Parental encouragement of initiative-taking and adjustment in Chinese children from rural, urban, and urbanized families.

Science.gov (United States)

Chen, Xinyin; Li, Dan

2012-12-01

Due to the requirements of the competitive, market-oriented urban society, parents in urban and urbanized families are more likely than parents in rural families to encourage initiative-taking in child rearing in China. The socialization experiences of children from different types of families may be related to their adjustment. This study examined parental socialization attitudes, social and school adjustment, and their relations in Chinese children from rural, urban, and urbanized families. Participants were elementary school students (N = 1,033; M age = 11 years) and their parents in China. Data were obtained from parental reports, peer evaluations, teacher ratings, and school records. A multivariate analysis of variance revealed that parents in urban and urbanized families had higher scores than parents in rural families on encouragement of initiative-taking. Urban children, particularly girls, were more sociable, obtained higher social status, and had fewer school problems than their rural counterparts. Children from urbanized families were different from rural children and similar to urban children in social and school adjustment. Moreover, multigroup invariance tests showed that parental encouragement of initiative-taking was associated more strongly with children's sociable-assertive behavior and social standing in the urban and urbanized groups than in the rural group. The results indicate that particular socialization attitudes may vary in their adaptive value in child development as a function of specific social and cultural requirements in changing societies. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Gait adjustments in obstacle crossing, gait initiation and gait termination after a recent lower limb amputation

NARCIS (Netherlands)

Vrieling, Aline H.; van Keeken, Helco G.; Schoppen, Tanneke; Hof, At L.; Otten, Bert; Halbertsma, Jan P. K.; Postema, Klaas

Objective: To describe the adjustments in gait characteristics of obstacle crossing, gait initiation and gait termination that occur in subjects with a recent lower limb amputation during the rehabilitation process. Design: Prospective and descriptive study. Subjects: Fourteen subjects with a recent

The Impact of AUC-Based Monitoring on Pharmacist-Directed Vancomycin Dose Adjustments in Complicated Methicillin-Resistant Staphylococcus aureus Infection.

Science.gov (United States)

Stoessel, Andrew M; Hale, Cory M; Seabury, Robert W; Miller, Christopher D; Steele, Jeffrey M

2018-01-01

This study aimed to assess the impact of area under the curve (AUC)-based vancomycin monitoring on pharmacist-initiated dose adjustments after transitioning from a trough-only to an AUC-based monitoring method at our institution. A retrospective cohort study of patients treated with vancomycin for complicated methicillin-resistant Staphylococcus aureus (MRSA) infection between November 2013 and December 2016 was conducted. The frequency of pharmacist-initiated dose adjustments was assessed for patients monitored via trough-only and AUC-based approaches for trough ranges: 10 to 14.9 mg/L and 15 to 20 mg/L. Fifty patients were included: 36 in the trough-based monitoring and 14 in the AUC-based-monitoring group. The vancomycin dose was increased in 71.4% of patients when troughs were 10 to 14.9 mg/L when a trough-only approach was used and in only 25% of patients when using AUC estimation ( P = .048). In the AUC group, the dose was increased only when AUC/minimum inhibitory concentration (MIC) AUC/MIC ≥400. The AUC-based monitoring did not significantly increase the frequency of dose reductions when trough concentrations were 15 to 20 mg/L (AUC: 33.3% vs trough: 4.6%; P = .107). The AUC-based monitoring resulted in fewer patients with dose adjustments when trough levels were 10 to 14.9 mg/L. The AUC-based monitoring has the potential to reduce unnecessary vancomycin exposure and warrants further investigation.

Industry initiatives in impact mitigation

Energy Technology Data Exchange (ETDEWEB)

Metz, W.C.

1982-08-01

The author concludes that mitigation is the focus of conflicting opinions regarding responsibility, strategy, and effort. There are no hard, fast, or tried and true rules for company involvement in mitigation efforts. Each mitigation effort must be tailored and negotiated to match the unique characteristics of individual projects and circumstances of specific locales. Companies must assume financial responsibility for the temporary impacts and area needs created by their projects. They must also offer financial and technical assistance to impact areas, not just the host political jurisdiction, when local, state, federal, and special fund sources of revenue or technical assistance are not available or insufficient. But, local, state, and federal governments must also recognize their responsibilities and make adjustments in tax jurisdiction boundaries and disbursement formulas so that impacted areas are properly defined and receive an adequate share of lease, royalty, severance tax, permit fee, special use and service charges, and sales tax payments. Laws need to allow innovative uses of tax pre-payments, housing mortgage bonds, changeable debt and bounding limits, industrial loans with delayed prepayment, and revised revenue assistance formulas. Enabling legislation is required in most states to allow impact areas to negotiate the mitigation efforts. A review of 7 types of mitigation effort is presented: transportation; housing; public utilities; health, public safety and recreation; miscellaneous; and company-community interaction. (PBS)

Stakeholder Pressures, Environmental Impact and Managerial Initiatives of SMEs

DEFF Research Database (Denmark)

Madsen, Henning; Ulhøi, John Parm

2015-01-01

impact was available in Denmark. Consequently, a longitudinal research project was initiated to enlighten the situation. This study investigates environmentally related initiatives taken in response to the perception of stakeholder pressures and the perceived corporate environmental impact. The empirical......Environmental sustainability has become an issue of uttermost importance for business organisations. Therefore, the implementation of corporate environmental initiatives has been vigorously embraced by industry. Two decades ago, no clear picture of industry initiatives to reduce their environmental...... popularity of self-regulation, voluntary initiatives do not tend to be widely adopted by SMEs, stressing a need for a continuing regulation of industry’s behaviour in relation to environmental issues....

The Impact of Adjustment for Socioeconomic Status on Comparisons of Cancer Incidence between Two European Countries

International Nuclear Information System (INIS)

Donnelly, D. W.; Gavin, A.; Hegarty, A.

2013-01-01

Cancer incidence rates vary considerably between countries and by socioeconomic status (SES). We investigate the impact of SES upon the relative cancer risk in two neighbouring countries. Methods. Data on 229,824 cases for 16 cancers diagnosed in 1995-2007 were extracted from the cancer registries in Northern Ireland (NI) and Republic of Ireland (RoI). Cancers in the two countries were compared using incidence rate ratios (IRRs) adjusted for age and age plus area-based SES. Results. Adjusting for SES in addition to age had a considerable impact on NI/RoI comparisons for cancers strongly related to SES. Before SES adjustment, lung cancer incidence rates were 11% higher for males and 7% higher for females in NI, while after adjustment, the IRR was not statistically significant. Cervical cancer rates were lower in NI than in RoI after adjustment for age (IRR: 0.90 (0.84-0.97)), with this difference increasing after adjustment for SES (IRR: 0.85 (0.79-0.92)). For cancers with a weak or nonexistent relationship to SES, adjustment for SES made little difference to the IRR. Conclusion. Socioeconomic factors explain some international variations but also obscure other crucial differences; thus, adjustment for these factors should not become part of international comparisons.

Aerobic composting of distilled grain waste eluted from a Chinese spirit-making process: The effects of initial pH adjustment.

Science.gov (United States)

Wang, Shi-Peng; Zhong, Xiao-Zhong; Wang, Ting-Ting; Sun, Zhao-Yong; Tang, Yue-Qin; Kida, Kenji

2017-12-01

Aerobic composting of distilled grain waste (DGW) at different initial pH values adjusted by CaO addition was investigated. Three pH-adjusted treatments with initial pH values of 4 (R1), 5 (R2) and 6 (R3) and a control treatment (R0) with a pH value of 3.5 were conducted simultaneously. The results showed that R0 had an unsuccessful start-up of composting. However, the pH-adjusted treatments produced remarkable results, with a relatively high initial pH being beneficial for the start-up. Within 65days of composting, the degradation of volatile solids (VS) and the physicochemical properties of R2 and R3 displayed similar tendencies, and both produced a mature end-product, while R1 exhibited a lower VS degradation rate, and some of its physicochemical properties indicated the end-product was immature. Quantitative PCR analysis of ammonia oxidizers indicated that the occurrence of nitrification during the composting of DGW could be attributed to the activity of ammonia-oxidizing bacteria. Copyright © 2017 Elsevier Ltd. All rights reserved.

Likely social impacts of proposed national-level policy initiatives

Energy Technology Data Exchange (ETDEWEB)

Piernot, C.A.; Rothweiler, M.A.; Levine, A.; Crews, R.

1981-03-01

The results are described of an investigation of likely social effects of enacting nine proposed national-level policy initiatives to accelerate development and use of solar energy. This study is part of the Technology Assessment of Solar Energy Systems (TASE) project supported by the US Department of Energy. The report presents general social impact information about the variety of ways in which the American people could be affected by enactment of these initiatives. It identifies the effects of each initiative on individuals, groups, organizations, communities, and society as a whole. In addition, it provides a framework for organizing a myriad of impact information into a set of conceptually exclusive impact categories. It illustrates that social impacts means effects on people as individuals, groups, organizations, and communities as well as on the infrastructure of society. Finally, it demonstrates the importance of specifying an audience of impact with a case example from the residential rental market.

Impact of selected risk factors on quality-adjusted life expectancy in Denmark

DEFF Research Database (Denmark)

Brønnum-Hansen, Henrik; Juel, Knud; Davidsen, Michael

2007-01-01

AIMS: The construct quality-adjusted life years (QALYs) combines mortality and overall health status and can be used to quantify the impact of risk factors on population health. The purpose of the study was to estimate the impact of tobacco smoking, high alcohol consumption, physical inactivity...... Health Survey 2000, and Danish EQ-5D values. RESULTS: The quality-adjusted life expectancy of 25-year-olds was 10-11 QALYs shorter for heavy smokers than for those who never smoke. The difference in life expectancy was 9-10 years. Men and women with high alcohol consumption could expect to lose about 5...... and 3 QALYs, respectively. Sedentary persons could expect to have about 7 fewer QALYs than physically active persons. Obesity shortened QALYs by almost 3 for men and 6 for women. CONCLUSIONS: Smoking, high alcohol consumption, physical inactivity, and obesity strongly reduce life expectancy and health...

The Impact of Adjustment for Socioeconomic Status on Comparisons of Cancer Incidence between Two European Countries

Directory of Open Access Journals (Sweden)

David W. Donnelly

2013-01-01

Full Text Available Background. Cancer incidence rates vary considerably between countries and by socioeconomic status (SES. We investigate the impact of SES upon the relative cancer risk in two neighbouring countries. Methods. Data on 229,824 cases for 16 cancers diagnosed in 1995–2007 were extracted from the cancer registries in Northern Ireland (NI and Republic of Ireland (RoI. Cancers in the two countries were compared using incidence rate ratios (IRRs adjusted for age and age plus area-based SES. Results. Adjusting for SES in addition to age had a considerable impact on NI/RoI comparisons for cancers strongly related to SES. Before SES adjustment, lung cancer incidence rates were 11% higher for males and 7% higher for females in NI, while after adjustment, the IRR was not statistically significant. Cervical cancer rates were lower in NI than in RoI after adjustment for age (IRR: 0.90 (0.84–0.97, with this difference increasing after adjustment for SES (IRR: 0.85 (0.79–0.92. For cancers with a weak or nonexistent relationship to SES, adjustment for SES made little difference to the IRR. Conclusion. Socioeconomic factors explain some international variations but also obscure other crucial differences; thus, adjustment for these factors should not become part of international comparisons.

Beyond preadoptive risk: The impact of adoptive family environment on adopted youth's psychosocial adjustment.

Science.gov (United States)

Ji, Juye; Brooks, Devon; Barth, Richard P; Kim, Hansung

2010-07-01

Adopted children often are exposed to preadoptive stressors--such as prenatal substance exposure, child maltreatment, and out-of-home placements--that increase their risks for psychosocial maladjustment. Psychosocial adjustment of adopted children emerges as the product of pre- and postadoptive factors. This study builds on previous research, which fails to simultaneously assess the influences of pre- and postadoptive factors, by examining the impact of adoptive family sense of coherence on adoptee's psychosocial adjustment beyond the effects of preadoptive risks. Using a sample of adoptive families (n = 385) taking part in the California Long Range Adoption Study, structural equation modeling analyses were performed. Results indicate a significant impact of family sense of coherence on adoptees' psychosocial adjustment and a considerably less significant role of preadoptive risks. The findings suggest the importance of assessing adoptive family's ability to respond to stress and of helping families to build and maintain their capacity to cope with stress despite the sometimes fractious pressures of adoption.

The impact of calcium assay change on a local adjusted calcium equation.

Science.gov (United States)

Davies, Sarah L; Hill, Charlotte; Bailey, Lisa M; Davison, Andrew S; Milan, Anna M

2016-03-01

Deriving and validating local adjusted calcium equations is important for ensuring appropriate calcium status classification. We investigated the impact on our local adjusted calcium equation of a change in calcium method by the manufacturer from cresolphthalein complexone to NM-BAPTA. Calcium and albumin results from general practice requests were extracted from the Laboratory Information Management system for a three-month period. Results for which there was evidence of disturbance in calcium homeostasis were excluded leaving 13,482 sets of results for analysis. The adjusted calcium equation was derived following least squares regression analysis of total calcium on albumin and normalized to the mean calcium concentration of the data-set. The revised equation (NM-BAPTA calcium method) was compared with the previous equation (cresolphthalein complexone calcium method). The switch in calcium assay resulted in a small change in the adjusted calcium equation but was not considered to be clinically significant. The calcium reference interval differed from that proposed by Pathology Harmony in the UK. Local adjusted calcium equations should be re-assessed following changes in the calcium method. A locally derived reference interval may differ from the consensus harmonized reference interval. © The Author(s) 2015.

Impact of Socio-Emotional Adjustment on Academic Achievement of Adolescent Girls in Jammu and Kashmir

Science.gov (United States)

Gul, Showkeen Bilal Ahmad

2015-01-01

The study examined the impact of socio-emotional adjustment on academic achievement of adolescent girls of Jammu and Kashmir. The purpose of the investigation was to study the relationship and effect of socio-emotional adjustment on academic achievement among adolescent girls. The descriptive survey research method was used for the study and the…

Arm-trunk coordination in wheelchair initiation displacement: A study of anticipatory and compensatory postural adjustments during different speeds and directions of propulsion.

Science.gov (United States)

Chikh, Soufien; Garnier, Cyril; Faupin, Arnaud; Pinti, Antonio; Boudet, Samuel; Azaiez, Fairouz; Watelain, Eric

2018-03-13

Arm-trunk coordination during the initiation of displacement in manual wheelchair is a complex task. The objective of this work is to study the arm-trunk coordination by measuring anticipatory and compensatory postural adjustments. Nine healthy subjects participated in the study after being trained in manual wheelchair. They were asked to initiate a displacement in manual wheelchair in three directions (forward vs. left vs. right), with two speeds (spontaneous vs. maximum) and with two initial hand's positions (hands on thighs vs. hands on handrails). Muscular activities in the trunk (postural component) and the arms (focal component) were recorded bilaterally. The results show two strategies for trunk control: An anticipatory adjustment strategy and a compensatory adjustment strategy with a dominance of compensation. These two strategies are influenced by the finalities of displacement in terms of speed and direction depending on the hands positions. Arm-trunk coordination is characterized by an adaptability of anticipatory and compensatory postural adjustments. The study of this type of coordination for subjects with different levels of spinal cord injury could be used to predict the forthcoming displacement and thus assist the user in a complex task. Copyright © 2018 Elsevier Ltd. All rights reserved.

Case-mix adjustment and the comparison of community health center performance on patient experience measures.

Science.gov (United States)

Johnson, M Laura; Rodriguez, Hector P; Solorio, M Rosa

2010-06-01

To assess the effect of case-mix adjustment on community health center (CHC) performance on patient experience measures. A Medicaid-managed care plan in Washington State collected patient survey data from 33 CHCs over three fiscal quarters during 2007-2008. The survey included three composite patient experience measures (6-month reports) and two overall ratings of care. The analytic sample includes 2,247 adult patients and 2,859 adults reporting for child patients. We compared the relative importance of patient case-mix adjusters by calculating each adjuster's predictive power and variability across CHCs. We then evaluated the impact of case-mix adjustment on the relative ranking of CHCs. Important case-mix adjusters included adult self-reported health status or parent-reported child health status, adult age, and educational attainment. The effects of case-mix adjustment on patient reports and ratings were different in the adult and child samples. Adjusting for race/ethnicity and language had a greater impact on parent reports than adult reports, but it impacted ratings similarly across the samples. The impact of adjustment on composites and ratings was modest, but it affected the relative ranking of CHCs. To ensure equitable comparison of CHC performance on patient experience measures, reports and ratings should be adjusted for adult self-reported health status or parent-reported child health status, adult age, education, race/ethnicity, and survey language. Because of the differential impact of case-mix adjusters for child and adult surveys, initiatives should consider measuring and reporting adult and child scores separately.

Impact of regulated price adjustments on price variability in a very low inflation transition economy: Case of Armenia

Directory of Open Access Journals (Sweden)

Aghassi Mkrtchyan

2005-06-01

Full Text Available This paper examines the impact of monetary policy and administrative price adjustments on price variability in a low inflation economy characterized by relatively frequent administrative price adjustments. Fluctuations of market determined prices, prices of agricultural goods in particular, are linked to poor synchronization between administrative price changes and monetary policy. If monetary policy does not account for expected changes in administrative prices, demand for free goods shifts, causing fluctuation of prices for agricultural goods, because the supply of these goods is highly inelastic in Armenia. The findings contribute to a better understanding of agricultural price variability during 1998-2002. The impact of macroeconomic policy and structural adjustments on income distribution and rural poverty incidence are also examined. This research has immediate policy implications, since Armenia will continue to undergo major upward price adjustments of regulated prices, which may have a negative impact on income distribution unless aggregate demand management is changed.

Longitudinal Psychosocial Adjustment of Women to Human Papillomavirus Infection.

Science.gov (United States)

Hsu, Yu-Yun; Wang, Wei-Ming; Fetzer, Susan Jane; Cheng, Ya-Min; Hsu, Keng-Fu

2018-05-29

The aim of this study was to examine the psychosocial adjustment trajectory, focusing on psychological distress, sexual relationships and health care information, as well as factors which have an impact on adjustment on receiving a positive diagnosis of human papillomavirus infection. Human papillomavirus is a common sexually transmitted infection in females. To date, knowledge of the longitudinal psychosocial response to the diagnosis of human papillomavirus is limited. A prospective longitudinal design was conducted with a convenience sample. Women aged 20-65 years old were followed at one, 6 and 12 months after a diagnosis of HPV. Participants completed measures of initial emotional distress and followed-up psychosocial adjustment. A mixed-effects model was applied to analyze the longitudinal changes in psychosocial adjustment. Seventy human papillomavirus positive women participated in the study with nearly 20% of the women reporting emotional distress during their first visit. Mixed-effects model analyses showed that a trajectory of psychosocial adjustment in health care orientation, sexual relationship and psychosocial distress occur from one to 6 months after HPV diagnosis. However, a declining trend from 6-12 months was significant in health care orientation. Initial emotional distress was associated with changes in psychological adjustment. Psychosocial adjustment to human papillomavirus was worse at one month compared with 6 and 12 months after diagnosis. Healthcare providers should offer health information and psychosocial support to women according to their disease progression. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Self-initiated expatriates' cross-cultural training and adjustment: a closer look at norwegian engineers : what kind of cross cultural training does self-initiated expatriate engineers in Norway receive and does this affect their cross cultural adjustment? Are the theories related to company expatriates applicable?

OpenAIRE

Carsten, Mona Skogseid

2014-01-01

Masteroppgave i økonomi og administrasjon – Universitetet i Agder 2014 Today many people move on their own initiative to foreign countries to work as a result of increased globalization and human mobility. At arrival in the new culture the self-initiated expatriate m meet a culture that might be different from what they are used too. Cross-cultural training can provide the expatriates with tools and information that can enable the self-initiated expatriates to more easily adjust. This ...

The medicine that might kill the patient: Structural Adjustment and its impacts on health care in Bangladesh.

Science.gov (United States)

Hossen, Md Abul; Westhues, Anne

2012-01-01

Over the past decade, reforms of the health sector have evolved as a global phenomenon. There is, by now, a fair literature on the relationship between globalization and health. Within this literature, however, there is relatively little attention given to the Structural Adjustment Program (SAP), one aspect of globalization, and its impact on health. It can be observed that the SAP has had a dramatic impact on the status of education, health, the environment, and women and children in many developing countries. The restructuring of the health sector has led to the collapse of preventive and curative care due to the lack of medical equipment, supplies, poor working conditions, low pay of medical personnel, and the resulting low morale in Ghana, Philippines, and Zimbabwe. User fees in primary health care have led to the exclusion of a large section of the population from accessing health services as they are unable to pay. This article discusses the health specific impact of the SAP and the economic reforms initiated under it in Bangladesh. In particular, it will analyze how these policies affect the health care delivery system in Bangladesh in relation to geographic accessibility, affordability, quality of services, administrative efficiency, the rural urban service gap, public provision of health care, and donor influence on health policy.

The Role of Proprioception in the Sagittal Setting of Anticipatory Postural Adjustments During Gait Initiation

Directory of Open Access Journals (Sweden)

Pereira Marcelo P.

2015-12-01

Full Text Available Purpose. Previous studies have studied the role of proprioception on the setting of anticipatory postural adjustments (APA during gait initiation. However, these studies did not investigate the role of proprioception in the sagittal APA setting. We aimed to investigate the role of proprioception manipulation to induce APA sagittal adaptations on gait initiation. Methods. Fourteen healthy adults performed gait initiation without, and with, vibration applied before movement onset, and during movement. In addition, the effects of two different vibration frequencies (80 and 120Hz were tested. Vibration was applied bilaterally on the tibialis anterior, rectus femoris and trapezius superior. The first step characteristics, ground reaction forces and CoP behaviour were assessed. Results. Vibration improved gait initiation performance regardless of the moment it was applied. CoP velocity during the initial phase of APA was increased by vibration only when it was applied before movement. When vibration was applied to disturb the movement, no effects on the CoP behaviour were observed. Manipulation of vibration frequency had no effects. Conclusions. Rather than proprioception manipulation, the results suggest that post-vibratory effects and attentional mechanisms were responsible for our results. Taken together, the results show that sagittal APA setting is robust to proprioception manipulation.

The Impact of Deployment on Parental, Family and Child Adjustment in Military Families.

Science.gov (United States)

Lester, Patricia; Aralis, Hilary; Sinclair, Maegan; Kiff, Cara; Lee, Kyung-Hee; Mustillo, Sarah; Wadsworth, Shelley MacDermid

2016-12-01

Since 9/11, military service in the United States has been characterized by wartime deployments and reintegration challenges that contribute to a context of stress for military families. Research indicates the negative impact of wartime deployment on the well being of service members, military spouses, and children. Yet, few studies have considered how parental deployments may affect adjustment in young children and their families. Using deployment records and parent-reported measures from primary caregiving (N = 680) and military (n = 310) parents, we examined the influence of deployment on adjustment in military families with children ages 0-10 years. Greater deployment exposure was related to impaired family functioning and marital instability. Parental depressive and posttraumatic stress symptoms were associated with impairments in social emotional adjustment in young children, increased anxiety in early childhood, and adjustment problems in school-age children. Conversely, parental sensitivity was associated with improved social and emotional outcomes across childhood. These findings provide guidance to developing preventive approaches for military families with young children.

Attachment to Parents and Depressive Symptoms in College Students: The Mediating Role of Initial Emotional Adjustment and Psychological Needs

Directory of Open Access Journals (Sweden)

Sanja Smojver-Ažić

2015-04-01

Full Text Available The aim of the present study was to explore the role of parental attachment in students' depressive symptoms. We have examined wheather initial emotional adjustment and psychological needs would serve as a mediator of the relationship between attachment dimensions (anxiety and avoidance and depressive symptoms.A sample consisted of 219 students (143 females randomly selected from the University of Rijeka, Croatia, with mean age 19.02 years. Participants provided self-report on the Experiences in Close Relationship Inventory and The Student Adaptation to College Questionnaire at the beginning of the first year of college, and The Basic Psychological Needs Satisfaction Scale and Beck Depression Inventory-II at the third year of college.Results of hierarchical regression analyses confirm that emotional adjustment had a full mediation effect on anxiety dimension and partial mediation on avoidance dimension. Only a partial mediation effect of psychological needs for autonomy and relatedness between attachment and depressive symptoms was found.The findings of this study give support to the researches indicating the importance of parental attachment for college students not only through its direct effects on depressive symptoms, but also through effects on the initial emotional adjustment and satisfaction of psychological needs. The results of the mediation analysis suggest that both attachment dimensions and emotional adjustment as well as psychological need satisfaction have a substantial shared variance when predicting depressive symptoms and that each variable also gives a unique contribution to depressive symptoms.

Measuring Impact of Stabilization Initiatives Survey Data (MISTI)

Data.gov (United States)

US Agency for International Development — The raw data from the Measuring Impact of Stabilization Initiatives (MISTI) project is the largest and most comprehensive evaluations of stabilization interventions...

Compression of thick laminated composite beams with initial impact-like damage

Science.gov (United States)

Breivik, N. L.; Guerdal, Z.; Griffin, O. H., Jr.

1992-01-01

While the study of compression after impact of laminated composites has been under consideration for many years, the complexity of the damage initiated by low velocity impact has not lent itself to simple predictive models for compression strength. The damage modes due to non-penetrating, low velocity impact by large diameter objects can be simulated using quasi-static three-point bending. The resulting damage modes are less coupled and more easily characterized than actual impact damage modes. This study includes the compression testing of specimens with well documented initial damage states obtained from three-point bend testing. Compression strengths and failure modes were obtained for quasi-isotropic stacking sequences from 0.24 to 1.1 inches thick with both grouped and interspersed ply stacking. Initial damage prior to compression testing was divided into four classifications based on the type, extent, and location of the damage. These classifications are multiple through-thickness delaminations, isolated delamination, damage near the surface, and matrix cracks. Specimens from each classification were compared to specimens tested without initial damage in order to determine the effects of the initial damage on the final compression strength and failure modes. A finite element analysis was used to aid in the understanding and explanation of the experimental results.

Factors Impacting the Psychological Adjustment of Saudi Arabian International Students in the United States: Self-Esteem, Social Support, and Discrimination

Science.gov (United States)

Rundles, Kyle

2013-01-01

International populations face difficulties adjusting to a new culture. This is especially true for international students, who have to adjust to a new country and face academic demands concurrently. Research has explored various factors that impact psychological adjustment of international students and show the influence of self-esteem and social…

A STUDY ON SOCIAL ADJUSTMENT AMONG HIGHER SECONDARY SCHOOL STUDENTS AND ITS IMPACT ON THEIR ACADEMIC ACHIEVEMENT IN COIMBATORE DISTRICT

OpenAIRE

P.Priya Packiaselvi; Ms.Malathi.V.A

2017-01-01

Every human being seeks adjustment to various situations. He constantly makes efforts to adjustment himself to his surroundings because a wholesome adjustment is essential for leading a happy life and going satisfaction. Social adjustment to other people is general and to the group with which they are identified is particular. The main motive of the study is to find out the social adjustment among higher secondary school students and its impact on academic achievement in Coimbatore Educationa...

Topology-optimized metasurfaces: impact of initial geometric layout.

Science.gov (United States)

Yang, Jianji; Fan, Jonathan A

2017-08-15

Topology optimization is a powerful iterative inverse design technique in metasurface engineering and can transform an initial layout into a high-performance device. With this method, devices are optimized within a local design phase space, making the identification of suitable initial geometries essential. In this Letter, we examine the impact of initial geometric layout on the performance of large-angle (75 deg) topology-optimized metagrating deflectors. We find that when conventional metasurface designs based on dielectric nanoposts are used as initial layouts for topology optimization, the final devices have efficiencies around 65%. In contrast, when random initial layouts are used, the final devices have ultra-high efficiencies that can reach 94%. Our numerical experiments suggest that device topologies based on conventional metasurface designs may not be suitable to produce ultra-high-efficiency, large-angle metasurfaces. Rather, initial geometric layouts with non-trivial topologies and shapes are required.

Impact of high resolution land surface initialization in Indian summer ...

Indian Academy of Sciences (India)

The direct impact of high resolution land surface initialization on the forecast bias in a regional climate model in recent years ... surface initialization using a regional climate model. ...... ization of the snow field in a cloud model; J. Clim. Appl.

The impact of ART initiation on household food security over time.

Science.gov (United States)

Patenaude, Bryan N; Chimbindi, Natsayi; Pillay, Deenan; Bärnighausen, Till

2018-02-01

While evidence suggests that adequate nutrition contributes to the efficacy of ART, the potential causal impact of ART initiation on household food security has not been thoroughly examined. In this study, we present some of the first causal evidence of the impact of ART initiation on household food security. We employ a quasi-experimental design, regression discontinuity, over 5540 individuals from an ongoing population cohort study in KwaZulu-Natal, South Africa, by utilizing the CD4 count-based ART eligibility threshold to examine the impact of ART initiation on household food security. We find that ART initiation causes a significant increase in the probability of food insecurity in the first year, which diminishes to zero within three years of initiation. Within the first year, ART initiation was found to significantly increase the probabilities that (1) the surveyed adult had missed any food in the past month by 10.2 percentage points (coefficient = 0.102, 95%CI = [0.039, 0.166]); (2) any adult in the household had missed a meal in the past month by 15.2 percentage points (coefficient = 0.152, 95%CI = [0.073, 0.231]); and (3) any child in the household had missed a meal in the past month by 8.9 percentage points (coefficient = 0.0898, 95%CI = [0.0317, 0.148]). While we cannot definitively isolate the mechanistic pathways from ART to household food security, our results are consistent with ART affecting food security through household resource strain and patient appetite recovery. Several policies could mitigate the negative impact of ART on food security, in particular food parcels or food vouchers for ART patients in the first two years after treatment initiation. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of minimum wage adjustments on Vietnamese wage inequality

DEFF Research Database (Denmark)

Hansen, Henrik; Rand, John; Torm, Nina

Using Vietnamese Labour Force Survey data we analyse the impact of minimum wage changes on wage inequality. Minimum wages serve to reduce local wage inequality in the formal sectors by decreasing the gap between the median wages and the lower tail of the local wage distributions. In contrast, local...... wage inequality is increased in the informal sectors. Overall, the minimum wages decrease national wage inequality. Our estimates indicate a decrease in the wage distribution Gini coefficient of about 2 percentage points and an increase in the 10/50 wage ratio of 5-7 percentage points caused...... by the adjustment of the minimum wages from 2011to 2012 that levelled the minimum wage across economic sectors....

Impacts of model initialization on an integrated surface water - groundwater model

KAUST Repository

Ajami, Hoori

2015-04-01

Integrated hydrologic models characterize catchment responses by coupling the subsurface flow with land surface processes. One of the major areas of uncertainty in such models is the specification of the initial condition and its influence on subsequent simulations. A key challenge in model initialization is that it requires spatially distributed information on model states, groundwater levels and soil moisture, even when such data are not routinely available. Here, the impact of uncertainty in initial condition was explored across a 208 km2 catchment in Denmark using the ParFlow.CLM model. The initialization impact was assessed under two meteorological conditions (wet vs dry) using five depth to water table and soil moisture distributions obtained from various equilibrium states (thermal, root zone, discharge, saturated and unsaturated zone equilibrium) during the model spin-up. Each of these equilibrium states correspond to varying computation times to achieve stability in a particular aspect of the system state. Results identified particular sensitivity in modelled recharge and stream flow to the different initializations, but reduced sensitivity in modelled energy fluxes. Analysis also suggests that to simulate a year that is wetter than the spin-up period, an initialization based on discharge equilibrium is adequate to capture the direction and magnitude of surface water–groundwater exchanges. For a drier or hydrologically similar year to the spin-up period, an initialization based on groundwater equilibrium is required. Variability of monthly subsurface storage changes and discharge bias at the scale of a hydrological event show that the initialization impacts do not diminish as the simulations progress, highlighting the importance of robust and accurate initialization in capturing surface water–groundwater dynamics.

The Impact of Capital Structure on Economic Capital and Risk Adjusted Performance

OpenAIRE

Porteous, Bruce; Tapadar, Pradip

2008-01-01

The impact that capital structure and capital asset allocation have on financial services firm economic capital and risk adjusted performance is considered. A stochastic modelling approach is used in conjunction with banking and insurance examples. It is demonstrated that gearing up Tier 1 capital with Tier 2 capital can be in the interests of bank Tier 1 capital providers, but may not always be so for insurance Tier 1 capital providers. It is also shown that, by allocating a bank or insuranc...

How have Global Health Initiatives impacted on health equity?

Science.gov (United States)

Hanefeld, Johanna

2008-01-01

This review examines the impact of Global Health Initiatives (GHIs) on health equity, focusing on low- and middle-income countries. It is a summary of a literature review commissioned by the WHO Commission on the Social Determinants of Health. GHIs have emerged during the past decade as a mechanism in development assistance for health. The review focuses on three GHIs, the US President's Emergency Plan For AIDS Relief (PEPFAR), the World Bank's Multi-country AIDS Programme (MAP) and the Global Fund to Fight AIDS, TB and Malaria. All three have leveraged significant amounts of funding for their focal diseases - together these three GHIs provide an estimated two-thirds of external resources going to HIV/AIDS. This paper examines their impact on gender equity. An analysis of these Initiatives finds that they have a significant impact on health equity, including gender equity, through their processes of programme formulation and implementation, and through the activities they fund and implement, including through their impact on health systems and human resources. However, GHIs have so far paid insufficient attention to health inequities. While increasingly acknowledging equity, including gender equity, as a concern, Initiatives have so far failed to adequately translate this into programmes that address drivers of health inequity, including gender inequities. The review highlights the comparative advantage of individual GHIs, which point to an increased need for, and continued difficulties in, harmonisation of activities at country level. On the basis of this comparative analysis, key recommendations are made. They include a call for equity-sensitive targets, the collection of gender-disaggregated data, the use of policy-making processes for empowerment, programmes that explicitly address causes of health inequity and impact assessments of interventions' effect on social inequities.

Inclusion of Highest Glasgow Coma Scale Motor Component Score in Mortality Risk Adjustment for Benchmarking of Trauma Center Performance.

Science.gov (United States)

Gomez, David; Byrne, James P; Alali, Aziz S; Xiong, Wei; Hoeft, Chris; Neal, Melanie; Subacius, Harris; Nathens, Avery B

2017-12-01

The Glasgow Coma Scale (GCS) is the most widely used measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor component (mGCS) score is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS score in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including the highest mGCS score on the performance of risk-adjustment models and subsequent external benchmarking results. Data were derived from the Trauma Quality Improvement Program analytic dataset (January 2014 through March 2015) and were limited to the severe TBI cohort (16 years or older, isolated head injury, GCS ≤8). Risk-adjustment models were created that varied in the mGCS covariates only (initial score, highest score, or both initial and highest mGCS scores). Model performance and fit, as well as external benchmarking results, were compared. There were 6,553 patients with severe TBI across 231 trauma centers included. Initial and highest mGCS scores were different in 47% of patients (n = 3,097). Model performance and fit improved when both initial and highest mGCS scores were included, as evidenced by improved C-statistic, Akaike Information Criterion, and adjusted R-squared values. Three-quarters of centers changed their adjusted odds ratio decile, 2.6% of centers changed outlier status, and 45% of centers exhibited a ≥0.5-SD change in the odds ratio of death after including highest mGCS score in the model. This study supports the concept that additional clinical information has the potential to not only improve the performance of current risk-adjustment models, but can also have a meaningful impact on external benchmarking strategies. Highest mGCS score is a good potential candidate for inclusion in additional models. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Self-initiated expatriates

DEFF Research Database (Denmark)

Selmer, Jan; Lauring, Jakob

2014-01-01

Purpose – As it has been suggested that adult third-culture kids may be more culturally adaptable than others, they have been labelled “the ideal” expatriates. In this article, we explore the adjustment of self-initiated expatriate academics in Hong Kong, comparing adult third-culture kids...... with adult mono-culture kids. Design/methodology/approach – We use survey results from 267 self-initiated expatriate academics in Hong Kong. Findings – Exploratory results show that adult third-culture kids had a higher extent of general adjustment. No significant results were found in relation...... to interaction adjustment and job adjustment. We also found that recent expatriate experiences generally had a positive association with the adjustment of adult mono-culture kids, but this association only existed in terms of general adjustment for adult third-culture kids. Originality/value – Once corroborated...

Impact of Physical, Psychological, and Sexual Violence on Social Adjustment of School Children in India

Science.gov (United States)

Deb, Sibnath; Walsh, Kerryann

2012-01-01

This study sought to understand the pervasiveness and impact of physical, psychological, and sexual violence on the social adjustment of Grade 8 and 9 school children in the state of Tripura, India. The study participants, 160 boys and 160 girls, were randomly selected from classes in eight English and Bengali medium schools in Agartala city,…

Initial Examination of Low Velocity Sphere Impact of Glass Ceramics

Energy Technology Data Exchange (ETDEWEB)

Morrissey, Timothy G [ORNL; Fox, Ethan E [ORNL; Wereszczak, Andrew A [ORNL; Ferber, Mattison K [ORNL

2012-06-01

This report summarizes US Army TARDEC sponsored work at Oak Ridge National Laboratory (ORNL) involving low velocity (< 30 m/s or < 65 mph) sphere impact testing of two materials from the lithium aluminosilicate family reinforced with different amounts of ceramic particulate, i.e., glass-ceramic materials, SCHOTT Resistan{trademark}-G1 and SCHOTT Resistan{trademark}-L. Both materials are provided by SCHOTT Glass (Duryea, PA). This work is a follow-up to similar sphere impact studies completed by the authors on PPG's Starphire{reg_sign} soda-lime silicate glass and SCHOTT BOROFLOAT{reg_sign} borosilicate glass. A gas gun or a sphere-drop test setup was used to produce controlled velocity delivery of silicon nitride (Si{sub 3}N{sub 4}) spheres against the glass ceramic tile targets. Minimum impact velocities to initiate fracture in the glass-ceramics were measured and interpreted in context to the kinetic energy of impact and the elastic property mismatch between sphere and target material. Quasistatic spherical indentation was also performed on both glass ceramics and their contact damage responses were compared to those of soda-lime silicate and borosilicate glasses. Lastly, variability of contact damage response was assessed by performing spherical indentation testing across the area of an entire glass ceramic tile. The primary observations from this low velocity (< 30 m/s or < 65 mph) testing were: (1) Resistan{trademark}-L glass ceramic required the highest velocity of sphere impact for damage to initiate. Starphire{reg_sign} soda-lime silicate glass was second best, then Resistan{trademark}-G1 glass ceramic, and then BOROFLOAT{reg_sign} borosilicate glass. (2) Glass-ceramic Resistan{trademark}-L also required the largest force to initiate ring crack from quasi-static indentation. That ranking was followed, in descending order, by Starphire{reg_sign} soda-lime silicate glass, Resistan{trademark}-G1 glass ceramic, and BOROFLOAT{reg_sign} borosilicate glass

10 CFR 905.34 - Adjustment provisions.

Science.gov (United States)

2010-01-01

... continue to take place based on existing contract/marketing criteria principles. ... 10 Energy 4 2010-01-01 2010-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment...

How large are the impacts of carbon-motivated border tax adjustments on China and how to mitigate them?

International Nuclear Information System (INIS)

Li, Aijun; Zhang, Aizhen; Cai, Hongbo; Li, Xingfeng; Peng, Shishen

2013-01-01

There have been growing clamours for carbon-motivated border tax adjustments (CBTAs) targeted at countries that do not accept the carbon emission reduction targets. Currently, China is the largest carbon emitter with large annual incremental carbon emissions and might have to face the challenge of CBTA. Therefore, it is a pressing policy challenge for the government to get prepared for mitigating the negative impacts of CBTAs on China. In this article, we compare the impacts of CBTAs across large developing economies and compare the performances of different policy options to mitigate the negative impacts. The main findings are as follows. First, CBTA would affect different economies and different sectors differently. CBTA would result in a shift of production across sectors and relocation of output from the target countries to CBTA users. Second, CBTA would contribute to world's emissions reduction, but less than expected due to carbon leakage. Finally, policy options, which could reduce the present distorting effects, would be preferred to other policy options that would add additional distorting effects to the economy. Looking ahead, the Chinese government should get prepared for mitigating the negative impacts of CBTAs because its economy could be adversely affected. - Highlights: • We compare impacts of carbon-motivated border tax adjustments (CBTAs) across large emerging countries. • We test effectiveness of different policy options to mitigate the negative impacts. • We investigate how to design policy mix to mitigate negative impacts of CBTAs

Neoliberalism’s legacy in Southern Africa: the economic and social impact of adjustment

Directory of Open Access Journals (Sweden)

Eduardo Bidaurrazaga Aurre

2003-01-01

Full Text Available This article seeks to provide a better understanding of the problems involved in the processes of economic liberalization undertaken in Africa, specifically in the various economies of Southern Africa, over the last two decades through the application of structural adjustment programs. An examination of the results, particularly the consequences for the most disadvantaged sectors of these societies in terms of social vulnerability and marginalization, makes clear that criticism of the liberalizing model, analysis of the most recently implemented initiatives, and proposals for alternatives that favour the meeting of basic needs among the population, are essential.

Do fair value adjustments influence dividend policy?

NARCIS (Netherlands)

Goncharov, I.; van Triest, S.

2011-01-01

We examine the impact of positive fair value adjustments on dividend policy. If fair value adjustments are transitory in nature and managers are able to assess their implications for future earnings, fair value adjustments in net income is expected to have no distribution consequences. However,

Maternal Employment and Perceived Stress: Their Impact on Children's Adjustment and Mother-Child Interaction in Young Divorced and Married Families.

Science.gov (United States)

Pett, Marjorie A.; And Others

1994-01-01

Examined impact of maternal employment, marital status, and perceived maternal stress on children's adjustment and mother-preschool child interaction in 104 married and 99 divorced families. Results indicated that maternal employment had little impact on these variables. Maternal stress, in form of divorce and daily maternal hassles, demonstrated…

The impact of statistical adjustment on conditional standard errors of measurement in the assessment of physician communication skills.

Science.gov (United States)

Raymond, Mark R; Clauser, Brian E; Furman, Gail E

2010-10-01

The use of standardized patients to assess communication skills is now an essential part of assessing a physician's readiness for practice. To improve the reliability of communication scores, it has become increasingly common in recent years to use statistical models to adjust ratings provided by standardized patients. This study employed ordinary least squares regression to adjust ratings, and then used generalizability theory to evaluate the impact of these adjustments on score reliability and the overall standard error of measurement. In addition, conditional standard errors of measurement were computed for both observed and adjusted scores to determine whether the improvements in measurement precision were uniform across the score distribution. Results indicated that measurement was generally less precise for communication ratings toward the lower end of the score distribution; and the improvement in measurement precision afforded by statistical modeling varied slightly across the score distribution such that the most improvement occurred in the upper-middle range of the score scale. Possible reasons for these patterns in measurement precision are discussed, as are the limitations of the statistical models used for adjusting performance ratings.

Adjusting water resources management to climate change

Energy Technology Data Exchange (ETDEWEB)

Riebsame, W E

1988-01-01

The nature of climate impacts and adjustment in water supply and flood management is discussed, and a case study of water manager response to climate fluctuation in California's Sacramento Basin is presented. The case illuminates the effect on climate impact and response of traditional management approaches, the dynamic qualities of maturing water systems, socially imposed constraints, and climate extremes. A dual pattern of crisis-response and gradual adjustment emerges, and specific mechanisms for effecting adjustment of water management systems are identified. The case study, and broader trends in US water development, suggest that oversized structural capacity, the traditional adjustment to climate variability in water resources, may prove less feasible in the future as projects become smaller and new facilities are delayed by economic and environmental concerns.

The Predictive Nature of Humor, Authoritative Parenting Style, and Academic Achievement on Indices of Initial Adjustment and Commitment to College among College Freshmen

Science.gov (United States)

Hickman, Gregory P.; Crossland, Garnet L.

2004-01-01

Through the administration of self-report surveys, this study examined the relationships among a) parenting styles, b) family structure, c) academic achievement, d) birth order, e) gender, and f) humor on the initial personal-emotional, social, academic, and commitment to college adjustment among 257 first-quarter college freshmen. Multiple…

Measuring and Analyzing the Scholarly Impact of Experimental Evaluation Initiatives

DEFF Research Database (Denmark)

Angelini, Marco; Ferro, Nicola; Larsen, Birger

2014-01-01

Evaluation initiatives have been widely credited with contributing highly to the development and advancement of information access systems, by providing a sustainable platform for conducting the very demanding activity of comparable experimental evaluation in a large scale. Measuring the impact...

Impact of initial surface parameters on the final quality of laser micro-polished surfaces

Science.gov (United States)

Chow, Michael; Bordatchev, Evgueni V.; Knopf, George K.

2012-03-01

Laser micro-polishing (LμP) is a new laser-based microfabrication technology for improving surface quality during a finishing operation and for producing parts and surfaces with near-optical surface quality. The LμP process uses low power laser energy to melt a thin layer of material on the previously machined surface. The polishing effect is achieved as the molten material in the laser-material interaction zone flows from the elevated regions to the local minimum due to surface tension. This flow of molten material then forms a thin ultra-smooth layer on the top surface. The LμP is a complex thermo-dynamic process where the melting, flow and redistribution of molten material is significantly influenced by a variety of process parameters related to the laser, the travel motions and the material. The goal of this study is to analyze the impact of initial surface parameters on the final surface quality. Ball-end micromilling was used for preparing initial surface of samples from H13 tool steel that were polished using a Q-switched Nd:YAG laser. The height and width of micromilled scallops (waviness) were identified as dominant parameter affecting the quality of the LμPed surface. By adjusting process parameters, the Ra value of a surface, having a waviness period of 33 μm and a peak-to-valley value of 5.9 μm, was reduced from 499 nm to 301 nm, improving the final surface quality by 39.7%.

Designing, implementing and monitoring social impact mitigation strategies: Lessons from Forest Industry Structural Adjustment Packages

International Nuclear Information System (INIS)

Loxton, Edwina A.; Schirmer, Jacki; Kanowski, Peter

2013-01-01

Social impact mitigation strategies are implemented by the proponents of policies and projects with the intent of reducing the negative, and increasing the positive social impacts of their activities, and facilitating the achievement of policy/project goals. Evaluation of mitigation strategies is critical to improving their future success and cost-effectiveness. This paper evaluates two Forest Industry Structural Adjustment Packages (FISAP) implemented in Australia in the 1990s to 2000s as part of broader policy changes that reduced access to timber from publicly owned native forests. It assesses the effectiveness of the structure, design, implementation and monitoring of the FISAPs, and highlights the interactions between these four elements and their influence on social impacts. The two FISAPs were found to be effective in terms of reducing negative impacts, encouraging positive impacts and contributing towards policy goals, although they did not mitigate negative impacts in all cases, and sometimes interacted with external factors and additional policy changes to contribute to significant short and long term negative impacts. -- Highlights: ► Mitigation strategies aim to reduce negative and enhance positive social impacts ► Mitigation strategy design, implementation, and monitoring are critical to success ► Effective mitigation enhanced the capacity of recipients to respond to change ► Mitigation strategies influenced multiple interacting positive and negative impacts ► Success required good communication, transparency, support, resources and timing

Criminal charges prior to and after initiation of office-based buprenorphine treatment

Directory of Open Access Journals (Sweden)

Harris Elizabeth E

2012-03-01

Full Text Available Abstract Background There is little data on the impact of office-based buprenorphine therapy on criminal activity. The goal of this study was to determine the impact of primary care clinic-based buprenorphine maintenance therapy on rates of criminal charges and the factors associated with criminal charges in the 2 years after initiation of treatment. Methods We collected demographic and outcome data on 252 patients who were given at least one prescription for buprenorphine. We searched a public database of criminal charges and recorded criminal charges prior to and after enrollment. We compared the total number of criminal cases and drug cases 2 years before versus 2 years after initiation of treatment. Results There was at least one criminal charge made against 38% of the subjects in the 2 years after initiation of treatment; these subjects were more likely to have used heroin, to have injected drugs, to have had any prior criminal charges, and recent criminal charges. There was no significant difference in the number of subjects with any criminal charge or a drug charge before and after initiation of treatment. Likewise, the mean number of all cases and drug cases was not significantly different between the two periods. However, among those who were opioid-negative for 6 or more months in the first year of treatment, there was a significant decline in criminal cases. On multivariable analysis, having recent criminal charges was significantly associated with criminal charges after initiation of treatment (adjusted odds ratio 3.92; subjects who were on opioid maintenance treatment prior to enrollment were significantly less likely to have subsequent criminal charges (adjusted odds ratio 0.52. Conclusions Among subjects with prior criminal charges, initiation of office-based buprenorphine treatment did not appear to have a significant impact on subsequent criminal charges.

The Impact and Feasibility of Introducing Height-Adjustable Desks on Adolescents’ Sitting in a Secondary School Classroom

Directory of Open Access Journals (Sweden)

Rick Baldock

2016-05-01

Full Text Available Children spend over 60% of their school day sitting; much of this occurs in the classroom. Emerging research has examined the impact of environmental interventions on classroom sitting. While this research is promising, it has predominantly focused on the primary school setting. This study examined the impact and feasibility of height-adjustable desks on time spent sitting/standing during classroom lessons in a secondary school. Traditional desks in a Melbourne secondary school classroom were replaced with 27 height-adjustable desks (intervention classroom. Forty-three adolescents (51% male; mean age 13.7 ± 1.4 years from Grades 7, 9 and 10 wore an inclinometer and accelerometer for schooldays and completed a survey after using the desks during lessons for seven weeks. Ten teachers (50% male completed a survey. Time spent sitting, standing, and the length of sitting bouts were compared between periods when adolescents were in the intervention classroom versus traditional classrooms (matched on teacher and subject. Compared to the traditional classroom, adolescents spent 25% less time sitting and 24% more time standing in the intervention classroom (effect size > 0.8, and had a greater frequency of short sitting bouts and fewer longer bouts. The majority of teachers (71% and students (70% reported wanting to continue to use the height-adjustable desks. When standing during lessons, adolescents reported working well (69%; however, a third reported difficulties paying attention (28% and becoming distracted (36%. Few teachers reported negative influences on adolescents’ ability to work (14% and concentrate (14%. Half the adolescents reported leg, or back pain with standing. Introducing height-adjustable desks resulted in lower levels of sitting compared with traditional classrooms, was acceptable and had some adverse effects on concentration and discomfort. The study provides preliminary evidence that height-adjustable desks may help reduce

Cropping pattern adjustment in China's grain production and its impact on land and water use

DEFF Research Database (Denmark)

Li, Tian-xiang; Zhu, Jing; Balezentis, Tomas

2016-01-01

This paper aims at decomposing China's grain output changes into three terms, namely area sown effect, pure yield effect, and cropping pattern adjustment effect. Furthermore, the paper analyses the impact of shifts in cropping pattern on water and land use in China's grain production. An index...... adjustments). However, these effects vary across regions: Southeast China experienced land-saving and water-using changes, while other regions underwent land- and water-saving changes. In general, China's grain output growth has increased the total amount of land and water needed, implying more severe...... played an important role in promoting China's grain production, with a contribution of over 15 per cent during 2003-2012. Moreover, such changes enabled to save about 6.8 million hectares of sown areas and 31.06 billion m3 of water in grain production (if compared to the case without cropping pattern...

The hidden cost of investment. The impact of adjustment costs on firm performance measurement and regulation

International Nuclear Information System (INIS)

Nick, Sebastian; Wetzel, Heike

2014-01-01

In this study, we address a major problem in the measurement of firm performance and the regulation of natural monopolies, namely the intertemporal character of long-term investment decisions. In specific, we focus on the impact of adjustment costs of investments on estimates of firms' technical and cost inefficiency. We apply nonparametric dynamic data envelopment analysis to investigate the dynamic inefficiency of electricity distribution and transmission companies in the US during the years 2004 to 2011 and compare our results with their static counterparts. Our empirical findings reveal that ignoring long-term investments and their corresponding adjustment costs does significantly distort both firm-specific and industrial inefficiency estimates and may thus create misleading incentives for the regulated firms to cut investments.

Assessing the impact of area-based initiatives in deprived neighborhoods

DEFF Research Database (Denmark)

Alves, Sonia

2017-01-01

assumptions, and social and spatial effects of these initiatives. Among other inter-related issues, the paper discusses the impact of conflicting ideologies upon processes of radical strategy shift and of social and territorial marginalization, and appeals to the need for more pluralistic approaches......Whilst there have been many area-based initiatives to regenerate rundown areas in numerous cities around the world, many of them involving the demolition of stigmatized housing estates, far fewer attempts have been made to assess the effects of these initiatives upon the fortunes of displaced...... households and those who remain in these areas. By presenting the results of an empirical in-depth case study on the effects of an area based initiative targeted at one of the most deprived neighborhoods in Porto, this paper raises several epistemological concerns related to the goals, ideological...

Psychological Availability between Self-Initiated Expatriates and Host Country Nationals during Their Adjustment: The Moderating Role of Supportive Supervisor Relations

Science.gov (United States)

Jannesari, Milad; Wang, Zhongming; McCall, Jacob; Zheng, Boyang

2017-01-01

This research examined the role of psychological availability as a means of psychological engagement between self-initiated expatriates (SIEs) and their host-country nationals (HCNs) colleagues during their work and interaction adjustment. To reveal this process, this study presented the concept of psychological availability, which refers to an individual’s belief that they are physically, cognitively, and emotionally ready or confident to engage the self with their colleagues, as a mediator between proactive personality and adjustment. Also, it investigated the relationship between proactive personality and psychological availability and how it was moderated by supportive supervisor relations. We hypothesized, this relationship would be weakened/strengthened when SIEs and HCNs received low/high level of support from their supervisor. This study was conducted as a quantitative study, data was used from 342 SIEs and 342 HCNs working in mainland China. Our finding supported the hypothesis that psychological availability mediated the relationship between proactive personality and their adjustment to an international work environment; in addition, the relationship between proactive personality and psychological availability would be stronger when the level of superiors relations support is high between SIEs and HCNs. This study demonstrated the value of proactive personality as an antecedent effect and supportive supervisor relations as a moderating effect, and investigated how these factors can lead to a sense of psychological availability and boost psychological engagement between SIEs and HCNs in order to improve the adjustment between them. PMID:29225587

Psychological Availability between Self-Initiated Expatriates and Host Country Nationals during Their Adjustment: The Moderating Role of Supportive Supervisor Relations

Directory of Open Access Journals (Sweden)

Milad Jannesari

2017-11-01

Full Text Available This research examined the role of psychological availability as a means of psychological engagement between self-initiated expatriates (SIEs and their host-country nationals (HCNs colleagues during their work and interaction adjustment. To reveal this process, this study presented the concept of psychological availability, which refers to an individual’s belief that they are physically, cognitively, and emotionally ready or confident to engage the self with their colleagues, as a mediator between proactive personality and adjustment. Also, it investigated the relationship between proactive personality and psychological availability and how it was moderated by supportive supervisor relations. We hypothesized, this relationship would be weakened/strengthened when SIEs and HCNs received low/high level of support from their supervisor. This study was conducted as a quantitative study, data was used from 342 SIEs and 342 HCNs working in mainland China. Our finding supported the hypothesis that psychological availability mediated the relationship between proactive personality and their adjustment to an international work environment; in addition, the relationship between proactive personality and psychological availability would be stronger when the level of superiors relations support is high between SIEs and HCNs. This study demonstrated the value of proactive personality as an antecedent effect and supportive supervisor relations as a moderating effect, and investigated how these factors can lead to a sense of psychological availability and boost psychological engagement between SIEs and HCNs in order to improve the adjustment between them.

7 CFR 4287.112 - Interest rate adjustments.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Interest rate adjustments. 4287.112 Section 4287.112... Loans § 4287.112 Interest rate adjustments. (a) Reductions. The borrower, lender, and holder (if any) may collectively initiate a permanent or temporary reduction in the interest rate of the guaranteed...

Equity Mispricing and Leverage Adjustment Costs

NARCIS (Netherlands)

Warr, R.S.; Elliott, W.B.; Koeter-Kant, J.; Oztekin, O.

2012-01-01

We find that equity mispricing impacts the speed at which firms adjust to their target leverage (TL) and does so in predictable ways depending on whether the firm is over- or underlevered. For example, firms that are above their TL and should therefore issue equity (or retire debt) adjust more

An Empirical Investigation of the Impact of the Anchor and Adjustment Heuristic on the Audit Judgment Process

Science.gov (United States)

1988-01-01

Pe ~ ** . . . ’ S .- ..% - - -- - - An Empirical Investigation of the Impact of the Anchor and Adjustment Heuristic on the Audit Judgment Process A...1 Introduction ....... ............... 1 Audit Opinion Process ... ............ 2 Professional Judgment ..... ........... 5 Heuristics in the Audit Process...to evaluating the results of analytic reviews and internal control compliance tests (Felix and Kinney 1982, also Libby 1981). Decomposing the audit opinion

Impact of Pre-Initiators on PSA in Research Reactor

Energy Technology Data Exchange (ETDEWEB)

Ochirbat, Chimedtseren [KAIST, Daejeon (Korea, Republic of); Kim, Sok Chul [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2014-10-15

Most of nuclear power plants had already conducted PSA work to examine their plant safety for identifying vulnerability and preparing the mitigating strategies for severe accident. However, the PSA for research reactor has been conducted limitedly comparing with nuclear power plants due to lack of awareness and resources. Most of PSA results demonstrated that human failure events (HFEs) take a major role of risk contributor in terms of core damage frequency. HFEs are categorized as the following three types: pre-initiating event interaction (e.g., maintenance of errors, testing errors, calibration errors), initiating event related interactions (e.g., human error causing loss of power, human error causing system trip), and post-initiating event (e.g., all action actuating manual safety system backup of an automatic system). Lack of resources and utilization of research reactor calls a vicious circle in terms of safety degradation. The safety degradation poses the vulnerability of human failure during research reactor utilization process. Typically, evaluation of pre-initiators related to test and maintenance are not taking into account in PSA for research reactors. This paper aims to investigate the impact of pre-initiating events related to test and maintenance activities on PSA results in terms of core damage frequency for a research reactor.

Impact of Pre-Initiators on PSA in Research Reactor

International Nuclear Information System (INIS)

Ochirbat, Chimedtseren; Kim, Sok Chul

2014-01-01

Most of nuclear power plants had already conducted PSA work to examine their plant safety for identifying vulnerability and preparing the mitigating strategies for severe accident. However, the PSA for research reactor has been conducted limitedly comparing with nuclear power plants due to lack of awareness and resources. Most of PSA results demonstrated that human failure events (HFEs) take a major role of risk contributor in terms of core damage frequency. HFEs are categorized as the following three types: pre-initiating event interaction (e.g., maintenance of errors, testing errors, calibration errors), initiating event related interactions (e.g., human error causing loss of power, human error causing system trip), and post-initiating event (e.g., all action actuating manual safety system backup of an automatic system). Lack of resources and utilization of research reactor calls a vicious circle in terms of safety degradation. The safety degradation poses the vulnerability of human failure during research reactor utilization process. Typically, evaluation of pre-initiators related to test and maintenance are not taking into account in PSA for research reactors. This paper aims to investigate the impact of pre-initiating events related to test and maintenance activities on PSA results in terms of core damage frequency for a research reactor

Remotely adjustable fishing jar and method for using same

International Nuclear Information System (INIS)

Wyatt, W.B.

1992-01-01

This patent describes a method for providing a jarring force to dislodge objects stuck in well bores, the method it comprises: connecting a jarring tool between an operating string and an object in a well bore; selecting a jarring force to be applied to the object; setting the selected reference jarring force into a mechanical memory mechanism by progressively engaging a first latch body and a second latch body; retaining the reference jarring force in the mechanical memory mechanism during diminution of tensional force applied by the operating string; and initiating an upwardly directed impact force within the jarring tool by increasing tensional force on the operating string to a value greater than the tensional force corresponding with the selected jarring force. This patent also describes a remotely adjustable downhole fishing jar apparatus comprising: an operating mandrel; an impact release spring; a mechanical memory mechanism; and releasable latching means

Impact of combination antiretroviral therapy initiation on adherence to antituberculosis treatment

Directory of Open Access Journals (Sweden)

Marlene Knight

2015-10-01

Full Text Available Background: Healthcare workers are often reluctant to start combination antiretroviral therapy (ART in patients receiving tuberculosis (TB treatment because of the fear of high pill burden, immune reconstitution inflammatory syndrome, and side-effects. Object: To quantify changes in adherence to tuberculosis treatment following ART initiation. Design: A prospective observational cohort study of ART-naïve individuals with baseline CD4 count between 50 cells/mm3 and 350 cells/mm3 at start of TB treatment at a primary care clinic in Johannesburg, South Africa. Adherence to TB treatment was measured by pill count,self-report, and electronic Medication Event Monitoring System (eMEMS before and after initiation of ART. Results: ART tended to negatively affect adherence to TB treatment, with an 8% – 10% decrease in the proportion of patients adherent according to pill count and an 18% – 22% decrease in the proportion of patients adherent according to eMEMS in the first month following ART initiation, independent of the cut-off used to define adherence (90%, 95% or 100%. Reasons for non-adherence were multi factorial, and employment was the only predictor for optimal adherence (adjusted odds ratio 4.11, 95% confidence interval 1.06–16.0. Conclusion: Adherence support in the period immediately following ART initiation could optimise treatment outcomes for people living with TB and HIV.

Nonlinear Coupled Dynamics of a Rod Fastening Rotor under Rub-Impact and Initial Permanent Deflection

Directory of Open Access Journals (Sweden)

Liang Hu

2016-10-01

Full Text Available A nonlinear coupled dynamic model of a rod fastening rotor under rub-impact and initial permanent deflection was developed in this paper. The governing motion equation was derived by the D’Alembert principle considering the contact characteristic between disks, nonlinear oil-film force, rub-impact force, unbalance mass, etc. The contact effects between disks was modeled as a flexural spring with cubical nonlinear stiffness. The coupled nonlinear dynamic phenomena of the rub-impact rod fastening rotor bearing system with initial permanent deflection were investigated by the fourth-order Runge-Kutta method. Bifurcation diagram, vibration waveform, frequency spectrum, shaft orbit and Poincaré map are used to illustrate the rich diversity of the system response with complicated dynamics. The studies indicate that the coupled dynamic responses of the rod fastening rotor bearing system under rub-impact and initial permanent deflection exhibit a rich nonlinear dynamic diversity, synchronous periodic-1 motion, multiple periodic motion, quasi-periodic motion and chaotic motion can be observed under certain conditions. Larger radial stiffness of the stator will simplify the system motion and make the oil whirl weaker or even disappear at a certain rotating speed. With the increase of initial permanent deflection length, the instability speed of the system gradually rises, and the chaotic motion region gets smaller and smaller. The corresponding results can provide guidance for the fault diagnosis of a rub-impact rod fastening rotor with initial permanent deflection and contribute to the further understanding of the nonlinear dynamic characteristics of the rod fastening rotor bearing system.

Parental Perceptions of Family Adjustment in Childhood Developmental Disabilities

Science.gov (United States)

Thompson, Sandra; Hiebert-Murphy, Diane; Trute, Barry

2013-01-01

Based on the adjustment phase of the double ABC-X model of family stress (McCubbin and Patterson, 1983) this study examined the impact of parenting stress, positive appraisal of the impact of child disability on the family, and parental self-esteem on parental perceptions of family adjustment in families of children with disabilities. For mothers,…

Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care-Sensitive Conditions in Germany.

Science.gov (United States)

Pollmanns, Johannes; Romano, Patrick S; Weyermann, Maria; Geraedts, Max; Drösler, Saskia E

2018-04-01

To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used. A retrospective cross-sectional study using in- and outpatient secondary data was performed. Hospitalization data for hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, and asthma were obtained from the German Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from the German Central Research Institute of Ambulatory Health Care. Crude hospitalization rates varied substantially across counties (coefficients of variation [CV] 28-37 percent across conditions); this variation was reduced by prevalence adjustment (CV 21-28 percent). Prevalence explained 40-50 percent of the observed variation (r = 0.65-0.70) in ACSH rates for all conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas moved into or outside condition-specific control limits with prevalence adjustment. Unadjusted ACSH rates should be used with caution for high-stakes public reporting as differences in prevalence may have a marked impact. Prevalence adjustment should be considered in models analyzing ACSH. © Health Research and Educational Trust.

Impact of Soil Moisture Initialization on Seasonal Weather Prediction

Science.gov (United States)

Koster, Randal D.; Suarez, Max J.; Houser, Paul (Technical Monitor)

2002-01-01

The potential role of soil moisture initialization in seasonal forecasting is illustrated through ensembles of simulations with the NASA Seasonal-to-Interannual Prediction Project (NSIPP) model. For each boreal summer during 1997-2001, we generated two 16-member ensembles of 3-month simulations. The first, "AMIP-style" ensemble establishes the degree to which a perfect prediction of SSTs would contribute to the seasonal prediction of precipitation and temperature over continents. The second ensemble is identical to the first, except that the land surface is also initialized with "realistic" soil moisture contents through the continuous prior application (within GCM simulations leading up to the start of the forecast period) of a daily observational precipitation data set and the associated avoidance of model drift through the scaling of all surface prognostic variables. A comparison of the two ensembles shows that soil moisture initialization has a statistically significant impact on summertime precipitation and temperature over only a handful of continental regions. These regions agree, to first order, with regions that satisfy three conditions: (1) a tendency toward large initial soil moisture anomalies, (2) a strong sensitivity of evaporation to soil moisture, and (3) a strong sensitivity of precipitation to evaporation. The degree to which the initialization improves forecasts relative to observations is mixed, reflecting a critical need for the continued development of model parameterizations and data analysis strategies.

Concurrently adjusting interrelated control parameters to achieve optimal engine performance

Science.gov (United States)

Jiang, Li; Lee, Donghoon; Yilmaz, Hakan; Stefanopoulou, Anna

2015-12-01

Methods and systems for real-time engine control optimization are provided. A value of an engine performance variable is determined, a value of a first operating condition and a value of a second operating condition of a vehicle engine are detected, and initial values for a first engine control parameter and a second engine control parameter are determined based on the detected first operating condition and the detected second operating condition. The initial values for the first engine control parameter and the second engine control parameter are adjusted based on the determined value of the engine performance variable to cause the engine performance variable to approach a target engine performance variable. In order to cause the engine performance variable to approach the target engine performance variable, adjusting the initial value for the first engine control parameter necessitates a corresponding adjustment of the initial value for the second engine control parameter.

Cultural Distance Asymmetry in Expatriate Adjustment

DEFF Research Database (Denmark)

Selmer, Jan; Chiu, Randy K.; Shenkar, Oded

2007-01-01

of the assignment. Design/methodology/approach - Using a two-flow sample of US expatriates in Germany and German expatriates in the USA, we examine and compare the psychological and socio-cultural adjustment of each group of executives. Findings - Controlling for the length of assignment, we find that German...... expatriates in the USA were better adjusted, both socio-culturally and psychologically, than American expatriates in Germany. These results support the asymmetry hypothesis and call into question previous findings attesting to the relationship between CD and expatriate adjustment. Originality......Purpose - The current literature implicitly assumes a symmetric impact of cultural distance (CD) on expatriate adjustment. By using distance as a predictor of adjustment, the literature has rendered the direction of the flow irrelevant: a US expatriate in Germany is presumed to face the same hurdle...

Interpersonal ambivalence, perceived relationship adjustment, and conjugal loss.

Science.gov (United States)

Bonanno, G A; Notarius, C I; Gunzerath, L; Keltner, D; Horowitz, M J

1998-12-01

Ambivalence is widely assumed to prolong grief. To examine this hypothesis, the authors developed a measure of ambivalence based on an algorithmic combination of separate positive and negative evaluations of one's spouse. Preliminary construct validity was evidenced in relation to emotional difficulties and to facial expressions of emotion. Bereaved participants, relative to a nonbereaved comparison sample, recollected their relationships as better adjusted but were more ambivalent. Ambivalence about spouses was generally associated with increased distress and poorer perceived health but did not predict long-term grief outcome once initial outcome was controlled. In contrast, initial grief and distress predicted increased ambivalence and decreased Dyadic Adjustment Scale scores at 14 months postloss, regardless of initial scores on these measures. Limitations and implications of the findings are discussed.

Maine Tidal Power Initiative: Environmental Impact Protocols For Tidal Power

Energy Technology Data Exchange (ETDEWEB)

Peterson, Michael Leroy [Univ. of Maine, Orono, ME; Zydlewski, Gayle Barbin [Univ. of Maine, Orono, ME; Xue, Huijie [Univ. of Maine, Orono, ME; Johnson, Teresa R. [Univ. of Maine, Orono, ME

2014-02-02

The Maine Tidal Power Initiative (MTPI), an interdisciplinary group of engineers, biologists, oceanographers, and social scientists, has been conducting research to evaluate tidal energy resources and better understand the potential effects and impacts of marine hydro-kinetic (MHK) development on the environment and local community. Project efforts include: 1) resource assessment, 2) development of initial device design parameters using scale model tests, 3) baseline environmental studies and monitoring, and 4) human and community responses. This work included in-situ measurement of the environmental and social response to the pre-commercial Turbine Generator Unit (TGU®) developed by Ocean Renewable Power Company (ORPC) as well as considering the path forward for smaller community scale projects.

Asking for work adjustments or initiating behavioural changes - what makes a 'problematic co-worker' score Brownie points? An experimental study on the reactions towards colleagues with a personality disorder.

Science.gov (United States)

Muschalla, Beate; Fay, Doris; Seemann, Anne

2016-10-01

People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues' reactions towards a problematic worker dependent on the returning person's reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.

Applications of sensitivity function to dosimetric data adjustments

International Nuclear Information System (INIS)

Nakazawa, Masaharu

1984-01-01

Sensitivity functions are applied to the dosimetric field in the spectrum unfolding technique, also called as the data adjustment technique which are statistical estimation procedures of the neutron spectrum or relating dosimetric quantities basing on the reaction-rate data measurements. Using the practical formulae and numerical examples of the sensitivity functions in the dosimetric data adjustments, two comments are made that (1) present sensitivity values are highly depending on the initial spectrum inputs and (2) more attention should be paid to the dependency of the sensitivity on the very uncertain covariance data inputs of the initial neutron spectrum. (author)

Proposal for a national inventory adjustment for trade in the presence of border carbon adjustment: Assessing carbon tax policy in Japan

International Nuclear Information System (INIS)

Zhou, Xin; Yano, Takashi; Kojima, Satoshi

2013-01-01

In this paper we pointed out a hidden inequality in accounting for trade-related emissions in the presence of border carbon adjustment. Under a domestic carbon pricing policy, producers pay for the carbon costs in exchange for the right to emit. Under border carbon adjustment, however, the exporting country pays for the carbon costs of their exports to the importing country but not be given any emission credits. As a result, export-related emissions will be remained in the national inventory of the exporting country based on the UNFCCC inventory approach. This hidden inequality is important to climate policy but has not yet been pointed out. To address this issue we propose a method of National Inventory Adjustment for Trade, by which export-related emissions will be deducted from the national inventory of the exporting country and added to the national inventory of the importing country which implements border carbon adjustment. To assess the policy impacts, we simulated a carbon tax policy with border tax adjustment for Japan using a multi-region computable general equilibrium model. The results indicate that with the National Inventory Adjustment for Trade, both Japan′s national inventory and the carbon leakage effects of Japan′s climate policy will be greatly different. - Highlights: • The inequality in GHG accounting caused by border carbon adjustment presented. • National inventory adjustment for trade under border carbon adjustment proposed. • Policy impacts on international competitiveness and carbon leakage assessed. • Practical issues related to the national inventory adjustment for trade discussed

Impact of Advocacy Initiatives on Nurses' Motivation to Sustain Momentum in Public Policy Advocacy.

Science.gov (United States)

Taylor, Melissa R S

2016-01-01

The purpose of this study is to elicit insight from the public policy leaders of 2 regional professional nursing organizations on key qualities of their current advocacy initiatives that motivate nurses to sustain momentum in public policy advocacy beyond a single episode. The goal is to inform quality improvement in the development of future advocacy initiatives to increase sustained engagement of nurses. Social cognitive theory was used as the rationale for this qualitative, descriptive study. A purposive convenience sample of executive leadership and board committee members from 2 regional professional nursing organizations were recruited to complete an initial Web-based electronic survey, followed by separate semistructured interview focus groups. One organization was composed primarily of advanced practice registered nurses, and the other group composed of diverse, multispecialty nursing members with varied educational levels. Nine themes emerged, categorized as facilitators or challenges to the positive impact of advocacy initiatives on nurses' motivation. Highlighting and marketing facilitators to the positive impact of advocacy initiatives on nurses' motivation to sustain momentum in public policy advocacy, while designing and testing new initiatives that address the challenges, may increase the number of nurses who sustain engagement in the policy advocacy process. Copyright © 2016 Elsevier Inc. All rights reserved.

The impact of structural adjustment and the changing nature of women's work in the People's Republic of China.

Science.gov (United States)

Roy, S

2000-01-01

This paper examines the impact of structural adjustment and the changing nature of women's work in the People's Republic of China (PRC). It is noted that more than two-thirds of the developing countries have adopted structural adjustment policy packages as an answer to the economic crisis they are facing. Such an adjustment is a conscious change in the fundamental nature of economic relationships within a society. In relation to women, the structural changes have resulted to the collapse of many small and home-based industries, thus changing the role of women in economy. It is noted that although the policy shifts have created a wide range of job opportunities for women in other countries, in PRC gender inequalities exist in the economic area wherein women experience low employment and lack of work benefits. In addition, the fact that the rate of women's employment in China is higher than other developing and some developed countries worsens the situation as it indicates that more women suffer under the discriminatory employment system.

HIV quality report cards: impact of case-mix adjustment and statistical methods.

Science.gov (United States)

Ohl, Michael E; Richardson, Kelly K; Goto, Michihiko; Vaughan-Sarrazin, Mary; Schweizer, Marin L; Perencevich, Eli N

2014-10-15

There will be increasing pressure to publicly report and rank the performance of healthcare systems on human immunodeficiency virus (HIV) quality measures. To inform discussion of public reporting, we evaluated the influence of case-mix adjustment when ranking individual care systems on the viral control quality measure. We used data from the Veterans Health Administration (VHA) HIV Clinical Case Registry and administrative databases to estimate case-mix adjusted viral control for 91 local systems caring for 12 368 patients. We compared results using 2 adjustment methods, the observed-to-expected estimator and the risk-standardized ratio. Overall, 10 913 patients (88.2%) achieved viral control (viral load ≤400 copies/mL). Prior to case-mix adjustment, system-level viral control ranged from 51% to 100%. Seventeen (19%) systems were labeled as low outliers (performance significantly below the overall mean) and 11 (12%) as high outliers. Adjustment for case mix (patient demographics, comorbidity, CD4 nadir, time on therapy, and income from VHA administrative databases) reduced the number of low outliers by approximately one-third, but results differed by method. The adjustment model had moderate discrimination (c statistic = 0.66), suggesting potential for unadjusted risk when using administrative data to measure case mix. Case-mix adjustment affects rankings of care systems on the viral control quality measure. Given the sensitivity of rankings to selection of case-mix adjustment methods-and potential for unadjusted risk when using variables limited to current administrative databases-the HIV care community should explore optimal methods for case-mix adjustment before moving forward with public reporting. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Parental Divorce during Adolescence and Adjustment in Early Adulthood.

Science.gov (United States)

Richardson, Stacey; McCabe, Marita P.

2001-01-01

Examined the impact of parental divorce during adolescence, interparental conflict, and intimacy with parents on young adult adjustment. High levels of interparental conflict were found to be negatively associated with adjustment and current intimacy of parents. (Author)

Advertising Receptivity and Youth Initiation of Smokeless Tobacco.

Science.gov (United States)

Timberlake, David S

2016-07-28

Cross-sectional data suggests that adolescents' receptivity to the advertising of smokeless tobacco is correlated with use of chewing tobacco or snuff. Lack of longitudinal data has precluded determination of whether advertising receptivity precedes or follows initiation of smokeless tobacco. The objective of this study was to test for the association between advertising receptivity and subsequent initiation of smokeless tobacco among adolescent males. Adolescent males from the 1993-1999 Teen Longitudinal California Tobacco Survey were selected at the baseline survey for never having used smokeless tobacco. Separate longitudinal analyses corresponded to two dependent variables, ever use of smokeless tobacco (1993-1996; N = 1,388) and use on 20 or more occasions (1993-1999; N = 1,014). Models were adjusted for demographic variables, risk factors for smokeless tobacco use, and exposure to users of smokeless tobacco. Advertising receptivity at baseline was predictive of ever use by late adolescence (RR(95% CI) = 2.0 (1.5, 2.8)) and regular use by young adulthood (RR(95% CI) = 3.7 (2.1, 6.7)) in models that were adjusted for covariates. Conclusions/ Importance: The findings challenge the tobacco industry's assertion that tobacco marketing does not impact youth initiation. This is particularly relevant to tobacco control in the United States because the 2009 Tobacco Control Act places fewer restrictions on smokeless tobacco products compared to cigarettes.

What policy adjustments in the EU ETS truly affected the carbon prices?

International Nuclear Information System (INIS)

Fan, Ying; Jia, Jun-Jun; Wang, Xin; Xu, Jin-Hua

2017-01-01

Carbon market becomes increasingly popular as a cost-effective instrument to mitigate CO_2 emissions. However, its construction is a learning-by-doing process, and needs consistent regulatory updates in order to deliver optimal effects. This paper uses the event study method to assess the impacts of different policy adjustments on the EUA returns in the European Union Emissions Trading Scheme (EU ETS) since 2005. Comparing to existing studies that focus on the impact of a single policy, this paper provides a complementary reference on if and to what extent policy adjustments can impact the carbon prices by classifying all regulatory update events into six categories. Its key findings are as follows. First, aggregate impacts of total 50 events studied are low while impacts of events having underlying negative impacts are higher than those having underlying positive impacts. Second, 24 events have significant impacts on EUA returns and are coherent to their theoretical impacts (except one event). Third, events having negligible impact on EUA returns are those that are announced not for the first time or those having no impact on CO_2 quotas supply and demand. Finally, there are different impact patterns: some events have different impacts on short-end and long-end carbon prices. - Highlights: • Impacts of policy adjustments in the EU ETS on carbon price are investigated. • Aggregate impacts of total 50 events studied are low. • Policy adjustments having underlying negative impacts have a higher impact. • Events that are announced for the first time are apt to have significant impact. • There are different impact patterns of events on EUA spot and futures returns.

Interharmonic analysis and mitigation in adjustable speed drives

DEFF Research Database (Denmark)

Soltani, Hamid; Loh, Poh Chiang; Blaabjerg, Frede

2014-01-01

This paper presents the theoretical background and studies on the supply side current interharmonics in a double-stage Adjustable Speed Drive (ASD), when they are initiated by motor current imbalance. Some useful approaches are then proposed to compensate for these interharmonic currents in parti......This paper presents the theoretical background and studies on the supply side current interharmonics in a double-stage Adjustable Speed Drive (ASD), when they are initiated by motor current imbalance. Some useful approaches are then proposed to compensate for these interharmonic currents...... in partially and/or fully controlled ASD, resulting in undistorted grid currents. The simulation studies verify the effectiveness of the proposed schemes....

Investigating the fall-injury reducing effect of impact absorbing flooring among female nursing home residents: initial results.

Science.gov (United States)

Gustavsson, Johanna; Bonander, Carl; Andersson, Ragnar; Nilson, Finn

2015-10-01

Fall-related injuries affect the lives of elderly to a substantial degree. This quasi-experimental study investigates the fall-injury reducing effect of impact absorbing flooring among female nursing home residents. The intervention site is a nursing home in Sweden where impact absorbing flooring was installed in parts of one of six wards (six out of 10 apartments (excluding bathrooms), the communal dining-room and parts of the corridor). The impact absorbing flooring is a 12 mm thick closed cell flexible polyurethane/polyurea composite tile (500×500 mm) with an exterior surface of polyurethane/polyurea. A generalised linear model (log-binomial) was used to calculate the RR of injury from falls on impact absorbing flooring compared to falls on regular flooring, adjusted for age, body mass index, visual and cognitive impairments. During the study period (1 October 2011 to 31 March 2014), 254 falls occurred on regular flooring and 77 falls on impact absorbing flooring. The injury/fall rate was 30.3% for falls on regular flooring and 16.9% for falls on impact absorbing flooring. Adjusted for covariates, the impact absorbing flooring significantly reduced the RR of injury in the event of a fall by 59% (RR 0.41 (95% Cl 0.20 to 0.80)). This is, to our knowledge, the first study evaluating the injury-reducing effect of impact absorbing flooring in a nursing home showing statistically significant effect. The results from this study are promising, indicating the considerable potential of impact absorbing flooring as a fall-related injury intervention among frail elderly. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Remote Sensing-based Methodologies for Snow Model Adjustments in Operational Streamflow Prediction

Science.gov (United States)

Bender, S.; Miller, W. P.; Bernard, B.; Stokes, M.; Oaida, C. M.; Painter, T. H.

2015-12-01

Water management agencies rely on hydrologic forecasts issued by operational agencies such as NOAA's Colorado Basin River Forecast Center (CBRFC). The CBRFC has partnered with the Jet Propulsion Laboratory (JPL) under funding from NASA to incorporate research-oriented, remotely-sensed snow data into CBRFC operations and to improve the accuracy of CBRFC forecasts. The partnership has yielded valuable analysis of snow surface albedo as represented in JPL's MODIS Dust Radiative Forcing in Snow (MODDRFS) data, across the CBRFC's area of responsibility. When dust layers within a snowpack emerge, reducing the snow surface albedo, the snowmelt rate may accelerate. The CBRFC operational snow model (SNOW17) is a temperature-index model that lacks explicit representation of snowpack surface albedo. CBRFC forecasters monitor MODDRFS data for emerging dust layers and may manually adjust SNOW17 melt rates. A technique was needed for efficient and objective incorporation of the MODDRFS data into SNOW17. Initial development focused in Colorado, where dust-on-snow events frequently occur. CBRFC forecasters used retrospective JPL-CBRFC analysis and developed a quantitative relationship between MODDRFS data and mean areal temperature (MAT) data. The relationship was used to generate adjusted, MODDRFS-informed input for SNOW17. Impacts of the MODDRFS-SNOW17 MAT adjustment method on snowmelt-driven streamflow prediction varied spatially and with characteristics of the dust deposition events. The largest improvements occurred in southwestern Colorado, in years with intense dust deposition events. Application of the method in other regions of Colorado and in "low dust" years resulted in minimal impact. The MODDRFS-SNOW17 MAT technique will be implemented in CBRFC operations in late 2015, prior to spring 2016 runoff. Collaborative investigation of remote sensing-based adjustment methods for the CBRFC operational hydrologic forecasting environment will continue over the next several years.

Impact of Psychological Problems and Marital Adjustment of Iranian Veterans on Their Children's Quality of Life and Happiness

Science.gov (United States)

Zargar, Fatemeh

2014-01-01

Background: The Iran-Iraq war during the 1980-1988 has left many consequences on veterans and their families that persist long after the war ended. Objectives: The aim of this study was to evaluate the impact of psychological problems and marital adjustment of Iranian veterans on their children's quality of life and happiness 24 years after the war ended. Patients and Methods: The sample was all children of veterans in Isfahan city that registered by Veterans and Martyrs Affair Foundation (VMAF). One hundred sixty-three veterans were selected by systematic randomized sampling and the symptom checklist-90-revised (SCL-90-R) and dyadic adjustment scale (DAS) were administered for them. Their wives filled out the DAS and their children answered to World Health Organization Quality of Life-Brief version (WHOQOL-BREF) and Oxford Happiness Inventory (OHI). The data from questionnaires completed by 149 families were analyzed using the multiple regressions analysis. Results: Global Severity Index (GSI) scores of veterans and veteran's age were inversely correlated with the scores of children's quality of life, while marital adjustment of parents and number of rooms in house were positively correlated. Mother's age was inversely correlated with the scores of children's happiness, while marital adjustment of the parents, the number of rooms in their house and the number of children were positively correlated. Conclusions: In veterans' family, psychological health of the veterans and marital adjustment of the parents have a significant relationship with their children's quality of life and happiness. PMID:25599063

Hawaii Clean Energy Initiative (HCEI) Scenario Analysis: Quantitative Estimates Used to Facilitate Working Group Discussions (2008-2010)

Energy Technology Data Exchange (ETDEWEB)

Braccio, R.; Finch, P.; Frazier, R.

2012-03-01

This report provides details on the Hawaii Clean Energy Initiative (HCEI) Scenario Analysis to identify potential policy options and evaluate their impact on reaching the 70% HECI goal, present possible pathways to attain the goal based on currently available technology, with an eye to initiatives under way in Hawaii, and provide an 'order-of-magnitude' cost estimate and a jump-start to action that would be adjusted with a better understanding of the technologies and market.

Validation of the force and frequency characteristics of the activator adjusting instrument: effectiveness as a mechanical impedance measurement tool.

Science.gov (United States)

Keller, T S; Colloca, C J; Fuhr, A W

1999-02-01

To determine the dynamic force-time and force-frequency characteristics of the Activator Adjusting Instrument and to validate its effectiveness as a mechanical impedance measurement device; in addition, to refine or optimize the force-frequency characteristics of the Activator Adjusting Instrument to provide enhanced dynamic structural measurement reliability and accuracy. An idealized test structure consisting of a rectangular steel beam with a static stiffness similar to that of the human thoracolumbar spine was used for validation of a method to determine the dynamic mechanical response of the spine. The Activator Adjusting Instrument equipped with a load cell and accelerometer was used to measure forces and accelerations during mechanical excitation of the steel beam. Driving point and transfer mechanical impedance and resonant frequency of the beam were determined by use of a frequency spectrum analysis for different force settings, stylus masses, and stylus tips. Results were compared with beam theory and transfer impedance measurements obtained by use of a commercial electronic PCB impact hammer. The Activator Adjusting Instrument imparted a very complex dynamic impact comprising an initial high force (116 to 140 N), short duration pulse (analysis of the Activator Adjusting Instrument impulse indicated that the Activator Adjusting Instrument has a variable force spectrum and delivers its peak energy at a frequency of 20 Hz. Added masses and different durometer stylus tips had very little influence on the Activator Adjusting Instrument force spectrum. The resonant frequency of the beam was accurately predicted by both the Activator Adjusting Instrument and electronic PCB impact hammer, but variations in the magnitude of the driving point impedance at the resonant frequency were high (67%) compared with the transfer impedance measurements obtained with the electronic PCB impact hammer, which had a more uniform force spectrum and was more repeatable (frequency

Optimal initial dose adjustment of warfarin in orthopedic patients.

Science.gov (United States)

Lenzini, Petra A; Grice, Gloria R; Milligan, Paul E; Gatchel, Susan K; Deych, Elena; Eby, Charles S; Burnett, R Stephen J; Clohisy, John C; Barrack, Robert L; Gage, Brian F

2007-11-01

Warfarin sodium is commonly prescribed for the prophylaxis and treatment of venous thromboembolism. Dosing algorithms have not been widely adopted because they require a fixed initial warfarin dose (eg, 5 mg) and are not tailored to other factors that may affect the international normalized ratio (INR). To develop an algorithm that could predict a therapeutic warfarin dose based on drug interactions, INR response after the initial warfarin doses, and other clinical factors. We used stepwise regression to quantify the relationship between these factors in patients beginning prophylactic warfarin therapy immediately prior to joint replacement. In the derivation cohort (n = 271), we separately modeled the therapeutic dose after 2 and 3 initial doses. We prospectively validated these 2 models in an independent cohort (n = 105). About half of the therapeutic dose variability was predictable after 3 days of therapy: R2 was 53% in the derivation cohort and 42% in the validation cohort. INR response after 3 warfarin doses (INR3) inversely correlated with therapeutic dose (p < 0.001). Intraoperative blood loss transiently, but significantly, elevated the postoperative INR values. Other significant (p < 0.03) predictors were the first and second warfarin doses (+7% and +6%, respectively, per 1 mg), and statin use (-15.0%). The model derived after 2 warfarin doses explained 32% of the variability in therapeutic dose. We developed and validated algorithms that estimate therapeutic warfarin doses based on clinical factors and INR response available after 2-3 days of warfarin therapy. The algorithms are implemented online at www.WarfarinDosing.org.

Psychological Outcomes and Predictors of Initial Weight Loss Outcomes among Severely Obese Adolescents Receiving Laparoscopic Adjustable Gastric Banding

Science.gov (United States)

Sysko, Robyn; Devlin, Michael J.; Hildebrandt, Tom B.; Brewer, Stephanie K.; Zitsman, Jeffrey L.; Walsh, B. Timothy

2013-01-01

Objective Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery. The role of mental health providers in this population is not well defined, and the selection of candidates is often the result of clinical judgment alone. The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric banding (LAGB) by: (1) examining changes in depressive symptoms and quality of life in the year following surgery, (2) evaluating the interaction between patterns of change in depression, quality of life, and weight post-surgery, and (3) identifying pre-surgical psychological predictors of initial weight change. Method Participants were 101 severely obese adolescents aged 14 to 18. Measures of height, weight, depressive symptoms, and quality of life were obtained in the first year following surgery. Changes in the Beck Depression Inventory (BDI), Pediatric Quality of Life Inventory (PedsQL), and body mass index were analyzed using latent growth curve modeling. Results Significant changes in total BDI [βslope=−0.885 SE=0.279, psurgery (pAdolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB, and measures of pre-operative binge eating and family conflict affected post-surgery body mass index among youth. PMID:23140654

Risk-adjusted impact of administrative costs on the distribution of terminal wealth for long-term investment.

Science.gov (United States)

Guillén, Montserrat; Jarner, Søren Fiig; Nielsen, Jens Perch; Pérez-Marín, Ana M

2014-01-01

The impact of administrative costs on the distribution of terminal wealth is approximated using a simple formula applicable to many investment situations. We show that the reduction in median returns attributable to administrative fees is usually at least twice the amount of the administrative costs charged for most investment funds, when considering a risk-adjustment correction over a reasonably long-term time horizon. The example we present covers a number of standard cases and can be applied to passive investments, mutual funds, and hedge funds. Our results show investors the potential losses they face in performance due to administrative costs.

A perinatal care quality and safety initiative: are there financial rewards for improved quality?

Science.gov (United States)

Kozhimannil, Katy B; Sommerness, Samantha A; Rauk, Phillip; Gams, Rebecca; Hirt, Charles; Davis, Stanley; Miller, Kristi K; Landers, Daniel V

2013-08-01

Although costs of providing care may decrease with hospital initiatives to improve obstetric and neonatal outcomes, the accompanying reduced adverse outcomes may negatively affect hospital revenues. In 2008 a Minnesota-based hospital system (Fairview Health Services) launched the Zero Birth Injury (ZBI) initiative, which used evidence-based care bundles to guide management of obstetric services. A pre-post analysis of financial impacts of ZBI was conducted by using hospital administrative records to measure costs and revenues associated with changes in maternal and neonatal birth injuries before (2008) and after (2009-2011) the initiative. For the Fairview Health Services hospitals, after adjusting for relevant covariates, implementation of ZBI was associated with a mean 11% decrease in the rate of maternal and neonatal adverse outcomes between 2008 and 2011 (adjusted odds ratio [AOR] = 0.89, p = .076). As a result of the adverse events avoided, the hospital system saved $284,985 in costs but earned $324,333 less revenue, which produced a net financial decrease of $39,348 (or a $305 net financial loss per adverse event avoided) in 2011, compared with 2008. Adoption of a perinatal quality and safety initiative that reduced birth injuries had little net financial impact on the hospital. ZBI produced better clinical results at a lower cost, which represents potential savings for payers, but the hospital system offering improved quality reaped no clear financial rewards. These results highlight the important role for shared-savings collaborations (among patients, providers, government and third-party payers, and employers) to incentivize QI. Widespread adoption of perinatal safety initiatives combined with innovative payment models may contribute to better health at reduced cost.

Contribution of the supplementary motor area and the cerebellum to the anticipatory postural adjustments and execution phases of human gait initiation.

Science.gov (United States)

Richard, Aliénor; Van Hamme, Angèle; Drevelle, Xavier; Golmard, Jean-Louis; Meunier, Sabine; Welter, Marie-Laure

2017-09-01

Several brain structures including the brainstem, the cerebellum and the frontal cortico-basal ganglia network, with the primary and premotor areas have been shown to participate in the functional organization of gait initiation and postural control in humans, but their respective roles remain poorly understood. The aim of this study was to better understand the role of the supplementary motor area (SMA) and posterior cerebellum in the gait initiation process. Gait initiation parameters were recorded in 22 controls both before and after continuous theta burst transcranial stimulation (cTBS) of the SMA and cerebellum, and were compared to sham stimulation, using a randomized double-blind design study. The two phases of gait initiation process were analyzed: anticipatory postural adjustments (APAs) and execution, with recordings of soleus and tibialis anterior muscles. Functional inhibition of the SMA led to a shortened APA phase duration with advanced and increased muscle activity; during execution, it also advanced muscle co-activation and decreased the duration of stance soleus activity. Cerebellar functional inhibition did not influence the APA phase duration and amplitude but increased muscle co-activation, it decreased execution duration and showed a trend to increase velocity, with increased swing soleus muscle duration and activity. The results suggest that the SMA contributes to both the timing and amplitude of the APAs with no influence on step execution and the posterior cerebellum in the coupling between the APAs and execution phases and leg muscle activity pattern during gait initiation. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Leveraging Agriculture for Nutrition Impact through the Feed the Future Initiative.

Science.gov (United States)

Du, Lidan; Pinga, Victor; Klein, Alyssa; Danton, Heather

2015-01-01

Nutrition is a multisectoral problem; current state of empirical evidence for agricultural interventions' impacts on nutrition is weak. In the past 10 years, both agriculture and nutrition have risen on the global policy agenda. Several recent international movements have created great momentum for nutrition among global political leaders and policymakers. The 2008 world food price crisis prompted larger investment pledges to agricultural development. The U.S. Government launched the Feed the Future initiative in 2009 to address global hunger and food security, with a primary goal to reduce poverty and undernutrition by simultaneously promoting inclusive agriculture sector growth and improved nutritional status for women and children. With operations in 19 focus countries, Feed the Future provides an important laboratory of learning where efforts can be effective and, once proven, taken to scale to make agriculture work for nutrition. The Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project has been conducting a series of research on the Feed the Future initiative. This chapter will first provide a review of the nutrition narrative in relation to food and nutrition, introduce the current understanding of linkages between agriculture and nutrition and the Feed the Future initiative's efforts to strengthen the nutritional impact of agricultural and economic growth activities, and describe an extensive review of how the design and early implementation of Feed the Future activities linked agriculture and nutrition. Finally, the chapter presents an updated framework that incorporates ways to improve nutrition outcomes of agricultural programming in the broader context of food system. © 2015 Elsevier Inc. All rights reserved.

The Impact Of Family Structure On Psychosocial Adjustment Of ...

African Journals Online (AJOL)

This paper x-ray the psychosocial adjustment of adolescences based on their families structure, hence families were further revealed to include intact family, divorced family, separated family, psychological and none psychological broken homes, as it influence adolescence generally. Under the definition of terms ...

Case-mix adjustment for diabetes indicators: a systematic review.

Science.gov (United States)

Calsbeek, Hiske; Markhorst, Joekle G M; Voerman, Gerlienke E; Braspenning, Jozé C C

2016-02-01

Case-mix adjustment is generally considered indispensable for fair comparison of healthcare performance. Inaccurate results are also unfair to patients as they are ineffective for improving quality. However, little is known about what factors should be adjusted for. We reviewed case-mix factors included in adjustment models for key diabetes indicators, the rationale for their inclusion, and their impact on performance. Systematic review. This systematic review included studies published up to June 2013 addressing case-mix factors for 6 key diabetes indicators: 2 outcomes and 2 process indicators for glycated hemoglobin (A1C), low-density lipoprotein cholesterol, and blood pressure. Factors were categorized as demographic, diabetes-related, comorbidity, generic health, geographic, or care-seeking, and were evaluated on the rationale for inclusion in the adjustment models, as well as their impact on indicator scores and ranking. Thirteen studies were included, mainly addressing A1C value and measurement. Twenty-three different case-mix factors, mostly demographic and diabetes-related, were identified, and varied from 1 to 14 per adjustment model. Six studies provided selection motives for the inclusion of case-mix factors. Marital status and body mass index showed a significant impact on A1C value. For the other factors, either no or conflicting associations were reported, or too few studies (n ≤ 2) investigated this association. Scientific knowledge about the relative importance of case-mix factors for diabetes indicators is emerging, especially for demographic and diabetes-related factors and indicators on A1C, but is still limited. Because arbitrary adjustment potentially results in inaccurate quality information, meaningful stratification that demonstrates inequity in care might be a better guide, as it can be a driver for quality improvement.

Financing urban adaptation to climate change impacts mapping of existing initiatives

International Nuclear Information System (INIS)

Eschalier, Claire; Leseur, Alexia; Archambault, Sabrina; Joubert, Marion; Larrue, Clement; Rossin, Nicolas; Salenson, Irene

2015-01-01

In June 2015, CDC Climat research, in partnership with AFD, published a mapping of the types of initiatives available for the financing of urban adaptation to climate change, offering additional options to more conventional sources of funding for climate change and sustainable development (national budget transfers, Official Development Aid, etc.). Based on the review of 27 main initiatives, the report shows a strong prevalence of initiatives supporting soft adaptation measures (strategy planning, capacity building, project design, technical assistance, etc). These are in a position to help support the development of a coherent portfolio of bankable projects. The mapping also reveals that local intermediaries (regional and local banks, national development funds, etc.) play a significant role in financing urban adaptation to climate change. Several key factor of success for the cities' access to these sources of funding are also identified, among which liaising with international development stakeholders (such as multilateral and bilateral donors) at the local level, and the identification of various co-benefits and synergies between the economic, environmental and climate impacts. (authors)

Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

Directory of Open Access Journals (Sweden)

Fiifi Amoako Johnson

Full Text Available The Community-based Health Planning and Services (CHPS initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas.Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km.Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

Science.gov (United States)

Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Matthews, Zoe; Harfoot, Andrew J P; Nyarko, Philomena; Baschieri, Angela; Gething, Peter W; Falkingham, Jane; Atkinson, Peter M

2015-01-01

The Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas. Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km. Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

View from Silicon Valley: Maximizing the Scientific Impact of Global Brain Initiatives through Entrepreneurship.

Science.gov (United States)

Joshi, Pushkar S; Ghosh, Kunal K

2016-11-02

In this era of technology-driven global neuroscience initiatives, the role of the neurotechnology industry remains woefully ambiguous. Here, we explain why industry is essential to the success of these global initiatives, and how it can maximize the scientific impact of these efforts by (1) scaling and ultimately democratizing access to breakthrough neurotechnologies, and (2) commercializing technologies as part of integrated, end-to-end solutions that accelerate neuroscientific discovery. Copyright © 2016 Elsevier Inc. All rights reserved.

The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility.

Science.gov (United States)

Chaves, Catarina; Canavarro, Maria Cristina; Moura-Ramos, Mariana

2018-04-30

Infertility is a challenging experience, affecting individual and couples' adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross-sectional study, a total of 134 participants (67 couples with infertility) completed self-report questionnaires assessing infertility-related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes. © 2018 Family Process Institute.

Changes in Attitudes, Beliefs and Behaviour: A Critical Review of Research into the Impacts of Environmental Education Initiatives

Science.gov (United States)

Gralton, Anna; Sinclair, Mark; Purnell, Ken

2004-01-01

This paper reviews research literature on the impact of environmental education initiatives on learners' attitudes, beliefs and behaviours. The review focuses on initiatives involving learners of all ages and school-aged learners in particular. The review shows two things. There is some evidence that environmental education initiatives are…

On the Output-Inflation Relationship When Price and Quantity Adjustments are Costly

DEFF Research Database (Denmark)

Danziger, Leif; Kreiner, Claus Thustrup

A vast literature analyzes the real effects of price-adjustment costs assuming that quantity adjustments are costless. In this paper, we analyze whether the presence of quantity-adjustments costs, which presumably are significant, change the traditional results on the impact of inflation....... In particular, recent findings suggest that quantity-adjustment costs may remove the linkage between output and inflation. We show that this is not the case when inflation is anticipated. On the contrary, quantity-adjustment costs may significantly amplify the consequences of price-adjustment costs...

Research on the Impacts of Expensive Food and Luxury Goods Import Tariff Adjustment on Chinese Economy and Related Measures

OpenAIRE

Qishen Zhou; Mingxing Yang

2013-01-01

This study aims to investigate the impacts of expensive food and luxury goods import tariff adjustment on Chinese economy and related measures. Nowadays, Asia especially China has been the world’s biggest expensive food and luxury goods market. However, due to relatively higher luxury import tariff in China, most consumers have chosen to purchase expensive food and luxury goods abroad which leads to a large of domestic consumption cash outflow. Therefore, whether to cut the luxury import tari...

Prevalence and impact of initial misclassification of pediatric type 1 diabetes mellitus.

Science.gov (United States)

Tripathi, Avnish; Rizvi, Ali A; Knight, Lisa M; Jerrell, Jeanette M

2012-10-01

To characterize rates of initial misclassification of type 1 diabetes mellitus as type 2/unspecified diabetes mellitus in a cohort of children/adolescents and to examine the impact of misclassification on the risk of diabetes-related complications. An 11-year dataset (1996-2006) was analyzed. Inclusion criteria included age 17 years and younger, enrollees in South Carolina State Medicaid, and diagnosis of type 2/unspecified or type 1 diabetes mellitus for at least two visits, 15 days apart. Survival analysis was used to assess the association of "misclassification" with the incidence of diabetic ketoacidosis (DKA), and the cumulative incidence of neuropathy, nephropathy, and cardiovascular complications, after controlling for individual risk factors and comorbid conditions. A total of 1130 individuals meeting the inclusion criteria were studied for a median of 7 years. Of the 1130 individuals, 669 (59.2%) maintained a diagnosis of type 2/unspecified diabetes mellitus, 205 (18.1%) were consistently diagnosed as type 1 diabetes mellitus, and the remaining 256 individuals (22.7%) were misclassified. Insulin treatment was used in 100% of the type 1 diabetes mellitus group and 73% of the misclassified group. Compared with the type 2 diabetes mellitus group, being misclassified was associated with earlier development of DKA (adjusted hazard ratio [aHR] 5.08, 95% confidence interval [CI] 3.09-8.37), neuropathy (aHR 1.94, CI 1.31-2.88), and nephropathy (aHR 1.72, CI 1.19-2.50), whereas being consistently classified with type 1 diabetes mellitus was associated only with earlier development of DKA (aHR 4.96, CI 2.56-9.61). Proper categorization of pediatric diabetes can be challenging, especially with comorbid obesity. Failure to ascertain type 1 diabetes mellitus in a timely manner in a pediatric population may increase the risk of substandard care and diabetes-related complications.

Impairment of gradual muscle adjustment during wrist circumduction in Parkinson's disease.

Directory of Open Access Journals (Sweden)

Carolien M Toxopeus

Full Text Available Purposeful movements are attained by gradually adjusted activity of opposite muscles, or synergists. This requires a motor system that adequately modulates initiation and inhibition of movement and selectively activates the appropriate muscles. In patients with Parkinson's disease (PD initiation and inhibition of movements are impaired which may manifest itself in e.g. difficulty to start and stop walking. At single-joint level, impaired movement initiation is further accompanied by insufficient inhibition of antagonist muscle activity. As the motor symptoms in PD primarily result from cerebral dysfunction, quantitative investigation of gradually adjusted muscle activity during execution of purposeful movement is a first step to gain more insight in the link between impaired modulation of initiation and inhibition at the levels of (i cerebrally coded task performance and (ii final execution by the musculoskeletal system. To that end, the present study investigated changes in gradual adjustment of muscle synergists using a manipulandum that enabled standardized smooth movement by continuous wrist circumduction. Differences between PD patients (N = 15, off-medication and healthy subjects (N = 16 concerning the relation between muscle activity and movement performance in these groups were assessed using kinematic and electromyographic (EMG recordings. The variability in the extent to which a particular muscle was active during wrist circumduction--defined as muscle activity differentiation--was quantified by EMG. We demonstrated that more differentiated muscle activity indeed correlated positively with improved movement performance, i.e. higher movement speed and increased smoothness of movement. Additionally, patients employed a less differentiated muscle activity pattern than healthy subjects. These specific changes during wrist circumduction imply that patients have a decreased ability to gradually adjust muscles causing a decline in

The impact of source initialization on performance of the FMBMC-ICEU algorithm

International Nuclear Information System (INIS)

Wenner, Michael T.; Haghighat, Alireza

2011-01-01

Recent work in the completely fission matrix based Monte Carlo (FMBMC) eigenvalue methodology showed that the fission matrix coefficients are independent of the source eigenvector in the limit of small mesh sizes. As a result, fission matrix element autocorrelation should be insignificant. We have developed a modified fission matrix based Monte Carlo methodology for achieving unbiased solutions even for high Dominance Ratio (DR) problems. This methodology utilizes an initial source from a deterministic calculation using the PENTRAN 3-D Parallel SN code, autocorrelation and normality tests, and a Monte Carlo Iterated Confidence Interval (ICI) formulation for estimation of uncertainties in the fundamental eigenvalue and eigenfunction. This methodology is referred to as Fission Matrix Based Monte Carlo Initial-source Controlled Elements with Uncertainties (FMBMC-ICEU). In this paper, we will investigate the impact of different starting sources (PENTRAN initialized with a flat source and a boundary source) on the final results of a test problem with high source correlation. It is shown that although the fission matrix element correlation is significantly reduced, a good initial guess is still important within the framework of the FMBMC-ICEU methodology since the FMBMC-ICEU methodology still utilizes a standard source iteration scheme. (author)

Methodological aspects of journaling a dynamic adjusting entry model

Directory of Open Access Journals (Sweden)

Vlasta Kašparovská

2011-01-01

Full Text Available This paper expands the discussion of the importance and function of adjusting entries for loan receivables. Discussion of the cyclical development of adjusting entries, their negative impact on the business cycle and potential solutions has intensified during the financial crisis. These discussions are still ongoing and continue to be relevant to members of the professional public, banking regulators and representatives of international accounting institutions. The objective of this paper is to evaluate a method of journaling dynamic adjusting entries under current accounting law. It also expresses the authors’ opinions on the potential for consistently implementing basic accounting principles in journaling adjusting entries for loan receivables under a dynamic model.

The Impact of Dynamic RTS Threshold Adjustment for IEEE 802.11 MAC Protocol

Directory of Open Access Journals (Sweden)

Mostafa Mjidi

2009-01-01

Full Text Available In recent years, wireless technologies and application received great attention. The Medium Access Control (MAC protocol is the main element that determines the efficiency in sharing the limited communication bandwidth of the wireless channel in wireless local area networks (WLANs. IEEE 802.11 introduced the optional RTS/CTS handshaking mechanism to address the hidden terminal problem as well as to reduces the chance of collision in case of higher node density and traffic. RTS Threshold (RT determines when RTS/CTS mechanism should be used and proved to be an important parameter for performance characteristics in data transmission. We first investigate to find a meaningful threshold value according to the network situation and determine the impact of using or disengaging the RTS/CTS optional mechanism and dynamically adjust the RTS Threshold to maximize data transmission. The results show a significant improvement over existing CSMA/CA and RTS/CTS schemes. Our adaptive scheme performed even better when data rate increases. We verify our proposed scheme both analytically and with extensive network simulation using ns-2.

ICT Integration in Mathematics Initial Teacher Training and Its Impact on Visualization: The Case of GeoGebra

Science.gov (United States)

Dockendorff, Monika; Solar, Horacio

2018-01-01

This case study investigates the impact of the integration of information and communications technology (ICT) in mathematics visualization skills and initial teacher education programmes. It reports on the influence GeoGebra dynamic software use has on promoting mathematical learning at secondary school and on its impact on teachers' conceptions…

Obesity-related costs and the economic impact of laparoscopic adjustable gastric banding procedures: benefits in the Texas Employees Retirement System.

Science.gov (United States)

Perryman, M Ray; Gleghorn, Virginia

2010-01-01

To assess the return on investment (ROI) and economic impact of providing insurance coverage for the laparoscopic adjustable gastric banding (LAGB) procedure in classes II and III obese members of the Texas Employees Retirement System (ERS) and their dependents from payer, employer, and societal perspectives. Classes II and III obese employee members and their adult dependents were identified in a Texas ERS database using self-reported health risk assessment (HRA) data. Direct health costs and related absenteeism and mortality losses were estimated using data from previous research. A dynamic input-output model was then used to calculate overall economic effects by incorporating direct, indirect, and induced impacts. Direct health costs were inflation-adjusted to 2008 US dollars using the Consumer Price Index for Medical Care and other spending categories were similarly adjusted using relevant consumer and industrial indices. The future cost savings and other monetary benefits were discounted to present value using a real rate of 4.00%. From the payer perspective (ERS), the payback period for direct health costs associated with the LAGB procedure was 23-24 months and the annual return (over 5 years) was 28.8%. From the employer perspective (State of Texas), the costs associated with the LAGB procedure were recouped within 17-19 months (in terms of direct, indirect, and induced gains as they translated into State revenue) and the annual return (over 5 years) was 45.5%. From a societal perspective, the impact on total business activity for Texas (over 5 years) included gains of $195.3 million in total expenditures, $93.8 million in gross product, and 1354 person-years of employment. The analysis was limited by the following: reliance on other studies for methodology and use of a control sample; restriction of cost savings to 2.5 years which required out-of-sample forecasting; conservative assumptions related to the cost of the procedure; exclusion of presenteeism

Cross-cultural adjustment to the United States: The role of contextualized extraversion change

Directory of Open Access Journals (Sweden)

Mengqiao eLiu

2015-10-01

Full Text Available Personality traits can predict how well sojourners and expatriates adjust to new cultures, but the adjustment process remains largely unexamined. Based on recent findings that reveal personality traits predict as well as respond to life events and experiences, this research focuses on within-person change in contextualized extraversion and its predictive validity for cross-cultural adjustment in international students who newly arrived in U.S. colleges. We proposed that the initial level as well as the rate of change in school extraversion (i.e., contextualized extraversion that reflects behavioral tendency in school settings will predict cross-cultural adjustment, withdrawal cognitions, and school satisfaction. Latent growth modeling of three-wave longitudinal surveys of 215 new international students (54% female, Mage = 24 years revealed that the initial level of school extraversion significantly predicted cross-cultural adjustment, (lower withdrawal cognitions, and satisfaction, while the rate of change (increase in school extraversion predicted cross-cultural adjustment and (lower withdrawal cognitions. We further modeled global extraversion and cross-cultural motivation as antecedents and explored within-person change in school extraversion as a proximal factor that affects adjustment outcomes. The findings highlight the malleability of contextualized personality, and more importantly, the importance of understanding within-person change in contextualized personality in a cross-cultural adjustment context. The study points to more research that explicate the process of personality change in other contexts.

Cross-cultural adjustment to the United States: the role of contextualized extraversion change.

Science.gov (United States)

Liu, Mengqiao; Huang, Jason L

2015-01-01

Personality traits can predict how well-sojourners and expatriates adjust to new cultures, but the adjustment process remains largely unexamined. Based on recent findings that reveal personality traits predict as well as respond to life events and experiences, this research focuses on within-person change in contextualized extraversion and its predictive validity for cross-cultural adjustment in international students who newly arrived in US colleges. We proposed that the initial level as well as the rate of change in school extraversion (i.e., contextualized extraversion that reflects behavioral tendency in school settings) will predict cross-cultural adjustment, withdrawal cognitions, and school satisfaction. Latent growth modeling of three-wave longitudinal surveys of 215 new international students (54% female, M age = 24 years) revealed that the initial level of school extraversion significantly predicted cross-cultural adjustment, (lower) withdrawal cognitions, and satisfaction, while the rate of change (increase) in school extraversion predicted cross-cultural adjustment and (lower) withdrawal cognitions. We further modeled global extraversion and cross-cultural motivation as antecedents and explored within-person change in school extraversion as a proximal factor that affects adjustment outcomes. The findings highlight the malleability of contextualized personality, and more importantly, the importance of understanding within-person change in contextualized personality in a cross-cultural adjustment context. The study points to more research that explicate the process of personality change in other contexts.

Cross-cultural adjustment to the United States: the role of contextualized extraversion change

Science.gov (United States)

Liu, Mengqiao; Huang, Jason L.

2015-01-01

Personality traits can predict how well-sojourners and expatriates adjust to new cultures, but the adjustment process remains largely unexamined. Based on recent findings that reveal personality traits predict as well as respond to life events and experiences, this research focuses on within-person change in contextualized extraversion and its predictive validity for cross-cultural adjustment in international students who newly arrived in US colleges. We proposed that the initial level as well as the rate of change in school extraversion (i.e., contextualized extraversion that reflects behavioral tendency in school settings) will predict cross-cultural adjustment, withdrawal cognitions, and school satisfaction. Latent growth modeling of three-wave longitudinal surveys of 215 new international students (54% female, Mage = 24 years) revealed that the initial level of school extraversion significantly predicted cross-cultural adjustment, (lower) withdrawal cognitions, and satisfaction, while the rate of change (increase) in school extraversion predicted cross-cultural adjustment and (lower) withdrawal cognitions. We further modeled global extraversion and cross-cultural motivation as antecedents and explored within-person change in school extraversion as a proximal factor that affects adjustment outcomes. The findings highlight the malleability of contextualized personality, and more importantly, the importance of understanding within-person change in contextualized personality in a cross-cultural adjustment context. The study points to more research that explicate the process of personality change in other contexts. PMID:26579033

Green initiative impact on stock prices: A quantitative study of the clean energy industry

Science.gov (United States)

Jurisich, John M.

The purpose of this quantitative ex post facto research study was to explore the relationship between green initiative expense disclosures and stock prices of 46 NASDAQ listed Clean Edge Green Energy global companies from 2007 to 2010. The independent variables were sales and marketing, environmental, customer and supplier, community, and corporate governance practices that were correlated with the dependent variable in the study of stock prices. Expense disclosures were examined in an effort to measure the impact of green initiative programs and to expose the interrelationships between green initiative expense disclosures and fluctuations of stock prices. The data for the research was secondary data from existing annual reports. A statistically significant relationship was revealed between environmental practices and changes in stock prices. The study results also provided substantial evidence for leadership and managerial decision making to reduce or increase green initiative practices to maximize shareholder wealth of their respective organizations.

Effect of microstructure on the nucleation and initiation of adiabatic shear bands (ASBs) during impact

Energy Technology Data Exchange (ETDEWEB)

Boakye Yiadom, Solomon, E-mail: boakyeys@cc.umanitoba.ca; Khaliq Khan, Abdul, E-mail: abdulkhaliq.khan@umanitoba.ca; Bassim, Nabil, E-mail: nabil.bassim@ad.umanitoba.ca

2014-10-06

While instability may occur homogenously during plastic deformation, the formation of adiabatic shear band (ASBs) does not follow a homogenous instability during impact. Geometrical stress concentration sites and/or microstructural inhomogeneities result in the nucleation and initiation of shear strain localization. In this study, initial microstructural inhomogeneity was found to produce nucleation sites for the initiation of ASBs. It was observed that double misfit interfaces and boundary layers with random arrangement of atomic columns are formed around precipitated carbides and they increase the volume fraction of dislocation sources within the specimens. The AISI 4340 steel specimens which were tempered at the lowest temperature had smaller precipitated carbides with high aspect ratios densely distributed within the matrix and were easily susceptible to the formation of ASBs. As the tempering temperature increased, the relative sizes of the carbides increased with a corresponding reduction in their aspect ratios and their distribution density within the matrix and thus were more resistant to the formation of ASBs. In this study, it is demonstrated that the intersection of an activated dislocation source with the direction of maximum shear (regions of stress concentrations) within the specimens during impact, is a necessary condition for the point of intersection to act as a possible site for the nucleation of ASBs, depending on the rate of dislocation generation, local strain and strain rate. At a constant carbide volume fraction, the higher susceptibility of the tempered specimens to the initiation of ASBs is attributed to the volume fraction of the points of intersection between activated dislocation sources and direction of maximum shear during impact. Additionally, the smaller carbides, with their higher aspect ratios and distribution densities, accentuate the effect of strain gradients and the microstructural inhomogeneities associated with the tempered

Structural adjustment and health: A conceptual framework and evidence on pathways.

Science.gov (United States)

Kentikelenis, Alexander E

2017-08-01

Economic reform programs designed by the International Monetary Fund and the World Bank-so-called 'structural adjustment programs'-have formed one of the most influential policy agendas of the past four decades. To gain access to financial support from these organizations, countries-often in economic crisis-have reduced public spending, limited the role of the state, and deregulated economic activity. This article identifies the multiple components of structural adjustment, and presents a conceptual framework linking them to health systems and outcomes. Based on a comprehensive review of the academic literature, the article identifies three main pathways through which structural adjustment affects health: policies directly targeting health systems; policies indirectly impacting health systems; and policies affecting the social determinants of health. The cogency of the framework is illustrated by revisiting Greece's recent experience with structural adjustment, drawing on original IMF reports and secondary literature. Overall, the framework offers a lens through which to analyze the health consequences of structural adjustment across time, space and levels of socioeconomic development, and can be utilized in ex ante health impact assessments of these policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Autogenic training as a therapy for adjustment disorder in adolescents

Directory of Open Access Journals (Sweden)

Jojić Boris R.

2005-01-01

Full Text Available INTRODUCTION Autogenic training is a widespread technique used in psychotherapy. The British school of autogenic training cites a large list of diseases, health states, and life changes, in which autogenic training can be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adolescents. The sample consisted of a homogeneous group of 31 individuals, with an average age of 17.3±0.2 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. OBJECTIVE The aim of our work was to figure out the influence of autogenic training on adjustment disorder, through biophysical and biochemical indicators, and to research the efficacy of autogenic training as a therapy for adjustment disorder in adolescents. METHOD We observed adjustment disorder indicators and their changes in three phases, using initial, final, and control values, which we measured immediately before the beginning, immediately after the completion, and six months after the completion, of the practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rates, cortisol levels in plasma, cholesterol levels in blood, as well as glucose concentrations. During that period, autogenic training was employed as the sole therapy. RESULTS The study confirmed our preliminary assumptions. The measurements we performed showed that arterial blood pressure, pulse rates, cholesterol and cortisol concentrations, after the application of autogenic training among adolescents suffering from adjustment disorder, were lower than the initial values. They remained lower even six months after the completion of the practical course in autogenic training. CONCLUSION We concluded that autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and eases the adaptation of

[Autogenic training as a therapy for adjustment disorder in adolescents].

Science.gov (United States)

Jojić, Boris R; Leposavić, Ljubica M

2005-01-01

Autogenic training is a widespread technique used in psychotherapy. The British school of autogenic training cites a large list of diseases, health states, and life changes, in which autogenic training can be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adolescents. The sample consisted of a homogeneous group of 31 individuals, with an average age of 17.3 +/- 0.2 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. The aim of our work was to figure out the influence of autogenic training on adjustment disorder, through biophysical and biochemical indicators, and to research the efficiacy of autogenic training as a therapy for adjustment disorder in adolescents. We observed adjustment disorder indicators and their changes in three phases, using initial, final, and control values, which we measured immediately before the beginning, immediately after the completion, and six months after the completion, of the practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rates, cortisol levels in plasma, cholesterol levels in blood, as well as glucose concentrations. During that period, autogenic training was employed as the sole therapy. The study confirmed our preliminary assumptions. The measurements we performed showed that arterial blood pressure, pulse rates, cholesterol and cortisol concentrations, after the application of autogenic training among adolescents suffering from adjustment disorder, were lower than the initial values. They remained lower even six months after the completion of the practical course in autogenic training. We concluded that autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and eases the adaptation of adolescents to stress, helping with recovery.

ADJUSTMENT DURING THE CRISIS: INSTITUTIONAL BUFFERS ON THE EASTERN EUROPEAN LABOUR MARKETS

Directory of Open Access Journals (Sweden)

Pavol Babos

2014-05-01

Full Text Available The economic crisis had profound effects on labour markets of the EU member states in terms of a decline in employment and a rise in unemployment. This paper investigates how the states limited the impact of the change in economic output on the employment and the unemployment. The analysis suggests that there are different labour market institutions influencing the impact of the fall in GDP on the employment decline and unemployment increase. The first part of the paper explores and compares the extent to which the labour market institutions cushioned the impact of the economic crisis on the EU countries. The second part of this paper provides an in-depth comparative analysis of the labour market institutions and the adjustment mechanisms in Central Eastern European countries: Latvia, Slovenia and Slovakia. In the end this paper suggests that the specific institutional setting of a country, according to the Varieties of Capitalism, might shape the form of the government response to the crisis and the effect of particular institutions on the adjustment channels. The study shows that adjustment in Slovenia took place mostly within the firms, while in Latvia the most efficient adjustment channels actuated outside the firms, mostly within the government sponsored training programmes and international migration. In Slovakia, government sponsored adjustment, which focused on maintaining the existing positions, prevailed together with the promotion of self-employment.

The Impact of Financial Sophistication on Adjustable Rate Mortgage Ownership

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Smith, Hyrum; Finke, Michael S.; Huston, Sandra J.

2011-01-01

The influence of a financial sophistication scale on adjustable-rate mortgage (ARM) borrowing is explored. Descriptive statistics and regression analysis using recent data from the Survey of Consumer Finances reveal that ARM borrowing is driven by both the least and most financially sophisticated households but for different reasons. Less…

Initial foot contact and related kinematics affect impact loading rate in running.

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Breine, Bastiaan; Malcolm, Philippe; Van Caekenberghe, Ine; Fiers, Pieter; Frederick, Edward C; De Clercq, Dirk

2017-08-01

This study assessed kinematic differences between different foot strike patterns and their relationship with peak vertical instantaneous loading rate (VILR) of the ground reaction force (GRF). Fifty-two runners ran at 3.2 m · s -1 while we recorded GRF and lower limb kinematics and determined foot strike pattern: Typical or Atypical rearfoot strike (RFS), midfoot strike (MFS) of forefoot strike (FFS). Typical RFS had longer contact times and a lower leg stiffness than Atypical RFS and MFS. Typical RFS showed a dorsiflexed ankle (7.2 ± 3.5°) and positive foot angle (20.4 ± 4.8°) at initial contact while MFS showed a plantar flexed ankle (-10.4 ± 6.3°) and more horizontal foot (1.6 ± 3.1°). Atypical RFS showed a plantar flexed ankle (-3.1 ± 4.4°) and a small foot angle (7.0 ± 5.1°) at initial contact and had the highest VILR. For the RFS (Typical and Atypical RFS), foot angle at initial contact showed the highest correlation with VILR (r = -0.68). The observed higher VILR in Atypical RFS could be related to both ankle and foot kinematics and global running style that indicate a limited use of known kinematic impact absorbing "strategies" such as initial ankle dorsiflexion in MFS or initial ankle plantar flexion in Typical RFS.

Impacts of Pre-Retirement Guidance and Family Involvement on Retirement Adjustment of Retirees in Nigeria

Directory of Open Access Journals (Sweden)

O.O. Olatomide

2017-12-01

Full Text Available The study examined retirement adjustment of teacher-retirees in Osun State, and explored the interaction effects of pre-retirement guidance and family in-volvement on retirement adjustment. Exposit-facto design was used. The population comprised retirees from public, civil and private establishments from which 122 teacher-retirees were selected using a multi-stage sampling technique. An instrument: Family Involvement, Pre-retirement Guidance and Retirement Adjustment Questionnaire was used for data collection. Three research questions and three hypotheses guided the study. Data were analyzed using descriptive and inferential statistics. Results revealed that retirees in Osun State are not optimally adjusted, and positive significant interaction effect was found between family involvement and pre-retirement guidance on retirees adjustment, among others. Appropriate policy implications are outlined.

Maternal involvement in children's leisure activities in rural China: Relations with adjustment outcomes.

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Zhao, Siman; Chen, Xinyin

2018-02-01

This 1-year longitudinal study examined maternal involvement in children's leisure activities and its relations with children's adjustment in rural China. Participants included 184 children (93 boys and 91 girls) initially in third grade (mean age = 9.31 years). Children were asked to report the frequencies of mothers' involvement in leisure activities. Information on children's social, school, and psychological adjustment were collected from multiple sources including peer evaluations, teacher ratings, self-reports, and school records. The results showed that children's perceptions of maternal involvement in leisure activities positively predicted later social and school adjustment, particularly in boys. Furthermore, child initial adjustment status moderated the relations between maternal leisure activity involvement and child outcomes. The results suggest that maternal involvement in children's leisure activities, which has traditionally been neglected in the society, is a significant factor in contributing to child development in today's rural China. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

New-onset diabetes after hemodialysis initiation: impact on survival.

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Salifu, Moro O; Abbott, Kevin C; Aytug, Serhat; Hayat, Amir; Haria, Dhiren M; Shah, Syed; Friedman, Eli A; Delano, Barbara G; McFarlane, Samy I; Hurst, Frank P; Flom, Peter L; Jindal, Rahul M

2010-01-01

The incidence of new-onset diabetes after initiation of hemodialysis (NODAD) and its impact on survival is not known. We used data from the United States Renal Data System (USRDS) from January 2000 to December 2001, with at least 3 years of follow-up for this study. Patients aged 18-80 years were included. NODAD was defined as two Medicare institutional claims for diabetes in patients with no history of diabetes prior to starting hemodialysis (HD). Incidence (per 1,000 patient-years), prevalence (%) and hazard ratios for mortality in patients with NODAD were calculated. There were 59,340 incident patients with no history of diabetes prior to starting HD, of which 3,853 met criteria for NODAD. The overall incidence and prevalence of NODAD were 20 per 1,000 patient-years and 7.6%, respectively. In a cohort of 444 patients without diabetes and documented glycosylated hemoglobin A1c, diabetes after initiation of HD. NODAD was associated with a significantly increased risk of death as compared to non-diabetes patients (hazard ratio 1.20, 95% confidence interval 1.14-1.25). The USRDS showed a high incidence of NODAD, associated with significantly higher mortality compared to those who did not develop NODAD. The mechanism of NODAD needs to be explored further in experimental and clinical studies. 2010 S. Karger AG, Basel.

ICT integration in mathematics initial teacher training and its impact on visualization: the case of GeoGebra

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Dockendorff, Monika; Solar, Horacio

2018-01-01

This case study investigates the impact of the integration of information and communications technology (ICT) in mathematics visualization skills and initial teacher education programmes. It reports on the influence GeoGebra dynamic software use has on promoting mathematical learning at secondary school and on its impact on teachers' conceptions about teaching and learning mathematics. This paper describes how GeoGebra-based dynamic applets - designed and used in an exploratory manner - promote mathematical processes such as conjectures. It also refers to the changes prospective teachers experience regarding the relevance visual dynamic representations acquire in teaching mathematics. This study observes a shift in school routines when incorporating technology into the mathematics classroom. Visualization appears as a basic competence associated to key mathematical processes. Implications of an early integration of ICT in mathematics initial teacher training and its impact on developing technological pedagogical content knowledge (TPCK) are drawn.

The Impact of Religiosity on Midshipman Adjustment and Feelings of Acceptance

National Research Council Canada - National Science Library

Krauz, Matthew B

2006-01-01

... in and practice of religion affects the overall adjustment and experience of midshipmen at the U.S. Naval Academy. Data were collected through focus groups with first and second class midshipmen...

Impact of an emergency medicine pharmacist on initial antibiotic prophylaxis for open fractures in trauma patients.

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Harvey, Somer; Brad Hall, A; Wilson, Kayla

2018-02-01

Targeted antibiotic treatment reduces the infection risk of open fractures when soft tissue and bone are exposed to the environment. The risk of infection increases with higher degrees of injury. The Gustilo-Anderson system was developed to identify the degree of injury of open fractures and can be utilized to guide initial antibiotic therapy. Few studies have been published evaluating the potential impact of emergency medicine pharmacists in trauma, and currently no study has evaluated a pharmacist's influence on antibiotic selection and timing for open fractures. The objective of this study was to determine the impact of an emergency medicine pharmacist on initial antibiotic selection and timing in trauma patients with open fractures. This was a retrospective cohort study. Trauma alerts with open fractures from May 1, 2014 to June 30, 2016 were eligible for inclusion. The primary outcome was to determine if pharmacist participation during trauma resuscitation was associated with an increased proportion of initial antibiotic selection meeting guideline recommendations. The secondary outcome was the door-to-antibiotic administration time during resuscitation. Initial prophylactic antibiotic recommendations were met in 81% of trauma resuscitations when a pharmacist was present versus 47% without a pharmacist present (pfractures. Copyright © 2017 Elsevier Inc. All rights reserved.

How Do I Deal with Depression and Adjustment to My Spinal Cord Injury?

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Full Text Available ... Gary Karp Resources The emotional impact of paralysis Learning that you are paralyzed is devastating and overwhelming ... adjustment and depression Adjustment to paralysis is a process of changing one's thoughts and feelings and is ...

Lateral step initiation behavior in older adults.

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Sparto, Patrick J; Jennings, J Richard; Furman, Joseph M; Redfern, Mark S

2014-02-01

Older adults have varied postural responses during induced and voluntary lateral stepping. The purpose of the research was to quantify the occurrence of different stepping strategies during lateral step initiation in older adults and to relate the stepping responses to retrospective history of falls. Seventy community-ambulating older adults (mean age 76 y, range 70-94 y) performed voluntary lateral steps as quickly as possible to the right or left in response to a visual cue, in a blocked design. Vertical ground reaction forces were measured using a forceplate, and the number and latency of postural adjustments were quantified. Subjects were assigned to groups based on their stepping strategy. The frequency of trials with one or two postural adjustments was compared with data from 20 younger adults (mean age 38 y, range 21-58 y). Logistic regression was used to relate presence of a fall in the previous year with the number and latency of postural adjustments. In comparison with younger adults, who almost always demonstrated one postural adjustment when stepping laterally, older adults constituted a continuous distribution in the percentage of step trials made with one postural adjustment (from 0% to 100% of trials). Latencies of the initial postural adjustment and foot liftoff varied depending on the number of postural adjustments made. A history of falls was associated a larger percentage of two postural adjustments, and a longer latency of foot liftoff. In conclusion, the number and latency of postural adjustments made during voluntary lateral stepping provides additional evidence that lateral control of posture may be a critical indicator of aging. Copyright © 2013 Elsevier B.V. All rights reserved.

Net Stable Funding Ratio: Impact on Funding Value Adjustment

OpenAIRE

Siadat, Medya; Hammarlid, Ola

2017-01-01

In this paper we investigate the relationship between Funding Value Adjustment (FVA) and Net Stable Funding Ratio (NSFR). FVA is defined in a consistent way with NSFR such that the new framework of FVA monitors the costs due to keeping NSFR at an acceptable level, as well. In addition, the problem of choosing the optimal funding strategy is formulated as a shortest path problem where the proposed FVA framework is applied in the optimization process. The solution provides us with the optimal f...

State infant mortality: an ecologic study to determine modifiable risks and adjusted infant mortality rates.

Science.gov (United States)

Paul, David A; Mackley, Amy; Locke, Robert G; Stefano, John L; Kroelinger, Charlan

2009-05-01

To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization procedures. Final risk adjusted IMR's were standardized and states were compared with the United States adjusted rates. Models for IMR in individual states in 2001 (r2 = 0.66, P < 0.01) and 2002 (r2 = 0.81, P < 0.01) were tested. African-American race, teen birth rate, and smoking during pregnancy remained independently associated with state infant mortality rates for 2001 and 2002. Ninety five percent confidence intervals (CI) were calculated around the regression lines to model the expected IMR. After adjustment, some states maintained a consistent IMR; for instance, Vermont and New Hampshire remained low, while Delaware and Louisiana remained high. However, other states such as Mississippi, which have traditionally high infant mortality rates, remained within the expected 95% CI for IMR after adjustment indicating confounding affected the initial unadjusted rates. Non-modifiable demographic variables, including the percentage of non-Hispanic African-American and Hispanic populations of the state are major factors contributing to individual variation in state IMR. Race and ethnicity may confound or modify the IMR in states that shifted inside or outside the 95% CI following adjustment. Other factors including smoking during pregnancy and teen birth rate, which are

Adjustable typography: an approach to enhancing low vision text accessibility.

Science.gov (United States)

Arditi, Aries

2004-04-15

Millions of people have low vision, a disability condition caused by uncorrectable or partially correctable disorders of the eye. The primary goal of low vision rehabilitation is increasing access to printed material. This paper describes how adjustable typography, a computer graphic approach to enhancing text accessibility, can play a role in this process, by allowing visually-impaired users to customize fonts to maximize legibility according to their own visual needs. Prototype software and initial testing of the concept is described. The results show that visually-impaired users tend to produce a variety of very distinct fonts, and that the adjustment process results in greatly enhanced legibility. But this initial testing has not yet demonstrated increases in legibility over and above the legibility of highly legible standard fonts such as Times New Roman.

Factors Influencing Adjustment in Siblings of Children with Autism Spectrum Disorders

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Meyer, Katherine A.; Ingersoll, Brooke; Hambrick, David Z.

2011-01-01

Siblings of children with autism spectrum disorders (ASD) may be at an increased risk of adjustment problems. To examine possible predictors of adjustment difficulties in siblings, 70 mothers with at least one child with ASD and one typical child completed surveys of symptom severity in the child with ASD, impact of the child with ASD on the…

Comparing colon cancer outcomes: The impact of low hospital case volume and case-mix adjustment.

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Fischer, C; Lingsma, H F; van Leersum, N; Tollenaar, R A E M; Wouters, M W; Steyerberg, E W

2015-08-01

When comparing performance across hospitals it is essential to consider the noise caused by low hospital case volume and to perform adequate case-mix adjustment. We aimed to quantify the role of noise and case-mix adjustment on standardized postoperative mortality and anastomotic leakage (AL) rates. We studied 13,120 patients who underwent colon cancer resection in 85 Dutch hospitals. We addressed differences between hospitals in postoperative mortality and AL, using fixed (ignoring noise) and random effects (incorporating noise) logistic regression models with general and additional, disease specific, case-mix adjustment. Adding disease specific variables improved the performance of the case-mix adjustment models for postoperative mortality (c-statistic increased from 0.77 to 0.81). The overall variation in standardized mortality ratios was similar, but some individual hospitals changed considerably. For the standardized AL rates the performance of the adjustment models was poor (c-statistic 0.59 and 0.60) and overall variation was small. Most of the observed variation between hospitals was actually noise. Noise had a larger effect on hospital performance than extended case-mix adjustment, although some individual hospital outcome rates were affected by more detailed case-mix adjustment. To compare outcomes between hospitals it is crucial to consider noise due to low hospital case volume with a random effects model. Copyright © 2015 Elsevier Ltd. All rights reserved.

The stress-buffering effects of hope on adjustment to multiple sclerosis.

Science.gov (United States)

Madan, Sindia; Pakenham, Kenneth I

2014-12-01

Hope is an important resource for coping with chronic illness; however, the role of hope in adjusting to multiple sclerosis (MS) has been neglected, and the mechanisms by which hope exerts beneficial impacts are not well understood. This study aims to examine the direct and stress-moderating effects of dispositional hope and its components (agency and pathways) on adjustment to MS. A total of 296 people with MS completed questionnaires at time 1 at 12 months later and time 2. Focal predictors were stress, hope, agency and pathways, and the adjustment outcomes were anxiety, depression, positive affect, positive states of mind and life satisfaction. Results of regression analyses showed that as predicted, greater hope was associated with better adjustment after controlling for the effects of time 1 adjustment and relevant demographics and illness variables. However, these direct effects of hope were subsumed by stress-buffering effects. Regarding the hope components, the beneficial impacts of agency emerged via a direct effects mechanism, whereas the effects of pathways were evidenced via a moderating mechanism. Findings highlight hope as an important protective coping resource for coping with MS and accentuate the roles of both agency and pathways thinking and their different modes of influence in this process.

Early Sex Work Initiation and Violence against Female Sex Workers in Mombasa, Kenya.

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Parcesepe, Angela M; L'Engle, Kelly L; Martin, Sandra L; Green, Sherri; Suchindran, Chirayath; Mwarogo, Peter

2016-12-01

Between 20 and 40 % of female sex workers (FSWs) began sex work before age 18. Little is known concerning whether early initiation of sex work impacts later experiences in adulthood, including violence victimization. This paper examines the relationship between early initiation of sex work and violence victimization during adulthood. The sample included 816 FSWs in Mombasa, Kenya, recruited from HIV prevention drop-in centers who were 18 years or older and moderate-risk drinkers. Early initiation was defined as beginning sex work at 17 or younger. Logistic regression modeled recent violence as a function of early initiation, adjusting for drop-in center, age, education, HIV status, supporting others, and childhood abuse. Twenty percent of the sample reported early initiation of sex work. Although both early initiators and other FSWs reported commonly experiencing recent violence, early initiators were significantly more likely to experience recent physical and sexual violence and verbal abuse from paying partners. Early initiation was not associated with physical or sexual violence from non-paying partners. Many FSWs begin sex work before age 18. Effective interventions focused on preventing this are needed. In addition, interventions are needed to prevent violence against all FSWs, in particular, those who initiated sex work during childhood or adolescence.

Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

Science.gov (United States)

Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

2004-01-01

This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

The Impact of Disability and Social Determinants of Health on Condition-Specific Readmissions beyond Medicare Risk Adjustments: A Cohort Study.

Science.gov (United States)

Meddings, Jennifer; Reichert, Heidi; Smith, Shawna N; Iwashyna, Theodore J; Langa, Kenneth M; Hofer, Timothy P; McMahon, Laurence F

2017-01-01

Readmission rates after pneumonia, heart failure, and acute myocardial infarction hospitalizations are risk-adjusted for age, gender, and medical comorbidities and used to penalize hospitals. To assess the impact of disability and social determinants of health on condition-specific readmissions beyond current risk adjustment. Retrospective cohort study of Medicare patients using 1) linked Health and Retirement Study-Medicare claims data (HRS-CMS) and 2) Healthcare Cost and Utilization Project State Inpatient Databases (Florida, Washington) linked with ZIP Code-level measures from the Census American Community Survey (ACS-HCUP). Multilevel logistic regression models assessed the impact of disability and selected social determinants of health on readmission beyond current risk adjustment. Outcomes measured were readmissions ≤30 days after hospitalizations for pneumonia, heart failure, or acute myocardial infarction. HRS-CMS models included disability measures (activities of daily living [ADL] limitations, cognitive impairment, nursing home residence, home healthcare use) and social determinants of health (spouse, children, wealth, Medicaid, race). ACS-HCUP model measures were ZIP Code-percentage of residents ≥65 years of age with ADL difficulty, spouse, income, Medicaid, and patient-level and hospital-level race. For pneumonia, ≥3 ADL difficulties (OR 1.61, CI 1.079-2.391) and prior home healthcare needs (OR 1.68, CI 1.204-2.355) increased readmission in HRS-CMS models (N = 1631); ADL difficulties (OR 1.20, CI 1.063-1.352) and 'other' race (OR 1.14, CI 1.001-1.301) increased readmission in ACS-HCUP models (N = 27,297). For heart failure, children (OR 0.66, CI 0.437-0.984) and wealth (OR 0.53, CI 0.349-0.787) lowered readmission in HRS-CMS models (N = 2068), while black (OR 1.17, CI 1.056-1.292) and 'other' race (OR 1.14, CI 1.036-1.260) increased readmission in ACS-HCUP models (N = 37,612). For acute myocardial infarction, nursing home status

Adjustment Criterion and Algorithm in Adjustment Model with Uncertain

Directory of Open Access Journals (Sweden)

SONG Yingchun

2015-02-01

Full Text Available Uncertainty often exists in the process of obtaining measurement data, which affects the reliability of parameter estimation. This paper establishes a new adjustment model in which uncertainty is incorporated into the function model as a parameter. A new adjustment criterion and its iterative algorithm are given based on uncertainty propagation law in the residual error, in which the maximum possible uncertainty is minimized. This paper also analyzes, with examples, the different adjustment criteria and features of optimal solutions about the least-squares adjustment, the uncertainty adjustment and total least-squares adjustment. Existing error theory is extended with new observational data processing method about uncertainty.

Evaluating the Impact of Open Access at Berkeley: Results from the 2015 Survey of Berkeley Research Impact Initiative (BRII) Funding Recipients

Science.gov (United States)

Teplitzky, Samantha; Phillips, Margaret

2016-01-01

The Berkeley Research Impact Initiative (BRII) was one of the first campus-based open access (OA) funds to be established in North America and one of the most active, distributing more than $244,000 to support University of California (UC) Berkeley authors. In April 2015, we conducted a qualitative study of 138 individuals who had received BRII…

Gender influences the initial impact of subarachnoid hemorrhage: an experimental investigation.

Directory of Open Access Journals (Sweden)

Victor Friedrich

Full Text Available Aneurysmal subarachnoid hemorrhage (SAH carries high early patient mortality. More women than men suffer from SAH and the average age of female SAH survivors is greater than that of male survivors; however, the overall mortality and neurological outcomes are not better in males despite their younger age. This pattern suggests the possibility of gender differences in the severity of initial impact and/or in subsequent pathophysiology. We explored gender differences in survival and pathophysiology following subarachnoid hemorrhage induced in age-matched male and female rats by endovascular puncture. Intracranial pressure (ICP, cerebral blood flow (CBF, blood pressure (BP and cerebral perfusion pressure (CPP were recorded at and after induction of SAH. Animals were sacrificed 3 hours after lesion and studied for subarachnoid hematoma size, vascular pathology (collagen and endothelium immunostaining, inflammation (platelet and neutrophil immunostaining, and cell death (TUNEL assay. In a second cohort, 24-hour survival was determined. Subarachnoid hematoma, post-hemorrhage ICP peak, BP elevation, reduction in CPP, intraluminal platelet aggregation and neutrophil accumulation, loss of vascular collagen, and neuronal and non-neuronal cell death were greater in male than in female rats. Hematoma size did not correlate with the number of apoptotic cells, platelet aggregates or neutrophil. The ICP peak correlated with hematoma size and with number of apoptotic cells but not with platelet aggregates and neutrophil number. This suggests that the intensity of ICP rise at SAH influences the severity of apoptosis but not of inflammation. Mortality was markedly greater in males than females. Our data demonstrate that in rats gender influences the initial impact of SAH causing greater bleed and early injury in males as compared to females.

Social Networking Site Use Predicts Changes in Young Adults’ Psychological Adjustment

Science.gov (United States)

Szwedo, David E.; Mikami, Amori Yee; Allen, Joseph P.

2012-01-01

This study examined youths’ friendships and posted pictures on social networking sites as predictors of changes in their adjustment over time. Observational, self-report, and peer report data were obtained from a community sample of 89 young adults interviewed at age 21 and again at age 22. Findings were consistent with a leveling effect for online friendships, predicting decreases in internalizing symptoms for youth with lower initial levels of social acceptance, but increases in symptoms for youth with higher initial levels over the following year. Across the entire sample, deviant behavior in posted photos predicted increases in young adults’ problematic alcohol use over time. The importance of considering the interplay between online and offline social factors for predicting adjustment is discussed. PMID:23109797

Impact of Generalist Physician Initiatives on Residency Selection

Directory of Open Access Journals (Sweden)

Michael H. Malloy

2001-10-01

Full Text Available Objective:To compare the residency selection choices of students who experienced courses resulting from generalist physician initiatives to choices made by students prior to the implementation of those courses and to describe the characteristics of students selecting primary care residencies. Background:In the fall of 1994 a first year Community Continuity Experience course was initiated and in the summer of 1995 a third year Multidisciplinary Ambulatory Clerkship was begun at the University of Texas Medical Branch in Galveston. These courses were inserted into the curriculum to enhance and promote primary care education. Design/Methods:We examined the residency selections of cohorts of graduating medical students before (1992-1996 and after (1997-1999 the implementation of the primary care courses. Survey information on career preferences at matriculation and in the fourth year of medical school were available for students graduating after the programs began. We compared the career preferences and characteristics of those students who selected a primary care residency to those who did not. Results:Prior to the implementation of the programs, 45%(425/950 of students graduating selected primary care residencies compared to 45% (210/465 of students participating in the programs (p=0.88. At matriculation, 45% of students had listed a primary care discipline as their first career choice. Among the students who had indicated this degree of primary care interest 61% ended up matching in a primary care discipline. At year 4, 31% of students indicated a primary care discipline as their first career choice and 92% of these students matched to a primary care residency. By univariate analysis, minority students (53% were more likely to select a primary care residency than non-minority students (40%; students in the two lowest grade point average quartiles (55% and 50% selected primary care residencies compared to 37% and 38% of students in the top 2

Simulation of the Initial 3-D Instability of an Impacting Drop Vortex Ring

DEFF Research Database (Denmark)

Sigurdson, Lorenz; Wiwchar, Justin; Walther, Jens Honore

2013-01-01

, a Rayleigh centrifugal instability, or a vortex breakdown-type instability. Simulations which simply have a perturbed solitary ring result in an instability similar to that seen experimentally. Waviness of the core which would be expected from a Widnall instability is not visible. Adding an opposite......-signed secondary vortex ring or an image vortex ring to the initial conditions, to trigger a Rayleigh or breakdown respectively, does not appear to significantly change the instability from what is seen with a solitary ring. This suggests that a Rayleigh or vortex breakdown-type instability are not likely at work......Computational vortex particle method simulations of a perturbed vortex ring are performed to recreate and understand the instability seen in impacting water drop experiments. Three fundamentally different initial vorticity distributions are used to attempt to trigger a Widnall instability...

Social capital practices as adaptive drivers for local adjustment of new public management in schools

DEFF Research Database (Denmark)

Olesen, Kristian Gylling; Hasle, Peter; Sørensen, Ole H.

2016-01-01

local adjustments of the reform initiatives, while also revealing some ambiguities. The results demonstrate that some reform initiatives can lead to new collaborative leadership and management practices in schools that solve the central school leadership and management tasks of coordination and planning....... This indicates that collaborative leadership and management practices may emerge from NPM reforms, and that such practices can prevent negative outcomes of such reforms....... on empirical case studies from two Danish municipal schools and the concept of organisational social capital, we investigate how two reform initiatives – ‘student plan-based school–home collaboration’ and ‘teamwork’ – were locally adjusted into collaborative practices. The analysis demonstrates surprising...

Decomposing cross-country differences in quality adjusted life expectancy: the impact of value sets.

Science.gov (United States)

Heijink, Richard; van Baal, Pieter; Oppe, Mark; Koolman, Xander; Westert, Gert

2011-06-23

The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL). We focused on the impact of value set choice on cross-country variation. We calculated Quality Adjusted Life Expectancy (QALE) at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers of differences in health-state values across populations. This

Decomposing cross-country differences in quality adjusted life expectancy: the impact of value sets

Directory of Open Access Journals (Sweden)

Oppe Mark

2011-06-01

Full Text Available Abstract Background The validity, reliability and cross-country comparability of summary measures of population health (SMPH have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL. We focused on the impact of value set choice on cross-country variation. Methods We calculated Quality Adjusted Life Expectancy (QALE at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. Results QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. Conclusions The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers

The Impact of Sex of Child on Breastfeeding in the United States.

Science.gov (United States)

Shafer, Emily Fitzgibbons; Hawkins, Summer Sherburne

2017-11-01

Background Sex of child has been shown to impact breastfeeding duration in India, Australia, Scandinavia, Latin America, and, within the US, in a sample in Eastern Connecticut and in a separate sample of Indian and Chinese immigrants. Objectives The objective of this study is to examine differences in breastfeeding initiation and duration by sex of child across racial/ethnic groups in the US. Methods We used the Pregnancy Risk Assessment Monitoring System 2009-2010 and logistic regression to examine whether sex of child impacts breastfeeding initiation and duration for at least 8 weeks by women's racial/ethnic group. Results Among the 66,107 women in our sample representing 12 different race/ethnic groups, Hispanic women (n = 9049) had lower odds of breastfeeding initiation (adjusted odds ratio [AOR] = 0.81, 95% CI 0.71-0.93) and breastfeeding duration (AOR = .87, 95% CI 0.80-0.96) if they have sons compared to Hispanic women who have daughters. Sex of child did not impact the odds of breastfeeding initiation or duration among any other race/ethnic group. Conclusion We have shown that, for Hispanics in the US, sex of child may have an impact on breastfeeding, a health behavior that has a variety of positive impacts on infants throughout their lives. Boys, relative to girls, were at a disadvantage in breastfeeding initiation and duration. Future work is necessary to unpack the mechanisms behind these findings. In particular, how sex of child impacts how mothers and fathers view the nutritional needs of their children and breastfeeding more broadly.

The impact of premorbid adjustment, neurocognition, and depression on social and role functioning in patients in an early psychosis treatment program.

Science.gov (United States)

Minor, Kyle S; Friedman-Yakoobian, Michelle; Leung, Y Jude; Meyer, Eric C; Zimmet, Suzanna V; Caplan, Brina; Monteleone, Thomas; Bryant, Caitlin; Guyer, Margaret; Keshavan, Matcheri S; Seidman, Larry J

2015-05-01

Functional impairments are debilitating concomitants of psychotic disorders and are present early in the illness course and, commonly, prior to psychosis onset. The factors affecting social and role functioning in early psychosis (EP) following treatment are unclear. We evaluated whether six months of participation in the PREP(R), Boston, EP treatment program, part of a public-academic community mental health center, was related to improvements in social and role functioning and whether premorbid adjustment in adolescence, baseline neurocognition, and depression symptoms predicted functional improvement. The Global Functioning Social and Role scales, MATRICS neurocognitive battery, and Calgary Depression Scale were assessed at baseline and six months during naturalistic treatment, while premorbid adjustment was measured at baseline. All participants were psychotic disorder patients in PREP(R) (n = 46 with social functioning and 47 with role functioning measures at both time points). Large improvements were observed in role functioning (d = 0.84) and medium to large improvements were observed in social functioning (d = 0.70). Models consisting of adolescent premorbid adjustment and change in depression symptoms predicted social and role functioning change, whereas neuropsychological functioning did not. Substantial improvements in social and role functioning were observed among this sample participating in a recovery-based EP program. The impact of clinical factors on social and role functioning was highlighted. Further studies of premorbid adjustment in adolescence and the treatment of depression in EP programs in controlled treatment trials are needed to confirm these findings. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Adjusting Wages to Living Costs: A Historical Note

Science.gov (United States)

Lowenstern, Henry

1974-01-01

The significant historical developments of the cost of living wage adjustments are summarized. Since the concept of cost of living took effect in 1919, developments that are noted are: World War II, the GM contract 1948, the GM Contract 1950, and the impact of the agreements. (DS)

Adjustment costs in a two-capital growth model

Czech Academy of Sciences Publication Activity Database

Duczynski, Petr

2002-01-01

Roč. 26, č. 5 (2002), s. 837-850 ISSN 0165-1889 R&D Projects: GA AV ČR KSK9058117 Institutional research plan: CEZ:AV0Z7085904 Keywords : adjustment costs * capital mobility * convergence * human capital Subject RIV: AH - Economics Impact factor: 0.738, year: 2002

A New and Versatile Adjustable Rigidity Actuator with Add-on Locking Mechanism (ARES-XL

Directory of Open Access Journals (Sweden)

Manuel Cestari

2018-01-01

Full Text Available Adjustable compliant actuators are being designed and implemented in robotic devices because of their ability to minimize large forces due to impacts, to safely interact with the user, and to store and release energy in passive elastic elements. Conceived as a new force-controlled compliant actuator, an adjustable rigidity with embedded sensor and locking mechanism actuator (ARES-XL is presented in this paper. This compliant system is intended to be implemented in a gait exoskeleton for children with neuro muscular diseases (NMDs to exploit the intrinsic dynamics during locomotion. This paper describes the mechanics and initial evaluation of the ARES-XL, a novel variable impedance actuator (VIA that allows the implementation of an add-on locking mechanism to this system, and in combination with its zero stiffness capability and large deflection range, provides this novel joint with improved properties when compared to previous prototypes developed by the authors and other state-of-the-art (SoA devices. The evaluation of the system proves how this design exceeds the main capabilities of a previous prototype as well as providing versatile actuation that could lead to its implementation in multiple joints.

Using multilevel modeling to assess case-mix adjusters in consumer experience surveys in health care.

Science.gov (United States)

Damman, Olga C; Stubbe, Janine H; Hendriks, Michelle; Arah, Onyebuchi A; Spreeuwenberg, Peter; Delnoij, Diana M J; Groenewegen, Peter P

2009-04-01

Ratings on the quality of healthcare from the consumer's perspective need to be adjusted for consumer characteristics to ensure fair and accurate comparisons between healthcare providers or health plans. Although multilevel analysis is already considered an appropriate method for analyzing healthcare performance data, it has rarely been used to assess case-mix adjustment of such data. The purpose of this article is to investigate whether multilevel regression analysis is a useful tool to detect case-mix adjusters in consumer assessment of healthcare. We used data on 11,539 consumers from 27 Dutch health plans, which were collected using the Dutch Consumer Quality Index health plan instrument. We conducted multilevel regression analyses of consumers' responses nested within health plans to assess the effects of consumer characteristics on consumer experience. We compared our findings to the results of another methodology: the impact factor approach, which combines the predictive effect of each case-mix variable with its heterogeneity across health plans. Both multilevel regression and impact factor analyses showed that age and education were the most important case-mix adjusters for consumer experience and ratings of health plans. With the exception of age, case-mix adjustment had little impact on the ranking of health plans. On both theoretical and practical grounds, multilevel modeling is useful for adequate case-mix adjustment and analysis of performance ratings.

Measuring Profitability Impacts of Information Technology: Use of Risk Adjusted Measures.

Science.gov (United States)

Singh, Anil; Harmon, Glynn

2003-01-01

Focuses on understanding how investments in information technology are reflected in the income statements and balance sheets of firms. Shows that the relationship between information technology investments and corporate profitability is much better explained by using risk-adjusted measures of corporate profitability than using the same measures…

Storm Water Management Model Climate Adjustment Tool (SWMM-CAT)

Science.gov (United States)

The US EPA’s newest tool, the Stormwater Management Model (SWMM) – Climate Adjustment Tool (CAT) is meant to help municipal stormwater utilities better address potential climate change impacts affecting their operations. SWMM, first released in 1971, models hydrology and hydrauli...

Convexity Adjustments

DEFF Research Database (Denmark)

M. Gaspar, Raquel; Murgoci, Agatha

2010-01-01

A convexity adjustment (or convexity correction) in fixed income markets arises when one uses prices of standard (plain vanilla) products plus an adjustment to price nonstandard products. We explain the basic and appealing idea behind the use of convexity adjustments and focus on the situations...

Unmitigated agency, social support, and psychological adjustment in men with cancer.

Science.gov (United States)

Hoyt, Michael A; Stanton, Annette L

2011-04-01

Unmitigated agency (UA), a gender-linked characteristic, has been associated with poorer cancer adjustment. Support from one's social network typically predicts adjustment but may be poorly matched to UA. The influence of UA on the utility of social support on adjustment over time is examined. Men with cancer (N=55) were assessed initially and 6 months later on three indicators of adjustment. Multilevel modeling analyses varied by adjustment indicator. UA was associated with increased cancer-related psychosocial symptoms but not depressive symptoms or cancer-related thought intrusion. Social support predicted fewer depressive symptoms and less cancer-related thought intrusion. However, a cross-level interaction revealed that the utility of social support on cancer-related thought intrusion was weaker for men with greater levels of UA. Men with cancer likely respond differently to changes in social support depending on their endorsement of UA. © 2011 The Authors. Journal of Personality © 2011, Wiley Periodicals, Inc.

Concern about aspects of body image and adjustment to early stage breast cancer.

Science.gov (United States)

Carver, C S; Pozo-Kaderman, C; Price, A A; Noriega, V; Harris, S D; Derhagopian, R P; Robinson, D S; Moffat, F L

1998-01-01

Several authors have suggested that patients adjust more poorly to breast cancer if they are heavily invested in body image as a source of their sense of self-worth. This prospective study examined this possibility, looking at two aspects of concern about body image as predictors of several indices of adjustment over the first postoperative year. At diagnosis (and again a year later) 66 women with early stage breast cancer reported how much they valued a) a sense of body integrity (or intactness) and b) a good physical appearance. The day before surgery, a week afterward, and at 3-month, 6-month, and 12-month follow ups, they reported on their mood. At presurgery and at follow ups they also rated their attractiveness and sexual desirability and reported on frequency of sexual interaction. At follow-ups they also indicated how much their illness and treatment were interfering with social and recreational activities. Initial investment in appearance was related to distress across the postsurgical year. In contrast, investment in appearance made women more resilient against deterioration in their perceptions of attractiveness. Concern about body integrity did not strongly predict emotional distress, but it related to adverse impact on social and recreational activities in the follow-up period, to deterioration in feelings of sexual desirability, and to feelings of alienation from the self (feeling "not like yourself anymore"). Body image is often thought of in terms of physical appearance, but there is also a body image pertaining to integrity, wholeness, and normal functioning. People who are greatly concerned about either aspect of their body image are vulnerable to poorer psychosocial adjustment when confronting treatment for breast cancer. The poorer adjustment takes a different form, however, depending on the nature of the patient's body-image concern.

Technology-Enhanced Science Partnership Initiative: Impact on Secondary Science Teachers

Science.gov (United States)

Ng, Wan; Fergusson, Jennifer

2017-07-01

The issue of student disengagement in school science continues to pose a threat to lifting the participation rates of students undertaking STEM courses and careers in Australia and other countries globally. In Australia, several science initiatives to reverse the problem have been funded over the last two decades. Many of these initiatives involve partnerships with scientists, science educators and with industries, as is the case in this paper. The research in this paper investigated a recent partnership initiative between secondary science teachers, scientists and an educational technology company to produce science e-modules on adaptive learning platforms, enabling students to engage in personalised, inquiry-based learning and the investigation of real-world problems. One of the objectives of the partnership project was to build theoretical and pedagogical skills in teachers to deliver science by exposing them to new ways of engaging students with new digital tools, for example analytics. Using a mixed methods approach, the research investigated science teachers' pedagogical involvement in the partnership project and their perceptions of the project's impact on their teaching and students' learning. The findings indicate that the teachers believed that new technology could enhance their teaching and students' learning and that while their students were motivated by the online modules, there was still a need for scaffolding for many of the students. The effectiveness of this would depend on the teachers' ability to internalise the new technological and content knowledge resulting from the partnership and realign them with their existing pedagogical framework. The research is significant in identifying elements for successful partnership projects as well as challenges that need to be considered. It is significant in facilitating continuous discourse about new evidence-based pedagogical approaches to science education in engaging students to learn STEM subjects in a

An Introduction to Cost-of-Living Adjustments in Public Retirement Plans: Details Matter

Science.gov (United States)

Jennings, Penelope R.; Jennings, William P.; Phillips, G. Michael

2016-01-01

While financial planning students are expected to be able to understand client retirement plans, subtle differences in cost-of-living adjustments can have major impact on the success of client retirement plans. This teaching note compares the cost-of-living adjustments in the largest government sponsored retirement systems and a hypothetical…

Children's adjustment to their divorced parents' new relationships.

Science.gov (United States)

Isaacs, Ar

2002-08-01

With new relationships common after divorce, researchers have tried to determine the factors that predict how well children adjust to their stepfamily. The many potential factors are often grouped into the categories of family process, individual risk and vulnerability, and ecological variables. Family process is concentrated on the impact of disrupted family relationships; positive outcomes are associated with low conflict and authoritative parenting. Individual risk and vulnerability includes attributes of the child and the adults; positive outcomes are associated with children who have an easy temperament. Adolescents and girls may have particular difficulty adjusting. Ecological perspectives include the larger social environment such as peers and school.

African marketing boards under structural adjustment : the experience of Sub-Saharan Africa during the 1980s

NARCIS (Netherlands)

Laan, van der H.L.; Haaren, van W.T.M.

1990-01-01

Sum.: The economic policy of structural adjustment, which was initiated in most African countries during the 1980s, posed a serious threat to agricultural marketing boards in sub-Saharan Africa. Two elements of structural adjustment were particularly ominous: 'privatization' threatened the continued

Parental smoking, exposure to secondhand smoke at home, and smoking initiation among young children.

Science.gov (United States)

Wang, Man Ping; Ho, Sai Yin; Lam, Tai Hing

2011-09-01

To investigate the associations of parental smoking and secondhand smoke (SHS) exposure at home with smoking initiation among young children in Hong Kong. A prospective school-based survey of Hong Kong primary 2-4 students was conducted at baseline in 2006 and followed up in 2008. Self-administered anonymous questionnaires were used to collect information about smoking, SHS exposure at home, parental smoking, and sociodemographic characteristics. Cross-sectional and prospective associations of SHS exposure at home and parental smoking with student smoking were analyzed using logistic regression adjusting for potential confounders. Cross-sectional association between parental smoking and ever smoking was significant with adjustment of sociodemographic characteristics but became insignificant after adjusting for home SHS exposure. Home SHS exposure mediated the association between parental smoking and students smoking (p = .03). Prospectively, parental smoking was not associated with smoking initiation after adjusting for home SHS exposure. Each day increase in home SHS exposure significantly predicted 16% excess risk of smoking initiation after adjusting for parental smoking. The prospective effect of parental smoking on smoking initiation was significantly mediated by baseline home SHS exposure (p smoking initiation of young Chinese children in Hong Kong independent of parental smoking status. On the other hand, the effect of parental smoking on smoking initiation was mediated through SHS exposure at home. To prevent children from smoking as well as the harm of SHS exposure, parents and other family members should quit smoking or at least reduce smoking at home.

Mexican-origin parents' work conditions and adolescents' adjustment.

Science.gov (United States)

Wheeler, Lorey A; Updegraff, Kimberly A; Crouter, Ann

2015-06-01

Mexican-origin parents' work experiences are a distal extrafamilial context for adolescents' adjustment. This 2-wave multiinformant study examined the prospective mechanisms linking parents' work conditions (i.e., self-direction, work pressure, workplace discrimination) to adolescents' adjustment (i.e., educational expectations, depressive symptoms, risky behavior) across the transition to high school drawing on work socialization and spillover models. We examined the indirect effects of parental work conditions on adolescent adjustment through parents' psychological functioning (i.e., depressive symptoms, role overload) and aspects of the parent-adolescent relationship (i.e., parental solicitation, parent-adolescent conflict), as well as moderation by adolescent gender. Participants were 246 predominantly immigrant, Mexican-origin, 2-parent families who participated in home interviews when adolescents were approximately 13 and 15 years of age. Results supported the positive impact of fathers' occupational self-direction on all 3 aspects of adolescents' adjustment through decreased father-adolescent conflict, after controlling for family socioeconomic status and earner status, and underemployment. Parental work pressure and discrimination were indirectly linked to adolescents' adjustment, with different mechanisms emerging for mothers and fathers. Adolescents' gender moderated the associations between fathers' self-direction and girls' depressive symptoms, and fathers' experiences of discrimination and boys' risk behavior. Results suggest that Mexican-origin mothers' and fathers' perceptions of work conditions have important implications for multiple domains of adolescents' adjustment across the transition to high school. (c) 2015 APA, all rights reserved).

Impact of Advanced Practice Registered Nurses on Quality Measures: The Missouri Quality Initiative Experience.

Science.gov (United States)

Rantz, Marilyn J; Popejoy, Lori; Vogelsmeier, Amy; Galambos, Colleen; Alexander, Greg; Flesner, Marcia; Murray, Cathy; Crecelius, Charles; Ge, Bin; Petroski, Gregory

2018-06-01

The purpose of this article is to review the impact of advanced practice registered nurses (APRNs) on the quality measure (QM) scores of the 16 participating nursing homes of the Missouri Quality Initiative (MOQI) intervention. The MOQI was one of 7 program sites in the US, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services Innovations Center. While the goals of the MOQI for long-stay nursing home residents did not specifically include improvement of the QM scores, it was anticipated that improvement most likely would occur. Primary goals of the MOQI were to reduce the frequency of avoidable hospital admissions and readmissions; improve resident health outcomes; improve the process of transitioning between inpatient hospitals and nursing facilities; and reduce overall healthcare spending without restricting access to care or choice of providers. A 2-group comparison analysis was conducted using statewide QMs; a matched comparison group was selected from facilities in the same counties as the intervention homes, similar baseline QM scores, similar size and ownership. MOQI nursing homes each had an APRN embedded full-time to improve care and help the facility achieve MOQI goals. Part of their clinical work with residents and staff was to focus on quality improvement strategies with potential to influence healthcare outcomes. Trajectories of QM scores for the MOQI intervention nursing homes and matched comparison group homes were tested with nonparametric tests to examine for change in the desired direction between the 2 groups from baseline to 36 months. A composite QM score for each facility was constructed, and baseline to 36-month average change scores were examined using nonparametric tests. Then, adjusting for baseline, a repeated measures analysis using analysis of covariance as conducted. Composite QM scores of the APRN intervention group were significantly better (P = .025) than the comparison group

Children's adjustment in conflicted marriage and divorce: a decade review of research.

Science.gov (United States)

Kelly, J B

2000-08-01

To review important research of the past decade in divorce, marital conflict, and children's adjustment and to describe newer divorce interventions. Key empirical studies from 1990 to 1999 were surveyed regarding the impact of marital conflict, parental violence, and divorce on the psychological adjustment of children, adolescents, and young adults. Recent studies investigating the impact of divorce on children have found that many of the psychological symptoms seen in children of divorce can be accounted for in the years before divorce. The past decade also has seen a large increase in studies assessing complex variables within the marriage which profoundly affect child and adolescent adjustment, including marital conflict and violence and related parenting behaviors. This newer literature provides provocative and helpful information for forensic and clinical psychiatrists in their work with both married and divorcing families. While children of divorced parents, as a group, have more adjustment problems than do children of never-divorced parents, the view that divorce per se is the major cause of these symptoms must be reconsidered in light of newer research documenting the negative effects of troubled marriages on children.

Assisting Older Persons With Adjusting to Hearing Aids.

Science.gov (United States)

Lane, Kari R; Clark, M Kathleen

2016-02-01

This intervention study tested the feasibility and initial effect of Hearing Aid Reintroduction (HEAR) to assist persons aged 70 to 85 years adjust to hearing aids. Following this 30-day intervention, hearing aid use increased between 1 and 8 hr per day with 50% of participants able to wear them for at least 4 hr. Hearing aid satisfaction improved from not satisfied to satisfied overall. The study demonstrated that HEAR is feasible and could improve hearing aid use of a substantial number of older persons who had previously failed to adjust to their hearing aids and had given up. However, further testing among a larger and more diverse population is needed to better understand the effectiveness and sustainability of the intervention. © The Author(s) 2014.

18 CFR 385.1104 - Initial petition (Rule 1104).

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Initial petition (Rule... COMMISSION, DEPARTMENT OF ENERGY PROCEDURAL RULES RULES OF PRACTICE AND PROCEDURE Petitions for Adjustments Under the NGPA § 385.1104 Initial petition (Rule 1104). (a) Content. (1) The petition must contain: (i...

Tropical cyclone losses in the USA and the impact of climate change - A trend analysis based on data from a new approach to adjusting storm losses

International Nuclear Information System (INIS)

Schmidt, Silvio; Kemfert, Claudia; Hoeppe, Peter

2009-01-01

Economic losses caused by tropical cyclones have increased dramatically. Historical changes in losses are a result of meteorological factors (changes in the incidence of severe cyclones, whether due to natural climate variability or as a result of human activity) and socio-economic factors (increased prosperity and a greater tendency for people to settle in exposed areas). This paper aims to isolate the socio-economic effects and ascertain the potential impact of climate change on this trend. Storm losses for the period 1950-2005 have been adjusted to the value of capital stock in 2005 so that any remaining trend cannot be ascribed to socio-economic developments. For this, we introduce a new approach to adjusting losses based on the change in capital stock at risk. Storm losses are mainly determined by the intensity of the storm and the material assets, such as property and infrastructure, located in the region affected. We therefore adjust the losses to exclude increases in the capital stock of the affected region. No trend is found for the period 1950-2005 as a whole. In the period 1971-2005, since the beginning of a trend towards increased intense cyclone activity, losses excluding socio-economic effects show an annual increase of 4% per annum. This increase must therefore be at least due to the impact of natural climate variability but, more likely than not, also due to anthropogenic forcings.

Approaches to evaluating climate change impacts on species: A guide to initiating the adaptation planning process

Science.gov (United States)

Erika L. Rowland; Jennifer E. Davison; Lisa J. Graumlich

2011-01-01

Assessing the impact of climate change on species and associated management objectives is a critical initial step for engaging in the adaptation planning process. Multiple approaches are available. While all possess limitations to their application associated with the uncertainties inherent in the data and models that inform their results, conducting and incorporating...

Initial experience with the Codman Certas adjustable valve in the management of patients with hydrocephalus

DEFF Research Database (Denmark)

Watt, Sara; Agerlin, Niels; Romner, Bertil

2012-01-01

A new adjustable valve, the Codman CertasTM valve for treatment of hydrocephalus was introduced into clinical practice in January 2011. It has 8 different settings with an opening pressure varying from 36 to over 400 mm H2O at a flow rate of 20 mL/h. The 8th setting is designed to provide...

Performance of an Adjustable Strength Permanent Magnet Quadrupole

CERN Document Server

Gottschalk, Stephen C; Kangas, Kenneth; Spencer, Cherrill M; Volk, James T

2005-01-01

An adjustable strength permanent magnet quadrupole suitable for use in Next Linear Collider has been built and tested. The pole length is 42cm, aperture diameter 13mm, peak pole tip strength 1.03Tesla and peak integrated gradient * length (GL) is 68.7 Tesla. This paper describes measurements of strength, magnetic centerline and field quality made using an air bearing rotating coil system. The magnetic centerline stability during -20% strength adjustment proposed for beam based alignment was < 0.2 microns. Strength hysteresis was negligible. Thermal expansion of quadrupole and measurement parts caused a repeatable and easily compensated change in the vertical magnetic centerline. Calibration procedures as well as centerline measurements made over a wider tuning range of 100% to 20% in strength useful for a wide range of applications will be described. The impact of eddy currents in the steel poles on the magnetic field during strength adjustments will be reported.

Positioning accuracy analysis of adjusting target mechanism of three-dimensional attitude

International Nuclear Information System (INIS)

Ma Li; Wang Kun; Sun Linzhi; Zhou Shasha

2012-01-01

A novel adjusting target mechanism of three-dimensional attitude is presented according to the characteristics of the target transport subsystem in inertial confinement fusion (ICF). The mechanism consists of a tangent mechanism adjusting rotation angle and a set of orthogonal tangent mechanism adjusting two-dimensional deflection angles. The structural parameters of the adjusting target mechanism are analyzed according to principle errors, structure errors and motion errors of following. The analysis results indicate that the system error of the adjusting target mechanism is influenced by the displacement of the linear actuators, the actuator ball radius, the working radius of the tangent mechanism, the angle error of the inclined installation hole, the centralization error of the actuators, the orthogonal error of the two tangent mechanism, and the angle errors of the inclined target rod inclined rotation shaft. The errors of the inclined target rod and inclined rotation shaft are the two greatest impact factors, the spherical contact error is the next. By means of precise assembly and control system compensation, the accuracy of the adjusting target mechanism can be less than 0.1 mrad. (authors)

Impact and Process Evaluation of the U.S. Department of Energy's Wind Powering America Initiative

Energy Technology Data Exchange (ETDEWEB)

None

2013-05-01

This report presents an evaluation of the impacts and processes of the former Wind Powering America(WPA) initiative sponsored by the U.S. Department of Energy (DOE). WPA has an underlying goal of dramatically increasing the use of wind energy in the U.S.

Empirical evidence for resource-rational anchoring and adjustment.

Science.gov (United States)

Lieder, Falk; Griffiths, Thomas L; M Huys, Quentin J; Goodman, Noah D

2018-04-01

People's estimates of numerical quantities are systematically biased towards their initial guess. This anchoring bias is usually interpreted as sign of human irrationality, but it has recently been suggested that the anchoring bias instead results from people's rational use of their finite time and limited cognitive resources. If this were true, then adjustment should decrease with the relative cost of time. To test this hypothesis, we designed a new numerical estimation paradigm that controls people's knowledge and varies the cost of time and error independently while allowing people to invest as much or as little time and effort into refining their estimate as they wish. Two experiments confirmed the prediction that adjustment decreases with time cost but increases with error cost regardless of whether the anchor was self-generated or provided. These results support the hypothesis that people rationally adapt their number of adjustments to achieve a near-optimal speed-accuracy tradeoff. This suggests that the anchoring bias might be a signature of the rational use of finite time and limited cognitive resources rather than a sign of human irrationality.

Impact of generic antiretroviral therapy (ART) and free ART programs on time to initiation of ART at a tertiary HIV care center in Chennai, India.

Science.gov (United States)

Solomon, Sunil S; Lucas, Gregory M; Kumarasamy, Nagalingeswaran; Yepthomi, Tokugha; Balakrishnan, Pachamuthu; Ganesh, Aylur K; Anand, Santhanam; Moore, Richard D; Solomon, Suniti; Mehta, Shruti H

2013-08-01

Antiretroviral therapy (ART) access in the developing world has improved, but whether increased access has translated to more rapid treatment initiation among those who need it is unknown. We characterize time to ART initiation across three eras of ART availability in Chennai, India (1996-1999: pregeneric; 2000-2003: generic; 2004-2007: free rollout). Between 1996 and 2007, 11,171 patients registered for care at the YR Gaitonde Centre for AIDS Research and Education (YRGCARE), a tertiary HIV referral center in southern India. Of these, 5726 patients became eligible for ART during this period as per Indian guidelines for initiation of ART. Generalized gamma survival models were used to estimate relative times (RT) to ART initiation by calendar periods of eligibility. Time to initiation of ART among patients in Chennai, India was also compared to an HIV clinical cohort in Baltimore, USA. Median age of the YRGCARE patients was 34 years; 77% were male. The median CD4 at presentation was 140 cells/µl. After adjustment for demographics, CD4 and WHO stage, persons in the pregeneric era took 3.25 times longer (95% confidence interval [CI]: 2.53-4.17) to initiate ART versus the generic era and persons in the free rollout era initiated ART more rapidly than the generic era (RT: 0.73; 95% CI: 0.63-0.83). Adjusting for differences across centers, patients at YRGCARE took longer than patients in the Johns Hopkins Clinical Cohort (JHCC) to initiate ART in the pregeneric era (RT: 4.90; 95% CI: 3.37-7.13) but in the free rollout era, YRGCARE patients took only about a quarter of the time (RT: 0.31; 95% CI: 0.22-0.44). These data demonstrate the benefits of generic ART and government rollouts on time to initiation of ART in one developing country setting and suggests that access to ART may be comparable to developed country settings.

Husbands' perceptions of their wives' breast cancer coping efficacy: testing congruence models of adjustment.

Science.gov (United States)

Merluzzi, Thomas V; Martinez Sanchez, MaryAnn

2018-01-01

Recent reviews have reinforced the notion that having a supportive spouse can help with the process of coping with and adjusting to cancer. Congruence between spouses' perspectives has been proposed as one mechanism in that process, yet alternative models of congruence have not been examined closely. This study assessed alternative models of congruence in perceptions of coping and their mediating effects on adjustment to breast cancer. Seventy-two women in treatment for breast cancer and their husbands completed measures of marital adjustment, self-efficacy for coping, and adjustment to cancer. Karnofsky Performance Status was obtained from medical records. Wives completed a measure of self-efficacy for coping (wives' ratings of self-efficacy for coping [WSEC]) and husbands completed a measure of self-efficacy for coping (husbands' ratings of wives' self-efficacy for coping [HSEC]) based on their perceptions of their wives' coping efficacy. Interestingly, the correlation between WSEC and HSEC was only 0.207; thus, they are relatively independent perspectives. The following three models were tested to determine the nature of the relationship between WSEC and HSEC: discrepancy model (WSEC - HSEC), additive model (WSEC + HSEC), and multiplicative model (WSEC × HSEC). The discrepancy model was not related to wives' adjustment; however, the additive ( B =0.205, P <0.001) and multiplicative ( B =0.001, P <0.001) models were significantly related to wives' adjustment. Also, the additive model mediated the relationship between performance status and adjustment. Husbands' perception of their wives' coping efficacy contributed marginally to their wives' adjustment, and the combination of WSEC and HSEC mediated the relationship between functional status and wives' adjustment, thus positively impacting wives' adjustment to cancer. Future research is needed to determine the quality of the differences between HSEC and WSEC in order to develop interventions to optimize the

Do transition towns have the potential to promote health and well-being? A health impact assessment of a transition town initiative.

Science.gov (United States)

Richardson, J; Nichols, A; Henry, T

2012-11-01

Climate change and energy vulnerability present significant challenges for the development and sustainability of our communities. The adverse effects will most likely impact on those already experiencing poverty, as energy and food costs will rise, thus increasing inequalities in health. Transition town initiatives seek to build cohesive sustainable communities to prepare for a future with limited oil and a changing climate. Increasingly, public health practitioners are interested in the role of transition towns as a community development initiative, and their potential to support the wider public health agenda. Health impact assessment (HIA) is an evidence-based process that aims to predict the positive and negative impacts of a strategy, proposal or development. The HIA process provides an opportunity to promote sustainable communities by ensuring that new strategies and developments are considered in the context of their contribution to the health and well-being of local populations. The aim of this study was to use an HIA to examine the potential health and well-being benefits of two related transition town initiatives. A rapid HIA to consider the potential lifestyle changes and health and well-being impacts of Transition Together/Transition Streets (TT/TS) projects. An HIA template was used to assess key documents related to the TT/TS initiatives and those related to the characteristics of the community. Additionally, meetings with 12 key informants (four involved in TT/TS and eight purposively selected for their local knowledge) were held using the HIA template to focus the discussion. The findings highlight the associated lifestyle changes such as increased physical activity and healthy eating, and possible social and well-being benefits of engagement in such an initiative. Engagement may be limited to those already concerned about environmental issues. This paper illustrates the important links between transition towns and the wider public health agenda

Initial Northwest Power Act Power Sales Contracts : Final Environmental Impact Statement. Volume 4, Comments and Responses.

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration.

1992-01-01

This volume of the Initial Northwest Power Act Power Sales Contracts Final Environmental Impact Statement (Final EIS) contains public comments addressing the Initial Northwest Power Act Power Sales Contracts Draft EIS, August 1990 and Bonneville Power Administration`s (BPA) responses. The Introduction provides information about the process BPA follows in addressing these comments. Part I contains a listing of the Alternative Actions evaluated in the Final EIS; Part II is organized by Alternatives and includes summaries of the comments and BPA responses; Part III provides copies of the original comments letters, and, for ease of identification, are coded in the margins according to the alternative(s) addressed.

Application of the Aquifer Impact Model to support decisions at a CO ₂ sequestration site: Modeling and Analysis: Application of the Aquifer Impact Model to support decisions at a CO ₂

Energy Technology Data Exchange (ETDEWEB)

Bacon, Diana Holford [Pacific Northwest National Laboratory, Richland WA USA; Locke II, Randall A. [University of Illinois, Illinois State Geological Survey Champaign IL USA; Keating, Elizabeth [Los Alamos National Laboratory, Los Alamos NM USA; Carroll, Susan [Lawrence Livermore National Laboratory, Livermore CA USA; Iranmanesh, Abbas [University of Illinois, Illinois State Geological Survey Champaign IL USA; Mansoor, Kayyum [Lawrence Livermore National Laboratory, Livermore CA USA; Wimmer, Bracken [University of Illinois, Illinois State Geological Survey Champaign IL USA; Zheng, Liange [Lawrence Berkeley National Laboratory, Berkeley CA USA; Shao, Hongbo [University of Illinois, Illinois State Geological Survey Champaign IL USA; Greenberg, Sallie E. [University of Illinois, Illinois State Geological Survey Champaign IL USA

2017-10-04

The National Risk Assessment Partnership (NRAP) has developed a suite of tools to assess and manage risk at CO2 sequestration sites (1). The NRAP tool suite includes the Aquifer Impact Model (AIM), based on reduced order models developed using site-specific data from two aquifers (alluvium and carbonate). The models accept aquifer parameters as a range of variable inputs so they may have more broad applicability. Guidelines have been developed for determining the aquifer types for which the ROMs should be applicable. This paper considers the applicability of the aquifer models in AIM to predicting the impact of CO2 or Brine leakage were it to occur at the Illinois Basin Decatur Project (IBDP). Based on the results of the sensitivity analysis, the hydraulic parameters and leakage source term magnitude are more sensitive than clay fraction or cation exchange capacity. Sand permeability was the only hydraulic parameter measured at the IBDP site. More information on the other hydraulic parameters, such as sand fraction and sand/clay correlation lengths, could reduce uncertainty in risk estimates. Some non-adjustable parameters, such as the initial pH and TDS and the pH no-impact threshold, are significantly different for the ROM than for the observations at the IBDP site. The reduced order model could be made more useful to a wider range of sites if the initial conditions and no-impact threshold values were adjustable parameters.

75 FR 1345 - Solicitation of Applications for the Community Trade Adjustment Assistance Program

Science.gov (United States)

2010-01-11

... communities respond to the loss of jobs caused by the layoffs at firms and other types of employers impacted..., planning, and infrastructure projects to help communities adapt to pressing trade impact issues and... the following three Trade Adjustment Assistance (TAA) programs: TAA for Workers, TAA for Firms, or TAA...

36 CFR 254.4 - Agreement to initiate an exchange.

Science.gov (United States)

2010-07-01

... exchange. 254.4 Section 254.4 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LANDOWNERSHIP ADJUSTMENTS Land Exchanges § 254.4 Agreement to initiate an exchange. (a) Exchanges may be proposed by the Forest Service or by any person, State, or local government. Initial exchange proposals...

Multi-model assessment of the impact of soil moisture initialization on mid-latitude summer predictability

Science.gov (United States)

Ardilouze, Constantin; Batté, L.; Bunzel, F.; Decremer, D.; Déqué, M.; Doblas-Reyes, F. J.; Douville, H.; Fereday, D.; Guemas, V.; MacLachlan, C.; Müller, W.; Prodhomme, C.

2017-12-01

Land surface initial conditions have been recognized as a potential source of predictability in sub-seasonal to seasonal forecast systems, at least for near-surface air temperature prediction over the mid-latitude continents. Yet, few studies have systematically explored such an influence over a sufficient hindcast period and in a multi-model framework to produce a robust quantitative assessment. Here, a dedicated set of twin experiments has been carried out with boreal summer retrospective forecasts over the 1992-2010 period performed by five different global coupled ocean-atmosphere models. The impact of a realistic versus climatological soil moisture initialization is assessed in two regions with high potential previously identified as hotspots of land-atmosphere coupling, namely the North American Great Plains and South-Eastern Europe. Over the latter region, temperature predictions show a significant improvement, especially over the Balkans. Forecast systems better simulate the warmest summers if they follow pronounced dry initial anomalies. It is hypothesized that models manage to capture a positive feedback between high temperature and low soil moisture content prone to dominate over other processes during the warmest summers in this region. Over the Great Plains, however, improving the soil moisture initialization does not lead to any robust gain of forecast quality for near-surface temperature. It is suggested that models biases prevent the forecast systems from making the most of the improved initial conditions.

Formation of Close-in Super-Earths by Giant Impacts: Effects of Initial Eccentricities and Inclinations of Protoplanets

Energy Technology Data Exchange (ETDEWEB)

Matsumoto, Yuji [Planetary Exploration Research Center, Chiba Institute of Technology, Narashino, Chiba, 275-0016 (Japan); Kokubo, Eiichiro, E-mail: ymatsumoto@cfca.nao.ac.jp [Center for Computational Astrophysics, National Astronomical Observatory of Japan, Osawa, Mitaka, Tokyo, 181-8588 (Japan)

2017-07-01

Recent observations have revealed the eccentricity and inclination distributions of close-in super-Earths. These distributions have the potential to constrain their formation processes. In the in situ formation scenario, the eccentricities and inclinations of planets are determined by gravitational scattering and collisions between protoplanets on the giant impact stage. We investigate the effect of the initial eccentricities and inclinations of protoplanets on the formation of close-in super-Earths. We perform N -body simulations of protoplanets in gas-free disks, changing the initial eccentricities and inclinations systematically. We find that while the eccentricities of protoplanets are well relaxed through their evolution, the inclinations are not. When the initial inclinations are small, they are not generally pumped up since scattering is less effective and collisions occur immediately after orbital crossing. On the other hand, when the initial inclinations are large, they tend to be kept large since collisional damping is less effective. Not only the resultant inclinations of planets, but also their number, eccentricities, angular momentum deficit, and orbital separations are affected by the initial inclinations of protoplanets.

Videoconferencing for site initiations in clinical studies: Mixed methods evaluation of usability, acceptability, and impact on recruitment.

Science.gov (United States)

Randell, Rebecca; Backhouse, Michael R; Nelson, E Andrea

2016-12-01

A critical issue for multicentre clinical studies is conducting site initiations, ensuring sites are trained in study procedures and comply with relevant governance requirements before they begin recruiting patients. How technology can support site initiations has not previously been explored. This study sought to evaluate use of off-the-shelf web-based videoconferencing to deliver site initiations for a large national multicentre study. Participants in the initiations, including podiatrists, diabetologists, trial coordinators, and research nurses, completed an online questionnaire based on the System Usability Scale (SUS) (N = 15). This was followed by semi-structured interviews, with a consultant diabetologist, a trial coordinator, and three research nurses, exploring perceived benefits and limitations of videoconferencing. The mean SUS score for the videoconferencing platform was 87.2 (SD = 13.7), suggesting a good level of usability. Interview participants perceived initiations delivered by videoconferencing as being more interactive and easier to follow than those delivered by teleconference. In comparison to face-to-face initiations, videoconferencing takes less time, easily fitting in with the work of staff at the local sites. Perceptions of impact on communication varied according to the hardware used. Off-the-shelf videoconferencing is a viable alternative to face-to-face site initiations and confers advantages over teleconferencing.

Initial validation of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale: study of Portuguese end-of-life cancer patients.

Science.gov (United States)

Pereira, Filomena Moreira Pinto; Santos, Célia Samarina Vilaça de Brito

2014-10-01

The Mini-Mental Adjustment to Cancer Scale (Mini-MAC) is a 29-item instrument designed to evaluate the responses developed by cancer patients during their mental adjustment to diagnosis and treatment. This study aims to validate the Mini-Mental Adjustment to Cancer Scale (Mini-MAC) translated and adapted to the Portuguese language and culture, in end-of-life cancer patients receiving palliative care. The instrument was administered to 346 Portuguese end-of-life cancer patients, receiving care through outpatient visits or admitted into palliative care units, without cognitive symptoms and with symptoms under control. A cross-sectional validation study using orthogonal rotation through the varimax method followed by convergent and discriminant validity. The analysis of the main components confirms the existence of five factors, demonstrating the validity of the construct, with good internal consistency in the subscales and Cronbach's alpha values between 0.78 and 0.93. Good test-retest reliability was also found, and r values for subscales ranged from 0.62 to 0.99. The instrument proved to be a reliable, valid and sensitive measure in the study of mental adjustment of Portuguese end-of-life patients with cancer receiving palliative care. Nurses can use the Mini-MAC Scale in research and clinical practice in order to evaluate the mental adjustment of Portuguese end-of-life cancer patients receiving palliative care. Copyright © 2014 Elsevier Ltd. All rights reserved.

A novel suture method to place and adjust peripheral nerve catheters

DEFF Research Database (Denmark)

Rothe, C.; Steen-Hansen, C.; Madsen, M. H.

2015-01-01

We have developed a peripheral nerve catheter, attached to a needle, which works like an adjustable suture. We used in-plane ultrasound guidance to place 45 catheters close to the femoral, saphenous, sciatic and distal tibial nerves in cadaver legs. We displaced catheters after their initial...

The impact of adjusted work conditions and disease-modifying drugs on work ability in multiple sclerosis.

Science.gov (United States)

Wickström, Anne; Fagerström, Maria; Wickström, Lucas; Granåsen, Gabriel; Dahle, Charlotte; Vrethem, Magnus; Sundström, Peter

2017-07-01

Multiple sclerosis (MS) is a neurological disorder that causes significantly reduced ability to work, and the Expanded Disability Status Scale (EDSS) is one of the main predictors for reduced work ability. To investigate how work requirements, flexible work conditions and disease-modifying drugs (DMDs) influence the work ability in relation to different EDSS grades in two MS populations. Work ability was studied in two MS populations: one in the southern and one in the northern part of Sweden, both demographically similar. In the latter population, more active work-promoting interventions have been practised and second-generation DMDs have been widely used from the onset of disease for several years. The proportion of MS patients who participated in the workforce or studied was significantly higher in the northern compared with the southern population ( p work conditions and were able to work more hours per week. Higher EDSS was associated with lower reduction in number of worked hours per week in the northern population ( p = 0.042). Our data indicated that treatment strategy and adjusted work conditions have impact on work ability in MS.

The Western Energy Corridor Initiative: Unconventional Fuel Development Issues, Impacts, and Management Assessment

Science.gov (United States)

Wolfsberg, A.; Hagood, M.; Pasqualini, D.; Wood, T.; Wilson, C.; Witkowski, M.; Levitt, D.; Pawar, R.; Keating, G.; Ziock, H.

2008-12-01

The United States is increasingly dependent on imported oil and gas; commodities for which other nations are competing and for which future supply may be inadequate to support our transportation fuel needs. Therefore, a renewed interest in 'harder-to-get' unconventional fuels has emerged in both industry and government with directed focus on world class hydrocarbon resources within a corridor extending from Canada southward through the Rocky Mountain States. Within this Western Energy Corridor, co-located with significant conventional hydrocarbon and renewable energy resources, lie some of the world's richest unconventional hydrocarbon resources in oil shales, oil sands and coal for coal-to-liquid conversion. However, development of these resources poses substantial environmental concerns as well as increasing competition for limited resources of water and habitat. With large-scale energy development in the predominantly rural region, local communities, infrastructures, and economies will face increasing demands for roads, electricity, law enforcement, labor, and other support services. The Western Energy Corridor Initiative (WECI) seeks to develop an integrated assessment of the impacts of unconventional fuel development, the interrelationships of planned energy developments in different basins, and the resultant demands placed on the region. This initial WECI study focuses on two of the most important current issues for industry, regulators, and stakeholders -- the assessment of carbon and water resources issues, impacts, and management strategies. Through scenario analyses using coupled systems and process level models, this study investigates the viability of integrated development of multiple energy resources in a carbon neutral and environmentally acceptable manner, and the interrelationships of various energy resource development plans. The modeling framework is designed to extend to include infrastructure, employment, training, fiscal and economic demands

Impact of Age at Smoking Initiation on Smoking-Related Morbidity and All-Cause Mortality.

Science.gov (United States)

Choi, Seung Hee; Stommel, Manfred

2017-07-01

Using a nationally representative sample of U.S. adults, the aims of this study were to examine the impact of early smoking initiation on the development of self-reported smoking-related morbidity and all-cause mortality. National Health Interview Survey data from 1997 through 2005 were linked to the National Death Index with follow-up to December 31, 2011. Two primary dependent variables were smoking-related morbidity and all-cause mortality; the primary independent variable was age of smoking initiation. The analyses included U.S. population of current and former smokers aged ≥30 years (N=90,278; population estimate, 73.4 million). The analysis relied on fitting logistic regression and Cox proportional hazards models. Among the U.S. population of smokers, 7.3% started smoking before age 13 years, 11.0% at ages 13-14 years, 24.2% at ages 15-16 years, 24.5% at ages 17-18 years, 14.5% at ages 19-20 years, and 18.5% at ages ≥21 years. Early smoking initiation before age 13 years was associated with increased risks for cardiovascular/metabolic (OR=1.67) and pulmonary (OR=1.79) diseases as well as smoking-related cancers (OR=2.1) among current smokers; the risks among former smokers were cardiovascular/metabolic (OR=1.38); pulmonary (OR=1.89); and cancers (OR=1.44). Elevated mortality was also related to early smoking initiation among both current (hazard ratio, 1.18) and former smokers (hazard ratio, 1.19). Early smoking initiation increases risks of experiencing smoking-related morbidities and all-cause mortality. These risks are independent of demographic characteristics, SES, health behaviors, and subsequent smoking intensity. Comprehensive tobacco control programs should be implemented to prevent smoking initiation and promote cessation among youth. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Impact of Group Support on Adjustment to Divorce by Single, Custodial Fathers.

Science.gov (United States)

Tedder, Sandra L.; And Others

1984-01-01

Discusses the effects of a support group for single, custodial fathers (N=36) on measures of divorce adjustment, loneliness, and self-concept. Results indicated that men who attended the group meetings made more positive changes than those who did not attend and indicated a desire for support, sharing, and discussion. (JAC)

Impact of Reduction Parameters on the Initial Performance and Stability of Ni/(Sc)YSZ Cermet Anodes for SOFCs

DEFF Research Database (Denmark)

Ebbehøj, Søren Lyng; Ramos, Tania; Mogensen, Mogens Bjerg

2012-01-01

In-situ reduction of Ni cermet anodes produces the porosity and influences the microstructure, performance and stability of the anodes. The impact on initial performance, stability and microstructure of two different reduction procedures currently in use at DTU Energy Conversion with reduction...

NET SALARY ADJUSTMENT

CERN Multimedia

Finance Division

2001-01-01

On 15 June 2001 the Council approved the correction of the discrepancy identified in the net salary adjustment implemented on 1st January 2001 by retroactively increasing the scale of basic salaries to achieve the 2.8% average net salary adjustment approved in December 2000. We should like to inform you that the corresponding adjustment will be made to your July salary. Full details of the retroactive adjustments will consequently be shown on your pay slip.

Sperm competition risk drives rapid ejaculate adjustments mediated by seminal fluid.

Science.gov (United States)

Bartlett, Michael J; Steeves, Tammy E; Gemmell, Neil J; Rosengrave, Patrice C

2017-10-31

In many species, males can make rapid adjustments to ejaculate performance in response to sperm competition risk; however, the mechanisms behind these changes are not understood. Here, we manipulate male social status in an externally fertilising fish, chinook salmon ( Oncorhynchus tshawytscha ), and find that in less than 48 hr, males can upregulate sperm velocity when faced with an increased risk of sperm competition. Using a series of in vitro sperm manipulation and competition experiments, we show that rapid changes in sperm velocity are mediated by seminal fluid and the effect of seminal fluid on sperm velocity directly impacts paternity share and therefore reproductive success. These combined findings, completely consistent with sperm competition theory, provide unequivocal evidence that sperm competition risk drives plastic adjustment of ejaculate quality, that seminal fluid harbours the mechanism for the rapid adjustment of sperm velocity and that fitness benefits accrue to males from such adjustment.

Self-adjustable glasses in the developing world

Directory of Open Access Journals (Sweden)

Murthy Gudlavalleti VS

2014-02-01

-6 to +6 diopters, compliance with international standards, quality and affordability, and the likely impact on health systems. Self-adjustable spectacles show poor agreement with conventional refraction methods for high myopia and are unable to correct astigmatism. A limitation of the fluid-filled adjustable spectacles (AdSpecs, Adaptive Eyecare Ltd, Oxford, UK is that once the spectacles are self-adjusted and the power fixed, they become unalterable, just like conventional spectacles. Therefore, they will need to be changed as refractive power changes over time. Current costs of adjustable spectacles are high in developing countries and therefore not affordable to a large segment of the population. Self-adjustable spectacles have potential for "upscaling" if some of the concerns raised are addressed satisfactorily. Keywords: developing countries, eye disease, refractive error, spectacles

Initial shunt type at the Norwood operation impacts myocardial function in hypoplastic left heart syndrome.

Science.gov (United States)

Ruotsalainen, Hanna K; Pihkala, Jaana; Salminen, Jukka; Hornberger, Lisa K; Sairanen, Heikki; Ojala, Tiina

2017-08-01

We investigated the impact of initial shunt type, a Blalock-Taussig (BT) shunt versus a right ventricle to pulmonary artery conduit (RV-PA) on myocardial function at different stages of surgical palliation in patients with hypoplastic left heart syndrome (HLHS). A population-based cohort of 63 Finnish children with HLHS (BT n  = 23, RV-PA n  = 40) born between 2003 and 2010 were studied retrospectively by echocardiography prior to Stages 1, 2 and 3 palliation and 0.5-3 years after Stage 3. For comparison of systolic myocardial function, we evaluated the RV fractional area change (FAC), strain, strain rate and mechanical synchrony from the apical 4-chamber view by velocity vector imaging. There were no intergroup differences in demographics during the study period. At baseline, no intergroup differences were detected in RV systolic myocardial function. Before Stage 2, RV FAC was higher ( P  = 0.03) in the RV-PA conduit group. At Stage 3, an increase in all systolic myocardial functional parameters was observed in the BT shunt group. After Stage 3, the BT shunt group had better RV systolic function. In multiple regression analysis, the shunt type and the stage of palliation had an impact on myocardial function. Although patients with HLHS initially palliated with a BT shunt demonstrate lower RV FAC after Stage I, RV FAC improves after Stage 2 with better systolic performance after Stage 3 compared with those initially palliated with an RV-PA conduit. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Damage initiation and growth in laminated polymer compsosite plates with fluid-structure interaction under impact loading

Directory of Open Access Journals (Sweden)

Y Kwon

2016-09-01

Full Text Available Damage initiation and growth as well as dynamic response of laminated polymer composite plates were investigated with the effect of Fluid-Structure Interaction (FSI when they were subjected to impact loading. The E-glass composite plates were clamped along the boundaries and impact loading was applied from a specially designed vertical drop-impact testing machine while the plates were surrounded by either water or air. The damage and transient responses such as force- and strain-time history were measured during the progressive impact tests, and the test data collected from either impact in air or under water were compared to determine the effect of FSI. The study showed that FSI was generally detrimental to composite plates because of the hydrodynamic mass effect so that damage occurred at a lower impact force for the composite plate submerged in water. The strain measure also suggested that the FSI effect varied from location to location of the plate surface. Additionally, the FSI effect yielded a significant change in the strain response in terms of both magnitude and shape in time history for the plate in water along with progressive damage. In summary, it is essential to include the FSI effect for design and analysis of composite structures when they are in contact with water.

Magnitude and Spatial Distribution of Impact Intensity Under the Foot Relates to Initial Foot Contact Pattern.

Science.gov (United States)

Breine, Bastiaan; Malcolm, Philippe; Segers, Veerle; Gerlo, Joeri; Derie, Rud; Pataky, Todd; Frederick, Edward C; De Clercq, Dirk

2017-12-01

In running, foot contact patterns (rear-, mid-, or forefoot contact) influence impact intensity and initial ankle and foot kinematics. The aim of the study was to compare impact intensity and its spatial distribution under the foot between different foot contact patterns. Forty-nine subjects ran at 3.2 m·s -1 over a level runway while ground reaction forces (GRF) and shoe-surface pressures were recorded and foot contact pattern was determined. A 4-zone footmask (forefoot, midfoot, medial and lateral rearfoot) assessed the spatial distribution of the vertical GRF under the foot. We calculated peak vertical instantaneous loading rate of the GRF (VILR) per foot zone as the impact intensity measure. Midfoot contact patterns were shown to have the lowest, and atypical rearfoot contact patterns the highest impact intensities, respectively. The greatest local impact intensity was mainly situated under the rear- and midfoot for the typical rearfoot contact patterns, under the midfoot for the atypical rearfoot contact patterns, and under the mid- and forefoot for the midfoot contact patterns. These findings indicate that different foot contact patterns could benefit from cushioning in different shoe zones.

Meat quality in pigs fed diets with gradual ractopamine supplementation and nutritional adjustments

Directory of Open Access Journals (Sweden)

M. Amin

2017-12-01

Full Text Available This study evaluated the effects that gradual ractopamine supplementation in diets with nutritional adjustments on pig meat. Were used 80 finishing crossbred barrows in a randomized block design with a 2×5 factorial arrangement (two diets: with and without nutritional adjustment; five levels of ractopamine supplementation: 5-5, 10-10, 20-20, 5-10 and 10-20 ppm in the 14 initial and 14 final study days, four replicates with two animals by experimental unit. Higher shear force values (P<0.05 were obtained using the 5-5 and 10-20 ppm ractopamine supplementation plans in the diets without nutritional adjustment. With nutritionally adjusted diets, the 5-10 ppm of ractopamine supplementation plan yielded higher shear force values (P<0.05. Water retention capacity was higher (P<0.05 for animals fed adjusted diets and 5-5 and 10-20 ppm of actopamine plans. In the 10-20 ppm of ractopamine supplementation plan, meat pH was higher (P<0.05 for diets without nutritional adjustment, whereas in the 20-20 ppm of supplementation plan, pH was higher for adjusted diets.

Optimism, Social Support, and Adjustment in African American Women with Breast Cancer

Science.gov (United States)

Shelby, Rebecca A.; Crespin, Tim R.; Wells-Di Gregorio, Sharla M.; Lamdan, Ruth M.; Siegel, Jamie E.; Taylor, Kathryn L.

2013-01-01

Past studies show that optimism and social support are associated with better adjustment following breast cancer treatment. Most studies have examined these relationships in predominantly non-Hispanic White samples. The present study included 77 African American women treated for nonmetastatic breast cancer. Women completed measures of optimism, social support, and adjustment within 10-months of surgical treatment. In contrast to past studies, social support did not mediate the relationship between optimism and adjustment in this sample. Instead, social support was a moderator of the optimism-adjustment relationship, as it buffered the negative impact of low optimism on psychological distress, well-being, and psychosocial functioning. Women with high levels of social support experienced better adjustment even when optimism was low. In contrast, among women with high levels of optimism, increasing social support did not provide an added benefit. These data suggest that perceived social support is an important resource for women with low optimism. PMID:18712591

Adjustments to financial benefits and contributions with effect from 1 January 2011

CERN Multimedia

HR Department

2011-01-01

In accordance with recommendations made by the Finance Committee and decisions taken by Council in December 2010, certain financial benefits and contributions impacting salaries and stipends have been adjusted with effect from 1 January 2011. 1) Annual adjustments An increase of 0.35% to the scale of basic salaries paid to Staff Members and the scale of stipends paid to Fellows (Annexes R A 5 and R A 6 of the Staff Regulations). No adjustments to the subsistence allowances of Paid Associates and Students (Annex R A 7 of the Staff Regulations). No modifications to the following social benefits: Family, child and infant allowances (Annex R A 3 of the Staff Regulations) Payment ceilings of education fees (Annex R A 4 of the Staff Regulations). 2) Five-yearly review 2010, financial elements: Adjustment of basic salaries: An increase of 1% for Career Path D. An increase of 2% for Career Paths E to G. Technical adjustment of th...

The impact of training problem-solving skills on self-esteem and behavioral adjustment in teenage girls who have irresponsible parents or no parents.

Science.gov (United States)

Shahgholy Ghahfarokhi, F; Moradi, N; Alborzkouh, P; Radmehr, S; Zainali, M

2015-01-01

Proper psychological interventions are of great importance because they help enhancing psychological and public health in adolescents with irresponsible parents or no parents. The current research aimed to examine the impact of training problem-solving experiment on self-esteem and behavioral adjustment in teenage girls with irresponsible parents or no parents. Methodology: The approach of the present research was a semi-test via a post-test-pre-test model and a check team. Hence, in Tehran, 40 girls with irresponsible parents or no parents were chosen by using the Convenience modeling, and they were classified into 2 teams: control and experiment. Both groups were pre-tested by using a demography questionnaire, Rosenberg's self-esteem scale, and a behavioral adjustment questionnaire. Afterwards, both groups were post-tested, and the obtained data were examined by using inferential and descriptive methods through SPSS 21. Findings: Findings indicated that the training problem-solving skills significantly increased the self-esteem and the behavioral adjustment in teenage girls with irresponsible parents or no parents (P < 0/ 001). Conclusion: The conclusion of this research was that training problem-solving methods greatly helps endangered people such as teenage girls with irresponsible parents or no parents, because these methods are highly efficient especially when they are performed in groups, as they are cheap and accepted by different people.

Learning course adjustments during arm movements with reversed sensitivity derivatives

Directory of Open Access Journals (Sweden)

Tweed Douglas B

2010-11-01

Full Text Available Abstract Background To learn, a motor system needs to know its sensitivity derivatives, which quantify how its neural commands affect motor error. But are these derivatives themselves learned, or are they known solely innately? Here we test a recent theory that the brain's estimates of sensitivity derivatives are revisable based on sensory feedback. In its simplest form, the theory says that each control system has a single, adjustable estimate of its sensitivity derivatives which affects all aspects of its task, e.g. if you learn to reach to mirror-reversed targets then your revised estimate should reverse not only your initial aiming but also your online course adjustments when the target jumps in mid-movement. Methods Human subjects bent a joystick to move a cursor to a target on a computer screen, but the cursor's motion was reversed relative to the joystick's. The target jumped once during each movement. Subjects had up to 4000 trials to practice aiming and responding to target jumps. Results All subjects learned to reverse both initial aiming and course adjustments. Conclusions Our study confirms that sensitivity derivatives can be relearned. It is consistent with the idea of a single, all-purpose estimate of those derivatives; and it suggests that the estimate is a function of context, as one would expect given that the true sensitivity derivatives may vary with the state of the controlled system, the target, and the motor commands.

Nursing Facility Initiative Annual Report

Data.gov (United States)

U.S. Department of Health & Human Services — This annual report summarizes impacts from the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in 2014. This initiative is designed...

The limit values for brightness and contrast adjustment in digital panoramic radiography

Science.gov (United States)

Zahra, A. T.; Syahraini, S. I.; Kiswanjaya, B.; Ustriyana, P.

2017-08-01

There is an overall lack of studies about digital panoramic radiography. The application of image enhancement techniques is still being done based on the operator’s preferences, since there is no objective limitation. The aim is to evaluate the limit values of the brightness and contrast adjustment in digital panoramic radiography. Digital panoramic radiographs were divided into three groups (dark, medium, and light), and the contrast and brightness adjustments were done using Digora for Windows. The static evaluations were done using three criteria: 1 if the image had lower quality, 2 if there was no difference and 3 if the image had better quality. The radiographic changes differed in each group depending on the initial imaging conditions. The brightness adjustment limit values in the dark and medium groups were -10 and +20, respectively, and -20 and +10 in the light group. The contrast adjustment limit values in all of the groups were -10 and +10.

Enhanced bioelectricity generation of air-cathode buffer-free microbial fuel cells through short-term anolyte pH adjustment.

Science.gov (United States)

Ren, Yueping; Chen, Jinli; Li, Xiufen; Yang, Na; Wang, Xinhua

2018-04-01

Short-term initial anolyte pH adjustment can relieve the performance deterioration of the single-chamber air-cathode buffer-free microbial fuel cell (BFMFC) caused by anolyte acidification. Adjusting the initial anolyte pH to 9 in 5 running cycles is the optimum strategy. The relative abundance of the electrochemically active Geobacter in the KCl-pH9-MFC anode biofilm increased from 59.01% to 75.13% after the short-term adjustment. The maximum power density (P max ) of the KCl-pH9-MFC was elevated from 316.4mW·m -2 to 511.6mW·m -2 , which was comparable with that of the PBS-MFC. And, after the short-term adjusting, new equilibrium between the anolyte pH and the anode biofilm electrochemical activity has been established in the BFMFC, which ensured the sustainability of the improved bioelectricity generation performance. Copyright © 2017 Elsevier B.V. All rights reserved.

Training and support to improve ICD coding quality: A controlled before-and-after impact evaluation.

Science.gov (United States)

Dyers, Robin; Ward, Grant; Du Plooy, Shane; Fourie, Stephanus; Evans, Juliet; Mahomed, Hassan

2017-05-24

The proposed National Health Insurance policy for South Africa (SA) requires hospitals to maintain high-quality International Statistical Classification of Diseases (ICD) codes for patient records. While considerable strides had been made to improve ICD coding coverage by digitising the discharge process in the Western Cape Province, further intervention was required to improve data quality. The aim of this controlled before-and-after study was to evaluate the impact of a clinician training and support initiative to improve ICD coding quality. To compare ICD coding quality between two central hospitals in the Western Cape before and after the implementation of a training and support initiative for clinicians at one of the sites. The difference in differences in data quality between the intervention site and the control site was calculated. Multiple logistic regression was also used to determine the odds of data quality improvement after the intervention and to adjust for potential differences between the groups. The intervention had a positive impact of 38.0% on ICD coding completeness over and above changes that occurred at the control site. Relative to the baseline, patient records at the intervention site had a 6.6 (95% confidence interval 3.5 - 16.2) adjusted odds ratio of having a complete set of ICD codes for an admission episode after the introduction of the training and support package. The findings on impact on ICD coding accuracy were not significant. There is sufficient pragmatic evidence that a training and support package will have a considerable positive impact on ICD coding completeness in the SA setting.

Land Tenure Adjustment Project. Preliminary Draft Environmental Impact Statement/Report

Science.gov (United States)

1987-04-16

southern California render the probability of major agricultural produrtion in the impact area unlikely. Extractive industry in the impact area is neither...American Indians, Vol. 8: California, ed. Robert F. Heizer . Smithsonian Institution, Washington, D.C. Bean, Lowell John, and Sylvia Brakke Vane. 1979...American Indians, Vol. 8: California, ed. Robert F. Heizer , pp. 567-569. Smithsonian Institution, Washington, D.C. LTA REVISION 2 B-2 California Air

The instability of the adjusted and unadjusted environmental Kuznets curves

International Nuclear Information System (INIS)

Auci, Sabrina; Becchetti, Leonardo

2006-01-01

We test the stability of the unadjusted and adjusted environmental Kuznets curves (EKCs). Our results provide evidence in favour of a theoretically funded 'adjusted EKC hypothesis' in which the impact of per capita GDP on CO 2 emissions is evaluated conditionally to the effects of the industry mix and of the energy-supply infrastructure. In this specification, the shape of the GDP-CO 2 relationship appears quite sensitive to changes in the estimation period. In the final part of the paper, signs and dynamics of fixed effects of individual countries in different specifications are interpreted as measures of virtuous or vicious of environmental behaviour. (author)

The instability of the adjusted and unadjusted environmental Kuznets curves

Energy Technology Data Exchange (ETDEWEB)

Auci, Sabrina; Becchetti, Leonardo [University of Rome Tor Vergata, Department of Economics, Via Columbia 2, 00133 Rome (Italy)

2006-11-01

We test the stability of the unadjusted and adjusted environmental Kuznets curves (EKCs). Our results provide evidence in favour of a theoretically funded 'adjusted EKC hypothesis' in which the impact of per capita GDP on CO{sub 2} emissions is evaluated conditionally to the effects of the industry mix and of the energy-supply infrastructure. In this specification, the shape of the GDP-CO{sub 2} relationship appears quite sensitive to changes in the estimation period. In the final part of the paper, signs and dynamics of fixed effects of individual countries in different specifications are interpreted as measures of virtuous or vicious of environmental behaviour. (author)

[An adjustable distractor for transverse maxillary distraction osteogenesis].

Science.gov (United States)

Leyder, P; Wycisk, G; Quilichini, J

2013-06-01

The posterior skeletal widening in conventional distractions (Surgical Assisted Rapid Maxillary Expansion) is often modest, in contrast with a predominant anterior expansion. Until recently, it was not possible to consider transverse palatal distraction osteogenesis and Le Fort I impaction or advancement in the same procedure, as the osteosynthesis plates impeded maxillary anterior opening. We developed new sliding osteosynthesis plates allowing to perform an advancement or impaction Le Fort I osteotomy associated with a low-resistance bipartite palatal distraction osteogenesis. We had for aim to describe the device and to determine its clinical applications. This new palatal distractor is made up of two independent stainless steel jacks allowing for an adjustable distraction in the anterior or posterior area as needed. Bone-borne and tooth-borne versions are available. This new distractor can be adjusted sagittally. The distraction can be angular or parallel, and the distraction mode can be modified during post-operative distraction. This device should be adapted to all clinical presentations. It can be used in combination with sliding osteosynthesis to perform a Le Fort 1 osteotomy and at the same time a complete correction of vertical, horizontal, and sagittal deficiencies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The Influence of Husbands' or Male Partners' Support on Women's Psychosocial Adjustment to Having an Ostomy Resulting from Colorectal Cancer

Science.gov (United States)

Altschuler, Andrea; Ramirez, Michelle; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C.; Herrinton, Lisa; Krouse, Robert S.

2009-01-01

Objective Some patients with colorectal cancer (CRC) require a permanent ostomy, which changes bodily function and can create psychosocial distress. However, little is known about the influence of men's support on women's psychosocial adjustment to having an ostomy as a result of CRC. Methods Participants initially completed the City of Hope-CRC Quality of Life questionnaire. We then conducted in-depth interviews with 30 female participants. Interview questions focused on body image, gender, and sexuality. Interviews were recorded and transcribed. We used qualitative methods to analyze the interview data and compared global HRQOL quartile scores to the overall ways that women discussed husbands' or partners' support regarding psychosocial adjustments to having ostomies. Results Of 30 participants, 22 were married or partnered at the time of surgery and 8 were single. The non-partnered respondents are not included in this analysis. Of the 22 married/partnered women, 17 described positive support from husbands being central to their psychosocial adjustment, 3 described a lack or withdrawal of support negatively affecting adjustment, and 2 described support as neither positive nor negative. In 17 cases, women's high or low quantitative HRQOL scores matched the positive or negative qualitative findings. There were 3 cases in which there were positive qualitative data and low HRQOL scores, but each of these cases, women reported serious current co-morbidities. Conclusions These findings suggest that the provision or withdrawal of husbands' or partners' support can have a considerable impact on the psychosocial adjustment of female CRC patients with ostomies. These findings appear to be both short- and long-term. Survivorship assessments should include appraisals of women's relationships to spouses/partners. PMID:19448512

The influence of husbands' or male partners' support on women's psychosocial adjustment to having an ostomy resulting from colorectal cancer.

Science.gov (United States)

Altschuler, Andrea; Ramirez, Michelle; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C; Herrinton, Lisa; Krouse, Robert S

2009-01-01

Some patients with colorectal cancer (CRC) require a permanent ostomy, which changes bodily function and can create psychosocial distress. However, little is known about the influence of men's support on women's psychosocial adjustment to having an ostomy as a result of CRC. Participants initially completed the City of Hope-CRC Quality of Life questionnaire. We then conducted in-depth interviews with 30 female participants. Interview questions focused on body image, gender, and sexuality. Interviews were recorded and transcribed. We used qualitative methods to analyze the interview data and compared global health-related quality of life (HRQOL) quartile scores to the overall ways that women discussed husbands' or partners' support regarding psychosocial adjustments to having ostomies. Of 30 participants, 22 were married or partnered at the time of surgery and 8 were single. The nonpartnered respondents are not included in this analysis. Of the 22 married/partnered women, 17 described positive support from husbands being central to their psychosocial adjustment, 3 described a lack or withdrawal of support negatively affecting adjustment, and 2 described support as neither positive nor negative. In 17 cases, women's high or low quantitative HRQOL scores matched the positive or negative qualitative findings. There were 3 cases in which there were positive qualitative data and low HRQOL scores, but in each of these cases, women reported serious current comorbidities. These findings suggest that the provision or withdrawal of husbands' or partners' support can have a considerable impact on the psychosocial adjustment of female CRC patients with ostomies. These findings appear to be both short term and long term. Survivorship assessments should include appraisals of women's relationships to their spouses/partners.

Conflict adaptation in time: foreperiods as contextual cues for attentional adjustment.

Science.gov (United States)

Wendt, Mike; Kiesel, Andrea

2011-10-01

Interference evoked by distractor stimulus information, such as flankers in the Eriksen task, is reduced when the proportion of conflicting stimuli is increased. This modulation is sensitive to contextual cues such as stimulus location or color, suggesting attentional adjustment to conflict contingencies on the basis of context information. In the present study, we explored whether conflict adjustment is modulated by temporal variation of conflict likelihood. To this end, we associated low and high proportions of conflict stimuli with foreperiods of different lengths. Flanker interference was higher with foreperiods associated with low conflict proportions, suggesting that participants use the foreperiod as a contextual cue for attentional adjustment. We conjecture that participants initially adopt the strategy useful for conflict contingencies associated with short foreperiods, and then readjust during the trial, in the absence of any additional exogenous cue, when the imperative stimulus has not occurred during a certain time interval.

Experiencing type 2 diabetes mellitus: qualitative analysis of adolescents' concept of illness, adjustment, and motivation to engage in self-care behaviors.

Science.gov (United States)

Salamon, Katherine S; Brouwer, Amanda M; Fox, Michelle M; Olson, Kimberly A; Yelich-Koth, Sara L; Fleischman, Katie M; Hains, Anthony A; Davies, W Hobart; Kichler, Jessica C

2012-01-01

The purpose of this study was to explore the perspectives of adolescents diagnosed with type 2 diabetes mellitus (T2DM) in terms of how youths conceptualized the effect of T2DM on daily life, adjustment to the illness, and motivation related to diabetes self-care management. The aims of the study were to gather essential information in order to develop appropriate intervention techniques and inform future studies intended to understand the psychosocial experiences of youths with T2DM. Eight adolescents diagnosed with T2DM were recruited from an outpatient pediatric diabetes clinic at a Midwestern children's hospital. A qualitative interview was developed, which was scheduled to last about 30 to 45 minutes. Data were analyzed using the consensual qualitative research methodology, wherein qualitative coders developed core ideas and themes related to the adolescent experience of T2DM. Three main themes were identified, including how the youths conceptualized the impact of T2DM, adjustment to self-care, and motivation to perform self-care behaviors. Knowledge related to the cause of T2DM and adjustment to completing self-care behaviors was varied among youths. Few adolescents spoke about motivation sources, although when mentioned, it typically involved witnessing negative health consequences in family members or friends with T2DM. The data represent essential initial information related to youths with T2DM, which will help guide in developing future studies designed to understand the psychosocial experiences of youths with T2DM and appropriate intervention techniques. Future research that aims to increase internal and external motivation may be able to subsequently impact adherence to self-care behaviors.

39 CFR 3010.25 - Limitation on unused rate adjustment authority rate adjustments.

Science.gov (United States)

2010-07-01

... only be applied together with inflation-based limitation rate adjustments or when inflation-based... used in lieu of an inflation-based limitation rate adjustment. ... 39 Postal Service 1 2010-07-01 2010-07-01 false Limitation on unused rate adjustment authority...

BUILDING HUMAN CAPITAL: THE IMPACT OF PARENTS´ INITIAL EDUCATIONAL LEVEL AND LIFELONG LEARNING ON THEIR CHILDREN

Directory of Open Access Journals (Sweden)

FISCHER, Jakub

2013-12-01

Full Text Available The aim of this paper is to examine the impact of parents´ educational level on lifelong learning of children and relationship between parents´ and student´ lifelong learning including language skills and computer literacy. This intergenerational transmission, if proven, could influence the investments into the human capital in the long run. We used data from Adult Education Survey 2011 (AES to test the hypothesis that the parental attained level of education has a significant impact on the initial educational level of their children as well as on their lifelong learning participation. Furthermore, using data from AES, we tested the association between parental educational level and children´s language skills and reading activity and between parental non-formal as well as informal education and students´ lifelong learning. We have found that the parental effect on lifelong learning participation is slightly weaker than the effect of initial adult´s education. Nevertheless, the intergenerational transmission mechanism obviously works. The relationship between parental and students computer literacy is statistically significant, nevertheless weak. As for the nominal and ordinal character of the data, we used mainly the standard statistical methods including nonparametric tests, logit model and correspondence analysis.

Two aspects of feedforward postural control: anticipatory postural adjustments and anticipatory synergy adjustments.

Science.gov (United States)

Klous, Miriam; Mikulic, Pavle; Latash, Mark L

2011-05-01

We used the framework of the uncontrolled manifold hypothesis to explore the relations between anticipatory synergy adjustments (ASAs) and anticipatory postural adjustments (APAs) during feedforward control of vertical posture. ASAs represent a drop in the index of a multimuscle-mode synergy stabilizing the coordinate of the center of pressure in preparation to an action. ASAs reflect early changes of an index of covariation among variables reflecting muscle activation, whereas APAs reflect early changes in muscle activation levels averaged across trials. The assumed purpose of ASAs is to modify stability of performance variables, whereas the purpose of APAs is to change magnitudes of those variables. We hypothesized that ASAs would be seen before APAs and that this finding would be consistent with regard to the muscle-mode composition defined on the basis of different tasks and phases of action. Subjects performed a voluntary body sway task and a quick, bilateral shoulder flexion task under self-paced and reaction time conditions. Surface muscle activity of 12 leg and trunk muscles was analyzed to identify sets of 4 muscle modes for each task and for different phases within the shoulder flexion task. Variance components in the muscle-mode space and indexes of multimuscle-mode synergy stabilizing shift of the center of pressure were computed. ASAs were seen ∼ 100-150 ms prior to the task initiation, before APAs. The results were consistent with respect to different sets of muscle modes defined over the two tasks and different shoulder flexion phases. We conclude that the preparation for a self-triggered postural perturbation is associated with two types of anticipatory adjustments, ASAs and APAs. They reflect different feedforward processes within the hypothetical hierarchical control scheme, resulting in changes in patterns of covariation of elemental variables and in their patterns averaged across trials, respectively. The results show that synergies quantified

CALMAR: A New Versatile Code Library for Adjustment from Measurements

Directory of Open Access Journals (Sweden)

Grégoire G.

2016-01-01

Full Text Available CALMAR, a new library for adjustment has been developed. This code performs simultaneous shape and level adjustment of an initial prior spectrum from measured reactions rates of activation foils. It is written in C++ using the ROOT data analysis framework,with all linear algebra classes. STAYSL code has also been reimplemented in this library. Use of the code is very flexible : stand-alone, inside a C++ code, or driven by scripts. Validation and test cases are under progress. Theses cases will be included in the code package that will be available to the community. Future development are discussed. The code should support the new Generalized Nuclear Data (GND format. This new format has many advantages compared to ENDF.

Impact initiation of explosives and propellants via statistical crack mechanics

Science.gov (United States)

Dienes, J. K.; Zuo, Q. H.; Kershner, J. D.

2006-06-01

A statistical approach has been developed for modeling the dynamic response of brittle materials by superimposing the effects of a myriad of microcracks, including opening, shear, growth and coalescence, taking as a starting point the well-established theory of penny-shaped cracks. This paper discusses the general approach, but in particular an application to the sensitivity of explosives and propellants, which often contain brittle constituents. We examine the hypothesis that the intense heating by frictional sliding between the faces of a closed crack during unstable growth can form a hot spot, causing localized melting, ignition, and fast burn of the reactive material adjacent to the crack. Opening and growth of a closed crack due to the pressure of burned gases inside the crack and interactions of adjacent cracks can lead to violent reaction, with detonation as a possible consequence. This approach was used to model a multiple-shock experiment by Mulford et al. [1993. Initiation of preshocked high explosives PBX-9404, PBX-9502, PBX-9501, monitored with in-material magnetic gauging. In: Proceedings of the 10th International Detonation Symposium, pp. 459-467] involving initiation and subsequent quenching of chemical reactions in a slab of PBX 9501 impacted by a two-material flyer plate. We examine the effects of crack orientation and temperature dependence of viscosity of the melt on the response. Numerical results confirm our theoretical finding [Zuo, Q.H., Dienes, J.K., 2005. On the stability of penny-shaped cracks with friction: the five types of brittle behavior. Int. J. Solids Struct. 42, 1309-1326] that crack orientation has a significant effect on brittle behavior, especially under compressive loading where interfacial friction plays an important role. With a reasonable choice of crack orientation and a temperature-dependent viscosity obtained from molecular dynamics calculations, the calculated particle velocities compare well with those measured using

Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Hospital Readmission Rates Following Hip and Knee Arthroplasty.

Science.gov (United States)

Martsolf, Grant R; Barrett, Marguerite L; Weiss, Audrey J; Kandrack, Ryan; Washington, Raynard; Steiner, Claudia A; Mehrotra, Ateev; SooHoo, Nelson F; Coffey, Rosanna

2016-08-17

Readmission rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are increasingly used to measure hospital performance. Readmission rates that are not adjusted for race/ethnicity and socioeconomic status, patient risk factors beyond a hospital's control, may not accurately reflect a hospital's performance. In this study, we examined the extent to which risk-adjusting for race/ethnicity and socioeconomic status affected hospital performance in terms of readmission rates following THA and TKA. We calculated 2 sets of risk-adjusted readmission rates by (1) using the Centers for Medicare & Medicaid Services standard risk-adjustment algorithm that incorporates patient age, sex, comorbidities, and hospital effects and (2) adding race/ethnicity and socioeconomic status to the model. Using data from the Healthcare Cost and Utilization Project, 2011 State Inpatient Databases, we compared the relative performances of 1,194 hospitals across the 2 methods. Addition of race/ethnicity and socioeconomic status to the risk-adjustment algorithm resulted in (1) little or no change in the risk-adjusted readmission rates at nearly all hospitals; (2) no change in the designation of the readmission rate as better, worse, or not different from the population mean at >99% of the hospitals; and (3) no change in the excess readmission ratio at >97% of the hospitals. Inclusion of race/ethnicity and socioeconomic status in the risk-adjustment algorithm led to a relative-performance change in readmission rates following THA and TKA at socioeconomic status in risk-adjusted THA and TKA readmission rates used for hospital accountability, payment, and public reporting. Prognostic Level III. See instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Pacific Northwest Laboratory's Solid Waste Initiative

International Nuclear Information System (INIS)

Holter, G.M.

1993-09-01

In fiscal year 1992 (FY-92), a Solid Waste Initiative was undertaken within the Pacific Northwest Laboratory (PNL). This action was partly in response to a perceived increase in the frequency and severity of impacts associated with solid waste issues at all levels. It also recognized the limited attention of previous efforts in addressing the broader impacts resulting from solid waste and, thus, dealing with solid waste issues in a holistic fashion. This paper provides a description of the Solid Waste Initiative at PNL, including a historical perspective on PNL's involvement in solid waste issues, the goals and objectives of the Solid Waste Initiative, and a discussion of selected activities being conducted under the Initiative

Perturbations in the initial soil moisture conditions: Impacts on hydrologic simulation in a large river basin

Science.gov (United States)

Niroula, Sundar; Halder, Subhadeep; Ghosh, Subimal

2018-06-01

Real time hydrologic forecasting requires near accurate initial condition of soil moisture; however, continuous monitoring of soil moisture is not operational in many regions, such as, in Ganga basin, extended in Nepal, India and Bangladesh. Here, we examine the impacts of perturbation/error in the initial soil moisture conditions on simulated soil moisture and streamflow in Ganga basin and its propagation, during the summer monsoon season (June to September). This provides information regarding the required minimum duration of model simulation for attaining the model stability. We use the Variable Infiltration Capacity model for hydrological simulations after validation. Multiple hydrologic simulations are performed, each of 21 days, initialized on every 5th day of the monsoon season for deficit, surplus and normal monsoon years. Each of these simulations is performed with the initial soil moisture condition obtained from long term runs along with positive and negative perturbations. The time required for the convergence of initial errors is obtained for all the cases. We find a quick convergence for the year with high rainfall as well as for the wet spells within a season. We further find high spatial variations in the time required for convergence; the region with high precipitation such as Lower Ganga basin attains convergence at a faster rate. Furthermore, deeper soil layers need more time for convergence. Our analysis is the first attempt on understanding the sensitivity of hydrological simulations of Ganga basin on initial soil moisture conditions. The results obtained here may be useful in understanding the spin-up requirements for operational hydrologic forecasts.

Autogenic training as a therapy for adjustment disorder in adults

Directory of Open Access Journals (Sweden)

Jojić Boris R.

2005-01-01

Full Text Available Introduction. Autogenic training is a widely recognised psychotherapy technique. The British School of Autogenic Training cites a large list of disorders, states, and changes, where autogenic training may prove to be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adults. Our sample consisted of a homogeneous group of 35 individuals, with an average age of 39.3±1.6 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. Aim. The aim of our study was to research the effectiveness of autogenic training as a therapy for adjustment disorder in adults, by checking the influence of autogenic training on the biophysical and biochemical indicators of adjustment disorder. Method. We measured the indicators of adjustment disorder and their changes in three phases: before the beginning, immediately after the beginning, and six months after the completion, of a practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rate as well as the levels of cortisol in plasma, of cholesterol in blood, and of glucose. During that period, autogenic training functioned as the sole therapy. Results. The study confirmed our preliminary assumptions. The measurements we performed demonstrated that arterial blood pressure, pulse rate, concentration of cholesterol and cortisol, after the application of autogenic training among the subjects suffering from adjustment disorder, were lower in comparison to the initial values. These values remained lower even six months after the completion of the practical course in autogenic training. Conclusion. Autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and helps adults to cope with stress, facilitating their recuperation.

[Autogenic training as a therapy for adjustment disorder in adults].

Science.gov (United States)

Jojić, Boris R; Leposavić, Ljubica M

2005-01-01

Autogenic training is a widely recognised psychotherapy technique. The British School of Autogenic Training cites a large list of disorders, states, and changes, where autogenic training may prove to be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adults. Our sample consisted of a homogeneous group of 35 individuals, with an average age of 39.3 +/- 1.6 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. The aim of our study was to research the effectiveness of autogenic training as a therapy for adjustment disorder in adults, by checking the influence of autogenic training on the biophysical and biochemical indicators of adjustment disorder. We measured the indicators of adjustment disorder and their changes in three phases: before the beginning, immediately after the beginning, and six months after the completion, of a practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rate as well as the levels of cortisol in plasma, of cholesterol in blood, and of glucose. During that period, autogenic training functioned as the sole therapy. The study confirmed our preliminary assumptions. The measurements we performed demonstrated that arterial blood pressure, pulse rate, concentration of cholesterol and cortisol, after the application of autogenic training among the subjects suffering from adjustment disorder, were lower in comparison to the initial values. These values remained lower even six months after the completion of the practical course in autogenic training. Autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and helps adults to cope with stress, facilitating their recuperation.

Balance of payments adjustment mechanisms in the Euro area

Directory of Open Access Journals (Sweden)

Pavel HNÁT

2012-06-01

Full Text Available The article aims at analysing the current situation in the Euro area with respect to the balance of payments adjustment mechanism that should normally be at place. Internally, the Euro area membership represents a combination of the fixed exchange rate, capital mobility and no monetary policy autonomy; externally, the Euro area countries apply floating exchange rates with high capital mobility, and autonomous monetary policy. Member states thus cannot use the monetary instruments to prevent external influences; they can only use fiscal policies, which are limited by the Stability and Growth Pact and debt constraint. When external imbalance occurs (such as today, the economies of member states are exposed to the price and income adjustment processes as well as to their own fiscal and ECB policy impacts. This article shows that all these factors interfere and influence real effects of automatic adjustment mechanisms which in some cases cannot come forth at all. Factors within domestic economic policies that limit the restoration of external balance within the Euro area thus create an important outcome of this paper.

The stress-buffering effects of hope on changes in adjustment to caregiving in multiple sclerosis.

Science.gov (United States)

Madan, Sindia; Pakenham, Kenneth I

2015-09-01

This study examined the direct and stress-buffering effects of global hope and its components (agency and pathways) on changes in adjustment to multiple sclerosis caregiving over 12 months. A total of 140 carers and their care-recipients completed questionnaires at Time 1 and 12 months later, Time 2. Focal predictors were stress, hope, agency and pathways, and the adjustment outcomes were anxiety, depression, positive affect, positive states of mind and life satisfaction. Results showed that as predicted, greater hope was associated with better adjustment after controlling for the effects of initial adjustment and caregiving and care-recipient illness variables. No stress-buffering effects of hope emerged. Regarding hope components, only the agency dimension emerged as a significant predictor of adjustment. Findings highlight hope as an important protective resource for coping with multiple sclerosis caregiving and underscore the role of agency thinking in this process. © The Author(s) 2013.

Coping and emotional adjustment following traumatic brain injury.

Science.gov (United States)

Anson, Katie; Ponsford, Jennie

2006-01-01

To examine the association between coping style and emotional adjustment following traumatic brain injury. Thirty three individuals who had sustained a traumatic brain injury (mean duration of posttraumatic amnesia = 32 days) between 1(1/2) months and almost 7 years previously. Coping Scale for Adults, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, State-Trait Anger Expression Inventory, and the Sickness Impact Profile. Approximately 50% of the sample reported clinically significant levels of anxiety and depression. Coping characterized by avoidance, worry, wishful thinking, self-blame, and using drugs and alcohol was associated with higher levels of anxiety, depression, and psychosocial dysfunction and lower levels of self-esteem. Coping characterized by actively working on the problem and using humor and enjoyable activities to manage stress was associated with higher self-esteem. Lower premorbid intelligence (measured via the National Adult Reading Test) and greater self-awareness (measured via the Self-Awareness of Deficits Interview) were associated with an increased rate of maladaptive coping. The strong association between the style of coping used to manage stress and emotional adjustment suggests the possibility that emotional adjustment might be improved by the facilitation of more adaptive coping styles. It is also possible that improving emotional adjustment may increase adaptive coping. The development and evaluation of interventions aimed at facilitating adaptive coping and decreasing emotional distress represent important and potentially fruitful contributions to enhancing long-term outcome following brain injury.

Annual Adjustment Factors

Data.gov (United States)

Department of Housing and Urban Development — The Department of Housing and Urban Development establishes the rent adjustment factors - called Annual Adjustment Factors (AAFs) - on the basis of Consumer Price...

Impact of Structural Adjustment Programmes on National Food Security in Kenya

International Nuclear Information System (INIS)

Oduol, A.B.

2002-01-01

Per capita food production in sub-Saharan Africa including Kenya has been declining over the past three decades.Despite the available efforts made by the governments in sub-Saharan Africa, food insecurity remains one of the most crucial issues.In Kenya, agriculture accounts for about 26 per cent of overall GDP, 60 per cent of foreign exchange earnings and employs about 70 per cent of the rural population. Agriculture therefore remains the main source of food security for a majority of Kenya's population. Kenya has been going through nearly a decade of transition in agriculture whereby the role of the state in production and marketing has been reduced allowing the public sector institutions to concentrate on doing a narrow range of tasks better. However concerns has arisen as to wether this transformation from state-led model of service provision to that of the private sector would result in the vibrant growth in agricultural production that was experienced in the 1960s and early 1970s. This study sought to determine the impact of policy reforms on national food security with a major focus on agricultural production of rural farmers in Kenya. The study also aimed at suggesting posssible recommendations to improve agricultural production while taking into consideration the fiscal constraint faced by the the country. By using descriptive analysis to compare changes in production of maize, coffee and tea as well as in the food security situation before and after policy reforms, the study revealed that maize production had declined in the post-reform period. Although the total contribution of tea and coffee to total agricultural export had increased in the pos-reform period, production of coffee showed a downward trend unlike that of tea. The results further revealed that food production had deteriorated in the post-reform period while dependence on food imports and food aid had increased. In conclusion, the structural adjustment programmes coupled with organisational

Religiosity influences on bereavement adjustments of older widows in Taiwan.

Science.gov (United States)

Shih, Shaw-Nin; Turale, Sue; Shih, Fu-Jin; Tsai, Jen-Chen

2010-03-01

To describe difficulties encountered by older widows in Taiwan and the impact of intrinsic or extrinsic religiosity on their coping strategies during early widowhood. There is very limited information about how Taiwan's widows cope with their bereavement and no studies reporting the relationship between religious beliefs and healthy adjustment during this distressing period. Between-method qualitative and quantitative triangulation was used. Semi-structured interviews were conducted and transcribed data were analysed by critical thematic analysis. Twenty women in Taiwan, >65 years old, (mean = 72.95) were interviewed within three years of being widowed. There were two informant groups: those with intrinsic religious beliefs and those with extrinsic religious beliefs. They all reported intrapersonal and interpersonal problems. Several major coping strategies arose: 'practising positive or negative attitudes for adaptation'; 'using person-focused actions'; and 'taking the initiative or passively seeking help from others or helping others'. Informants with intrinsic religious beliefs reported fewer coping problems by holding positive attitudes and taking multiple actions for adaptation. The extrinsic religious group had more negative adaptation attitudes, such as withdrawal and low self-esteem and practised less faith religious activities in worshipping ancestors, experiencing fatalism and using divination. They reported more coping problems than the intrinsic religious group. Widows in Taiwan have different coping problems and strategies in postbereavement adjustment, affected by their different religious beliefs systems. More research is required to establish the generalisabilty of these findings. Widows in Taiwan need to be assessed for their religious belief systems and how this affects their ability to cope during bereavement. Clinicians should actively provide grief support and encourage new methods of social adaptation, especially with widows with extrinsic

Gender Identity and Adjustment: Understanding the Impact of Individual and Normative Differences in Sex Typing

Science.gov (United States)

Lurye, Leah E.; Zosuls, Kristina M.; Ruble, Diane N.

2009-01-01

The relationship among gender identity, sex typing, and adjustment has attracted the attention of social and developmental psychologists for many years. However, they have explored this issue with different assumptions and different approaches. Generally the approaches differ regarding whether sex typing is considered adaptive versus maladaptive, measured as an individual or normative difference, and whether gender identity is regarded as a unidimensional or multidimensional construct. In this chapter, we consider both perspectives and suggest that the developmental timing and degree of sex typing, as well as the multidimensionality of gender identity, be considered when examining their relationship to adjustment. PMID:18521861

Convexity Adjustments for ATS Models

DEFF Research Database (Denmark)

Murgoci, Agatha; Gaspar, Raquel M.

. As a result we classify convexity adjustments into forward adjustments and swaps adjustments. We, then, focus on affine term structure (ATS) models and, in this context, conjecture convexity adjustments should be related of affine functionals. In the case of forward adjustments, we show how to obtain exact...

Automatic Adjustments of a Trans-oesophageal Ultrasound Robot for Monitoring Intra-operative Catheters

Science.gov (United States)

Wang, Shuangyi; Housden, James; Singh, Davinder; Rhode, Kawal

2017-12-01

3D trans-oesophageal echocardiography (TOE) has become a powerful tool for monitoring intra-operative catheters used during cardiac procedures in recent years. However, the control of the TOE probe remains as a manual task and therefore the operator has to hold the probe for a long period of time and sometimes in a radiation environment. To solve this problem, an add-on robotic system has been developed for holding and manipulating a commercial TOE probe. This paper focuses on the application of making automatic adjustments to the probe pose in order to accurately monitor the moving catheters. The positioning strategy is divided into an initialization step based on a pre-planning method and a localized adjustments step based on the robotic differential kinematics and related image servoing techniques. Both steps are described in the paper along with simulation experiments performed to validate the concept. The results indicate an error less than 0.5 mm for the initialization step and an error less than 2 mm for the localized adjustments step. Compared to the much bigger live 3D image volume, it is concluded that the methods are promising. Future work will focus on evaluating the method in the real TOE scanning scenario.

Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility.

Science.gov (United States)

Murray, Meghan T; Jackson, Olivia; Cohen, Bevin; Hutcheon, Gordon; Saiman, Lisa; Larson, Elaine; Neu, Natalie

2016-07-01

We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. Infect Control Hosp Epidemiol 2016;37:859-862.

Battered Women: The Relationship of Stress, Support and Coping to Adjustment.

Science.gov (United States)

Mitchell, Roger E.; Hodson, Christine A.

Recent research on domestic violence has sought to provide insight into the psychological consequences of such violence. A conceptual framework, which suggests that both situational and person-centered factors contribute to adjustment to violence and affect a woman's personal and social resources, was formulated to examine the impact of stress,…

Validation of a novel laparoscopic adjustable gastric band simulator.

Science.gov (United States)

Sankaranarayanan, Ganesh; Adair, James D; Halic, Tansel; Gromski, Mark A; Lu, Zhonghua; Ahn, Woojin; Jones, Daniel B; De, Suvranu

2011-04-01

Morbid obesity accounts for more than 90,000 deaths per year in the United States. Laparoscopic adjustable gastric banding (LAGB) is the second most common weight loss procedure performed in the US and the most common in Europe and Australia. Simulation in surgical training is a rapidly advancing field that has been adopted by many to prepare surgeons for surgical techniques and procedures. The aim of our study was to determine face, construct, and content validity for a novel virtual reality laparoscopic adjustable gastric band simulator. Twenty-eight subjects were categorized into two groups (expert and novice), determined by their skill level in laparoscopic surgery. Experts consisted of subjects who had at least 4 years of laparoscopic training and operative experience. Novices consisted of subjects with medical training but with less than 4 years of laparoscopic training. The subjects used the virtual reality laparoscopic adjustable band surgery simulator. They were automatically scored according to various tasks. The subjects then completed a questionnaire to evaluate face and content validity. On a 5-point Likert scale (1 = lowest score, 5 = highest score), the mean score for visual realism was 4.00 ± 0.67 and the mean score for realism of the interface and tool movements was 4.07 ± 0.77 (face validity). There were significant differences in the performances of the two subject groups (expert and novice) based on total scores (p virtual reality laparoscopic adjustable gastric band simulator. Our initial results demonstrate excellent face, construct, and content validity findings. To our knowledge, this is the first virtual reality simulator with haptic feedback for training residents and surgeons in the laparoscopic adjustable gastric banding procedure.

The initial impact of EU ETS verification events on stock prices

International Nuclear Information System (INIS)

Brouwers, Roel; Schoubben, Frederiek; Van Hulle, Cynthia; Van Uytbergen, Steve

2016-01-01

This paper studies the impact of verified emissions publications in the European Emissions Trading Scheme (EU ETS) on the market value of participating companies. Using event study methodology on a unique sample of 368 listed companies, we show that verified emissions only resulted in statistically significant market responses when the carbon price was high and allowance scarcity was anticipated. The cross-section analysis of abnormal returns surrounding the publication of verified emissions shows that share prices decrease when actual emissions relative to allocated emissions increase. This negative relationship between allocation shortfalls and firm value is only significant for firms that are either carbon-intensive, compared to sector peers, or are less likely to pass through carbon-related costs in their product prices. The results suggest that although the EU ETS has been deemed unsuccessful so far due to over-allocation and low carbon price, shareholders initially perceived allowance holdings as value relevant. Our results highlight that a significant carbon market price and addressing pass-through costing are essential for successful future reforms of the EU ETS and other analogous carbon cap-and-trade systems implemented or planned worldwide. - Highlights: •We study the impact of EU ETS verified emissions disclosure on firms' market value. •Disclosure is relevant if carbon price is high and permits scarcity is anticipated. •We find a negative relationship between allocation shortfalls and firm value. •Stronger relationship for carbon – intensive and no cost pass-through firms. •High carbon price and addressing cost pass-through are crucial for EU ETS reforms.

Training and support to improve ICD coding quality: A controlled before-and-after impact evaluation

Directory of Open Access Journals (Sweden)

Robin Dyers

2017-06-01

Full Text Available Background. The proposed National Health Insurance policy for South Africa (SA requires hospitals to maintain high-quality International Statistical Classification of Diseases (ICD codes for patient records. While considerable strides had been made to improve ICD coding coverage by digitising the discharge process in the Western Cape Province, further intervention was required to improve data quality. The aim of this controlled before-and-after study was to evaluate the impact of a clinician training and support initiative to improve ICD coding quality. Objective. To compare ICD coding quality between two central hospitals in the Western Cape before and after the implementation of a training and support initiative for clinicians at one of the sites. Methods. The difference in differences in data quality between the intervention site and the control site was calculated. Multiple logistic regression was also used to determine the odds of data quality improvement after the intervention and to adjust for potential differences between the groups. Results. The intervention had a positive impact of 38.0% on ICD coding completeness over and above changes that occurred at the control site. Relative to the baseline, patient records at the intervention site had a 6.6 (95% confidence interval 3.5 - 16.2 adjusted odds ratio of having a complete set of ICD codes for an admission episode after the introduction of the training and support package. The findings on impact on ICD coding accuracy were not significant. Conclusion. There is sufficient pragmatic evidence that a training and support package will have a considerable positive impact on ICD coding completeness in the SA setting.

Differential impact of fathers' authoritarian parenting on early adolescent adjustment in conservative protestant versus other families.

Science.gov (United States)

Gunnoe, Marjorie Lindner; Hetherington, E Mavis; Reiss, David

2006-12-01

The purpose of the study was to determine whether well-established associations between authoritarian parenting and adolescent adjustment pertain to conservative Protestant (CP) families. Structural equation modeling was used to test paths from biological fathers' authoritarian parenting to adolescent adjustment in 65 CP versus 170 comparison families in the Nonshared Environment and Adolescent Development Study (NEAD; D. Reiss et al., 1994). The hypothesis that adolescents in CP families would be less harmed by authoritarian parenting than would adolescents in control families was partially supported: Authoritarian parenting directly predicted greater externalizing and internalizing for adolescents in control families but not for adolescents in CP families. In contrast, parents' religious affiliation failed to moderate the negative associations between authoritarian parenting and positive adjustment. Understanding family processes specific to the CP subculture is important for helping these families raise competent children. (c) 2006 APA, all rights reserved.

PMHS impact response in 3 m/s and 8 m/s nearside impacts with abdomen offset.

Science.gov (United States)

Miller, Carl S; Madura, Nathaniel H; Schneider, Lawrence W; Klinich, Kathleen D; Reed, Matthew P; Rupp, Jonathan D

2013-11-01

Lateral impact tests were performed using seven male post-mortem human subjects (PMHS) to characterize the force-deflection response of contacted body regions, including the lower abdomen. All tests were performed using a dual-sled, side-impact test facility. A segmented impactor was mounted on a sled that was pneumatically accelerated into a second, initially stationary sled on which a subject was seated facing perpendicular to the direction of impact. Positions of impactor segments were adjusted for each subject so that forces applied to different anatomic regions, including thorax, abdomen, greater trochanter, iliac wing, and thigh, could be independently measured on each PMHS. The impactor contact surfaces were located in the same vertical plane, except that the abdomen plate was offset 5.1 cm towards the subject. The masses of the sleds and the force- deflection characteristics of the energy-absorbing interface material between the sleds were set to provide the impactor sled with a velocity profile that matched the average driver door velocity history produced in a series of side NCAP tests. Impactor padding was also selected so that average ATD pelvis and thorax responses from the same series of side NCAP tests were reproduced when the ATD used in these tests was impacted using the average door-velocity history. Each subject was first impacted on one side of the body using an initial impactor speed of 3 m/s. If a post-test CT scan and strain-gage data revealed two or fewer non-displaced rib fractures, then the PMHS was impacted on the contralateral side of the body at a speed of 8 m/s or 10 m/s. The results of tests in the 3 m/s and 8 m/s conditions were used to develop force-deflection response corridors for the abdomen, force history response corridors for the pelvis (iliac wing and greater trochanter), the midthigh, and the thorax. Response corridors for the lateral acceleration of the pelvis were also developed. Future work will compare side impact ATD

How Do I Deal with Depression and Adjustment to My Spinal Cord Injury?

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Full Text Available ... with Gary Karp Resources The emotional impact of paralysis Learning that you are paralyzed is devastating and ... speak with your physician immediately. Webcast: Adjusting to paralysis, with Gary Karp Resources If you are looking ...

Pet Ownership and Cancer Risk in the Women’s Health Initiative

Science.gov (United States)

Garcia, David O.; Lander, Eric M.; Wertheim, Betsy C.; Manson, JoAnn E.; Volpe, Stella L.; Chlebowski, Rowan T.; Stefanick, Marcia L.; Lessin, Lawrence S.; Kuller, Lewis H.; Thomson, Cynthia A.

2016-01-01

Background Pet ownership and cancer are both highly prevalent in the U.S. Evidence suggest associations may exist between this potentially modifiable factor and cancer prevention, though studies are sparse. The present report examined whether pet ownership (dog, cat, or bird) is associated with lower risk for total cancer and site-specific obesity-related cancers. Methods A prospective analysis of 123,560 participants (20,981 dog owners; 19,288 cat owners; 1,338 bird owners; and 81,953 non-pet owners) enrolled in the Women’s Health Initiative (WHI) observational study and clinical trials. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between pet ownership and cancer, adjusted for potential confounders. Results There were no significant relationships between ownership of a dog, cat, or bird and incidence of cancer overall. When site-specific cancers were examined, no associations were observed after adjustment for multiple comparisons. Conclusion Pet ownership had no association with overall cancer incidence. Impact This is the first large epidemiological study to date to explore relationships between pet ownership and cancer risk, as well as associated risks for individual cancer types. This study requires replication in other sizable, diverse cohorts. PMID:27365150

Productivity growth in outpatient child and adolescent mental health services: the impact of case-mix adjustment.

Science.gov (United States)

Halsteinli, Vidar; Kittelsen, Sverre A; Magnussen, Jon

2010-02-01

The performance of health service providers may be monitored by measuring productivity. However, the policy value of such measures may depend crucially on the accuracy of input and output measures. In particular, an important question is how to adjust adequately for case-mix in the production of health care. In this study, we assess productivity growth in Norwegian outpatient child and adolescent mental health service units (CAMHS) over a period characterized by governmental utilization of simple productivity indices, a substantial increase in capacity and a concurrent change in case-mix. We analyze the sensitivity of the productivity growth estimates using different specifications of output to adjust for case-mix differences. Case-mix adjustment is achieved by distributing patients into eight groups depending on reason for referral, age and gender, as well as correcting for the number of consultations. We utilize the nonparametric Data Envelopment Analysis (DEA) method to implicitly calculate weights that maximize each unit's efficiency. Malmquist indices of technical productivity growth are estimated and bootstrap procedures are performed to calculate confidence intervals and to test alternative specifications of outputs. The dataset consist of an unbalanced panel of 48-60 CAMHS in the period 1998-2006. The mean productivity growth estimate from a simple unadjusted patient model (one single output) is 35%; adjusting for case-mix (eight outputs) reduces the growth estimate to 15%. Adding consultations increases the estimate to 28%. The latter reflects an increase in number of consultations per patient. We find that the governmental productivity indices strongly tend to overestimate productivity growth. Case-mix adjustment is of major importance and governmental utilization of performance indicators necessitates careful considerations of output specifications. Copyright 2009 Elsevier Ltd. All rights reserved.

Psychological Adjustment of Siblings of Children with Autism Spectrum Disorder in Hong Kong.

Science.gov (United States)

Chan, J Yn; Lai, K Yc

2016-12-01

Findings about the psychological adjustment of siblings of children with autism spectrum disorder have been inconsistent in western literature and little is known among non-western societies. This study explored the psychological adjustment of siblings of children with autism spectrum disorder in Hong Kong. A total of 116 families with siblings of children with autism spectrum disorders co-morbid with learning disability were included in the study. Parents completed questionnaires about sibling emotional and behavioural adjustment, and their own mental well-being, quality of life, and family functioning. Siblings completed a questionnaire on their relationship with the autistic proband. Parent ratings did not reveal any significant negative impact on the emotional and behavioural adjustment of the typically developing siblings of children with autism spectrum disorder, but there were concerns about their peer relationships and weak prosocial behaviours. When cut-off scores were used to screen for risk of mental health problems, a quarter of the siblings warranted further assessment. Parents' quality of life and family functioning were significant predictors of sibling adjustment. In managing children with autism spectrum disorder, it is necessary to bear in mind the adjustment of their siblings, especially their peer relationships and prosocial behaviour. Adopting a holistic approach to address the psychosocial needs of the parents can facilitate sibling adjustment.

Siblings of children with life-limiting conditions: psychological adjustment and sibling relationships.

Science.gov (United States)

Fullerton, J M; Totsika, V; Hain, R; Hastings, R P

2017-05-01

This study explored psychological adjustment and sibling relationships of siblings of children with life-limiting conditions (LLCs), expanding on previous research by defining LLCs using a systematic classification of these conditions. Thirty-nine siblings participated, aged 3-16 years. Parents completed measures of siblings' emotional and behavioural difficulties, quality of life, sibling relationships and impact on families and siblings. Sibling and family adjustment and relationships were compared with population norms, where available, and to a matched comparison group of siblings of children with autistic spectrum disorder (ASD), as a comparable 'high risk' group. LLC siblings presented significantly higher levels of emotional and behavioural difficulties, and lower quality of life than population norms. Their difficulties were at levels comparable to siblings of children with ASD. A wider impact on the family was confirmed. Family socio-economic position, time since diagnosis, employment and accessing hospice care were factors associated with better psychological adjustment. Using a systematic classification of LLCs, the study supported earlier findings of increased levels of psychological difficulties in siblings of children with a LLC. The evidence is (i) highlighting the need to provide support to these siblings and their families, and (ii) that intervention approaches could be drawn from the ASD field. © 2016 John Wiley & Sons Ltd.

Impact of initial tumor volume on radiotherapy outcome in patients with T2 glottic cancer

International Nuclear Information System (INIS)

Rutkowski, T.

2014-01-01

The aim of this study was to quantify the impact of initial tumor volume (TV) on radiotherapy (RT) outcome in patients with T2 glottic cancer. Initial TV was calculated for 115 consecutive patients with T2 glottic cancer who had been treated with definitive RT alone at a single institution. The results showed strong correlations of TV with 3-year local tumor control (LTC) and disease-free survival (DFS). For TV ≤ 0.7 cm 3 , 3-year LTC was 83 %; for TV 0.7-3.6 cm 3 this was 70 % and for TV 3.6-17 cm 3 44 %. Analysis of total dose vs. initial TV showed that larger T2 glottic tumors with a TV of around 5 cm 3 (2-2.5 cm in diameter with 10 10 cancer cells) need an extra 6.5 Gy to achieve similar 3-year LTC rates as for small tumors with a TV of 0.5 cm 3 (∝1 cm in diameter with 10 9 cancer cells). Although classification of tumors according to TV cannot replace TNM staging in daily practice, it could represent a valuable numerical supplement for planning the optimal dose fractionation scheme for individual patients. (orig.)

Initial impact of a systematic multidisciplinary approach on the management of patients with gastroenteropancreatic neuroendocrine tumor.

LENUS (Irish Health Repository)

Tamagno, Gianluca

2013-10-01

According to the international guidelines, a multidisciplinary approach is currently advised for the optimal care of patients with a gastroenteropancreatic neuroendocrine tumor (GEP NET). In our institution (tertiary care center), a systematic multidisciplinary approach was established in May 2007. In this study, we have aimed to assess the initial impact of establishing a systematic multidisciplinary approach to the management of GEP NET patients. We have collected and compared the biochemical, imaging, and pathological data and the therapeutic strategies in GEP NET patients diagnosed, treated, or followed-up from January 1993 to April 2007 versus GEP NET patients attending our institution after the multidisciplinary approach starting, from May 2007 to October 2008. Data of 91 patients before and 42 patients after the establishment of the multidisciplinary approach (total: 133 consecutive GEP NET patients) have been finally collected and analyzed. Before the establishment of the multidisciplinary approach, a lack of consistency in the biochemical, imaging, and pathological findings before treatment initiation as well as during follow-up of GEP NET patients was identified. These inconsistencies have been reduced by the systematic multidisciplinary approach. In addition, the therapeutic management of GEP NET patients has been altered by the multidisciplinary approach and became more consistent with recommended guidelines. We think that a systematic multidisciplinary approach significantly impacts on GEP NET patient care and should be established in all centers dealing with these tumors.

The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives.

Science.gov (United States)

Leibowitz, Scott F; Spack, Norman P

2011-10-01

Few interdisciplinary treatment programs that tend to the needs of youth with gender nonconforming behaviors, expressions, and identities exist in academic medical centers with formal residency training programs. Despite this, the literature provides evidence that these youth have higher rates of poor psychosocial adjustment and suicide attempts. This article explores the logistical considerations involved in developing a specialized interdisciplinary service to these gender minority youth in accordance with the existing treatment guidelines.Demographic data will be presented and treatment issues will be explored. The impact that a specialized interdisciplinary treatment program has on clinical expansion, research development, education and training, and community outreach initiatives is discussed.

Development of a MELCOR self-initialization algorithm for boiling water reactors

International Nuclear Information System (INIS)

Chien, C.S.; Wang, S.J.; Cheng, S.K.

1996-01-01

The MELCOR code, developed by Sandia National Laboratories, is suitable for calculating source terms and simulating severe accident phenomena of nuclear power plants. Prior to simulating a severe accident transient with MELCOR, the initial steady-state conditions must be generated in advance. The current MELCOR users' manuals do not provide a self-initialization procedure; this is the reason users have to adjust the initial conditions by themselves through a trial-and-error approach. A MELCOR self-initialization algorithm for boiling water reactor plants has been developed, which eliminates the tedious trial-and-error procedures and improves the simulation accuracy. This algorithm adjusts the important plant variable such as the dome pressure, downcomer level, and core flow rate to the desired conditions automatically. It is implemented through input with control functions provided in MELCOR. The reactor power and feedwater temperature are fed as input data. The initialization work of full-power conditions of the Kuosheng nuclear power station is cited as an example. These initial conditions are generated successfully with the developed algorithm. The generated initial conditions can be stored in a restart file and used for transient analysis. The methodology in this study improves the accuracy and consistency of transient calculations. Meanwhile, the algorithm provides all MELCOR users an easy and correct method for establishing the initial conditions

An evaluation of the process and initial impact of disseminating a nursing e-thesis.

Science.gov (United States)

Macduff, Colin

2009-05-01

This paper is a report of a study conducted to evaluate product, process and outcome aspects of the dissemination of a nursing PhD thesis via an open-access electronic institutional repository. Despite the growth of university institutional repositories which make theses easily accessible via the world wide web, nursing has been very slow to evaluate related processes and outcomes. Drawing on Stake's evaluation research methods, a case study design was adopted. The case is described using a four-phase structure within which key aspects of process and impact are reflexively analysed. In the conceptualization/re-conceptualization phase, fundamental questions about the purpose, format and imagined readership for a published nursing PhD were considered. In the preparation phase, seven key practical processes were identified that are likely to be relevant to most e-theses. In the dissemination phase email invitations were primarily used to invite engagement. The evaluation phase involved quantitative indicators of initial impact, such as page viewing and download statistics and qualitative feedback on processes and product. Analysis of process and impact elements of e-thesis dissemination is likely to have more than intrinsic value. The advent of e-theses housed in web-based institutional repositories has the potential to transform thesis access and use. It also offers potential to transform the nature and scope of thesis production and dissemination. Nursing scholars can exploit and evaluate such opportunities.

Lipid and Creatinine Adjustment to Evaluate Health Effects of Environmental Exposures.

Science.gov (United States)

O'Brien, Katie M; Upson, Kristen; Buckley, Jessie P

2017-03-01

Urine- and serum-based biomarkers are useful for assessing individuals' exposure to environmental factors. However, variations in urinary creatinine (a measure of dilution) or serum lipid levels, if not adequately corrected for, can directly impact biomarker concentrations and bias exposure-disease association measures. Recent methodological literature has considered the complex relationships between creatinine or serum lipid levels, exposure biomarkers, outcomes, and other potentially relevant factors using directed acyclic graphs and simulation studies. The optimal measures of urinary dilution and serum lipids have also been investigated. Existing evidence supports the use of covariate-adjusted standardization plus creatinine adjustment for urinary biomarkers and standardization plus serum lipid adjustment for lipophilic, serum-based biomarkers. It is unclear which urinary dilution measure is best, but all serum lipid measures performed similarly. Future research should assess methods for pooled biomarkers and for studying diseases and exposures that affect creatinine or serum lipids directly.

Are Students Really Connected? Predicting College Adjustment from Social Network Usage

Science.gov (United States)

Raacke, John; Bonds-Raacke, Jennifer

2015-01-01

The rapid growth in popularity of social networking sites has spurred research exploring the impact of usage in a variety of areas. The current study furthered this line of research by examining the relationships between social network usage and adjustment to college in the academic, social, personal-emotional and university affiliation domains.…

Women and Retirement: The Effect of Multiple Careers on Retirement Adjustment.

Science.gov (United States)

Connidis, Ingrid

1982-01-01

The concept of career set is employed as the basis for a framework designed to analyze the impact of women's involvement in multiple careers on their adjustment to retirement. The author concludes that the familial careers engaged in by married, working women have a mediative effect on their transition to retirement. (Author/CT)

Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries.

Science.gov (United States)

Montagu, Dominic; Ngamkitpaiboon, Lek; Duvall, Susan; Ratcliffe, Amy

2013-01-01

Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social franchising spreads beyond family planning

Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries

Science.gov (United States)

2013-01-01

Background Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Methods Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Results Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. Conclusion In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social

How Do I Deal with Depression and Adjustment to My Spinal Cord Injury?

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Full Text Available ... I deal with depression and adjustment to my SCI? ☷ ▾ Page contents The emotional impact of paralysis Understanding ... Americans living with some form of paralysis (stroke, SCI, MS, ALS, etc.) and many resources to help ...

Changes in living arrangement, daily smoking, and risky drinking initiation among young Swiss men: a longitudinal cohort study.

Science.gov (United States)

Bähler, C; Foster, S; Estévez, N; Dey, M; Gmel, G; Mohler-Kuo, M

2016-11-01

The aim of this study was to assess the association between changes in living arrangement and the initiation of daily smoking and monthly risky single-occasion drinking (RSOD) in a cohort of young Swiss men. Longitudinal cohort study. The sample consisted of 4662 young men drawn from the Cohort Study on Substance Use Risk Factors who lived with their family at baseline. Follow-up assessments occurred 15 months later. Multiple regression models were adjusted for individual and family factors (family model), as well as for individual and peer-related factors (peer model). Relative to those still living with their parents at follow-up (n = 3845), those who had moved out (n = 817) were considerably more likely to have taken up smoking or RSOD after adjusting for several individual, family, and peer-related variables: OR (daily smoking) = 1.67 (95% CI 1.15-2.41) (P = 0.007) and OR (monthly RSOD) = 1.42 (95% CI 1.08-1.88) (P = 0.012). The strongest family-related predictors of smoking initiation were family structure and the lack of parental regulation and the strongest peer-related factors alcohol/drug problems in peers. Meanwhile, the strongest peer-related predictors of RSOD initiation were peer pressure (misconduct), perceived social support from friends, and perceived social support from a significant other, whereas family factors were not associated with RSOD initiation. Further subanalyses were conducted to examine the impact of different living arrangement changes on substance use initiation and revealed that living with peers at follow-up was associated with the greatest risk. We identified a strong association between moving out of one's parents' home and daily smoking and monthly RSOD initiation in young Swiss men. Moving out to live with peers was an especially strong predictor of substance use initiation. Campaigns that aim to prevent heavy smoking and drinking should be intensified at the end of obligatory school. Copyright © 2016 The Royal

Parental attachment and adolescents' emotional adjustment: The associations with social skills and relational competence

NARCIS (Netherlands)

Engels, R.C.M.E.; Finkenauer, C.; Meeus, W.H.J.; Dekovic, M.

2001-01-01

Young people learn from their interactions with their parents how to initiate and maintain satisfying and warm friendships. Attachment with parents thereby plays an important role in adolescents' social and emotional adjustment. The model tested in this study proposes that the relation between

pH-adjustment strategy for volatile fatty acid production from high-strength wastewater for biological nutrient removal.

Science.gov (United States)

Xie, Li; Liu, Hui; Chen, Yin-Guang; Zhou, Qi

2014-01-01

Volatile fatty acid (VFA) production from three types of high-strength organic wastewater (cassava thin stillage, starch wastewater and yellow-wine processing wastewater) were compared. The results showed that cassava thin stillage was the most suitable substrate, based on its high specific VFA production (0.68 g chemical oxygen demand (COD)/g initial soluble chemical oxygen demand (SCOD)) and yield (0.72 g COD/g SCOD) as well as low nutrient content in the substrate and fermented liquid. The acid fermented cassava thin stillage was evaluated and compared with sodium acetate in a sequencing batch reactor system. Total nitrogen removal efficiency was higher with fermented cassava thin stillage than with the sodium acetate. The effects of pH and a pH-adjustment strategy on VFA production and composition were determined using cassava thin stillage. At an initial pH range of 7-11, a relatively high VFA concentration of about 9 g COD/L was obtained. The specific VFA production (g COD/g initial SCOD) increased from 0.27 to 0.47 to 0.67 at pH 8 and from 0.26 to 0.68 to 0.81 at pH 9 (initial pH, interval pH, and constant pH adjustment, respectively). The dominant VFA species changed significantly with the increasing frequency of the pH adjustment. Further studies will examine the metabolic pathways responsible for VFA composition.

Patterns of attachment and parents' adjustment to the death of their child

NARCIS (Netherlands)

Wijngaards-de Meij, L.D.N.V.; Stroebe, M.S.; Schut, H.A.W.; Stroebe, W.; Van den Bout, J.; Van der Heijden, P.G.M.; Dijkstra, I.C.

2007-01-01

The impact of adult attachment on psychological adjustment among bereaved parents and the mediating effect of relationship satisfaction were examined among a sample of 219 couples of parents. Data collection took place 6, 13, and 20 months after loss. Use of the actor partner interdependence model

Research on Initiation Sensitivity of Solid Explosive and Planer Initiation System

Directory of Open Access Journals (Sweden)

N Matsuo

2016-09-01

Full Text Available Firstly, recently, there are a lot of techniques being demanded for complex process, various explosive initiation method and highly accurate control of detonation are needed. In this research, the metal foil explosion using high current is focused attention on the method to obtain linear or planate initiation easily, and the main evaluation of metal foil explosion to initiate explosive was conducted. The explosion power was evaluated by observing optically the underwater shock wave generated from the metal foil explosion. Secondly, in high energy explosive processing, there are several applications, such as shock compaction, explosive welding, food processing and explosive forming. In these explosive applications, a high sensitive explosive has been mainly used. The high sensitive explosive is so dangerous, since it can lead to explosion suddenly. So, for developing explosives, the safety is the most important thing as well as low manufacturing cost and explosive characteristics. In this work, we have focused on the initiation sensitivity of a solid explosive and performed numerical analysis of sympathetic detonation. The numerical analysis is calculated by LS-DYNA 3D (commercial code. To understand the initiation reaction of an explosive, Lee-Tarver equation was used and impact detonation process was analyzed by ALE code. Configuration of simulation model is a quarter of circular cylinder. The donor type of explosive (SEP was used as initiation explosive. When the donor explosive is exploded, a shock wave is generated and it propagates into PMMA, air and metallic layers in order. During passing through the layers, the shock wave is attenuated and finally, it has influence on the acceptor explosive, Comp. B. Here, we evaluate the initiation of acceptor explosive and discuss about detonation pressure, reactive rate of acceptor explosive and attenuation of impact pressure.

Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents

International Nuclear Information System (INIS)

Weaver, Virginia M.; Vargas, Gonzalo García; Silbergeld, Ellen K.; Rothenberg, Stephen J.; Fadrowski, Jeffrey J.; Rubio-Andrade, Marisela; Parsons, Patrick J.; Steuerwald, Amy J.

2014-01-01

Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, blood lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m 2 ; 95% confidence interval=1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary. - Highlights: • Positive associations between urine metals and creatinine-based eGFR are unexpected. • Optimal approach to urine concentration adjustment for urine biomarkers uncertain. • We compared urine concentration adjustment methods. • Positive associations observed only with urine creatinine adjustment. • Additional research using non-creatinine-based methods of adjustment needed

Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents

Energy Technology Data Exchange (ETDEWEB)

Weaver, Virginia M., E-mail: vweaver@jhsph.edu [Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States); Johns Hopkins University School of Medicine, Baltimore, MD (United States); Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States); Vargas, Gonzalo García [Faculty of Medicine, University of Juárez of Durango State, Durango (Mexico); Secretaría de Salud del Estado de Coahuila, Coahuila, México (Mexico); Silbergeld, Ellen K. [Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States); Rothenberg, Stephen J. [Instituto Nacional de Salud Publica, Centro de Investigacion en Salud Poblacional, Cuernavaca, Morelos (Mexico); Fadrowski, Jeffrey J. [Johns Hopkins University School of Medicine, Baltimore, MD (United States); Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States); Rubio-Andrade, Marisela [Faculty of Medicine, University of Juárez of Durango State, Durango (Mexico); Parsons, Patrick J. [Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY (United States); Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, NY (United States); Steuerwald, Amy J. [Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY (United States); and others

2014-07-15

Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, blood lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m{sup 2}; 95% confidence interval=1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary. - Highlights: • Positive associations between urine metals and creatinine-based eGFR are unexpected. • Optimal approach to urine concentration adjustment for urine biomarkers uncertain. • We compared urine concentration adjustment methods. • Positive associations observed only with urine creatinine adjustment. • Additional research using non-creatinine-based methods of adjustment needed.

Metric-adjusted skew information

DEFF Research Database (Denmark)

Liang, Cai; Hansen, Frank

2010-01-01

on a bipartite system and proved superadditivity of the Wigner-Yanase-Dyson skew informations for such states. We extend this result to the general metric-adjusted skew information. We finally show that a recently introduced extension to parameter values 1 ...We give a truly elementary proof of the convexity of metric-adjusted skew information following an idea of Effros. We extend earlier results of weak forms of superadditivity to general metric-adjusted skew information. Recently, Luo and Zhang introduced the notion of semi-quantum states...... of (unbounded) metric-adjusted skew information....

Brazilian Alcohol Program (Proalcool): economic re-evaluation and demand adjustments

International Nuclear Information System (INIS)

Motta, R.S. da; Rocha Ferreira, L. da

1987-01-01

The aim of this paper is to discuss the economic impact on the Brazilian National Alcohol Programme caused by changes in the energy scenery, in view of recent oil price fall in the international market, and evaluate the necessary adjustments of the Programme according to the new Brazilian economic reality. The economic analysis concludes that the alcohol production, considering current production capacity and its investments, could be economically feasible at international oil prices near US$ 30.00. Excluding investments, its feasibility would be between US$ 18.00 and US$ 20.00 per equivalent oil barrel. Based on these conclusions, proposals for adjusting the PROALCOOL are discussed, including alternative pricing, fiscal and credit policies to control the alcohol-fuel demand. (author)

Final Report on the Study of the Impact of the Statewide Systemic Initiatives. Lessons Learned about Designing, Implementing, and Evaluating Statewide Systemic Reform. WCER Working Paper No. 2003-12

Science.gov (United States)

Heck, Daniel J.; Weiss, Iris R.; Boyd, Sally E.; Howard, Michael N.; Supovitz, Jonathan A.

2003-01-01

This document represents the first of two volumes presented in "Study of the Impact of the Statewide Systemic Initiatives Program" (Norman L. Webb and Iris R. Weiss). In an effort to evaluate the impact of the Statewide Systemic Initiatives (SSIs) on student achievement and the lessons that could be learned from the National Science…

ADJUSTABLE CHIP HOLDER

DEFF Research Database (Denmark)

2009-01-01

An adjustable microchip holder for holding a microchip is provided having a plurality of displaceable interconnection pads for connecting the connection holes of a microchip with one or more external devices or equipment. The adjustable microchip holder can fit different sizes of microchips...

Self-initialization of the RELAP4 code momentum equation

International Nuclear Information System (INIS)

Kern, R.C.; Hsu, M.T.

1978-01-01

One difficulty in using the RELAP4 code is that, owing to the overspecification of the volume and junction input data for the initial conditions, a residual friction term must be defined to establish steady-state conditions. If the corresponding residual friction coefficient is out of allowable range, the calculation is terminated at the initial data checking phase. An allowable residual friction coefficient is added to the form loss coefficient and is used throughout the transient calculation. This might affect the results if the residual friction coefficient is large. However, to model a system represented by a large number of volumes and junctions, manual adjustment of the input data, such as the pressure distribution, to reduce the effect of residual terms can take a significant amount of engineering time. A procedure that allows the code to do the adjustment internally is described

Non-canonical transcription initiation: the expanding universe of transcription initiating substrates

Czech Academy of Sciences Publication Activity Database

Barvík, I.; Rejman, Dominik; Panova, Natalya; Šanderová, Hana; Krásný, Libor

2017-01-01

Roč. 41, č. 2 (2017), s. 131-138 ISSN 0168-6445 R&D Projects: GA ČR GA15-05228S; GA ČR GA15-11711S Institutional support: RVO:61388963 ; RVO:61388971 Keywords : RNA polymerase * non-canonical transcription initiation * transcription initiating substrate * nicotinamide adenine dinucleotide (NAD(+)) * coenzymes * RNA stability Subject RIV: EB - Genetics ; Molecular Biology; EE - Microbiology, Virology (MBU-M) OBOR OECD: Biochemistry and molecular biology; Microbiology (MBU-M) Impact factor: 12.198, year: 2016

Does Maternal HIV Disclosure Self-Efficacy Enhance Parent-Child Relationships and Child Adjustment?

Science.gov (United States)

Armistead, Lisa; Goodrum, Nada; Schulte, Marya; Marelich, William; LeCroix, Rebecca; Murphy, Debra A

2018-02-09

Nondisclosure of maternal HIV status to young children can negatively impact child functioning; however, many mothers do not disclose due to lack of self-efficacy for the disclosure process. This study examines demographic variations in disclosure self-efficacy, regardless of intention to disclose, and assesses the relationship between self-efficacy and child adjustment via the parent-child relationship among a sample of HIV+ mothers and their healthy children (N = 181 pairs). Mothers completed demographic and self-efficacy measures; children completed measures assessing the parent-child relationship and child adjustment (i.e., worry, self-concept, depression). Across demographics, few mothers reported confidence in disclosure. Results from covariance structural modeling showed mothers endorsing higher self-efficacy had children who reported better relationship quality, and, in turn, reported fewer adjustment difficulties; higher levels of disclosure self-efficacy also directly predicted fewer adjustment problems. Findings offer support for interventions aimed at providing mothers with skills to enhance confidence for disclosing their HIV status.

Repatriation Adjustment: Literature Review

Directory of Open Access Journals (Sweden)

Gamze Arman

2009-12-01

Full Text Available Expatriation is a widely studied area of research in work and organizational psychology. After expatriates accomplish their missions in host countries, they return to their countries and this process is called repatriation. Adjustment constitutes a crucial part in repatriation research. In the present literature review, research about repatriation adjustment was reviewed with the aim of defining the whole picture in this phenomenon. Present research was classified on the basis of a theoretical model of repatriation adjustment. Basic frame consisted of antecedents, adjustment, outcomes as main variables and personal characteristics/coping strategies and organizational strategies as moderating variables.

Children born through reproductive donation: a longitudinal study of psychological adjustment.

Science.gov (United States)

Golombok, Susan; Blake, Lucy; Casey, Polly; Roman, Gabriela; Jadva, Vasanti

2013-06-01

Parenting and children's adjustment were examined in 30 surrogacy families, 31 egg donation families, 35 donor insemination families, and 53 natural conception families. Parenting was assessed at age 3 by a standardized interview designed to assess quality of parenting and by questionnaire measures of anxiety, depression, and marital quality. Children's adjustment was assessed at ages 3, 7, and 10 using the Strengths and Difficulties Questionnaire (SDQ). Although children born through reproductive donation obtained SDQ scores within the normal range, surrogacy children showed higher levels of adjustment difficulties at age 7 than children conceived by gamete donation. Mothers who had kept their child's origins secret showed elevated levels of distress. However, maternal distress had a more negative impact on children who were aware of their origins. The absence of a gestational connection to the mother may be more problematic for children than the absence of a genetic link. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

Corruption kills: estimating the global impact of corruption on children deaths.

Science.gov (United States)

Hanf, Matthieu; Van-Melle, Astrid; Fraisse, Florence; Roger, Amaury; Carme, Bernard; Nacher, Mathieu

2011-01-01

Information on the global risk factors of children mortality is crucial to guide global efforts to improve survival. Corruption has been previously shown to significantly impact on child mortality. However no recent quantification of its current impact is available. The impact of corruption was assessed through crude Pearson's correlation, univariate and multivariate linear models coupling national under-five mortality rates in 2008 to the national "perceived level of corruption" (CPI) and a large set of adjustment variables measured during the same period. The final multivariable model (adjusted R(2)= 0.89) included the following significant variables: percentage of people with improved sanitation (p.valueCorruption Perception Index (p.valuecorruption) was associated with an increase in the log of national under-five mortality rate of 0.0644. According to this result, it could be roughly hypothesized that more than 140000 annual children deaths could be indirectly attributed to corruption. Global response to children mortality must involve a necessary increase in funds available to develop water and sanitation access and purchase new methods for prevention, management, and treatment of major diseases drawing the global pattern of children deaths. However without paying regard to the anti-corruption mechanisms needed to ensure their proper use, it will also provide further opportunity for corruption. Policies and interventions supported by governments and donors must integrate initiatives that recognise how they are inter-related.

Continuing Education Workshops in Bioinformatics Positively Impact Research and Careers.

Science.gov (United States)

Brazas, Michelle D; Ouellette, B F Francis

2016-06-01

Bioinformatics.ca has been hosting continuing education programs in introductory and advanced bioinformatics topics in Canada since 1999 and has trained more than 2,000 participants to date. These workshops have been adapted over the years to keep pace with advances in both science and technology as well as the changing landscape in available learning modalities and the bioinformatics training needs of our audience. Post-workshop surveys have been a mandatory component of each workshop and are used to ensure appropriate adjustments are made to workshops to maximize learning. However, neither bioinformatics.ca nor others offering similar training programs have explored the long-term impact of bioinformatics continuing education training. Bioinformatics.ca recently initiated a look back on the impact its workshops have had on the career trajectories, research outcomes, publications, and collaborations of its participants. Using an anonymous online survey, bioinformatics.ca analyzed responses from those surveyed and discovered its workshops have had a positive impact on collaborations, research, publications, and career progression.

Time to ART Initiation among Patients Treated for Rifampicin-Resistant Tuberculosis in Khayelitsha, South Africa: Impact on Mortality and Treatment Success.

Science.gov (United States)

Daniels, Johnny Flippie; Khogali, Mohammed; Mohr, Erika; Cox, Vivian; Moyo, Sizulu; Edginton, Mary; Hinderaker, Sven Gudmund; Meintjes, Graeme; Hughes, Jennifer; De Azevedo, Virginia; van Cutsem, Gilles; Cox, Helen Suzanne

2015-01-01

Khayelitsha, South Africa, with high burdens of rifampicin-resistant tuberculosis (RR-TB) and HIV co-infection. To describe time to antiretroviral treatment (ART) initiation among HIV-infected RR-TB patients initiating RR-TB treatment and to assess the association between time to ART initiation and treatment outcomes. A retrospective cohort study of patients with RR-TB and HIV co-infection not on ART at RR-TB treatment initiation. Of the 696 RR-TB and HIV-infected patients initiated on RR-TB treatment between 2009 and 2013, 303 (44%) were not on ART when RR-TB treatment was initiated. The median CD4 cell count was 126 cells/mm3. Overall 257 (85%) patients started ART during RR-TB treatment, 33 (11%) within 2 weeks, 152 (50%) between 2-8 weeks and 72 (24%) after 8 weeks. Of the 46 (15%) who never started ART, 10 (21%) died or stopped RR-TB treatment within 4 weeks and 16 (37%) had at least 4 months of RR-TB treatment. Treatment success and mortality during treatment did not vary by time to ART initiation: treatment success was 41%, 43%, and 50% among patients who started ART within 2 weeks, between 2-8 weeks, and after 8 weeks (p = 0.62), while mortality was 21%, 13% and 15% respectively (p = 0.57). Mortality was associated with never receiving ART (adjusted hazard ratio (aHR) 6.0, CI 2.1-18.1), CD4 count ≤100 (aHR 2.1, CI 1.0-4.5), and multidrug-resistant tuberculosis (MDR-TB) with second-line resistance (aHR 2.5, CI 1.1-5.4). Despite wide variation in time to ART initiation among RR-TB patients, no differences in mortality or treatment success were observed. However, a significant proportion of patients did not initiate ART despite receiving >4 months of RR-TB treatment. Programmatic priorities should focus on ensuring all patients with RR-TB/HIV co-infection initiate ART regardless of CD4 count, with special attention for patients with CD4 counts ≤ 100 to initiate ART as soon as possible after RR-TB treatment initiation.

Design procedure for a wind-wheel with self-adjusting blade mechanism

Directory of Open Access Journals (Sweden)

Gennady A. Oborsky

2014-12-01

Full Text Available Developed is a wind-wheel design equipped with the self-adjusting blade. The blade is positioned eccentrically to the balance wheel and can freely rotate around its axis. Elaborated is the method of calculating the energy characteristics for a wind-wheel with the self-adjusting blade, considering not only the wind force but the force of air counter flow resistance to the blade’s rotation. Initially, the blade being located at an angle α = 45 to the wheel rotation plane, the air flow rotates the wheel with the maximum force. Thus, the speed of rotation increases that involves the increase in air counter flow resistance and results in blade turning with respective angle α reduction. This, consequently, reduces the torque. When the torsional force and the resistance enter into equilibrium, the blade takes a certain angle α, and the wheel speed becomes constant. This wind-wheel design including a self-adjusting blade allows increasing the air flow load ratio when compared to the wind-wheel equipped with a jammed blade.

River adjustments under varying flow and sediment sypply regimes. The role of hydrograh shape

Science.gov (United States)

Ferrer-Boix, C.; Elgueta, M. A.; Hassan, M. A.

2016-12-01

This research aims to explore how sediment supply conditions and hydrograph shape influence bed surface evolution, vertical and downstream sediment sorting, and sediment transport in gravel bed streams. While a significant body of research has been focused on channel evolution under constant flow regimes, few studies have focused on the impacts of flow variations in channel adjustments. Particularly, we are interested in examining the impact of the sediment supply regime and hydrograph magnitude and duration on channel adjustments and sediment transport rates. To this end, we conducted a set of experiments in a 0.8 m-wide, 5 m-long tilting flume. Flow discharge during the runs was increased and decreased at steps of certain duration allowing us to vary the steepness of rising and falling limbs of hydrographs. The influence of hydrograph shape (symmetrical and asymmetrical) on river morphodynamics was tested. Flow rates during the experiments ranged from 30 l/s to 70 l/s. Some of the experiments were conducted under no feed conditions while others were carried out with sediment supply, which ranged from 10 kg/h to 80 kg/h. The feed texture in these latter runs was identical to that of the original mixture (Dmin = 0.5 mm, Dmax = 64 mm, Dg = 5.65 mm and σg = 3.05). Initial bed slope and surface configuration were obtained after varying times of conditioning under constant flow and no feed. Finally, we conducted equilibrium experiments under constant flow and sediment supply that were used as reference. All these sets of experiments benefited from a very detailed and extensive data monitoring which allowed us to provide a unique description or river adjustments under varying flow conditions. Data acquisition included: 1) bed surface images covering the entire flume, 2) bed scans at 2 mm resolution of the whole flume and 3) real-time measurements of bedload transport (rate and texture) at the outlet of the flume. This set up allows us to obtain fractional particle

Ideological trends in initial teacher education curricula: the case of East African universities

Directory of Open Access Journals (Sweden)

Proscovia Namubiru Ssentamu

2014-12-01

Full Text Available This paper reviews the ideological trends in initial teacher education curricula in East African universities during the post-independent and contemporary times. From the mid-1960s and mid-1980s, initial teacher education curricula were integrated and harmonised with support from the East African Community whose efforts were coordinated by the Inter-University Council for East Africa. With the breakup of the Community in 1977, each independent state pursued its own educational strategy. However, underfunding of the public sector by governments, introduction of market-friendly reforms under the World Bank Structural Adjustment Programme in 1987 and the de-regularisation policies led to the liberalisation of public services, including education. Liberalisation affected among others, the quality of the initial teacher education curricula. Consequently, national councils and commissions for higher education were established to control standards in higher education, and the Inter-University Council for East Africa was revived to standardise and harmonise educational standards at regional level. The review shows that over the past five decades, the structure and organisation of initial teacher education curricula has continuously adjusted itself and been adjusted to a hybrid culture blending classical humanism, utilitarianism, social re-constructionism, market and global ideologies. Comparable ideological inclinations at socio-economic and political levels have influenced this trend in the region. The paper highlights the implications of such trends on the future of initial teacher education in the region.

A scale on beliefs about children's adjustment in same-sex families: reliability and validity.

Science.gov (United States)

Frias-Navarro, Dolores; Monterde-I-Bort, Hector

2012-01-01

In this study, we developed a new instrument named Scale Beliefs about Children's Adjustment on Same-Sex Families (SBCASSF). The scale was developed to assess of the adults' beliefs about negative impacts on children who are raised by same-sex parents. An initial pool of 95 items was generated by the authors based on a review of the literature on homophobia and feedback from several focus groups. Research findings, based on a sample of 212 university students (mean age 22 years, SD = 8.28), supported the reliability and validity of the scale. The final versions of the SBCASSF included items reflecting the following two factors: individual opposition (α = .87) and normative opposition (α = .88). Convergent validity of the scale is demonstrated by predictable correlations with beliefs about the cause of same-sex sexual orientation and the support for gay and lesbian rights. Our study reveals a strong positive association between high scores on SBCASSF and beliefs that the origin of same-sex sexual orientation is learned and opposition to gay and lesbian rights.

The impact of adjustment latitude on self-assessed work ability in regard to gender and occupational type

OpenAIRE

Johansson, Gun; Hultin, Hanna; Möller, Jette; Hallqvist, Johan; Kjellberg, Katarina

2012-01-01

Objective: Adjustment latitude describes opportunities to change demands at work when ill and may affect work ability. The aim here is to study the association between adjustment latitude and self-assessed work ability among men and women and employees from different occupational sectors. Methods: This cross-sectional study used data from a questionnaire sent to 3020 employees in three occupational sectors in Sweden; 1430 responded. Subjects were divided into: full, moderately reduced, and gr...

Child adjustment to separation or divorce of parents

OpenAIRE

Raposo, Hélder Silva; Figueiredo, Bárbara; Lamela, Diogo; Costa, Rui Alexandre Nunes; Castro, Maria; Prego, Joana

2011-01-01

OBJETIVO: O presente artigo procura relacionar e analisar evidências empíricas e teóricas sobre o impacto e os fatores associados ao impacto da separação ou divórcio dos pais no ajustamento da criança. MÉTODO: Realizou-se uma revisão agregativa da literatura, recorrendo às palavras-chave "divorce adjustment", "child divorce" e "divorce impact", nas bases de dados JSTOR, PsycInfo, SciELO e Medline e em livros da especialidade. RESULTADOS: Respostas adaptativas e desadaptativas da criança são d...

Clean Energy Policy Analysis: Impact Analysis of Potential Clean Energy Policy Options for the Hawaii Clean Energy Initiative (HCEI)

Energy Technology Data Exchange (ETDEWEB)

Busche, S.; Doris, E.; Braccio, R.; Lippert, D.; Finch, P.; O' Toole, D.; Fetter, J.

2010-04-01

This report provides detailed analyses of 21 clean energy policy options considered by the Hawaii Clean Energy Initiative working groups for recommendation to the 2010 Hawaii State Legislature. The report considers the impact each policy may have on ratepayers, businesses, and the state in terms of energy saved, clean energy generated, and the financial costs and benefits. The analyses provide insight into the possible impacts, both qualitative and quantitative, that these policies may have in Hawaii based on the experience with these policies elsewhere. As much as possible, the analyses incorporate Hawaii-specific context to reflect the many unique aspects of energy use in the State of Hawaii.

The impact of structural adjustment policies on women's and children's health in Tanzania.

Science.gov (United States)

Lugalla, J L

1995-03-01

Since 1981, the government of Tanzania has adopted a variety of policy measures including the National Economic Survival Plan (NESP), Structural Adjustment Program (SAP), Economic Recovery Program (ERP) I, ERP II, Economic and Social Action Plan (ESAP), and Priority Social Action Plan (PSAP) to deal with the country's present social and economic crisis dating back to the late 1970s. The main objective of the these adjustment measures has been to attain macroeconomic balance by bringing national expenditure into line with national income to reduce inflation and to increase exports. Other objectives have been to maintain egalitarian income distribution and the provision of basic social services to the majority of the population. To realize these objectives, the government has been controlling credit and removed subsidies on certain food items and agricultural inputs, introduced a system of progressive devaluation, liberalized trade, and has been trying to reduce government expenditure by introducing cost sharing measures in the education and health sector. The author concludes that the erosion of real incomes and increased poverty have had a devastating effect upon women and children. Rural women have heavier workloads as males migrate to urban areas in search of work, there is increased maternal mortality, and chronic malnutrition and poverty make it difficult to implement HIV/AIDS intervention strategies.

Can structural adjustment work for women farmers.

Science.gov (United States)

Mehra, R

1991-12-01

This article discusses the impact of structural adjustment programs (SAPs) on women farmers in developing countries. SAPs aim to improve economic efficiency and promote more rapid economic growth. SAPs are introduced in two phases. The first phase involves short-term loans with the condition that the country adopt monetary restraints and currency devaluation measures. In the second phase, long-term loans are given with the provision that the country deregulate their economy and open up markets. The agricultural sector is affected by SAPs because of their importance in employment, income generation, and export earnings. SAPs result in lower farm commodity prices due to currency devaluations and in removal of subsidies, which results in market-sensitive pricing or higher food prices. The impact of SAPs on agriculture vary between countries. In Morocco and Algeria, agriculture expanded under SAPs. In Indonesia, Bolivia, Costa Rica, and Mexico, the agriculture stagnated or declined. Agricultural growth was slowest in Africa. SAPs were somewhat successful in increasing agricultural exports. Food production grew slowly in many adjusting countries. Blame for failures of SAPs has been placed on government failure to implement reforms properly and overly optimistic assumptions about the timing of productive gains. Little attention has focused on the constraints facing women farmers, who are a large proportion of farmers, particularly in sub-Saharan Africa. This article focuses on the issues of limited access to resources, credit, agricultural extension and information, land ownership, education, and time as constraints to women farmers. Women also must ensure household food security. For SAPs to work effectively, complementary policies must be implemented that reallocate available productive resources and new technologies to women and that deal with women's constraints.

Anatomically constrained dipole adjustment (ANACONDA) for accurate MEG/EEG focal source localizations

Science.gov (United States)

Im, Chang-Hwan; Jung, Hyun-Kyo; Fujimaki, Norio

2005-10-01

This paper proposes an alternative approach to enhance localization accuracy of MEG and EEG focal sources. The proposed approach assumes anatomically constrained spatio-temporal dipoles, initial positions of which are estimated from local peak positions of distributed sources obtained from a pre-execution of distributed source reconstruction. The positions of the dipoles are then adjusted on the cortical surface using a novel updating scheme named cortical surface scanning. The proposed approach has many advantages over the conventional ones: (1) as the cortical surface scanning algorithm uses spatio-temporal dipoles, it is robust with respect to noise; (2) it requires no a priori information on the numbers and initial locations of the activations; (3) as the locations of dipoles are restricted only on a tessellated cortical surface, it is physiologically more plausible than the conventional ECD model. To verify the proposed approach, it was applied to several realistic MEG/EEG simulations and practical experiments. From the several case studies, it is concluded that the anatomically constrained dipole adjustment (ANACONDA) approach will be a very promising technique to enhance accuracy of focal source localization which is essential in many clinical and neurological applications of MEG and EEG.

Anatomically constrained dipole adjustment (ANACONDA) for accurate MEG/EEG focal source localizations

International Nuclear Information System (INIS)

Im, Chang-Hwan; Jung, Hyun-Kyo; Fujimaki, Norio

2005-01-01

This paper proposes an alternative approach to enhance localization accuracy of MEG and EEG focal sources. The proposed approach assumes anatomically constrained spatio-temporal dipoles, initial positions of which are estimated from local peak positions of distributed sources obtained from a pre-execution of distributed source reconstruction. The positions of the dipoles are then adjusted on the cortical surface using a novel updating scheme named cortical surface scanning. The proposed approach has many advantages over the conventional ones: (1) as the cortical surface scanning algorithm uses spatio-temporal dipoles, it is robust with respect to noise; (2) it requires no a priori information on the numbers and initial locations of the activations; (3) as the locations of dipoles are restricted only on a tessellated cortical surface, it is physiologically more plausible than the conventional ECD model. To verify the proposed approach, it was applied to several realistic MEG/EEG simulations and practical experiments. From the several case studies, it is concluded that the anatomically constrained dipole adjustment (ANACONDA) approach will be a very promising technique to enhance accuracy of focal source localization which is essential in many clinical and neurological applications of MEG and EEG

Cross-border migration and initiation of others into drug injecting in Tijuana, Mexico.

Science.gov (United States)

Rafful, Claudia; Melo, Jason; Medina-Mora, María Elena; Rangel, Gudelia; Sun, Xiaoying; Jain, Sonia; Werb, Dan

2018-04-01

Efforts to prevent injection drug use (IDU) are increasingly focusing on the role that people who inject drugs (PWID) play in facilitating the entry of others into this behaviour. This is particularly relevant in settings experiencing high levels of IDU, such as Mexico's northern border region, where cross-border migration, particularly through forced deportation, has been found to increase a range of health and social harms related to injecting. PWID enrolled in a prospective cohort study in Tijuana, Mexico, since 2011 were interviewed semi-annually, which solicited responses on their experiences initiating others into injecting. Univariate and multivariable logistic regression analyses were conducted at the Preventing Injection by Modifying Existing Responses (PRIMER) baseline, with the dependent variable defined as reporting ever initiating others into injection. The primary independent variable was lifetime deportation from the USA to Mexico. Among 532 participants, 14% (n = 76) reported initiating others into injecting, the majority of participants reporting initiating acquaintances (74%, n = 56). In multivariable analyses, initiating others into injecting was independently associated with reporting living in the USA for 1-5 years [adjusted odds ratio (AOR) = 2.42; 95% confidence interval (CI) 1.22-4.79, P = 0.01], and methamphetamine and heroin injection combined (AOR = 3.67; 95% CI 1.11-12.17, P = 0.03). Deportation was not independently associated with initiating others into injecting. The impact of migration needs to be considered within binational programming seeking to prevent the expansion of epidemics of injecting and HIV transmission among mobile populations residing in the Mexico-USA border region. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Increased non-AIDS mortality among persons with AIDS-defining events after antiretroviral therapy initiation

DEFF Research Database (Denmark)

Pettit, April C; Giganti, Mark J; Ingle, Suzanne M

2018-01-01

) initiation. METHODS: We included HIV treatment-naïve adults from the Antiretroviral Therapy Cohort Collaboration (ART-CC) who initiated ART from 1996 to 2014. Causes of death were assigned using the Coding Causes of Death in HIV (CoDe) protocol. The adjusted hazard ratio (aHR) for overall and cause......-specific non-AIDS mortality among those with an ADE (all ADEs, tuberculosis (TB), Pneumocystis jiroveci pneumonia (PJP), and non-Hodgkin's lymphoma (NHL)) compared to those without an ADE was estimated using a marginal structural model. RESULTS: The adjusted hazard of overall non-AIDS mortality was higher...

Maximizing cost-effectiveness by adjusting treatment strategy according to glaucoma severity

Science.gov (United States)

Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta; Gomes, Carlos Eduardo de Mello; Chaoubah, Alfredo

2016-01-01

Abstract Background: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. Methods: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population. Different strategies were tested according to disease severity. For early glaucoma, we compared observation, laser and medications. For moderate glaucoma, medications, laser and surgery. For advanced glaucoma, medications and surgery. Main outcome measures were ICER (incremental cost-effectiveness ratio), medical direct costs and QALY (quality-adjusted life year). Results: In early glaucoma, both laser and medical treatment were cost-effective (ICERs of initial laser and initial medical treatment over observation only, were R$ 2,811.39/QALY and R$ 3,450.47/QALY). Compared to observation strategy, the two alternatives have provided significant gains in quality of life. In moderate glaucoma population, medical treatment presented the highest costs among treatment strategies. Both laser and surgery were highly cost-effective in this group. For advanced glaucoma, both tested strategies were cost-effective. Starting age had a great impact on results in all studied groups. Initiating glaucoma therapy using laser or surgery were more cost-effective, the younger the patient. Conclusion: All tested treatment strategies for glaucoma provided real gains in quality of life and were cost-effective. However, according to the disease severity, not all strategies provided the same cost-effectiveness profile. Based on our findings, there should be a

32 CFR 989.4 - Initial considerations.

Science.gov (United States)

2010-07-01

... alternatives analyzed in the environmental documents. (f) Pursue the objective of furthering foreign policy and... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.4 Initial considerations. Air Force personnel will: (a... CATEX from environmental impact analysis (appendix B). (c) Make environmental documents, comments, and...

Families created through surrogacy: Mother-child relationships and children’s psychological adjustment at age 7

Science.gov (United States)

Golombok, Susan; Readings, Jennifer; Blake, Lucy; Casey, Polly; Marks, Alex; Jadva, Vasanti

2011-01-01

Each year, an increasing number of children are born through surrogacy and thus lack a genetic and/or gestational link with their mother. This study examined the impact of surrogacy on mother-child relationships and children’s psychological adjustment. Assessments of maternal positivity, maternal negativity, mother-child interaction and child adjustment were administered to 32 surrogacy, 32 egg donation and 54 natural conception families with a 7-year-old child. No differences were found for maternal negativity, maternal positivity or child adjustment, although the surrogacy and egg donation families showed less positive mother-child interaction than the natural conception families. The findings suggest that both surrogacy and egg donation families function well in the early school years. PMID:21895360

Should adjustment disorder be conceptualized as transitional disorder? In pursuit of adjustment disorders definition.

Science.gov (United States)

Israelashvili, Moshe

2012-12-01

The DSM classification of an adjustment disorder is frequently criticized for not being well differentiated from other disorders. A possible reason for this is the vague definition of the term adjustment in social science literature. Hence, the current paper discusses the definition of adjustment and its implications for understanding maladjustment. Differential definitions of the terms adjustment, adaptation, socialization and coping are outlined, leading to the proposition that each one of them represents a different type of demand that is imposed on an individual who encounters a transitional event. Moreover, the four types of demands might be the possible sources of maladjustment. Helping people in transition requires an identification of the source, or combination of sources, that have led to the adjustment problem first, followed by the implementation of an adequate helping approach.

Some adjustments to the human capital and the friction cost methods.

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Targoutzidis, Antonis

2018-03-21

The cost of lost output is a major component of the total cost of illness estimates, especially those for the cost of workplace accidents and diseases. The two main methods for estimating this output, namely the human capital and the friction cost method, lead to very different results, particularly for cases of long-term absence, which makes the choice of method a critical dilemma. Two hidden assumptions, one for each method, are identified in this paper: for human capital method, the assumption that had the accident not happened the individual would remain alive, healthy and employed until retirement, and for friction cost method, the assumption that any created vacancy is covered by an unemployed person. Relevant adjustments to compensate for their impact are proposed: (a) to depreciate the estimates of the human capital method for the risks of premature death, disability or unemployment and (b) to multiply the estimates of the friction cost method with the expected number of job shifts that will be caused by a disability. The impact of these adjustments on the final estimates is very important in terms of magnitude and can lead to better results for each method.

STUDY ON THE ACCOUNTING OF ADJUSTMENTS FOR RECEIVABLES DEPRECIATION IN OPERATIONS WITH CLIENTS

Directory of Open Access Journals (Sweden)

ILIE RĂSCOLEAN

2015-12-01

Full Text Available The present work approaches an important topic for credit institutions: limiting the credit risk and determining the prudential value adjustments for the depreciation of client credits, and their reflection in the accounting statements. The Chart of Accounts applicable to credit institutions includes class-two accounts Operations with clients and expenses and revenues accounts, which help record the adjustments for receivables depreciation in operations with clients. To constitute, diminish or annul depreciations, credit institutions have the obligation to assure the classification of their credits based on classification categories according to three criteria: financial performance, debt service and initiation of juridical procedures. By the present study, we present the way the credit portfolio is structured according to the criteria mentioned and the reflection in accounting of the prudential adjustments of value. The article ends with the authors’ conclusions regarding the specificity of the way of classification of the credits according to risk categories in agreement to the evolution of the class determination criteria.

Corporate income tax and its impact on financial reporting

OpenAIRE

Krajčová, Lenka

2010-01-01

Thesis called "Corporate income tax and its impact on financial reporting" focuses on the problem of calculating the tax on corporate income of legal entity established for business purposes. The thesis deals with the issue of adjustment of profit in order to create the tax base and displays impact of this adjustment on due tax.

Adjustable Pitot Probe

Science.gov (United States)

Ashby, George C., Jr.; Robbins, W. Eugene; Horsley, Lewis A.

1991-01-01

Probe readily positionable in core of uniform flow in hypersonic wind tunnel. Formed of pair of mating cylindrical housings: transducer housing and pitot-tube housing. Pitot tube supported by adjustable wedge fairing attached to top of pitot-tube housing with semicircular foot. Probe adjusted both radially and circumferentially. In addition, pressure-sensing transducer cooled internally by water or other cooling fluid passing through annulus of cooling system.

Utility-adjusted analysis of the cost of palliative radiotherapy for bone metastases

International Nuclear Information System (INIS)

Barton, M.B.; Jacob, S.A.

2003-01-01

Palliative radiotherapy is effective in the treatment of bone metastases but is under-utilized, possibly because it is perceived to be expensive. We performed a cost-utility analysis of palliative radiotherapy for bone metastases, evaluating both the actual cost of radiotherapy as well as its impact on quality of life by adjusting for the variation in response to treatment. Hospital records between July 1991 and July 1996 were reviewed to ascertain the number of patients treated with palliative radiotherapy for bone metastases, the average number of fields of radiation delivered to each patient and the average duration of survival. Partial and complete response rates to palliative radiotherapy were obtained from a review of all published randomized controlled trials of radiation treatment of bone metastases. Utility values were assigned to the response rates, and an overall adjusted response rate to radiotherapy was derived. The cost of delivering a field of radiation was calculated. The total cost was divided by the total number of response months to give a utility-adjusted cost per month of palliative radiotherapy. The utility-adjusted cost per month of palliative radiotherapy of bone metastases was found to be AUS$ 100 per month or AUS$ 1200 per utility-adjusted life-year. This study demonstrates that, contrary to popular perception, palliative radiotherapy is a cost-effective treatment modality for bone metastases. Copyright (2003) Blackwell Science Pty Ltd

Impact of Tobacco Control Interventions on Smoking Initiation, Cessation, and Prevalence: A Systematic Review

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Lisa M. Wilson

2012-01-01

Full Text Available Background. Policymakers need estimates of the impact of tobacco control (TC policies to set priorities and targets for reducing tobacco use. We systematically reviewed the independent effects of TC policies on smoking behavior. Methods. We searched MEDLINE (through January 2012 and EMBASE and other databases through February 2009, looking for studies published after 1989 in any language that assessed the effects of each TC intervention on smoking prevalence, initiation, cessation, or price participation elasticity. Paired reviewers extracted data from studies that isolated the impact of a single TC intervention. Findings. We included 84 studies. The strength of evidence quantifying the independent effect on smoking prevalence was high for increasing tobacco prices and moderate for smoking bans in public places and antitobacco mass media campaigns. Limited direct evidence was available to quantify the effects of health warning labels and bans on advertising and sponsorship. Studies were too heterogeneous to pool effect estimates. Interpretations. We found evidence of an independent effect for several TC policies on smoking prevalence. However, we could not derive precise estimates of the effects across different settings because of variability in the characteristics of the intervention, level of policy enforcement, and underlying tobacco control environment.

Assessing the initial adaptability and impact of a mobile dictation and reporting system in the radiology department of an academic hospital

Science.gov (United States)

Gali, Raja L.; Dave, Jaydev K.

2017-03-01

Mobile Radiologist 360, rolled out as part of the voice dictation system upgrade from Nuance Powerscribe 5.0 to PS360 allows an attending radiologist to edit and sign-off a report assigned by a trainee or that has been started by the radiologist on a workstation. The purpose of this study was to evaluate the adoptability and impact of this application. Report turnaround time data was extracted from the RIS (GE-Centricity RIS-IC) for 60 days before- (period-1) and 60 days after- (period-2) the application implementation and then, for 60 days after end of period-2 (period-3). Adoptability of the application was evaluated using two metrics; first, the number of attending radiologists who signed-off reports using the application in periods 2 and 3, and second, the proportion of reports signed-off by the top five users of the mobile application using the application. Impact of the application was evaluated by comparing the time from initial dictation to final sign-off (time_PF) for the top five users of the mobile application to the time_PF by other five radiologists who did not use the application. 41% radiologists used the mobile application at least once during the study period; the proportion of cases signed-off using the mobile application ranged from 1% to 20%. ANOVA revealed no statistically significant effect of the mobile application system on time_PF (p=0.842). In conclusion, there was low initial adoptability and no impact of the mobile dictation and reporting system in reducing the time from initial dictation to final sign-off on a radiology report.

The impact of minimum wage adjustments on Vietnamese wage inequality

DEFF Research Database (Denmark)

Hansen, Henrik; Rand, John; Torm, Nina

Using Vietnamese Labour Force Survey data we analyse the impact of minimum wage changes on wage inequality. Minimum wages serve to reduce local wage inequality in the formal sectors by decreasing the gap between the median wages and the lower tail of the local wage distributions. In contrast, local...

Adjustment modes in the trajectory of progressive multiple sclerosis: a qualitative study and conceptual model.

Science.gov (United States)

Bogosian, Angeliki; Morgan, Myfanwy; Bishop, Felicity L; Day, Fern; Moss-Morris, Rona

2017-03-01

We examined cognitive and behavioural challenges and adaptations for people with progressive multiple sclerosis (MS) and developed a preliminary conceptual model of changes in adjustment over time. Using theoretical sampling, 34 semi-structured interviews were conducted with people with MS. Participants were between 41 and 77 years of age. Thirteen were diagnosed with primary progressive MS and 21 with secondary progressive MS. Data were analysed using a grounded theory approach. Participants described initially bracketing the illness off and carrying on their usual activities but this became problematic as the condition progressed and they employed different adjustment modes to cope with increased disabilities. Some scaled back their activities to live a more comfortable life, others identified new activities or adapted old ones, whereas at times, people disengaged from the adjustment process altogether and resigned to their condition. Relationships with partners, emotional reactions, environment and perception of the environment influenced adjustment, while people were often flexible and shifted among modes. Adjusting to a progressive condition is a fluid process. Future interventions can be tailored to address modifiable factors at different stages of the condition and may involve addressing emotional reactions concealing/revealing the condition and perceptions of the environment.

Effects of Increasing Space Allowance by Removing a Pig or Gate Adjustment on Finishing Pig Growth Performance.

Science.gov (United States)

Carpenter, Corey B; Holder, Cheyenne J; Wu, Fanghou; Woodworth, Jason C; DeRouchey, Joel M; Tokach, Mike D; Goodband, Robert D; Dritz, Steve S

2018-05-03

A total of 256 pigs (initially 55.9 ± 4.88 kg) were used in a 71-d study to determine the effects of increasing space allowance and pig removal on pig growth performance. Pens of pigs were blocked by body weight (BW) and allotted to one of four space allowance treatments, initially with 8 pigs per pen and 8 pens per treatment. First two treatments included pens with 0.91 m2 per pig or 0.63 m2 per pig for the entire study; two additional treatments initially provided 0.63 m2 per pig, but either a gate was adjusted on d 28, 45, and 62 or the heaviest pig in the pen was removed from the pen on d 28 and 45 to provide more space and keep pigs in accordance with their predicted minimum space requirement [(m2) = 0.0336 × (BW, kg)0.67]. From d 0 to 14 (56 to 69 kg), there was no effect of stocking density observed for average daily gain (ADG), average daily feed intake (ADFI), and gain:feed (G:F). From d 14 to 28 (69 to 83 kg), pigs provided 0.91 m2 had increased (P space adjustment treatments had greater (P space adjustments intermediate. In summary, pigs with 0.91 m2 grew faster and consumed more feed than pigs restricted in space. As pigs reached the critical k value, gate adjustments and pig removals affected growth similarly. As pigs grew to the predicted space requirement and were subsequently allowed more space, performance was greater than those provided 0.63 m2 but less than those allowed 0.91 m2. It appears that the industry accepted critical k value, 0.0336, may not be adequate for optimal pig performance across multiple BW ranges.

Direct medical costs and medication compliance among fibromyalgia patients: duloxetine initiators vs. pregabalin initiators.

Science.gov (United States)

Sun, Peter; Peng, Xiaomei; Sun, Steve; Novick, Diego; Faries, Douglas E; Andrews, Jeffrey S; Wohlreich, Madelaine M; Wu, Andrew

2014-01-01

To assess and compare direct medical costs and medication compliance between patients with fibromyalgia who initiated duloxetine and patients with fibromyalgia who initiated pregabalin in 2008. A retrospective cohort study design was used based on a large US national commercial claims database (2006 to 2009). Patients with fibromyalgia aged 18 to 64 who initiated duloxetine or pregabalin in 2008 and who had continuous health insurance 1 year preceding and 1 year following the initiation were selected into duloxetine cohort or pregabalin cohort based on their initiated agent. Medication compliance was measured by total supply days, medication possession ratio (MPR), and proportion of patients with MPR ≥ 0.8. Direct medical costs were measured by annual costs per patient and compared between the cohorts in the year following the initiation. Propensity score stratification and bootstrapping methods were used to adjust for distribution bias, as well as cross-cohort differences in demographic, clinical and economic characteristics, and medication history prior to the initiation. Both the duloxetine (n = 3,033) and pregabalin (n = 4,838) cohorts had a mean initiation age around 49 years, 89% were women. During the postindex year, compared to the pregabalin cohort, the duloxetine cohort had higher totally annual supply days (273.5 vs. 176.6, P costs ($2,994.9 vs. $4,949.6, P costs ($8,259.6 vs. $10,312.2, P costs ($5,214.6 vs. $5,290.8, P > 0.05), and lower total medical costs ($16,469.1 vs. $20,552.6, P compliance and consumed less inpatient, outpatient, and total medical costs than those who initiated pregabalin. © 2013 The Authors Pain Practice © 2013 World Institute of Pain.

Requirement for specific gravity and creatinine adjustments for urinary steroids and luteinizing hormone concentrations in adolescents.

Science.gov (United States)

Singh, Gurmeet K S; Balzer, Ben W R; Desai, Reena; Jimenez, Mark; Steinbeck, Katharine S; Handelsman, David J

2015-11-01

Urinary hormone concentrations are often adjusted to correct for hydration status. We aimed to determine whether first morning void urine hormones in growing adolescents require adjustments and, if so, whether urinary creatinine or specific gravity are better adjustments. The study population was adolescents aged 10.1 to 14.3 years initially who provided fasting morning blood samples at 0 and 12 months (n = 343) and first morning urine every three months (n = 644). Unadjusted, creatinine and specific gravity-adjusted hormonal concentrations were compared by Deming regression and Bland-Altman analysis and grouped according to self-rated Tanner stage or chronological age. F-ratios for self-rated Tanner stages and age groups were used to compare unadjusted and adjusted hormonal changes in growing young adolescents. Correlations of paired serum and urinary hormonal concentration of unadjusted and creatinine and specific gravity-adjusted were also compared. Fasting first morning void hormone concentrations correlated well and were unbiased between unadjusted or adjusted by either creatinine or specific gravity. Urine creatinine concentration increases with Tanner stages, age and male gender whereas urine specific gravity was not influenced by Tanner stage, age or gender. Adjustment by creatinine or specific gravity of urinary luteinizing hormone, estradiol, testosterone, dihydrotestosterone and dehydroepiandrosterone concentrations did not improve correlation with paired serum concentrations. Urine steroid and luteinizing hormone concentrations in first morning void samples of adolescents are not significantly influenced by hydration status and may not require adjustments; however, if desired, both creatinine and specific gravity adjustments are equally suitable. © The Author(s) 2015.

Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis.

Science.gov (United States)

Romm, Kristin Lie; Rossberg, Jan Ivar; Hansen, Charlotte Fredslund; Haug, Elisabeth; Andreassen, Ole A; Melle, Ingrid

2011-08-19

Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. A total of 113 patients from the Thematically Organized Psychosis research study (TOP) were included at first treatment. The Positive and Negative Syndrome Scale (PANSS) was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS) and self-esteem by the Rosenberg Self-Esteem Scale (RSES). Premorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression. There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.

Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis

Directory of Open Access Journals (Sweden)

Haug Elisabeth

2011-08-01

Full Text Available Abstract Background Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. Method A total of 113 patients from the Thematically Organized Psychosis research study (TOP were included at first treatment. The Positive and Negative Syndrome Scale (PANSS was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS and self-esteem by the Rosenberg Self-Esteem Scale (RSES. Results Premorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression. Conclusion There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.

Cigarette advertising and teen smoking initiation.

Science.gov (United States)

Hanewinkel, Reiner; Isensee, Barbara; Sargent, James D; Morgenstern, Matthis

2011-02-01

To test the specificity of the association between cigarette advertising and adolescent smoking initiation. A longitudinal survey of 2102 adolescents, aged 10 to 17 years at baseline, who never smoked was conducted by using masked images of 6 cigarette advertisements and 8 other commercial products with all brand information digitally removed. The exposure variable was a combination of contact frequency and cued recall of brands for cigarette and other advertisements. Multilevel mixed-effects Poisson regressions were used to assess smoking initiation 9 months after the baseline assessment as a function of cigarette-advertisement exposure, other advertisement exposure, and baseline covariates. Thirteen percent (n = 277) of students initiated smoking during the observation period. Although the incidence of trying smoking was associated with increased exposure to cigarette advertisements (10% in the low, 12% in the medium, and 19% in the high cigarette-advertisement exposure tertile initiated smoking), exposure to other advertisements did not predict smoking initiation. Compared with low exposure to cigarette advertisements, high exposure remained a significant predictor of adolescent smoking initiation after controlling for baseline covariates (adjusted relative risk: 1.46 [95% confidence interval: 1.08-1.97]; P content-related effect of cigarette advertisements and underlines the specificity of the relationship between tobacco marketing and teen smoking; exposure to cigarette advertisements, but not other advertisements, is associated with smoking initiation.

Athletic Trainers' Roles and Responsibilities Regarding Academic Adjustments as Part of the Concussion-Management Process in the Secondary School Setting.

Science.gov (United States)

Bacon, Cailee E Welch; Kay, Melissa C; McLeod, Tamara C Valovich

2017-10-01

  Athletic trainers (ATs) play a vital role in managing the care of student-athletes after a sport-related concussion, yet little is known about their specific involvement in the implementation of academic adjustments as part of the concussion-management plan.   To explore ATs' perceived roles and responsibilities regarding the implementation of academic adjustments for concussed student-athletes.   Qualitative study.   Individual telephone interviews.   Sixteen ATs employed in the secondary school setting (8 women, 8 men; age = 39.6 ± 7.9 years; athletic training experience = 15.1 ± 5.6 years), representing 12 states, were interviewed.   One telephone interview was conducted with each participant. After the interviews were transcribed, the data were analyzed and coded into themes and categories, which were determined via consensus of a 4-person research team. To decrease researcher bias, triangulation occurred through participant member checking, the inclusion of multiple researchers, and an internal auditor.   Several categories related to participants' perceptions regarding their roles and responsibilities within the academic-adjustments process emerged from data analysis: (1) understanding of academic adjustments, (2) perceptions of their roles in academic adjustments, (3) initiation of academic adjustments, (4) facilitation of academic adjustments, and (5) lack of a role in the academic-adjustments process. Although most ATs perceived that they had a role in the initiation and facilitation of academic adjustments for concussed student-athletes, some reported they did not want a role in the process. Regardless, participants frequently suggested the need for further education.   These findings highlight that ATs either wanted to be involved in the implementation of academic adjustments but felt further education was needed or they did not want to be involved because they felt that it was not in their area of expertise. To create a cohesive

Adolescent Mothers' Adjustment to Parenting.

Science.gov (United States)

Samuels, Valerie Jarvis; And Others

1994-01-01

Examined adolescent mothers' adjustment to parenting, self-esteem, social support, and perceptions of baby. Subjects (n=52) responded to questionnaires at two time periods approximately six months apart. Mothers with higher self-esteem at Time 1 had better adjustment at Time 2. Adjustment was predicted by Time 2 variables; contact with baby's…

Psychological impact on house staff of an initial versus subsequent emergency medicine rotation.

Science.gov (United States)

Alagappan, K; Grlic, N; Steinberg, M; Pollack, S

2001-01-01

The objective of this study was to assess the psychological impact of a 4-week emergency medicine (EM) rotation on residents undergoing their first EM experience. These findings were compared to the psychological impact the rotation had on residents with prior EM experience. Data were obtained from a post hoc analysis of a previous study. Prerotation and postrotation psychological distress levels were assessed over a 4-week EM rotation. Anxiety and depressive symptoms were evaluated by the Brief Symptom Inventory and the Dissociative Experience Scale that together comprise a total of 14 psychometric scales. All scales were given at the beginning and end of the initial EM rotation for the academic year of 1994-1995. All information was coded and confidential. Eighteen junior residents (9/18 EM [50%]) were analyzed as a group and compared to 53 residents (34/51 EM [66%]) with prior exposure to the authors' emergency department. Residents doing their first EM rotation (N = 18) showed improvement in 13 of 14 scales (P = .002). Of the 13 scales that improved, 3 improved significantly: Brief Symptom Inventory = anxiety (P = .002) and Dissociative Experience Scale = absorption (P = .001) and other (P = .001). Residents with prior EM experience (N = 53) displayed worsening in 9 of 13 scales (P = not significant) and no change in 1. Residents undergoing their first EM rotation showed a significant decrease in psychological distress over the 4-week period. Residents with prior EM experience did not show a similar change.

Physical Activity Producing Low, but Not Medium or Higher, Vertical Impacts Is Inversely Related to BMI in Older Adults: Findings From a Multicohort Study

Science.gov (United States)

Elhakeem, Ahmed; Hannam, Kimberly; Deere, Kevin C; Hartley, April; Clark, Emma M; Moss, Charlotte; Edwards, Mark H; Dennison, Elaine; Gaysin, Tim; Kuh, Diana; Wong, Andrew; Cooper, Cyrus; Cooper, Rachel; Tobias, Jon H

2018-01-01

Abstract Background High impact physical activity (PA) is thought to improve skeletal health, but its relation to other health outcomes are unclear. We investigated associations between PA impact magnitude and body mass index (BMI) in older adults. Methods Data were taken from the Cohort for Skeletal Health in Bristol and Avon (COSHIBA), Hertfordshire Cohort Study, and MRC National Survey of Health and Development. Vertical acceleration peaks from 7-day hip-worn accelerometer recordings were used to classify PA as low (0.5 impact. Cohort-specific associations of low, medium, and higher impact PA with BMI were examined using linear regressions and estimates combined using random-effects meta-analysis. Results A total of 1182 participants (mean age = 72.7 years, 68% female) were included. Low, medium, and higher impact PA were inversely related to BMI in initial models. After adjustment for confounders and other impacts, low, but not medium or higher, impacts were inversely related to BMI (−0.31, p impacts). In adjusted analyses of body composition measured by dual-energy X-ray absorptiometry in COSHIBA, low, but not medium or higher, impacts were inversely related to total body fat mass (−0.19, p impact PA was weakly and positively associated with lean mass (0.05, p = .06). Conclusions Greater exposure to PA producing low magnitude vertical impacts was associated with lower BMI and fat mass at older age. Low impact PA may help reduce obesity risk in older adults. PMID:29028919

Parental Divorce and Children's Adjustment.

Science.gov (United States)

Lansford, Jennifer E

2009-03-01

This article reviews the research literature on links between parental divorce and children's short-term and long-term adjustment. First, I consider evidence regarding how divorce relates to children's externalizing behaviors, internalizing problems, academic achievement, and social relationships. Second, I examine timing of the divorce, demographic characteristics, children's adjustment prior to the divorce, and stigmatization as moderators of the links between divorce and children's adjustment. Third, I examine income, interparental conflict, parenting, and parents well-being as mediators of relations between divorce and children's adjustment. Fourth, I note the caveats and limitations of the research literature. Finally, I consider notable policies related to grounds for divorce, child support, and child custody in light of how they might affect children s adjustment to their parents divorce. © 2009 Association for Psychological Science.

The impact of radiologists' expertise on screen results decisions in a CT lung cancer screening trial

International Nuclear Information System (INIS)

Heuvelmans, Marjolein A.; Vliegenthart, Rozemarijn; Oudkerk, Matthijs; Jong, Pim A. de; Mali, Willem P.; Groen, Harry J.M.

2015-01-01

To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial. In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule's volume. The protocol allowed radiologists to manually adjust screen results in cases of high suspicion of benign or malignant nodule nature. Participants whose baseline CT result was based on a solid or part-solid nodule were included in this study. Adjustments by radiologists at baseline were evaluated. Histology was the reference for diagnosis or to confirm benignity and stability on subsequent CT examinations. A total of 3,318 participants (2,796 male, median age 58.0 years) were included. In 195 participants (5.9 %) the initial baseline screen result was adjusted by the radiologist. Adjustment was downwards from positive or indeterminate to negative in two and 119 participants, respectively, and from positive to indeterminate in 65 participants. None of these nodules turned out to be malignant. In 9/195 participants (4.6 %) the screen result was adjusted upwards from negative to indeterminate or indeterminate to positive; two nodules were malignant. In one in 20 cases of baseline lung cancer screening, nodules were reclassified by the radiologist, leading to a reduction of false-positive screen results. (orig.)

Indoor transient SOA formation from ozone + α-pinene reactions: Impacts of air exchange and initial product concentrations, and comparison to limonene ozonolysis

Science.gov (United States)

Youssefi, Somayeh; Waring, Michael S.

2015-07-01

The ozonolysis of reactive organic gases (ROG), e.g. terpenes, generates secondary organic aerosol (SOA) indoors. The SOA formation strength of such reactions is parameterized by the aerosol mass fraction (AMF), a.k.a. SOA yield, which is the mass ratio of generated SOA to oxidized ROG. AMFs vary in magnitude both among and for individual ROGs. Here, we quantified dynamic SOA formation from the ozonolysis of α-pinene with 'transient AMFs,' which describe SOA formation due to pulse emission of a ROG in an indoor space with air exchange, as is common when consumer products are intermittently used in ventilated buildings. We performed 19 experiments at low, moderate, and high (0.30, 0.52, and 0.94 h-1, respectively) air exchange rates (AER) at varying concentrations of initial reactants. Transient AMFs as a function of peak SOA concentrations ranged from 0.071 to 0.25, and they tended to increase as the AER and product of the initial reactant concentrations increased. Compared to our similar research on limonene ozonolysis (Youssefi and Waring, 2014), for which formation strength was driven by secondary ozone reactions, the AER impact for α-pinene was opposite in direction and weaker, while the initial reactant product impact was in the same direction but stronger for α-pinene than for limonene. Linear fits of AMFs for α-pinene ozonolysis as a function of the AER and initial reactant concentrations are provided so that future indoor models can predict SOA formation strength.

Energy Saving in Three-Phase Diode Rectifiers Using EI Technique with Adjustable Switching Frequency Scheme

DEFF Research Database (Denmark)

Davari, Pooya; Zare, Firuz; Yang, Yongheng

2016-01-01

A front-end rectifier can significantly impact a power electronics system performance and efficiency for applications such as motor drive where the system commonly operates under partial loading conditions. This paper proposes an adjustable switching frequency scheme using an electronic inductor...

Adjusting the specificity of an engine map based on the sensitivity of an engine control parameter relative to a performance variable

Science.gov (United States)

Jiang, Li; Lee, Donghoon; Yilmaz, Hakan; Stefanopoulou, Anna

2014-10-28

Methods and systems for engine control optimization are provided. A first and a second operating condition of a vehicle engine are detected. An initial value is identified for a first and a second engine control parameter corresponding to a combination of the detected operating conditions according to a first and a second engine map look-up table. The initial values for the engine control parameters are adjusted based on a detected engine performance variable to cause the engine performance variable to approach a target value. A first and a second sensitivity of the engine performance variable are determined in response to changes in the engine control parameters. The first engine map look-up table is adjusted when the first sensitivity is greater than a threshold, and the second engine map look-up table is adjusted when the second sensitivity is greater than a threshold.

Properties of global- and local-ancestry adjustments in genetic association tests in admixed populations.

Science.gov (United States)

Martin, Eden R; Tunc, Ilker; Liu, Zhi; Slifer, Susan H; Beecham, Ashley H; Beecham, Gary W

2018-03-01

Population substructure can lead to confounding in tests for genetic association, and failure to adjust properly can result in spurious findings. Here we address this issue of confounding by considering the impact of global ancestry (average ancestry across the genome) and local ancestry (ancestry at a specific chromosomal location) on regression parameters and relative power in ancestry-adjusted and -unadjusted models. We examine theoretical expectations under different scenarios for population substructure; applying different regression models, verifying and generalizing using simulations, and exploring the findings in real-world admixed populations. We show that admixture does not lead to confounding when the trait locus is tested directly in a single admixed population. However, if there is more complex population structure or a marker locus in linkage disequilibrium (LD) with the trait locus is tested, both global and local ancestry can be confounders. Additionally, we show the genotype parameters of adjusted and unadjusted models all provide tests for LD between the marker and trait locus, but in different contexts. The local ancestry adjusted model tests for LD in the ancestral populations, while tests using the unadjusted and the global ancestry adjusted models depend on LD in the admixed population(s), which may be enriched due to different ancestral allele frequencies. Practically, this implies that global-ancestry adjustment should be used for screening, but local-ancestry adjustment may better inform fine mapping and provide better effect estimates at trait loci. © 2017 WILEY PERIODICALS, INC.

The Use of a Spectral Nudging Technique to Determine the Impact of Environmental Factors on the Track of Typhoon Megi (2010

Directory of Open Access Journals (Sweden)

Xingliang Guo

2017-12-01

Full Text Available Sensitivity tests based on a spectral nudging (SN technique are conducted to analyze the effect of large-scale environmental factors on the movement of typhoon Megi (2010. The error of simulated typhoon track is effectively reduced using SN and the impact of dynamical factors is more significant than that of thermal factors. During the initial integration and deflection period of Megi (2010, the local steering flow of the whole and lower troposphere is corrected by a direct large-scale wind adjustment, which improves track simulation. However, environmental field nudging may weaken the impacts of terrain and typhoon system development in the landfall period, resulting in large simulated track errors. Comparison of the steering flow and inner structure of the typhoon reveals that the large-scale circulation influences the speed and direction of typhoon motion by: (1 adjusting the local steering flow and (2 modifying the environmental vertical wind shear to change the location and symmetry of the inner severe convection.

Adjustable collimator

International Nuclear Information System (INIS)

Carlson, R.W.; Covic, J.; Leininger, G.

1981-01-01

In a rotating fan beam tomographic scanner there is included an adjustable collimator and shutter assembly. The assembly includes a fan angle collimation cylinder having a plurality of different length slots through which the beam may pass for adjusting the fan angle of the beam. It also includes a beam thickness cylinder having a plurality of slots of different widths for adjusting the thickness of the beam. Further, some of the slots have filter materials mounted therein so that the operator may select from a plurality of filters. Also disclosed is a servo motor system which allows the operator to select the desired fan angle, beam thickness and filter from a remote location. An additional feature is a failsafe shutter assembly which includes a spring biased shutter cylinder mounted in the collimation cylinders. The servo motor control circuit checks several system conditions before the shutter is rendered openable. Further, the circuit cuts off the radiation if the shutter fails to open or close properly. A still further feature is a reference radiation intensity monitor which includes a tuning-fork shaped light conducting element having a scintillation crystal mounted on each tine. The monitor is placed adjacent the collimator between it and the source with the pair of crystals to either side of the fan beam

Social and emotional loneliness and self-reported difficulty initiating and maintaining sleep (DIMS) in a sample of Norwegian university students.

Science.gov (United States)

Hayley, Amie C; Downey, Luke A; Stough, Con; Sivertsen, Børge; Knapstad, Marit; Øverland, Simon

2017-02-01

Social and emotional loneliness negatively impact several areas of health, including sleep. However, few comprehensive population-based studies have evaluated this relationship. Over 12,000 students aged 21-35 years who participated in the student survey for higher education in Norway (the SHoT study) were assessed. Loneliness was assessed using the Social and Emotional Loneliness Scale. Difficulty initiating and maintaining sleep (DIMS) was assessed by a single-item subjective response on the depression scale of the Hopkins Symptoms Checklist (HSCL-25). Social loneliness was associated with more serious DIMS (unadjusted proportional odds-ratio [OR] = 2.69, 95% CI = 2.46-2.95). This association was attenuated following adjustment for anxiety (adjusted OR = 1.92, 95% CI = 1.75-2.10) and depression (adjusted OR = 1.48, 95% CI = 1.34-1.63), however was not substantially altered when all demographics and psychological distress were accounted for (fully adjusted OR = 1.46, 95% CI = 1.30-1.63). Emotional loneliness was also associated with more serious DIMS (unadjusted proportional OR = 2.33, 95% CI = 2.12-2.57). Adjustment for anxiety (adjusted OR = 1.96, 95% CI = 1.78-2.15) and depression (adjusted OR = 1.64, 95% CI = 1.48-1.80) attenuated, but did not extinguish this relationship in the fully adjusted model (adjusted OR = 1.22, 95% CI = 1.09-1.31). Mediation analyses revealed that the social loneliness-DIMS association was fully attributed to psychological distress, while the emotional loneliness-DIMS association was only partially mediated, and a direct association was still observed. Associations between social and emotional loneliness and subjective DIMS were embedded in a larger pattern of psychological distress. Mitigating underlying feelings of loneliness may reduce potentially deleterious effects on sleep health and psychological wellbeing in young adults. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Initial surface deformations during impact on a liquid pool

NARCIS (Netherlands)

Bouwhuis, W.; Hendrix, M.H.W.; van der Meer, Roger M.; Snoeijer, Jacobus Hendrikus

2015-01-01

A tiny air bubble can be entrapped at the bottom of a solid sphere that impacts onto a liquid pool. The bubble forms due to the deformation of the liquid surface by a local pressure buildup inside the surrounding gas, as also observed during the impact of a liquid drop on a solid wall. Here, we

Small-scale bioenergy initiatives: brief description and preliminary lessons on livelihood impacts from case studies in Asia, Latin America and Afica. Final Report

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-01-15

Fifteen case studies from Africa, Asia, and Latin America were undertaken to assess the impacts that different types of local-level bioenergy initiatives can have on rural livelihoods. The report concludes with preliminary lessons and recommendations for further work.

Differentiation of Self, Personal Adjustment, Problem Solving, and Ethnic Group Belonging among Persons of Color.

Science.gov (United States)

Skowron, Elizabeth A.

2004-01-01

This study focused on examining the cross-cultural validity of Bowen family systems theory (M. Bowen, 1978), namely differentiation of self for individuals of color. Ethnic minority men and women completed measures of differentiation of self, ethnic group belonging, and 3 indices of personal adjustment. Initial support for the cross-cultural…

Beyond the Individual: The Impact of Ethnic Context and Classroom Behavioral Norms on Victims' Adjustment

Science.gov (United States)

Bellmore, Amy D.; Witkow, Melissa R.; Graham, Sandra; Juvonen, Jaana

2004-01-01

With a sample of 1,630 sixth-grade students from 77 classrooms, the authors used hierarchical linear modeling to examine how ethnicity within context and classroom social disorder influenced the association between peer victimization and social-psychological adjustment (loneliness and social anxiety). Victimized students in classrooms where many…

Case mix adjustment of health outcomes, resource use and process indicators in childbirth care: a register-based study.

Science.gov (United States)

Mesterton, Johan; Lindgren, Peter; Ekenberg Abreu, Anna; Ladfors, Lars; Lilja, Monica; Saltvedt, Sissel; Amer-Wåhlin, Isis

2016-05-31

Unwarranted variation in care practice and outcomes has gained attention and inter-hospital comparisons are increasingly being used to highlight and understand differences between hospitals. Adjustment for case mix is a prerequisite for meaningful comparisons between hospitals with different patient populations. The objective of this study was to identify and quantify maternal characteristics that impact a set of important indicators of health outcomes, resource use and care process and which could be used for case mix adjustment of comparisons between hospitals. In this register-based study, 139 756 deliveries in 2011 and 2012 were identified in regional administrative systems from seven Swedish regions, which together cover 67 % of all deliveries in Sweden. Data were linked to the Medical birth register and Statistics Sweden's population data. A number of important indicators in childbirth care were studied: Caesarean section (CS), induction of labour, length of stay, perineal tears, haemorrhage > 1000 ml and post-partum infections. Sociodemographic and clinical characteristics deemed relevant for case mix adjustment of outcomes and resource use were identified based on previous literature and based on clinical expertise. Adjustment using logistic and ordinary least squares regression analysis was performed to quantify the impact of these characteristics on the studied indicators. Almost all case mix factors analysed had an impact on CS rate, induction rate and length of stay and the effect was highly statistically significant for most factors. Maternal age, parity, fetal presentation and multiple birth were strong predictors of all these indicators but a number of additional factors such as born outside the EU, body mass index (BMI) and several complications during pregnancy were also important risk factors. A number of maternal characteristics had a noticeable impact on risk of perineal tears, while the impact of case mix factors was less pronounced for

Task-related and person-related variables influence the effect of low back pain on anticipatory postural adjustments.

Science.gov (United States)

Jacobs, Jesse V; Lyman, Courtney A; Hitt, Juvena R; Henry, Sharon M

2017-08-01

People with low back pain exhibit altered postural coordination that has been suggested as a target for treatment, but heterogeneous presentation has rendered it difficult to identify appropriate candidates and protocols for such treatments. This study evaluated the associations of task-related and person-related factors with the effect of low back pain on anticipatory postural adjustments. Thirteen subjects with and 13 without low back pain performed seated, rapid arm flexion in self-initiated and cued conditions. Mixed-model ANOVA were used to evaluate group and condition effects on APA onset latencies of trunk muscles, arm-raise velocity, and pre-movement cortical potentials. These measures were evaluated for correlation with pain ratings, Fear Avoidance Beliefs Questionnaire scores, and Modified Oswestry Questionnaire scores. Delayed postural adjustments of subjects with low back pain were greater in the cued condition than in the self-initiated condition. The group with low back pain exhibited larger-amplitude cortical potentials than the group without pain, but also significantly slower arm-raise velocities. With arm-raise velocity as a covariate, the effect of low back pain remained significant for the latencies of postural adjustments but not for cortical potentials. Latencies of the postural adjustments significantly correlated with Oswestry and Fear Avoidance Beliefs scores. Delayed postural adjustments with low back pain appear to be influenced by cueing of movement, pain-related disability and fear of activity. These results highlight the importance of subject characteristics, task condition, and task performance when comparing across studies or when developing treatment of people with low back pain. Copyright © 2017 Elsevier B.V. All rights reserved.

12 CFR 19.240 - Inflation adjustments.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b) The...

Patients' Experiences of Performing Self-care of Stomas in the Initial Postoperative Period.

Science.gov (United States)

Lim, Siew Hoon; Chan, Sally Wai Chi; He, Hong-Gu

2015-01-01

With the loss of an important bodily function and the distortion in body image, a stoma patient experiences physical, psychological, and social changes. With limited current studies exploring experiences of patients in the management of their stoma, there is a need to explore their experiences, their needs, and factors that influence their self-management. The aim of this study was to investigate patients' experiences of performing self-care of stomas in the initial postoperative period. This study adopted a descriptive qualitative approach from the interpretive paradigm. Semistructured interviews were conducted with 12 patients 1 month postoperatively in a colorectal ward in a hospital in Singapore. Thematic analysis was applied to the interview data. Five themes were identified: process of acceptance and self-management of stoma, physical limitations, psychological reactions, social support, and need for timely and sufficient stoma preparation and education. This study highlights the importance of health professionals' role in helping patients adjust preoperatively and postoperatively and accept the presence of a stoma. Health professionals need to be aware of the physical, psychological, and social impact of stoma on patients in the initial 30-day postoperative period. Research findings informed the type and level of assistance and support to be offered to patients by nurses and the importance of encouraging patients to be involved in stoma care at an early stage, which will ultimately contribute to effective and independent self-management. Patients can be prepared preoperatively to reduce the psychological and social impact of stoma after creation of their stoma.

Environment-adjusted total-factor energy efficiency of Taiwan's service sectors

International Nuclear Information System (INIS)

Fang, Chin-Yi; Hu, Jin-Li; Lou, Tze-Kai

2013-01-01

This study computes the pure technical efficiency (PTE) and energy-saving target of Taiwan's service sectors during 2001–2008 by using the input-oriented data envelopment analysis (DEA) approach with the assumption of a variable returns-to-scale (VRS) situation. This paper further investigates the effects of industry characteristics on the energy-saving target by applying the four-stage DEA proposed by Fried et al. (1999). We also calculate the pre-adjusted and environment-adjusted total-factor energy efficiency (TFEE) scores in these service sectors. There are three inputs (labor, capital stock, and energy consumption) and a single output (real GDP) in the DEA model. The most energy efficient service sector is finance, insurance and real estate, which has an average TFEE of 0.994 and an environment-adjusted TFEE (EATFEE) of 0.807. The study utilizes the panel-data, random-effects Tobit regression model with the energy-saving target (EST) as the dependent variable. Those service industries with a larger GDP output have greater excess use of energy. The capital–labor ratio has a significantly positive effect while the time trend variable has a significantly negative impact on the EST, suggesting that future new capital investment should also be accompanied with energy-saving technology in the service sectors. - Highlights: • The technical efficiency and energy-saving target of service sectors are assessed. • The pre-adjusted and environment-adjusted total-factor energy efficiency scores in services are assessed. • The industrial characteristic differences are examined by the panel-data, random-effects Tobit regression model. • Labor, capital, and energy and an output (GDP) are included in the DEA model. • Future new capital investment should also be accompanied with energy-saving technology in the service sectors

Community Involvement and Victimization at School: An Analysis through Family, Personal and Social Adjustment

Science.gov (United States)

Jimenez, Teresa Isabel; Musitu, Gonzalo; Ramos, Manuel Jesus; Murgui, Sergio

2009-01-01

The present study analyzes the impact of adolescents' community involvement on victimization by peers at school through various indicators of family, personal and social adjustment (openness of communication with mother and father, life satisfaction, social self-esteem, and loneliness). Participating in the project were 565 adolescents aged 11 to…

Families Created through Surrogacy: Mother-Child Relationships and Children's Psychological Adjustment at Age 7

Science.gov (United States)

Golombok, Susan; Readings, Jennifer; Blake, Lucy; Casey, Polly; Marks, Alex; Jadva, Vasanti

2011-01-01

Each year, an increasing number of children are born through surrogacy and thus lack a genetic and/or gestational link with their mother. This study examined the impact of surrogacy on mother-child relationships and children's psychological adjustment. Assessments of maternal positivity, maternal negativity, mother-child interaction, and child…

THE EVOLUTION OF CURRENCY RELATIONS IN THE LIGHT OF MAJOR EXCHANGE RATE ADJUSTMENT THEORIES

Directory of Open Access Journals (Sweden)

Sergiy TKACH

2014-07-01

Full Text Available This paper examines the impact of major exchange rate adjustment theories on the global monetary system. The reasons of the previous organization forms of monetary relations collapse at the global level are defined. The main achievements and failures of major exchange rate theories are described.

Can statistic adjustment of OR minimize the potential confounding bias for meta-analysis of case-control study? A secondary data analysis.

Science.gov (United States)

Liu, Tianyi; Nie, Xiaolu; Wu, Zehao; Zhang, Ying; Feng, Guoshuang; Cai, Siyu; Lv, Yaqi; Peng, Xiaoxia

2017-12-29

Different confounder adjustment strategies were used to estimate odds ratios (ORs) in case-control study, i.e. how many confounders original studies adjusted and what the variables are. This secondary data analysis is aimed to detect whether there are potential biases caused by difference of confounding factor adjustment strategies in case-control study, and whether such bias would impact the summary effect size of meta-analysis. We included all meta-analyses that focused on the association between breast cancer and passive smoking among non-smoking women, as well as each original case-control studies included in these meta-analyses. The relative deviations (RDs) of each original study were calculated to detect how magnitude the adjustment would impact the estimation of ORs, compared with crude ORs. At the same time, a scatter diagram was sketched to describe the distribution of adjusted ORs with different number of adjusted confounders. Substantial inconsistency existed in meta-analysis of case-control studies, which would influence the precision of the summary effect size. First, mixed unadjusted and adjusted ORs were used to combine individual OR in majority of meta-analysis. Second, original studies with different adjustment strategies of confounders were combined, i.e. the number of adjusted confounders and different factors being adjusted in each original study. Third, adjustment did not make the effect size of original studies trend to constringency, which suggested that model fitting might have failed to correct the systematic error caused by confounding. The heterogeneity of confounder adjustment strategies in case-control studies may lead to further bias for summary effect size in meta-analyses, especially for weak or medium associations so that the direction of causal inference would be even reversed. Therefore, further methodological researches are needed, referring to the assessment of confounder adjustment strategies, as well as how to take this kind

Environmental impact assessments of the Three Gorges Project in China: Issues and interventions

Science.gov (United States)

Xu, Xibao; Tan, Yan; Yang, Guishan

2013-09-01

The paper takes China's authoritative Environmental Impact Statement for the Yangzi (Yangtze) Three Gorges Project (TGP) in 1992 as a benchmark against which to evaluate emerging major environmental outcomes since the initial impoundment of the Three Gorges reservoir in 2003. The paper particularly examines five crucial environmental aspects and associated causal factors. The five domains include human resettlement and the carrying capacity of local environments (especially land), water quality, reservoir sedimentation and downstream riverbed erosion, soil erosion, and seismic activity and geological hazards. Lessons from the environmental impact assessments of the TGP are: (1) hydro project planning needs to take place at a broader scale, and a strategic environmental assessment at a broader scale is necessary in advance of individual environmental impact assessments; (2) national policy and planning adjustments need to react quickly to the impact changes of large projects; (3) long-term environmental monitoring systems and joint operations with other large projects in the upstream areas of a river basin should be established, and the cross-impacts of climate change on projects and possible impacts of projects on regional or local climate considered.

Evidence that Risk Adjustment is Unnecessary in Estimates of the User Cost of Money

Directory of Open Access Journals (Sweden)

Diego A. Restrepo-Tobón

2015-12-01

Full Text Available Investors value the  special attributes of monetary assets (e.g.,  exchangeability, liquidity, and safety  and pay a premium for holding them in the form of a lower return rate. The user cost of holding monetary assets can be measured approximately by the difference between the  returns on illiquid risky assets and  those of safer liquid assets. A more appropriate measure should adjust this difference by the  differential risk of the  assets in question. We investigate the  impact that time  non-separable preferences has on the  estimation of the  risk-adjusted user cost of money. Using U.K. data from 1965Q1 to 2011Q1, we estimate a habit-based asset pricing model  with money  in the utility function and  find that the  risk  adjustment for risky monetary assets is negligible. Thus, researchers can dispense with risk adjusting the  user cost of money  in constructing monetary aggregate indexes.

The impact of a workplace catering initiative on dietary intakes of salt and other nutrients: a pilot study.

Science.gov (United States)

Geaney, F; Harrington, J; Fitzgerald, Ap; Perry, Ij

2011-08-01

Owing to modern lifestyles, individuals are dependent on out-of-home eating. The catering sector can have a pivotal role in influencing our food choices. The objective of the present study was to examine the impact of a structured catering initiative on food choices in a public sector workplace setting. A cross-sectional comparison study in two hospitals, one of which had implemented a catering initiative designed to provide nutritious food while reducing sugar, fat and salt intakes. Two public sector hospitals in Cork, Ireland. A total of 100 random participants aged 18-64 years (fifty intervention, fifty non-intervention) who consumed at least one main meal in the hospital staff canteen daily. Each respondent was asked to complete one anonymous 24 h dietary recall and questionnaire. Food and nutrient analysis was conducted using WISP (Weighed Intake Software Program). Reported mean intakes of total sugars (P catering initiatives in the workplace are a potentially important option in the promotion of healthy food choices. Targeted public health programmes and health policy changes are needed to motivate caterers in the public sector and other industries to develop interventions that promote a healthy diet.

A longitudinal study about the body image and psychosocial adjustment of breast cancer patients during the course of the disease.

Science.gov (United States)

Moreira, Helena; Canavarro, Maria Cristina

2010-09-01

The research of body image among breast cancer patients is characterized by some limitations, such as the lack of longitudinal studies or the absence of a multidimensional perspective of body image. This study intends to overcome these limitations, by examining the evolution of body image dimensions (investment, emotions and evaluations) from the period of surgery (T1) to 6-months after the treatment's ending (T2). It also aims to explore the predictors of body image at T2 and, simultaneously, the predictive role of initial body image to psychosocial adjustment at T2. A total of 56 breast cancer patients participated in both assessments and completed a battery of instruments that included measures of body image dimensions (appearance investment, self-consciousness of appearance, shame and appearance satisfaction) and psychosocial adjustment (quality of life and emotional distress). Within the dimensions of body image, only shame increased over time. In general, initial levels of investment predicted subsequent body image dimensions and having a mastectomy done was associated with higher shame and lower appearance satisfaction at T2. Initial body image did not predict later adjustment, with the exception of depression, where appearance investment played a relevant role. Our findings contributed to the advance of knowledge in this area, providing relevant data about the evolution of body image dimensions, its predictors and its predictive role on psychosocial adjustment among breast cancer patients. This study also suggested some clinical implications that can assist health professionals to implement strategies focused on body image throughout the disease.

Activities of NASA's Global Modeling Initiative (GMI) in the Assessment of Subsonic Aircraft Impact

Science.gov (United States)

Rodriquez, J. M.; Logan, J. A.; Rotman, D. A.; Bergmann, D. J.; Baughcum, S. L.; Friedl, R. R.; Anderson, D. E.

2004-01-01

The Intergovernmental Panel on Climate Change estimated a peak increase in ozone ranging from 7-12 ppbv (zonal and annual average, and relative to a baseline with no aircraft), due to the subsonic aircraft in the year 2015, corresponding to aircraft emissions of 1.3 TgN/year. This range of values presumably reflects differences in model input (e.g., chemical mechanism, ground emission fluxes, and meteorological fields), and algorithms. The model implemented by the Global Modeling Initiative allows testing the impact of individual model components on the assessment calculations. We present results of the impact of doubling the 1995 aircraft emissions of NOx, corresponding to an extra 0.56 TgN/year, utilizing meteorological data from NASA's Data Assimilation Office (DAO), the Goddard Institute for Space Studies (GISS), and the Middle Atmosphere Community Climate Model, version 3 (MACCM3). Comparison of results to observations can be used to assess the model performance. Peak ozone perturbations ranging from 1.7 to 2.2 ppbv of ozone are calculated using the different fields. These correspond to increases in total tropospheric ozone ranging from 3.3 to 4.1 Tg/Os. These perturbations are consistent with the IPCC results, due to the difference in aircraft emissions. However, the range of values calculated is much smaller than in IPCC.

The impact of radiologists' expertise on screen results decisions in a CT lung cancer screening trial

Energy Technology Data Exchange (ETDEWEB)

Heuvelmans, Marjolein A.; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Groningen (Netherlands); University of Groningen / University Medical Center Groningen, Department of Radiology, Groningen (Netherlands); Oudkerk, Matthijs [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Groningen (Netherlands); Jong, Pim A. de; Mali, Willem P. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Groen, Harry J.M. [University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen (Netherlands)

2014-11-04

To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial. In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule's volume. The protocol allowed radiologists to manually adjust screen results in cases of high suspicion of benign or malignant nodule nature. Participants whose baseline CT result was based on a solid or part-solid nodule were included in this study. Adjustments by radiologists at baseline were evaluated. Histology was the reference for diagnosis or to confirm benignity and stability on subsequent CT examinations. A total of 3,318 participants (2,796 male, median age 58.0 years) were included. In 195 participants (5.9 %) the initial baseline screen result was adjusted by the radiologist. Adjustment was downwards from positive or indeterminate to negative in two and 119 participants, respectively, and from positive to indeterminate in 65 participants. None of these nodules turned out to be malignant. In 9/195 participants (4.6 %) the screen result was adjusted upwards from negative to indeterminate or indeterminate to positive; two nodules were malignant. In one in 20 cases of baseline lung cancer screening, nodules were reclassified by the radiologist, leading to a reduction of false-positive screen results. (orig.)

Should measures of patient experience in primary care be adjusted for case mix? Evidence from the English General Practice Patient Survey.

Science.gov (United States)

Paddison, Charlotte; Elliott, Marc; Parker, Richard; Staetsky, Laura; Lyratzopoulos, Georgios; Campbell, John L; Roland, Martin

2012-08-01

Uncertainties exist about when and how best to adjust performance measures for case mix. Our aims are to quantify the impact of case-mix adjustment on practice-level scores in a national survey of patient experience, to identify why and when it may be useful to adjust for case mix, and to discuss unresolved policy issues regarding the use of case-mix adjustment in performance measurement in health care. Secondary analysis of the 2009 English General Practice Patient Survey. Responses from 2 163 456 patients registered with 8267 primary care practices. Linear mixed effects models were used with practice included as a random effect and five case-mix variables (gender, age, race/ethnicity, deprivation, and self-reported health) as fixed effects. Primary outcome was the impact of case-mix adjustment on practice-level means (adjusted minus unadjusted) and changes in practice percentile ranks for questions measuring patient experience in three domains of primary care: access; interpersonal care; anticipatory care planning, and overall satisfaction with primary care services. Depending on the survey measure selected, case-mix adjustment changed the rank of between 0.4% and 29.8% of practices by more than 10 percentile points. Adjusting for case-mix resulted in large increases in score for a small number of practices and small decreases in score for a larger number of practices. Practices with younger patients, more ethnic minority patients and patients living in more socio-economically deprived areas were more likely to gain from case-mix adjustment. Age and race/ethnicity were the most influential adjustors. While its effect is modest for most practices, case-mix adjustment corrects significant underestimation of scores for a small proportion of practices serving vulnerable patients and may reduce the risk that providers would 'cream-skim' by not enrolling patients from vulnerable socio-demographic groups.

Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survviors

Science.gov (United States)

Sun, Virginia; Grant, Marcia; Wendel, Christopher S.; McMullen, Carmit K.; Bulkley, Joanna E.; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M.; Herrinton, Lisa J.; Hornbrook, Mark C.; Krouse, Robert S.

2015-01-01

BACKGROUND Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors’ health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. METHODS This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N=856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high versus low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. RESULTS CRC survivors made substantial, permanent dietary and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CONCLUSIONS CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship. PMID:26159443

Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors.

Science.gov (United States)

Sun, Virginia; Grant, Marcia; Wendel, Christopher S; McMullen, Carmit K; Bulkley, Joanna E; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M; Herrinton, Lisa J; Hornbrook, Mark C; Krouse, Robert S

2015-12-01

Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors' health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N = 856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high vs. low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. CRC survivors made substantial, permanent dietary, and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship.

Mapping longitudinal scientific progress, collaboration and impact of the Alzheimer's disease neuroimaging initiative.

Directory of Open Access Journals (Sweden)

Xiaohui Yao

Full Text Available Alzheimer's disease neuroimaging initiative (ADNI is a landmark imaging and omics study in AD. ADNI research literature has increased substantially over the past decade, which poses challenges for effectively communicating information about the results and impact of ADNI-related studies. In this work, we employed advanced information visualization techniques to perform a comprehensive and systematic mapping of the ADNI scientific growth and impact over a period of 12 years.Citation information of ADNI-related publications from 01/01/2003 to 05/12/2015 were downloaded from the Scopus database. Five fields, including authors, years, affiliations, sources (journals, and keywords, were extracted and preprocessed. Statistical analyses were performed on basic publication data as well as journal and citations information. Science mapping workflows were conducted using the Science of Science (Sci2 Tool to generate geospatial, topical, and collaboration visualizations at the micro (individual to macro (global levels such as geospatial layouts of institutional collaboration networks, keyword co-occurrence networks, and author collaboration networks evolving over time.During the studied period, 996 ADNI manuscripts were published across 233 journals and conference proceedings. The number of publications grew linearly from 2008 to 2015, so did the number of involved institutions. ADNI publications received much more citations than typical papers from the same set of journals. Collaborations were visualized at multiple levels, including authors, institutions, and research areas. The evolution of key ADNI research topics was also plotted over the studied period.Both statistical and visualization results demonstrate the increasing attention of ADNI research, strong citation impact of ADNI publications, the expanding collaboration networks among researchers, institutions and ADNI core areas, and the dynamic evolution of ADNI research topics. The visualizations

The Mediating Role of Psychological Adjustment between Peer Victimization and Social Adjustment in Adolescence.

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Romera, Eva M; Gómez-Ortiz, Olga; Ortega-Ruiz, Rosario

2016-01-01

There is extensive scientific evidence of the serious psychological and social effects that peer victimization may have on students, among them internalizing problems such as anxiety or negative self-esteem, difficulties related to low self-efficacy and lower levels of social adjustment. Although a direct relationship has been observed between victimization and these effects, it has not yet been analyzed whether there is a relationship of interdependence between all these measures of psychosocial adjustment. The aim of this study was to examine the relationship between victimization and difficulties related to social adjustment among high school students. To do so, various explanatory models were tested to determine whether psychological adjustment (negative self-esteem, social anxiety and social self-efficacy) could play a mediating role in this relationship, as suggested by other studies on academic adjustment. The sample comprised 2060 Spanish high school students (47.9% girls; mean age = 14.34). The instruments used were the scale of victimization from European Bullying Intervention Project Questionnaire , the negative scale from Rosenberg Self-Esteem Scale, Social Anxiety Scale for Adolescents and a general item about social self-efficacy, all of them self-reports. Structural equation modeling was used to analyze the data. The results confirmed the partial mediating role of negative self-esteem, social anxiety and social self-efficacy between peer victimization and social adjustment and highlight the importance of empowering victimized students to improve their self-esteem and self-efficacy and prevent social anxiety. Such problems lead to the avoidance of social interactions and social reinforcement, thus making it difficult for these students to achieve adequate social adjustment.

The Mediating Role of Psychological Adjustment between Peer Victimization and Social Adjustment in Adolescence

Directory of Open Access Journals (Sweden)

Eva M. Romera

2016-11-01

Full Text Available There is extensive scientific evidence of the serious psychological and social effects that peer victimization may have on students, among them internalizing problems such as anxiety or negative self-esteem, difficulties related to low self-efficacy and lower levels of social adjustment. Although a direct relationship has been observed between victimization and these effects, it has not yet been analyzed whether there is a relationship of interdependence between all these measures of psychosocial adjustment. The aim of this study was to examine the relationship between victimization and difficulties related to social adjustment among high school students. To do so, various explanatory models were tested to determine whether psychological adjustment (negative self-esteem, social anxiety and social self-efficacy could play a mediating role in this relationship, as suggested by other studies on academic adjustment. The sample comprised 2060 Spanish high school students (47.9% girls; mean age = 14.34. The instruments used were the scale of victimization from European Bullying Intervention Project Questionnaire, the negative scale from Rosenberg Self-Esteem Scale, Social Anxiety Scale for Adolescents and a general item about social self-efficacy, all of them self-reports. Structural equation modeling was used to analyze the data. The results confirmed the partial mediating role of negative self-esteem, social anxiety and social self-efficacy between peer victimization and social adjustment and highlight the importance of empowering victimized students to improve their self-esteem and self-efficacy and prevent social anxiety. Such problems lead to the avoidance of social interactions and social reinforcement, thus making it difficult for these students to achieve adequate social adjustment.

Acculturation and Psychological Adjustment of Vietnamese Refugees: An Ecological Acculturation Framework.

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Salo, Corrina D; Birman, Dina

2015-12-01

Acculturation to the culture of the host society as well as to one's heritage culture have been shown to impact immigrants' adjustment during the years following resettlement. While acculturation has been identified as an important factor in adjustment of Vietnamese immigrants (Birman and Tran in Am J Orthopsychiatr 78(1):109-120. doi: 10.1037/0002-9432.78.1.109 , 2008), no clear pattern of findings has emerged and too few studies have employed an ecological approach. The purpose of this paper is to contextualize the study of acculturation and adjustment by taking an ecological approach to exploring these relationships across several life domains, using a bilinear scale, and examining mediators of these relationships for adult Vietnamese refugees (N = 203) in the United States. We call this approach the Ecological Acculturation Framework (EAF). Results of a structural equation model (SEM) showed that job satisfaction fully mediated the relationship between American acculturation and psychological distress, demonstrating that this relationship was specific to an occupational domain. However, while Vietnamese acculturation predicted co-ethnic social support satisfaction, it did not predict reduced psychological distress. Implications for a life domains approach, including domain specificity, are discussed.

Investigation and microstructural analyses of massive LSP impacts with coverage area on crack initiation location and tensile properties of AM50 magnesium alloy

Energy Technology Data Exchange (ETDEWEB)

Luo, K.Y.; Wang, C.Y. [School of Mechanical Engineering, Jiangsu University, Zhenjiang 212013 (China); Sun, G.F. [School of Mechanical Engineering, Southeast University, Nanjing 211189 (China); Cui, C.Y.; Sheng, J. [School of Mechanical Engineering, Jiangsu University, Zhenjiang 212013 (China); Lu, J.Z., E-mail: blueesky2005@163.com [School of Mechanical Engineering, Jiangsu University, Zhenjiang 212013 (China)

2016-01-05

The influence of massive laser shock peening (LSP) impacts with coverage area on tensile properties of AM50 magnesium alloy was investigated using MTS880-10 servo-hydraulic material testing machine system. Microstructure in the surface layer and fracture morphologies of as-machined and LSPed tensile specimens were also characterized and analyzed by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and cross-sectional optical microscopy (OM). Special attention is paid to the crack initiation location as a function of LSPed coverage area in the gauge part of tensile specimen. Experimental results and analysis indicate that coverage area significantly influenced tensile properties of the tensile specimen. In addition, the grain refinement process in the top surface layer of AM50 magnesium alloy caused by massive LSP impacts is presented. Furthermore, the underlying influence mechanism of LSPed coverage area on tensile properties and crack initiation location of tensile specimen was clearly revealed.

Investigation and microstructural analyses of massive LSP impacts with coverage area on crack initiation location and tensile properties of AM50 magnesium alloy

International Nuclear Information System (INIS)

Luo, K.Y.; Wang, C.Y.; Sun, G.F.; Cui, C.Y.; Sheng, J.; Lu, J.Z.

2016-01-01

The influence of massive laser shock peening (LSP) impacts with coverage area on tensile properties of AM50 magnesium alloy was investigated using MTS880-10 servo-hydraulic material testing machine system. Microstructure in the surface layer and fracture morphologies of as-machined and LSPed tensile specimens were also characterized and analyzed by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and cross-sectional optical microscopy (OM). Special attention is paid to the crack initiation location as a function of LSPed coverage area in the gauge part of tensile specimen. Experimental results and analysis indicate that coverage area significantly influenced tensile properties of the tensile specimen. In addition, the grain refinement process in the top surface layer of AM50 magnesium alloy caused by massive LSP impacts is presented. Furthermore, the underlying influence mechanism of LSPed coverage area on tensile properties and crack initiation location of tensile specimen was clearly revealed.

Birth-Order Complementarity and Marital Adjustment.

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Vos, Cornelia J. Vanderkooy; Hayden, Delbert J.

1985-01-01

Tested the influence of birth-order complementarity on marital adjustment among 327 married women using the Spanier Dyadic Adjustment Scale (1976). Birth-order complementarity was found to be unassociated with marital adjustment. (Author/BL)

The academic adjustment scale : Measuring the adjustment of permanent resident or sojourner students

NARCIS (Netherlands)

Anderson, Joel R.; Guan, Yao; Koc, Yasin

In this paper we developed and validated the Academic Adjustment Scale (AAS) - a new scale for measuring academic adjustment, which was developed with a focus on student sojourners who temporarily relocate to a new culture for the purpose of tertiary education, but also is validated for use with

Case-mix adjustment of consumer reports about managed behavioral health care and health plans.

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Eselius, Laura L; Cleary, Paul D; Zaslavsky, Alan M; Huskamp, Haiden A; Busch, Susan H

2008-12-01

To develop a model for adjusting patients' reports of behavioral health care experiences on the Experience of Care and Health Outcomes (ECHO) survey to allow for fair comparisons across health plans. Survey responses from 4,068 individuals enrolled in 21 managed behavioral health plans who received behavioral health care within the previous year (response rate = 48 percent). Potential case-mix adjustors were evaluated by combining information about their predictive power and the amount of within- and between-plan variability. Changes in plan scores and rankings due to case-mix adjustment were quantified. The final case-mix adjustment model included self-reported mental health status, self-reported general health status, alcohol/drug treatment, age, education, and race/ethnicity. The impact of adjustment on plan report scores was modest, but large enough to change some plan rankings. Adjusting plan report scores on the ECHO survey for differences in patient characteristics had modest effects, but still may be important to maintain the credibility of patient reports as a quality metric. Differences between those with self-reported fair/poor health compared with those in excellent/very good health varied by plan, suggesting quality differences associated with health status and underscoring the importance of collecting quality information.

"Effect of Anxiety Reduction on Children's School Performance and Social Adjustment": Correction to Wood (2006)

Science.gov (United States)

Wood, Jeffrey J.

2007-01-01

Reports an error in "Effect of anxiety reduction on children's school performance and social adjustment" by Jeffrey Wood (Developmental Psychology, 2006[Mar], Vol 42[2], 345-349). The byline and author note should have included the author's middle initial, J. Thus, the byline and author note should refer to "Jeffrey J. Wood." The correction is…

Life-span adjustment of children to their parents' divorce.

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Amato, P R

1994-01-01

Children who experience parental divorce, compared with children in intact two-parent families, exhibit more conduct problems, more symptoms of psychological maladjustment, lower academic achievement, more social difficulties, and poorer self-concepts. Similarly, adults who experienced parental divorce as children, compared with adults raised in continuously intact two-parent families, score lower on a variety of indicators of psychological, interpersonal, and socioeconomic well-being. However, the overall group differences between offspring from divorced and intact families are small, with considerable diversity existing in children's reactions to divorce. Children's adjustment to divorce depends on several factors, including the amount and quality of contact with noncustodial parents, the custodial parents' psychological adjustment and parenting skills, the level of interparental conflict that precedes and follows divorce, the degree of economic hardship to which children are exposed, and the number of stressful life events that accompany and follow divorce. These factors can be used as guides to assess the probable impact of various legal and therapeutic interventions to improve the well-being of children of divorce.

The struggle towards 'the New Normal': a qualitative insight into psychosexual adjustment to prostate cancer.

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Hanly, Narelle; Mireskandari, Shab; Juraskova, Ilona

2014-07-30

Despite the growing body of literature which highlights the potential for significant and enduring side-effects of prostate cancer treatment, there is limited research exploring the experience of living with the treatment-induced side-effects such as sexual dysfunction, and their repercussions for men and their partners. The aim of this qualitative study was to explore factors influencing psychosexual adjustment, self-perception, and unmet information and support needs of prostate cancer patients and their partners. Twenty-one men, recruited via a prostate cancer support group newsletter, participated in face-to-face semi-structured interviews, which were subjected to thematic analysis. The qualitative analysis revealed three inter-connected main themes which contributed to men's psychosexual adjustment: i) Psychosexual impact, ii) Communication and support, and iii) Integration process. Men reported distressing sexual and urinary difficulties, tainted self-perception and altered intimate relationships. Receiving adequate information and support, and having good communication with their doctors and partners facilitated better adjustment to prostate cancer treatment. Coming to terms with the significant impact of treatment had involved making lifestyle changes, coping with emotional struggles and striving to accept and integrate their post-treatment "new normal" self and sexual life. The importance of adequate communication with health professionals and partners, especially regarding treatment effects on sexual function and rehabilitation options, was highlighted as a key factor facilitating the adjustment process. Prostate cancer patients would benefit from improved access to timely and tailored information and decision-making resources, ongoing multidisciplinary care, and support groups, as well as appropriate referrals for sexual and psychological counselling.

Comparison of clinical probability-adjusted D-dimer and age-adjusted D-dimer interpretation to exclude venous thromboembolism.

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Takach Lapner, Sarah; Julian, Jim A; Linkins, Lori-Ann; Bates, Shannon; Kearon, Clive

2017-10-05

Two new strategies for interpreting D-dimer results have been proposed: i) using a progressively higher D-dimer threshold with increasing age (age-adjusted strategy) and ii) using a D-dimer threshold in patients with low clinical probability that is twice the threshold used in patients with moderate clinical probability (clinical probability-adjusted strategy). Our objective was to compare the diagnostic accuracy of age-adjusted and clinical probability-adjusted D-dimer interpretation in patients with a low or moderate clinical probability of venous thromboembolism (VTE). We performed a retrospective analysis of clinical data and blood samples from two prospective studies. We compared the negative predictive value (NPV) for VTE, and the proportion of patients with a negative D-dimer result, using two D-dimer interpretation strategies: the age-adjusted strategy, which uses a progressively higher D-dimer threshold with increasing age over 50 years (age in years × 10 µg/L FEU); and the clinical probability-adjusted strategy which uses a D-dimer threshold of 1000 µg/L FEU in patients with low clinical probability and 500 µg/L FEU in patients with moderate clinical probability. A total of 1649 outpatients with low or moderate clinical probability for a first suspected deep vein thrombosis or pulmonary embolism were included. The NPV of both the clinical probability-adjusted strategy (99.7 %) and the age-adjusted strategy (99.6 %) were similar. However, the proportion of patients with a negative result was greater with the clinical probability-adjusted strategy (56.1 % vs, 50.9 %; difference 5.2 %; 95 % CI 3.5 % to 6.8 %). These findings suggest that clinical probability-adjusted D-dimer interpretation is a better way of interpreting D-dimer results compared to age-adjusted interpretation.

Increased Persistence of Initial Treatment for HIV Infection With Modern Antiretroviral Therapy.

Science.gov (United States)

Davy-Mendez, Thibaut; Eron, Joseph J; Zakharova, Oksana; Wohl, David A; Napravnik, Sonia

2017-10-01

Initiating antiretroviral therapy (ART) early improves clinical outcomes and prevents transmission. Guidelines for first-line therapy have changed with the availability of newer ART agents. In this study, we compared persistence and virologic responses with initial ART according to the class of anchor agent used. An observational clinical cohort study in the Southeastern United States. All HIV-infected patients participating in the UNC Center for AIDS Research Clinical Cohort (UCHCC) and initiating ART between 1996 and 2014 were included. Separate time-to-event analyses with regimen discontinuation and virologic failure as outcomes were used, including Kaplan-Meier survival curves and adjusted Cox proportional hazards models. One thousand six hundred twenty-four patients were included (median age of 37 years at baseline, 28% women, 60% African American, and 28% white). Eleven percent initiated integrase strand transfer inhibitor (INSTI), 33% non-nucleoside reverse transcriptase inhibitor (NNRTI), 20% boosted protease inhibitor, 27% other, and 9% NRTI only regimens. Compared with NNRTI-containing regimens, INSTI-containing regimens had an adjusted hazard ratio of 0.49 (95% confidence interval, 0.35 to 0.69) for discontinuation and 0.70 (95% confidence interval, 0.46 to 1.06) for virologic failure. All other regimen types were associated with increased rates of discontinuation and failure compared with NNRTI. Initiating ART with an INSTI-containing regimen was associated with lower rates of regimen discontinuation and virologic failure.

Psychological Adjustment to Lung Cancer: the role of self-compassion and social support

Directory of Open Access Journals (Sweden)

Rute Batista

2016-02-01

Full Text Available // Introduction: The impact of the diagnosis of an oncologic disease is well-known in terms of psychological adjustment and quality of life. On the other hand it is known that depressive symptoms may also overlap the physical symptoms of cancer and cancer treatment, which may interfere in their detection and appropriate treatment approach.   Objectives: The aim of the current study was to explore the relationship between psychological adjustment to lung cancer, self-compassion, social support and emotional negative states in patients with lung cancer.   Method: Fifty-five patients diagnosed with lung cancer (38 men and 17 women with ages ranging from 44 to 87 years old participated in the study. A set of self-report instruments was used: the Mini Mental Adjustment to Cancer Scale (MiniMac, the Self-compassion Scale (SCS; Neff, 2003, the Social Support Satisfaction Scale (SSSS and the Depression, Anxiety and Stress Scale (DASS-21.   Results: Significant correlations were found between psychological adjustment, psychopathology, emotion regulation strategies (self-compassion, and social support. The predictive models for psychological adjustment and stress related symptomatology include self-compassion and social support as significant predictive variables. Regarding the predictive model for depressive symptomatology, mindfulness seems to be the only significant predictor.   Conclusions: Our findings suggest that these patients may benefit, in their therapeutic approach, from the development of this kind of strategies (new ways of relating themselves with their emotional experiences and quality of their social networks in order to promote a better psychological adjustment to their clinical condition.

Structural adjustment and drought in Zambia.

Science.gov (United States)

Mulwanda, M

1995-06-01

While drought is not uncommon in Zambia, the country is now facing the worst drought in history. The monetary and social costs will be enormous. Although it is too early to measure the economic and social costs of the drought on Zambia, it is obvious that the impact is catastrophic on a country whose economy is under pressure. The drought will affect the structural adjustment programme (SAP) unveiled by the new government which has embraced the market economy. The country has imported, and will continue to import, large quantities of maize and other foodstuffs, a situation likely to strain the balance of payments. Earlier targets with regard to export earnings, reductions in the budget deficit, and GDP growth as contained in the Policy Framework Paper (PFP) are no longer attainable due to the effects of the drought.

Some post operational adjustments to the prototype fast reactor at Dounreay

International Nuclear Information System (INIS)

Lunt, A.R.W.

1979-01-01

Prior to and during the initial operation of the Prototype Fast Reactor at Dounreay certain features have been considered to be in need of adjustment to provide better operating characteristics. This article describes the work done to support the consequential changes of operational techniques and plant design in the following areas: maintenance of dry conditions at the superheater steam inlets, the temperature control of the reactor roof, and the introduction of a system enabling the reactor to continue running after a turbine trip. (author)

Residual pathological stage at radical cystectomy significantly impacts outcomes for initial T2N0 bladder cancer.

Science.gov (United States)

Isbarn, Hendrik; Karakiewicz, Pierre I; Shariat, Shahrokh F; Capitanio, Umberto; Palapattu, Ganesh S; Sagalowsky, Arthur I; Lotan, Yair; Schoenberg, Mark P; Amiel, Gilad E; Lerner, Seth P; Sonpavde, Guru

2009-08-01

We hypothesized that in patients with T2N0 stage disease at transurethral bladder tumor resection a lower residual cancer stage (P1N0 or less) at radical cystectomy may correlate with improved outcomes relative to those with residual P2N0 disease. We analyzed 208 patients with T2N0 stage disease at transurethral bladder tumor resection whose tumors were organ confined at radical cystectomy (P2 or lower, pN0). None received perioperative chemotherapy. Kaplan-Meier as well as univariable and multivariable Cox regression models addressed the effect of residual pT stage at radical cystectomy on recurrence and cancer specific mortality rates. Covariates consisted of age, gender, grade, lymphovascular invasion, carcinoma in situ, number of lymph nodes removed and year of surgery. Residual pT stage at radical cystectomy was P0 in 24 (11.5%) patients, Pa in 9 (4.3%), PCIS in 22 (10.6%), P1 in 35 (16.8%) and P2 in 118 (56.7%). Median followup of censored patients was 55.7 months for recurrence and 52.1 months for cancer specific mortality analyses. The 5-year recurrence-free survival rates of patients with P0/Pa/PCIS, P1 and P2 stage disease were 100%, 85% and 75%, respectively. The 5-year cancer specific survival rates for the same cohorts were 100%, 93% and 81%, respectively. On multivariable analysis the effect of residual stage P1 or lower at radical cystectomy achieved independent predictor status for recurrence (adjusted HR 0.20, p = 0.002) and cancer specific mortality (adjusted HR 0.24, p = 0.02). Down staging from initial T2N0 bladder cancer at transurethral bladder tumor resection to lower stage at radical cystectomy significantly reduces recurrence and cancer specific mortality. Further validation of this finding is warranted.

18F-FDG PET/CT for initial staging in breast cancer patients. Is there a relevant impact on treatment planning compared to conventional staging modalities?

International Nuclear Information System (INIS)

Krammer, J.; Schnitzer, A.; Kaiser, C.G.; Buesing, K.A.; Schoenberg, S.O.; Wasser, K.; Sperk, E.; Brade, J.; Wasgindt, S.; Suetterlin, M.; Sutton, E.J.

2015-01-01

To evaluate the impact of whole-body 18 F-FDG PET/CT on initial staging of breast cancer in comparison to conventional staging modalities. This study included 102 breast cancer patients, 101 patients were eligible for evaluation. Preoperative whole-body staging with PET/CT was performed in patients with clinical stage ≥ T2 tumours or positive local lymph nodes (n = 91). Postoperative PET/CT was performed in patients without these criteria but positive sentinel lymph node biopsy (n = 10). All patients underwent PET/CT and a conventional staging algorithm, which included bone scan, chest X-ray and abdominal ultrasound. PET/CT findings were compared to conventional staging and the impact on therapeutic management was evaluated. PET/CT led to an upgrade of the N or M stage in overall 19 patients (19 %) and newly identified manifestation of breast cancer in two patients (2 %). PET/CT findings caused a change in treatment of 11 patients (11 %). This is within the range of recent studies, all applying conventional inclusion criteria based on the initial T and N status. PET/CT has a relevant impact on initial staging and treatment of breast cancer when compared to conventional modalities. Further studies should assess inclusion criteria beyond the conventional T and N status, e.g. tumour grading and receptor status. (orig.)

Understanding Links between Punitive Parenting and Adolescent Adjustment: The Relevance of Context and Reciprocal Associations

Science.gov (United States)

Roche, Kathleen M.; Ghazarian, Sharon R.; Little, Todd D.; Leventhal, Tama

2011-01-01

There is considerable debate regarding the extent to which punitive parenting adversely impacts youth well-being. Using an ecological-transactional model of human development, we examined reciprocity and contextual variability in associations between maternal punitive discipline and adolescent adjustment among 1,147 low-income, urban youth…

Neurally Adjusted Ventilatory Assist After Pediatric Cardiac Surgery: Clinical Experience and Impact on Ventilation Pressures.

Science.gov (United States)

Crulli, Benjamin; Khebir, Mariam; Toledano, Baruch; Vobecky, Suzanne; Poirier, Nancy; Emeriaud, Guillaume

2018-02-01

After pediatric cardiac surgery, ventilation with high airway pressures can be detrimental to right ventricular function and pulmonary blood flow. Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interactions, helping maintain spontaneous ventilation. This study reports our experience with the use of NAVA in children after a cardiac surgery. We hypothesize that using NAVA in this population is feasible and allows for lower ventilation pressures. We retrospectively studied all children ventilated with NAVA (invasively or noninvasively) after undergoing cardiac surgery between January 2013 and May 2015 in our pediatric intensive care unit. The number and duration of NAVA episodes were described. For the first period of invasive NAVA in each subject, detailed clinical and ventilator data in the 4 h before and after the start of NAVA were extracted. 33 postoperative courses were included in 28 subjects with a median age of 3 [interquartile range (IQR) 1-12] months. NAVA was used invasively in 27 courses for a total duration of 87 (IQR 15-334) h per course. Peak inspiratory pressures and mean airway pressures decreased significantly after the start of NAVA (mean differences of 5.8 cm H 2 O (95% CI 4.1-7.5) and 2.0 cm H 2 O (95% CI 1.2-2.8), respectively, P < .001 for both). There was no significant difference in vital signs or blood gas values. NAVA was used noninvasively in 14 subjects, over 79 (IQR 25-137) h. NAVA could be used in pediatric subjects after cardiac surgery. The significant decrease in airway pressures observed after transition to NAVA could have a beneficial impact in this specific population, which should be investigated in future interventional studies. Copyright © 2018 by Daedalus Enterprises.

The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia.

Science.gov (United States)

Eliseev, Platon; Balantcev, Grigory; Nikishova, Elena; Gaida, Anastasia; Bogdanova, Elena; Enarson, Donald; Ornstein, Tara; Detjen, Anne; Dacombe, Russell; Gospodarevskaya, Elena; Phillips, Patrick P J; Mann, Gillian; Squire, Stephen Bertel; Mariandyshev, Andrei

2016-01-01

In the Arkhangelsk region of Northern Russia, multidrug-resistant (MDR) tuberculosis (TB) rates in new cases are amongst the highest in the world. In 2014, MDR-TB rates reached 31.7% among new cases and 56.9% among retreatment cases. The development of new diagnostic tools allows for faster detection of both TB and MDR-TB and should lead to reduced transmission by earlier initiation of anti-TB therapy. The PROVE-IT (Policy Relevant Outcomes from Validating Evidence on Impact) Russia study aimed to assess the impact of the implementation of line probe assay (LPA) as part of an LPA-based diagnostic algorithm for patients with presumptive MDR-TB focusing on time to treatment initiation with time from first-care seeking visit to the initiation of MDR-TB treatment rather than diagnostic accuracy as the primary outcome, and to assess treatment outcomes. We hypothesized that the implementation of LPA would result in faster time to treatment initiation and better treatment outcomes. A culture-based diagnostic algorithm used prior to LPA implementation was compared to an LPA-based algorithm that replaced BacTAlert and Löwenstein Jensen (LJ) for drug sensitivity testing. A total of 295 MDR-TB patients were included in the study, 163 diagnosed with the culture-based algorithm, 132 with the LPA-based algorithm. Among smear positive patients, the implementation of the LPA-based algorithm was associated with a median decrease in time to MDR-TB treatment initiation of 50 and 66 days compared to the culture-based algorithm (BacTAlert and LJ respectively, ptime to MDR-TB treatment initiation of 78 days when compared to the culture-based algorithm (LJ, ptime to MDR diagnosis and earlier treatment initiation as well as better treatment outcomes for patients with MDR-TB. These findings also highlight the need for further improvements within the health system to reduce both patient and diagnostic delays to truly optimize the impact of new, rapid diagnostics.

Fiscal Adjustment in IMF-Supported Adjustment Programmes: The ...

African Journals Online (AJOL)

Fiscal adjustment is an essential element of macro-economic stability and economic growth. Given that economic growth is the most powerful weapon in the fight for higher living standards, poor growth performance in African countries, has been a challenge to economists, policy makers and international development ...

Impact of Communication on Parents' and First-Year College Students' Ratings of Student Academic, Emotional, and Social Adjustment

Science.gov (United States)

Yogan, Lissa; Freedle, Agata; Ringenberg, Matthew

2017-01-01

This study explored the effects of parents' and students' communication patterns on students' social, emotional, and academic adjustment to college. It matched 118 pairs of parents and students (n = 236) and asked them to report their frequency and mode of communication, as well as the first-year students' perceived adjustment to college. The…

The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy

Directory of Open Access Journals (Sweden)

Duncan I

2012-04-01

Full Text Available Michael Taitel1, Jenny Jiang1, Kristi Rudkin2, Susan Ewing2, Ian Duncan 1Clinical Outcomes and Analytics, Walgreens, 2Corporate Innovation Team, Walgreens, Deerfield, Illinois, USAPurpose: To evaluate the impact of a community-based pharmacist-led face-to-face counseling program on medication adherence for patients who were new to therapy (NTT for statin medications.Patients and methods: This retrospective cohort study evaluated a program that was implemented in 76 national community pharmacies located in the midwest USA. It consisted of two face-to-face patient counseling sessions with a pharmacist that addressed patient barriers to adherence. A group of 2056 NTT statin patients was identified between September 1, 2010 and October 31, 2010, and was followed for 12 months. The intervention group consisted of 586 patients, and the comparison group comprised 516 patients. Outcomes were measured using the continuous medication possession ratio (MPR, categorical MPR, and medication persistency.Results: After adjusting for covariates, the intervention group had statistically greater MPR than the comparison group at every month measured. For example, at 12 months the intervention group had a MPR of 61.8% (CI, 54.5%–69.2% and the comparison group had a MPR of 56.9% (CI, 49.5%–64.3%; this 4.9% difference is significant (P < 0.01. The 12 month categorical MPR also showed significant differences between groups (χ2 = 6.12, P < 0.05; 40.9% of the intervention group and 33.7% of comparison group had a MPR greater than or equal to 80%. Finally, the intervention group had significantly greater persistency with their medication therapy than the comparison group at 60, 90, 120, and 365 days.Conclusion: Patients who participated in brief face-to-face counseling sessions with a community pharmacist at the beginning of statin therapy demonstrated greater medication adherence and persistency than a comparison group. This brief targeted intervention at the

Fitting method of pseudo-polynomial for solving nonlinear parametric adjustment

Institute of Scientific and Technical Information of China (English)

陶华学; 宫秀军; 郭金运

2001-01-01

The optimal condition and its geometrical characters of the least-square adjustment were proposed. Then the relation between the transformed surface and least-squares was discussed. Based on the above, a non-iterative method, called the fitting method of pseudo-polynomial, was derived in detail. The final least-squares solution can be determined with sufficient accuracy in a single step and is not attained by moving the initial point in the view of iteration. The accuracy of the solution relys wholly on the frequency of Taylor's series. The example verifies the correctness and validness of the method.

Refining dermatology journal impact factors using PageRank.

Science.gov (United States)

Dellavalle, Robert P; Schilling, Lisa M; Rodriguez, Marko A; Van de Sompel, Herbert; Bollen, Johan

2007-07-01

Thomson Institute for Scientific Information's journal impact factor, the most common measure of journal status, is based on crude citation counts that do not account for the quality of the journals where the citations originate. This study examines how accounting for citation origin affects the impact factor ranking of dermatology journals. The 2003 impact factors of dermatology journals were adjusted by a weighted PageRank algorithm that assigned greater weight to citations originating in more frequently cited journals. Adjusting for citation origin moved the rank of the Journal of the American Academy of Dermatology higher than that of the Archives of Dermatology (third to second) but did not affect the ranking of the highest impact dermatology journal, the Journal of Investigative Dermatology. The dermatology journals most positively affected by adjusting for citation origin were Contact Dermatitis (moving from 22nd to 7th in rankings) and Burns (21st to 10th). Dermatology journals most negatively affected were Seminars in Cutaneous Medicine and Surgery (5th to 14th), the Journal of Cutaneous Medicine and Surgery (19th to 27th), and the Journal of Investigative Dermatology Symposium Proceedings (26th to 34th). Current measures of dermatology journal status do not incorporate survey data from dermatologists regarding which journals dermatologists esteem most. Adjusting for citation origin provides a more refined measure of journal status and changes relative dermatology journal rankings.

Less efficient oculomotor performance is associated with increased incidence of head impacts in high school ice hockey.

Science.gov (United States)

Kiefer, Adam W; DiCesare, Christopher; Nalepka, Patrick; Foss, Kim Barber; Thomas, Staci; Myer, Gregory D

2018-01-01

To evaluate associations between pre-season oculomotor performance on visual tracking tasks and in-season head impact incidence during high school boys ice hockey. Prospective observational study design. Fifteen healthy high school aged male hockey athletes (M=16.50±1.17years) performed two 30s blocks each of a prosaccade and self-paced saccade task, and two trials each of a slow, medium, and fast smooth pursuit task (90°s -1 ; 180°s -1 ; 360°s -1 ) during the pre-season. Regular season in-game collision data were collected via helmet-mounted accelerometers. Simple linear regressions were used to examine relations between oculomotor performance measures and collision incidence at various impact thresholds. The variability of prosaccade latency was positively related to total collisions for the 20g force cutoff (p=0.046, adjusted R 2 =0.28). The average self-paced saccade velocity (p=0.020, adjusted R 2 =0.37) and variability of smooth pursuit gaze velocity (p=0.012, adjusted R 2 =0.47) were also positively associated with total collisions for the 50g force cutoff. These results provide preliminary evidence that less efficient oculomotor performance on three different oculomotor tasks is associated with increased incidence of head impacts during a competitive ice hockey season. The variability of prosaccade latency, the average self-paced saccade velocity and the variability of gaze velocity during predictable smooth pursuit all related to increased head impacts. Future work is needed to further understand player initiated collisions, but this is an important first step toward understanding strategies to reduce incidence of injury risk in ice hockey, and potentially contact sports more generally. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Adjusting export tax rebates to reduce the environmental impacts of trade: Lessons from China.

Science.gov (United States)

Song, Peng; Mao, Xianqiang; Corsetti, Gabriel

2015-09-15

Export tax rebates are an important policy instrument for stimulating exports, which many developing countries make use of. However, excessive export tax rebates and inappropriate structural arrangements can lead to over-production in highly polluting industries and cause the environment to deteriorate. This paper, taking China as the study case, tests and verifies the statistical significance of the causal relationship between export tax rebates and pollution emissions. With a computable general equilibrium modeling, the current study further analyzes the effectiveness of export tax rebate adjustments aimed at alleviating environmental pressure for different time periods. It is found that before 2003, export tax rebates primarily promoted exports and boosted foreign exchange reserves, and highly polluting sectors enjoyed above-average export tax rebates, which led to increased pollution emissions. Between 2003 and 2010, the export tax rebate system was reformed to reduce support for the highly polluting export sectors, which led to decreases in emissions. Canceling export tax rebates for highly polluting sectors is shown to be the most favorable policy choice for improving the environmental performance of China's international trade. This study can serve as reference for other developing countries which similarly rely on export tax rebates, so that they can adjust their policies so as to combine economic growth with pollution control. Copyright © 2015 Elsevier Ltd. All rights reserved.

Bicultural identity, bilingualism, and psychological adjustment in multicultural societies: immigration-based and globalization-based acculturation.

Science.gov (United States)

Chen, Sylvia Xiaohua; Benet-Martínez, Verónica; Harris Bond, Michael

2008-07-01

The present investigation examined the impact of bicultural identity, bilingualism, and social context on the psychological adjustment of multicultural individuals. Our studies targeted three distinct types of biculturals: Mainland Chinese immigrants in Hong Kong, Filipino domestic workers (i.e., sojourners) in Hong Kong, and Hong Kong and Mainland Chinese college students. Individual differences in Bicultural Identity Integration (BII; Benet-Martínez, Leu, Lee, & Morris, 2002) positively predicted psychological adjustment for all the samples except sojourners even after controlling for the personality traits of neuroticism and self-efficacy. Cultural identification and language abilities also predicted adjustment, although these associations varied across the samples in meaningful ways. We concluded that, in the process of managing multiple cultural environments and group loyalties, bilingual competence, and perceiving one's two cultural identities as integrated are important antecedents of beneficial psychological outcomes.

An Efficient Bundle Adjustment Model Based on Parallax Parametrization for Environmental Monitoring

Science.gov (United States)

Chen, R.; Sun, Y. Y.; Lei, Y.

2017-12-01

With the rapid development of Unmanned Aircraft Systems (UAS), more and more research fields have been successfully equipped with this mature technology, among which is environmental monitoring. One difficult task is how to acquire accurate position of ground object in order to reconstruct the scene more accurate. To handle this problem, we combine bundle adjustment method from Photogrammetry with parallax parametrization from Computer Vision to create a new method call APCP (aerial polar-coordinate photogrammetry). One impressive advantage of this method compared with traditional method is that the 3-dimensional point in space is represented using three angles (elevation angle, azimuth angle and parallax angle) rather than the XYZ value. As the basis for APCP, bundle adjustment could be used to optimize the UAS sensors' pose accurately, reconstruct the 3D models of environment, thus serving as the criterion of accurate position for monitoring. To verity the effectiveness of the proposed method, we test on several UAV dataset obtained by non-metric digital cameras with large attitude angles, and we find that our methods could achieve 1 or 2 times better efficiency with no loss of accuracy than traditional ones. For the classical nonlinear optimization of bundle adjustment model based on the rectangular coordinate, it suffers the problem of being seriously dependent on the initial values, making it unable to converge fast or converge to a stable state. On the contrary, APCP method could deal with quite complex condition of UAS when conducting monitoring as it represent the points in space with angles, including the condition that the sequential images focusing on one object have zero parallax angle. In brief, this paper presents the parameterization of 3D feature points based on APCP, and derives a full bundle adjustment model and the corresponding nonlinear optimization problems based on this method. In addition, we analyze the influence of convergence and

Impact of initial lipid content and oxygen supply on alcoholic fermentation in champagne-like musts.

Science.gov (United States)

Ochando, Thomas; Mouret, Jean-Roch; Humbert-Goffard, Anne; Sablayrolles, Jean-Marie; Farines, Vincent

2017-08-01

Available nitrogen, lipids, or oxygen are nutrients with major impact on the kinetics of winemaking fermentation. Assimilable nitrogen is usually the growth-limiting nutrient which availability determines the fermentation rate and therefore the fermentation duration. In some particular cases, as in Champagne, grape musts have high available nitrogen content and low turbidity, i.e., below 50 Nephelometric Turbidity Unit (NTU). In the case of low turbidity, the availability of lipids, particularly phytosterols, becomes limiting. In this situation, control of oxygenation, which is necessary for lipid synthesis by yeast, is particularly crucial during fermentation. To mimic and understand these situations, a synthetic medium simulating the average composition of a Champagne must was used. This medium contained phytosterol (mainly β-sitosterol) concentrations ranging from 0 to 8mg/L corresponding to turbidity between 10 and 90 NTU. Population reached during the stationary phase and the maximum fermentation rate are conditioned by the initial phytosterol concentration determining the amount of nitrogen consumption. An early loss of viability was observed when the lipid concentrations were very low. For example, the viability continuously decreased during the stationary phase to a final value of 50% for an initial phytosterol concentration of 1mg/L. In some fermentations, 10mg/L oxygen were added at the end of the growth phase to combine the effects of initial content of phytosterols in the musts and the de novo synthesis of ergosterol and unsaturated fatty acids induced by oxygen addition. Effect of oxygen supply on the fermentation kinetics was particularly significant for media with low phytosterol contents. For example, the maximum fermentation rate was increased by 1.4-fold and the fermentation time was 70h shorter with oxygen addition in the medium containing 2mg/L of phytosterols. As a consequence of the oxygen supply, for the media containing 3, 5 and 8mg/L of

The impact of augmented information on visuo-motor adaptation in younger and older adults.

Directory of Open Access Journals (Sweden)

Mathias Hegele

Full Text Available BACKGROUND: Adjustment to a visuo-motor rotation is known to be affected by ageing. According to previous studies, the age-related differences primarily pertain to the use of strategic corrections and the generation of explicit knowledge on which strategic corrections are based, whereas the acquisition of an (implicit internal model of the novel visuo-motor transformation is unaffected. The present study aimed to assess the impact of augmented information on the age-related variation of visuo-motor adjustments. METHODOLOGY/PRINCIPAL FINDINGS: Participants performed aiming movements controlling a cursor on a computer screen. Visual feedback of direction of cursor motion was rotated 75 degrees relative to the direction of hand motion. Participants had to adjust to this rotation in the presence and absence of an additional hand-movement target that explicitly depicted the input-output relations of the visuo-motor transformation. An extensive set of tests was employed in order to disentangle the contributions of different processes to visuo-motor adjustment. Results show that the augmented information failed to affect the age-related variations of explicit knowledge, adaptive shifts, and aftereffects in a substantial way, whereas it clearly affected initial direction errors during practice and proprioceptive realignment. CONCLUSIONS: Contrary to expectations, older participants apparently made no use of the augmented information, whereas younger participants used the additional movement target to reduce initial direction errors early during practice. However, after a first block of trials errors increased, indicating a neglect of the augmented information, and only slowly declined thereafter. A hypothetical dual-task account of these findings is discussed. The use of the augmented information also led to a selective impairment of proprioceptive realignment in the younger group. The mere finding of proprioceptive realignment in adaptation to a visuo

Direct comparison of risk-adjusted and non-risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes.

Science.gov (United States)

Novick, Richard J; Fox, Stephanie A; Stitt, Larry W; Forbes, Thomas L; Steiner, Stefan

2006-08-01

We previously applied non-risk-adjusted cumulative sum methods to analyze coronary bypass outcomes. The objective of this study was to assess the incremental advantage of risk-adjusted cumulative sum methods in this setting. Prospective data were collected in 793 consecutive patients who underwent coronary bypass grafting performed by a single surgeon during a period of 5 years. The composite occurrence of an "adverse outcome" included mortality or any of 10 major complications. An institutional logistic regression model for adverse outcome was developed by using 2608 contemporaneous patients undergoing coronary bypass. The predicted risk of adverse outcome in each of the surgeon's 793 patients was then calculated. A risk-adjusted cumulative sum curve was then generated after specifying control limits and odds ratio. This risk-adjusted curve was compared with the non-risk-adjusted cumulative sum curve, and the clinical significance of this difference was assessed. The surgeon's adverse outcome rate was 96 of 793 (12.1%) versus 270 of 1815 (14.9%) for all the other institution's surgeons combined (P = .06). The non-risk-adjusted curve reached below the lower control limit, signifying excellent outcomes between cases 164 and 313, 323 and 407, and 667 and 793, but transgressed the upper limit between cases 461 and 478. The risk-adjusted cumulative sum curve never transgressed the upper control limit, signifying that cases preceding and including 461 to 478 were at an increased predicted risk. Furthermore, if the risk-adjusted cumulative sum curve was reset to zero whenever a control limit was reached, it still signaled a decrease in adverse outcome at 166, 653, and 782 cases. Risk-adjusted cumulative sum techniques provide incremental advantages over non-risk-adjusted methods by not signaling a decrement in performance when preoperative patient risk is high.

Executive functions and theory of mind as predictors of social adjustment in childhood traumatic brain injury.

Science.gov (United States)

Robinson, Kristen E; Fountain-Zaragoza, Stephanie; Dennis, Maureen; Taylor, H Gerry; Bigler, Erin D; Rubin, Kenneth; Vannatta, Kathryn; Gerhardt, Cynthia A; Stancin, Terry; Yeates, Keith Owen

2014-11-15

This study examined whether executive function and theory of mind mediate the effects of pediatric traumatic brain injury (TBI) on social adjustment, relative to children with orthopedic injury (OI). Participants included 19 children with severe TBI, 41 children with complicated mild/moderate TBI, and 57 children with OI. They completed measures of executive function, as well as cognitive, affective, and conative theory of mind. Parents provided ratings of children's social adjustment. Children with severe TBI performed more poorly than children with OI on executive function and theory of mind tasks and were rated by parents as having more behavioral symptoms and worse communication and social skills. Executive function and theory of mind were positively correlated with social skills and communication skills, and negatively correlated with behavioral symptoms. In multiple mediator models, theory of mind and executive function were not significant direct predictors of any measure of social adjustment, but mediated the association between injury and adjustment for children with severe TBI. Theory of mind was a significant independent mediator when predicting social skills, but executive function was not. TBI in children, particularly severe injury, is associated with poor social adjustment. The impact of TBI on children's social adjustment is likely mediated by its effects on executive function and theory of mind.

Negative life events and school adjustment among Chinese nursing students: The mediating role of psychological capital.

Science.gov (United States)

Liu, Chunqin; Zhao, Yuanyuan; Tian, Xiaohong; Zou, Guiyuan; Li, Ping

2015-06-01

Adjustment difficulties of college students are common and their school adjustment has gained wide concern in recent years. Negative life events and psychological capital (PsyCap) have been associated with school adjustment. However, the potential impact of negative life events on PsyCap, and whether PsyCap mediates the relationship between negative life events and school adjustment among nursing students have not been studied. To investigate the relationship among negative life events, PsyCap, and school adjustment among five-year vocational high school nursing students in China and the mediating role of PsyCap between negative life events and school adjustment. A cross-sectional survey design was conducted. 643 five-year vocational high school nursing students were recruited from three public high vocational colleges in Shandong of China. Adolescent Self-Rating Life Event Checklist (ASLEC), the Psychological Capital Questionnaire for Adolescent Students scale (PCQAS), and the Chinese College Student Adjustment Scale (CCSAS) were used in this study. Hierarchical linear regression analyses were performed to explore the mediating role of PsyCap. Negative life events were negatively associated with the dimensions of school adjustment (interpersonal relationship adaptation, learning adaptation, campus life adaptation, career adaptation, emotional adaptation, self-adaptation, and degree of satisfaction). PsyCap was positively associated with the dimensions of school adjustment and negatively associated with negative life events. PsyCap partially mediated the relationship between negative life events and school adjustment. Negative life events may increase the risk of school maladjustment in individuals with low PsyCap. Interventions designed to increase nursing students' PsyCap might buffer the stress of adverse life events, and thereby, enhance students' positive adjustment to school. Copyright © 2015 Elsevier Ltd. All rights reserved.

Adjustment of equations to predict the metabolizable energy of corn for meat type quails

Directory of Open Access Journals (Sweden)

Tiago Junior Pasquetti

2015-08-01

Full Text Available The metabolizable energy (ME determination for foods used in quail diets, through metabolism assays, takes time, infrastructure and financial resources, which makes the development of prediction equations based on proximal composition of foods to estimate the ME values of particular interest. The objective of this study was to adjust the prediction equations of metabolizable energy (ME of corn for quail. The chemical compositions of 12 maize varieties were determined and a metabolism assay was carried out in order to determine the apparent metabolizable energy (AME and nitrogen-corrected apparent metabolizable energy (AMEn of these corn varieties. The values of chemical composition, AME and AMEn, converted to dry matter, were used to adjust the prediction equations. The initial adjustment of simple and multiple linear regression of the AME and AMEn was performed using the values of crude protein (CP, ether extract (EE, neutral (NDF and acid (ADF detergent fiber, mineral matter (MM, calcium (Ca and phosphorus (P as regressors (full model. To adjust the prediction equations the statistical procedure of simple and multiple linear regression was used, with the technique of indirect elimination (Backward. There was adjustment of 10 prediction equations, in which five were for AME and another five for AMEn, the R² values of which ranged from 0.20 to 0.75 and from 0.21 to 0.78, respectively. For all adjusted equations, negative correlations for MM were observed, which may be related to its dilutive effect of the gross energy contained in corn. In conclusion, the equations that showed better adjustment were AME= 5605.46 - 385.074CP + 111.648EE + 48.1133NDF + 303.924ADF - 929.931MM (R²= 0.75 and AMEn= 5878.16 - 403.937CP + 81.9618EE + 41.8954NDF + 303.506FDA - 901.621MM (R²= 0.78.

12 CFR 313.55 - Salary adjustments.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Salary adjustments. 313.55 Section 313.55 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT COLLECTION Salary Offset § 313.55 Salary adjustments. Any negative adjustment to pay arising...

24 CFR 5.611 - Adjusted income.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Adjusted income. 5.611 Section 5... Serving Persons with Disabilities: Family Income and Family Payment; Occupancy Requirements for Section 8 Project-Based Assistance Family Income § 5.611 Adjusted income. Adjusted income means annual income (as...

How to design a border adjustment for the European Union Emissions Trading System?

International Nuclear Information System (INIS)

Monjon, Stephanie; Quirion, Philippe

2010-01-01

Border adjustments are currently discussed to limit the possible adverse impact of climate policies on competitiveness and carbon leakage. We discuss the main choices that will have to be made if the European Union implements such a system alongside the EU ETS. Although more analysis is required on some issues, on others some design options seem clearly preferable to others. First, the import adjustment should be a requirement to surrender allowances rather than a tax. Second, the general rule to determine the amount of allowances per ton imported should be the product-specific benchmarks that the European Commission is currently elaborating for a different purpose (i.e. to determine the amount of free allowances). Third, this obligation should apply when the imported product is registered at the EU border, and not after the end of the year as is the case for domestic emitters. Fourth, the export adjustment should take the form of a rebate on the amount of allowances a domestic emitter has to surrender. Five, this rebate should equal the above-mentioned product-specific benchmarks, not the emissions of the particular exporting plant or firm. Finally, the adjustment does not have to apply to consumer products but mostly to basic products. (author)

Marketing strategy adjustments in the ambulatory care center industry: implications for community pharmacy.

Science.gov (United States)

Phillips, J H

1989-01-01

Each stage of a product's life cycle requires marketing strategy modifications in response to changing demand levels. The purpose of this study was to investigate changes in ambulatory care center (ACC) operational characteristics indicative of product, market, and distribution channel adjustments that could have a competitive impact upon community pharmacy practice. A questionnaire was mailed to a national sample of 325 ACC managers. Evidence of new product feature additions includes increased emphasis on continued care and increased prevalence of prescription drug dispensing. Expansion into new market segments and distribution channels was demonstrated by increased participation in HMO and employer relationships. The observed adjustments in ACC marketing strategies present obvious challenges as well as less obvious opportunities for community pharmacy practice.

Do law enforcement interactions reduce the initiation of injection drug use? An investigation in three North American settings.

Science.gov (United States)

Melo, J S; Garfein, R S; Hayashi, K; Milloy, M J; DeBeck, K; Sun, S; Jain, S; Strathdee, S A; Werb, D

2018-01-01

The prevention of drug injecting is often cited as a justification for the deployment of law enforcement and for the continuation of drug criminalization policies. We sought to characterize the impact of law enforcement interactions on the risk that people who inject drugs (PWID) report assisting others with injection initiation in three North American countries. Cross-sectional data from PWID participating in cohort studies in three cities (San Diego, USA; Tijuana, Mexico; Vancouver, Canada) were pooled (August 2014-December 2016). The dependent variable was defined as recently (i.e., past six months) providing injection initiation assistance; the primary independent variable was the frequency of recent law enforcement interactions, defined categorically (0 vs. 1 vs. 2-5 vs. ≥6). We employed multivariable logistic regression analyses to assess this relationship while controlling for potential confounders. Among 2122 participants, 87 (4.1%) reported recently providing injection initiation assistance, and 802 (37.8%) reported recent law enforcement interactions. Reporting either one or more than five recent interactions with law enforcement was not significantly associated with injection initiation assistance. Reporting 2-5 law enforcement interactions was associated with initiation assistance (Adjusted Odds Ratio=1.74, 95% Confidence Interval: 1.01-3.02). Reporting interactions with law enforcement was not associated with a reduced likelihood that PWID reported initiating others into injection drug use. Instead, we identified a positive association between reporting law enforcement interactions and injection initiation assistance among PWID in multiple settings. These findings raise concerns regarding the effectiveness of drug law enforcement to deter injection drug use initiation. Copyright © 2017 Elsevier B.V. All rights reserved.

Protecting entanglement by adjusting the velocities of moving qubits inside non-Markovian environments

Science.gov (United States)

Mortezapour, Ali; Ahmadi Borji, Mahdi; Lo Franco, Rosario

2017-05-01

Efficient entanglement preservation in open quantum systems is a crucial scope towards a reliable exploitation of quantum resources. We address this issue by studying how two-qubit entanglement dynamically behaves when two atom qubits move inside two separated identical cavities. The moving qubits independently interact with their respective cavity. As a main general result, we find that under resonant qubit-cavity interaction the initial entanglement between two moving qubits remains closer to its initial value as time passes compared to the case of stationary qubits. In particular, we show that the initial entanglement can be strongly protected from decay by suitably adjusting the velocities of the qubits according to the non-Markovian features of the cavities. Our results supply a further way of preserving quantum correlations against noise with a natural implementation in cavity-QED scenarios and are straightforwardly extendable to many qubits for scalability.

Adjusting estimative prediction limits

OpenAIRE

Masao Ueki; Kaoru Fueda

2007-01-01

This note presents a direct adjustment of the estimative prediction limit to reduce the coverage error from a target value to third-order accuracy. The adjustment is asymptotically equivalent to those of Barndorff-Nielsen & Cox (1994, 1996) and Vidoni (1998). It has a simpler form with a plug-in estimator of the coverage probability of the estimative limit at the target value. Copyright 2007, Oxford University Press.

12 CFR 1780.80 - Inflation adjustments.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Inflation adjustments. 1780.80 Section 1780.80... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE Civil Money Penalty Inflation Adjustments § 1780.80 Inflation adjustments. The maximum amount of each civil money penalty within OFHEO's...

Exploring methods for comparing the real-world effectiveness of treatments for osteoporosis: adjusted direct comparisons versus using patients as their own control.

Science.gov (United States)

Karlsson, Linda; Mesterton, Johan; Tepie, Maurille Feudjo; Intorcia, Michele; Overbeek, Jetty; Ström, Oskar

2017-09-21

Using Swedish and Dutch registry data for women initiating bisphosphonates, we evaluated two methods of comparing the real-world effectiveness of osteoporosis treatments that attempt to adjust for differences in patient baseline characteristics. Each method has advantages and disadvantages; both are potential complements to clinical trial analyses. We evaluated methods of comparing the real-world effectiveness of osteoporosis treatments that attempt to adjust for both observed and unobserved confounding. Swedish and Dutch registry data for women initiating zoledronate or oral bisphosphonates (OBPs; alendronate/risedronate) were used; the primary outcome was fracture. In adjusted direct comparisons (ADCs), regression and matching techniques were used to account for baseline differences in known risk factors for fracture (e.g., age, previous fracture, comorbidities). In an own-control analysis (OCA), for each treatment, fracture incidence in the first 90 days following treatment initiation (the baseline risk period) was compared with fracture incidence in the 1-year period starting 91 days after treatment initiation (the treatment exposure period). In total, 1196 and 149 women initiating zoledronate and 14,764 and 25,058 initiating OBPs were eligible in the Swedish and Dutch registries, respectively. Owing to the small Dutch zoledronate sample, only the Swedish data were used to compare fracture incidences between treatment groups. ADCs showed a numerically higher fracture incidence in the zoledronate than in the OBPs group (hazard ratio 1.09-1.21; not statistically significant, p > 0.05). For both treatment groups, OCA showed a higher fracture incidence in the baseline risk period than in the treatment exposure period, indicating a treatment effect. OCA showed a similar or greater effect in the zoledronate group compared with the OBPs group. ADC and OCA each possesses advantages and disadvantages. Combining both methods may provide an estimate of real

The Saudi Initiative for asthma

Directory of Open Access Journals (Sweden)

Al-Moamary Mohamed

2009-01-01

Full Text Available The Saudi Initiative for Asthma (SINA provides up-to-date guidelines for healthcare workers managing patients with asthma. SINA was developed by a panel of Saudi experts with respectable academic backgrounds and long-standing experience in the field. SINA is founded on the latest available evidence, local literature, and knowledge of the current setting in Saudi Arabia. Emphasis is placed on understanding the epidemiology, pathophysiology, medications, and clinical presentation. SINA elaborates on the development of patient-doctor partnership, self-management, and control of precipitating factors. Approaches to asthma treatment in SINA are based on disease control by the utilization of Asthma Control Test for the initiation and adjustment of asthma treatment. This guideline is established for the treatment of asthma in both children and adults, with special attention to children 5 years and younger. It is expected that the implementation of these guidelines for treating asthma will lead to better asthma control and decrease patient utilization of the health care system.

Family boundary structures and child adjustment: the indirect role of emotional reactivity.

Science.gov (United States)

Lindahl, Kristin M; Bregman, Hallie R; Malik, Neena M

2012-12-01

Structural and system theories propose that disruptions in family subsystem functioning increase risk for youth maladjustment. While there is growing evidence to support this proposition, studies that specifically focus on the larger family system remain relatively rare. Furthermore, the pathways that connect problems in family subsystem alliances to externalizing or internalizing problems in youth are as yet largely unexplored. This study examined youth emotional reactivity (anger and sadness) to family conflict as an indirect pathway of the association between family boundary disturbances and youth adjustment in a sample of two-parent families (N = 270). Observational coding was used to group families into Balanced, Dyadic, or Disengaged family alliance structures and to assess youth emotional reactivity, and parent-report was used to assess youth psychopathology. Structural equation modeling indicated both anger and sadness served as indirect pathways through which family boundary disturbances are linked with youth adjustment. In addition, gender was tested as a moderator and important gender differences were found. Specifically, boys were directly impacted by dyadic disturbances while girls were directly impacted by family disengagement. The findings help target goals for intervention and indicate that worthwhile objectives may include realigning family subsystem boundaries, changing family communication patterns, and improving affective coping skills for youth. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Exploring associations between state education initiatives and teachers' sleep: A social-ecological approach.

Science.gov (United States)

Fujishiro, Kaori; Farley, Amy N; Kellemen, Marie; Swoboda, Christopher M

2017-10-01

Social policies that are not specifically aimed at impacting health can still have health consequences. State education reforms, such as standardized testing and stringent accountability for schools and teachers, may affect teacher health by changing their working conditions. This study explores associations between state education initiatives and teachers' sleep, an important predictor of productivity and chronic health conditions. The Behavioral Risk Factor Surveillance System 2013 and 2014 data sets provided sleep and demographic data for 7836 teachers in 29 states in the United States. We linked the teacher data to state education reform data from the U.S. Department of Education. Logistic regression was used to estimate odds ratios (ORs) of reporting inadequate sleep (i.e., state education policies after adjusting for demographic characteristics. Teachers had significantly higher odds of reporting inadequate sleep if their state financed professional development, sanctioned or rewarded schools based on student performance, and regulated classroom materials for state-wide common core standards (ORs ranging from 1.25 to 1.84). More strictly defined inadequate sleep (states to implement reforms through regulations and legislations, was also associated with inadequate sleep (OR = 1.41, p state education policies may have impacts on teacher sleep. Consequences of education reform for teacher health deserve more attention. Published by Elsevier Ltd.

Do Community Based Initiatives foster sustainability transitions? Towards a unique Environmental Impact Assessment.

Science.gov (United States)

Martellozzo, Federico; Hendrickson, Cary; Gozdowska, Iga; Groß, Helge; Henderson, Charles; Reusser, Dominik

2015-04-01

The active participation in Community Based Initiatives (CBI) is a spreading phenomenon that has reached a significant magnitude and - in some cases - CBIs are also supposed to have catalysed social and technological innovation, thus contributing to global transition into low-carbon economy. Generally speaking, CBIs are grassroots initiatives with broad sustainability foci that promote a plethora of activities such as alternative transportation, urban gardening, renewable energy implementation, waste regeneration/reduction, etc. Some advocate that such practices fostered by bottom-up activities, rather than top-down policies, represent a proficient countermeasure to alleviate global environmental change and effectively foster a societal transition towards sustainability. However, thus far most empirical research grounds mainly on anecdotal evidence and little work has been done to quantitatively assess CBIs' "environmental impacts" (EI) or their carbon footprints using comparative methodologies. This research main aim is to frame a methodology to assess univocally CBIs' EIs which are crucial to understanding their role in societal sustainability transition. However, to do so, three main caveats need to be addressed: first, some CBIs do not directly produce tangible measurable outputs, nor have an intelligibly defined set of inputs (e.g. CBIs focusing on environmental education and awareness rising). Thus, calculating their "indirect" EI may represent an intricate puzzle that is very much open to subjective interpretation. Second, CBIs' practices are heterogenic and therefore existing methodologies to make comparisons of their EIs are neither straightforward nor proficient, also given the lack of available data. Third, another issue closely related to the one previously mentioned, is a general lack of consensus among already existing impact-assessment frameworks for certain practices (e.g. composting). A potential way of estimating a CBI's EI is a standard Carbon

Modeling Quality-Adjusted Life Expectancy Loss Resulting from Tobacco Use in the United States

Science.gov (United States)

Kaplan, Robert M.; Anderson, John P.; Kaplan, Cameron M.

2007-01-01

Purpose: To describe the development of a model for estimating the effects of tobacco use upon Quality Adjusted Life Years (QALYs) and to estimate the impact of tobacco use on health outcomes for the United States (US) population using the model. Method: We obtained estimates of tobacco consumption from 6 years of the National Health Interview…

Electronic gaming and psychosocial adjustment.

Science.gov (United States)

Przybylski, Andrew K

2014-09-01

The rise of electronic games has driven both concerns and hopes regarding their potential to influence young people. Existing research identifies a series of isolated positive and negative effects, yet no research to date has examined the balance of these potential effects in a representative sample of children and adolescents. The objective of this study was to explore how time spent playing electronic games accounts for significant variation in positive and negative psychosocial adjustment using a representative cohort of children aged 10 to 15 years. A large sample of children and adolescents aged 10 to 15 years completed assessments of psychosocial adjustment and reported typical daily hours spent playing electronic games. Relations between different levels of engagement and indicators of positive and negative psychosocial adjustment were examined, controlling for participant age and gender and weighted for population representativeness. Low levels (3 hours daily) of game engagement was linked to key indicators of psychosocial adjustment. Low engagement was associated with higher life satisfaction and prosocial behavior and lower externalizing and internalizing problems, whereas the opposite was found for high levels of play. No effects were observed for moderate play levels when compared with non-players. The links between different levels of electronic game engagement and psychosocial adjustment were small (Games consistently but not robustly associated with children's adjustment in both positive and negative ways, findings that inform policy-making as well as future avenues for research in the area. Copyright © 2014 by the American Academy of Pediatrics.

Youth Psychosocial Adjustment Following Wildfire: The Role of Family Resilience, Emotional Support, and Concrete Support

Science.gov (United States)

Sprague, Caryll M.; Kia-Keating, Maryam; Felix, Erika; Afifi, Tamara; Reyes, Gilbert; Afifi, Walid

2015-01-01

Background: Natural disasters can have a significant impact on youth and family mental health and well-being. However, the relationship between family protective factors and youth adjustment in the aftermath of disaster remains unclear. Objective: In order to address the present gaps in the field, this study investigated perceived disaster-related…

Data analysis-based autonomic bandwidth adjustment in software defined multi-vendor optical transport networks.

Science.gov (United States)

Li, Yajie; Zhao, Yongli; Zhang, Jie; Yu, Xiaosong; Jing, Ruiquan

2017-11-27

Network operators generally provide dedicated lightpaths for customers to meet the demand for high-quality transmission. Considering the variation of traffic load, customers usually rent peak bandwidth that exceeds the practical average traffic requirement. In this case, bandwidth provisioning is unmetered and customers have to pay according to peak bandwidth. Supposing that network operators could keep track of traffic load and allocate bandwidth dynamically, bandwidth can be provided as a metered service and customers would pay for the bandwidth that they actually use. To achieve cost-effective bandwidth provisioning, this paper proposes an autonomic bandwidth adjustment scheme based on data analysis of traffic load. The scheme is implemented in a software defined networking (SDN) controller and is demonstrated in the field trial of multi-vendor optical transport networks. The field trial shows that the proposed scheme can track traffic load and realize autonomic bandwidth adjustment. In addition, a simulation experiment is conducted to evaluate the performance of the proposed scheme. We also investigate the impact of different parameters on autonomic bandwidth adjustment. Simulation results show that the step size and adjustment period have significant influences on bandwidth savings and packet loss. A small value of step size and adjustment period can bring more benefits by tracking traffic variation with high accuracy. For network operators, the scheme can serve as technical support of realizing bandwidth as metered service in the future.

7 CFR 1744.64 - Budget adjustment.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from another...

US hospital payment adjustments for innovative technology lag behind those in Germany, France, and Japan.

Science.gov (United States)

Hernandez, John; Machacz, Susanne F; Robinson, James C

2015-02-01

Medicare pioneered add-on payments to facilitate the adoption of innovative technologies under its hospital prospective payment system. US policy makers are now experimenting with broader value-based payment initiatives, but these have not been adjusted for innovation. This article examines the structure, processes, and experience with Medicare's hospital new technology add-on payment program since its inception in 2001 and compares it with analogous payment systems in Germany, France, and Japan. Between 2001 and 2015 CMS approved nineteen of fifty-three applications for the new technology add-on payment program. We found that the program resulted in $201.7 million in Medicare payments in fiscal years 2002-13-less than half the level anticipated by Congress and only 34 percent of the amount projected by CMS. The US program approved considerably fewer innovative technologies, compared to analogous technology payment mechanisms in Germany, France and Japan. We conclude that it is important to adjust payments for new medical innovations within prospective and value-based payment systems explicitly as well as implicitly. The most straightforward method to use in adjusting value-based payments is for the insurer to retrospectively adjust spending targets to account for the cost of new technologies. If CMS made such retrospective adjustments, it would not financially penalize hospitals for adopting beneficial innovations. Project HOPE—The People-to-People Health Foundation, Inc.

Work situation and sickness absence in the initial period after breast cancer surgery.

Science.gov (United States)

Petersson, Lena-Marie; Wennman-Larsen, Agneta; Nilsson, Marie; Olsson, Mariann; Alexanderson, Kristina

2011-02-01

Breast cancer is the most common cancer diagnosis in women, many of whom are of working age, and the five-year survival rate in Sweden is approaching 90%. Accordingly, aspects of working life and sickness absence are of increasing importance for breast cancer survivors and may have a long-term impact on health and quality of life of these women. The aim was to elucidate the work situation and sickness absence during the initial period after breast cancer surgery and to explore factors associated with sickness absence. This is a cross-sectional questionnaire study 4-6 weeks after breast cancer surgery of women aged 20-63 years, and living in Stockholm. A consecutive sample of 933 women were invited and 756 (81%) accepted to participate. Logistic regression analyses were computed to estimate crude and adjusted odds ratios for associations between sick leave and other variables. Most women (86%) were employed (including self-employed) at diagnosis, and 91% of those worked ≥75% of full-time. At time of survey, 56% were on sick leave, the majority for full-time. Low self-rated health, poorer health than before diagnosis, having a strenuous work posture, and younger age were associated with sick leave during the initial period after breast cancer surgery in both univariate and multivariate analyses. The results of this study is not fully consistent compared to previous studies in this field, often performed in later phases after breast cancer surgery or after other cancer diagnoses. Therefore our results indicate that knowledge is needed during all phases of the breast cancer trajectory to determine factors of importance regarding sick leave and their impact throughout the disease trajectory.

Building Adjustable Pre-storm Reservoir Flood-control Release Rules

Science.gov (United States)

Yang, Shun-Nien; Chang, Li-Chiu; Chang, Fi-John; Hsieh, Cheng-Daw

2017-04-01

Typhoons hit Taiwan several times every year, which could cause serious flood disasters. Because mountainous terrains and steep landforms can rapidly accelerate the speed of flood flow during typhoon events, rivers cannot be a stable source of water supply. Reservoirs become the most effective floodwater storage facilities for alleviating flood damages in Taiwan. The pre-storm flood-control release can significantly increase reservoir storage capacity available to store floodwaters for reducing downstream flood damage, while the uncertainties of total forecasted rainfalls are very high in different stages of an oncoming typhoon, which may cause the risk of water shortage in the future. This study proposes adjustable pre-storm reservoir flood-control release rules in three designed operating stages with various hydrological conditions in the Feitsui Reservoir, a pivot reservoir for water supply to Taipei metropolitan in Taiwan, not only to reduce the risk of reservoir flood control and downstream flooding but also to consider water supply. The three operating stages before an oncoming typhoon are defined upon the timings when: (1) typhoon news is issued (3-7days before typhoon hit); (2) the sea warning is issued (2-4 days before typhoon hit); and (3) the land warning is issued (1-2 days before typhoon hit). We simulate 95 historical typhoon events with 3000 initial water levels and build some pre-storm flood-control release rules to adjust the amount of pre-release based on the total forecasted rainfalls at different operating stages. A great number of simulations (68.4 millions) are conducted to extract their major consequences and then build the adjustable pre-storm reservoir flood-control release rules. Accordingly, given a total forecasted rainfall and a water level, reservoir decision makers can easily identify the corresponding rule to tell the amount of pre-release in any stage. The results show that the proposed adjustable pre-release rules can effectively

Salary adjustments

CERN Multimedia

HR Department

2008-01-01

In accordance with decisions taken by the Finance Committee and Council in December 2007, salaries are adjusted with effect from 1 January 2008. Scale of basic salaries and scale of stipends paid to fellows (Annex R A 5 and R A 6 respectively): increased by 0.71% with effect from 1 January 2008. As a result of the stability of the Geneva consumer price index, following elements do not increase: a) Family Allowance, Child Allowance and Infant Allowance (Annex R A 3). b) Reimbursement of education fees: maximum amounts of reimbursement (Annex R A 4.01) for the academic year 2007/2008. Related adjustments will be implemented, wherever applicable, to Paid Associates and Students. As in the past, the actual percentage increase of each salary position may vary, due to the application of a constant step value and the rounding effects. Human Resources Department Tel. 73566

Salary adjustments

CERN Multimedia

HR Department

2008-01-01

In accordance with decisions taken by the Finance Committee and Council in December 2007, salaries are adjusted with effect from 1 January 2008. Scale of basic salaries and scale of stipends paid to fellows (Annex R A 5 and R A 6 respectively): increased by 0.71% with effect from 1 January 2008. As a result of the stability of the Geneva consumer price index, the following elements do not increase: a)\tFamily Allowance, Child Allowance and Infant Allowance (Annex R A 3); b)\tReimbursement of education fees: maximum amounts of reimbursement (Annex R A 4.01) for the academic year 2007/2008. Related adjustments will be applied, wherever applicable, to Paid Associates and Students. As in the past, the actual percentage increase of each salary position may vary, due to the application of a constant step value and rounding effects. Human Resources Department Tel. 73566

The impact of highway base-saturation flow rate adjustment on Kuwait's transport and environmental parameters estimation.

Science.gov (United States)

AlRukaibi, Fahad; AlKheder, Sharaf; Al-Rukaibi, Duaij; Al-Burait, Abdul-Aziz

2018-03-23

Traditional transportation systems' management and operation mainly focused on improving traffic mobility and safety without imposing any environmental concerns. Transportation and environmental issues are interrelated and affected by the same parameters especially at signalized intersections. Additionally, traffic congestion at signalized intersections has a major contribution in the environmental problem as related to vehicle emission, fuel consumption, and delay. Therefore, signalized intersections' design and operation is an important parameter to minimize the impact on the environment. The design and operation of signalized intersections are highly dependent on the base saturation flow rate (BSFR). Highway Capacity Manual (HCM) uses a base-saturation flow rate of 1900-passenger car/h/lane for areas with a population intensity greater than or equal to 250,000 and a value of 1750-passenger car/h/lane for less populated areas. The base-saturation flow rate value in HCM is derived from a field data collected in developed countries. The adopted value in Kuwait is 1800passengercar/h/lane, which is the value that used in this analysis as a basis for comparison. Due to the difference in behavior between drivers in developed countries and their fellows in Kuwait, an adjustment was made to the base-saturation flow rate to represent Kuwait's traffic and environmental conditions. The reduction in fuel consumption and vehicles' emission after modifying the base-saturation flow rate (BSFR increased by 12.45%) was about 34% on average. Direct field measurements of the saturation flow rate were used while using the air quality mobile lab to calculate emissions' rates. Copyright © 2018 Elsevier B.V. All rights reserved.

A complete generalized adjustment criterion

NARCIS (Netherlands)

Perković, Emilija; Textor, Johannes; Kalisch, Markus; Maathuis, Marloes H.

2015-01-01

Covariate adjustment is a widely used approach to estimate total causal effects from observational data. Several graphical criteria have been developed in recent years to identify valid covariates for adjustment from graphical causal models. These criteria can handle multiple causes, latent

The impact of global health initiatives on the health system in Angola.

Science.gov (United States)

Craveiro, Isabel; Dussault, Gilles

2016-01-01

We assessed the impact of global health initiatives (GHIs) on the health care system of Angola, as a contribution to documenting how GHIs, such as the Global Fund, GAVI and PEPFAR, influence the planning and delivery of health services in low-income countries and how national systems respond. We collected the views of national and sub-national key informants through 42 semi-structured interviews between April 2009 and May 2011 (12 at the national level and 30 at the sub-national level). We used a snowball technique to identify respondents from government, donors and non-governmental organisations. GHIs stimulated the formulation of a health policy and of plans and strategies, but the country has yet to decide on its priorities for health. At the regional level, managers lack knowledge of how GHIs' function, but they assess the effects of external funds as positive as they increased training opportunities, and augment the number of workers engaged in HIV or other specific disease programmes. However, GHIs did not address the challenge of attraction and retention of qualified personnel in provinces. Since Angola is not entirely dependent on external funding, national strategic programmes and the interventions of GHIs co-habit well, in contrast to countries such as Mozambique, which heavily depend on external aid.

Can pricing deter adolescents and young adults from starting to drink: An analysis of the effect of alcohol taxation on drinking initiation

Directory of Open Access Journals (Sweden)

Bundit Sornpaisarn

2015-12-01

Full Text Available The objective of this study is to assess the relationship between alcohol taxation changes and drinking initiation among adolescents and young adults (collectively “youth” in Thailand (a middle-income country. Using a survey panel, this study undertook an age-period-cohort analysis using four large-scale national cross-sectional surveys of alcohol consumption performed in Thailand in 2001, 2004, 2007 and 2011 (n = 87,176 Thai youth, 15–24 years of age to test the hypothesis that changes in the inflation-adjusted alcohol taxation rates are associated with drinking initiation. Regression analyses were used to examine the association between inflation-adjusted taxation increases and the prevalence of lifetime drinkers. After adjusting for potential confounders, clear cohort and age effects were observed. Furthermore, a 10% increase of the inflation-adjusted taxation rate of the total alcohol market was significantly associated with a 4.3% reduction in the prevalence of lifetime drinking among Thai youth. In conclusion, tax rate changes in Thailand from 2001 to 2011 were associated with drinking initiation among youth. Accordingly, increases in taxation may prevent drinking initiation among youth in countries with a high prevalence of abstainers and may reduce the harms caused by alcohol.

Initial uncertainty impacts statistical learning in sound sequence processing.

Science.gov (United States)

Todd, Juanita; Provost, Alexander; Whitson, Lisa; Mullens, Daniel

2016-11-01

This paper features two studies confirming a lasting impact of first learning on how subsequent experience is weighted in early relevance-filtering processes. In both studies participants were exposed to sequences of sound that contained a regular pattern on two different timescales. Regular patterning in sound is readily detected by the auditory system and used to form "prediction models" that define the most likely properties of sound to be encountered in a given context. The presence and strength of these prediction models is inferred from changes in automatically elicited components of auditory evoked potentials. Both studies employed sound sequences that contained both a local and longer-term pattern. The local pattern was defined by a regular repeating pure tone occasionally interrupted by a rare deviating tone (p=0.125) that was physically different (a 30msvs. 60ms duration difference in one condition and a 1000Hz vs. 1500Hz frequency difference in the other). The longer-term pattern was defined by the rate at which the two tones alternated probabilities (i.e., the tone that was first rare became common and the tone that was first common became rare). There was no task related to the tones and participants were asked to ignore them while focussing attention on a movie with subtitles. Auditory-evoked potentials revealed long lasting modulatory influences based on whether the tone was initially encountered as rare and unpredictable or common and predictable. The results are interpreted as evidence that probability (or indeed predictability) assigns a differential information-value to the two tones that in turn affects the extent to which prediction models are updated and imposed. These effects are exposed for both common and rare occurrences of the tones. The studies contribute to a body of work that reveals that probabilistic information is not faithfully represented in these early evoked potentials and instead exposes that predictability (or conversely

Specifications for adjusted cross section and covariance libraries based upon CSEWG fast reactor and dosimetry benchmarks

International Nuclear Information System (INIS)

Weisbin, C.R.; Marable, J.H.; Collins, P.J.; Cowan, C.L.; Peelle, R.W.; Salvatores, M.

1979-06-01

The present work proposes a specific plan of cross section library adjustment for fast reactor core physics analysis using information from fast reactor and dosimetry integral experiments and from differential data evaluations. This detailed exposition of the proposed approach is intended mainly to elicit review and criticism from scientists and engineers in the research, development, and design fields. This major attempt to develop useful adjusted libraries is based on the established benchmark integral data, accurate and well documented analysis techniques, sensitivities, and quantified uncertainties for nuclear data, integral experiment measurements, and calculational methodology. The adjustments to be obtained using these specifications are intended to produce an overall improvement in the least-squares sense in the quality of the data libraries, so that calculations of other similar systems using the adjusted data base with any credible method will produce results without much data-related bias. The adjustments obtained should provide specific recommendations to the data evaluation program to be weighed in the light of newer measurements, and also a vehicle for observing how the evaluation process is converging. This report specifies the calculational methodology to be used, the integral experiments to be employed initially, and the methods and integral experiment biases and uncertainties to be used. The sources of sensitivity coefficients, as well as the cross sections to be adjusted, are detailed. The formulae for sensitivity coefficients for fission spectral parameters are developed. A mathematical formulation of the least-square adjustment problem is given including biases and uncertainties in methods

Measuring co-authorship and networking-adjusted scientific impact.

Science.gov (United States)

Ioannidis, John P A

2008-07-23

Appraisal of the scientific impact of researchers, teams and institutions with productivity and citation metrics has major repercussions. Funding and promotion of individuals and survival of teams and institutions depend on publications and citations. In this competitive environment, the number of authors per paper is increasing and apparently some co-authors don't satisfy authorship criteria. Listing of individual contributions is still sporadic and also open to manipulation. Metrics are needed to measure the networking intensity for a single scientist or group of scientists accounting for patterns of co-authorship. Here, I define I(1) for a single scientist as the number of authors who appear in at least I(1) papers of the specific scientist. For a group of scientists or institution, I(n) is defined as the number of authors who appear in at least I(n) papers that bear the affiliation of the group or institution. I(1) depends on the number of papers authored N(p). The power exponent R of the relationship between I(1) and N(p) categorizes scientists as solitary (R>2.5), nuclear (R = 2.25-2.5), networked (R = 2-2.25), extensively networked (R = 1.75-2) or collaborators (Raccountable co-authorship behaviour in published articles.

K Basin Sludge Conditioning Process Testing Partitioning of PCBs in Dissolver Solution After Neutralization/Precipitation (Caustic Adjustment)

International Nuclear Information System (INIS)

Schmidt, A.J.; Thornton, B.M.; Hoppe, E.W.; Mong, G.M.; Silvers, K.L.; Slate, S.O.

1999-01-01

The purpose of the work described in this report was to gain a better understanding of how PCB congeners present in a simulated K Basin sludge dissolver solution will partition upon neutralization and precipitation (i.e., caustic adjustment). In a previous study (Mong et al. 1998),the entire series of sludge conditioning steps (acid dissolution, filtration, and caustic adjustment) were examined during integrated testing. In the work described here, the caustic adjustment step was isolated to examine the fate of PCBs in more detail within this processing step. For this testing, solutions of dissolver simulant (containing no solids) with a known initial concentration of PCB congeners were neutralized with caustic to generate a clarified supernatant and a settled sludge phase. PCBs were quantified in each phase (including the PCBs associated with the test vessel rinsates), and material balance information was collected

Cognition and adjustment after late and early operation for ruptured aneurysm.

Science.gov (United States)

Sonesson, B; Ljunggren, B; Säveland, H; Brandt, L

1987-09-01

Does early aneurysm operation, while lowering the overall management mortality, result in an unacceptable morbidity in terms of increased cognitive disturbances and psychosocial maladjustment? The present study evaluates quality of life, degree of cognitive dysfunction, and adjustment of 93 patients with satisfactory neurological recoveries after operations for ruptured supratentorial aneurysms. All patients had been in neurological Grades I to III (Hunt and Hess) after subarachnoid hemorrhage (SAH). Fifty-five patients were operated upon during the acute state, i.e., within 72 hours after bleeding (early surgery = ES), and 38 patients had been subjected to late surgery (LS), i.e., were operated on 9 days or more after SAH. Each patient was subjected to a clinical interview and a comprehensive neuropsychological investigation. The time interval between SAH and assessment varied between 12 and 103 months (mean, 56 months). The results confirm that there are indication of cognitive malfunctioning and psychosocial disturbances of varying severity and distribution in patients who have undergone LS. The pattern and distribution of sequelae after LS did not differ substantially from that in patients subjected to ES. The results offer strong support to the concept that remaining disturbances in cognition are mainly related to the impact of the initial hemorrhage per se. In patients with anterior communicating artery aneurysms, a larger decrease in tempo and perceptual vigilance was noted, suggesting that the subfrontal midline structures are particularly involved in processes demanding flexibility, attention, and capacity to adapt to novel demands in a perceptual situation.

RESPONSE OF NIGERIAN CASSAVA EXPANSION INITIATIVES TO CLIMATE CHANGES, ECONOMIC GROWTH AND SOME POLICY INSTRUMENT (1970-2012

Directory of Open Access Journals (Sweden)

Onwumere Joseph

2013-10-01

Full Text Available This study considered the limiting response of Nigeria cassava expansion initiative to climate changes, economic growth and some policy instruments. The presidential initiative to make cassava a foreign exchange earner as well as ensuring that national demand are satisfied has made cassava a significant economic crop and resource input of industrial and international status. Currently, its derivatives such as animal feed, starch, ethanol, cassava chip, cassava flour, cassava liquor etc are in high demand. Having gained international recognition some factors need be examined to ascertain the limiting response of this economic crop some exogenous factors. The specific objectives of interest were to ascertain the response of cassava output expansion to rainfall, temperature, imports, exports, credit allocation to agribusiness, exchange rate, nominal interest rate, inflation and GDP from 1970 – 2012. Also, it examined the short and long run effects of these variables to cassava output so as to know how much adjustment it makes to reach the equilibrium. Secondary data were used for this research work. The technique of data analysis was auto- regressive modeling regression. To capture the long run and short run dynamics of cassava output behavior, the error correction model (ECM using the Engle-Granger methodology was adopted. The result revealed a very high rate of adjustment to long run equilibrium and the variables are correlated which means that impact of each variable on cassava output behavior in the economy is inseparable. The Error correction coefficient of -0.975 measures the speed of adjustment towards long run equilibrium earned the expected negative sign and is statistically significant at 1% risk level. Thus, this study recommends that the emerging cassava economy of Nigeria would be adequately empowered for efficient productivity if the Government stipulate policies that will encourage domestic output expansion to meet the national and

A Key Challenge in Global HRM: Adding New Insights to Existing Expatriate Spouse Adjustment Models

Science.gov (United States)

Gupta, Ritu; Banerjee, Pratyush; Gaur, Jighyasu

2012-01-01

This study is an attempt to strengthen the existing knowledge about factors affecting the adjustment process of the trailing expatriate spouse and the subsequent impact of any maladjustment or expatriate failure. We conducted a qualitative enquiry using grounded theory methodology with 26 Indian spouses who had to deal with their partner's…

Psychosocial Influences on College Adjustment in Division I Student-Athletes: The Role of Athletic Identity

Science.gov (United States)

Melendez, Mickey C.

2010-01-01

Traditionally, graduation rates have been employed as a primary measure of college success for student-athletes. However, other sport related factors influencing college success and adjustment have yet to be adequately researched in the literature. The purpose of this study was to examine more closely the impact of race, gender, and athletic…

Timing of Initiating Glycopeptide Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia: The Impact on Clinical Outcome

Directory of Open Access Journals (Sweden)

Chen-Hsiang Lee

2013-01-01

Full Text Available When a Staphylococcus-like organism (SLO is microscopically found in Gram staining of blood culture (BC specimen, it seems reasonable to administrate a glycopeptide (GP for empirical therapy. The paper investigates the risk factors for 14-day mortality in patients with methicillin-resistance Staphylococcus aureus bacteremia (MRSAB and clarifies the impact of the timing for initiating GP therapy. A retrospective study identifies patients with MRSAB (endocarditis was excluded between 2006 and 2009. Patients were categorized as receiving GP at the interval before a preliminary BC report indicating the growth of SLO and the onward 24 hours or receiving GP 24 h after a preliminary BC report indicating the growth of SLO. Total 339 patients were enrolled. There was no difference on the 14-day overall or infection-related mortality rates at the time to administer GP. Multivariate analysis disclosed pneumonia (OR = 4.47; of 95% CI; of 2.09–9.58; and high APACHE II score (OR, 2.81, with 95% CI, 1.19–6.65; were independent risk factors for infection-related mortality. The mortality rate did not decrease following administrating GP immediately after a preliminary BC indicating SLO growth. An additional research for the optimal timing for initiating GP treatment is warranted.

Increased plasma soluble uPAR level is a risk marker of respiratory cancer in initially cancer-free individuals

DEFF Research Database (Denmark)

Langkilde, Anne A; Hansen, Tine Willum; Ladelund, Steen

2011-01-01

BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is a stable plasma biomarker associated with inflammation and disease. This study tested the association between suPAR levels and incident respiratory, gastrointestinal or other types of cancer in initially cancer-free individuals...... with respiratory, gastrointestinal and other cancer types, respectively.CONCLUSIONS: Elevated suPAR levels were associated with increased risk of incident respiratory cancer and other types of cancer, but not gastrointestinal cancers, independently of established risk factors, CRP and leukocyte numbers. Impact.......RESULTS: suPAR levels ranged from 0.6-22 ng/ml, and median suPAR level was 4.01 ng/ml. 1 ng/ml increase in baseline suPAR was associated with adjusted hazard ratios (HR) of 1.61 (95% CI: 1.23-2.11, P

Depletion calculations of adjuster rods in Darlington

Energy Technology Data Exchange (ETDEWEB)

Arsenault, B.; Tsang, K., E-mail: benoit.arsenault@amecfw.com, E-mail: kwok.tsang@amecfw.com [AMEC Foster Wheeler, Toronto, ON (Canada)

2015-07-01

This paper describes the simulation methodology and reactivity worth calculated for aged adjuster rods in the Darlington core. ORIGEN-S IST was applied to simulate the isotope transmutation process of the stainless steel and titanium adjusters. The compositions were used in DRAGON-IST to calculate the change in incremental properties of aged adjusters. Pre-simulations of the reactivity worth of the stainless steel and titanium adjusters in Darlington were performed using RFSP-IST and the results showed that the titanium adjuster rods exhibit faster reactivity-worth drop than that of stainless steel rods. (author)

Positive Adjustment Among American Repatriated Prisoners of the Vietnam War: Modeling the Long-Term Effects of Captivity.

Science.gov (United States)

King, Daniel W; King, Lynda A; Park, Crystal L; Lee, Lewina O; Kaiser, Anica Pless; Spiro, Avron; Moore, Jeffrey L; Kaloupek, Danny G; Keane, Terence M

2015-11-01

A longitudinal lifespan model of factors contributing to later-life positive adjustment was tested on 567 American repatriated prisoners from the Vietnam War. This model encompassed demographics at time of capture and attributes assessed after return to the U.S. (reports of torture and mental distress) and approximately 3 decades later (later-life stressors, perceived social support, positive appraisal of military experiences, and positive adjustment). Age and education at time of capture and physical torture were associated with repatriation mental distress, which directly predicted poorer adjustment 30 years later. Physical torture also had a salutary effect, enhancing later-life positive appraisals of military experiences. Later-life events were directly and indirectly (through concerns about retirement) associated with positive adjustment. Results suggest that the personal resources of older age and more education and early-life adverse experiences can have cascading effects over the lifespan to impact well-being in both positive and negative ways.

Familism, Family Ethnic Socialization, and Mexican-Origin Adolescent Mothers’ Educational Adjustment

Science.gov (United States)

Bravo, Diamond Y.; Umaña-Taylor, Adriana J.; Guimond, Amy B.; Updegraff, Kimberly A.; Jahromi, Laudan B.

2016-01-01

The current longitudinal study examined how familism values and family ethnic socialization impacted Mexican-origin adolescent mothers’ (N = 205) educational adjustment (i.e., educational expectations, educational utility), and whether these associations were moderated by adolescent mothers’ ethnic centrality. Findings indicated that adolescent mothers’ reports of familism values and family ethnic socialization were positively associated with their beliefs about educational utility, but not educational expectations. Ethnic centrality moderated the association between adolescent mothers’ familism values and educational utility, such that adolescent mothers’ endorsement of familism values during pregnancy were associated with significant increases in educational utility after their transition to parenthood, but only when adolescents reported high levels of ethnic centrality. Moreover, ethnic centrality was positively associated with adolescent mothers’ educational expectations. Results highlight the importance of familism, ethnic socialization, and ethnic centrality for promoting Mexican-origin adolescent mothers’ educational outcomes. Findings are discussed with respect to understanding adolescent mothers’ educational adjustment in the context of family and culture. PMID:25045950

Familism, family ethnic socialization, and Mexican-origin adolescent mothers' educational adjustment.

Science.gov (United States)

Bravo, Diamond Y; Umaña-Taylor, Adriana J; Guimond, Amy B; Updegraff, Kimberly A; Jahromi, Laudan B

2014-07-01

The current longitudinal study examined how familism values and family ethnic socialization impacted Mexican-origin adolescent mothers' (N = 205) educational adjustment (i.e., educational expectations, educational utility), and whether these associations were moderated by adolescent mothers' ethnic centrality. Findings indicated that adolescent mothers' reports of familism values and family ethnic socialization were positively associated with their beliefs about educational utility, but not educational expectations. Ethnic centrality moderated the association between adolescent mothers' familism values and educational utility, such that adolescent mothers' endorsement of familism values during pregnancy were associated with significant increases in educational utility after their transition to parenthood, but only when adolescents reported high levels of ethnic centrality. Moreover, ethnic centrality was positively associated with adolescent mothers' educational expectations. Results highlight the importance of familism, ethnic socialization, and ethnic centrality for promoting Mexican-origin adolescent mothers' educational outcomes. Findings are discussed with respect to understanding adolescent mothers' educational adjustment in the context of family and culture.

PACE and the Medicare+Choice risk-adjusted payment model.

Science.gov (United States)

Temkin-Greener, H; Meiners, M R; Gruenberg, L

2001-01-01

This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.

The impact of hemoglobin on the efficacy of phototherapy in hyperbilirubinemic infants

DEFF Research Database (Denmark)

Donneborg, Mette L; Vandborg, Pernille K; Hansen, Bo M

2017-01-01

BackgroundPhototherapy is the routine treatment for neonatal hyperbilirubinemia. Absorption of light in the skin transforms the native Z,Z-bilirubin to photobilirubins. This study investigates whether the hemoglobin concentration has an impact on efficacy of phototherapy, expressed by the decline...... decrease in TsB after 24 h was 121 (57-199) μmol/l; the median hemoglobin was 12.0 (7.0-14.7) mmol/l. There was a significant effect of hemoglobin concentration on the decrease in TsB of -3.61 μmol/mmol hemoglobin (P=0.022), after adjusting for initial TsB and postnatal age. That is, assuming the same...... initial TsB and postnatal age, for each mmol/l increase in hemoglobin, the decrease in TsB was 3.61 μmol/l smaller. In our hemoglobin range, the decrease in TsB is reduced by 28 μmol/l (23%).ConclusionIncreasing hemoglobin levels led to a decrease in the efficacy of phototherapy. Our data provide...

Effect of benchmarking projects on outcomes of coronary artery bypass graft surgery: challenges and prospects regarding the quality improvement initiative.

Science.gov (United States)

Miyata, Hiroaki; Motomura, Noboru; Murakami, Arata; Takamoto, Shinichi

2012-06-01

The Japan Cardiovascular Surgery Database (JCVSD) was established in 2000 and initiated a benchmarking project to improve the quality of cardiovascular surgery. Although the importance of quality improvement initiatives has been emphasized, few studies have reported the effects on outcomes. To examine the time-trend effects in initial JCVSD participants (n = 44), we identified 8224 isolated coronary artery bypass graft (CABG) procedures performed between 2004 and 2007. The impact of surgery year was examined using a multiple logistic regression model that set previously identified clinical risk factors and surgery year as fixed effects. To examine the difference in outcomes between initial participants (n = 44) and halfway participants (n = 55), we identified 3882 isolated CABG procedures performed in 2007. The differences between the 2 hospital groups were examined using a multiple logistic regression model that set clinical risk factors, hospital procedure volume, and hospital groups as fixed effects. For operative mortality, the odds ratio of surgery year was 0.88 (P = .083). Observed/expected (OE) ratios for operative mortality were 0.71 in 2004, 0.73 in 2005, 0.63 in 2006, and 0.54 in 2007. As for composite mortality and major morbidities (reoperation, stroke, dialysis, infection, and prolonged ventilation), odds ratio of surgery year was 0.97 (P = .361). OE ratios for composite mortality and morbidities were 1.01 in 2004, 1.04 in 2005, 1.04 in 2006, and 0.94 in 2007. Compared with halfway participants, initial participants had a significantly lower rate of operative mortality (odds ratio = 0.527; P = .008) and composite mortality and major morbidities (odds ratio 0.820; P = .047). This study demonstrated that a quality improvement initiative for cardiovascular surgery has positive impacts on risk-adjusted outcomes. Although the primary target of benchmarking was 30-day mortality in Japan, major morbidities were less affected by those activities. Copyright �

Adjustment of trendy, gaming and less assimilated tweens in the United States.

Science.gov (United States)

Comulada, W Scott; Rotheram-Borus, Mary Jane; Carey, George; Poris, Michelle; Lord, Lynwood R; Mayfield Arnold, Elizabeth

2011-09-01

Youth transitioning from childhood to adolescence (tweens) are exposed to increasing amounts of media and advertisement. Tweens have also emerged as a major marketing segment for corporate America with increasing buying power.We examine how tweens relate to popular culture messages and the association of different orientations to popular culture on adjustment. A secondary data analysis was conducted on a marketing survey of 3527 tweens, aged 10-14 years, obtained from 49 schools using stratified sampling methods. A sample of children nationwide described their preferences on popular culture and measures of psychosocial adjustment. Using cluster analysis, we identified three main clusters or adaptation styles of tweens: (1) those who enjoyed gaming, (2) trendy youth and (3) youth less assimilated into popular culture. There were differences in clusters based on adjustment indices. Gaming and trendy tweens reported higher self-perceptions of being smart, caring and confident compared to less assimilated tweens. However, gaming and trendy tweens worried more about fitting in than less assimilated tweens. Gaming and trendy tweens also endorsed future goals and traditional values more strongly than less assimilated tweens. Trendy tweens reported the strongest positive feelings about substance use. Results suggest that for each method of adaptation (gamer, trendy and less assimilated), there are unique differences in adjustment that can impact the child's future. Parents and service providers must recognize the complexity of these decisions and be sensitive to the unique needs of youth as they move from childhood to adolescence.

Basel III : how have banks adjusted to increase CET1 ratios?

OpenAIRE

Bjerketvedt, Oda; Arneberg-Bauer, Tonje

2013-01-01

In 2010 the Basel Committee finalised the global framework called Basel III, which will have a significant impact on the global banking sector. A large part of the framework focuses on capital adequacy, where the Common Equity Tier 1 (CET1) ratio is essential. Through an analysis of four banks from the United Kingdom – HSBC, Barclays, Lloyds Banking Group and Standard Chartered – this thesis aim to examine how these banks have adjusted to the new CET1 requirements. In the EU the Basel III ...

Different initiatives across Europe to enhance losartan utilization post generics: impact and implications

Science.gov (United States)

Moon, James C.; Godman, Brian; Petzold, Max; Alvarez-Madrazo, Samantha; Bennett, Kathleen; Bishop, Iain; Bucsics, Anna; Hesse, Ulrik; Martin, Andrew; Simoens, Steven; Zara, Corinne; Malmström, Rickard E.

2014-01-01

Introduction: There is an urgent need for health authorities across Europe to fully realize potential savings from increased use of generics to sustain their healthcare systems. A variety of strategies were used across Europe following the availability of generic losartan, the first angiotensin receptor blocker (ARB) to be approved and marketed, to enhance its prescribing vs. single-sourced drugs in the class. Demand-side strategies ranged from 100% co-payment for single-sourced ARBs in Denmark to no specific measures. We hypothesized this heterogeneity of approaches would provide opportunities to explore prescribing in a class following patent expiry. Objective: Contrast the impact of the different approaches among European countries and regions to the availability of generic losartan to provide future guidance. Methodology: Retrospective segmented regression analyses applying linear random coefficient models with country specific intercepts and slopes were used to assess the impact of the various initiatives across Europe following the availability of generic losartan. Utilization measured in defined daily doses (DDDs). Price reductions for generic losartan were also measured. Results: Utilization of losartan was over 90% of all ARBs in Denmark by the study end. Multiple measures in Sweden and one English primary care group also appreciably enhanced losartan utilization. Losartan utilization actually fell in some countries with no specific demand-side measures. Considerable differences were seen in the prices of generic losartan. Conclusion: Delisting single-sourced ARBs produced the greatest increase in losartan utilization. Overall, multiple demand-side measures are needed to change physician prescribing habits to fully realize savings from generics. There is no apparent “spill over” effect from one class to another to influence future prescribing patterns even if these are closely related. PMID:25339902

Knowledge, attitudes, and normative beliefs as predictors of hookah smoking initiation: a longitudinal study of university students.

Science.gov (United States)

Sidani, Jaime E; Shensa, Ariel; Barnett, Tracey E; Cook, Robert L; Primack, Brian A

2014-06-01

While cross-sectional studies have shown that hookah tobacco smoking (HTS) is an increasingly popular behavior among university students, little is known about factors associated with initiation. This study sought to determine associations between knowledge, attitudes, and normative beliefs and initiation of HTS among university students. Data were from a prospective longitudinal cohort study of 569 randomly selected first- and second-year university students. Online questionnaires that were developed in accordance with our composite theoretical model were completed in September 2010 and April 2011. About one-seventh (13%) of participants initiated HTS by follow-up. Positive attitudes and favorable normative beliefs were associated with increased adjusted odds of initiation (AOR = 4.12, 95% CI = 2.56, 6.59; and AOR = 2.01, 95% CI = 1.35, 2.99, respectively), while negative attitudes were associated with decreased adjusted odds (AOR = 0.62, 95% CI = 0.48, 0.80). Correct knowledge regarding toxicants associated with HTS was not significantly associated with initiation. While positive attitudes and favorable normative beliefs are associated with initiation of HTS in a cohort of never-users, increased knowledge about toxins is not associated with lower initiation. It may be particularly valuable for educational interventions to attempt to alter positive attitudes and normative beliefs related to HTS.

Formation and adjustment of typhoon-impacted reef islands interpreted from remote imagery: Nadikdik Atoll, Marshall Islands

Science.gov (United States)

Ford, Murray R.; Kench, Paul S.

2014-06-01

In 1905, a devastating typhoon hit Nadikdik Atoll (5°54‧ N and 172°09‧ E) in the southern Marshall Islands. Evidence suggests that large sections of reef islands on Nadikdik were overwashed and destroyed. Comparison of aerial photographs taken in 1945 and modern satellite imagery provides a unique record of the geomorphic adjustment of islands after the typhoon. Between 1945 and 2010 the vegetated area of islands on Nadikdik grew from 0.74 to 0.90 km2. Observed changes to Nadikdik reef islands manifested through a range of styles and were largely accretionary. Of note, the formation of a new island was tracked from an embryonic deposit to a fully vegetated and stable island over a 61 year period. Similarly, a number of previously discrete islands have agglomerated and formed a single larger island. These changes were rapid and indicate that reef island formation can occur quickly. Evidence suggests that despite the typhoon occurring over a century ago the geomorphic adjustment of islands is still on-going.

7 CFR 718.110 - Adjustments.

Science.gov (United States)

2010-01-01

... MARKETING QUOTAS, ACREAGE ALLOTMENTS, AND PRODUCTION ADJUSTMENT PROVISIONS APPLICABLE TO MULTIPLE PROGRAMS... in order to avoid a marketing quota penalty if such person: (1) Notifies the county committee of such... committee; and (2) Pays the cost of a farm inspection to determine the adjusted acreage prior to the date...

Gastric emptying of orally administered glucose solutions and incretin hormone responses are unaffected by laparoscopic adjustable gastric banding

DEFF Research Database (Denmark)

Usinger, Lotte; Hansen, Katrine B; Kristiansen, Viggo B

2011-01-01

Laparoscopic adjustable gastric banding (LAGB) provides weight loss in obese individuals and is associated with improved glucose homeostasis and resolution of type 2 diabetes. However, in most available reports, potentially inappropriate methodology has been applied when measuring the impact...

Veterans Affairs facility performance on Washington Circle indicators and casemix-adjusted effectiveness.

Science.gov (United States)

Harris, Alex H S; Humphreys, Keith; Finney, John W

2007-12-01

Self-administered Addiction Severity Index (ASI) data were collected on 5,723 patients who received substance abuse treatment in 1 of 110 programs located at 73 Veterans Affairs facilities. The associations between each of three Washington Circle (WC) performance indicator scores (identification, initiation, and engagement) and their casemix-adjusted facility-level improvement in ASI drug and alcohol composites 7 months after intake were estimated. Higher initiation rates were not associated with facility-level improvement in ASI alcohol composite scores but were modestly associated with greater improvements in ASI drug composite scores. Identification and engagement rates were unrelated to 7-month outcomes. WC indicators focused on the early stages of treatment may tap necessary but insufficient processes for patients with substance use disorder to achieve good posttreatment outcomes. Ideally, the WC indicators would be supplemented with other measures of treatment quality.

Risk-adjusted antibiotic consumption in 34 public acute hospitals in Ireland, 2006 to 2014

Science.gov (United States)

Oza, Ajay; Donohue, Fionnuala; Johnson, Howard; Cunney, Robert

2016-01-01

As antibiotic consumption rates between hospitals can vary depending on the characteristics of the patients treated, risk-adjustment that compensates for the patient-based variation is required to assess the impact of any stewardship measures. The aim of this study was to investigate the usefulness of patient-based administrative data variables for adjusting aggregate hospital antibiotic consumption rates. Data on total inpatient antibiotics and six broad subclasses were sourced from 34 acute hospitals from 2006 to 2014. Aggregate annual patient administration data were divided into explanatory variables, including major diagnostic categories, for each hospital. Multivariable regression models were used to identify factors affecting antibiotic consumption. Coefficient of variation of the root mean squared errors (CV-RMSE) for the total antibiotic usage model was very good (11%), however, the value for two of the models was poor (> 30%). The overall inpatient antibiotic consumption increased from 82.5 defined daily doses (DDD)/100 bed-days used in 2006 to 89.2 DDD/100 bed-days used in 2014; the increase was not significant after risk-adjustment. During the same period, consumption of carbapenems increased significantly, while usage of fluoroquinolones decreased. In conclusion, patient-based administrative data variables are useful for adjusting hospital antibiotic consumption rates, although additional variables should also be employed. PMID:27541730

The College Adjustment Questionnaire: A Measure of Students' Educational, Relational, and Psychological Adjustment to the College Environment

Science.gov (United States)

O'Donnell, Maeve B.; Shirley, Lauren A.; Park, Stacey S.; Nolen, Julian P.; Gibbons, Alyssa M.; Rosén, Lee A.

2018-01-01

Several instruments exist to measure college adjustment: the Student Adaptation to College Questionnaire (SACQ; Baker & Siryk, 1989), the College Adjustment Rating Scale (Zitzow, 1984), and the College Adjustment Scales (Anton & Reed, 1991). Of these, the SACQ is the most widely used and takes a multifaceted approach to measuring college…

Sickness presence, sick leave and adjustment latitude

Directory of Open Access Journals (Sweden)

Joachim Gerich

2014-10-01

Full Text Available Objectives: Previous research on the association between adjustment latitude (defined as the opportunity to adjust work efforts in case of illness and sickness absence and sickness presence has produced inconsistent results. In particular, low adjustment latitude has been identified as both a risk factor and a deterrent of sick leave. The present study uses an alternative analytical strategy with the aim of joining these results together. Material and Methods: Using a cross-sectional design, a random sample of employees covered by the Upper Austrian Sickness Fund (N = 930 was analyzed. Logistic and ordinary least square (OLS regression models were used to examine the association between adjustment latitude and days of sickness absence, sickness presence, and an estimator for the individual sickness absence and sickness presence propensity. Results: A high level of adjustment latitude was found to be associated with a reduced number of days of sickness absence and sickness presence, but an elevated propensity for sickness absence. Conclusions: Employees with high adjustment latitude experience fewer days of health complaints associated with lower rates of sick leave and sickness presence compared to those with low adjustment latitude. In case of illness, however, high adjustment latitude is associated with a higher pro­bability of taking sick leave rather than sickness presence.

Funding issues for Victorian hospitals: the risk-adjusted vision beyond casemix funding.

Science.gov (United States)

Antioch, K; Walsh, M

2000-01-01

This paper discusses casemix funding issues in Victoria impacting on teaching hospitals. For casemix payments to be acceptable, the average price and cost weights must be set at an appropriate standard. The average price is based on a normative, policy basis rather than benchmarking. The 'averaging principle' inherent in cost weights has resulted in some AN-DRG weights being too low for teaching hospitals that are key State-wide providers of high complexity services such as neurosurgery and trauma. Casemix data have been analysed using international risk adjustment methodologies to successfully negotiate with the Victorian State Government for specified grants for several high complexity AN-DRGs. A risk-adjusted capitation funding model has also been developed for cystic fibrosis patients treated by The Alfred, called an Australian Health Maintenance Organisation (AHMO). This will facilitate the development of similar models by both the Victorian and Federal governments.

Public Reporting of Primary Care Clinic Quality: Accounting for Sociodemographic Factors in Risk Adjustment and Performance Comparison.