina

2018-01-01

Greater occipital nerve (GON) blocks are frequently used to treat migraine headaches, although a paucity of supporting clinical evidence exists. The objective of this study was to assess the efficacy of GON block in acute treatment of migraine headache, with a focus on pain relief. This retrospective cohort study was undertaken between January 2009 and August 2014 and included patients who underwent at least 1 GON block and attended at least 1 follow-up appointment. Change in the 11-point numeric pain rating scale (NPRS) was used to assess the response to GON block. Response was defined as "minimal" (50% NPRS point reduction). A total of 562 patients met inclusion criteria; 423 were women (75%). Mean age was 58.6 ± 16.7 years. Of these 562, 459 patients (82%) rated their response to GON block as moderate or significant. No statistically significant relationship existed between previous treatment regimens and response to GON block. GON block was equally effective across the different age and sex groups. Greater occipital block seems to be an effective option for acute management of migraine headache, with promising reductions in pain scores. © Copyright 2018 by the American Board of Family Medicine.

Development of methodology to assess application of practical elimination for nuclear power plants

International Nuclear Information System (INIS)

Jung, J.; Sivekumar, D.; Thambirasa, S.

2015-01-01

The Fukushima Daiichi nuclear accident is presented as the primary case study for the topic of practical elimination. A decision matrix was created to assess whether practical elimination has been achieved or not. Public acceptance is included as a factor in practical elimination. An evaluation of an underground High-Temperature Gas Cooled Reactor was performed, where it was determined that a greater than 10 earthquake on the Richter scale is practically eliminated, but can easily be overturned based on public acceptance. A plane crash scenario was also practically eliminated. The gap analysis performed concluded that the developed decision matrix requires reworking. (author)

Greater general startle reflex is associated with greater anxiety levels: a correlational study on 111 young women

Directory of Open Access Journals (Sweden)

Eleonora ePoli

2015-02-01

Full Text Available Startle eyeblink reflex is a valid non-invasive tool for studying attention, emotion and psychiatric disorders. In the absence of any experimental manipulation, the general (or baseline startle reflex shows a high inter-individual variability, which is often considered task-irrelevant and therefore normalized across participants. Unlike the above view, we hypothesized that greater general startle magnitude is related to participants’ higher anxiety level. 111 healthy young women, after completing the State-Trait Anxiety Inventory, were randomly administered 10 acoustic white noise probes (50 ms, 100 dBA acoustic level while integrated EMG from left and right orbicularis oculi was recorded. Results showed that participants with greater state anxiety levels exhibited larger startle reflex magnitude from the left eye (r109=0.23, p<0.05. Furthermore, individuals who perceived the acoustic probe as more aversive reported the largest anxiety scores (r109=0.28, p<0.05 and had the largest eyeblinks, especially in the left eye (r109 = 0.34, p<0.001. Results suggest that general startle may represent a valid tool for studying the neural excitability underlying anxiety and emotional dysfunction in neurological and mental disorders.

PRACTICING FIELD HOCKEY SKILLS ALONG THE CONTEXTUAL INTERFERENCE CONTINUUM: A COMPARISON OF FIVE PRACTICE SCHEDULES

Directory of Open Access Journals (Sweden)

Jadeera Phaik Geok Cheong

2012-06-01

Full Text Available To overcome the weakness of the contextual interference (CI effect within applied settings, Brady, 2008 recommended that the amount of interference be manipulated. This study investigated the effect of five practice schedules on the learning of three field hockey skills. Fifty-five pre-university students performed a total of 90 trials for each skill under blocked, mixed or random practice orders. Results showed a significant time effect with all five practice conditions leading to improvements in acquisition and learning of the skills. No significant differences were found between the groups. The findings of the present study did not support the CI effect and suggest that either blocked, mixed, or random practice schedules can be used effectively when structuring practice for beginners

Knowledge, Attitude, and Practices Regarding Occupational HIV Exposure and Protection among Health Care Workers in China: Census Survey in a Rural Area.

Science.gov (United States)

Wu, Qian; Xue, Xiao Fei; Shah, Dimpy; Zhao, Jian; Hwang, Lu-Yu; Zhuang, GuiHua

2016-09-01

Health care workers (HCWs) seek, treat, and care for patients living with HIV/AIDS on a daily basis and thus face a significant risk to work-related infections. To assess the knowledge, attitude, and practices regarding occupational HIV exposure and protection among HCWs in low HIV prevalence areas of rural China. A cross-sectional questionnaire survey was carried out among all medical units in Pucheng County, Shaanxi, China. Response rate of this study was 94%. The average overall knowledge score of HCWs was 10.9 of 21.0. Deficiencies in general, transmission, exposure, and protection knowledge were identified among HCWs at all levels. A high rate of occupational exposure (85%) and lack of universal precautions practice behavior were recorded. Significant predictors of universal precautions practice behavior were female sex, prior training, and greater knowledge about HIV/AIDS. Health care workers at various levels have inadequate knowledge on HIV/AIDS and do not practice universal precautions. Nurses and medical technicians at the county level faced more occupation risk than other HCWs. The key of AIDS training for different levels of HCWs should be distinguished. © The Author(s) 2014.

How do we make sense of significance?

DEFF Research Database (Denmark)

Lyhne, Ivar; Kørnøv, Lone

2013-01-01

Determination of significance is widely recognised as an important step in environmental assessment (EA) processes. The prescriptive literature and guidance on significance determination is comprehensive within the field of EA, whereas descriptive and explorative studies of how we go about making......' sense-making, including important differences in the way individuals screen and scope. These patterns concern what we notice, how fast we frame the choice, and when we are critical about the provided information. The indications provide a basis for reflections on practice and on how to organise EA...

Spatial pattern of groundwater arsenic occurrence and association with bedrock geology in greater augusta, maine

Science.gov (United States)

Yang, Q.; Jung, H.B.; Culbertson, C.W.; Marvinney, R.G.; Loiselle, M.C.; Locke, D.B.; Cheek, H.; Thibodeau, H.; Zheng, Yen

2009-01-01

In New England, groundwater arsenic occurrence has been linked to bedrock geology on regional scales. To ascertain and quantify this linkage at intermediate (100-101 km) scales, 790 groundwater samples from fractured bedrock aquifers in the greater Augusta, Maine area are analyzed, and 31% of the sampled wells have arsenic concentrations >10 ??g/L. The probability of [As] exceeding 10 ??g/L mapped by indicator kriging is highest in Silurian pelite-sandstone and pelite-limestone units (???40%). This probability differs significantly (p bedrock map. Thus, bedrock geology is associated with arsenic occurrence in fractured bedrock aquifers of the study area at intermediate scales relevant to water resources planning. The arsenic exceedance rate for each rock unit is considered robust because low, medium, and high arsenic occurrences in four cluster areas (3-20 km2) with a low sampling density of 1-6 wells per km2 are comparable to those with a greater density of 5-42 wells per km2. About 12,000 people (21% of the population) in the greater Augusta area (???1135 km2) are at risk of exposure to >10 ??g/L arsenic in groundwater. ?? 2009 American Chemical Society.

Effects of psychological therapies in randomized trials and practice-based studies.

Science.gov (United States)

Barkham, Michael; Stiles, William B; Connell, Janice; Twigg, Elspeth; Leach, Chris; Lucock, Mike; Mellor-Clark, John; Bower, Peter; King, Michael; Shapiro, David A; Hardy, Gillian E; Greenberg, Leslie; Angus, Lynne

2008-11-01

Randomized trials of the effects of psychological therapies seek internal validity via homogeneous samples and standardized treatment protocols. In contrast, practice-based studies aim for clinical realism and external validity via heterogeneous samples of clients treated under routine practice conditions. We compared indices of treatment effects in these two types of studies. Using published transformation formulas, the Beck Depression Inventory (BDI) scores from five randomized trials of depression (N = 477 clients) were transformed into Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) scores and compared with CORE-OM data collected in four practice-based studies (N = 4,196 clients). Conversely, the practice-based studies' CORE-OM scores were transformed into BDI scores and compared with randomized trial data. Randomized trials showed a modest advantage over practice-based studies in amount of pre-post improvement. This difference was compressed or exaggerated depending on the direction of the transformation but averaged about 12%. There was a similarly sized advantage to randomized trials in rates of reliable and clinically significant improvement (RCSI). The largest difference was yielded by comparisons of effect sizes which suggested an advantage more than twice as large, reflecting narrower pre-treatment distributions in the randomized trials. Outcomes of completed treatments for depression in randomized trials appeared to be modestly greater than those in routine care settings. The size of the difference may be distorted depending on the method for calculating degree of change. Transforming BDI scores into CORE-OM scores and vice versa may be a preferable alternative to effect sizes for comparisons of studies using these measures.

Observations of territorial breeding common ravens caching eggs of greater sage-grouse

Science.gov (United States)

Howe, Kristy B.; Coates, Peter S.

2015-01-01

Previous investigations using continuous video monitoring of greater sage-grouse Centrocercus urophasianus nests have unambiguously identified common ravens Corvus corax as an important egg predator within the western United States. The quantity of greater sage-grouse eggs an individual common raven consumes during the nesting period and the extent to which common ravens actively hunt greater sage-grouse nests are largely unknown. However, some evidence suggests that territorial breeding common ravens, rather than nonbreeding transients, are most likely responsible for nest depredations. We describe greater sage-grouse egg depredation observations obtained opportunistically from three common raven nests located in Idaho and Nevada where depredated greater sage-grouse eggs were found at or in the immediate vicinity of the nest site, including the caching of eggs in nearby rock crevices. We opportunistically monitored these nests by counting and removing depredated eggs and shell fragments from the nest sites during each visit to determine the extent to which the common raven pairs preyed on greater sage-grouse eggs. To our knowledge, our observations represent the first evidence that breeding, territorial pairs of common ravens cache greater sage-grouse eggs and are capable of depredating multiple greater sage-grouse nests.

Comparative Education in Greater China: Contexts, Characteristics, Contrasts and Contributions.

Science.gov (United States)

Bray, Mark; Qin, Gui

2001-01-01

The evolution of comparative education in Greater China (mainland China, Taiwan, Hong Kong, and Macau) has been influenced by size, culture, political ideologies, standard of living, and colonialism. Similarities and differences in conceptions of comparative education are identified among the four components and between Greater China and other…

Lost in translation? Moving contingency management and cognitive behavioral therapy into clinical practice.

Science.gov (United States)

Carroll, Kathleen M

2014-10-01

In the treatment of addictions, the gap between the availability of evidence-based therapies and their limited implementation in practice has not yet been bridged. Two empirically validated behavioral therapies, contingency management (CM) and cognitive behavioral therapy (CBT), exemplify this challenge. Both have a relatively strong level of empirical support but each has weak and uneven adoption in clinical practice. This review highlights examples of how barriers to their implementation in practice have been addressed systematically, using the Stage Model of Behavioral Therapies Development as an organizing framework. For CM, barriers such as cost and ideology have been addressed through the development of lower-cost and other adaptations to make it more community friendly. For CBT, barriers such as relative complexity, lack of trained providers, and need for supervision have been addressed via conversion to standardized computer-assisted versions that can serve as clinician extenders. Although these and other modifications have rendered both interventions more disseminable, diffusion of innovation remains a complex, often unpredictable process. The existing specialty addiction-treatment system may require significant reforms to fully implement CBT and CM, particularly greater focus on definable treatment goals and performance-based outcomes. © 2014 New York Academy of Sciences.

Expanding role of MR angiography in clinical practice

International Nuclear Information System (INIS)

Prince, M.R.; Meaney, J.F.M.

2006-01-01

MRA has higher accuracy, less operator dependence, a larger field-of-view, three-dimensionality and superior contrast resolution than ultrasonography. Additionally, MRA offers a safer alternative to the patient than CTA as neither ionizing radiation nor iodinated contrast agents are used. Contrast-enhanced MRA with extra cellular contrast agents is fast and flow-independent, offers substantially higher spatial and temporal resolution compared to non-contrast techniques and has become the standard of practice. The highly accurate but static anatomical road-map thus generated can be supplemented with time-resolved MRA and blood flow measurement techniques for a more comprehensive assessment of systemic vascular disease. In the context of burgeoning technological advances with rapid translation into clinical MRA practice, this review explores the current position of MRA and the potential role for the new and exciting blood-pool contrast agents for diagnosing and characterizing vascular disease. Blood-pool agents offer the potential to take MRA to the next level by combining first-pass arterial phase imaging with steady state high-resolution images that exploit the persistent high intravascular enhancement generated by blood-pool agents and which is significantly greater than with extra cellular agents. Additional benefits derive from the ability to characterize plaque and to detect internal bleeding. (orig.)

Active convergence between the Lesser and Greater Caucasus in Georgia: Constraints on the tectonic evolution of the Lesser-Greater Caucasus continental collision

Science.gov (United States)

Sokhadze, G.; Floyd, M.; Godoladze, T.; King, R.; Cowgill, E. S.; Javakhishvili, Z.; Hahubia, G.; Reilinger, R.

2018-01-01

We present and interpret newly determined site motions derived from GPS observations made from 2008 through 2016 in the Republic of Georgia, which constrain the rate and locus of active shortening in the Lesser-Greater Caucasus continental collision zone. Observation sites are located along two ∼160 km-long profiles crossing the Lesser-Greater Caucasus boundary zone: one crossing the Rioni Basin in western Georgia and the other crossing further east near the longitude of Tbilisi. Convergence across the Rioni Basin Profile occurs along the southern margin of the Greater Caucasus, near the surface trace of the north-dipping Main Caucasus Thrust Fault (MCTF) system, and is consistent with strain accumulation on the fault that generated the 1991 MW6.9 Racha earthquake. In contrast, convergence along the Tbilisi Profile occurs near Tbilisi and the northern boundary of the Lesser Caucasus (near the south-dipping Lesser Caucasus Thrust Fault), approximately 50-70 km south of the MCTF, which is inactive within the resolution of geodetic observations (< ± 0.5 mm/yr) at the location of the Tbilisi Profile. We suggest that the southward offset of convergence along strike of the range is related to the incipient collision of the Lesser-Greater Caucasus, and closing of the intervening Kura Basin, which is most advanced along this segment of the collision zone. The identification of active shortening near Tbilisi requires a reevaluation of seismic hazards in this area.

Building a successful archival programme a practical approach

CERN Document Server

Ramos, Marisol

2006-01-01

This valuable resource provides information on best practices and solutions to successfully establish an archival programme; it uses a practical approach, without the use of technical or theoretical jargon. Additionally it serves as a companion text in a theoretical archival course. The book provides easy-to-follow advice on how to assess the information needs of any institution and the greater community for which the archives were created to serve. Guidelines for achievable goals are provided for starting an archives programme in an environment where a small budget or even a 'no budget' can threaten the future of the archives. First book that attempts to de-mystify archives Practical approaches without the use of technical jargon Easy to follow Plans of Action.

Updating Financial Ratios: Seeking Greater Understanding, Precision, and Practicality.

Science.gov (United States)

Jenny, Hans H.; Minter, W. John

1993-01-01

Modifications to current methods of calculating and reporting financial ratios are outlined for college managers. The modified ratios, felt to be more realistic, are illustrated with applications in three areas: (1) student revenues; (2) endowment and other investment income; and (3) public and private gifts, grants, and contracts revenue. (MSE)

Practicing field hockey skills along the contextual interference continuum: a comparison of five practice schedules.

Science.gov (United States)

Cheong, Jadeera Phaik Geok; Lay, Brendan; Grove, J Robert; Medic, Nikola; Razman, Rizal

2012-01-01

To overcome the weakness of the contextual interference (CI) effect within applied settings, Brady, 2008 recommended that the amount of interference be manipulated. This study investigated the effect of five practice schedules on the learning of three field hockey skills. Fifty-five pre-university students performed a total of 90 trials for each skill under blocked, mixed or random practice orders. Results showed a significant time effect with all five practice conditions leading to improvements in acquisition and learning of the skills. No significant differences were found between the groups. The findings of the present study did not support the CI effect and suggest that either blocked, mixed, or random practice schedules can be used effectively when structuring practice for beginners. Key pointsThe contextual interference effect did not surface when using sport skills.There appears to be no difference between blocked and random practice schedules in the learning of field hockey skills.Low (blocked), moderate (mixed) or high (random) interference practice schedules can be used effectively when conducting a multiple skill practice session for beginners.

Greater physiological and behavioral effects of interrupted stress pattern compared to daily restraint stress in rats.

Directory of Open Access Journals (Sweden)

Wei Zhang

Full Text Available Repeated stress can trigger a range of psychiatric disorders, including anxiety. The propensity to develop abnormal behaviors after repeated stress is related to the severity, frequency and number of stressors. However, the pattern of stress exposure may contribute to the impact of stress. In addition, the anxiogenic nature of repeated stress exposure can be moderated by the degree of coping that occurs, and can be reflected in homotypic habituation to the repeated stress. However, expectations are not clear when a pattern of stress presentation is utilized that diminishes habituation. The purpose of these experiments is to test whether interrupted stress exposure decreases homotypic habituation and leads to greater effects on anxiety-like behavior in adult male rats. We found that repeated interrupted restraint stress resulted in less overall homotypic habituation compared to repeated daily restraint stress. This was demonstrated by greater production of fecal boli and greater corticosterone response to restraint. Furthermore, interrupted restraint stress resulted in a lower body weight and greater adrenal gland weight than daily restraint stress, and greater anxiety-like behavior in the elevated plus maze. Control experiments demonstrated that these effects of the interrupted pattern could not be explained by differences in the total number of stress exposures, differences in the total number of days that the stress periods encompased, nor could it be explained as a result of only the stress exposures after an interruption from stress. These experiments demonstrate that the pattern of stress exposure is a significant determinant of the effects of repeated stress, and that interrupted stress exposure that decreases habituation can have larger effects than a greater number of daily stress exposures. Differences in the pattern of stress exposure are therefore an important factor to consider when predicting the severity of the effects of repeated

Neural markers of a greater female responsiveness to social stimuli

Directory of Open Access Journals (Sweden)

Zani Alberto

2008-06-01

Full Text Available Abstract Background There is fMRI evidence that women are neurally predisposed to process infant laughter and crying. Other findings show that women might be more empathic and sensitive than men to emotional facial expressions. However, no gender difference in the brain responses to persons and unanimated scenes has hitherto been demonstrated. Results Twenty-four men and women viewed 220 images portraying persons or landscapes and ERPs were recorded from 128 sites. In women, but not in men, the N2 component (210–270 was much larger to persons than to scenes. swLORETA showed significant bilateral activation of FG (BA19/37 in both genders when viewing persons as opposed to scenes. Only women showed a source of activity in the STG and in the right MOG (extra-striate body area, EBA, and only men in the left parahippocampal area (PPA. Conclusion A significant gender difference was found in activation of the left and right STG (BA22 and the cingulate cortex for the subtractive condition women minus men, thus indicating that women might have a greater preference or interest for social stimuli (faces and persons.

The Influence of Methods Massed Practice and Distributed Practice Model on The Speed and Accuracy of Service Tennis Courts

Directory of Open Access Journals (Sweden)

Desak Wiwin,

2017-06-01

Full Text Available The purpose of this study was to analyze about (1 the effect of the method massed practice against the speed and accuracy of service, (2 the effect of the method of distributed practice against the speed and accuracy of service and (3 the influence of methods of massed practice and distributed practice against the speed and accuracy of service. This type of research used in this research is quantitative with quasiexperimental methods. The research design uses a non-randomized control group pretest posttest design, and data analysis using Manova. The process of data collection is done by testing the speed of service (dartfish and test accuracy (Hewitt during the pretest and posttest. The results of the study as follows: (1 there is a significant influence on the methods of massed practice to increase the speed and accuracy of service (2 there is a significant influence on the method of distributed practice to increase the speed and accuracy of service (3 There is no significant difference influence among methods massed ptactice practice and distributed to the speed and accuracy of service. Conclusions of this research is a method massed practice and distributed practice equally provide significant results but that gives the influence of better is method distributed practice to speed and accuracy of service.

Rib fractures and their association With solid organ injury: higher rib fractures have greater significance for solid organ injury screening.

Science.gov (United States)

Rostas, Jack W; Lively, Timothy B; Brevard, Sidney B; Simmons, Jon D; Frotan, Mohammad A; Gonzalez, Richard P

2017-04-01

The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures. Right-sided rib fractures with highest sensitivity for liver injury were middle rib segment (5 to 8) and lower segment (9 to 12) with liver injury sensitivities of 68% and 43%, respectively (P rib fractures. Left middle segment rib fractures and lower segment rib fractures had sensitivities of 80% and 63% for splenic injury, respectively (P Rib fractures higher in the thoracic cage have significant association with solid organ injury. Using rib fractures from middle plus lower segments as indication for abdominal screening will significantly improve rib fracture sensitivity for identification of solid organ injury. Copyright © 2016 Elsevier Inc. All rights reserved.

Commentary on the MID3 Good Practices Paper.

Science.gov (United States)

Manolis, Efthymios; Brogren, Jacob; Cole, Susan; Hay, Justin L; Nordmark, Anna; Karlsson, Kristin E; Lentz, Frederike; Benda, Norbert; Wangorsch, Gaby; Pons, Gerard; Zhao, Wei; Gigante, Valeria; Serone, Francesca; Standing, Joseph F; Dokoumetzidis, Aris; Vakkilainen, Juha; van den Heuvel, Michiel; Mangas Sanjuan, Victor; Taminiau, Johannes; Kerwash, Essam; Khan, David; Musuamba, Flora Tshinanu; Skottheim Rusten, Ine

2017-07-01

During the last 10 years the European Medicines Agency (EMA) organized a number of workshops on modeling and simulation, working towards greater integration of modeling and simulation (M&S) in the development and regulatory assessment of medicines. In the 2011 EMA - European Federation of Pharmaceutical Industries and Associations (EFPIA) Workshop on Modelling and Simulation, European regulators agreed to the necessity to build expertise to be able to review M&S data provided by companies in their dossier. This led to the establishment of the EMA Modelling and Simulation Working Group (MSWG). Also, there was agreement reached on the need for harmonization on good M&S practices and for continuing dialog across all parties. The MSWG acknowledges the initiative of the EFPIA Model-Informed Drug Discovery and Development (MID3) group in promoting greater consistency in practice, application, and documentation of M&S and considers the paper is an important contribution towards achieving this objective. © 2017 The Authors CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

Translating Neurodevelopmental Care Policies Into Practice: The Experience of Neonatal ICUs in France—The EPIPAGE-2 Cohort Study

Science.gov (United States)

Coquelin, Anaëlle; Cuttini, Marina; Khoshnood, Babak; Glorieux, Isabelle; Claris, Olivier; Durox, Mélanie; Kaminski, Monique; Ancel, Pierre-Yves; Arnaud, Catherine

2016-01-01

Objectives: To describe the implementation of neurodevelopmental care for newborn preterm infants in neonatal ICUs in France in 2011, analyze changes since 2004, and investigate factors associated with practice. Design: Prospective national cohort study of all births before 32 weeks of gestation. Setting: Twenty-five French regions. Participants: All neonatal ICUs (n = 66); neonates surviving at discharge (n = 3,005). Interventions: None. Measurements and Main Results: Neurodevelopmental care policies and practices were assessed by structured questionnaires. Proportions of neonates initiating kangaroo care during the first week of life and those whose mothers expressed breast milk were measured as neurodevelopmental care practices. Multilevel logistic regression analyses were used to investigate relationships between kangaroo care or breast-feeding practices and unit policies, taking into account potential confounders. Free visiting policies, bed availability for parents, and kangaroo care encouragement significantly improved between 2004 and 2011 but with large variabilities between units. Kangaroo care initiation varied from 39% for neonates in the most restrictive units to 68% in less restrictive ones (p neurodevelopmental care significantly influenced kangaroo care initiation (odds ratio, 3.5; 95% CI, 1.8–7.0 for Newborn Individualized Developmental Care and Assessment Program implementation compared with no training). Breast milk expression by mothers was greater in units with full-time availability professionals trained for breast-feeding support (60% vs 73%; p neurodevelopmental practices occurred between 2004 and 2011, but large variabilities between units persist. Practices increased in units with supportive policies. Specific neurodevelopmental care training with multifaceted interventions strengthened the implementation of policies. PMID:27518584

Breeding of Greater and Lesser Flamingos at Sua Pan, Botswana ...

African Journals Online (AJOL)

to fledging was unknown owing to the rapid drying of the pan in late March 1999. No Greater Flamingo breeding was seen that season. Exceptional flooding during 1999–2000 produced highly favourable breeding conditions, with numbers of Greater and Lesser Flamingos breeding estimated to be 23 869 and 64 287 pairs, ...

Surgical anatomy of greater occipital nerve and its relation to ...

African Journals Online (AJOL)

Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to study the anatomy of ...

Surgical anatomy of greater occipital nerve and its relation to ...

African Journals Online (AJOL)

Nancy Mohamed El Sekily

2014-08-19

Aug 19, 2014 ... Abstract Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to ...

Greater-than-Class C low-level waste characterization. Appendix I: Impact of concentration averaging low-level radioactive waste volume projections

International Nuclear Information System (INIS)

Tuite, P.; Tuite, K.; O'Kelley, M.; Ely, P.

1991-08-01

This study provides a quantitative framework for bounding unpackaged greater-than-Class C low-level radioactive waste types as a function of concentration averaging. The study defines the three concentration averaging scenarios that lead to base, high, and low volumetric projections; identifies those waste types that could be greater-than-Class C under the high volume, or worst case, concentration averaging scenario; and quantifies the impact of these scenarios on identified waste types relative to the base case scenario. The base volume scenario was assumed to reflect current requirements at the disposal sites as well as the regulatory views. The high volume scenario was assumed to reflect the most conservative criteria as incorporated in some compact host state requirements. The low volume scenario was assumed to reflect the 10 CFR Part 61 criteria as applicable to both shallow land burial facilities and to practices that could be employed to reduce the generation of Class C waste types

Significance of abolishing British National Oil Corporation

Energy Technology Data Exchange (ETDEWEB)

Mabro, R

1985-04-01

The decision to abolish British National Oil Corporation has greater significance than any commentator, so far, has cared to admit. Mr. Mabro says the Government has done much more than get rid of an institution it had previously weakened and emasculated; in effect, it had abdicated its responsibilities for the pricing of North Sea oil. He further observes that these moves may be consistent with the tenets of a simplistic free-market ideology: they betray, however, a lack of understanding of the economics of oil, and of the UK economic interest in oil.

Generating Ideas in Jazz Improvisation: Where Theory Meets Practice

Science.gov (United States)

Hargreaves, Wendy

2012-01-01

Idea generation is an integral component of jazz improvising. This article merges theoretical origins and practical experiences through the examination of two seminal works from Pressing and Sudnow. A comparative analysis yields three common sources with distinct characteristics. The greater body of jazz literature supports this potential link…

Opinions and practices of medical rehabilitation professionals regarding prayer and meditation.

Science.gov (United States)

Schoenberger, Nancy E; Matheis, Robert J; Shiflett, Samuel C; Cotter, Ann C

2002-02-01

To assess the attitudes and practices of professionals in the field of physical medicine and rehabilitation (PM&R) regarding prayer and meditation. A national mail survey that included questions about the use of a number of complementary and alternative therapies. The survey was mailed to 7,479 physicians, nurses, physical therapists, and occupational therapists who specialize in PM&R, and 1221 (17%) returned completed surveys. Although the majority of respondents endorsed prayer as a legitimate health care practice, there was greater belief in the benefits of meditation. Older respondents were more likely to recommend meditation to their patients and more likely to meditate themselves. Gender differences that were observed in opinions and practices are better interpreted as differences in professional specialty. In general, nurses and occupational therapists responded more positively toward meditation and prayer than did physicians and physical therapists. Personal use of a technique was the strongest predictor of professional behaviors. Attitude was a stronger predictor of professional use or referral for prayer than meditation, but correlations between attitude and behavior were generally weak for both techniques. Despite their acceptance of these techniques, the vast majority of rehabilitation professionals did not refer their patients for meditation or religious consultation. Although there were significant relationships among beliefs, and personal and professional behaviors regarding these techniques, a large part of the variance in professional behaviors was not accounted for by age, gender, opinion, or personal behavior, indicating that other influences exert a stronger effect on professional practice decisions.

Which Instructional Practices Most Help First Grade Students with and without Mathematics Difficulties?

Science.gov (United States)

Morgan, Paul L.; Farkas, George; Maczuga, Steve

2015-01-01

We used population-based, longitudinal data to investigate the relation between mathematics instructional practices used by 1st grade teachers in the U.S. and the mathematics achievement of their students. Factor analysis identified four types of instructional activities (i.e., teacher-directed, student-centered, manipulatives/calculators, movement/music) and eight types of specific skills taught (e.g., adding two-digit numbers). First-grade students were then classified into five groups on the basis of their fall and/or spring of kindergarten mathematics achievement—three groups with mathematics difficulties (MD) and two without MD. Regression analysis indicated that a higher percentage of MD students in 1st grade classrooms was associated with greater use by teachers of manipulatives/calculators and movement/music to teach mathematics. Yet follow-up analysis for each of the MD and non-MD groups indicated that only teacher-directed instruction was significantly associated with the achievement of students with MD (covariate-adjusted ESs = .05–.07). The largest predicted effect for a specific instructional practice was for routine practice and drill. In contrast, for both groups of non-MD students, teacher-directed and student-centered instruction had approximately equal, statistically significant positive predicted effects (covariate-adjusted ESs = .03–.04). First-grade teachers in the U.S. may need to increase their use of teacher-directed instruction if they are to raise the mathematics achievement of students with MD. PMID:26180268

Technical concept for a Greater Confinement Disposal test facility

International Nuclear Information System (INIS)

Hunter, P.H.

1982-01-01

For the past two years, Ford, Bacon and Davis has been performing technical services for the Department of Energy at the Nevada Test Site in specific development of defense low-level waste management concepts for greater confinement disposal concept with particular application to arid sites. The investigations have included the development of Criteria for Greater Confinement Disposal, NVO-234, which was published in May of 1981 and the draft of the technical concept for Greater Confinement Disposal, with the latest draft published in November 1981. The final draft of the technical concept and design specifications are expected to be published imminently. The document is prerequisite to the actual construction and implementation of the demonstration facility this fiscal year. The GCD Criteria Document, NVO-234 is considered to contain information complimentary and compatible with that being developed for the reserved section 10 CFR 61.51b of the NRCs proposed licensing rule for low level waste disposal facilities

Physiotherapy co-management of rheumatoid arthritis: identification of red flags, significance to clinical practice and management pathways.

Science.gov (United States)

Briggs, Andrew M; Fary, Robyn E; Slater, Helen; Ranelli, Sonia; Chan, Madelynn

2013-12-01

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune disease. Physiotherapy interventions for people with RA are predominantly targeted at ameliorating disability resulting from articular and peri-articular manifestations of the disease and providing advice and education to improve functional capacity and quality of life. To ensure safe and effective care, it is critical that physiotherapists are able to identify potentially serious articular and peri-articular manifestations of RA, such as instability of the cervical spine. Additionally, as primary contact professionals, it is essential that physiotherapists are aware of the potentially serious extra-articular manifestations of RA. This paper provides an overview of the practice-relevant manifestations associated with RA that might warrant further investigation by a medical practitioner (red flags), their relevance to physiotherapy practice, and recommended management pathways. Copyright © 2013 Elsevier Ltd. All rights reserved.

Characteristics of Health Care Practices and Systems That Excel in Hypertension Control.

Science.gov (United States)

Young, An; Ritchey, Matthew D; George, Mary G; Hannan, Judy; Wright, Janet

2018-06-07

Approximately 1 in 3 US adults has hypertension, but only half have their blood pressure controlled. We identified characteristics of health care practices and systems (hereinafter practices) effective in achieving control rates at or above 70% by using data collected via applications submitted from April through June 2017 for consideration in the Million Hearts Hypertension Control Challenge. We included 96 practices serving 635,000 patients with hypertension across 34 US states in the analysis. Mean hypertension control rate was 77.1%; 27.1% of practices had a control rate of 80% or greater. Although many practices served large populations with multiple risk factors for uncontrolled hypertension, high control rates were achieved with implementation of evidenced-based strategies.

Accuracy of Carotid Duplex Criteria in Diagnosis of Significant Carotid Stenosis in Asian Patients.

Science.gov (United States)

Dharmasaroja, Pornpatr A; Uransilp, Nattaphol; Watcharakorn, Arvemas; Piyabhan, Pritsana

2018-03-01

Extracranial carotid stenosis can be diagnosed by velocity criteria of carotid duplex. Whether they are accurately applied to define severity of internal carotid artery (ICA) stenosis in Asian patients needs to be proved. The purpose of this study was to evaluate the accuracy of 2 carotid duplex velocity criteria in defining significant carotid stenosis. Carotid duplex studies and magnetic resonance angiography were reviewed. Criteria 1 was recommended by the Society of Radiologists in Ultrasound; moderate stenosis (50%-69%): peak systolic velocity (PSV) 125-230 cm/s, diastolic velocity (DV) 40-100 cm/s; severe stenosis (>70%): PSV greater than 230 cm/s, DV greater than 100 cm/s. Criteria 2 used PSV greater than 140 cm/s, DV less than 110 cm/s to define moderate stenosis (50%-75%) and PSV greater than 140 cm/s, DV greater than 110 cm/s for severe stenosis (76%-95%). A total of 854 ICA segments were reviewed. There was moderate stenosis in 72 ICAs, severe stenosis in 50 ICAs, and occlusion in 78 ICAs. Criteria 2 had slightly lower sensitivity, whereas higher specificity and accuracy than criteria 1 were observed in detecting moderate stenosis (criteria 1: sensitivity 95%, specificity 83%, accuracy 84%; criteria 2: sensitivity 92%, specificity 92%, and accuracy 92%). However, in detection of severe ICA stenosis, no significant difference in sensitivity, specificity, and accuracy was found (criteria 1: sensitivity 82%, specificity 99.57%, accuracy 98%; criteria 2: sensitivity 86%, specificity 99.68%, and accuracy 99%). In the subgroup of moderate stenosis, the criteria using ICA PSV greater than 140 cm/s had higher specificity and accuracy than the criteria using ICA PSV 125-230 cm/s. However, there was no significant difference in detection of severe stenosis or occlusion of ICA. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Inducing preschool children's emotional eating: relations with parental feeding practices.

Science.gov (United States)

Blissett, Jackie; Haycraft, Emma; Farrow, Claire

2010-08-01

Children's emotional eating is related to greater body mass index and a less-healthy diet, but little is known about the early development of this behavior. This study aimed to examine the relations between preschool children's emotional eating and parental feeding practices by using experimental manipulation of child mood and food intake in a laboratory setting. Twenty-five 3-5-y-old children and their mothers sat together and ate a standard meal to satiety. Mothers completed questionnaires regarding their feeding practices. Children were assigned to a control or negative mood condition, and their consumption of snack foods in the absence of hunger was measured. Children whose mothers often used food to regulate emotions ate more cookies in the absence of hunger than did children whose mothers used this feeding practice infrequently, regardless of condition. Children whose mothers often used food for emotion regulation purposes ate more chocolate in the experimental condition than in the control condition. The pattern was reversed for children of mothers who did not tend to use food for emotion regulation. There were no significant effects of maternal use of restriction, pressure to eat, and use of foods as a reward on children's snack food consumption. Children of mothers who use food for emotion regulation consume more sweet palatable foods in the absence of hunger than do children of mothers who use this feeding practice infrequently. Emotional overeating behavior may occur in the context of negative mood in children whose mothers use food for emotion regulation purposes. This trial was registered at clinicaltrials.gov as NCT01122290.

Predicting significant torso trauma.

Science.gov (United States)

Nirula, Ram; Talmor, Daniel; Brasel, Karen

2005-07-01

Identification of motor vehicle crash (MVC) characteristics associated with thoracoabdominal injury would advance the development of automatic crash notification systems (ACNS) by improving triage and response times. Our objective was to determine the relationships between MVC characteristics and thoracoabdominal trauma to develop a torso injury probability model. Drivers involved in crashes from 1993 to 2001 within the National Automotive Sampling System were reviewed. Relationships between torso injury and MVC characteristics were assessed using multivariate logistic regression. Receiver operating characteristic curves were used to compare the model to current ACNS models. There were a total of 56,466 drivers. Age, ejection, braking, avoidance, velocity, restraints, passenger-side impact, rollover, and vehicle weight and type were associated with injury (p < 0.05). The area under the receiver operating characteristic curve (83.9) was significantly greater than current ACNS models. We have developed a thoracoabdominal injury probability model that may improve patient triage when used with ACNS.

Butterfly valves: greater use in power plants

International Nuclear Information System (INIS)

McCoy, M.

1975-01-01

Improvements in butterfly valves, particularly in the areas of automatic control and leak tightness are described. The use of butterfly valves in nuclear power plants is discussed. These uses include service in component cooling, containment cooling, and containment isolation. The outlook for further improvements and greater uses is examined. (U.S.)

Greater-than-Class C low-level waste characterization technical review process

Energy Technology Data Exchange (ETDEWEB)

Hutchison, D.; Magleby, M.

1990-01-01

Existing volume projections of greater-than-Class C low-level waste (GTCC LLW) vary significantly. The Department of Energy (DOE) National Low-Level Waste Management Program (NLLWMP) has undertaken activities to develop a best estimate of GTCC LLW volumes and activities for use as the planning basis. Initial information about the generation of GTCC LLW was obtained through a DOE Energy Information Administration survey. That information, combined with information from other related literature, formed the basis of a computer model, which projects potential GTCC LLW. This paper describes uncertainties in existing GTCC LLW characterization and volume projections data and describes the technical review process that is being used to assist in projections of GTCC LLW expected for storage and disposal. 8 refs., 2 tabs.

Greater-than-Class C low-level waste characterization technical review process

International Nuclear Information System (INIS)

Hutchison, D.; Magleby, M.

1990-01-01

Existing volume projections of greater-than-Class C low-level waste (GTCC LLW) vary significantly. The Department of Energy (DOE) National Low-Level Waste Management Program (NLLWMP) has undertaken activities to develop a best estimate of GTCC LLW volumes and activities for use as the planning basis. Initial information about the generation of GTCC LLW was obtained through a DOE Energy Information Administration survey. That information, combined with information from other related literature, formed the basis of a computer model, which projects potential GTCC LLW. This paper describes uncertainties in existing GTCC LLW characterization and volume projections data and describes the technical review process that is being used to assist in projections of GTCC LLW expected for storage and disposal. 8 refs., 2 tabs

Active ageing on the company level: the theory vs. the day-to-day practice in Slovenia

Directory of Open Access Journals (Sweden)

Vlado Dimovski

2009-11-01

Full Text Available The need to improve the labour market participation of older people has received ever greater attention in recent years, especially in view of the significant demographic changes the European Union will undergo due to population ageing. Besides the macroeconomic level, implications of this trend are strongly seen at the company level, particularly when it comes to managing the ageing workforce. Companies are thus introducing new approaches, policies and instruments which seek to foster the higher employment rates of the elderly by implementing the active-ageing concept in business and HRM practice. The paper aims to highlight the development of active-ageing initiatives within Slovenian companies where the practice of age management is still in its early stages. Consequently, we shed light on problems and obstacles appearing in the developmental process of implementing the active-ageing concept in Slovenian companies, and conclude with some recommendations for the future development of active-ageing practice with an emphasis on new HRM approaches, policies and instruments which seem to be extremely important when striving to prolong working life.

Clinical Practice in Teacher Training

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Hidayet Tok

2011-12-01

Full Text Available Recently, it seems that there has been a concept change in the aspect of teaching practice course which is regarded as one of the most significant course in teacher education program. This new concept requires the increase period of teaching practice in teacher education program and parallel to this, it also requires the change in the function of practice schools and highlighted “clinical practice in teacher education” concept. In this study, “clinical practice in teacher education” concept and its implementation processes were explained. Furthermore, clinical practice and traditional school practices were presented and the parallels between teaching and clinical practices were explained as well

Expatriate job performance in Greater China: Does age matter?

DEFF Research Database (Denmark)

Selmer, Jan; Lauring, Jakob; Feng, Yunxia

to expatriates in Chinese societies. It is possible that older business expatriates will receive more respect and be treated with more deference in a Chinese cultural context than their apparently younger colleagues. This may have a positive impact on expatriates’ job performance. To empirically test...... this presumption, business expatriates in Greater Chine were targeted by a survey. Controlling for the potential bias of a number of background variables, results indicate that contextual/managerial performance, including general managerial functions applied to the subsidiary in Greater China, had a positive...

Absenteeism movement in Greater Poland in 1840–1902

OpenAIRE

Izabela Krasińska

2013-01-01

The article presents the origins and development of the idea of absenteeism in Greater Poland in the 19th century. The start date for the research is 1840, which is considered to be a breakthrough year in the history of an organized absenteeism movement in Greater Poland. It was due to the Association for the Suppression of the Use of Vodka (Towarzystwo ku Przytłumieniu Używania Wódki) in the Great Duchy of Posen that was then established in Kórnik. It was a secular organization that came int...

Gender differences in commuting behavior: Women's greater sensitivity

Energy Technology Data Exchange (ETDEWEB)

Olmo Sanchez, M.I.; Maeso Gonzalez, E.

2016-07-01

Women's greater sensitivity to changes in their environment is one of the most distinguishing features between both genders. This article raises women's greater sensitivity to the different variables which influence their commuting modal choice. In order to do this, gender gaps detected in the choice of means of transport in commuting trips with respect to the decision factors such as age, education level, driver's license, private transport access; location, household size and net income, are quantified.The results show a greater female sensitivity to the different variables that affect their modal choice, which helps to better understand the different mobility patterns and it is useful for planning measures favoring sustainable mobility policies and equity. (Author)

Is gerontology ready for anti-racist pedagogy? A survey of educators' practices and perspectives.

Science.gov (United States)

Karasik, Rona J; Kishimoto, Kyoko

2018-01-01

The older population in the United States is becoming more diverse, bringing increasing attention to the ways in which diversity and multiculturalism are addressed in gerontological education. Although diversity and multiculturalism have long been recognized as important components of the aging experience, our approach to understanding their significance and impact continues to grow and change. Anti-racist pedagogy represents one catalyst to stimulate such change. To evaluate the potential for anti-racist pedagogy in gerontology, this study explored gerontological educators' (N = 121) current practices and perspectives regarding the inclusion of diversity content in their courses, as well as the extent to which they are familiar with and/or use anti-racist pedagogy in their classes. The findings suggest that greater attention to issues of race, ethnicity, and multicultural diversity throughout the gerontological curriculum is needed and wanted. Although respondents were generally unfamiliar with the name anti-racist pedagogy, many indicated that their current teaching practices employed select components of it. Overall, the findings point toward the need for continued exploration of how anti-racist pedagogy may be brought into the gerontological classroom, as well as its implications for future research, policy, and practice.

Retinopathy of Prematurity in Neonatal Patients with Birth Weight Greater than 1500 g in Taiwan

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Yi-Hsing Chen

2013-04-01

Full Text Available Background: To understand the characteristics, ophthalmic outcomes, and risk factors of retinopathy of prematurity (ROP in patients with birth weight (BW greater than 1500 g. The applicability of the ROP screening criteria to the Taiwanese population was also examined. Methods: The study included 104 eyes from 54 ROP patients who had BW greater than 1500 g from 1981 to 2008. Demographic information, disease courses, ophthalmic outcomes, and possible systemic risk factors were recorded. The infants were divided into groups of mild and severe ROP for a risk factor analysis. Results: The mean gestational age (GA of the infants was 31 ± 1.3 weeks, and the mean BW was 1675 ± 249 g. Mild ROP regressed in 94 eyes (90%, and 10 eyes (10% developed severe ROP. After various treatments, the regression rates for prethreshold or threshold ROP (n = 8 and stage 4 ROP (n = 2 were 100% and 50%, respectively. Forty-eight patients (85% had at least three associated systemic risk factors. A multiple logistic regression analysis revealed that patients with an intraventricular hemorrhage were found to have an increased chance of developing severe ROP, especially those with BW greater than 1500 g (p = 0.015. There was also a significant association between patients who had severe ROP and an increased risk of having cerebral palsy (CP at 1.5 years of age (p = 0.013. Conclusion: The majority of patients with BW greater than 1500 g developed mild ROP. However, advanced ROP with poor visual outcome was also encountered in some patients.

Brain morphometry shows effects of long-term musical practice in middle-aged keyboard players

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Hanna eGärtner

2013-09-01

Full Text Available To what extent does musical practice change the structure of the brain? In order to understand how long-lasting musical training changes brain structure, 20 male right-handed, middle-aged professional musicians and 19 matched controls were investigated. Among the musicians, 13 were pianists or organists with intensive practice regimes. The others were either music teachers at schools or string instrumentalists, who had studied the piano at least as a subsidiary subject, and practiced less intensively. The study was based on T1-weighted MR images, which were analyzed using Deformation Field Morphometry. Cytoarchitectonic probabilistic maps of cortical areas and subcortical nuclei as well as myeloarchitectonic maps of fiber tracts were used as regions of interest to compare volume differences in the brains of musicians and controls. In addition, maps of voxel-wise volume differences were computed and analyzed.Musicians showed a significantly better symmetric motor performance as well as a greater capability of controlling hand independence than controls. Structural MRI-data revealed significant volumetric differences between the brains of keyboard players, who practiced intensively and controls in right sensorimotor areas and the corticospinal tract as well as in the entorhinal cortex and the left superior parietal lobule. Moreover, they showed also larger volumes in a comparable set of regions than the less intensively practicing musicians. The structural changes in the sensory and motor systems correspond well to the behavioral results, and can be interpreted in terms of plasticity as a result of intensive motor training. Areas of the superior parietal lobule and the entorhinal cortex might be enlarged in musicians due to their special skills in sight-playing and memorizing of scores. In conclusion, intensive and specific musical training seems to have an impact on brain structure, not only during the sensitive period of childhood but throughout

Association of intervention outcomes with practice capacity for change: Subgroup analysis from a group randomized trial

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Weyer Sharon

2008-05-01

Full Text Available Abstract Background The relationship between health care practices' capacity for change and the results and sustainability of interventions to improve health care delivery is unclear. Methods In the setting of an intervention to increase preventive service delivery (PSD, we assessed practice capacity for change by rating motivation to change and instrumental ability to change on a one to four scale. After combining these ratings into a single score, random effects models tested its association with change in PSD rates from baseline to immediately after intervention completion and 12 months later. Results Our measure of practices' capacity for change varied widely at baseline (range 2–8; mean 4.8 ± 1.6. Practices with greater capacity for change delivered preventive services to eligible patients at higher rates after completion of the intervention (2.7% per unit increase in the combined effort score, p Conclusion Greater capacity for change is associated with a higher probability that a practice will attain and sustain desired outcomes. Future work to refine measures of this practice characteristic may be useful in planning and implementing interventions that result in sustained, evidence-based improvements in health care delivery.

Radiographic features of tuberculous osteitis in greater trochanter and lschium

International Nuclear Information System (INIS)

Hahm, So Hee; Lee, Ye Ri; Kim, Dong Jin; Sung, Ki Jun; Lim, Jong Nam

1996-01-01

To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis

Radiographic features of tuberculous osteitis in greater trochanter and lschium

Energy Technology Data Exchange (ETDEWEB)

Hahm, So Hee; Lee, Ye Ri [Hanil Hospital Affiliated to KEPCO, Seoul (Korea, Republic of); Kim, Dong Jin; Sung, Ki Jun [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of); Lim, Jong Nam [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)

1996-11-01

To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.

Personalized Video Feedback and Repeated Task Practice Improve Laparoscopic Knot-Tying Skills: Two Controlled Trials.

Science.gov (United States)

Abbott, Eduardo F; Thompson, Whitney; Pandian, T K; Zendejas, Benjamin; Farley, David R; Cook, David A

2017-11-01

Compare the effect of personalized feedback (PF) vs. task demonstration (TD), both delivered via video, on laparoscopic knot-tying skills and perceived workload; and evaluate the effect of repeated practice. General surgery interns and research fellows completed four repetitions of a simulated laparoscopic knot-tying task at one-month intervals. Midway between repetitions, participants received via e-mail either a TD video (demonstration by an expert) or a PF video (video of their own performance with voiceover from a blinded senior surgeon). Each participant received at least one video per format, with sequence randomly assigned. Outcomes included performance scores and NASA Task Load Index (NASA-TLX) scores. To evaluate the effectiveness of repeated practice, scores from these trainees on a separate delayed retention test were compared against historical controls who did not have scheduled repetitions. Twenty-one trainees completed the randomized study. Mean change in performance scores was significantly greater for those receiving PF (difference = 23.1 of 150 [95% confidence interval (CI): 0, 46.2], P = .05). Perceived workload was also significantly reduced (difference = -3.0 of 20 [95% CI: -5.8, -0.3], P = .04). Compared with historical controls (N = 93), the 21 with scheduled repeated practice had higher scores on the laparoscopic knot-tying assessment two weeks after the final repetition (difference = 1.5 of 10 [95% CI: 0.2, 2.8], P = .02). Personalized video feedback improves trainees' procedural performance and perceived workload compared with a task demonstration video. Brief monthly practice sessions support skill acquisition and retention.

Young worker safety in construction: do family ties and workgroup size affect hazard exposures and safety practices?

Science.gov (United States)

Rauscher, Kimberly J; Myers, Douglas J; Runyan, Carol W; Schulman, Michael

2012-01-01

Little is known about how social aspects of the work environment influence exposures or safety practices affecting young construction workers. Our objective was to investigate whether working on a construction site with a small number of workers (≤10 vs. 11-50) or having a family-firm connection (working in a family-owned firm or one in which a family member also works) impacts hazard exposures and safety practices. Participants included 187 North Carolina construction workers 14 to 17 years old who were surveyed about their jobs. We conducted stratified analyses using cross-tabulations and chi-square statistics to measure associations between workgroup size (i.e., the total number of workers on a jobsite) and family-firm connections (yes/no) and hazard exposures (e.g., saws) and safety practices (e.g., supervision). Having a family-firm connection was associated with fewer hazard exposures and greater safety practices. Youth who worked on jobsites with a larger workgroup (11-50 workers) reported more hazards but also more safety practices. Family-firm connections, in particular, may have a protective effect for youth in construction. Even though the statistical significance of our findings on workgroup size was limited in places, the pattern of differences found suggest that further research in this area is warranted.

[Knowledge and adherence to bio-safety measures and biological accidents by nursing students during their clinical practice].

Science.gov (United States)

Merino-de la Hoz, Felicitas; Durá-Ros, María Jesús; Rodríguez-Martín, Elías; González-Gómez, Silvia; Mariano López-López, Luis; Abajas-Bustillo, Rebeca; de la Horra-Gutiérrez, Inmaculada

2010-01-01

To identify the degree of knowledge and performance of bio-safety measures by nursing students and knowing the type of biological accidents suffered during their clinical practice. A cross-sectional study was conducted on the students of three Nursing courses held in May of 2008. Data was collected by an anonymous self-administered questionnaire, with a return of 54%. A total of 97% of students seemed to know the standard biosafety measures, and all of them (100%) stated that those measures must be applied to every patient. However, the reality of clinical practice shows that biosafety measures are only partially applied. An average of 60.2% implement the personal hygiene measures, 66.1% use physical barriers, and 44% use sharp materials safely. Around 32.25% of the students have suffered some biological accident, with a greater incidence in the second year: administering injections (24%), drawing blood samples with Venojet needles (18%) and recapping used needles (17%). The high level of knowledge shown by the students on standard precautions is not always shown in clinical practice. There are significant deficiencies in student safety practices: recapping of used needles continues to be one of the most common risk practices carried out. Copyright (c) 2009 Elsevier España, S.L. All rights reserved.

Meeting patient needs trumps adherence. A cross-sectional study of adherence and adaptations when national guidelines are used in practice.

Science.gov (United States)

Kakeeto, Mikael; Lundmark, Robert; Hasson, Henna; von Thiele Schwarz, Ulrica

2017-08-01

In the evidence-to-practice pathway, guidelines are developed to provide a practical summary of evidence and stimulate change. However, when guidelines are used in practice, adherence to the recommendations in guidelines is limited, and adaptations are common. Thus, we need more detailed knowledge about adherence and adaptations when guidelines are used in practice to understand the end of the evidence-to-practice pathway. Subsequently, the aim is to examine adherence to and adaptations of recommendations in the Swedish National Guidelines for Methods of Preventing Disease. A questionnaire was sent to healthcare professionals and managers in Stockholm between January and March 2014. Adherence to the recommendations was compared between practice settings, and the frequency of different adaptations and reasons for adaptations was analysed. Partial adherence to the guidelines was found. The adherence was significantly greater within primary care than at the hospitals (P guidelines are used in practice. Work with lifestyle habits was partially done in accordance with the guidelines. Lack of time and lack of resources were not the most common reasons for adaptations. Rather, the findings suggest that when patient needs and capabilities contrast with guideline recommendations, patient needs trump adherence to guidelines. © 2017 John Wiley & Sons, Ltd.

The radiological impact on the Greater London population of postulated accidental releases from the Sizewell PWR

CERN Document Server

Kelly, G N; Charles, D; Hemming, C R

1983-01-01

This report contains an assessment of the radiological impact on the Greater London population of postulated accidental releases from the Sizewell PWR. Three of the degraded core accident releases postulated by the CEGB are analysed. The consequences, conditional upon each release, are evaluated in terms of the health impact on the exposed population and the impact of countermeasures taken to limit the exposure. Consideration is given to the risk to the Greater London population as a whole and to individuals within it. The consequences are evaluated using the NRPB code MARC (Methodology for Assessing Radiological Consequences). The results presented in this report are all conditional upon the occurrence of each release. In assessing the significance of the results, due account must be taken of the frequency with which such releases may be predicted to occur.

What do beginning students, in a rurally focused medical course, think about rural practice?

Science.gov (United States)

Young, Louise; Lindsay, Daniel B; Ray, Robin A

2016-12-07

Medical schools may select students for their attitudes towards rural medical practice, yet the rural-urban disparity in availability of medical practitioners and services has not diminished in recent times despite government initiatives and increasing numbers being trained for a career in medicine. One medical school, with a focus on rural and remote medicine, aims to select students with positive perceptions for rural medical practice. A research project collected data on the perceptions of these medical students in the first week of their medical studies. Students completed a low stakes essay on the life and work of a rural doctor. Initially, this formed part of a literacy assessment to determine any students requiring remediation. All students were asked if they would consent to their essay being reviewed for a research project. Data was obtained from those students who consented and handed their essays in for review. The 103 student essays underwent thematic analysis and sentences were coded into three main themes of rural lifestyle, doctor role and rural practice. Second level themes were further elicited and results were quantified according to whether they were positive or negative. Positive themes included rural lifestyle, doctor role, views of doctor, impact on community, broader work and skills knowledge, and better relationships with community and patients. Negative themes included doctor's health, pressure on doctor, family problems, greater workload, privacy and confidentiality issues, cultural issues, isolation, limited resources and financial impacts. Quantitisation of this data was used to transform essay sentences into a numerical form which allowed statistical analysis and comparison of perceptions using Z tests. No significant differences on the number of positive and negative responses for rural lifestyle and rural practice were found. The rural doctor role had a significantly more positive than negative views. Significant differences were

Integrating soil conservation practices and glyphosate-resistant crops: impacts on soil.

Science.gov (United States)

Locke, Martin A; Zablotowicz, Robert M; Reddy, Krishna N

2008-04-01

Conservation practices often associated with glyphosate-resistant crops, e.g. limited tillage and crop cover, improve soil conditions, but only limited research has evaluated their effects on soil in combination with glyphosate-resistant crops. It is assumed that conservation practices have similar benefits to soil whether or not glyphosate-resistant crops are used. This paper reviews the impact on soil of conservation practices and glyphosate-resistant crops, and presents data from a Mississippi field trial comparing glyphosate-resistant and non-glyphosate-resistant maize (Zea mays L.) and cotton (Gossypium hirsutum L.) under limited tillage management. Results from the reduced-tillage study indicate differences in soil biological and chemical properties owing to glyphosate-resistant crops. Under continuous glyphosate-resistant maize, soils maintained greater soil organic carbon and nitrogen as compared with continuous non-glyphosate-resistant maize, but no differences were measured in continuous cotton or in cotton rotated with maize. Soil microbial community structure based on total fatty acid methyl ester analysis indicated a significant effect of glyphosate-resistant crop following 5 years of continuous glyphosate-resistant crop as compared with the non-glyphosate-resistant crop system. Results from this study, as well as the literature review, indicate differences attributable to the interaction of conservation practices and glyphosate-resistant crop, but many are transient and benign for the soil ecosystem. Glyphosate use may result in minor effects on soil biological/chemical properties. However, enhanced organic carbon and plant residues in surface soils under conservation practices may buffer potential effects of glyphosate. Long-term field research established under various cropping systems and ecological regions is needed for critical assessment of glyphosate-resistant crop and conservation practice interactions. Copyright (c) 2008 by John Wiley & Sons

Interdisciplinary Practice Approach to Proteins Study and Analysis in Undergraduate Program in Biotechnology

Directory of Open Access Journals (Sweden)

L.P. Xavier

2013-05-01

Full Text Available The undergraduate program in Biotechnology at Federal University of Pará has been consolidated as excellence course in Pará, however there are still difficulties in some practice classes. In this way, the aim of this research was to develop low cost and easy implementation methodologies of teaching and learning that help the students to understand the integration of contents, and promote interdisciplinary and greater integration among professors. The main theme of the study was “Proteins: obtaining to analysis”. Professors charged of subjects in Biochemistry, Protein Biochemistry, Protein Engineering, Microbiology and Separation Methods of Biotech Products, has developed this work, which has been promoted by the program PROINT of UFPA. The main purpose of PROINT has been the consolidation of undergraduate teaching projects. Thirty students enrolled in the third semester were involved in this study. To perform the practice classes: a were made models with alternative materials (Styrofoam, cardboard; b were used the tutorials and exercises online as a complement to the teaching and learning process and; c were analyzed chromatograms, simulation purification steps, assembled and interpreted tables purification (falcon tubes, colored beads. Were used also conventional materials and reagents purchased in practices related to microbiology with the support of PROINT. Until now had been a greater interest and participation of students in the implementation of practices and a greater understanding of the theoretical content covered.

Effectiveness of Mentoring Program Practices. Research in Action. Issue 2

Science.gov (United States)

DuBois, David L.

2007-01-01

This article focuses on mentoring program practices in relation to issues of effectiveness, while recognizing that implications for program quality conceptualized more broadly is a key concern in need of greater investigation. The author provides an overview of selected conceptual and methodological issues involved with identification of…

Search for greater stability in nuclear regulation

International Nuclear Information System (INIS)

Asselstine, J.K.

1985-01-01

The need for greater stability in nuclear regulation is discussed. Two possible approaches for dealing with the problems of new and rapidly changing regulatory requirements are discussed. The first approach relies on the more traditional licensing reform initiatives that have been considered off and on for the past decade. The second approach considers a new regulator philosophy aimed at the root causes of the proliferation of new safety requirements that have been imposed in recent years. For the past few years, the concepts of deregulation and regulatory reform have been in fashion in Washington, and the commercial nuclear power program has not remained unaffected. Many look to these concepts to provide greater stability in the regulatory program. The NRC, the nuclear industry and the administration have all been avidly pursuing regulatory reform initiatives, which take the form of both legislative and administrative proposals. Many of these proposals look to the future, and, if adopted, would have little impact on currently operating nuclear power plants or plants now under construction

Greater-than-Class C low-level radioactive waste characterization. Appendix E-3: GTCC LLW assumptions matrix

International Nuclear Information System (INIS)

1995-01-01

This study identifies four categories of GTCC LLW: nuclear utility; sealed sources; DOE-held; and other generators. Within each category, inventory and projection data are modeled in three scenarios: (1) Unpackaged volume--this is the unpackaged volume of waste that would exceed Class C limits if the waste calculation methods in 10 CFR 61.55 were applied to the discrete items before concentration averaging methods were applied to the volume; (2) Not-concentration-averaged (NCA) packaged volume--this is the packaged volume of GTCC LLW assuming that no concentration averaging is allowed; and (3) After-concentration-averaging (ACA) packaged volume--this is the packaged volume of GTCC LLW, which, for regulatory or practical reasons, cannot be disposed of in a LLW disposal facility using allowable concentration averaging practices. Three cases are calculated for each of the volumes described above. These values are defined as the low, base, and high cases. The following tables explain the assumptions used to determine low, base, and high case estimates for each scenario, within each generator category. The appendices referred to in these tables are appendices to Greater-Than-Class C Low-Level Radioactive Waste Characterization: Estimated Volumes, Radionuclide Activities, and Other Characteristics (DOE/LLW-114, Revision 1)

Backyard chicken keeping in the Greater London Urban Area: welfare status, biosecurity and disease control issues.

Science.gov (United States)

Karabozhilova, I; Wieland, B; Alonso, S; Salonen, L; Häsler, B

2012-01-01

1. The aim of the study was to collect baseline data on welfare, biosecurity and diseases of backyard chickens kept in the Greater London Urban Area (GLUA), United Kingdom (UK). 2. A total of 65 backyard chicken flock-keepers were recruited from May to July 2010 through adverts on websites, at City farms, veterinary practices and pet feed stores and surveyed by means of a questionnaire. A total of 30 responses were suitable for analysis. 3. Information on keepers' and flocks' characteristics, housing and husbandry practices and owners' knowledge of health problems in chickens and zoonotic diseases was collected. A welfare assessment protocol was developed and the flocks assessed accordingly. 4. Results showed that chickens were generally provided with living conditions that allowed them to perform their natural behaviours. 5. Most of the flock owners did not comply with the regulations of the Department for Environment, Food and Rural Affairs (Defra) on the feeding of catering waste. 6. Disease prevention measures such as vaccination and biosecurity, including limiting the access of human visitors, wild birds and rodents to the flocks were rare. 7. A lack of avian and zoonotic disease knowledge and awareness among the owners has implications for disease control and highlights the need for improved communication between owners, authorities and veterinarians.

Children acquire the later-greater principle after the cardinal principle.

Science.gov (United States)

Le Corre, Mathieu

2014-06-01

Many have proposed that the acquisition of the cardinal principle (CP) is a result of the discovery of the numerical significance of the order of the number words in the count list. However, this need not be the case. Indeed, the CP does not state anything about the numerical significance of the order of the number words. It only states that the last word of a correct count denotes the numerosity of the counted set. Here, we test whether the acquisition of the CP involves the discovery of the later-greater principle - that is, that the order of the number words corresponds to the relative size of the numerosities they denote. Specifically, we tested knowledge of verbal numerical comparisons (e.g., Is 'ten' more than 'six'?) in children who had recently learned the CP. We find that these children can compare number words between 'six' and 'ten' only if they have mapped them onto non-verbal representations of numerosity. We suggest that this means that the acquisition of the CP does not involve the discovery of the correspondence between the order of the number words and the relative size of the numerosities they denote. © 2013 The British Psychological Society.

Social information-processing and coping in adolescent females diagnosed with an eating disorder: toward a greater understanding of control.

Science.gov (United States)

McFillin, Roger K; Cahn, Stacey C; Burks, Virginia Salzer; Levine, Martha Peaslee; Loney, Susan Lane; Levine, Richard L

2012-01-01

The objective of this study was to examine differences in social information-processing and coping strategies between adolescent females in treatment for an eating disorder and asymptomatic peers. Adolescent females in treatment for an eating disorder (n = 50) were compared to asymptomatic control participants (n = 59) on a measure of social information-processing. Participants were presented with 4 hypothetical, ambiguous social dilemmas in which the intent of a peer provocateur was unclear. Questions followed each dilemma assessing intent attributions, the participant's emotional reaction, the intensity of the emotion, and coping strategies. The participants in treatment for an eating disorder were significantly more likely to perceive hostile intent from a peer provocateur, reported a greater intensity of negative emotions, and identified a significantly greater number of avoidant coping strategies. Specifically, the eating disorder group identified significantly more intrapunitive avoidant coping strategies that reflect maladaptive and self-destructive means of coping with distressing events. Results indicate social cognitive processing biases and maladaptive coping strategies may be instrumental in perceived loss of control and influence the development/maintenance of eating disorders.

Spatial Pattern of Groundwater Arsenic Occurrence and Association with Bedrock Geology in Greater Augusta, Maine, USA

Science.gov (United States)

Yang, Qiang; Jung, Hun Bok; Culbertson, Charles W.; Marvinney, Robert G.; Loiselle, Marc C.; Locke, Daniel B.; Cheek, Heidi; Thibodeau, Hilary; Zheng, Yan

2009-01-01

In New England, groundwater arsenic occurrence has been linked to bedrock geology on regional scales. To ascertain and quantify this linkage at intermediate (100-101 km) scales, 790 groundwater samples from fractured bedrock aquifers in the greater Augusta, Maine area are analyzed. 31% of the sampled wells have arsenic >10 μg/L. The probability of [As] exceeding 10 μg/L mapped by indicator kriging is highest in Silurian pelite-sandstone and pelite-limestone units (~40%). This probability differs significantly (pbedrock map. Thus, bedrock geology is associated with arsenic occurrence in fractured bedrock aquifers of the study area at intermediate scales relevant to water resources planning. The arsenic exceedance rate for each rock unit is considered robust because low, medium and high arsenic occurrences in 4 cluster areas (3-20 km2) with a low sampling density of 1-6 wells per km2 are comparable to those with a greater density of 5-42 wells per km2. About 12,000 people (21% of the population) in the greater Augusta area (~1135 km2) are at risk of exposure to >10 μg/L arsenic in groundwater. PMID:19475939

Workplace discrimination: experiences of practicing physicians.

Science.gov (United States)

Coombs, Alice A Tolbert; King, Roderick K

2005-04-01

In response to a growing concern regarding physician discrimination in the workplace, this study was developed to: (1) describe the types of discrimination that exist for the practicing physician and (2) determine which groups of physicians are more likely to experience the various forms of discrimination. Surveys were mailed to 1930 practicing physicians in Massachusetts. Participants were asked if they had encountered discrimination, how significant the discrimination was against a specific group, the frequency of personal discrimination, and the type of discrimination. Factor analysis identified four types of discrimination: career advancement, punitive behaviors, practice barriers and hiring barriers. A total of 445 responses were received (a 24% response rate). Sixty-three percent of responding physicians had experienced some form of discrimination. Respondents were women (46%), racial/ethnic minorities (42%) and international medical graduates (IMGs) (40%). In addition, 26% of those classified as white were also IMGs. Over 60% of respondents believed discrimination against IMGs was very or somewhat significant. Almost 27% of males acknowledged that gender bias against females was very or somewhat significant. IMGs were more likely to indicate that discrimination against IMGs was significant in their current organization. Of U.S. medical graduates (USMGs) 44% reported that discrimination against IMGs in their current organization was significant. Nonwhites were more likely to report that discrimination based on race/ethnicity was significant. Nearly 29% of white respondents also believed that such discrimination was very or somewhat significant. Physicians practicing in academic, research, and private practice sectors experience discrimination based on gender, ethnic/racial, and IMG status.

Towards Greater Harmonisation of Decommissioning Cost Estimates

International Nuclear Information System (INIS)

O'Sullivan, Patrick; ); Laraia, Michele; ); LaGuardia, Thomas S.

2010-01-01

The NEA Decommissioning Cost Estimation Group (DCEG), in collaboration with the IAEA Waste Technology Section and the EC Directorate-General for Energy and Transport, has recently studied cost estimation practices in 12 countries - Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Slovakia, Spain, Sweden, the United Kingdom and the United States. Its findings are to be published in an OECD/NEA report entitled Cost Estimation for Decommissioning: An International Overview of Cost Elements, Estimation Practices and Reporting Requirements. This booklet highlights the findings contained in the full report. (authors)

Impact of engaging middle management in practice interventions on staff support and learning culture: a quasi-experimental design.

Science.gov (United States)

Henderson, Amanda; Burmeister, Liz; Schoonbeek, Sue; Ossenberg, Christine; Gneilding, Julieanne

2014-11-01

This study evaluated the impact of different levels of engaging middle management in ward based strategies implemented by a project educator. The challenge for learning in practice is to develop effective teams where experienced staff engage and foster learning with students and other novice staff. A quasi-experimental pre- and post- intervention four group design was conducted from November 2009 to May 2010 across four general surgical and four general medical inpatient matched units in two settings in South East Queensland, Australia. Staff survey data was used to compare control and intervention groups (one actively engaging nurse managers) before and after 'practice learning' interventions. The survey comprised demographic data and data from two validated scales (support instrument for nurses facilitating learning and clinical learning organisational culture). Number of surveys returned pre- and post-intervention was 336 from 713 (47%). There were significant differences across many subscales pertaining to staff perception of support in the intervention groups, with only one change in the control group. The number of significant different subscales in the learning culture was also greater when middle management supported the intervention. Middle management should work closely with facilitators to assist embedding practice interventions. © 2013 John Wiley & Sons Ltd.

MANAGING CUSTOMER RELATIONSHIPS IN PRIVATE HEALTH CARE FACILITIES - A STUDY WITH REFERENCE TO GREATER NOIDA CITY OF UTTAR PRADESH

Directory of Open Access Journals (Sweden)

Arun Kumar Panda

2011-03-01

Full Text Available Customer relationship management (CRM which has overriding significance for any business isno less significant for hospital services. Hospitals are most important elements in any health caredelivery system. A hospital plays a major role in maintaining and restoring the health of the people.Care of the sick and injured, preventive health care, health research, and training of medical andparamedical staff are general broad functions of a hospital. It involves to the outpatient and inpatienthospital services and on many occasions emergency medical services. An important resource in ahospital is a human resource. This should be particularly emphasized. This should be particularlyemphasized in the content of a hospital since relationship of medical staff plays important role intreating patients - the hospital customers. In health care, CRM practices are essentially patient -focused strategies that involve effective management of hospital interface and interaction withpatients. Effective CRM practices in a hospital may mean providing services related information toa patient very quickly. Responding to the patent appointment and an admission requests promptly,dealing with patient queries and complaints expeditiously, exercising all kinds of flexibilities inserving patients to the patients. This research paper made an attempt to analyze the factorsinfluencing the customers to select the hospital and to suggest better ways and means to retain thecustomers. For the study, the researcher has collected data from 200 respondents of 10 privatehospitals located in Greater Noida city. For this purpose stratified random sampling method was usedto select the samples. The present study highlights the extent of utilization of the hospital services bythe selected sample respondents. It also shed light on the common problems faced by therespondents. The major features of the service sectors especially on hospital performance is projectedin order to utilize the

Rural Livelihoods, Climate Change and Micro-Level Adaptive Capacity in the Greater Mekong Subregion

DEFF Research Database (Denmark)

Jiao, Xi

The Greater Mekong Subregion (GMS) is one of the fastest developing regions in the world, experiencing significant economic, environmental and social transformations. There is an increasing demand for policy relevant and decision support information at micro level. This PhD research contributes...... and Laos, two of the poorest countries in the GMS. Structured household surveys and participatory focus group discussions were the primary data collection methods. The findings provide new, additional and much needed quantitative information in the region, and several policy implications for rural...

Testing Significance Testing

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Joachim I. Krueger

2018-04-01

Full Text Available The practice of Significance Testing (ST remains widespread in psychological science despite continual criticism of its flaws and abuses. Using simulation experiments, we address four concerns about ST and for two of these we compare ST’s performance with prominent alternatives. We find the following: First, the 'p' values delivered by ST predict the posterior probability of the tested hypothesis well under many research conditions. Second, low 'p' values support inductive inferences because they are most likely to occur when the tested hypothesis is false. Third, 'p' values track likelihood ratios without raising the uncertainties of relative inference. Fourth, 'p' values predict the replicability of research findings better than confidence intervals do. Given these results, we conclude that 'p' values may be used judiciously as a heuristic tool for inductive inference. Yet, 'p' values cannot bear the full burden of inference. We encourage researchers to be flexible in their selection and use of statistical methods.

Dentists’ practice patterns regarding caries prevention: results from a dental practice-based research network

Science.gov (United States)

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H; Gordan, Valeria V

2013-01-01

Objective The purposes of this study were to (1) quantify dentists' practice patterns regarding caries prevention and (2) test the hypothesis that certain dentists' characteristics are associated with these practice patterns. Design The study used a cross-sectional study design consisting of a questionnaire survey. Participants The study queried dentists who worked in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan, which seeks to engage dentists in investigating research questions and sharing experiences and expertise (n=282). Measurement Dentists were asked about their practice patterns regarding caries preventive dentistry. Background data on patients, practice and dentist were also collected. Results 38% of dentists (n=72) provided individualised caries prevention to more than 50% of their patients. Overall, 10% of the time in daily practice was spent on caries preventive dentistry. Dentists who provided individualised caries prevention to more than 50% of their patients spent significantly more time on preventive care and less time on removable prosthetics treatment, compared to dentists who did not provide individualised caries prevention. Additionally, they provided oral hygiene instruction, patient education, fluoride recommendations, intraoral photographs taken and diet counselling to their patients significantly more often than dentists who did not provide individualised caries prevention. Multiple logistic regression analysis suggested that the percentage of patients interested in caries prevention and the percentage of patients who received hygiene instruction, were both associated with the percentage of patients who receive individualised caries prevention. Conclusions We identified substantial variation in dentists' practice patterns regarding preventive dentistry. Individualised caries prevention was significantly related to provision of other preventive services and to having a higher percentage

CSR Strategies in Greater China: Global, East Asian, American, European Style?

Directory of Open Access Journals (Sweden)

Heiduk Guenter

2014-10-01

Full Text Available The concept of Corporate Social Responsibility emerged in the United States and spread to Europe and Asia while being adapted to national/local characteristics. Since borders between markets and societies are blurring and globalization is promoting MNCs which find themselves acting in hybrid societies, international institutions put efforts into the development and moral acceptance of global CSR standards. The scientific interest in CSR focused on the conflicts between company returns and benefits for society. The resulting concepts of performance-oriented, awareness-oriented and welfare-oriented CSR should facilitate the evaluation of CSR strategies implemented by MNCs. In research on the cultural dimensions of economies, it might be possible to allocate geographically the three concepts. Regarding the newly emerging Chinese MNCs, the paper aims to shed light on which concept they follow. On the one hand, CSR concepts of American and/or European MNCs that are present in China might serve as a role model; on the other hand, by learning from Taiwanese/ Hong Kong MNCs, a “greater China CSR approach” might emerge. Empirical studies and own field research suggest that compared to American and European companies, CSR is less deeply rooted in Chinese companies. Furthermore, significant differences between Mainland China, Hong Kong and Taiwanese companies indicate that a Greater Chinese CSR approach does not yet exist. Therefore, it cannot be assumed that American and European CSR concepts will experience a Chinese influence in the near future.

Can the Farnsworth D15 Color Vision Test Be Defeated through Practice?

Science.gov (United States)

Ng, Jason S; Liem, Sophia C

2018-05-01

This study suggests that it is possible for some patients with severe red-green color vision deficiency to do perfectly on the Farnsworth D15 test after practicing it. The Farnsworth D15 is a commonly used test to qualify people for certain occupations. For patients with color vision deficiency, there may be high motivation to try to pass the test through practice to gain entry into a particular occupation. There is no evidence in the literature on whether it is possible for patients to learn to pass the D15 test through practice. Ten subjects with inherited red-green color vision deficiency and 15 color-normal subjects enrolled in the study. All subjects had anomaloscope testing, color vision book tests, and a Farnsworth D15 at an initial visit. For the D15, the number of major crossovers was determined for each subject. Failing the D15 was determined as greater than 1 major crossover. Subjects with color vision deficiency practiced the D15 as long as desired to achieve a perfect score and then returned for a second visit for D15 testing. A paired t test was used to analyze the number of major crossovers at visit 1 versus visit 2. Color-normal subjects did not have any major crossovers. Subjects with color vision deficiency had significantly (P color vision deficiency, and this should be considered in certain cases where occupational entry is dependent on D15 testing.

Food expenditures, cariogenic dietary practices and childhood dental caries in southern Brazil.

Science.gov (United States)

Feldens, C A; Rodrigues, P H; Rauber, F; Chaffee, B W; Vitolo, M R

2013-01-01

Family expenditures on food for children may represent an important barrier to the adoption of healthy feeding practices in populations of low socioeconomic status. The aim of this study was to explore the relationship between cariogenic feeding practices, expenditures on food for children and dental caries. This cross-sectional study included 329 four-year-old children from São Leopoldo in southern Brazil. Cariogenic dietary practices were assessed at 4 years of age using two 24-hour recalls conducted with the children's mothers. Expenditures on food for children were estimated based on all reported food items and the respective amounts ingested. Early childhood caries and severe early childhood caries were assessed by clinical examination at 4 years of age. Cariogenic dietary habits were not associated with lower food expenditures. On the contrary, in multivariable regression analysis, the intake of chocolate (p = 0.007), soft drinks (p = 0.027) and a higher number of meals and snacks per day (p food for children. No statistically significant differences were observed in food expenditures or in the proportion of household income spent on feeding children between caries-free children, those with early childhood caries and those with severe early childhood caries. In conclusion, keeping children free of dental caries does not necessarily increase food expenditures or the proportion of household income spent on feeding children in low-socioeconomic status populations. Some cariogenic dietary practices were associated with greater expenditures on child feeding. Copyright © 2013 S. Karger AG, Basel.

The development of professional practice standards for Australian general practice nurses.

Science.gov (United States)

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2017-08-01

The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. Concurrent mixed methods design. Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance. © 2017 John Wiley & Sons Ltd.

A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol

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Bunker Jeremy M

2012-09-01

Full Text Available Abstract Background Chronic Obstructive Pulmonary Disease (COPD is a leading cause of disability, hospitalization, and premature mortality. General practice is well placed to diagnose and manage COPD, but there is a significant gap between evidence and current practice, with a low level of awareness and implementation of clinical practice guidelines. Under-diagnosis of COPD is a world-wide problem, limiting the benefit that could potentially be achieved through early intervention strategies such as smoking cessation, dietary advice, and exercise. General practice is moving towards more structured chronic disease management, and the increasing involvement of practice nurses in delivering chronic care. Design A pragmatic cluster randomised trial will test the hypothesis that intervention by a practice nurse-general practitioner (GP team leads to improved health-related quality of life and greater adherence with clinical practice guidelines for patients with newly-diagnosed COPD, compared with usual care. Forty general practices in greater metropolitan Sydney Australia will be recruited to identify patients at risk of COPD and invite them to attend a case finding appointment. Practices will be randomised to deliver either practice nurse-GP partnership care, or usual care, to patients newly-diagnosed with COPD. The active intervention will involve the practice nurse and GP working in partnership with the patient in developing and implementing a care plan involving (as appropriate, smoking cessation, immunisation, pulmonary rehabilitation, medication review, assessment and correction of inhaler technique, nutritional advice, management of psycho-social issues, patient education, and management of co-morbidities. The primary outcome measure is health-related quality of life, assessed with the St George’s Respiratory Questionnaire 12 months after diagnosis. Secondary outcome measures include validated disease-specific and general health related

Factoring local sequence composition in motif significance analysis.

Science.gov (United States)

Ng, Patrick; Keich, Uri

2008-01-01

We recently introduced a biologically realistic and reliable significance analysis of the output of a popular class of motif finders. In this paper we further improve our significance analysis by incorporating local base composition information. Relying on realistic biological data simulation, as well as on FDR analysis applied to real data, we show that our method is significantly better than the increasingly popular practice of using the normal approximation to estimate the significance of a finder's output. Finally we turn to leveraging our reliable significance analysis to improve the actual motif finding task. Specifically, endowing a variant of the Gibbs Sampler with our improved significance analysis we demonstrate that de novo finders can perform better than has been perceived. Significantly, our new variant outperforms all the finders reviewed in a recently published comprehensive analysis of the Harbison genome-wide binding location data. Interestingly, many of these finders incorporate additional information such as nucleosome positioning and the significance of binding data.

Selecting practice management information systems.

Science.gov (United States)

Worley, R; Ciotti, V

1997-01-01

Despite enormous advances in information systems, the process by which most medical practices select them has remained virtually unchanged for decades: the request for proposal (RFP). Unfortunately, vendors have learned ways to minimize the value of RFP checklists to where purchasers now learn little about the system functionality. The authors describe a selection methodology that replaces the RFP with scored demos, reviews of vendor user manuals and mathematically structured reference checking. In a recent selection process at a major medical center, these techniques yielded greater user buy-in and favorable contract terms as well.

Sedation practice in Nordic and non-Nordic ICUs: a European survey.

Science.gov (United States)

Egerod, Ingrid; Albarran, John W; Ring, Mette; Blackwood, Bronagh

2013-07-01

A trend towards lighter sedation has been evident in many intensive care units (ICUs). The aims of the survey were to describe sedation practice in European ICUs and to compare sedation practice in Nordic and non-Nordic countries. A cross-sectional survey of ICU nurses attending the fourth European federation of Critical Care Nursing associations (EfCCNa) in Denmark, 2011. Data included use of protocols; sedation, pain and delirium assessment tools; collaborative decision-making; sedation and analgesic medications; and educational preparation related to sedation. Response rate was 42% (n = 291) from 22 countries where 53% (n = 148) used sedation protocols. Nordic nurses reported greater use of sedation (91% versus 67%, p Nordic nurses. Decision-making on sedation was more inter-professionally collaborative in Nordic ICUs (83% versus 61%, p Nordic nurses reported greater consistency in maintaining circadian rhythm (66% versus 49%, p Nordic context might be more germane to the goal of lighter sedation and better pain management. Our study raises awareness of current sedation practice, paving the way towards optimized ICU sedation management. © 2013 The Authors. Nursing in Critical Care © 2013 British Association of Critical Care Nurses.

Diversity of faculty practice in workshop classrooms

Science.gov (United States)

Franklin, Scott V.; Chapman, Tricia

2013-01-01

We present a temporally fine-grained characterization of faculty practice in workshop-style introductory physics courses. Practice is binned in five minute intervals and coded through two complementary observational protocols: the Reform Teaching Observation Protocol provides a summative assessment of fidelity to reform-teaching principles, while the Teaching Dimensions Observation Protocol records direct practice. We find that the TDOP's direct coding of practice explains nuances in the holistic RTOP score, with higher RTOP scores corresponding to less lecture, but not necessarily more student-directed activities. Despite using similar materials, faculty show significant differences in practice that manifests in both TDOP and RTOP scores. We also find a significant dependence of practice on course subject reflected in both RTOP and TDOP scores, with Electricity & Magnetism using more instructor-centered practices (lecture, illustration, etc.) than Mechanics courses.

Opportunities outside private practice before 1860.

Science.gov (United States)

Deacon, Harriet; van Heyningen, Elizabeth

2004-01-01

This chapter discusses the restrictions and opportunities which salaried employment offered Cape doctors in the pay of government and charitable organisations during the first two thirds of the nineteenth century. Although Cape doctors often acted as agents of the colonial state there were many nuances within this relationship. While military doctors played an important role in the profession during the first few decades of the century, by the 1840s civilian doctors were beginning to assert greater influence in Cape Town, if not yet in the Eastern Cape. Hospital posts and an expanding network of charitable organisations and government-funded district surgeoncies provided part-time employment for some doctors throughout the colony. This helped urban-based doctors to sustain practices and encouraged more doctors to practice in the smaller country towns serving large farming areas.

Knowledge of risk factors, beliefs and practices of female healthcare ...

African Journals Online (AJOL)

Background: Breast cancer is the most common cancer affecting women in Morocco. Screening for early detection has led to reduction in mortality from the disease. It is known that female healthcare professionals have greater influence on women's positive perception of breast cancer and motivation to practice screening ...

Environmental pollution and DNA methylation: carcinogenesis, clinical significance, and practical applications.

Science.gov (United States)

Cao, Yi

2015-09-01

Environmental pollution is one of the main causes of human cancer. Exposures to environmental carcinogens result in genetic and epigenetic alterations which induce cell transformation. Epigenetic changes caused by environmental pollution play important roles in the development and progression of environmental pollution-related cancers. Studies on DNA methylation are among the earliest and most conducted epigenetic research linked to cancer. In this review, the roles of DNA methylation in carcinogenesis and their significance in clinical medicine were summarized, and the effects of environmental pollutants, particularly air pollutants, on DNA methylation were introduced. Furthermore, prospective applications of DNA methylation to environmental pollution detection and cancer prevention were discussed.

The Relationship Between Personality Traits, Flow-Experience, and Different Aspects of Practice Behavior of Amateur Vocal Students

Science.gov (United States)

Heller, Katharina; Bullerjahn, Claudia; von Georgi, Richard

2015-01-01

Most of the existing studies on musical practice are concerned with instrumentalists only. Since singers are seldom considered in research, the present study is based on an online-sample of amateur vocal students (N = 120; 92 female, 28 male). The study investigated the correlations between personality traits, flow-experience and several aspects of practice characteristics. Personality was represented by the three personality dimensions extraversion, neuroticism and psychoticism, assessed by Eysenck’s Personality Profiler as well as the trait form of the Positive and Negative Affect Schedule. ‘Flow-experience,’ ‘self-congruence’ and ‘fear of losing control over concentration,’ assessed by the Practice Flow Inventory, served as variables for flow-experience. The practice motivation was measured by the Practice Motivation Questionnaire in four categories (‘self,’ ‘group,’ ‘audience,’ ‘teacher’). In addition, the Practice Behavior Questionnaire was used to provide an insight into the practice situation and behavior of singing students. The results show significant correlations: participants with high extraversion-scores experience significantly more flow than less extraverted persons, whereas lesser flow-experience seems to be related to high neuroticism-scores. Nevertheless, there is no influence in flow-experience concerning singing style (‘classical’ or ‘popular’). The longer the practicing time, the more likely students are to achieve flow-experience. However, older singers tend to have less flow-experience. Consequently, singers seem to differ in their personality and practice behavior compared to other musicians. Most of the findings show that having control over one’s instrument is decisive for achieving a performance of high quality, especially for singers. On the other hand, certainty in handling an instrument is essential to arouse a flow-feeling. However, flow-experience seems to be common mainly with amateur singers

Non-doctor consultations and self-medication practices in patients seen at a tertiary dental center in Ibadan

Directory of Open Access Journals (Sweden)

Happy Adeyinka Adedapo

2011-01-01

Conclusion: Self-medication practices were quite high in this study, and these practices were also prevalent among the educated people. Drug control enforcement needs to be intensified and dental public health education needs to be given greater priority in the overall public health campaigns.

Dust-associated microbiomes from dryland wheat fields differ with tillage practice and biosolids application

Science.gov (United States)

Schlatter, Daniel C.; Schillinger, William F.; Bary, Andy I.; Sharratt, Brenton; Paulitz, Timothy C.

2018-07-01

Wind erosion is a significant threat to the productivity and sustainability of agricultural soils. In the dryland winter wheat (Triticum aestivum L.)-fallow region of Inland Pacific Northwest of the USA (PNW), farmers increasingly use conservation tillage practices to control wind erosion. In addition, some farmers in this dry region apply municipal biosolids to soils as fertilizer and a source of stable organic matter. The impacts of soil management practices on emissions of dust microbiota to the atmosphere are understudied. We used high-throughput DNA sequencing to examine the impacts of conservation tillage and biosolids amendments on the transport of dust-associated fungal and bacterial communities during simulated high-wind events over two years at Lind, WA. The fungal and bacterial communities contained in windblown dust differed significantly with tillage (conservation vs. conventional) and fertilizer (synthetic vs. biosolids) treatments. However, the richness and diversity of fungal and bacterial communities of dust did not vary significantly with tillage or fertilizer treatments. Taxa enriched in dust from fields under conservation tillage represented many plant-associated taxa that likely grow on residue left on the soil surface, whereas taxa that were more abundant with conventional tillage were those that likely grow on buried plant residue. Dust from biosolids-amended fields harbored greater abundances of taxa that likely feed on introduced carbon. Most human-associated taxa that may pose a health risk were not present in dust after biosolids amendment, although members of Clostridiaceae were enriched with this treatment. Results show that tillage and fertilizer management practices impact the composition of bioaerosols emitted during high-wind events and have potential implications for plant and human health.

Orthodontic practices in Australasia: practice activity.

Science.gov (United States)

Mathew, Rachael; Sampson, Wayne J; Spencer, A John

2005-05-01

To collect baseline data on practice types and services provided by orthodontists in Australia and New Zealand. A total of 510 questionnaires was sent and 258 were returned. The response rate was 53 per cent. The average age of respondents was 50 years (SD: 9.8 years) with female orthodontists being younger (Mean: 42.3 years; SD: 6.5). The ratio of responding female to male orthodontists was 1:8.8. Overall, more orthodontists were in solo private practice than associateships or partnerships. New Zealand orthodontists were more likely to be in associateships. Australian orthodontists had twice the number of practices (Mean: 2.4; SD: 1.4) than their New Zealand counterparts (Mean: 1.1; SD: 0.3). Orthodontists estimated they saw a mean of 21.3 (SD: 11.3) patients per day. Older orthodontists saw few patients in a day and spent fewer hours in any practice activity in a week. The mean waiting time for a consultation appointment in the private sector in New Zealand was nearly twice that in Australia. There was a significant association between male orthodontists and referral of patients by general dental practitioners. More than three quarters of respondents incorporated retention fees into the treatment fee. Overall, orthodontists were satisfied with the workload and did not want more orthodontists in their geographical area. This study provides a sound basis for consideration of challenges in practice and changes over time.

Investigation of iron deficiency in patients with congestive heart failure: A medical practice that requires greater attention.

Science.gov (United States)

Belmar Vega, Lara; de Francisco, Alm; Albines Fiestas, Zoila; Serrano Soto, Mara; Kislikova, María; Seras Mozas, Miguel; Unzueta, Mayte García; Arias Rodríguez, Manuel

2016-01-01

Iron deficiency in congestive heart failure (CHF), with or without concomitant anaemia, is associated with health-related quality of life, NYHA functional class, and exercise capacity. Prospective, randomised studies have demonstrated that correcting iron deficiency improves the quality of life and functional status of patients with CHF, including those who do not have anaemia. The aim of this study was to analyse how frequently these iron parameters are tested and thus determine the extent to which this quality improvement tool has been implemented in patients admitted with CHF. Retrospective observational study of patients from a university hospital diagnosed with CHF on admission between 01/01/2012 and 11/06/2013. Iron parameters were tested in 39% (324) of the 824 patients analysed. There was no significant difference in age between the patients whose iron was tested and those whose iron was not tested, but the difference in terms of gender was significant (P=.007). Glomerular filtration rate and haemoglobin, were significantly lower in the group of patients whose iron was tested (Prenal failure or both was significantly higher in the group of patients who had iron tests (Prenal failure (79 vs. 66%, respectively, P=.013), but not in terms of haemoglobin concentration. Congestive heart failure is very frequently associated with anaemia, iron deficiency and renal failure. Despite the fact that correcting iron deficiency is known to improve symptoms, testing of iron parameters in patients admitted with CHF is not performed as often as it should be. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Possible global environmental impacts of solid waste practices

Energy Technology Data Exchange (ETDEWEB)

Davis, M.M.; Holter, G.M.; DeForest, T.J.; Stapp, D.C. [Pacific Northwest Lab., Richland, WA (United States); Dibari, J.C. [Heritage College, Toppenish, WA (United States)

1994-09-01

Pollutants resulting from the management of solid waste have been shown to affect the air, land, oceans, and waterways. In addition, solid wastes have other, more indirect impacts such as reduction in feedstocks of natural resources, because useful materials are disposed of rather than recycled. The objective of this study is to evaluate solid waste management practices that have negative implications on the global environment and develop recommendations for reducing such impacts. Recommendations identifying needed changes are identified that will reduce global impacts of solid waste practices in the future. The scope of this study includes the range of non-hazardous solid wastes produced within our society, including municipal solid waste (MSW) and industrial solid waste (ISW), as well as industry-specific wastes from activities such as construction, demolition, and landclearing. Most solid waste management decisions continue to be made and implemented at very local levels, predominantly with a short-term focus to respond to relatively immediate pressures of landfill shortages, funding problems, political considerations, and the like. In this rush to address immediate local problems, little consideration is being given to potential impacts, either short- or long-term, at the national or global level resulting from solid waste management practices. More and more, the cumulative impacts from local decisions concerning solid waste management are beginning to manifest themselves in broader, longer-term impacts than are being addressed by the decision-makers or, at the very least, are presenting a greater and greater potential for such impacts.

Unpacking Docent Practice in Free Choice Science Learning Settings: A Qualitative Study Documenting the What and Whys of Docent Interpretive Practice

Science.gov (United States)

Good, Laura H.

whole, and have to be flexible when working with different types of learners. They believe that being a docent means balancing potentially conflicting roles; and 4) docents use interpretation as a pedagogy to engage visitors with science and create personally meaningful experiences. Analysis of significant interactions between docents and visitors shows that such practices are mediated through a variety of discursive and physical tools and implemented by docents as a means of engaging visitors with science and conservation. Moreover, most of these skills appear to be learned on-the-job within their communities of practice, and while specific docent actions and skills may be different across contexts, member checks with docents working in other museum settings demonstrate the resonance of the findings across contexts. The findings of the study are placed in the context of interpretation theories of communication as well as research on docents as lifelong, free-choice learners both facilitating and participating in societal STEM learning activity. Findings and methods of research from this study are valuable to the greater understanding of how docents learn and enact interpretive practice and the development of more effective professional development for docents in museum settings.

Hospitals with greater diversities of physiologically complex procedures do not achieve greater surgical growth in a market with stable numbers of such procedures.

Science.gov (United States)

Dexter, Franklin; Epstein, Richard H; Lubarsky, David A

2018-05-01

Although having a large diversity of types of procedures has a substantial operational impact on the surgical suites of hospitals, the strategic importance is unknown. In the current study, we used longitudinal data for all hospitals and patient ages in the State of Florida to evaluate whether hospitals with greater diversity of types of physiologically complex major therapeutic procedures (PCMTP) also had greater rates of surgical growth. Observational cohort study. 1479 combinations of hospitals in the State of Florida and fiscal years, 2008-2015. The types of International Classification of Diseases, Ninth revision, Clinical Modification (ICD-9-CM) procedures studied were PCMT, defined as: a) major therapeutic procedure; b) >7 American Society of Anesthesiologists base units; and c) performed during a hospitalization with a Diagnosis Related Group with a mean length of stay ≥4.0days. The number of procedures of each type of PCMTP commonly performed at each hospital was calculated by taking 1/Herfindahl index (i.e., sum of the squares of the proportions of all procedures of each type of PCMTP). Over the 8 successive years studied, there was no change in the number of PCMTP being performed (Kendall's τ b =-0.014±0.017 [standard error], P=0.44; N=1479 hospital×years). Busier and larger hospitals commonly performed more types of PCMTP, respectively categorized based on performed PCMTP (τ=0.606±0.017, P<0.0001) or hospital beds (τ=0.524±0.017, P<0.0001). There was no association between greater diversity of types of PCMTP commonly performed and greater annual growth in numbers of PCMTP (τ=0.002±0.019, P=0.91; N=1295 hospital×years). Conclusions were the same with multiple sensitivity analyses. Post hoc, it was recognized that hospitals performing a greater diversity of PCMTP were more similar to the aggregate of other hospitals within the same health district (τ=0.550±0.017, P<0.0001). During a period with no overall growth in PCMTP, hospitals with

Diversified cropping systems support greater microbial cycling and retention of carbon and nitrogen

Energy Technology Data Exchange (ETDEWEB)

King, Alison E.; Hofmockel, Kirsten S.

2017-03-01

Diversifying biologically simple cropping systems often entails altering other management practices, such as tillage regime or nitrogen (N) source. We hypothesized that the interaction of crop rotation, N source, and tillage in diversified cropping systems would promote microbially-mediated soil C and N cycling while attenuating inorganic N pools. We studied a cropping systems trial in its 10th year in Iowa, USA, which tested a 2-yr cropping system of corn (Zea mays L.)/soybean [Glycine max (L.) Merr.] managed with conventional fertilizer N inputs and conservation tillage, a 3-yr cropping system of corn/soybean/small grain + red clover (Trifolium pratense L.), and a 4-yr cropping system of corn/soybean/small grain + alfalfa (Medicago sativa L.)/alfalfa. Three year and 4-yr cropping systems were managed with composted manure, reduced N fertilizer inputs, and periodic moldboard ploughing. We assayed soil microbial biomass carbon (MBC) and N (MBN), soil extractable NH4 and NO3, gross proteolytic activity of native soil, and potential activity of six hydrolytic enzymes eight times during the growing season. At the 0-20cm depth, native protease activity in the 4-yr cropping system was greater than in the 2-yr cropping system by a factor of 7.9, whereas dissolved inorganic N pools did not differ between cropping systems (P = 0.292). At the 0-20cm depth, MBC and MBN the 4-yr cropping system exceeded those in the 2-yr cropping system by factors of 1.51 and 1.57. Our findings suggest that diversified crop cropping systems, even when periodically moldboard ploughed, support higher levels of microbial biomass, greater production of bioavailable N from SOM, and a deeper microbially active layer than less diverse cropping systems.

How Can Asian Snack FuLoi Plan Successful Entering to Greater Helsinki Area? : Market research

OpenAIRE

Nguyen, Loc

2014-01-01

This thesis introduces the significant factors of market research and its importance when considering doing international business. Furthermore, it could be useful for investors who have same favour to enter Finnish market. The case company is Asian Snack FuLoi- a German food industry company looking for new market. The goal of this study was to investigate the possibility for a company to enter Finland in general and Greater Helsinki in particular. The thesis was structured with theor...

Factors that influence soft tissue thickness over the greater trochanter: application to understanding hip fractures.

Science.gov (United States)

Levine, Iris C; Minty, Lauren E; Laing, Andrew C

2015-03-01

Fall-related hip injuries are a concern for the growing population of older adults. Evidence suggests that soft tissue overlying the greater trochanter attenuates the forces transmitted to the proximal femur during an impact, reducing mechanical risk of hip fracture. However, there is limited information about the factors that influence trochanteric soft tissue thickness. The current study used ultrasonography and electromyography to determine whether trochanteric soft tissue thickness could be quantified reproducibly and whether it was influenced by: (1) gender; (2) hip postures associated with potential falling configurations in the sagittal plane (from 30° of extension to 60° of flexion, at 15° intervals), combined adduction-flexion, and combined adduction-extension; and (3) activation levels of the tensor fascia lata (TFL) and gluteus medius (GM) muscles. Our results demonstrated that soft tissue thickness can be measured reliably in nine hip postures and three muscle activation conditions (for all conditions, ICC >0.98). Mean (SD) thickness in quiet stance was 2.52 cm. Thickness was 27.0% lower for males than females during quiet stance. It was 16.4% greater at maximum flexion than quiet standing, 27.2% greater at maximum extension, and 12.5% greater during combined adduction-flexion. However, there was no significant difference between combined adduction-extension and quiet standing. Thickness was not affected by changes in muscle activity. Forces applied to the femoral neck during a lateral fall decrease as trochanteric soft tissue thickness increases; gender and postural configuration at impact could influence the loads applied to the proximal femur (and thus hip fracture risk) during falls on the hip. © 2014 Wiley Periodicals, Inc.

Standard practice for examination of liquid-Filled atmospheric and Low-pressure metal storage tanks using acoustic emission

CERN Document Server

American Society for Testing and Materials. Philadelphia

2007-01-01

1.1 This practice covers guidelines for acoustic emission (AE) examinations of new and in-service aboveground storage tanks of the type used for storage of liquids. 1.2 This practice will detect acoustic emission in areas of sensor coverage that are stressed during the course of the examination. For flat-bottom tanks these areas will generally include the sidewalls (and roof if pressure is applied above the liquid level). The examination may not detect flaws on the bottom of flat-bottom tanks unless sensors are located on the bottom. 1.3 This practice may require that the tank experience a load that is greater than that encountered in normal use. The normal contents of the tank can usually be used for applying this load. 1.4 This practice is not valid for tanks that will be operated at a pressure greater than the examination pressure. 1.5 It is not necessary to drain or clean the tank before performing this examination. 1.6 This practice applies to tanks made of carbon steel, stainless steel, aluminum and oth...

Contemporary marketing practice : theoretical propositions and practical implications

NARCIS (Netherlands)

Lindgreen, A.; Palmer, R.; Vanhamme, J.

2004-01-01

Marketing has changed significantly since it first emerged as a distinct business and management phenomenon. We identify some of the major factors causing the observed change in marketing practice. We then describe a classification scheme that is based on transaction marketing and relationship

Charter School Autonomy: The Mismatch between Theory and Practice

Science.gov (United States)

Finnigan, Kara S.

2007-01-01

In theory, the charter school concept is based on a trade-off or exchange: greater autonomy for increased accountability. Although charter schools have been operating for more than 10 years, little is known about charter school autonomy in practice. This mixed-methods study used survey and case study data to examine the degree of autonomy of…

Associations between rule-based parenting practices and child screen viewing: A cross-sectional study

Directory of Open Access Journals (Sweden)

Joanna M. Kesten

2015-01-01

Conclusions: Limit setting is associated with greater SV. Collaborative rule setting may be effective for managing boys' game-console use. More research is needed to understand rule-based parenting practices.

Split thickness skin graft meshing ratio indications and common practices.

Science.gov (United States)

Pripotnev, Stahs; Papp, Anthony

2017-12-01

Split thickness skin grafting is a commonly used technique in burn surgery for resurfacing wounds that are unlikely to heal without scarring. Meshing and expanding skin grafts allow for reconstruction of larger wounds with smaller donor sites. A retrospective chart review was performed of 210 patients with burns equal to or greater than 20% total body surface area admitted to Vancouver General Hospital between 1998 and 2014. Charts were reviewed to collect data on patient and burn demographics. A survey was sent to Canadian plastic surgeons registered with the CSPS to collect data on common practices in burn surgery nationwide. The patients that received 3:1 or higher meshed grafts were all flame burns, had a significantly higher average TBSA (51.89%±14.87 vs 29.13%±9.48, p=0.001), and a significantly higher full thickness burn TBSA (25.76%±21.97 vs 6.20%±9.04, p=0.001). We found no significant differences in gender, age, or burn location between the less than 2:1 and 3:1 or greater meshing ratio groups. The survey of plastic surgeons performing burn surgery in Canada revealed that 60% of responders had experience with skin grafts using meshing ratios of 3:1 or higher. Of these surgeons, 100% felt that burn size and 36% felt that burn location would influence their decision to use a 3:1 or higher meshing ratio. A larger burn size is the major influencing factor for the use of higher skin graft meshing ratios by Canadian burn surgeons. Furthermore, burn location determines the choice of donor and recipient sites in these cases. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes.

Science.gov (United States)

Loth, K A; Friend, S; Horning, M L; Neumark-Sztainer, D; Fulkerson, J A

2016-12-01

This study examines associations between an expanded conceptualization of food-related parenting practices, specifically, directive and non-directive control, and child weight (BMI z-score) and dietary outcomes [Healthy Eating Index (HEI) 2010, daily servings fruits/vegetables] within a sample of parent-child dyads (8-12 years old; n = 160). Baseline data from the Healthy Home Offerings via the Mealtime Environment (HOME Plus) randomized controlled trial was used to test associations between directive and non-directive control and child dietary outcomes and weight using multiple regression analyses adjusted for parental education. Overall variance explained by directive and non-directive control constructs was also calculated. Markers of directive control included pressure-to-eat and food restriction, assessed using subscales from the Child Feeding Questionnaire; markers of non-directive control were assessed with a parental role modeling scale and a home food availability inventory in which an obesogenic home food environment score was assigned based on the types and number of unhealthful foods available within the child's home food environment. Food restriction and pressure-to-eat were positively and negatively associated with BMI z-scores, respectively, but not with dietary outcomes. An obesogenic home food environment was inversely associated with both dietary outcomes; parental role modeling of healthful eating was positively associated with both dietary outcomes. Neither non-directive behavioral construct was significantly associated with BMI z-scores. Greater total variance in BMI-z was explained by directive control; greater total variance in dietary outcomes was explained by non-directive control. Including a construct of food-related parenting practices with separate markers for directive and non-directive control should be considered for future research. These concepts address different forms of parental control and, in the present study, yielded

Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis.

Science.gov (United States)

Long, Suzanne S; Surrey, David E; Nazarian, Levon N

2013-11-01

Greater trochanteric pain syndrome is a common condition with clinical features of pain and tenderness at the lateral aspect of the hip. Diagnosing the origin of greater trochanteric pain is important because the treatment varies depending on the cause. We hypothesized that sonographic evaluation of sources for greater trochanteric pain syndrome would show that bursitis was not the most commonly encountered abnormality. We performed a retrospective review of musculoskeletal sonographic examinations performed at our institution over a 6-year period for greater trochanteric pain syndrome; completed a tabulation of the sonographic findings; and assessed the prevalence of trochanteric bursitis, gluteal tendon abnormalities, iliotibial band abnormalities, or a combination of findings. Prevalence of abnormal findings, associations of bursitis, gluteal tendinosis, gluteal tendon tears, and iliotibial band abnormalities were calculated. The final study population consisted of 877 unique patients: 602 women, 275 men; average age, 54 years; and age range, 15-87 years). Of the 877 patients with greater trochanteric pain, 700 (79.8%) did not have bursitis on ultrasound. A minority of patients (177, 20.2%) had trochanteric bursitis. Of the 877 patients with greater trochanteric pain, 438 (49.9%) had gluteal tendinosis, four (0.5%) had gluteal tendon tears, and 250 (28.5%) had a thickened iliotibial band. The cause of greater trochanteric pain syndrome is usually some combination of pathology involving the gluteus medius and gluteus minimus tendons as well as the iliotibial band. Bursitis is present in only the minority of patients. These findings have implications for treatment of this common condition.

Radionuclide therapy practice and facilities in Europe

International Nuclear Information System (INIS)

Hoefnagel, C.A.; Clarke, S.E.M.; Fischer, M.; Chatal, J.F.; Lewington, V.J.; Nilsson, S.; Troncone, L.; Vieira, M.R.

1999-01-01

Using a questionnaire the EANM Task Group Radionuclide Therapy in 1993 collected data on the current practice of radionuclide therapy in European countries. Subsequently, at the request of the EANM Executive Committee, the EANM Radionuclide Therapy Committee has made an inventory of the distribution of facilities for radionuclide therapy and undertaken an assessment of the total number of patients treated throughout Europe and of the types of treatment provides, with the aim of supporting the development of policy to adjust the available capacity to the needs by the year 2000. For this purpose, a second, more detailed questionnaire was sent out the members and national advisors of the Committee (see below), who gathered the data for each country that was a member of the EANM at the time. It is concluded that a wide bariation in therapy practice exists across Europe, particularly in the utilisation of radionuclide therapy, the requirement and availability of proper isolation facilities and the background training of those undertaking therapy. More uniform guidelines and legislation are required, although changes in legislation may have a significant impact in some countries. Although there is wide variation in the therapies used in each country, one the whole it appears that there is an underutilisation of nuclear medicine as a therapeutic modality. A rapidly increasing role may be expected, in particular for oncological indications requiring high-dose radionuclide treatment. Therefore there is an urgent need for a greater number of isolation beds in dedicated centers throughout Europe

Promoting Energy Efficiency Best Practices in Cities

Energy Technology Data Exchange (ETDEWEB)

NONE

2008-07-01

This pilot project is the first attempt to address the lack of rigorous and transparent approach to defining best practice in city energy efficiency programmes. The project has provided interesting insights into a range of exciting projects being implemented in cities around the world. However, the potential exists for far greater benefit. The study has found that it is possible to collate the detailed information needed to identify best practice energy efficiency projects in cities. However, gathering the data is not easy. The data is often not recorded in an easily accessible format. Nor is it easy to get city officials to allocate time to the necessary data collation given the many other competing demands on their time. A key area that this project identifies as requiring urgent attention is the development of a common data management format for energy efficiency projects by Cas. Further work could also focus on refining the criteria used to define best practice, and broadening the scope of projects beyond energy efficiency.

Meaning and significance of

Directory of Open Access Journals (Sweden)

Ph D Student Roman Mihaela

2011-05-01

Full Text Available The concept of "public accountability" is a challenge for political science as a new concept in this area in full debate and developement ,both in theory and practice. This paper is a theoretical approach of displaying some definitions, relevant meanings and significance odf the concept in political science. The importance of this concept is that although originally it was used as a tool to improve effectiveness and eficiency of public governance, it has gradually become a purpose it itself. "Accountability" has become an image of good governance first in the United States of America then in the European Union.Nevertheless,the concept is vaguely defined and provides ambiguous images of good governance.This paper begins with the presentation of some general meanings of the concept as they emerge from specialized dictionaries and ancyclopaedies and continues with the meanings developed in political science. The concept of "public accontability" is rooted in economics and management literature,becoming increasingly relevant in today's political science both in theory and discourse as well as in practice in formulating and evaluating public policies. A first conclusin that emerges from, the analysis of the evolution of this term is that it requires a conceptual clarification in political science. A clear definition will then enable an appropriate model of proving the system of public accountability in formulating and assessing public policies, in order to implement a system of assessment and monitoring thereof.

Global warming: the significance of methane

International Nuclear Information System (INIS)

Dessus, B.; Le Treut, H.; Laponche, B.

2008-01-01

the concept of Global Warming Potential (GWP) indicates the relative contribution to global warming over a given period (for example 100 years) of a pulse emission at the start of the period of 1 kg of a specific greenhouse gas (GHG) in comparison to the contribution, over the same period, of an emission of 1 kg of CO 2 . The GWPs calculated for different time intervals take into account the differences in atmospheric lifetimes of the different GHGs. Using the '100-year GWP' to measure non CO 2 GHG emissions is not well suited to the case of permanent or long lifetime measures whose effectiveness is to be assessed at a given time horizon. In this context, it contributes to significantly playing down the importance of reducing emissions of GHGs with short atmospheric lifetimes. Thus, for example, methane which is not emitted over the period 2020- 2100 as a result of a landfill site being closed in 2020 will have an impact (as opposed to if the site remained in operation) that would be far greater towards 2100 compared to a CO 2 emission source that has also been stopped permanently and whose climate impact is measured in an equivalent manner. Using the GWP is only appropriate if applied year after year to time horizons considered to be of concern or decisive by climate studies, thus in particular 2050, 2100 and 2150. This is all the more significant as climate experts' current concerns lead them not only to advocate long-term stabilisation of GHG concentrations but also to avoid as far as possible intermediate excess of these concentrations over the coming century. Finally, it is noted that CH 4 prevention policies implemented in the short term may continue to have a long-term impact greater than merely taking into account the current GWP would imply. To more or less ignore the impact of CH 4 as it is unsuitable for accounting purposes affects the exclusive character of the link that may exist between the issue of GHGs and that of energy. Furthermore, if the

Current practice trends in allergy: results of a united states survey of otolaryngologists, allergist-immunologists, and primary care physicians.

Science.gov (United States)

Ryan, Matthew W; Marple, Bradley F; Leatherman, Bryan; Mims, J Whit; Fornadley, John; Veling, Maria; Lin, Sandra Y

2014-10-01

Clinical practices for the diagnosis and treatment of allergic disease evolve over time in response to a variety of forces. The techniques used by various physician specialties are not clearly defined and may vary from published descriptions or recommendations in the literature. This work is a Web-based survey enrolling 250 U.S. physicians in the following specialties: otolaryngology (ENT), allergy-immunology (A/I), and primary care (PCP). Respondents reported that skin-prick testing is the most common diagnostic testing method, followed by in vitro specific immunoglobulin E (IgE) testing. ENTs were more likely to use intradermal testing compared to other specialties (p = 0.0003 vs A/I; p 60). Significant use of home immunotherapy injections (defined as >10% of immunotherapy patients) ranged from 27% to 36% of physicians, with no statistically significant difference noted based upon specialty. PCPs reported greater use of sublingual immunotherapy (PCP, 68%; A/I, 45%; otolaryngology, 35%; A/I vs PCP, p = 0.005; ENT vs PCP p allergy testing and treatment methods are employed by U.S. physicians, with some differences noted based upon specialty. Home immunotherapy continues to be employed in allergy practices, and sublingual immunotherapy is a common form of delivery, especially in primary care practices. © 2014 ARS-AAOA, LLC.

Quantifying the Clinical Significance of Cannabis Withdrawal

Science.gov (United States)

Allsop, David J.; Copeland, Jan; Norberg, Melissa M.; Fu, Shanlin; Molnar, Anna; Lewis, John; Budney, Alan J.

2012-01-01

Background and Aims Questions over the clinical significance of cannabis withdrawal have hindered its inclusion as a discrete cannabis induced psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). This study aims to quantify functional impairment to normal daily activities from cannabis withdrawal, and looks at the factors predicting functional impairment. In addition the study tests the influence of functional impairment from cannabis withdrawal on cannabis use during and after an abstinence attempt. Methods and Results A volunteer sample of 49 non-treatment seeking cannabis users who met DSM-IV criteria for dependence provided daily withdrawal-related functional impairment scores during a one-week baseline phase and two weeks of monitored abstinence from cannabis with a one month follow up. Functional impairment from withdrawal symptoms was strongly associated with symptom severity (p = 0.0001). Participants with more severe cannabis dependence before the abstinence attempt reported greater functional impairment from cannabis withdrawal (p = 0.03). Relapse to cannabis use during the abstinence period was associated with greater functional impairment from a subset of withdrawal symptoms in high dependence users. Higher levels of functional impairment during the abstinence attempt predicted higher levels of cannabis use at one month follow up (p = 0.001). Conclusions Cannabis withdrawal is clinically significant because it is associated with functional impairment to normal daily activities, as well as relapse to cannabis use. Sample size in the relapse group was small and the use of a non-treatment seeking population requires findings to be replicated in clinical samples. Tailoring treatments to target withdrawal symptoms contributing to functional impairment during a quit attempt may improve treatment outcomes. PMID:23049760

Quantifying the clinical significance of cannabis withdrawal.

Directory of Open Access Journals (Sweden)

David J Allsop

Full Text Available Questions over the clinical significance of cannabis withdrawal have hindered its inclusion as a discrete cannabis induced psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV. This study aims to quantify functional impairment to normal daily activities from cannabis withdrawal, and looks at the factors predicting functional impairment. In addition the study tests the influence of functional impairment from cannabis withdrawal on cannabis use during and after an abstinence attempt.A volunteer sample of 49 non-treatment seeking cannabis users who met DSM-IV criteria for dependence provided daily withdrawal-related functional impairment scores during a one-week baseline phase and two weeks of monitored abstinence from cannabis with a one month follow up. Functional impairment from withdrawal symptoms was strongly associated with symptom severity (p=0.0001. Participants with more severe cannabis dependence before the abstinence attempt reported greater functional impairment from cannabis withdrawal (p=0.03. Relapse to cannabis use during the abstinence period was associated with greater functional impairment from a subset of withdrawal symptoms in high dependence users. Higher levels of functional impairment during the abstinence attempt predicted higher levels of cannabis use at one month follow up (p=0.001.Cannabis withdrawal is clinically significant because it is associated with functional impairment to normal daily activities, as well as relapse to cannabis use. Sample size in the relapse group was small and the use of a non-treatment seeking population requires findings to be replicated in clinical samples. Tailoring treatments to target withdrawal symptoms contributing to functional impairment during a quit attempt may improve treatment outcomes.

Ecology of greater sage-grouse in the Dakotas

Science.gov (United States)

Christopher C. Swanson

2009-01-01

Greater sage-grouse (Centrocercus urophasianus) populations and the sagebrush (Artemisia spp.) communities that they rely on have dramatically declined from historic levels. Moreover, information regarding sage-grouse annual life-history requirements at the eastern-most extension of sagebrush steppe communities is lacking....

Planning for greater confinement disposal

International Nuclear Information System (INIS)

Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

1985-01-01

A report that provides guidance for planning for greater-confinement disposal (GCD) of low-level radioactive waste is being prepared. The report addresses procedures for selecting a GCD technology and provides information for implementing these procedures. The focus is on GCD; planning aspects common to GCD and shallow-land burial are covered by reference. Planning procedure topics covered include regulatory requirements, waste characterization, benefit-cost-risk assessment and pathway analysis methodologies, determination of need, waste-acceptance criteria, performance objectives, and comparative assessment of attributes that support these objectives. The major technologies covered include augered shafts, deep trenches, engineered structures, hydrofracture, improved waste forms, and high-integrity containers. Descriptive information is provided, and attributes that are relevant for risk assessment and operational requirements are given. 10 refs., 3 figs., 2 tabs

Mind-Body Practices and the Self: Yoga and Meditation Do Not Quiet the Ego but Instead Boost Self-Enhancement.

Science.gov (United States)

Gebauer, Jochen E; Nehrlich, Andreas D; Stahlberg, Dagmar; Sedikides, Constantine; Hackenschmidt, Anke; Schick, Doreen; Stegmaier, Clara A; Windfelder, Cara C; Bruk, Anna; Mander, Johannes

2018-06-01

Mind-body practices enjoy immense public and scientific interest. Yoga and meditation are highly popular. Purportedly, they foster well-being by curtailing self-enhancement bias. However, this "ego-quieting" effect contradicts an apparent psychological universal, the self-centrality principle. According to this principle, practicing any skill renders that skill self-central, and self-centrality breeds self-enhancement bias. We examined those opposing predictions in the first tests of mind-body practices' self-enhancement effects. In Experiment 1, we followed 93 yoga students over 15 weeks, assessing self-centrality and self-enhancement bias after yoga practice (yoga condition, n = 246) and without practice (control condition, n = 231). In Experiment 2, we followed 162 meditators over 4 weeks (meditation condition: n = 246; control condition: n = 245). Self-enhancement bias was higher in the yoga (Experiment 1) and meditation (Experiment 2) conditions, and those effects were mediated by greater self-centrality. Additionally, greater self-enhancement bias mediated mind-body practices' well-being benefits. Evidently, neither yoga nor meditation fully quiet the ego; to the contrary, they boost self-enhancement.

Nesting success and resource selection of Greater Sage-Grouse [chapter 8

Science.gov (United States)

Nicholas W. Kaczor; Kent C. Jensen; Robert W. Klaver; Mark A. Rumble; Katie M. Herman-Brunson; Christopher C. Swanson

2011-01-01

Declines of Greater Sage-Grouse (Centrocercus urophasianus) in South Dakota are a concern because further population declines may lead to isolation from populations in Wyoming and Montana. Furthermore, little information exists about reproductive ecology and resource selection of sage grouse on the eastern edge of their distribution. We investigated Greater Sage-Grouse...

Resource selection during brood-rearing by Greater Sage-Grouse [chapter 12

Science.gov (United States)

Nicholas W. Kaczor; Katie M. Herman-Brunson; Kent C. Jensen; Mark A. Rumble; Robert W. Klaver; Christopher C. Swanson

2011-01-01

Understanding population dynamics and resource selection is crucial in developing wildlife resource management plans for sensitive species such as Greater Sage-Grouse (Centrocercus urophasianus). Little is known about sage grouse habitats on the eastern edge of their range. We investigated resource selection of Greater Sage-Grouse during brood- rearing in North and...

Virginia Tech launches Energy Efficiency Partnership with Hannon Armstrong and Pepco Energy Services aimed at greening greater Washington, D.C.

OpenAIRE

Micale, Barbara L.

2007-01-01

Virginia Tech announced Monday the "Energy Efficiency Partnership of Greater Washington," a landmark initiative to tackle the problem of global warming by retrofitting existing buildings with energy efficiency products designed to decrease energy use and significantly cut carbon emissions.

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: quantitative examination of variation between practices in recruitment, implementation and effectiveness.

Science.gov (United States)

Dreischulte, Tobias; Grant, Aileen; Hapca, Adrian; Guthrie, Bruce

2018-01-05

The cluster randomised trial of the Data-driven Quality Improvement in Primary Care (DQIP) intervention showed that education, informatics and financial incentives for general medical practices to review patients with ongoing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets reduced the primary end point of high-risk prescribing by 37%, where both ongoing and new high-risk prescribing were significantly reduced. This quantitative process evaluation examined practice factors associated with (1) participation in the DQIP trial, (2) review activity (extent and nature of documented reviews) and (3) practice level effectiveness (relative reductions in the primary end point). Invited practices recruited (n=33) and not recruited (n=32) to the DQIP trial in Scotland, UK. (1) Characteristics of recruited versus non-recruited practices. Associations of (2) practice characteristics and 'adoption' (self-reported implementation work done by practices) with documented review activity and (3) of practice characteristics, DQIP adoption and review activity with effectiveness. (1) Recruited practices had lower performance in the quality and outcomes framework than those declining participation. (2) Not being an approved general practitioner training practice and higher self-reported adoption were significantly associated with higher review activity. (3) Effectiveness ranged from a relative increase in high-risk prescribing of 24.1% to a relative reduction of 77.2%. High-risk prescribing and DQIP adoption (but not documented review activity) were significantly associated with greater effectiveness in the final multivariate model, explaining 64.0% of variation in effectiveness. Intervention implementation and effectiveness of the DQIP intervention varied substantially between practices. Although the DQIP intervention primarily targeted review of ongoing high-risk prescribing, the finding that self-reported DQIP adoption was a stronger predictor of

Management and non-supervisory perceptions surrounding the implementation and significance of high-performance work practices in a nuclear power plant

Science.gov (United States)

Ashbridge, Gayle Ann

Change management has become an imperative for organizations as they move into the 21st century; up to 75 percent of change initiatives fail. Nuclear power plants face the same challenges as industrial firms with the added challenge of deregulation. Faced with this challenge, restructuring the electric utility has raised a number of complex issues. Under traditional cost-of-service regulation, electric utilities were able to pass on their costs to consumers who absorbed them. In the new competitive environment, customers will now choose their suppliers based on the most competitive price. The purpose of this study is to determine the degree of congruence between non-supervisory and supervisory personnel regarding the perceived implementation of high performance workplace practices at a nuclear power plant. This study used as its foundation the practices identified in the Road to High Performance Workplaces: A Guide to Better Jobs and Better Business Results by the U.S. Department of Labor's Office of the American Workplace (1994). The population for this study consisted of organizational members at one nuclear power plant. Over 300 individuals completed surveys on high performance workplace practices. Two surveys were administered, one to non-supervisory personnel and one to first line supervisors and above. The determination of implementation levels was accomplished through descriptive statistical analysis. Results of the study revealed 32 areas of noncongruence between non-supervisory and supervisory personnel in regard to the perceived implementation level of the high performance workplace practices. Factor analysis further revealed that the order in which the respondents place emphasis on the variables varies between the two groups. This study provides recommendations that may improve the nuclear power plants alignment of activities. Recommendations are also provided for additional research on high-performance work practices.

Military men and sexual practices: Discourses of 'othering' in safer ...

African Journals Online (AJOL)

Military men and sexual practices: Discourses of 'othering' in safer sex in the light of HIV/AIDS. ... Military men are particularly vulnerable to HIV because of their working conditions; for example, working far from home and being among communities where they have greater economic and political power, as well as in relation ...

Networks of Practice in Science Education Research: A Global Context

Science.gov (United States)

Martin, Sonya N.; Siry, Christina

2011-01-01

In this paper, we employ cultural sociology and Braj Kachru's model of World Englishes as theoretical and analytical tools for considering English as a form of capital necessary for widely disseminating research findings from local networks of practice to the greater science education research community. We present a brief analysis of recent…

Effect of exposure to greater active videogame variety on time spent in moderate- to vigorous-intensity physical activity.

Science.gov (United States)

Raynor, Hollie A; Cardoso, Chelsi; Bond, Dale S

2016-07-01

This investigation examined whether exposure to greater active videogame variety increases moderate- to vigorous-intensity physical activity (MVPA). Twenty-three participants (age=22.7±4.2yrs; body mass index=23.5±3.0kg/m(2); self-reported MVPA=298.7±116.7min/wk; 62.2% female; 73.9% Caucasian) participated in VARIETY (4 different active videogames during 4, 15-min bouts) and NON-VARIETY (only 1 active videogame during 4, 15-min bouts) counterbalanced sessions. VARIETY provided a different active videogame in each bout. NON-VARIETY provided participants their most highly liked active videogame in each bout. The Sensewear Mini Armband objectively assessed MVPA. For MVPA minutes, a session×bout (p<0.05) interaction occurred. In NON-VARIETY, bouts 2, 3, and 4 had significantly (p<0.05) fewer minutes than bout 1, with no decrease occurring in VARIETY. In bout 4, VARIETY had significantly (p<0.05) more minutes than NON-VARIETY. A main effect of session (p<0.05) occurred for MVPA minutes and energy expenditure, with VARIETY achieving greater amounts (31.8±14.3min vs. 27.6±16.9min; 186.1±96.8kcal vs. 171.2±102.8kcal). Exposure to greater activity variety within a session increased MVPA. Future research should examine exposure to a variety of activities over a longer time frame with participants of differing lifestyles in free-living environments. Copyright © 2016. Published by Elsevier Inc.

Contemporary analysis of practicing otolaryngologists.

Science.gov (United States)

Harrill, Willard C; Melon, David E; Seshul, Merritt J; Katz, Marc S; Zanation, Adam M

2018-05-04

To investigate contemporary issues facing practicing otolaryngologists including workforce dynamics, ancillary service modeling, otolaryngic allergy integration, ambulatory surgery center utilization, and relevant certificate of need legislation. A cross-sectional survey analysis of academic and private practicing otolaryngologists in North and South Carolina in 2016. A cross-sectional survey was e-mailed to 510 practicing otolaryngologists in North and South Carolina. A 21.3% survey response rate was achieved. Otolaryngology workforce was defined by horizontal aggregation of otolaryngologists into larger group models, with fewer solo practitioners being replaced by younger otolaryngologists or employing otolaryngology extenders. Excluding academic practice, few otolaryngologists have chosen direct hospital employment as a career option, although otolaryngologists with fewer years of practice are pursuing that option with greater frequency. Ancillary services showed audiology and hearing aid services being the most common, followed by otolaryngic allergy, point-of-service computed tomography, and ultrasound. Although otolaryngologists tend to avoid vertical integration, ambulatory surgery center (ASC) ownership trends favor a joint venture model with a hospital system partner. Most otolaryngologists favor changes to certificate of need legislation to improve patient access to these lower-cost facilities, regardless of whether they currently utilize or have access to an ASC. Otolaryngology is uniquely positioned to adapt and respond to current paradigm shifts within ambulatory medicine. Further analysis is needed to prepare current and future otolaryngologists for the demands and opportunities these challenges pose as patient-centered care models and consumer dynamics shape future patient expectations and utilization of healthcare. 5. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

Patient expectations predict greater pain relief with joint arthroplasty.

Science.gov (United States)

Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

2009-08-01

We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.

Better, Sooner, More Convenient? The reality of pursuing greater integration between primary and secondary healthcare providers in New Zealand.

Science.gov (United States)

Lovelock, Kirsten; Martin, Greg; Gauld, Robin; MacRae, Jayden

2017-01-01

This article focuses on the results of evaluations of two business plans developed in response to a policy initiative which aimed to achieve greater integration between primary and secondary health providers in New Zealand. We employ the Consolidated Framework for Implementation Research to inform our analysis. The Better, Sooner, More Convenient policy programme involved the development of business plans and, within each business plan, a range of areas of focus and associated work-streams. The evaluations employed a mixed method multi-level case study design, involving qualitative face-to-face interviews with front-line staff, clinicians and management in two districts, one in the North Island and the other in the South Island, and an analysis of routine data tracked ambulatory sensitive hospitalisations and emergency department presentations. Two postal surveys were conducted, one focussing on the patient care experiences of integration and care co-ordination and the second focussing on the perspectives of health professionals in primary and secondary settings in both districts. Both evaluations revealed non-significant changes in ambulatory sensitive hospitalisations and emergency department presentation rates and slow uneven progress with areas of focus and their associated work-streams. Our evaluations revealed a range of implementation issues, the barriers and facilitators to greater integration of healthcare services and the implications for those who were responsible for putting policy into practice. The business plans were shown to be overly ambitious and compromised by the size and scope of the business plans; dysfunctional governance arrangements and associated accountability issues; organisational inability to implement change quickly with appropriate and timely funding support; an absence of organisational structural change allowing parity with the policy objectives; barriers that were encountered because of inadequate attention to organisational

Better, Sooner, More Convenient? The reality of pursuing greater integration between primary and secondary healthcare providers in New Zealand

Directory of Open Access Journals (Sweden)

Kirsten Lovelock

2017-03-01

Full Text Available Objectives: This article focuses on the results of evaluations of two business plans developed in response to a policy initiative which aimed to achieve greater integration between primary and secondary health providers in New Zealand. We employ the Consolidated Framework for Implementation Research to inform our analysis. The Better, Sooner, More Convenient policy programme involved the development of business plans and, within each business plan, a range of areas of focus and associated work-streams. Methods: The evaluations employed a mixed method multi-level case study design, involving qualitative face-to-face interviews with front-line staff, clinicians and management in two districts, one in the North Island and the other in the South Island, and an analysis of routine data tracked ambulatory sensitive hospitalisations and emergency department presentations. Two postal surveys were conducted, one focussing on the patient care experiences of integration and care co-ordination and the second focussing on the perspectives of health professionals in primary and secondary settings in both districts. Results: Both evaluations revealed non-significant changes in ambulatory sensitive hospitalisations and emergency department presentation rates and slow uneven progress with areas of focus and their associated work-streams. Our evaluations revealed a range of implementation issues, the barriers and facilitators to greater integration of healthcare services and the implications for those who were responsible for putting policy into practice. Conclusion: The business plans were shown to be overly ambitious and compromised by the size and scope of the business plans; dysfunctional governance arrangements and associated accountability issues; organisational inability to implement change quickly with appropriate and timely funding support; an absence of organisational structural change allowing parity with the policy objectives; barriers that were

Emittance of a finite scattering medium with refractive index greater than unity

International Nuclear Information System (INIS)

Crosbie, A.L.

1980-01-01

Refractive index and scattering can significantly influence the transfer of radiation in a semitransparent medium such as water, glass, plastics, or ceramics. In a recent article (1979), the author presented exact numerical results for the emittance of a semiinfinite scattering medium with a refractive index greater than unity. The present investigation extends the analysis to a finite medium. The physical situation consists of a finite planar layer. The isothermal layer emits, absorbs, and isotropically scatters thermal radiation. It is characterized by single scattering albedo, optical thickness, refractive index, and temperature. A formula for the directional emittance is derived, the directional emittance being the emittance of the medium multiplied by the interface transmittance. The ratio of hemispherical to normal emittance is tabulated and discussed

Using the 4 Pillars Practice Transformation Program to Increase Pneumococcal Immunizations for Older Adults: A Cluster-Randomized Trial.

Science.gov (United States)

Zimmerman, Richard K; Brown, Anthony E; Pavlik, Valory N; Moehling, Krissy K; Raviotta, Jonathan M; Lin, Chyongchiou J; Zhang, Song; Hawk, Mary; Kyle, Shakala; Patel, Suchita; Ahmed, Faruque; Nowalk, Mary Patricia

2017-01-01

To test the effectiveness of a step-by step, evidence-based guide, the 4 Pillars Practice Transformation Program, to increase adult pneumococcal vaccination. Randomized controlled cluster trial (RCCT) in Year 1 (June 1, 2013 to May 31, 2014) and pre-post study in Year 2 (June 1, 2014 to January 31, 2015) with data analyzed in 2016. Baseline year was June 1, 2012, to May 31, 2013. Demographic and vaccination data were derived from deidentified electronic medical record extractions. Primary care practices (n = 25) stratified according to metropolitan area (Houston, Pittsburgh), location (rural, urban, suburban), and type (family medicine, internal medicine), randomized to receive the intervention in Year 1 (n = 13) or Year 2 (n = 12). Individuals aged 65 and older at baseline (N = 18,107; mean age 74.2; 60.7% female, 16.5% non-white, 15.7% Hispanic). The 4 Pillars Program, provider education, and one-on-one coaching of practice-based immunization champions. Outcome measures were 23-valent pneumococcal polysaccharide vaccine (PPSV) and pneumococcal conjugate vaccine (PCV) vaccination rates and percentage point (PP) changes in vaccination rates. In the Year 1 RCCT, PPSV vaccination rates increased significantly in all intervention and control groups, with average increases ranging from 6.5 to 8.7 PP (P < .001). The intervention was not related to greater likelihood of PPSV vaccination. In the Year 2 pre-post study, the likelihood of PPSV and PCV vaccination was significantly higher in the active intervention sites than the maintenance sites in Pittsburgh but not in Houston. In a RCCT, PPSV vaccination rates increased in the intervention and control groups in Year 1. In a pre-post study, private primary care practices actively participating in the 4 Pillars Practice Transformation Program improved PPSV and PCV uptake significantly more than practices that were in the maintenance phase of the study. © 2016, Copyright the Authors Journal compilation © 2016, The American

Reporting effect sizes as a supplement to statistical significance ...

African Journals Online (AJOL)

The purpose of the article is to review the statistical significance reporting practices in reading instruction studies and to provide guidelines for when to calculate and report effect sizes in educational research. A review of six readily accessible (online) and accredited journals publishing research on reading instruction ...

Bacterial Colonization of Disposable Soft Contact Lenses Is Greater during Corneal Infiltrative Events than during Asymptomatic Extended Lens Wear

Science.gov (United States)

Sankaridurg, Padmaja R.; Sharma, Savitri; Willcox, Mark; Naduvilath, Thomas J.; Sweeney, Deborah F.; Holden, Brien A.; Rao, Gullapalli N.

2000-01-01

Microorganisms, especially gram-negative bacteria, are considered to play a role in the etiology of certain corneal infiltrative events (CIEs) observed during soft contact lens wear. This study explored the possibility of microbial colonization of soft contact lenses as a risk factor leading to CIEs. In a clinical trial conducted from March 1993 to January 1996, 330 subjects wore disposable soft contact lenses on a 6-night extended-wear and disposal schedule. During this period, 4,321 lenses (118 during CIEs; 4,203 during asymptomatic lens wear) were recovered aseptically and analyzed for microbial colonization. A greater percentage of lenses were free from microbial colonization during asymptomatic wear than during CIEs (42 versus 23%; P bacteria, gram-negative bacteria and fungi was greater during CIEs than during asymptomatic lens wear (P bacteria were isolated most frequently and were usually normal external ocular microbiota. Of the gram-positive bacteria, the incidence of Streptococcus pneumoniae was greater during CIE than during asymptomatic wear (7.6 versus 0.6%; P bacteria were seen in few cases during asymptomatic wear, their incidence during CIE in comparison to asymptomatic wear was substantial and significant (23.7 versus 3.8%; P bacteria or S. pneumoniae. Colonization of soft contact lenses with pathogenic bacteria, especially gram-negative bacteria and S. pneumoniae, appears to be a significant risk factor leading to CIE. PMID:11101574

Moderate Baseline Vagal Tone Predicts Greater Prosociality in Children

Science.gov (United States)

Miller, Jonas G.; Kahle, Sarah; Hastings, Paul D.

2016-01-01

Vagal tone is widely believed to be an important physiological aspect of emotion regulation and associated positive behaviors. However, there is inconsistent evidence for relations between children’s baseline vagal tone and their helpful or prosocial responses to others (Hastings & Miller, 2014). Recent work in adults suggests a quadratic association (inverted U-shape curve) between baseline vagal tone and prosociality (Kogan et al., 2014). The present research examined whether this nonlinear association was evident in children. We found consistent evidence for a quadratic relation between vagal tone and prosociality across 3 samples of children using 6 different measures. Compared to low and high vagal tone, moderate vagal tone in early childhood concurrently predicted greater self-reported prosociality (Study 1), observed empathic concern in response to the distress of others and greater generosity toward less fortunate peers (Study 2), and longitudinally predicted greater self-, mother-, and teacher-reported prosociality 5.5 years later in middle childhood (Study 3). Taken together, our findings suggest that moderate vagal tone at rest represents a physiological preparedness or tendency to engage in different forms of prosociality across different contexts. Early moderate vagal tone may reflect an optimal balance of regulation and arousal that helps prepare children to sympathize, comfort, and share with others. PMID:27819463

Defining greater-than-class-C low-level radioactive waste

International Nuclear Information System (INIS)

Knecht, M.A.; Oztunali, O.I.

1986-01-01

The Low-Level Radioactive Waste Policy Amendments Act of 1985 (LLRWPAA) was signed by President Reagan on January 15, 1986. This act requires the federal government to be responsible for the disposal of greater-than-class-C low-level radioactive waste (LLRW) that is generated commercially by state agencies and by federal entities (other than waste generated by atomic weapons research, development, or testing, or by decommissioning of vessels of the nuclear navy). To plan for disposal, the federal government will require estimates of the volume of waste involved and characterization of this waste. A clear definition of greater-than-class-C LLRW is the first step in determining what wastes will be included in the waste to be received by the federal government. This definition will influence major policy decisions to be made for management of such waste. The purpose of this paper is to examine the existing information on greater-than-class-C LLRW in view of the current definition of such waste and potential changes in this definition - for example, an upper limit on the concentrations of radionuclides in LLRW. The paper identifies further information needs to develop a clear definition of such waste for use in federal planning for acceptance of responsibility for disposal of such waste

Entrepreneurial Saving Practices and Reinvestment

NARCIS (Netherlands)

Beck, Thorsten; Pamuk, Haki; Uras, Burak R.

2017-01-01

We use a novel enterprise survey to gauge the relationship between saving instruments and entrepreneurial reinvestment. We show that while most informal saving practices are not associated with a lower likelihood of reinvestment when compared with formal saving practices, there is a significantly

Impact of the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention on adherence to national obesity clinical practice guidelines in a primary care centre.

Science.gov (United States)

Barnes, Emily R; Theeke, Laurie A; Mallow, Jennifer

2015-04-01

Obesity is significantly underdiagnosed and undertreated in primary care settings. The purpose of this clinical practice change project was to increase provider adherence to national clinical practice guidelines for the diagnosis and treatment of obesity in adults. Based upon the National Institutes of Health guidelines for the diagnosis and treatment of obesity, a clinical change project was implemented. Guided by the theory of planned behaviour, the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention includes education sessions, additional provider resources for patient education, a provider reminder system and provider feedback. Primary care providers did not significantly increase on documentation of diagnosis and planned management of obesity for patients with body mass index (BMI) greater than or equal to 30. Medical assistants increased recording of height, weight and BMI in the patient record by 13%, which was significant. Documentation of accurate BMI should lead to diagnosis of appropriate weight category and subsequent care planning. Future studies will examine barriers to adherence to clinical practice guidelines for obesity. Interventions are needed that include inter-professional team members and may be more successful if delivered separately from routine primary care visits. © 2015 John Wiley & Sons, Ltd.

Job-Sharing at the Greater Victoria Public Library.

Science.gov (United States)

Miller, Don

1978-01-01

Describes the problems associated with the management of part-time library employees and some solutions afforded by a job sharing arrangement in use at the Greater Victoria Public Library. This is a voluntary work arrangement, changing formerly full-time positions into multiple part-time positions. (JVP)

Role of the greater sciatic notch of the hip bone in sexual dimorphism: a morphometric study of the north Indian population.

Science.gov (United States)

G, Kalsey; R K, Singla; K, Sachdeva

2011-04-01

The distinctive morphology and sexual dimorphism of the human hip bone makes it of interest from the anatomical, anthropological and forensic points of view. The shape of the greater sciatic notch has attracted great attention in the past. In the current investigation, an attempt has been made to find the baseline data of various parameters pertaining to the greater sciatic notch of 100 hip bones of known sex (male:female = 80:20) and side (right:left = 50:50), obtained from the Department of Anatomy, Government Medical College, Amritsar, Punjab, India, during the period 2007-2009. Seven parameters of the notch, viz. width, depth, posterior segment width, total angle, posterior segment angle, index I and index II of the greater sciatic notch were studied. The results thus obtained were compiled, tabulated, statistically analysed and were compared with the accessible literature. Out of all the parameters studied, width of the notch, posterior segment width, total angle, posterior segment angle and index II of notch were found to be significantly greater in women as compared with men. Thus the greater sciatic notch can serve as a reliable sex indicator even when the complete hip bone has not been well preserved.

Professional performance attributes according to accounting entrepreneurs from greater São Paulo

Directory of Open Access Journals (Sweden)

Ivam Ricardo Peleias

2015-06-01

Full Text Available Accounting has a broad activity universe, which requires skilled professionals who are prepared to practice the profession. One possibility is to be an accounting entrepreneur, whose profile requires specific attributes and attitudes. The results reported on in this paper derive from a research developed using the oral history technique, concerning the identification and analysis of attributes valued in the performance of the profession by accounting entrepreneurs from greater São Paulo. A field research was developed, involving face-to-face interviews with a group of seven accounting entrepreneurs of outstanding professional reputation, seeking evidence on the administration of the accounting organization and on the interviewees’ entrepreneurial profile. The theoretical framework was focused on the accounting organizations and the entrepreneurial behavior. The data revealed common attributes and profiles needed to perform the profession among the interviewees and the accounting organizations they manage, such as: they started the organizations in a simple manner, in a family environment; the organizations are structured in a departmentalized manner, delegating powers; they declared having achieved an outstanding position in the accounting segment with great work, dedication and persistence; they execute their activities based on ethics, honesty and seriousness; they look for new challenges and enterprises and target the valuation of the accounting profession.

From workshop to work practice: An exploration of context and facilitation in the development of evidence-based practice.

Science.gov (United States)

Ellis, Isabelle; Howard, Peter; Larson, Ann; Robertson, Jeanette

2005-01-01

This article examines the process of translating evidence into practice using a facilitation model developed by the Western Australian Centre for Evidence Based Nursing and Midwifery. Using the conceptual framework Promoting Action on Research Implementation in Health Services (PARIHS), the aims of the study were (1) to explore the relative and combined importance of context and facilitation in the successful implementation of a new evidence-based clinical practice protocol and (2) to examine the establishment of more lasting change to individuals and organizations that resulted in greater incorporation of the principles of evidence-based practice (EBP). A pre-workshop, semi-structured telephone survey with 16 nurse managers in six rural hospitals; a summative evaluation immediately post-workshop with 54 participants; and follow-up, semi-structured interviews with 23 workshop participants. The contexts in each of the participating hospitals were very different; of the six hospitals, only one had not implemented the new protocol. Five had reviewed their practices and brought them in line with the protocol developed at the workshop. The rate of adoption varied considerably from 2 weeks to months. The participants reported being better informed about EBP in general and were positive about their ability to improve their practice and search more efficiently for best practice information. Underlying motivations for protocol development should be included in the PARIHS framework. IMPLICATIONS FOR EDUCATION: Good facilitation appears to be more influential than context in overcoming the barriers to the uptake of EBP.

A STUDY ON THE INTERACTION BETWEEN SCIENTIFIC RESEARCH AND PROFESSIONAL ACCOUNTING PRACTICE

Directory of Open Access Journals (Sweden)

Ana Paula Batista da Silva

2012-06-01

Full Text Available The aim of this study was to analyze the interaction between scientific research and professional accounting practice. In this exploratory study, as it examines a theme that has been little explored in Brazil, a quantitative approach was adopted and a survey was used as the data collection technique, supported by a research instrument with questions on aspects like: interest in and use of research; study and development of themes; means to disseminate the research; and causes of the gap between research and practice. Considering the objectives, it is classified as descriptive, since it was described how this interaction occurs. Data were analyze through factor analysis in R, resuming them in factors for further analysis, validated through the Kaiser-Meyer-Olkin (KMO test and Bartlett’s sphericity yet. In conclusion, due to their different characteristics, it is natural that some distancing exists between research and accounting practice. This can be minimized though, among other factors, through professionals’ great interest in knowing and applying the research results in practice, and also by confirming that the most researched themes in accountancy are the themes of greatest interest in accounting professionals’ opinion. These results suggest that greater attention is due to the interaction and communication between the academy and accounting professionals, with a view to greater efficacy.

Self-Concept in Childhood: The Role of Body Image and Sport Practice

Science.gov (United States)

Mendo-Lázaro, Santiago; Polo-del-Río, María I.; Amado-Alonso, Diana; Iglesias-Gallego, Damián; León-del-Barco, Benito

2017-01-01

The purpose of this study was to explore the differences in satisfaction with body image depending on whether the subject practices organized sport or not, as well as the gender of the children. In addition, the study aims to examine the role of body image and the practice of organized sport on the process of building the academic, social, emotional, family and physical dimensions of self-concept in childhood. To do so, a sample of 944 pupils was used. These children were attending primary school in different centers of the Autonomous Community of Extremadura (Spain) and were between 9 and 12 years of age. The main results of the study show that three out of every four children participating in this study were not satisfied with their figure and one out of every five was very dissatisfied. The satisfaction or dissatisfaction with the figure was similar in boys and girls, although it could be appreciated that the ideal body image is partly conditioned by gender stereotypes. The children most satisfied with their body image had a greater academic and physical self-concept. The children that practiced organized sports had a greater physical and emotional self-concept. The children most dissatisfied with their body image and practiced organized sports had a lower family self-concept. All these findings are discussed with reference to previous research literature. PMID:28596750

Women at greater risk of HIV infection.

Science.gov (United States)

Mahathir, M

1997-04-01

Although many people believe that mainly men get infected with HIV/AIDS, women are actually getting infected at a faster rate than men, especially in developing countries, and suffer more from the adverse impact of AIDS. As of mid-1996, the Joint UN Program on AIDS estimated that more than 10 million of the 25 million adults infected with HIV since the beginning of the epidemic are women. The proportion of HIV-positive women is growing, with almost half of the 7500 new infections daily occurring among women. 90% of HIV-positive women live in a developing country. In Asia-Pacific, 1.4 million women have been infected with HIV out of an estimated total 3.08 million adults from the late 1970s until late 1994. Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production. Concurrent sexually transmitted diseases increase the risk of HIV transmission. Women's risk is also related to their exposure to gender inequalities in society. The social and economic pressures of poverty exacerbate women's risk. Prevention programs are discussed.

A More Practical Method for Explaining Equilibrium

OpenAIRE

Yi-Jang Yu

2014-01-01

The aim of this study is to suggest a more practical method for explaining market equilibrium in a two-dimensional risk-return world. Its main difference from textbook contents is to define, in both qualitative and quantitative ways, the environment or the system factor and treat it as an endogenous variable. Once the two-dimensional framework that is capable of managing uncertainty and environmental relationship can be reasonably established, a greater number of economic issues can be effect...

Improving the implementation of responsible alcohol management practices by community sporting clubs: A randomised controlled trial.

Science.gov (United States)

Kingsland, Melanie; Wolfenden, Luke; Tindall, Jennifer; Rowland, Bosco; Sidey, Maree; McElduff, Patrick; Wiggers, John H

2015-07-01

Despite an increased prevalence of risky alcohol consumption and alcohol-related harm among members of sporting groups and at sporting venues, sporting clubs frequently fail to implement alcohol management practices consistent with liquor legislation and best practice guidelines. The aim of this study was to assess the impact of a multi-strategy intervention in improving the implementation of responsible alcohol management practices by sports clubs. A randomised controlled trial was conducted with 87 football clubs, with half randomised to receive a multi-strategy intervention to support clubs to implement responsible alcohol management practices. The 2-year intervention, which was based on implementation and capacity building theory and frameworks, included project officer support, funding, accreditation rewards, printed resources, observational audit feedback, newsletters, training and support from state sporting organisations. Interviews were undertaken with club presidents at baseline and post-intervention to assess alcohol management practice implementation. Post-intervention, 88% of intervention clubs reported implementing '13 or more' of 16 responsible alcohol management practices, which was significantly greater than the proportion of control groups reporting this level of implementation (65%) [odds ratio: 3.7 (95% confidence interval: 1.1-13.2); P = 0.04]. All intervention components were considered highly useful and three-quarters or more of clubs rated the amount of implementation support to be sufficient. The multi-strategy intervention was successful in improving alcohol management practices in community sports clubs. Further research is required to better understand implementation barriers and to assess the long-term sustainability of the change in club alcohol management practices. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Advanced practice nursing role delineation in acute and critical care: application of the strong model of advanced practice.

Science.gov (United States)

Mick, D J; Ackerman, M H

2000-01-01

This purpose of this study was to differentiate between the roles of clinical nurse specialists and acute care nurse practitioners. Hypothesized blending of the clinical nurse specialist and acute care nurse practitioner roles is thought to result in an acute care clinician who integrates the clinical skills of the nurse practitioner with the systems knowledge, educational commitment, and leadership ability of the clinical nurse specialist. Ideally, this role blending would facilitate excellence in both direct and indirect patient care. The Strong Model of Advanced Practice, which incorporates practice domains of direct comprehensive care, support of systems, education, research, and publication and professional leadership, was tested to search for practical evidence of role blending. This descriptive, exploratory, pilot study included subjects (N = 18) solicited from an academic medical center and from an Internet advanced practice listserv. Questionnaires included self-ranking of expertise in practice domains, as well as valuing of role-related tasks. Content validity was judged by an expert panel of advanced practice nurses. Analyses of descriptive statistics revealed that clinical nurse specialists, who had more experience both as registered nurses and in the advanced practice nurse role, self-ranked their expertise higher in all practice domains. Acute care nurse practitioners placed higher importance on tasks related to direct comprehensive care, including conducting histories and physicals, diagnosing, and performing diagnostic procedures, whereas clinical nurse specialists assigned greater importance to tasks related to education, research, and leadership. Levels of self-assessed clinical expertise as well as valuing of role-related tasks differed among this sample of clinical nurse specialists and acute care nurse practitioners. Groundwork has been laid for continuing exploration into differentiation in advanced practice nursing roles. As the clinical

Psychotherapy in Contemporary Psychiatric Practice.

Science.gov (United States)

Hadjipavlou, George; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

2015-06-01

American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice. A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests. A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy. Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services.

Speech-Language Therapists' Process of Including Significant Others in Aphasia Rehabilitation

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Hallé, Marie-Christine; Le Dorze, Guylaine; Mingant, Anne

2014-01-01

Background: Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical…

Overview of Milestone E activities, greater confinement than shallow land burial

International Nuclear Information System (INIS)

Mezga, L.J.

1981-01-01

In summary, the objective of Milestone E is to provide the technology and documentation needed to open a site providing greater confinement than shallow land burial. To that end, ORNL has prepared a technical position paper defining greater confinement disposal, options for achieving it, and the need for this disposal technology. In order to meet the objective of the milestones, the LLWMP evaluated the full range of options to shallow land burial and decided to focus on a combination of greater depth solidification containment and engineered barriers. The program identified a series of research needs and then focused program efforts on resolving those needs. These tasks are proceeding on schedule at this time but budget reductions may have an impact on our ability to maintain the schedule

Keeping the medical practice financially viable: a marketer's approach.

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Patrick, Michelle L; Capraro, Anthony J; Credito, Candace M

2002-01-01

This paper explores a way that medical practices might develop a higher margin revenue source by offering a differentiated service that caters to patients who value more personalized service. Using SERVQUAL, German patients were surveyed to determine if there is a relationship between a desire for personalized service and a willingness to pay a premium for medical care. The results indicate that a greater desire for personalized care distinguishes those who pay a premium for medical care from those who do not. This suggests that medical practices can differentiate their service based on more personalized care and charge a higher fee for this service.

National survey of practices to prevent health care-associated infections in Thailand: The role of prevention bundles.

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Apisarnthanarak, Anucha; Ratz, David; Greene, M Todd; Khawcharoenporn, Thana; Weber, David J; Saint, Sanjay

2017-07-01

We evaluated the practices used in Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). From January 1, 2014-November 30, 2014, we surveyed all Thai hospitals with an intensive care unit and at least 250 beds. The use of prevention practices for CAUTI, CLABSI, and VAP was assessed. High compliance (≥75%) with all components of the CLABSI and VAP prevention bundles were determined. CAUTI, CLABSI, and VAP infection rates before and after implementing infection control practices are reported. Multivariable regression was used to examine associations between infection prevention bundle compliance and infection rate changes. Out of 245 eligible hospitals, 212 (86.5%) responded. A total of 120 (56.6%) and 115 hospitals (54.2%) reported ≥75% compliance for all components of the CLABSI and VAP prevention bundles, respectively, and 91 hospitals (42.9%) reported using ≥ 4 recommended CAUTI-prevention practices. High compliance with all of the CLABSI and VAP bundle components was associated with significant infection rate reductions (CLABSI, 38.3%; P Hospitals regularly using ≥ 4 CAUTI-prevention practices did not have greater reductions in CAUTI (0.02%; P = .99). Compliance with practices to prevent hospital infections was suboptimal. Policies and interventions promoting bundled approaches may help reduce hospital infections for Thai hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Distributed retrieval practice promotes superior recall of anatomy information.

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Dobson, John L; Perez, Jose; Linderholm, Tracy

2017-07-01

Effortful retrieval produces greater long-term recall of information when compared to studying (i.e., reading), as do learning sessions that are distributed (i.e., spaced apart) when compared to those that are massed together. Although the retrieval and distributed practice effects are well-established in the cognitive science literature, no studies have examined their additive effect with regard to learning anatomy information. The aim of this study was to determine how the benefits of retrieval practice vary with massed versus distributed learning. Participants used the following strategies to learn sets of skeletal muscle anatomy: (1) studying on three different days over a seven day period (SSSS 7,2,0 ), (2) studying and retrieving on three different days over a seven day period (SRSR 7,2,0 ), (3) studying on two different days over a two day period (SSSSSS 2,0 ), (4) studying and retrieving on two separate days over a two day period (SRSRSR 2,0 ), and (5) studying and retrieving on one day (SRx6 0 ). All strategies consisted of 12 learning phases and lasted exactly 24 minutes. Muscle information retention was assessed via free recall and using repeated measures ANOVAs. A week after learning, the recall scores were 24.72 ± 3.12, 33.88 ± 3.48, 15.51 ± 2.48, 20.72 ± 2.94, and 12.86 ± 2.05 for the SSSS 7,2,0 , SRSR 7,2,0 , SSSSSS 2,0 , STSTST 2,0 , and SRx6 0 strategies, respectively. In conclusion, the distributed strategies produced significantly better recall than the massed strategies, the retrieval-based strategies produced significantly better recall than the studying strategies, and the combination of distributed and retrieval practice generated the greatest recall of anatomy information. Anat Sci Educ 10: 339-347. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

Food addiction in children: Associations with obesity, parental food addiction and feeding practices.

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Burrows, T; Skinner, J; Joyner, M A; Palmieri, J; Vaughan, K; Gearhardt, A N

2017-08-01

Food addiction research in children is limited, and to date addictive-like eating behaviors within families have not been investigated. The aim of this study is to understand factors associated with addictive-like eating in children. The association between food addiction in children with obesity, parental food addiction, and parental feeding practices (i.e., restriction, pressure to eat, monitoring) was investigated. Parents/primary caregivers (aged≥18years) of children aged 5-12years, recruited and completed an online cross-sectional survey including demographics, the Yale Food Addiction Scale (YFAS), and the Child Feeding Questionnaire (CFQ). Parents, reporting on themselves and one of their children, were given a food addiction diagnosis and symptom score according to the YFAS predefined criteria. The total sample consisted of 150 parents/primary caregivers (48% male) and 150 children (51% male). Food addiction was found to be 12.0% in parents and 22.7% in children. In children, food addiction was significantly associated with higher child BMI z-scores. Children with higher food addiction symptoms had parents with higher food addiction scores. Parents of FA children reported significantly higher levels of Restriction and Pressure to eat feeding practices, but not Monitoring. Children with elevated YFAS-C scores may be at greater risk for eating-related issues. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relating Business Goals to Architecturally Significant Requirements for Software Systems

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2010-05-01

must respond within five seconds” [ EPF 2010]. A major source of architecturally significant requirements is the set of business goals that led to the...Projects for Competitive Advantage, Center for Business Practices, 1999. [ EPF 2010] Eclipse Process Framework Project. Concept: Architecturally

Evaluation of Technological, Economic and Social Indicators for Different Farming Practices in Lithuania

Directory of Open Access Journals (Sweden)

Aistė Galnaitytė

2017-12-01

Full Text Available Organic and integrated farming practices contribute to protecting biodiversity, reducing environmental pollution, improving soil quality, and providing high-quality raw material for food industry. The objective of the article is to establish the methodology and evaluate the system of indicators, which enables answering the question which farming practice has more advantages: organic or integrated? Multi-criteria analysis methods were used to achieve this objective. When being compared with between conventional and integrated farming practices, organic farming practice achieves higher profitability and greater energy efficiency. Organic farming reveals to be either superior, or similar to integrated farming practices in environmental terms. Potatoes, fruits and berries under both conventional and integrated farming practices have obtained the same rank (1–2 according to the selected criterions (yield, share of sold product, expenses on plant protection, production cost, price and labour input. Organic farming practice has shown worse rank. Organic farming practice has appeared to be the most suitable for vegetables.

The Stereotype-Matching Effect: Greater Influence on Functioning When Age Stereotypes Correspond to Outcomes

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Levy, Becca R.; Leifheit-Limson, Erica

2009-01-01

Older individuals assimilate, and are targeted by, contradictory positive and negative age stereotypes. It was unknown whether the influence of stereotype valence is stronger when the stereotype content corresponds to the outcome domain. We randomly assigned older individuals to either positive-cognitive, negative-cognitive, positive-physical, or negative-physical subliminal-age-stereotype groups and assessed cognitive and physical outcomes. As predicted, when the age stereotypes corresponded to the outcome domains, their valence had a significantly greater impact on cognitive and physical performance. This suggests that if a match occurs, it is more likely to generate expectations that become self-fulfilling prophecies. PMID:19290757

Doctors' attitudes and confidence towards providing nutrition care in practice: Comparison of New Zealand medical students, general practice registrars and general practitioners.

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Crowley, Jennifer; Ball, Lauren; Han, Dug Yeo; McGill, Anne-Thea; Arroll, Bruce; Leveritt, Michael; Wall, Clare

2015-09-01

Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (ppractice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (pmedical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted.

The significance of relative density for particle damage in loaded and sheared gravels

Directory of Open Access Journals (Sweden)

Fityus Stephen

2017-01-01

Full Text Available For granular assemblages of strong particles, an increase in the relative density usually leads to a significant increase in shear strength, which is evident as a peak strength, accompanied by significant dilation as the peak strength is attained. This paper describes an experimental study of shearing in assemblages of weak particles, where particle breakage offsets dilation for all but the lowest of confining stresses. In such materials, prone to particle breakage, the shear strengths of loose and dense assemblages rapidly converge to similar values as confining stress increases, and any benefit of greater relative density is lost. This is attributed to the densification effect associated with the loading under a high stress prior to shearing, which is characterised by widespread particle breakage and the formation of smaller particles to occupy space between coarser ones. Interestingly, under both low and high stresses, there was a tendency for greater particle breakage in the loose samples, as a result of both shearing and compression. This result suggests that, despite the denser assemblage having its particles more rigidly constrained and less able to rearrange to avoid direct loading, the influence of greater load-spreading capacity afforded by an increased number of particle contacts in a denser sample, is more dominant in controlling breakage.

Contemporary dental practice in the UK: demographic data and practising arrangements.

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Burke, F J T; Wilson, N H F; Christensen, G J; Cheung, S W; Brunton, P A

2005-01-08

To investigate, by questionnaire, various aspects of primary dental care provision in the North West of England and Scotland. A questionnaire containing 79 questions was sent to 1,000 practitioners, selected at random, in the North West of England and Scotland. Non-responders were sent another questionnaire after a period of 4 weeks had elapsed. Overall a response rate of 70% was achieved. The majority of practitioners were practice principals (65%), working in a group NHS practice (80%) located in a city or town centre (49%). On average 10-20 patients were treated each session with fewer patients treated per session under private arrangements. Many practitioners were found to lack hygienist support (44%) and to employ unqualified dental nurses (82%). Younger practitioners were more likely than senior colleagues to have access to up-to-date computers whilst 37% and 74% of respondents never used CAL programmes or magnification respectively. Contemporary cross-infection control standards were used by the majority of practitioners, although 3% of practitioners reported only autoclaving their handpiece once a day. The majority of practitioners, involved in this study, worked under National Health Service (NHS) regulations as principals in a group practice where the workload was greater than the private/independent sector. Contemporary cross-infection procedures were used routinely. In contrast computer-aided learning programmes and magnification were not used routinely. The practitioners in this study employed significant numbers of unqualified dental nurses.

The Transformative Power of Communication: Democratizing Practices for the General Education Classroom

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Haynal, Kaitlyn

2016-01-01

This article examines the common communication practices of deliberation, discussion, delivery, and debate, for their democratizing potential through their greater inclusion in all general education classrooms. It argues that these tools are underutilized outside of communication classrooms but offer numerous benefits to teachers and students…

Impacts of generic competition and benefit management practices on spending for prescription drugs: evidence from Medicare's Part D benefit.

Science.gov (United States)

Sheingold, Steven; Nguyen, Nguyen Xuan

2014-01-01

This study estimates the effects of generic competition, increased cost-sharing, and benefit practices on utilization and spending for prescription drugs. We examined changes in Medicare price and utilization from 2007 to 2009 of all drugs in 28 therapeutic classes. The classes accounted for 80% of Medicare Part D spending in 2009 and included the 6 protected classes and 6 classes with practically no generic competition. All variables were constructed to measure each drug relative to its class at a specific plan sponsor. We estimated that the shift toward generic utilization had cut in half the rate of increase in the price of a prescription during 2007-2009. Specifically, the results showed that (1) rapid generic penetration had significantly held down costs per prescription, (2) copayment and other benefit practices shifted utilization to generics and favored brands, and (3) price increases were generally greater in less competitive classes of drugs. In many ways, Part D was implemented at a fortuitous time; since 2006, there have been relatively few new blockbuster drugs introduced, and many existing high-volume drugs used by beneficiaries were in therapeutic classes with multiple brands and generic alternatives. Under these conditions, our paper showed that plan sponsors have been able to contain costs by encouraging use of generics or drugs offering greater value within therapeutic classes. It is less clear what will happen to future Part D costs if a number of new and effective drugs for beneficiaries enter the market with no real competitors.

Significant Revisions to OSHA 29 CFR 1910.269.

Science.gov (United States)

Neitzel, Dennis K

2015-06-01

The updated OSHA 29 CFR 1910.269 requirements are significant for assisting employers in their efforts to protect their employees from electrical hazards. In addition, OSHA based these revisions on the latest consensus standards and improvements in electrical safety technology. Together, the updated regulation creates a unified and up-to-date set of requirements to help employers more effectively establish safe work practices to protect their workers.

Industry relationships are associated with performing a greater number of sinus balloon dilation procedures.

Science.gov (United States)

Eloy, Jean Anderson; Svider, Peter F; Bobian, Michael; Harvey, Richard J; Gray, Stacey T; Baredes, Soly; Folbe, Adam J

2017-09-01

Industry outreach promotes awareness of novel technologies. However, concerns have been raised that such relationships may also unduly impact medical decision-making. Our objective in this study was to evaluate industry relationships among practitioners who frequently employ balloon dilation (BD), characterizing whether there is any association between financial relationships and BD utilization. Provider utilization data (FY-2014) was accessed for individuals billing BD procedures to Medicare, the largest healthcare payor in the United States. The names of individuals included in these data sets were cross-referenced with the Centers for Medicare and Medicaid Services Open Payment site to determine the extent of industry relationships during this same year. Individuals included in this analysis were organized by those with "significant" ($1,000 to $10,000) and "major" (> $10,000) industry relationships. Practice setting, training, and experience were also evaluated. Of the 302 otolaryngologists who billed enough BDs for inclusion in this data set, 99.3% were in private practice, 89.7% were board-certified, 8.3% had facial plastic and reconstructive fellowship training, and 1.3% had rhinology fellowship training. There was a significant increase in BDs performed with increasing BD company financial contributions (analysis of variance, p = 0.0003). Individuals without "significant" relationships with BD companies billed fewer BDs than those with at least "significant" (>$1,000) relationships (57.0 ± 4.3 vs 87.7 ± 10.0, p = 0.001). There is an association between receiving money from industry and the frequency with which otolaryngologists employ BD. Although our analysis demonstrates an association, these results in no way imply causation. Further analysis exploring the reasons for this association may be necessary. © 2017 ARS-AAOA, LLC.

Daily Mindful Responding Mediates the Effect of Meditation Practice on Stress and Mood: The Role of Practice Duration and Adherence.

Science.gov (United States)

Lacaille, Julien; Sadikaj, Gentiana; Nishioka, Midori; Carrière, Kimberly; Flanders, Joseph; Knäuper, Bärbel

2018-01-01

Although meditation practice is an important component of many mindfulness-based interventions (MBIs), empirical findings of its effects on psychological functioning are mixed and the mechanisms for the effects remain unclear. Responding with mindfulness (i.e., returning one's attention back to a nonjudgmental, present-oriented awareness) is a fundamental skill practiced in meditations. With repeated meditation practice, this skill is thought to become internalized and be applied to one's daily life. We thus hypothesized that the extent to which individuals responded to daily events with mindfulness would mediate the effects of meditation practice (instance, duration, and adherence to instructions) on psychological well-being. Using a daily diary methodology, we tracked the meditation practice, use of mindful responding during the day, and psychological outcomes (perceived stress, negative and positive affect) of 117 mindfulness-based stress reduction program participants. We found that on days when participants meditated, they responded with greater mindfulness to daily events, which accounted for the beneficial effects of meditating on psychological outcomes. Furthermore, findings suggest that on meditation days, longer and more closely adhered meditation practices were independently associated with increases in mindful responding, which in turn were associated with better psychological outcomes. These results suggest that regular, longer, and more closely adhered meditation practice is an important component of MBIs, in part because it leads to responding more mindfully in daily life, which promotes well-being. © 2017 Wiley Periodicals, Inc.

Predicting Greater Prairie-Chicken Lek Site Suitability to Inform Conservation Actions.

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Torre J Hovick

Full Text Available The demands of a growing human population dictates that expansion of energy infrastructure, roads, and other development frequently takes place in native rangelands. Particularly, transmission lines and roads commonly divide rural landscapes and increase fragmentation. This has direct and indirect consequences on native wildlife that can be mitigated through thoughtful planning and proactive approaches to identifying areas of high conservation priority. We used nine years (2003-2011 of Greater Prairie-Chicken (Tympanuchus cupido lek locations totaling 870 unique leks sites in Kansas and seven geographic information system (GIS layers describing land cover, topography, and anthropogenic structures to model habitat suitability across the state. The models obtained had low omission rates (0.81, indicating high model performance and reliability of predicted habitat suitability for Greater Prairie-Chickens. We found that elevation was the most influential in predicting lek locations, contributing three times more predictive power than any other variable. However, models were improved by the addition of land cover and anthropogenic features (transmission lines, roads, and oil and gas structures. Overall, our analysis provides a hierarchal understanding of Greater Prairie-Chicken habitat suitability that is broadly based on geomorphological features followed by land cover suitability. We found that when land features and vegetation cover are suitable for Greater Prairie-Chickens, fragmentation by anthropogenic sources such as roadways and transmission lines are a concern. Therefore, it is our recommendation that future human development in Kansas avoid areas that our models identified as highly suitable for Greater Prairie-Chickens and focus development on land cover types that are of lower conservation concern.

Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program.

Science.gov (United States)

McHugh, Megan; Brown, Tiffany; Liss, David T; Walunas, Theresa L; Persell, Stephen D

2018-04-01

Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators' and practice leaders' perspectives on implementation of a practice facilitator-supported quality improvement program and describe where their perspectives aligned and diverged. We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program's ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator-supported efforts rather than larger, comprehensive quality improvement projects. © 2018 Annals of Family Medicine, Inc.

Greater impairment of postprandial triacylglycerol than glucose response in metabolic syndrome subjects with fasting hyperglycaemia.

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Jackson, Kim G; Walden, Charlotte M; Murray, Peter; Smith, Adrian M; Minihane, Anne M; Lovegrove, Julie A; Williams, Christine M

2013-08-01

Studies have started to question whether a specific component or combinations of metabolic syndrome (MetS) components may be more important in relation to cardiovascular disease risk. Our aim was to examine the impact of the presence of raised fasting glucose as a MetS component on postprandial lipaemia. Men classified with the MetS underwent a sequential test meal investigation, in which blood samples were taken at regular intervals after a test breakfast (t=0 min) and lunch (t=330 min). Lipids, glucose and insulin were measured in the fasting and postprandial samples. MetS subjects with 3 or 4 components were subdivided into those without (n=34) and with (n=23) fasting hyperglycaemia (≥5.6 mmol/l), irrespective of the combination of components. Fasting lipids and insulin were similar in the two groups, with glucose significantly higher in the men with glucose as a MetS component (Pcurve (AUC) and incremental AUC (P ≤0.016) for the postprandial triacylglycerol (TAG) response in men with fasting hyperglycaemia. Greater glucose AUC (Pglucose to be an important predictor of the postprandial TAG and glucose response. Our data analysis has revealed a greater impairment of postprandial TAG than glucose response in MetS subjects with raised fasting glucose. The worsening of postprandial lipaemic control may contribute to the greater CVD risk reported in individuals with MetS component combinations which include hyperglycaemia. Copyright © 2013 Elsevier Inc. All rights reserved.

Teaching efficacy of nurses in clinical practice education: A cross-sectional study.

Science.gov (United States)

Kim, Eun-Kyeung; Shin, Sujin

2017-07-01

Clinical nurses play a vital role in clinical practice education; thus, it is necessary to help clinical nurses have teaching efficacy through the development and application of systematic education programs. To identify nurses' teaching efficacy for clinical education and analyze the influencing factors of teaching efficacy. The study used a cross-sectional design. We used a convenience sample of 263 nurses from two hospitals. Teaching efficacy, general characteristics, and perception of clinical practice education were collected via self-reported questionnaires. Teaching efficacy was measured using Hwang's (2006) questionnaire, while perception of clinical practice education was measured using the Clinical Nurse Teacher Survey developed by Nishioka et al. (2014). Participants completed the questionnaire directly. The collected data were then analyzed using descriptive statistics, t-tests, ANOVAs, and multiple regression analysis with PASW Statistics 18.0. The mean total score of teaching efficacy was 72.5 (range 21-105). The leadership for students subscale had the highest score (3.56±0.59). The factors influencing teaching efficacy were length of clinical career (β=0.26, pteaching efficacy in nurses. Based on these results, nursing educators might need to develop greater confidence in their knowledge and enhance control of their teaching strategies. Nursing schools and hospitals might need to provide greater support and educational opportunities to nurse clinical practice instructors. Furthermore, constructing a system of cooperation between these colleges and educational hospitals, developing programs to enhance teaching efficacy, and identifying the clinical instructor's role are all necessary to promote clinical practice education. Copyright © 2017. Published by Elsevier Ltd.

Effectiveness of an Online Educational Module in Improving Evidence-Based Practice Skills of Practicing Registered Nurses.

Science.gov (United States)

Moore, Lora

2017-10-01

Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.

Aging gracefully in Greater Beirut: are there any gender-based differences?

Science.gov (United States)

Mitri, Rosy N; Boulos, Christa M; Adib, Salim M

2017-06-01

The implications of rapid aging of the Lebanese population are under-researched. No national studies have so far investigated the living conditions and the health status of urban Lebanese elderly across gender. This was a cross-sectional study involving 905 randomly selected community dwelling elderly aged ≥65 years living in Greater Beirut. Gender differences were assessed among participants who completed a standardized questionnaire on socio-demographic factors, nutritional, health, and functional characteristics. The sample included 533 men (59%) and 372 women (41%). Elderly were regrouped into 'younger elderly' (≤70 years), and 'older elderly' (>70 years) which represented respectively 44.3% and 55.7% of the total population. Women, regardless of their age, were less educated and more likely to live alone. Moreover, poor nutritional status, self-perceived health, absence of physical activity, comorbidity, polymedication and depression were significantly higher among women. 'Older elderly' women became significantly more functionally disabled compared with men of their age. This study evidenced that Lebanese elderly women were disadvantaged regarding their socio-economic, health and functional status. It is requested a nationwide effort to improve the socio-economic status and the health of Lebanese elderly, especially women. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Planning for greater-confinement disposal

International Nuclear Information System (INIS)

Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

1984-01-01

This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objectives and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 references

Planning for greater-confinement disposal

International Nuclear Information System (INIS)

Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

1984-01-01

This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objecties and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 refs