WorldWideScience

Sample records for individual presentations delivered

  1. Android App Incorporating the PVT to Deliver Individualized Fatigue Risk Management in Commercial Trucking

    Data.gov (United States)

    National Aeronautics and Space Administration — The overarching objective of this project is to achieve an Android App that incorporates the Psychomotor Vigilance Task (PVT) to deliver Individualized Fatigue Risk...

  2. Training radiographers to deliver an intervention to promote early presentation of breast cancer

    International Nuclear Information System (INIS)

    Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

    2012-01-01

    Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

  3. A Multilevel Approach to Breastfeeding Promotion: Using Healthy Start to Deliver Individual Support and Drive Collective Impact.

    Science.gov (United States)

    Leruth, Chelsey; Goodman, Jacqueline; Bragg, Brian; Gray, Dara

    2017-12-01

    Purpose Breastfeeding has been linked to a host of positive health effects for women and children. However, disparities in breastfeeding initiation and duration prevent many low-income and African-American women from realizing these benefits. Existing breastfeeding promotion efforts often do not reach women who need support the most. In response, the Westside Healthy Start program (WHS), located in Chicago, Illinois, developed an ongoing multilevel approach to breastfeeding promotion. Description Key elements of our WHS breastfeeding model include individual education and counseling from pregnancy to 6 months postpartum and partnership with a local safety-net hospital to implement the Baby-Friendly Hospital Initiative and provide lactation support to delivering patients. Assessment In the year our model was implemented, 44.6% (49/110) of prenatal WHS participants reported that they planned to breastfeed, and 67.0% (183/273) of delivered participants initiated. Among participants reaching 6 months postpartum, 10.5% (9/86) were breastfeeding. WHS also had 2667 encounters with women delivering at our partner hospital during breastfeeding rounds, with 65.1% of contacts initiating. Community data was not available to assess the efficacy of our model at the local level. However, WHS participants fared better than all delivering patients at our partner hospital, where 65.0% initiated in 2015. Conclusion Healthy Start programs are a promising vehicle to improve breastfeeding initiation at the individual and community level. Additional evaluation is necessary to understand barriers to duration and services needed for this population.

  4. Individualized, home-based interactive training of cerebral palsy children delivered through the Internet

    DEFF Research Database (Denmark)

    Bilde, Peder E; Kliim-Due, Mette; Rasmussen, Betina

    2011-01-01

    The available health resources limit the amount of therapy that may be offered to children with cerebral palsy and the amount of training in each session may be insufficient to drive the neuroplastic changes, which are necessary for functional improvements to take place. The aim of this pilot study...... was to provide proof of concept that individualized and supervised interactive home-based training delivered through the internet may provide an efficient way of maintaining intensive training of children with cerebral palsy over prolonged periods....

  5. SOLVING THE STUDENTS’ SPEAKING PROBLEM IN DELIVERING ENGLISH PRESENTATION THROUGH 3-P TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Nadif Ulfia

    2017-01-01

    Full Text Available Abstract: Solving the Students’ Speaking Problem in Delivering English Presentation Through 3-P Technique. The aims of this study were to (1 identify whether and to what extent 3-P Technique can improve the students’ speaking competence in delivering presentation;(2 describe the teaching and learning when 3-P technique is implemented in English class. This research was conducted at the eleventh grades of MAN 1 Bojonegoro. The subjects of the research were the teacher and the students in the academic year 2016/2017. This study applied 3 cycle action research. In collecting the data, the researcher used observations through field notes, video recording, questionnaire and interview. To analyze the quantitative data, the researcher applied descriptive statistics. Besides, to analyze qualitative data, the researcher applied constant comparative method as suggested by Garner. The findings shows that: (1 3-P Technique can improve students’ speaking competence in delivering presentation in terms of students achievement, fluency, pronunciation, ability to express their opinions, arguments, and ideas using appropriate vocabulary and grammatical form, using appropriate body language, voice control, gesture, and eye contact; and (2 3-P technique can improve classroom situation in terms of increasing students’ motivation and participation, creating live teaching atmosphere, and increasing teacher motivation. Key words: Speaking, 3 P technique, Action research Abstrak: Memecahkan Masalah Keterampilan Berbicara Siswa dalam Menyampaikan Presentasi Berbahasa Inggris Melalui Teknik 3-P. Tujuan dari penelitian ini adalah untuk (1 mengidentifikasi dan mengetahui sejauh mana teknik 3-P dapat meningkatkan kemampuan berbicara para siswa dalam menyampaikan sebuah presentasi; (2 mendeskripsikan kegiatan pembelajaran dalam penerapan teknik 3-P dalam pembelajaran Bahasa Inggris. Penelitian ini dilakukan pada kelas sebelas MAN 1 Bojonegoro. Subyek  penelitian ini

  6. Improved immunogenicity of individual influenza vaccine components delivered with a novel dissolving microneedle patch stable at room temperature

    Science.gov (United States)

    Vassilieva, Elena V.; Kalluri, Haripriya; McAllister, Devin; Taherbhai, Misha T.; Esser, E. Stein; Pewin, Winston P.; Pulit-Penaloza, Joanna A.; Prausnitz, Mark R.; Compans, Richard W.; Skountzou, Ioanna

    2015-01-01

    Prevention of seasonal influenza epidemics and pandemics relies on widespread vaccination coverage to induce protective immunity. In addition to a good antigenic match with the circulating viruses, the effectiveness of individual strains represented in the trivalent vaccines depends on their immunogenicity. In this study we evaluated the immunogenicity of H1N1, H3N2 and B seasonal influenza virus vaccine strains delivered individually with a novel dissolving microneedle patch and the stability of this formulation during storage at 25°C. Our data demonstrate that all strains retained their antigenic activity after incorporation in the dissolving patches as measured by SRID assay and immune responses to vaccination in BALB/c mice. After a single immunization all three antigens delivered with microneedle patches induced superior neutralizing antibody titers compared to intramuscular immunization. Cutaneous antigen delivery was especially beneficial for the less immunogenic B strain. Mice immunized with dissolving microneedle patches encapsulating influenza A/Brisbane/59/07 (H1N1) vaccine were fully protected against lethal challenge by homologous mouse-adapted influenza virus. All vaccine components retained activity during storage at room temperature for at least three months as measured in vitro by SRID assay and in vivo by mouse immunization studies. Our data demonstrate that dissolving microneedle patches are a promising advance for influenza cutaneous vaccination due to improved immune responses using less immunogenic influenza antigens and enhanced stability. PMID:25895053

  7. Can radiographers be trained to deliver an intervention to raise breast cancer awareness, and thereby promote early presentation of breast cancer, in older women?

    International Nuclear Information System (INIS)

    Omar, L.; Burgess, C.C.; Tucker, L.D.; Whelehan, P.; Ramirez, A.J.

    2010-01-01

    Aims: To assess the feasibility of training radiographers to deliver a one-to-one intervention to raise breast cancer awareness among older women. The ultimate aim is to increase the likelihood of early presentation of breast cancer by older women and improve survival from the disease. Method: Four radiographers were trained to deliver a 10-min scripted one-to-one intervention. Key elements of training included rehearsal of the intervention using role-play with actors and colleagues and practice interviews with women attending NHS breast screening clinics. All practice interventions were videotaped to facilitate positive, constructive feedback on performance. Competence to deliver the intervention was assessed on delivery of the key messages and the style of delivery. Radiographers' experiences of training and intervention delivery were collated from reflective diaries. Results: Three radiographers were assessed as competent after training and all four increased in confidence to deliver the intervention. Reported benefits to radiographers included increased awareness of communication skills and enhanced interaction with women attending breast screening. Radiographers reported challenges relating to mastering the prescriptive nature of the intervention and to delivering complex health messages within time constraints. Discussion: It was feasible but challenging for radiographers to be trained to deliver a one-to-one intervention designed to raise breast cancer awareness and thereby to promote early presentation of breast cancer. If the intervention is found to be cost-effective it may be implemented across the NHS Breast Screening Programme with diagnostic radiographers playing a key role in promoting early presentation of breast cancer.

  8. Construction, Presentation and Consumption of Individualism in Social Media

    Directory of Open Access Journals (Sweden)

    Gulsum Calisir

    2014-12-01

    Full Text Available The concept ıf individualism involves the whole properties of being esteemed and confirmed of the individual in society. The situation of being esteemed is an extension of individuality. Together with social media, individuals can build new individualities right along with the present. Social media offers individuals a new “individuality area”. As a socialization medium, social media also lays the grounwork for a consumption of individualism during daily use. Different than consumption in real life, it is allowed for individual’s consumption of individualism by texts, visuality, varied connections and comments in social media. At the same time, individual also exhausts his or her own individualism during construction process of his or her own individualism. Consumption of individualism in daily life, seems to find its imaginary equivalent in social media. Individual realizes a consumption by sharing in social media what he or she eats, places he or she visits or shops in real life. In this way,individual both is able to reach more wide areas and to continue to be on the agenda. Social media offers individuals this chance. Individual can be on the agenda as he or she consumes and shares to the extent. As soon as the individual achieves this, he or she can gain admiration and comment; but at the moment he or she becomes silent, individual encounters the risk of falling down the agenda. So, individual trends to expend more in real life tos tay active in virtual world. The agenda in the real world is not enough anymore. Individual is wishing to deploy on a much more broad area in virtual world. In this respect, the work takes individual’s dilemma of construction and consumption of individualism which he or she builds on social media, as its case.

  9. Impact of peer delivered wellness coaching.

    Science.gov (United States)

    Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

    2016-09-01

    People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Effects of Individual Differences in Working Memory on Plan Presentational Choices.

    Science.gov (United States)

    Tintarev, Nava; Masthoff, Judith

    2016-01-01

    This paper addresses research questions that are central to the area of visualization interfaces for decision support: (RQ1) whether individual user differences in working memory should be considered when choosing how to present visualizations; (RQ2) how to present the visualization to support effective decision making and processing; and (RQ3) how to evaluate the effectiveness of presentational choices. These questions are addressed in the context of presenting plans, or sequences of actions, to users. The experiments are conducted in several domains, and the findings are relevant to applications such as semi-autonomous systems in logistics. That is, scenarios that require the attention of humans who are likely to be interrupted, and require good performance but are not time critical. Following a literature review of different types of individual differences in users that have been found to affect the effectiveness of presentational choices, we consider specifically the influence of individuals' working memory (RQ1). The review also considers metrics used to evaluate presentational choices, and types of presentational choices considered. As for presentational choices (RQ2), we consider a number of variants including interactivity, aggregation, layout, and emphasis. Finally, to evaluate the effectiveness of plan presentational choices (RQ3) we adopt a layered-evaluation approach and measure performance in a dual task paradigm, involving both task interleaving and evaluation of situational awareness. This novel methodology for evaluating visualizations is employed in a series of experiments investigating presentational choices for a plan. A key finding is that emphasizing steps (by highlighting borders) can improve effectiveness on a primary task, but only when controlling for individual variation in working memory.

  11. Effects of Individual Differences in Working Memory on Plan Presentational Choices

    Directory of Open Access Journals (Sweden)

    Nava Tintarev

    2016-11-01

    Full Text Available This paper addresses research questions that are central to the area of visualization interfaces for decision support: RQ1 whether individual user differences in working memory should be considered when making choosing how to present visualizations; RQ2 how to present the visualization to support effective decision making and processing; and RQ3 how to evaluate the effectiveness of presentational choices. These questions are addressed in the context of presenting plans, or sequences of actions, to users. The experiments are conducted in several domains, and the findings are relevant to applications such as semi-autonomous systems in logistics. That is, scenarios that require the attention of humans who are likely to be interrupted, and require good performance but are not time critical. Following a literature review of different types of individual differences in users that have been found to affect the effectiveness of presentational choices, we consider specifically the influence of individuals' working memory (RQ1. The review also considers metrics used to evaluate presentational choices, and types of presentational choices considered. As for presentational choices (RQ2, we consider a number of variants including interactivity, aggregation, layout, and emphasis. Finally, to evaluate the effectiveness of plan presentational choices (RQ3 we adopt a layered-evaluation approach and measure performance in a dual task paradigm, involving both task interleaving and evaluation of situational awareness. This novel methodology for evaluating visualizations is employed in a series of experiments investigating presentational choices for a plan. A key finding is that emphasizing steps (by highlighting borders can improve effectiveness on a primary task, but only when controlling for individual variation in working memory.

  12. Individual differences in detecting rapidly presented fearful faces.

    Directory of Open Access Journals (Sweden)

    Dandan Zhang

    Full Text Available Rapid detection of evolutionarily relevant threats (e.g., fearful faces is important for human survival. The ability to rapidly detect fearful faces exhibits high variability across individuals. The present study aimed to investigate the relationship between behavioral detection ability and brain activity, using both event-related potential (ERP and event-related oscillation (ERO measurements. Faces with fearful or neutral facial expressions were presented for 17 ms or 200 ms in a backward masking paradigm. Forty-two participants were required to discriminate facial expressions of the masked faces. The behavioral sensitivity index d' showed that the detection ability to rapidly presented and masked fearful faces varied across participants. The ANOVA analyses showed that the facial expression, hemisphere, and presentation duration affected the grand-mean ERP (N1, P1, and N170 and ERO (below 20 Hz and lasted from 100 ms to 250 ms post-stimulus, mainly in theta band brain activity. More importantly, the overall detection ability of 42 subjects was significantly correlated with the emotion effect (i.e., fearful vs. neutral on ERP (r = 0.403 and ERO (r = 0.552 measurements. A higher d' value was corresponding to a larger size of the emotional effect (i.e., fearful--neutral of N170 amplitude and a larger size of the emotional effect of the specific ERO spectral power at the right hemisphere. The present results suggested a close link between behavioral detection ability and the N170 amplitude as well as the ERO spectral power below 20 Hz in individuals. The emotional effect size between fearful and neutral faces in brain activity may reflect the level of conscious awareness of fearful faces.

  13. A physiotherapist-delivered integrated exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Bennell Kim L

    2012-07-01

    Full Text Available Abstract Background Knee osteoarthritis (OA is a prevalent chronic musculoskeletal condition with no cure. Pain is the primary symptom and results from a complex interaction between structural changes, physical impairments and psychological factors. Much evidence supports the use of strengthening exercises to improve pain and physical function in this patient population. There is also a growing body of research examining the effects of psychologist-delivered pain coping skills training (PCST particularly in other chronic pain conditions. Though typically provided separately, there are symptom, resource and personnel advantages of exercise and PCST being delivered together by a single healthcare professional. Physiotherapists are a logical choice to be trained to deliver a PCST intervention as they already have expertise in administering exercise for knee OA and are cognisant of the need for a biopsychosocial approach to management. No studies to date have examined the effects of an integrated exercise and PCST program delivered solely by physiotherapists in this population. The primary aim of this multisite randomised controlled trial is to investigate whether an integrated 12-week PCST and exercise treatment program delivered by physiotherapists is more efficacious than either program alone in treating pain and physical function in individuals with knee OA. Methods/design This will be an assessor-blinded, 3-arm randomised controlled trial of a 12-week intervention involving 10 physiotherapy visits together with home practice. Participants with symptomatic and radiographic knee OA will be recruited from the community in two cities in Australia and randomized into one of three groups: exercise alone, PCST alone, or integrated PCST and exercise. Randomisation will be stratified by city (Melbourne or Brisbane and gender. Primary outcomes are overall average pain in the past week measured by a Visual Analogue Scale and physical function measured by

  14. Assessing the Impact of Voice-Over Screen-Captured Presentations Delivered Online on Dental Students' Learning.

    Science.gov (United States)

    Schönwetter, Dieter J; Gareau-Wilson, Nicole; Cunha, Rodrigo Sanches; Mello, Isabel

    2016-02-01

    The traditional lecturing method is still one of the most common forms of delivering content to students in dental education, but innovative learning technologies have the potential to improve the effectiveness and quality of teaching dental students. What challenges instructors is the extent to which these learning tools have a direct impact on student learning outcomes. The aim of this study was to assess the impact of a voice-over screen-captured learning tool by identifying a positive, nil, or negative impact on student learning as well as student engagement (affective, behavioral, and cognitive) when compared to the traditional face-to-face lecture. Extraneous variables thought to impact student learning were controlled by the use of baseline measures as well as random assignment of second-year dental students to one of two teaching conditions: voice-over screen-captured presentation delivered online and the traditional classroom lecture. A total of 28 students enrolled in the preclinical course in endodontics at a Canadian dental school participated in the study, 14 in each of the two teaching conditions. The results showed that, in most cases, the students who experienced the online lecture had somewhat higher posttest scores and perceived satisfaction levels than those in the face-to-face lecture group, but the differences did not achieve statistical significance except for their long-term recognition test scores. This study found that the students had comparable learning outcomes whether they experienced the face-to-face or the online lecture, but that the online lecture had a more positive impact on their long-term learning. The controls for extraneous variables used in this study suggest ways to improve research into the comparative impact of traditional and innovative teaching methods on student learning outcomes.

  15. When women deliver with no one present in Nigeria: who, what, where and so what?

    Directory of Open Access Journals (Sweden)

    Bolaji M Fapohunda

    Full Text Available With the current maternal mortality ratio (MMR of 630/100,000 live births, Nigeria ranks among the nations with the highest mortality rates in the world. The use of skilled assistants during delivery has been identified a key predictor in the reduction of mortality rates in the world over. Not only are Nigerian women predominantly using unskilled attendants, one in five births are delivered with No One Present (NOP. We assessed who, what, where and the so what of this practice using 2008 Nigeria DHS (NDHS data. The study revealed that the prevalence of NOP is highest in the northern part of Nigeria with 94% of all observed cases. Socio-demographic factors, including, women's age at birth, birth order, being Muslim, and region of residence, were positively associated with NOP deliveries. Mother's education, higher wealth quintiles, urban residence, decision-making autonomy, and a supportive environment for women's social and economic security were inversely associated with NOP deliveries. Women's autonomy and social standing were critical to choosing to deliver with skilled attendance, which were further amplified by economic prosperity. Women's' economic wellbeing is entwined with their feelings of independence and freedom. Programs that seek to improve the autonomy of women and their strategic participation in sound health seeking decisions will, most likely, yield better results with improvements in women's education, income, jobs, and property ownership. As a short term measure, the use of conditional cash transfer, proven to work in several countries, including 18 in sub-Saharan Africa, is recommended. Its use has the potential to reduce household budget constraint by lowering cost-related barriers associated with women's ability to demand and use life-saving services. Given the preponderance of NOP in the Northern region, the study suggests that interventions to eradicate NOP deliveries must initially focus this region as priority.

  16. Using Videoconferencing to Deliver Individual Therapy and Pediatric Psychology Interventions with Children and Adolescents.

    Science.gov (United States)

    Nelson, Eve-Lynn; Patton, Susana

    2016-04-01

    Because of the widening access gap between need for individual and pediatric psychology services and child specialist availability, secure videoconferencing options are more needed than ever to address access challenges across underserved settings. The authors summarize real-time videoconferencing evidence to date across individual therapy with children and pediatric psychology interventions using videoconferencing. The authors summarize emerging guidelines that inform best practices for individual child therapy over videoconferencing. The authors present three case examples to illustrate best practices. The first behavioral pediatrics case summarizes evidence-based approaches in treating a rural young adolescent with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and hearing impairment. The second pediatric psychology case describes similarities and difference between on-site and videoconferencing services in treating a rural child with toileting concerns. The third adolescent case describes treatment of an urban honors student with depression. Videoconferencing is an effective approach to improving access to individual and pediatric psychology interventions for children and adolescents. Videoconferencing approaches are well accepted by families and show promise for disseminating evidence-based treatments to underserved communities.

  17. Scientific Presenting: Using Evidence-Based Classroom Practices to Deliver Effective Conference Presentations

    Science.gov (United States)

    Corwin, Lisa A.; Prunuske, Amy; Seidel, Shannon B.

    2018-01-01

    Scientists and educators travel great distances, spend significant time, and dedicate substantial financial resources to present at conferences. This highlights the value placed on conference interactions. Despite the importance of conferences, very little has been studied about what is learned from the presentations and how presenters can…

  18. The Effects of a Peer-Delivered Social Skills Intervention for Adults with Comorbid Down Syndrome and Autism Spectrum Disorder.

    Science.gov (United States)

    Davis, Matthew A Cody; Spriggs, Amy; Rodgers, Alexis; Campbell, Jonathan

    2018-06-01

    Deficits in social skills are often exhibited in individuals with comorbid Down syndrome (DS) and autism spectrum disorder (ASD), and there is a paucity of research to help guide intervention for this population. In the present study, a multiple probe study across behaviors, replicated across participants, assessed the effectiveness of peer-delivered simultaneous prompting in teaching socials skills to adults with DS-ASD using visual analysis techniques and Tau-U statistics to measure effect. Peer-mediators with DS and intellectual disability (ID) delivered simultaneous prompting sessions reliably (i.e., > 80% reliability) to teach social skills to adults with ID and a dual-diagnoses of DS-ASD with small (Tau Weighted  = .55, 90% CI [.29, .82]) to medium effects (Tau Weighted  = .75, 90% CI [.44, 1]). Statistical and visual analysis findings suggest a promising social skills intervention for individuals with DS-ASD as well as reliable delivery of simultaneous prompting procedures by individuals with DS.

  19. The breech presentation and the vertex presentation following an external version represent risk factors for neonatal hip instability.

    Science.gov (United States)

    Andersson, J E; Odén, A

    2001-08-01

    The aim of this study was to evaluate the frequency and type of hip-joint instability and the frequency of hip dislocation requiring treatment in neonates who had been lying in the breech presentation and were delivered vaginally after an external version or by caesarean section, and to compare them with neonates who were naturally in the vertex presentation. Breech presentations without ongoing labour were subjected to an attempted external version and, in cases where this proved unsuccessful or where labour had started, to deliver by caesarean section. None of the breech presentations was vaginally delivered. The anterior-dynamic ultrasound method was used to assess the hip-joint status of the neonates. Out of 6,571 foetuses, 257 were in breech presentation after 36 wk of pregnancy. Sixty-two were vaginally delivered following an external version to vertex presentation and 195 were delivered by caesarean section, 75 of these following unsuccessful attempts to perform a version. Treatment for congenital hip-joint dislocation was performed on 0.2%. Out of the breech presentations, 1.0% of those delivered by caesarean section were treated, while in those with vaginal delivery following an external version the treatment frequency was 3.2%. No case of late diagnosed hip dislocation was recorded. Significant differences in frequency of hip-joint instability and treatment were found between (i) neonates delivered in breech presentation and those delivered with vertex presentation, (ii) infants delivered in vertex presentation, naturally or after successful version, and (iii) those delivered by caesarean section with or without attempted external version and those delivered with vortex presentation. Breech presentation predisposes to increased hip instability. The instability is present prior to delivery and is certainly not a primary result of delivery forces. Both breech and vertex presentations following an external or spontaneous version should be considered as risk

  20. C-SAFE: A Computer-Delivered Sexual Health Promotion Program for Latinas.

    Science.gov (United States)

    Klein, Charles H; Kuhn, Tamara; Altamirano, Midori; Lomonaco, Carmela

    2017-07-01

    This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days in the past month when their mental health was not good (p = .02). C-SAFE condition women also reported more satisfaction than control condition women in their assessment of information presentation (on a scale of 1 = poor and 5 = excellent; C-SAFE = 4.45 vs. control = 4.25, p = .053) and having learned something new (C-SAFE = 95.1% vs. control = 79.3%, χ 2 importance of teachable moments, matching of delivery modalities to implementation contexts, and possible directions for evidence-based sexual health promotion programs given the current sexual health landscape.

  1. Interventions to Promote Cancer Awareness and Early Presentation: Systematic Review

    OpenAIRE

    J Austoker; C Bankhead; Lindsay J. L. Forbes; L Atkins; F Martin; K Robb; J Wardle; A J. Ramirez

    2009-01-01

    Background: Low cancer awareness contributes to delay in presentation for cancer symptoms and may lead to delay in cancer diagnosis. The aim of this study was to review the evidence for the effectiveness of interventions to raise cancer awareness and promote early presentation in cancer to inform policy and future research. Methods: We searched bibliographic databases and reference lists for randomised controlled trials of interventions delivered to individuals, and controlled or uncontrolled...

  2. Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Insomnia

    Science.gov (United States)

    Arnedt, J. Todd; Cuddihy, Leisha; Swanson, Leslie M.; Pickett, Scott; Aikens, James; Chervin, Ronald D.

    2013-01-01

    Study Objectives: To compare the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia to an information pamphlet control on sleep and daytime functioning at pretreatment, posttreatment, and 12-wk follow-up. Design: Randomized controlled parallel trial. Setting: N/A. Participants: Thirty individuals with chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years). Interventions: Cognitive behavioral therapy for insomnia (CBTI) delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus an information pamphlet control (IPC, n = 15). Measurements and Results: Sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life) were completed at pretreatment, posttreatment, and 12-wk follow-up. Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups and remained stable at 12-wk follow-up. More CBTI-Phone than IPC patients showed posttreatment improvements in unhelpful sleep-related cognitions (P insomnia at follow-up (P insomnia. Future larger-scale studies with more diverse samples are warranted. Some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support. Citation: Arnedt JT; Cuddihy L; Swanson LM; Pickett S; Aikens J; Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. SLEEP 2013;36(3):353-362. PMID:23450712

  3. The Preference for Internet-Based Psychological Interventions by Individuals Without Past or Current Use of Mental Health Treatment Delivered Online: A Survey Study With Mixed-Methods Analysis

    Science.gov (United States)

    Mattsson, Susanne; Olsson, Erik Martin Gustaf

    2016-01-01

    Background The use of the Internet has the potential to increase access to evidence-based mental health services for a far-reaching population at a low cost. However, low take-up rates in routine care indicate that barriers for implementing Internet-based interventions have not yet been fully identified. Objective The aim of this study was to evaluate the preference for Internet-based psychological interventions as compared to treatment delivered face to face among individuals without past or current use of mental health treatment delivered online. A further aim was to investigate predictors of treatment preference and to complement the quantitative analyses with qualitative data about the perceived advantages and disadvantages of Internet-based interventions. Methods Two convenience samples were used. Sample 1 was recruited in an occupational setting (n=231) and Sample 2 consisted of individuals previously treated for cancer (n=208). Data were collected using a paper-and-pencil survey and analyzed using mixed methods. Results The preference for Internet-based psychological interventions was low in both Sample 1 (6.5%) and Sample 2 (2.6%). Most participants preferred psychological interventions delivered face to face. Use of the Internet to search for and read health-related information was a significant predictor of treatment preference in both Sample 1 (odds ratio [OR] 2.82, 95% CI 1.18-6.75) and Sample 2 (OR 3.52, 95% CI 1.33-9.29). Being born outside of Sweden was a significant predictor of preference for Internet-based interventions, but only in Sample 2 (OR 6.24, 95% CI 1.29-30.16). Similar advantages and disadvantages were mentioned in both samples. Perceived advantages of Internet-based interventions included flexibility regarding time and location, low effort, accessibility, anonymity, credibility, user empowerment, and improved communication between therapist and client. Perceived disadvantages included anonymity, low credibility, impoverished

  4. Does a presentation's medium affect its message? PowerPoint, Prezi, and oral presentations.

    Science.gov (United States)

    Moulton, Samuel T; Türkay, Selen; Kosslyn, Stephen M

    2017-01-01

    Despite the prevalence of PowerPoint in professional and educational presentations, surprisingly little is known about how effective such presentations are. All else being equal, are PowerPoint presentations better than purely oral presentations or those that use alternative software tools? To address this question we recreated a real-world business scenario in which individuals presented to a corporate board. Participants (playing the role of the presenter) were randomly assigned to create PowerPoint, Prezi, or oral presentations, and then actually delivered the presentation live to other participants (playing the role of corporate executives). Across two experiments and on a variety of dimensions, participants evaluated PowerPoint presentations comparably to oral presentations, but evaluated Prezi presentations more favorably than both PowerPoint and oral presentations. There was some evidence that participants who viewed different types of presentations came to different conclusions about the business scenario, but no evidence that they remembered or comprehended the scenario differently. We conclude that the observed effects of presentation format are not merely the result of novelty, bias, experimenter-, or software-specific characteristics, but instead reveal a communication preference for using the panning-and-zooming animations that characterize Prezi presentations.

  5. Sexuality of the elder individual presented on paintings

    Directory of Open Access Journals (Sweden)

    Josiane Aparecida Duarte

    2013-12-01

    Full Text Available The sexuality of the elder has a history of negligence, seen as a taboo, both by society and by the individual himself, contributing to maintain the oppressive cultural standards related to the theme of sexuality related to aging. In the great majority of paintings, the elder individual is presented as an asexual character. The representation of the elder in paintings is usually shown in the following contexts: domestic (“St Joseph, The carpenter” – George de La Tour, 1642; “The Paralytic” – Jean Baptiste Greuze, 1763 and in the decadence of health (“Old man in sorrow” – Van Gogh, 1890; “The old guitarist” – Picasso, 1903. On the few paintings that retract the sexuality of the elder, we can see a clear prominence of the male gender (“Susana and the elders” – Artemisia Gentileschi, 1610; “Elderly nude in the sun” – Mariano Fortuny, 1871. Sexuality of the elder woman is little referred to, being predominantly portrayed in her domestic role. When sexuality is shown it is in the context of prostitution, as in the work “The Salon I”, of Otto Dix, 1921. Between painters of the 20th century, there are self portraits in which artists of both genders paint themselves naked in advanced age, showing a tendency in changing the current paradigm: “Painter working, Reflection” – Lucian Freud, 1993 that portrayed himself at the age of 70; and “Self Portrait” – Alice Neel, 1980, at the age of 80.

  6. Needles in the haystack: identifying individuals present in pooled genomic data.

    Directory of Open Access Journals (Sweden)

    Rosemary Braun

    2009-10-01

    Full Text Available Recent publications have described and applied a novel metric that quantifies the genetic distance of an individual with respect to two population samples, and have suggested that the metric makes it possible to infer the presence of an individual of known genotype in a sample for which only the marginal allele frequencies are known. However, the assumptions, limitations, and utility of this metric remained incompletely characterized. Here we present empirical tests of the method using publicly accessible genotypes, as well as analytical investigations of the method's strengths and limitations. The results reveal that the null distribution is sensitive to the underlying assumptions, making it difficult to accurately calibrate thresholds for classifying an individual as a member of the population samples. As a result, the false-positive rates obtained in practice are considerably higher than previously believed. However, despite the metric's inadequacies for identifying the presence of an individual in a sample, our results suggest potential avenues for future research on tuning this method to problems of ancestry inference or disease prediction. By revealing both the strengths and limitations of the proposed method, we hope to elucidate situations in which this distance metric may be used in an appropriate manner. We also discuss the implications of our findings in forensics applications and in the protection of GWAS participant privacy.

  7. Delivering social work services in collaboration with the legal representation for individual clients: An effective, ethical and economical approach to supporting families in child abuse and neglect legal proceedings.

    Science.gov (United States)

    Pott, Robbin

    2017-11-01

    This article discusses the need to improve the quality of helping relationships between families and social workers in the child protection system and the growing body of evidence that teams of social workers and lawyers are effective at improving outcomes in child protection legal proceedings. The author presents an alternative structure of delivering social work services within the child protection systems once a court gets involved with a family, proposing that social workers should focus on individual clients in collaboration with their legal representation, rather than the traditional model of a governmental agency social worker serving the family as a unit as it also determines placement of the children. Pairing the social worker to an individual client in tandem with their legal representative would help resolve the widely observed relationship problems between service users and governmental agency social workers that include the power imbalance created by the agency's authority to determine placement of children, the conflicts of interest that agency workers face when required to manage differing family members' needs, and the lack of protection of the due process right of confidentiality for parties involved in legal proceedings. This alternative structure also impacts the need to use resources more efficiently and has been demonstrated to result in substantial returns on investment. This article concludes that when a family becomes involved in child abuse and neglect legal proceedings, the child welfare agency should shift the delivery of social work services to the individual parties, away from the governmental agency and in conjunction with their legal representation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Pelvic Radiotherapy for Cancer of the Cervix: Is What You Plan Actually What You Deliver?

    International Nuclear Information System (INIS)

    Lim, Karen; Kelly, Valerie; Stewart, James; Xie, Jason; Cho, Young-Bin; Moseley, Joanne B.; Brock, Kristy; Fyles, Anthony; Lundin, Anna; Rehbinder, Henrik; Milosevic, Michael

    2009-01-01

    Purpose: Whole pelvic intensity-modulated radiotherapy (IMRT) is increasingly being used to treat cervix cancer and other gynecologic tumors. However, tumor and normal organ movement during treatment can substantially detract from the benefits of this approach. This study explored the effect of internal anatomic changes on the dose delivered to the tumor and organs at risk using a strategy integrating deformable soft-tissue modeling with simulated dose accumulation. Methods and Materials: Twenty patients with cervix cancer underwent baseline and weekly pelvic magnetic resonance imaging during treatment. Interfraction organ motion and delivered (accumulated) dose was modeled for three treatment scenarios: four-field box, large-margin whole pelvic IMRT (20-mm planning target volume, but 10 mm inferiorly) and small-margin IMRT (5-mm planning target volume). Results: Individually, the planned dose was not the same as the simulated delivered dose; however, when taken as a group, this was not statistically significant for the four-field box and large-margin IMRT plans. The small-margin IMRT plans yielded adequate target coverage in most patients; however, significant target underdosing occurred in 1 patient who displayed excessive, unpredictable internal target movement. The delivered doses to the organs at risk were significantly reduced with the small-margin plan, although substantial variability was present among the patients. Conclusion: Simulated dose accumulation might provide a more accurate depiction of the target and organ at risk coverage during fractionated whole pelvic IMRT for cervical cancer. The adequacy of primary tumor coverage using 5-mm planning target volume margins is contingent on the use of daily image-guided setup.

  9. Effects of Presentation Mode on Veridical and False Memory in Individuals with Intellectual Disability

    Science.gov (United States)

    Carlin, Michael; Toglia, Michael P.; Belmonte, Colleen; DiMeglio, Chiara

    2012-01-01

    In the present study the effects of visual, auditory, and audio-visual presentation formats on memory for thematically constructed lists were assessed in individuals with intellectual disability and mental age-matched children. The auditory recognition test included target items, unrelated foils, and two types of semantic lures: critical related…

  10. Recombinant Secreted Antigens from Mycoplasma hyopneumoniae Delivered as a Cocktail Vaccine Enhance the Immune Response of Mice

    Science.gov (United States)

    Galli, Vanessa; Simionatto, Simone; Marchioro, Silvana Beutinger; Klabunde, Gustavo Henrique Ferrero; Conceição, Fabricio Rochedo

    2013-01-01

    Mycoplasma hyopneumoniae is the etiological agent of porcine enzootic pneumonia (EP), which is a respiratory disease responsible for huge economic losses in the pig industry worldwide. The commercially available vaccines provide only partial protection and are expensive. Thus, the development of alternatives for the prophylaxis of EP is critical for improving pig health. The use of multiple antigens in the same immunization may represent a promising alternative. In the present study, seven secreted proteins of M. hyopneumoniae were cloned, expressed in Escherichia coli, and evaluated for antigenicity using serum from naturally and experimentally infected pigs. In addition, the immunogenicity of the seven recombinant proteins delivered individually or in protein cocktail vaccines was evaluated in mice. In Western blot assays and enzyme-linked immunosorbent assays, most of the recombinant proteins evaluated were recognized by convalescent-phase serum from the animals, indicating that they are expressed during the infectious process. The recombinant proteins were also immunogenic, and most induced a mixed IgG1/IgG2a humoral immune response. The use of these proteins in a cocktail vaccine formulation enhanced the immune response compared to their use as antigens delivered individually, providing evidence of the efficacy of the multiple-antigen administration strategy for the induction of an immune response against M. hyopneumoniae. PMID:23803903

  11. Feasibility of Delivering a Dance Intervention for SubAcute Stroke in a Rehabilitation Hospital Setting

    Science.gov (United States)

    Demers, Marika; McKinley, Patricia

    2015-01-01

    Dance can be a promising treatment intervention used in rehabilitation for individuals with disabilities to address physical, cognitive and psychological impairments. The aim of this pilot study was to determine the feasibility of a modified dance intervention as an adjunct therapy designed for people with subacute stroke, in a rehabilitation setting. Using a descriptive qualitative study design, a biweekly 45-min dance intervention was offered to individuals with a subacute stroke followed in a rehabilitation hospital, over 4 weeks. The dance intervention followed the structure of an usual dance class, but the exercises were modified and progressed to meet each individual’s needs. The dance intervention, delivered in a group format, was feasible in a rehabilitation setting. A 45-min dance class of moderate intensity was of appropriate duration and intensity for individuals with subacute stroke to avoid excessive fatigue and to deliver the appropriate level of challenge. The overall satisfaction of the participants towards the dance class, the availability of space and equipment, and the low level of risks contributed to the feasibility of a dance intervention designed for individuals in the subacute stage of post-stroke recovery. PMID:25785497

  12. Feasibility of Delivering a Dance Intervention for SubAcute Stroke in a Rehabilitation Hospital Setting

    Directory of Open Access Journals (Sweden)

    Marika Demers

    2015-03-01

    Full Text Available Dance can be a promising treatment intervention used in rehabilitation for individuals with disabilities to address physical, cognitive and psychological impairments. The aim of this pilot study was to determine the feasibility of a modified dance intervention as an adjunct therapy designed for people with subacute stroke, in a rehabilitation setting. Using a descriptive qualitative study design, a biweekly 45-min dance intervention was offered to individuals with a subacute stroke followed in a rehabilitation hospital, over 4 weeks. The dance intervention followed the structure of an usual dance class, but the exercises were modified and progressed to meet each individual’s needs. The dance intervention, delivered in a group format, was feasible in a rehabilitation setting. A 45-min dance class of moderate intensity was of appropriate duration and intensity for individuals with subacute stroke to avoid excessive fatigue and to deliver the appropriate level of challenge. The overall satisfaction of the participants towards the dance class, the availability of space and equipment, and the low level of risks contributed to the feasibility of a dance intervention designed for individuals in the subacute stage of post-stroke recovery.

  13. Individual Training, Performance Improvement, and the Future for Organizations

    Science.gov (United States)

    Kaufman, Roger

    2015-01-01

    Human competence is a vital element for any organization that expects to survive and then thrive. Developing individual performance ability is necessary but not sufficient because trained people alone will not make an organization successful. We must determine what people should deliver and why it should be delivered in order to add measurable…

  14. BEING DELIVERED: SPIRITUALITY IN SURVIVORS OF SEXUAL VIOLENCE

    Science.gov (United States)

    Knapik, Gregory P.; Martsolf, Donna S.; Draucker, Claire B.

    2011-01-01

    A theoretical framework explaining how survivors of sexual violence use spirituality to respond to or recover from sexual violence is presented. Data were drawn from open-ended interviews of 27 women and 23 men who participated in a larger, ongoing study of women’s and men’s responses to sexual violence. Grounded theory methodology was used to develop the core category of Being Delivered, reflecting the participants’ experiences of being rescued, saved, or set free from the effects of sexual violence by a spiritual being or power. The theoretical framework describing Being Delivered is composed of three dimensions: Spiritual Connection, Spiritual Journey, and Spiritual Transformation. The framework can be used by clinicians to guide discussions of spirituality and healing with survivors of sexual violence. PMID:18382913

  15. Rotating Poster Presentations

    Science.gov (United States)

    Lagares, Manuel; Reisenleutner, Sandra

    2017-01-01

    Oral presentations are a common practice in foreign language classes, often used to assess students' speaking skills. Usually, the presentations are delivered by students in front of the class, often with PowerPoint slides or Prezi as support. However, frequently the audience does not engage with the presentation and thus, the benefits of this…

  16. Predictors and moderators of response to internet-delivered Interpersonal Psychotherapy and Cognitive Behaviour Therapy for depression.

    NARCIS (Netherlands)

    Donker, T.; Batterham, P.J.; Warmerdam, L.; Bennett, K.; Bennett, A.; Cuijpers, P.; Griffiths, K.M.

    2013-01-01

    Background: By identifying which predictors and moderators lead to beneficial outcomes, accurate selection of the best initial treatment will have significant benefits for depressed individuals. Method: An automated, fully self-guided randomized controlled internet-delivered noninferiority trial was

  17. The effect of support on Internet-delivered treatment for insomnia: Does baseline depression severity matter?

    NARCIS (Netherlands)

    Lancee, J.; Sorbi, M.J.; Eisma, M.C.; van Straten, A.; van den Bout, J.

    2014-01-01

    Internet-delivered cognitive-behavioral treatment is effective for insomnia. However, little is known about the beneficial effects of support. Recently we demonstrated that motivational support moderately improved the effects of Internet-delivered treatment for insomnia. In the present study, we

  18. Equivalent weight loss for weight management programs delivered by phone and clinic

    Science.gov (United States)

    Donnelly, Joseph E.; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K.; Lee, Robert; Smith, Bryan K.; Lambourne, Kate; Mayo, Matthew S.; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J.; Washburn, Richard A.

    2013-01-01

    Objective Face-to-face weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by face-to-face (FTF) clinic or group conference calls (phone). Design and Methods Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0–6 months) was achieved by reducing energy intake between 1,200– 1,500 kcal/day and progressing physical activity to 300 minutes/week. Weight maintenance (7–18 months) provided adequate energy to maintain weight and continued 300 minutes/week of physical activity. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during months 7–18. A cost analysis provided a comparison of expenses between groups. Results Weight change from baseline to 6 months was −13.4 ± 6.7% and −12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6 months to 18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more person. Conclusions Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. PMID:23408579

  19. Internet delivered diabetes self-management education: a review.

    Science.gov (United States)

    Pereira, Katherine; Phillips, Beth; Johnson, Constance; Vorderstrasse, Allison

    2015-01-01

    Diabetes self-management education is a cornerstone of successful diabetes management. Various methods have been used to reach the increasing numbers of patients with diabetes, including Internet-based education. The purpose of this article is to review various delivery methods of Internet diabetes education that have been evaluated, as well as their effectiveness in improving diabetes-related outcomes. Literature was identified in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Medline, EBSCO, the Cochrane Library, and the Web of Science databases through searches using the following terms: "type 2 diabetes AND internet/web based AND education" and "type 2 diabetes AND diabetes self-management education (DSME) AND web-based/internet OR technology assisted education." The search was limited to English language articles published in the last 10 years. The search yielded 111 articles; of these, 14 met criteria for inclusion in this review. Nine studies were randomized controlled trials, and study lengths varied from 2 weeks to 24 months, for a total of 2,802 participants. DSME delivered via the Internet is effective at improving measures of glycemic control and diabetes knowledge compared with usual care. In addition, results demonstrate that improved eating habits and increased attendance at clinic appointments occur after the online DSME, although engagement and usage of Internet materials waned over time. Interventions that included an element of interaction with healthcare providers were seen as attractive to participants. Internet-delivered diabetes education has the added benefit of easier access for many individuals, and patients can self-pace themselves through materials. More research on the cost-benefits of Internet diabetes education and best methods to maintain patient engagement are needed, along with more studies assessing the long-term impact of Internet-delivered DSME.

  20. Overt attention and context factors: the impact of repeated presentations, image type, and individual motivation.

    Directory of Open Access Journals (Sweden)

    Kai Kaspar

    Full Text Available The present study investigated the dynamic of the attention focus during observation of different categories of complex scenes and simultaneous consideration of individuals' memory and motivational state. We repeatedly presented four types of complex visual scenes in a pseudo-randomized order and recorded eye movements. Subjects were divided into groups according to their motivational disposition in terms of action orientation and individual rating of scene interest.Statistical analysis of eye-tracking data revealed that the attention focus successively became locally expressed by increasing fixation duration; decreasing saccade length, saccade frequency, and single subject's fixation distribution over images; and increasing inter-subject variance of fixation distributions. The validity of these results was supported by verbal reports. This general tendency was weaker for the group of subjects who rated the image set as interesting as compared to the other group. Additionally, effects were partly mediated by subjects' motivational disposition. Finally, we found a generally strong impact of image type on eye movement parameters. We conclude that motivational tendencies linked to personality as well as individual preferences significantly affected viewing behaviour. Hence, it is important and fruitful to consider inter-individual differences on the level of motivation and personality traits within investigations of attention processes. We demonstrate that future studies on memory's impact on overt attention have to deal appropriately with several aspects that had been out of the research focus until now.

  1. Delivering Online Examinations: A Case Study

    Directory of Open Access Journals (Sweden)

    John MESSING

    2004-07-01

    Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

  2. Develop your presentation skills

    CERN Document Server

    Theobald, Theo

    2016-01-01

    Going beyond handling nerves and presenting PowerPoint slides, the third edition of "Develop Your Presentation Skills "offers practical advice on developing a captivating presentation, constructing compelling content, and boosting self-confidence. The book includes three new chapters on delivering a "stripped down"presentation, using new media to engage with the audience, and handling being asked to present on short notice."

  3. A Holistic Approach to Delivering Sustainable Design Education in Civil Engineering

    Science.gov (United States)

    Vemury, Chandra Mouli; Heidrich, Oliver; Thorpe, Neil; Crosbie, Tracey

    2018-01-01

    Purpose: The purpose of this paper is to present pedagogical approaches developed and implemented to deliver sustainable design education (SDE) to second-year undergraduate students on civil engineering programmes in the (then) School of Civil Engineering and Geosciences at Newcastle University. In doing so, the work presented offers an example of…

  4. What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder? A randomized controlled trial.

    Science.gov (United States)

    Bring, Annika; Åsenlöf, Pernilla; Söderlund, Anne

    2016-05-01

    To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders. A multicentre, randomized, three-group design, with concealed allocation. A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden. Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions. Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention. Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group. An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions. © The Author(s) 2015.

  5. Delivering Instruction via Streaming Media: A Higher Education Perspective.

    Science.gov (United States)

    Mortensen, Mark; Schlieve, Paul; Young, Jon

    2000-01-01

    Describes streaming media, an audio/video presentation that is delivered across a network so that it is viewed while being downloaded onto the user's computer, including a continuous stream of video that can be pre-recorded or live. Discusses its use for nontraditional students in higher education and reports on implementation experiences. (LRW)

  6. The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention

    Science.gov (United States)

    2013-01-01

    Background The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. Methods The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants’ characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. Results A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. Conclusions With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle

  7. The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention.

    Science.gov (United States)

    Schneider, Francine; Schulz, Daniela N; Pouwels, Loes H L; de Vries, Hein; van Osch, Liesbeth A D M

    2013-08-05

    The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants' characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive

  8. Papers presented at the 7th status report of the Reprocessing and Waste Treatment Project

    International Nuclear Information System (INIS)

    1988-10-01

    The report contains all lectures on the present state of the R+D work which were delivered on the occasion of the 7th seminar on the present state of the Reprocessing and Waste Treatment Project in the Karlsruhe Nuclear Research Centre on 15/16 March 1988. The project is aimed at improving methods for nuclear waste disposal with regard to the German reprocessing plant for light-water reactor fuels currently under construction in Wackersdorf. The individual contributions were separately adapted for the INIS and EDB data banks. (RB) [de

  9. Inter-individual differences in how presentation modality affects verbal learning performance in children aged 5 to 16

    NARCIS (Netherlands)

    Meijs, Celeste; Hurks, Petra P M; Wassenberg, Renske; Feron, Frans J M; Jolles, Jelle

    2016-01-01

    This study examines inter-individual differences in how presentation modality affects verbal learning performance. Children aged 5 to 16 performed a verbal learning test within one of three presentation modalities: pictorial, auditory, or textual. The results indicated that a beneficial effect of

  10. Delivering an effective elearning program for psychiatrists in Ireland – a framework for other health professionals (presentation)

    LENUS (Irish Health Repository)

    Lawton, Aoife

    2010-11-18

    Up until September 2010 teaching was delivered in person by the College of Psychiatry in Ireland to its students. A move towards elearning was initiated and as part of this move, an online instruction module in “Health Information Literacy” based on the five steps of Evidence-Based-Medicine was developed. The Systems Librarian from the Health Service Executive wrote the content which was reviewed by a senior Psychiatrist in the college. The Librarian worked with the e-learning specialist at the College to develop the online e-tutorial. This consisted of seven lessons. Feedback to date has been positive. At the end of the module, participants received a certificate of achievement. The methodology used for this course could be expanded to other medical disciplines.

  11. SU-E-J-21: Advantages of Ultra Fast Radiation Dose Delivering

    International Nuclear Information System (INIS)

    Feng, Y

    2014-01-01

    Purpose: For delivering conformed dose to a moving tumor and sparing normal tissue, we presented an innovation that was combined a linear accelerator and a storage ring to generate ultra high dose rate. This innovation allows delivering prescribed dose to a moving target in such a short time period, for an example 0.1 second, during which the displacement of the target could be ignored. Methods: The advantages of this approach were evaluated based on normal tissue sparing, feasibility, accuracy, and time saving in clinical treatment. The target volume reduction with this innovation approach was demonstrated by analyzing the values of GTVs, ITVs, and PTVs obtained from 15 patients who had been diagnosed with malignant neoplasm of lung and treated with SBRT. The processes of SBRT treatment were investigated and advantages of this innovation in improving SBRT lung treatment were evaluated. Results: With the ultra-high dose rate, the target volumes could be reduced by ∼30% to 50%. The innovation combining with IGRT technique could deliver prescribed dose to moving target accurately with simpler procedures than that of adaptive approach. This new approach could reduce the time of guiding treatment by many times. The new technique make a new strategy became feasible that was to deliver the dose to a target when it moved to a desirable location, such as away from critical organs. Conclusion: Combining with IGRT technique, this innovation could significantly improve the accuracy to deliver dose to moving targets with a shorter time than conventional techniques. The innovation opens a door for new strategies to deliver dose to moving targets

  12. Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Seyffert, Michael; Lagisetty, Pooja; Landgraf, Jessica; Chopra, Vineet; Pfeiffer, Paul N.; Conte, Marisa L.; Rogers, Mary A. M.

    2016-01-01

    Background Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia. Objectives The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings. Data Sources We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials. Methods Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis. Results We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; pinternet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to

  13. Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Michael Seyffert

    Full Text Available Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia.The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings.We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials.Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis.We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001 with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017 compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004. The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013 in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post

  14. Voice Over the Internet Protocol as a Medium for Delivering Reading Intervention

    Directory of Open Access Journals (Sweden)

    Craig Wright

    2011-10-01

    Full Text Available Voice Over the Internet Protocol (VoIP holds promise as a platform by which services can be delivered to students in rural and remote regions who have reading difficulties. VoIP is an Internet-based protocol that allows two or more individuals to videoconference from remote locations. This study used a single-case research design to investigate whether VoIP would produce significant gains in reading ability in BM, a 10-year-old with long-standing word-level reading problems. BM was provided with a theoretically motivated reading intervention 4 times weekly. The intervention was delivered remotely using the Apple iChat software. Substantial growth in regular- and nonword reading covaried with onset and removal of treatment. Treatment gains were maintained at 10-week follow-up. Meaningful gains were also seen in text-reading accuracy and reading comprehension. VoIP-based instruction represents an important avenue for future research and is a teaching method that holds much promise for rural and remote students.

  15. Delivering high performance BWR fuel reliably

    International Nuclear Information System (INIS)

    Schardt, J.F.

    1998-01-01

    Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

  16. A Sentiment Delivering Estimate Scheme Based on Trust Chain in Mobile Social Network

    Directory of Open Access Journals (Sweden)

    Meizi Li

    2015-01-01

    Full Text Available User sentiment analysis has become a flourishing frontier in data mining mobile social network platform since the mobile social network plays a significant role in users’ daily communication and sentiment interaction. This study studies the scheme of sentiment estimate by using the users’ trustworthy relationships for evaluating sentiment delivering. First, we address an overview of sentiment delivering estimate scheme and propose its related definitions, that is, trust chain among users, sentiment semantics, and sentiment ontology. Second, this study proposes the trust chain model and its evaluation method, which is composed of evaluation of atomic, serial, parallel, and combined trust chains. Then, we propose sentiment modeling method by presenting its modeling rules. Further, we propose the sentiment delivering estimate scheme from two aspects: explicit and implicit sentiment delivering estimate schemes, based on trust chain and sentiment modeling method. Finally, examinations and results are given to further explain effectiveness and feasibility of our scheme.

  17. Delivering high performance BWR fuel reliably

    Energy Technology Data Exchange (ETDEWEB)

    Schardt, J.F. [GE Nuclear Energy, Wilmington, NC (United States)

    1998-07-01

    Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

  18. Long-term corporate climate change targets: What could they deliver?

    International Nuclear Information System (INIS)

    Gouldson, Andy; Sullivan, Rory

    2013-01-01

    Highlights: ► Increasingly, companies are setting long-term greenhouse gas emission reduction targets. ► Many of these corporate targets appear to exceed those being set by national governments. ► Achieving these corporate targets relies on energy prices remaining high. ► Weaknesses in corporate reporting make it difficult to tell whether targets are being achieved. -- Abstract: Driven by the rising cost of energy, stakeholder pressure and the expectation that governments will continue to implement policy measures directed at reducing greenhouse gas emissions, an increasing number of companies have set targets to reduce their greenhouse gas emissions. These commitments raise two important questions. The first is whether they can be considered – individually or collectively – to be an appropriate response to the threat presented by climate change. The second is whether they are dependable; that is, can policy makers and other stakeholders can rely on companies to deliver on the commitments that they have made? This article examines these two questions using the case of the UK supermarket sector to illustrate and explain the issues at stake and, more generally, to examine the contribution that these types of voluntary commitments can make to wider public policy goals on climate change. The reasons for focusing on the UK supermarket sector are that the companies in this sector are some of the largest retailers in the world, they are significant emitters (their direct emissions account for 0.9% of UK carbon emissions, and some indications suggest that their indirect emissions account for ten times as much), and they are less heavily regulated that other sectors with comparable carbon footprints. The article concludes that the targets being set voluntarily by companies in this sector align with, or may even exceed, the climate change policy goals being set by national governments. Moreover, the article concludes that the companies targets are plausible and

  19. The Oratorical Scientist: A Guide for Speechcraft and Presentation for Scientists

    Science.gov (United States)

    Lau, G. E.

    2015-12-01

    Public speaking organizations are highly valuable for individuals seeking to improve their skills in speech development and delivery. The methodology of such groups usually focuses on repetitive, guided practice. Toastmasters International, for instance, uses a curriculum based on topical manuals that guide their members through some number of prepared speeches with specific goals for each speech. I have similarly developed a public speaking manual for scientists with the intention of guiding scientists through the development and presentation of speeches that will help them hone their abilities as public speakers. I call this guide The Oratorical Scientist. The Oratorical Scientist will be a free, digital publication that is meant to guide scientists through five specific types of speech that the scientist may be called upon to deliver during their career. These five speeches are: The Coffee Talk, The Educational Talk, Research Talks for General Science Audiences, Research Talks for Specific Subdiscipline Audiences, and Taking the Big Stage (talks for public engagement). Each section of the manual focuses on speech development, rehearsal, and presentation for each of these specific types of speech. The curriculum was developed primarily from my personal experiences in public engagement. Individuals who use the manual may deliver their prepared speeches to groups of their peers (e.g. within their research group) or through video sharing websites like Youtube and Vimeo. Speeches that are broadcast online can then be followed and shared through social media networks (e.g. #OratoricalScientist), allowing a larger audience to evaluate the speech and to provide criticism. I will present The Oratorical Scientist, a guide for scientists to become better public speakers. The process of guided repetitive practice of scientific talks will improve the speaking capabilities of scientists, in turn benefitting science communication and public engagement.

  20. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1966-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1965 in compliance with requests the Agency had made under Article IX. D. Part III contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

  1. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1965-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1964 in compliance with requests the Agency had made under Article IX. D. Part II contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

  2. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1968-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1968 in compliance with requests the Agency had made under Article IX,D. Part II contains information about materials which had not been delivered by 30 June 1968 but which had been allocated, in accordance with Article XI.F.I of the Statute, to approved Agency projects for which project arrangements were in force on that date

  3. How to deliver better policy integration?

    International Nuclear Information System (INIS)

    Hattori, Takashi

    2015-01-01

    Several challenges and possible ways forward in reconciling the delivery of energy policy goals including security and affordability are presented, based on the recent analyses by the International Energy Agency (IEA). This article addresses five topics: multiple challenging policy goals of the IEA’s 3 E’s (energy security, economic growth, and environmental sustainability); needs in the transformation to low carbon societies in the energy sectors; major policies and measures for energy sector transformation; multiple related policy goals and multiple benefits of energy efficiency policy; and realising climate and energy policy integration. Overall, this article explores how to better deliver climate and energy policy integration in the real world.

  4. The relation of breech presentation at term to epilepsy in childhood

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens

    2006-01-01

    with epilepsy until year 1996. For each case delivered in breech presentation (n = 290), the two subsequent deliveries of non-malformed, singleton infants delivered in breech presentation at term at the same hospital were selected as controls (n = 580). RESULTS: Breech presentation was a risk factor...

  5. Treatment of child anxiety disorders via guided parent-delivered cognitive-behavioural therapy: randomised controlled trial.

    Science.gov (United States)

    Thirlwall, Kerstin; Cooper, Peter J; Karalus, Jessica; Voysey, Merryn; Willetts, Lucy; Creswell, Cathy

    2013-12-01

    Promising evidence has emerged of clinical gains using guided self-help cognitive-behavioural therapy (CBT) for child anxiety and by involving parents in treatment; however, the efficacy of guided parent-delivered CBT has not been systematically evaluated in UK primary and secondary settings. To evaluate the efficacy of low-intensity guided parent-delivered CBT treatments for children with anxiety disorders. A total of 194 children presenting with a current anxiety disorder, whose primary carer did not meet criteria for a current anxiety disorder, were randomly allocated to full guided parent-delivered CBT (four face-to-face and four telephone sessions) or brief guided parent-delivered CBT (two face-to-face and two telephone sessions), or a wait-list control group (trial registration: ISRCTN92977593). Presence and severity of child primary anxiety disorder (Anxiety Disorders Interview Schedule for DSM-IV, child/parent versions), improvement in child presentation of anxiety (Clinical Global Impression - Improvement scale), and change in child anxiety symptoms (Spence Children's Anxiety Scale, child/parent version and Child Anxiety Impact scale, parent version) were assessed at post-treatment and for those in the two active treatment groups, 6 months post-treatment. Full guided parent-delivered CBT produced superior diagnostic outcomes compared with wait-list at post-treatment, whereas brief guided parent-delivered CBT did not: at post-treatment, 25 (50%) of those in the full guided CBT group had recovered from their primary diagnosis, compared with 16 (25%) of those on the wait-list (relative risk (RR) 1.85, 95% CI 1.14-2.99); and in the brief guided CBT group, 18 participants (39%) had recovered from their primary diagnosis post-treatment (RR = 1.56, 95% CI 0.89-2.74). Level of therapist training and experience was unrelated to child outcome. Full guided parent-delivered CBT is an effective and inexpensive first-line treatment for child anxiety.

  6. Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel

    Science.gov (United States)

    Trucks Seattle Bakery Delivers With Biodiesel Trucks to someone by E-mail Share Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Facebook Tweet about Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Twitter Bookmark Alternative Fuels

  7. Non-Dam Alternatives for Delivering Water Services at Least Cost and Risk

    Directory of Open Access Journals (Sweden)

    Michael P. Totten

    2010-06-01

    We present evidence that a value-adding and risk-minimising water planning process can be achieved by shifting from the conventional focus on supply expansion to one that concentrates on efficiently delivering services at and near the point of use. The State of California has two decades of experience with this approach, demonstrating that market-based policy and regulatory innovations can unleash efficiency gains resulting in more utility water services and energy services delivered with less supply expansion at lower costs, while minimising climate-change risk, pollution and the social cost that accompany large infrastructural projects. Efficiency in delivered water services could be accomplished with investments in the range of US$10-25 billion annually, while obviating the need for spending hundreds of billions of dollars on more expensive hydropower and related infrastructural expansion projects. The shift to a regulatory system that encompasses cost-effective end-use efficiency improvements in delivering water and energy services could eliminate the need for an estimated half of all proposed dams globally, thus allowing for the maintenance of other ecosystem service benefits and offer the best hopes of meeting basic human needs for water at a more achievable level of investment.

  8. Delivering business analytics practical guidelines for best practice

    CERN Document Server

    Stubbs, Evan

    2013-01-01

    AVOID THE MISTAKES THAT OTHERS MAKE - LEARN WHAT LEADS TO BEST PRACTICE AND KICKSTART SUCCESS This groundbreaking resource provides comprehensive coverage across all aspects of business analytics, presenting proven management guidelines to drive sustainable differentiation. Through a rich set of case studies, author Evan Stubbs reviews solutions and examples to over twenty common problems spanning managing analytics assets and information, leveraging technology, nurturing skills, and defining processes. Delivering Business Analytics also outlines the Data Scientist's Code, fifteen principle

  9. Organization-and-technological model of medical care delivered to patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Kiselev A.R.

    2014-09-01

    Full Text Available Organization-and-technological model of medical care delivered to patients with arterial hypertension based on IDEF0 methodology and corresponded with clinical guidelines is presented.

  10. Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Seyffert, Michael; Lagisetty, Pooja; Landgraf, Jessica; Chopra, Vineet; Pfeiffer, Paul N; Conte, Marisa L; Rogers, Mary A M

    2016-01-01

    Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia. The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings. We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials. Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis. We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; pcognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post-treatment assessment. There were no statistically

  11. Accuracy of the Approximation Function Deduced from the Fixed 3-Points Calibration Delivered with the Cernox™ Sensor

    CERN Document Server

    Balle, C; Fortescue-Beck, E; Vauthier, N

    2013-01-01

    The cernox™ sensor is delivered with a 3-point resistance versus temperature cal-ibration that permits the construction of an individual interpolation table by using the data in the CERN thermometer database. For instance at the 4.2 K point, the individual calibration and the manufacturer data are within +/-0.1 K for 99.39% of a sample population of about 5700 sensors. Preliminary results also indicate that accuracies of 0.1 K and 1 K can be obtained below respectively 5 K and 77 K.

  12. Effect of Maternal and Pregnancy Risk Factors on Early Neonatal Death in Planned Home Births Delivering at Home.

    Science.gov (United States)

    Bachilova, Sophia; Czuzoj-Shulman, Nicholas; Abenhaim, Haim Arie

    2018-05-01

    The prevalence of home birth in the United States is increasing, although its safety is undetermined. The objective of this study was to investigate the effects of obstetrical risk factors on early neonatal death in planned home births delivering at home. The authors conducted a retrospective 3-year cohort study consisting of planned home births that delivered at home in the United States between 2011 and 2013. The study excluded infants with congenital and chromosomal anomalies and infants born at ≤34 weeks' gestation. Multivariate logistic regression models were used to estimate the adjusted effects of individual obstetrical variables on early neonatal deaths within 7 days of delivery. During the study period, there were 71 704 planned and delivered home births. The overall early neonatal death rate was 1.5 deaths per 1000 planned home births. The risks of early neonatal death were significantly higher in nulliparous births (OR 2.71; 95% CI 1.71-4.31), women with a previous CS (OR 2.62, 95% CI 1.25-5.52), non-vertex presentations (OR 4.27; 95% CI 1.33-13.75), plural births (OR 9.79; 95% CI 4.25-22.57), preterm births (OR 4.68; 95% CI 2.30-9.51), and births at ≥41 weeks of gestation (OR 1.76; 95% CI 1.09-2.84). Early neonatal deaths occur more commonly in certain obstetrical contexts. Patient selection may reduce adverse neonatal outcomes among planned home births. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  13. Social Goals and Conflict Strategies of Individuals with Mild to Moderate Intellectual Disabilities Who Present Problems of Aggression

    Science.gov (United States)

    Pert, C.; Jahoda, A.

    2008-01-01

    Background: A few recent studies have adopted a social cognitive perspective to explore how individuals with intellectual disabilities (IDs), who present problems of aggression, view their social world. The focus has mainly been on participants' perceptions of others' behaviour within conflict situations. The present exploratory study aims to…

  14. Live Cell Characterization of DNA Aggregation Delivered through Lipofection.

    Science.gov (United States)

    Mieruszynski, Stephen; Briggs, Candida; Digman, Michelle A; Gratton, Enrico; Jones, Mark R

    2015-05-27

    DNA trafficking phenomena, such as information on where and to what extent DNA aggregation occurs, have yet to be fully characterised in the live cell. Here we characterise the aggregation of DNA when delivered through lipofection by applying the Number and Brightness (N&B) approach. The N&B analysis demonstrates extensive aggregation throughout the live cell with DNA clusters in the extremity of the cell and peri-nuclear areas. Once within the nucleus aggregation had decreased 3-fold. In addition, we show that increasing serum concentration of cell media results in greater cytoplasmic aggregation. Further, the effects of the DNA fragment size on aggregation was explored, where larger DNA constructs exhibited less aggregation. This study demonstrates the first quantification of DNA aggregation when delivered through lipofection in live cells. In addition, this study has presents a model for alternative uses of this imaging approach, which was originally developed to study protein oligomerization and aggregation.

  15. Reduced IL-7R T Cell Expression and Increased Plasma sCD127 in Late Presenting HIV-Infected Individuals

    DEFF Research Database (Denmark)

    Hartling, Hans J; Jespersen, Sofie; Gaardbo, Julie C

    2017-01-01

    homeostasis. This study aimed to describe IL-7R and IL-7 before and after initiation of cART in late presenting HIV-infected individuals, and the impact on immune recovery and T cell subset distribution after initiation of cART. METHODS: A total of 100 HIV-infected individuals initiating cART were included......BACKGROUND: Late presentation of HIV infection is associated with reduced chance of optimal immune recovery after initiating combination antiretroviral therapy (cART). Interleukin-7 (IL-7) and the corresponding receptor, IL-7 receptor (IL-7R) made up of CD127 and CD132, are crucial for T cell...

  16. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1962-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered up to 30 September 1962 by Member States in compliance with requests the Agency has made under Article IX. D. Part II contains information about materials which have not yet been delivered but which have been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project agreements were in force on 30 September 1962. Reports on subsequent deliveries of materials and revised information about allocated but undelivered materials will be issued from time to time

  17. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

    OpenAIRE

    Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

    2016-01-01

    Introduction The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. Methods and analysis This systematic review addresses the following question: in underserviced populations and low-reso...

  18. Organization-and-technological model of medical care delivered to patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Kiselev A.R.

    2014-09-01

    Full Text Available Organization-and-technological model of medical care delivered to patients with chronic heart failure based on IDEF0 methodology and corresponded with clinical guidelines is presented.

  19. Organization-and-technological model of medical care delivered to patients with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Popova Y.V.

    2014-09-01

    Full Text Available Organization-and-technological model of medical care delivered to patients with coronary heart disease based on IDEF0 methodology and corresponded with clinical guidelines is presented.

  20. Low dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized 4-way crossover trial with nasal cavity dimension assessment

    OpenAIRE

    Quintana, Daniel; Westlye, Lars Tjelta; Rustan, Øyvind; Tesli, Natalia; Poppy, Claire; Smevik, Hanne; Tesli, Martin Steen; Røine, Marianne; Mahmoud, Ramy; Smerud, Knut Terje; Djupesland, Per G.; Andreassen, Ole Andreas

    2015-01-01

    Despite the promise of intranasal oxytocin (OT) for modulating social behavior, recent work has provided mixed results. This may relate to suboptimal drug deposition achieved with conventional nasal sprays, inter-individual differences in nasal physiology and a poor understanding of how intranasal OT is delivered to the brain in humans. Delivering OT using a novel ?Breath Powered' nasal device previously shown to enhance deposition in intranasal sites targeted for nose-to-brain transport, we ...

  1. Content Validation of Athletic Therapy Clinical Presentations in Canada

    Science.gov (United States)

    Lafave, Mark R.; Yeo, Michelle; Westbrook, Khatija; Valdez, Dennis; Eubank, Breda; McAllister, Jenelle

    2016-01-01

    Context: Competency-based education requires strong planning and a vehicle to deliver and track students' progress across their undergraduate programs. Clinical presentations (CPs) are proposed as 1 method to deliver a competency-based curriculum in a Canadian undergraduate athletic therapy program. Objective: Validation of 253 CPs. Setting:…

  2. Predictors and moderators of response to internet-delivered Interpersonal Psychotherapy and Cognitive Behavior Therapy for depression.

    Science.gov (United States)

    Donker, T; Batterham, P J; Warmerdam, L; Bennett, K; Bennett, A; Cuijpers, P; Griffiths, K M; Christensen, H

    2013-10-01

    By identifying which predictors and moderators lead to beneficial outcomes, accurate selection of the best initial treatment will have significant benefits for depressed individuals. An automated, fully self-guided randomized controlled internet-delivered noninferiority trial was conducted comparing two new interventions (Interpersonal Psychotherapy [IPT; n=620] and Cognitive Behavioral Therapy [CBT; n=610]) to an active control intervention (MoodGYM; n=613) over a period of 4 weeks to spontaneous visitors of an internet-delivered therapy website (e-couch). A range of putative predictors and moderators (socio-demographic characteristics [age, gender, marital status, education level], clinical characteristics [depression/anxiety symptoms, disability, quality of life, medication use], skills [mastery and dysfunctional attitudes] and treatment preference) were assessed using internet-delivered self-report measures at baseline and immediately following treatment and at six months follow-up. Analyses were conducted using Mixed Model Repeated Measures (MMRM). Female gender, lower mastery and lower dysfunctional attitudes predicted better outcome at post-test and/or follow-up regardless of intervention. No overall differential effects for condition on depression as a function of outcome were found. However, based on time-specific estimates, a significant interaction effect of age was found. For younger people, internet-delivered IPT may be the preferred treatment choice, whereas older participants derive more benefits from internet-delivered CBT programs. Although the sample of participants was large, power to detect moderator effects was still lacking. Different e-mental health programs may be more beneficial for specific age groups. The findings raise important possibilities for increasing depression treatment effectiveness and improving clinical practice guidelines for depression treatment of different age groups. © 2013 Elsevier B.V. All rights reserved.

  3. Can learning health systems help organisations deliver personalised care?

    Science.gov (United States)

    Nwaru, Bright I; Friedman, Charles; Halamka, John; Sheikh, Aziz

    2017-10-02

    There is increasing international policy and clinical interest in developing learning health systems and delivering precision medicine, which it is hoped will help reduce variation in the quality and safety of care, improve efficiency, and lead to increasing the personalisation of healthcare. Although reliant on similar policies, informatics tools, and data science and implementation research capabilities, these two major initiatives have thus far largely progressed in parallel. In this opinion piece, we argue that they should be considered as complementary, synergistic initiatives whereby the creation of learning health systems infrastructure can support and catalyse the delivery of precision medicine that maximises the benefits and minimises the risks associated with treatments for individual patients. We illustrate this synergy by considering the example of treatments for asthma, which is now recognised as an umbrella term for a heterogeneous group of related conditions.

  4. The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities.

    Science.gov (United States)

    Marwood, Hayley; Chinn, Deborah; Gannon, Kenneth; Scior, Katrina

    2018-01-01

    People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear. Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT. The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs. Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access. © 2017 John Wiley & Sons Ltd.

  5. USL NASA/RECON project presentations at the 1985 ACM Computer Science Conference: Abstracts and visuals

    Science.gov (United States)

    Dominick, Wayne D. (Editor); Chum, Frank Y.; Gallagher, Suzy; Granier, Martin; Hall, Philip P.; Moreau, Dennis R.; Triantafyllopoulos, Spiros

    1985-01-01

    This Working Paper Series entry represents the abstracts and visuals associated with presentations delivered by six USL NASA/RECON research team members at the above named conference. The presentations highlight various aspects of NASA contract activities pursued by the participants as they relate to individual research projects. The titles of the six presentations are as follows: (1) The Specification and Design of a Distributed Workstation; (2) An Innovative, Multidisciplinary Educational Program in Interactive Information Storage and Retrieval; (3) Critical Comparative Analysis of the Major Commercial IS and R Systems; (4) Design Criteria for a PC-Based Common User Interface to Remote Information Systems; (5) The Design of an Object-Oriented Graphics Interface; and (6) Knowledge-Based Information Retrieval: Techniques and Applications.

  6. Internet-delivered cognitive-behavioral treatment for adolescents with chronic pain and their parents: a randomized controlled multicenter trial.

    Science.gov (United States)

    Palermo, Tonya M; Law, Emily F; Fales, Jessica; Bromberg, Maggie H; Jessen-Fiddick, Tricia; Tai, Gabrielle

    2016-01-01

    Internet-delivered interventions are emerging as a strategy to address barriers to care for individuals with chronic pain. This is the first large multicenter randomized controlled trial of Internet-delivered cognitive-behavioral therapy (CBT) for pediatric chronic pain. Participants included were 273 adolescents (205 females and 68 males), aged 11 to 17 years with mixed chronic pain conditions and their parents, who were randomly assigned in a parallel-group design to Internet-delivered CBT (n = 138) or Internet-delivered Education (n = 135). Assessments were completed before treatment, immediately after treatment, and at 6-month follow-up. All data collection and procedures took place online. The primary analysis used linear growth models. Results demonstrated significantly greater reduction on the primary outcome of activity limitations from baseline to 6-month follow-up for Internet CBT compared with Internet education (b = -1.13, P = 0.03). On secondary outcomes, significant beneficial effects of Internet CBT were found on sleep quality (b = 0.14, P = 0.04), on reducing parent miscarried helping (b = -2.66, P = 0.007) and protective behaviors (b = -0.19, P = 0.001), and on treatment satisfaction (P values parent-perceived impact (ie, reductions in depression, anxiety, self-blame about their adolescent's pain, and improvement in parent behavioral responses to pain). In conclusion, our Internet-delivered CBT intervention produced a number of beneficial effects on adolescent and parent outcomes, and could ultimately lead to wide dissemination of evidence-based psychological pain treatment for youth and their families.

  7. Oral microflora in infants delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

    2011-01-01

    International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

  8. Initial Progress Toward Development of a Voice-Based Computer-Delivered Motivational Intervention for Heavy Drinking College Students: An Experimental Study

    Science.gov (United States)

    Lechner, William J; MacGlashan, James; Wray, Tyler B; Littman, Michael L

    2017-01-01

    Background Computer-delivered interventions have been shown to be effective in reducing alcohol consumption in heavy drinking college students. However, these computer-delivered interventions rely on mouse, keyboard, or touchscreen responses for interactions between the users and the computer-delivered intervention. The principles of motivational interviewing suggest that in-person interventions may be effective, in part, because they encourage individuals to think through and speak aloud their motivations for changing a health behavior, which current computer-delivered interventions do not allow. Objective The objective of this study was to take the initial steps toward development of a voice-based computer-delivered intervention that can ask open-ended questions and respond appropriately to users’ verbal responses, more closely mirroring a human-delivered motivational intervention. Methods We developed (1) a voice-based computer-delivered intervention that was run by a human controller and that allowed participants to speak their responses to scripted prompts delivered by speech generation software and (2) a text-based computer-delivered intervention that relied on the mouse, keyboard, and computer screen for all interactions. We randomized 60 heavy drinking college students to interact with the voice-based computer-delivered intervention and 30 to interact with the text-based computer-delivered intervention and compared their ratings of the systems as well as their motivation to change drinking and their drinking behavior at 1-month follow-up. Results Participants reported that the voice-based computer-delivered intervention engaged positively with them in the session and delivered content in a manner consistent with motivational interviewing principles. At 1-month follow-up, participants in the voice-based computer-delivered intervention condition reported significant decreases in quantity, frequency, and problems associated with drinking, and increased

  9. Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study

    Science.gov (United States)

    Galvão Gomes da Silva, Joana; Kavanagh, David J; Belpaeme, Tony; Taylor, Lloyd; Beeson, Konna

    2018-01-01

    Background Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. Objective The aim of this study was to explore participants’ qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. Methods NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot’s head sensor. Evaluations were content-analyzed utilizing Boyatzis’ steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. Results Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for

  10. Delivered volumes of enteral nutrition exceed prescribed volumes.

    Science.gov (United States)

    Walker, Renee Nichole; Utech, Anne; Velez, Maria Eugenia; Schwartz, Katie

    2014-10-01

    Enteral nutrition (EN) provisions are typically calculated based on a 24-hour infusion period. However, feedings are often interrupted for daily activities, procedures, or gastrointestinal intolerance. The study's objective was to determine the delivered EN quantities provided to stable hospitalized patients, using cellular time and measured volumes to verify our EN calculation adjustment. A supply of consecutively numbered ready-to-hang (RTH) EN product was delivered to the bedside of 26 inpatients with established EN tolerance at goal rates on various types of nursing units. The dietitian weighed the volume remaining in the infusing product and recorded the measurement time. On the following days, the dietitian continued to weigh the infusing RTH product and the empty RTH bottles saved by nursing. The primary outcome was the difference between the prescribed and delivered EN provisions, which was calculated with a paired t test. Patients received significantly more calories in the delivered enteral feeding (mean [SD], 1678 [385] kcal) than prescribed calories in the EN order (1489 [246 kcal]; t = 3.736, P = .001), adjusting for observed time. No significant differences were found between nursing units, product, and rate. EN delivered may actually exceed ordered amounts by 5%–21% (mean, 12%) with feeding pump inaccuracy as the primary contributing factor. This differs from what others have found. Our findings support using a volume-based ordering system vs a rate-based ordering system for more accurate EN delivery.

  11. Evaluation of active transition, a website-delivered physical activity intervention for university students: pilot study.

    Science.gov (United States)

    Kwan, Matthew; Faulkner, Guy; Bray, Steven

    2013-04-29

    While physical activity in individuals tends to decline steadily with age, there are certain periods where this decline occurs more rapidly, such as during early adulthood. Interventions aimed at attenuating the declines in physical activity during this transition period appear warranted. The purpose of the study was to test the feasibility and efficacy of a theoretically informed, website-delivered physical activity intervention aimed at students entering university. Using a quasi-experimental design, 65 participants (44 females; mean age 18.51, SD 0.91) were assigned to either an intervention (receiving website access plus weekly prompts) or comparison condition (receiving unprompted website access only), completing questionnaires at baseline and follow-up 8 weeks later. The intervention website, "Active Transition", was specifically designed to target students' physical activity cognitions and self-regulatory skills. Intervention usage was low, with only 47% (18/38) of participants assigned to the intervention condition logging into the website 2 or more times. Among the broader student sample, there were significant declines in students' physical activity behaviors (F1,63=18.10, Pusers (29/65, individuals logging in 2 or more times) and non-users (36/65, individuals logging in once or not at all), there was a significant interaction effect for intervention usage and time on perceived behavioral control (F1,62=5.13, P=.03). Poor intervention usage suggests that future efforts need to incorporate innovative strategies to increase intervention uptake and better engage the student population. The findings, however, suggest that a website-delivered intervention aimed at this critical life stage may have positive impact on students' physical activity cognitions. Future studies with more rigorous sampling designs are required.

  12. Adaptation of community health worker-delivered behavioral activation for torture survivors in Kurdistan, Iraq.

    Science.gov (United States)

    Magidson, J F; Lejuez, C W; Kamal, T; Blevins, E J; Murray, L K; Bass, J K; Bolton, P; Pagoto, S

    2015-12-01

    Growing evidence supports the use of Western therapies for the treatment of depression, trauma, and stress delivered by community health workers (CHWs) in conflict-affected, resource-limited countries. A recent randomized controlled trial (Bolton et al . 2014 a ) supported the efficacy of two CHW-delivered interventions, cognitive processing therapy (CPT) and brief behavioral activation treatment for depression (BATD), for reducing depressive symptoms and functional impairment among torture survivors in the Kurdish region of Iraq. This study describes the adaptation of the CHW-delivered BATD approach delivered in this trial (Bolton et al .2014 a ), informed by the Assessment-Decision-Administration-Production-Topical experts-Integration-Training-Testing (ADAPT-ITT) framework for intervention adaptation (Wingood & DiClemente, 2008). Cultural modifications, adaptations for low-literacy, and tailored training and supervision for non-specialist CHWs are presented, along with two clinical case examples to illustrate delivery of the adapted intervention in this setting. Eleven CHWs, a study psychiatrist, and the CHW clinical supervisor were trained in BATD. The adaptation process followed the ADAPT-ITT framework and was iterative with significant input from the on-site supervisor and CHWs. Modifications were made to fit Kurdish culture, including culturally relevant analogies, use of stickers for behavior monitoring, cultural modifications to behavioral contracts, and including telephone-delivered sessions to enhance feasibility. BATD was delivered by CHWs in a resource-poor, conflict-affected area in Kurdistan, Iraq, with some important modifications, including low-literacy adaptations, increased cultural relevancy of clinical materials, and tailored training and supervision for CHWs. Barriers to implementation, lessons learned, and recommendations for future efforts to adapt behavioral therapies for resource-limited, conflict-affected areas are discussed.

  13. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1969-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1969 in compliance with requests the Agency had made under Article IX. D

  14. Initial Progress Toward Development of a Voice-Based Computer-Delivered Motivational Intervention for Heavy Drinking College Students: An Experimental Study.

    Science.gov (United States)

    Kahler, Christopher W; Lechner, William J; MacGlashan, James; Wray, Tyler B; Littman, Michael L

    2017-06-28

    Computer-delivered interventions have been shown to be effective in reducing alcohol consumption in heavy drinking college students. However, these computer-delivered interventions rely on mouse, keyboard, or touchscreen responses for interactions between the users and the computer-delivered intervention. The principles of motivational interviewing suggest that in-person interventions may be effective, in part, because they encourage individuals to think through and speak aloud their motivations for changing a health behavior, which current computer-delivered interventions do not allow. The objective of this study was to take the initial steps toward development of a voice-based computer-delivered intervention that can ask open-ended questions and respond appropriately to users' verbal responses, more closely mirroring a human-delivered motivational intervention. We developed (1) a voice-based computer-delivered intervention that was run by a human controller and that allowed participants to speak their responses to scripted prompts delivered by speech generation software and (2) a text-based computer-delivered intervention that relied on the mouse, keyboard, and computer screen for all interactions. We randomized 60 heavy drinking college students to interact with the voice-based computer-delivered intervention and 30 to interact with the text-based computer-delivered intervention and compared their ratings of the systems as well as their motivation to change drinking and their drinking behavior at 1-month follow-up. Participants reported that the voice-based computer-delivered intervention engaged positively with them in the session and delivered content in a manner consistent with motivational interviewing principles. At 1-month follow-up, participants in the voice-based computer-delivered intervention condition reported significant decreases in quantity, frequency, and problems associated with drinking, and increased perceived importance of changing drinking

  15. Contractor firm strategies in delivering green project: A review

    Science.gov (United States)

    Powmya, Ayisha; Abidin, Nazirah Zainul; Azizi, Nurul Sakina Mokhtar

    2017-10-01

    Building green requires effort from various parties, from those who plan, design, manage and construct the building. Contractors are responsible for converting the design on paper into a real building and their role at the construction site support environmental sustainability by implementing responsible construction practices. Inefficient or inexperienced contractor in green construction project may find that delivering this type of project is not an easy task due to added requirement in design, stringent practices at site and the use of green technology and materials. Adopting suitable strategies at firm level will assist in preparatory process and readiness of delivering the green project. This paper reviews the strategies at firm level to deliver green construction project. From extensive literature review, it was discovered that there are six strategies to be adopted by the contractor. Understanding these strategies is expected to promote more contractors to be proactive in delivering green projects.

  16. Maternal and neonatal complications in term breech delivered vaginally

    International Nuclear Information System (INIS)

    Jadoon, S.; Jadoon, S.M.K.; Shah, R.

    2008-01-01

    To evaluate the maternal and neonatal complications in terms of genital tract trauma to mother, perinatal mortality. Apgar score at 5 minutes and neonatal trauma in all singleton term breech cases delivered vaginally. A 100 consecutive patients with singleton breech presentation, whether booked or unbooked, were admitted and delivered vaginally in hospital during the study period. They were studied for maternal and neonatal complications. Maternal complication included any genital tract trauma during delivery while neonatal complications were perinatal mortality, low Apgar score (less than eight at 5 minutes) and birth trauma. There were a total 3977 deliveries during this study period, 145 breech presentation (incidence 3.6%). Out of those, 100 were included in the study. All were unbooked cases, 87% were multigravida while 13% were primigravida. An Apgar score of eight was recorded in 87% babies while 10% had an Apgar score of less than eight after 5 minutes. There were 3 still births and one neonatal death. Aggregated perinatal mortality rate was 40/1000 live births. Only one baby had birth trauma (Erbs paralysis) during vaginal breech delivery. Ninety seven (97%) mothers had no complications while only 3 (3%) had complications. Out of these, one had cervical tear and 2 had vaginal tears. Offering a trial of vaginal breech delivery to strictly selected and well-counselled patients remains an appropriate option without compromising perinatal and maternal outcome. It also decreases the rate of operative delivery for this malpresentation. (author)

  17. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1975-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 30 June 1975, in compliance with requests the Agency had made under Article IX. D

  18. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1974-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 31 March 1974, in compliance with requests the Agency had made under Article IX. D

  19. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1971-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1970, in compliance with requests the Agency had made under Article IX. D

  20. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1973-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1972, in compliance with requests the Agency had made under Article IX. D

  1. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1972-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1971, in compliance with requests the Agency had made under Article IX. D

  2. Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas

    Science.gov (United States)

    Trucks Golden Eagle Delivers Beer With Natural Gas Trucks to someone by E-mail Share Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas Trucks on Facebook Tweet about Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas Trucks on Twitter Bookmark

  3. IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients

    International Nuclear Information System (INIS)

    Fregnani, Eduardo Rodrigues; Parahyba, Cláudia Joffily; Morais-Faria, Karina; Fonseca, Felipe Paiva; Ramos, Pedro Augusto Mendes; Moraes, Fábio Yone de; Conceição Vasconcelos, Karina Gondim Moutinho da; Menegussi, Gisela; Santos-Silva, Alan Roger; Brandão, Thais B.

    2016-01-01

    Radiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient’s morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed. Therefore, the aim of this study is to assess whether IMRT delivers lower radiation doses to dental structures than conformal 3D radiotherapy (3DRT). Radiation dose delivery to dental structures of 80 patients treated for head and neck cancers (oral cavity, tongue, nasopharynx and oropharynx) with IMRT (40 patients) and 3DRT (40 patients) were assessed by individually contouring tooth crowns on patients’ treatment plans. Clinicopathological data were retrieved from patients’ medical files. The average dose of radiation to teeth delivered by IMRT was significantly lower than with 3DRT (p = 0.007); however, only patients affected by nasopharynx and oral cavity cancers demonstrated significantly lower doses with IMRT (p = 0.012 and p = 0.011, respectively). Molars received more radiation with both 3DRT and IMRT, but the latter delivered significantly lower radiation in this group of teeth (p < 0.001), whereas no significant difference was found for the other dental groups. Maxillary teeth received lower doses than mandibular teeth, but only IMRT delivered significantly lower doses (p = 0.011 and p = 0.003). Ipsilateral teeth received higher doses than contralateral teeth with both techniques and IMRT delivered significantly lower radiation than 3DRT for contralateral dental structures (p < 0.001). IMRT delivered lower radiation doses to teeth than 3DRT, but only for some groups of patients and

  4. IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients.

    Science.gov (United States)

    Fregnani, Eduardo Rodrigues; Parahyba, Cláudia Joffily; Morais-Faria, Karina; Fonseca, Felipe Paiva; Ramos, Pedro Augusto Mendes; de Moraes, Fábio Yone; da Conceição Vasconcelos, Karina Gondim Moutinho; Menegussi, Gisela; Santos-Silva, Alan Roger; Brandão, Thais B

    2016-09-07

    Radiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient's morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed. Therefore, the aim of this study is to assess whether IMRT delivers lower radiation doses to dental structures than conformal 3D radiotherapy (3DRT). Radiation dose delivery to dental structures of 80 patients treated for head and neck cancers (oral cavity, tongue, nasopharynx and oropharynx) with IMRT (40 patients) and 3DRT (40 patients) were assessed by individually contouring tooth crowns on patients' treatment plans. Clinicopathological data were retrieved from patients' medical files. The average dose of radiation to teeth delivered by IMRT was significantly lower than with 3DRT (p = 0.007); however, only patients affected by nasopharynx and oral cavity cancers demonstrated significantly lower doses with IMRT (p = 0.012 and p = 0.011, respectively). Molars received more radiation with both 3DRT and IMRT, but the latter delivered significantly lower radiation in this group of teeth (p dental groups. Maxillary teeth received lower doses than mandibular teeth, but only IMRT delivered significantly lower doses (p = 0.011 and p = 0.003). Ipsilateral teeth received higher doses than contralateral teeth with both techniques and IMRT delivered significantly lower radiation than 3DRT for contralateral dental structures (p radiation doses to teeth than 3DRT, but only for some groups of patients and teeth, suggesting that this decrease was more likely due to the protection of

  5. Support for hands-on optics immersions (Conference Presentation)

    Science.gov (United States)

    Spalding, Gabriel C.; McCann, Lowell I.

    2016-09-01

    The Advanced Laboratory Physics Association (ALPhA) is an official affiliate organization of the AAPT, supporting upper-level undergraduate instructional lab education in physics. The ALPhA Immersions program is intended to be an efficient use of an instructor's time: with expert colleague-mentors on hand they spend 2.5 days learning a key new instructional experiment (of their choice) well enough to confidently teach it to the students at their home institutions. At an ALPhA Immersion, participants work in groups of no more than three per experimental setup. Our follow-up surveys support the notion that this individualized, concentrated focus directly results in significant updating and improvement of undergraduate laboratory instruction in physics across the country. Such programs have the effect of encouraging investment, on the part of individual institutions. For example, we have disseminated ideas, training, and equipment for contemporary single-photon-based instructional labs dealing with core, contemporary issues in Quantum Mechanics. By the time this paper is presented, ALPhA will have delivered at least 420 single-photon detectors to a wide variety of educational institutions. We have also partnered with the non-profit Jonathan F. Reichert Foundation to support equipment acquisition by institutions participating in our wide variety of training programs.

  6. Individual psychological therapy in an acute inpatient setting: Service user and psychologist perspectives.

    Science.gov (United States)

    Small, Catherine; Pistrang, Nancy; Huddy, Vyv; Williams, Claire

    2018-01-18

    The acute inpatient setting poses potential challenges to delivering one-to-one psychological therapy; however, there is little research on the experiences of both receiving and delivering therapies in this environment. This qualitative study aimed to explore service users' and psychologists' experiences of undertaking individual therapy in acute inpatient units. It focused on the relationship between service users and psychologists, what service users found helpful or unhelpful, and how psychologists attempted to overcome any challenges in delivering therapy. The study used a qualitative, interview-based design. Eight service users and the six psychologists they worked with were recruited from four acute inpatient wards. They participated in individual semi-structured interviews eliciting their perspectives on the therapy. Service users' and psychologists' transcripts were analysed together using Braun and Clarke's (2006, Qualitative Research in Psychology, 3, 77) method of thematic analysis. The accounts highlighted the importance of forming a 'human' relationship - particularly within the context of the inpatient environment - as a basis for therapeutic work. Psychological therapy provided valued opportunities for meaning-making. To overcome the challenges of acute mental health crisis and environmental constraints, psychologists needed to work flexibly and creatively; the therapeutic work also extended to the wider context of the inpatient unit, in efforts to promote a shared understanding of service users' difficulties. Therapeutic relationships between service users and clinicians need to be promoted more broadly within acute inpatient care. Psychological formulation can help both service users and ward staff in understanding crisis and working collaboratively. Practice-based evidence is needed to demonstrate the effectiveness of adapted psychological therapy models. Developing 'human' relationships at all levels of acute inpatient care continues to be an

  7. A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults

    Science.gov (United States)

    Merriman, Niamh A.; Young, William R.; Newell, Fiona N.; Craig, Cathy

    2015-01-01

    Abstract Background: Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall. Study Design: Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments. Results: Balance game training had a significant effect on levels of functional balance and balance confidence (P risk of falls. The overall pattern of results suggests the training program is effective and suitable for individuals at all levels of ability and may therefore play a role in reducing the risk of falls. Conclusions: Commercial hardware can be modified to deliver engaging methods of effective balance assessment and training for the older population. PMID:26469308

  8. Current perspectives on Internet delivered cognitive behavioral therapy for adults with anxiety and related disorders

    Directory of Open Access Journals (Sweden)

    Mewton L

    2014-01-01

    Full Text Available Louise Mewton, Jessica Smith, Pieter Rossouw, Gavin Andrews Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Sydney, NSW, Australia Abstract: The aim of the current review is to provide a summary of research into Internet-delivered cognitive behavioral therapy (iCBT for anxiety disorders. We include 37 randomized controlled trials that examined the efficacy of iCBT programs in adults (aged over 18 years, as compared with waiting list or active control. The included studies were identified from Medline searches and from reference lists, and only published data were included. Several trials of iCBT for generalized anxiety disorder, panic disorder, and social phobia were identified. Two trials of iCBT for obsessive-compulsive disorder were identified, whilst one trial each was identified for hypochondriasis, specific phobia (spiders, and post-traumatic stress disorder. Finally, there were five trials that focused on transdiagnostic therapy for either a range of comorbid anxiety disorders or comorbid anxiety and depression. Between-group effect sizes were moderate to large for all disorders, and ranged from 0.30 to 2.53. iCBT was found to be commensurate with face-to-face cognitive behavioral therapy whether delivered individually or in group format. Guidance may not be necessary for iCBT to be effective for immediate gains, but may be more important in longer-term maintenance of symptom improvement and maximizing patient adherence. The clinical experience of the individual providing guidance does not appear to impact treatment outcomes. Future research needs to focus on the optimal level of guidance required to generate maximum patient benefits, whilst balancing the efficient use of clinician time and resources. Evidence-based contraindications to iCBT should also be developed so that the choice of treatment modality accurately reflects patients’ needs. Further research should be conducted into the effective elements of

  9. An exploration of factors related to dissemination of and exposure to internet-delivered behavior change interventions aimed at adults: A Delphi study approach

    NARCIS (Netherlands)

    W. Brouwer (Wendy); A. Oenema (Anke); R. Crutzen (Rik); J. de Nooijer (Jascha); N.K. de Vries (Nanne); J. Brug (Hans)

    2008-01-01

    textabstractBackground: The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of

  10. Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study.

    Science.gov (United States)

    Galvão Gomes da Silva, Joana; Kavanagh, David J; Belpaeme, Tony; Taylor, Lloyd; Beeson, Konna; Andrade, Jackie

    2018-05-03

    Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. The aim of this study was to explore participants' qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot's head sensor. Evaluations were content-analyzed utilizing Boyatzis' steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for change. Some participants felt that the

  11. Understanding the Experiences of Rural Community-Dwelling Older Adults in Using a New DVD-Delivered Otago Exercise Program: A Qualitative Study.

    Science.gov (United States)

    Agha, Arun; Liu-Ambrose, Teresa Y L; Backman, Catherine L; Leese, Jennifer; Li, Linda C

    2015-08-13

    The home-based Otago Exercise Program (OEP) has been shown to reduce the occurrence of falls in community-dwelling seniors. A new OEP DVD was recently developed for people living in rural communities to be used with minimal coaching by a physical therapist. This study aimed to understand older adults' experiences using the DVD-delivered OEP and explore barriers and facilitators to implementing the DVD-delivered OEP from the participants' perspectives. Rural community-dwelling older adults (75 years and older) who participated in a six-month DVD-delivered OEP study were invited to participate in this qualitative study. Two small group interviews were initially conducted to explore the breadth of participants' experiences with the program. These were followed by semi-structured individual interviews to gain an in-depth understanding of these experiences. An inductive constant comparison analysis of the transcripts was performed. To ensure methodological rigor, field notes, journaling, and an audit trail were maintained, supplemented by peer-review. Of 32 eligible participants, five participated in group interviews and 16 in individual interviews. Three themes emerged. Theme 1, The OEP DVD-useful training tool but in need of more pep, represented participants' experiences that the DVD provided important guidance at program onset, but was too slow and low-energy for longer-term use. Theme 2, Gaining control over one's exercise regimen, but sometimes life gets in the way of staying active, described participants' appreciation of the program's flexibility, but personal health concerns and everyday lives posed challenges to adhering to the program. Theme 3, Social creatures-wanting greater human connection during exercise, described how some participants desired further social interactions for enhancing motivation and receiving guidance. Individuals should be encouraged to refer to the OEP user manual or DVD as needed and engage friends and family in exercises. The

  12. TYPES OF ACADEMIC INTERNET-RESOURCES FOR IT STUDENTS’ INDIVIDUAL WORK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    O. Glazunova

    2014-11-01

    Full Text Available Individual work is one of the main forms of organization of academic process for students of IT specialties. Main practical professionally oriented skills and abilities are retained only due to students’ hard individual work while doing tasks in programming, algorithmization, designing etc. development of effective academic resources will help students to work individually as well as comfortable ways of delivering such materials with the help of Internet guarantees enhancing the quality of studies. Information and educational resources for independent work of students today are one of the most effective means. The technique of creating and using these tools requires constant research through the rapid development of new information technologies. The present article describes the most effective tools and technologies for creating online resources for self-study of IT students, grounded methods of their use in the educational process. The most commonly used tools for formal and informal components of independent work are identified: professionally-oriented sites, massive open online courses, blogs programmers professionally groups on social networks, news sites, and so on. Studies show a significant improvement of independent work of students on the study material by using video tutorials.

  13. How to design and deliver a local teaching program

    OpenAIRE

    Limb, Christopher; Whitehurst, Katharine; Gundogan, Buket; Koshy, Kiron; Agha, Riaz

    2017-01-01

    Teaching is an invaluable aspect of any medical or surgical career. Many trainees will find themselves delivering teaching at several stages in their career and in this “How to” article we explain how to design, set up, and deliver a successful teaching program, as well as how to evidence this in your portfolio.

  14. A randomized controlled trial of an Internet delivered dialectical behavior therapy skills training for suicidal and heavy episodic drinkers.

    Science.gov (United States)

    Wilks, Chelsey R; Lungu, Anita; Ang, Sin Yee; Matsumiya, Brandon; Yin, Qingqing; Linehan, Marsha M

    2018-05-01

    Given that alcohol misuse elevates risk of suicide death among ideators, the paucity of treatment outcome research for individuals presenting with both suicide ideation and problem drinking is particularly troubling. Dialectical behavior therapy (DBT) skills training, which effectively targets behaviors associated with emotion dysregulation including addictive and suicidal behaviors, provides a fitting model amenable to computerization. As stigma and scarcity stand as potential barriers to treatment, online dissemination platforms provide means for efficient treatment delivery that can augment the utility of suitable interventions. This pilot RCT sought to evaluate the feasibility, acceptability, and preliminary efficacy of an Internet-delivered DBT skills training intervention (iDBT-ST) for suicidal individuals who engage in heavy episodic drinking METHODS: Participants (N = 59) were randomized to receive iDBT-ST immediately or after an 8-week waiting period. Clinical outcomes were suicide ideation, alcohol use, and emotion dysregulation. Participants on average saw a significant reduction in all outcomes over the four-month study period. Compared to waitlist controls, individuals who received iDBT-ST immediately showed faster reductions in alcohol consumption. Preliminary results suggest that iDBT-ST may be a viable resource for the high-risk and underserved group represented in this study, and pathways for future development are suggested. There was difficulty retaining and engaging participants due to technological barriers. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Particle tracker system delivered to CERN

    CERN Multimedia

    Pitcher, Graham

    2006-01-01

    "The CCLRC Rutherford Appleton Laboratory (RAL) has delivered a system to CERN that will help to process the vast amounts of data generated by the silicon tracking detector within the Compact Muon Solenoid experiment." (1/2 page)

  16. Student-Led Presentations "in Situ": The Challenges to Presenting on the Edge of a Volcano

    Science.gov (United States)

    Marvell, Alan

    2008-01-01

    Student-led seminars are commonplace within higher education but few are allowed the opportunity of being delivered in situ. Presentations in situ widen the experience of students and develop a range of transferable skills, encouraging a greater sense of place and facilitating reflective learning. This case study describes the experiences of a…

  17. The Art and Skill of Delivering Culturally Responsive TF-CBT in Tanzania and Kenya

    Science.gov (United States)

    Kava, Christine M.; Akiba, Christopher F.; Lucid, Leah; Dorsey, Shannon

    2016-01-01

    Objective This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known how about western-developed EBTs are delivered in a culturally responsive manner. Method Semistructured qualitative interviews were conducted with 12 TF-CBT lay counselors involved in a large randomized controlled trial of TF-CBT in Kenya and Tanzania. An inductive approach was used to analyze the data. Results Lay counselors described the importance of being responsive to TF-CBT participants’ customs, beliefs, and socioeconomic conditions and highlighted the value of TF-CBT for their community. They also discussed the importance of partnering with other organizations to address unmet socioeconomic needs. Conclusion The findings from this study provide support for the acceptability and appropriateness of TF-CBT as a treatment approach for improving child mental health. Having a better understanding of the strategies used by lay counselors to ensure that treatment is relevant to the cultural and socioeconomic context of participants can help to inform the implementation of future EBTs. PMID:27414470

  18. A dynamic allocation mechanism of delivering capacity in coupled networks

    International Nuclear Information System (INIS)

    Du, Wen-Bo; Zhou, Xing-Lian; Zhu, Yan-Bo; Zheng, Zheng

    2015-01-01

    Traffic process is ubiquitous in many critical infrastructures. In this paper, we introduce a mechanism to dynamically allocate the delivering capacity into the data-packet traffic model on the coupled Internet autonomous-system-level network of South Korea and Japan, and focus on its effect on the transport efficiency. In this mechanism, the total delivering capacity is constant and the lowest-load node will give one unit delivering capacity to the highest-load node at each time step. It is found that the delivering capacity of busy nodes and non-busy nodes can be well balanced and the effective betweenness of busy nodes with interconnections is significantly reduced. Consequently, the transport efficiency such as average traveling time and packet arrival rate is remarkably improved. Our work may shed some light on the traffic dynamics in coupled networks.

  19. Reflections on delivering a cross-discipline, cross-cultural, international, masters-level collaborative course using e-Learning technologies

    NARCIS (Netherlands)

    Leung, W.S.; Coulter, D.A.; Moes, C.C.M.; Horvath, I.

    2012-01-01

    This paper presents a case study on the experience of delivering an Internet-based international collaborative semester course at intermediate postgraduate level and attempts to distill a model for exploring the success factors involved when presenting such courses. The pedagogic and practical

  20. Perspectives of healthcare professionals and patients on the application of mindfulness in individuals with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Harrison, Samantha L; Lee, Annemarie; Goldstein, Roger S; Brooks, Dina

    2017-02-01

    To explore the views of healthcare professionals (HCPs) and patients towards mindfulness for individuals with COPD. A qualitative study design informed by and analyzed using deductive thematic analysis. Twenty HCPs, with at least one year's clinical experience in COPD management and 19 individuals with moderate to severe COPD participated in semi-structured interviews. Analysis revealed seven themes. 1. Mindfulness is difficult to articulate and separate from relaxation. 2. Mindfulness has a role in disease management. 3. Mindfulness therapy should be optional. 4. Preferred techniques include; breathing meditation, music and body scan. 5. Mindfulness should be delivered by knowledgeable, enthusiastic and compassionate trainers. 6. Preferred mode of delivery is shorter sessions delivered alongside pulmonary rehabilitation, with refresher courses 7. Efficacy should be assessed using psychological outcome measures and qualitative methodologies. Mindfulness appears to be an attractive therapy for individuals with COPD. An understanding of the perspectives of HCPs and patients should inform the delivery of such programs. Individuals with COPD were comfortable using breathing to reduce anxiety. Stigma and negative preconceptions were considered barriers to participation. Short sessions delivered by experienced trainers were preferred. A combination of methodologies should be used to examine effectiveness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Delivering migrant workers' remittances

    OpenAIRE

    Ballard, Roger

    2004-01-01

    As globalization has led to ever higher levels of labour mobility, so the volume of funds remitted to their families by workers employed in countries far distant from their homes has increased by leaps and bounds. The total volume of such transfers currently amounts to over $100 billion per annum, the greater part of which flows from economically advanced regions in the West and North to developing countries in the East and South. Delivering those funds swiftly, reliably and cheaply to relati...

  2. Housing and Independent Living for Individuals with Intellectual and Developmental Disabilities

    Science.gov (United States)

    Leach, Debra

    2016-01-01

    This manuscript provides a review of housing and independent living options for individuals with intellectual and developmental disabilities (I/DD). While there has certainly been an increased emphasis on community integration and inclusion for people with I/DD, barriers to delivering housing supports and services in natural, integrated settings…

  3. 'This is the beginning of the new me': process evaluation of a group fitness intervention to promote wellbeing in formerly homeless individuals.

    Science.gov (United States)

    Sofija, Ernesta; Plugge, Melanie; Wiseman, Nicola; Harris, Neil

    2018-02-27

    Homelessness is a persistent social issue with diverse impacts reaching far beyond individuals. Strategies and research concerning homelessness and health have largely focused on the risk factors and weaknesses of individuals. Such preoccupation has meant the potential strengths and resources within individuals, and so-called strength-based approaches have received less attention. Consequently, understanding how to effectively work with and engage this population in such interventions is limited. The current study presents a process evaluation of an 8-week group fitness intervention in a supportive housing facility. The purpose of the intervention was to increase tenants' physical activity together with opportunities for social interaction and support to, in turn, improve physical and mental wellbeing, and ultimately help individuals re-engage in their community. The evaluation focused on seven key components: context, recruitment, reach/participation, dose delivered, dose received, satisfaction/feedback and fidelity. Data collection methods included observation, attendance records and participant and staff interviews. Findings indicate the intervention was appropriate, well delivered, and enjoyed by participants who highlighted the importance of the sessions for their mental wellbeing and social inclusion. The intervention being conducted on site, the trainers' ability to build good rapport with participants together with the supportive environment they created were central to successful implementation. Group fitness sessions represent a promising intervention to improve wellbeing of this population. However, the need for more personalised care when delivering fitness sessions, due to the complexity of health issues prevalent in this population, was identified. This has implications for already limited resources, including staffing. Strategies to address this are required to ensure the continuity of fitness programs. Impact evaluation to quantify changes

  4. Compressor-less Hydrogen Transmission Pipelines Deliver Large-scale Stranded Renewable Energy at Competitive Cost

    International Nuclear Information System (INIS)

    W Leighty; J Holloway; R Merer; B Somerday; C San Marchi; G Keith; D White

    2006-01-01

    We assume a transmission-constrained world, where large new wind plants and other renewable energies must pay all transmission costs for delivering their energy to distant markets. We modeled a 1,000 MW (1 GW) (name plate) wind plant in the large wind resource of the North America Great Plains, delivering exclusively hydrogen fuel, via a new gaseous hydrogen (GH2) pipeline, to an urban market at least 300 km distant. All renewable electric energy output would be converted, at the source, to hydrogen, via 100 bar output electrolyzers, directly feeding the GH2 transmission pipeline without costly compressor stations at inlet or at midline. The new GH2 pipeline is an alternative to new electric transmission lines. We investigate whether the pipeline would provide valuable energy storage. We present a simple model by which we estimate the cost of wind-source hydrogen fuel delivered to the distant city gate in year 2010, at GW scale. Ammonia, synthetic hydrocarbons, and other substances may also be attractive renewable-source energy carriers, storage media, and fuels; they are not considered in this paper. (authors)

  5. When in doubt, ask the audience: potential users' perceptions of Internet-delivered cognitive behavioural therapy for chronic pain.

    Science.gov (United States)

    Schneider, Luke H; Hadjistavropoulos, Heather D

    2014-01-01

    Although research has demonstrated that Internet-delivered cognitive behavioural therapy (ICBT) for chronic pain helps with adjustment to pain, it remains unclear how this treatment option would initially be perceived by individuals with chronic pain. To explore initial perceptions of ICBT and to examine variables that correlate with an expressed interest in ICBT as a treatment option among individuals with chronic pain. A total of 129 individuals with chronic pain completed a survey assessing perceptions of ICBT and individual difference variables that could be correlated with expressed interest in ICBT (eg, demographic characteristics, pain, computer self-efficacy). Results showed that most participants perceived ICBT as a potentially valuable service with multiple benefits. Being female, having greater pain severity and interference, and having greater computer self-efficacy and lower computer anxiety were positively correlated with interest in receiving ICBT. Combined with previous research on treatment efficacy of ICBT for chronic pain, the results should serve to stimulate further research on integrating ICBT within existing health care services.

  6. Psychological profile of individuals presenting with chronic cough

    Directory of Open Access Journals (Sweden)

    Katrin Hulme

    2017-03-01

    Full Text Available Chronic refractory cough (CRC is a common problem in respiratory clinics. Adverse effects on quality of life are documented in the literature, but relatively little is known about the underlying psychological factors in this patient population. We aimed to investigate the association of psychological factors with chronic cough, comparing CRC to explained cough and non-cough groups. 67 patients attending a specialist cough clinic (CRC, n=25; explained cough, n=42 and 22 non-cough individuals participated. All participants completed the Hospital Anxiety & Depression Scale, Big Five Inventory (Personality, Chalder Fatigue Scale and Patient Health Questionnaire-15. Cough patients also completed the Illness Perception Questionnaire-Revised. Appropriate statistical analyses were used to compare participant groups. Chronic refractory coughers displayed significantly higher levels of anxiety, depression, fatigue and somatic physical symptoms than non-cough participants. Compared to explained coughers, there were higher depression and fatigue scores and significantly more negative illness representations (specifically, strong beliefs regarding negative consequences, lower illness coherence and higher emotional representations. “Explained” coughers reported significantly increased fatigue and somatic symptoms in comparison to non-coughers. The prevalence of fatigue, low mood, negative illness beliefs and increased physical symptom reporting should be considered in consultations and in developing novel interventions for CRC patients.

  7. Managing disclosure following recent-onset psychosis: utilizing the individual placement and support model.

    Science.gov (United States)

    Allott, Kelly A; Turner, Luana R; Chinnery, Gina L; Killackey, Eoin J; Nuechterlein, Keith H

    2013-08-01

    Individual Placement and Support is the most defined and evidence-based approach to supported employment for severe mental illness, including recent-onset psychosis. However, there is limited evidence or detailed guidelines informing the management of mental illness disclosure to educators or employers when delivering individual placement and support. In this paper, we describe the initial disclosure preferences of young people with recent-onset psychosis enrolled in individual placement and support and provide guidance for managing disclosure when delivering Individual Placement and Support with this population. Drawing from sites in Melbourne, Australia and Los Angeles, USA, clients' initial disclosure preferences were examined. We describe approaches to providing individual placement and support when no disclosure is permitted compared with when disclosure is permitted, including two illustrative case vignettes. No disclosure of mental illness or disability was requested by 54-59% of clients; 41-46% of clients permitted partial or complete disclosure. The 'no disclosure' scenario required the individual placement and support worker to provide support 'behind the scenes', whereas when disclosure was permitted, the individual placement and support worker could have contact with instructors/employers and work 'on the front lines'. The case vignettes illustrate how both approaches can lead to successful vocational outcomes. We found that Individual Placement and Support can be provided in an educative, flexible, creative and collaborative manner according to client disclosure preferences. We suggest that disclosure preferences do not prevent successful vocational outcomes, although this supposition requires empirical investigation. © 2013 Wiley Publishing Asia Pty Ltd.

  8. Impact of online training on delivering a difficult medical diagnosis: Acquiring communication skills.

    Science.gov (United States)

    Saint-Dizier de Almeida, Valérie; Agnoletti, Marie-France

    2015-09-01

    This paper deals with developing and assessing the training of physicians to deliver a difficult diagnosis to patients. The training is provided by a web-based self-training package. This online training emphasizes the structural, functional and relational dimensions of interviews delivering a serious diagnosis, and a logical set of recommendations for behavior towards the patient. The content is illustrated by numerous delivery interview sequences that are described and for which commentary is provided. This online package was expected to enable physicians to acquire new skills and change their mental picture of diagnosis delivery. Here we discuss the assessment of training in managing the delivery of a serious diagnosis. The approach taken and the methods used to measure knowledge and skills are presented. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  9. [External cephalic version of breech presentation at term].

    Science.gov (United States)

    Albrechtsen, Susanne; Berge, Lillian N; Børdahl, Per E; Egeland, Thore; Henriksen, Tore; Håheim, Lise Lund; Øian, Pål

    2005-03-03

    External cephalic version could be an alternative to either vaginal delivery or caesarean section in breech presentation at term. A systematic literature review about external cephalic version in breech presentation. The numbers of breech presentation delivered by caesarean section could probably be reduced in Norway by offering version, but this would not affect perinatal mortality.

  10. Does an individual estimation of halflife improve the results of radioiodine therapy of Graves' disease?

    International Nuclear Information System (INIS)

    Schneider, P.; Koerber, C.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, Chr.

    2002-01-01

    Aim: The impact of our dosimetry concept on radioiodine therapy success in Graves' disease (GD) was analysed. Three questions arised: Did individual estimation of pretherapeutic halflife improve therapeutic success? Did individual dosimetry result in accurate dose calculation? Did antithyroid medication have a measurable influence on therapeutic success under the prevailing conditions? Methods: 126 consecutive patients were treated with 200 Gy I-131 in our therapy ward for GD and followed-up six to nine months after therapy. Success quote was assessed using a standardized protocol and treatment was classified as successful when the patients was eu- or hypothyroid, or unsuccessful when he or she presented with a suppressed TSH-level or in hyperthyroid condition after antithyroid medication withdrawal. Antithyroid medication, activity I-131, dose, concentration of fT 3 and fT 4 , specific delivered dose and halflife were put into a multiple regression model to assess their influence on therapeutic success. In order to assess possible factors disturbing the therapeutic outcome, relevant parameters were analyzed using Logit transformation. Results: Out of 126 patients 84 were classified as successfully treated and 42 (33,3%) as failures. A significant influence on the outcome only was found for thyroid mass. However, therapeutic success appeared to be more distinctly determined by the specific delivered dose using an estimated halflife of 5.5 days (Odds: 10.0, p [de

  11. How natural capital delivers ecosystem services

    NARCIS (Netherlands)

    Smith, A.C.; Harrison, P.A.; Pérez Soba, M.; Archaux, F.; Blicharska, M.; Egoh, B.N.; Erős, T.; Fabrega Domenech, N.; György, I.; Haines-Young, R.; Li, S.; Lommelen, E.; Meiresonne, L.; Miguel Ayala, L.; Mononen, L.; Simpson, G.; Stange, E.; Turkelboom, F.; Uiterwijk, M.; Veerkamp, C.J.; Wyllie de Echeverria, V.

    2017-01-01

    There is no unified evidence base to help decision-makers understand how the multiple components of natural capital interact to deliver ecosystem services. We systematically reviewed 780 papers, recording how natural capital attributes (29 biotic attributes and 11 abiotic factors) affect the

  12. NASA Enterprise Managed Cloud Computing (EMCC): Delivering an Initial Operating Capability (IOC) for NASA use of Commercial Infrastructure-as-a-Service (IaaS)

    Science.gov (United States)

    O'Brien, Raymond

    2017-01-01

    In 2016, Ames supported the NASA CIO in delivering an initial operating capability for Agency use of commercial cloud computing. This presentation provides an overview of the project, the services approach followed, and the major components of the capability that was delivered. The presentation is being given at the request of Amazon Web Services to a contingent representing the Brazilian Federal Government and Defense Organization that is interested in the use of Amazon Web Services (AWS). NASA is currently a customer of AWS and delivered the Initial Operating Capability using AWS as its first commercial cloud provider. The IOC, however, designed to also support other cloud providers in the future.

  13. Developments in Technology-Delivered Psychological Interventions / Desarrollos en Intervenciones Psicológicas utilizando la Tecnología

    Directory of Open Access Journals (Sweden)

    Derek Richards

    2013-06-01

    Full Text Available The worldwide penetration of the Internet and its related technologies, the rapid developments of new technologies and the pervasive use of technology in people’s lives, are indicators that we live in a technological age. New technologies and their potential for use in psychological interventions and mental health services have not gone unnoticed. The last 15 years or so have witnessed the employment of new technologies in developing and delivering a variety of psychological interventions, these include information WebPages, internet-based computer programs that are addressed to treatment of specific problems, the use of mobile phones and games to help psychological practice, among others. However, while a broad range of technology-delivered psychological interventions have demonstrated success in high-income countries, little is known of their potential for countries such as Colombia. The paper begins with a brief history, followed by an overview of the field of technology-delivered psychological interventions. Lastly, the paper seeks to present a justification for the potential use of technology delivered psychological interventions in Colombia.

  14. Group vs. Individual Treatment for Acute Insomnia: A Pilot Study Evaluating a “One-Shot” Treatment Strategy

    Directory of Open Access Journals (Sweden)

    Pam Boullin

    2016-12-01

    Full Text Available Background: Despite undeniable evidence for the efficacy and effectiveness of Cognitive Behaviour Therapy for Insomnia (CBT-I, the potential for its widespread dissemination and implementation has yet to be realised. A suggested reason for this is that traditional CBT-I is considered too burdensome for deployment, in its current form, within the context of where it would be most beneficial—Primary Care. One strategy, aimed to address this, has been to develop briefer versions of CBT-I, whilst another has been to deliver CBT-I in a group format. An alternative has been to attempt to address insomnia during its acute phase with a view to circumventing its progression to chronic insomnia. The aim of the present study was to compare a brief version of CBT-I (one-shot when delivered individually or in groups to those with acute insomnia. Method: Twenty-eight individuals with acute insomnia (i.e., meeting full DSM-5 criteria for insomnia disorder for less than three months self-assigned to either a group or individual treatment arm. Treatment consisted of a single one-hour session accompanied by a self-help pamphlet. Subjects completed measures of insomnia severity, anxiety and depression pre-treatment and at one-month post-treatment. Additionally, daily sleep diaries were compared between pre-treatment and at the one-month follow up. Results: There were no significant between group differences in treatment outcome on any sleep or mood measures although those in the group treatment arm were less adherent than those who received individual treatment. Furthermore, the combined (group and individual treatment arms pre-post test effect size on insomnia symptoms, using the Insomnia Severity Index, was large (d = 2.27. Discussion: It appears that group treatment is as efficacious as individual treatment within the context of a “one shot” intervention for individuals with acute insomnia. The results are discussed with a view to integrating one-shot CBT

  15. Slide:ology: the art and science of creating great presentations

    National Research Council Canada - National Science Library

    Duarte, Nancy

    2008-01-01

    ... take off. But much to our surprise it did. Up to this point business presentations were delivered in 35mm format and created by specialized professional designers. Presentation software was developed in...

  16. Present status of practical aspects of individual dosimetry. Pt. 2. Eastern European countries

    International Nuclear Information System (INIS)

    Goeksu, H.Y.; Regulla, D.; Drexler, G.

    1995-01-01

    The report is prepared in a historically rather unstable period concerning the Eastern European countries. Many independent states are formed which brought political, economical and administrative changes in the region. However such changes had not direct effect on the radiation protection practices concerning the occupationally exposed persons. In general all the newly formed states have adopted the former laws and regulation. Therefore we kept the names of the country of the origin. In near future laws and regulations are expected to be altered in many of these new states. The present laws and regulations are in great extent very similar to each other. However there are variations in practical aspects of the individual dosimetry due to the size of the country and their involvement with nuclear activities. Almost all countries based their regulations on International Safety Standards of IAEA and ICRP-26 recommendations. Since the Chernobyl accident, very many bilateral agreements have been concluded between Eastern European and OECD for the transfer of technology on the radiation safety of the public as well as occupationally exposed persons. (orig./HP)

  17. Market-Oriented Cloud Computing: Vision, Hype, and Reality for Delivering IT Services as Computing Utilities

    OpenAIRE

    Buyya, Rajkumar; Yeo, Chee Shin; Venugopal, Srikumar

    2008-01-01

    This keynote paper: presents a 21st century vision of computing; identifies various computing paradigms promising to deliver the vision of computing utilities; defines Cloud computing and provides the architecture for creating market-oriented Clouds by leveraging technologies such as VMs; provides thoughts on market-based resource management strategies that encompass both customer-driven service management and computational risk management to sustain SLA-oriented resource allocation; presents...

  18. A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults.

    Science.gov (United States)

    Whyatt, Caroline; Merriman, Niamh A; Young, William R; Newell, Fiona N; Craig, Cathy

    2015-12-01

    Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall. Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments. Balance game training had a significant effect on levels of functional balance and balance confidence (P Commercial hardware can be modified to deliver engaging methods of effective balance assessment and training for the older population.

  19. Inefficient charging for delivered gas by local gas distributors

    Directory of Open Access Journals (Sweden)

    Siniša Bikić

    2005-10-01

    Full Text Available In this region, especially in Serbia, common belief is that local distributors of gas used by households don’t charge for gas properly. It is suspected that there are two sources for improper ways of gas charging. Local distributors charge for delivered gas only, according to flow rat but not according to gas quality. It is usual that local distributors deliver gas of different quality than one signed in contract. In this work will be considered only one of aspects inefficient charging for delivered gas by local gas distributors, which is connected to variable atmospheric pressure. There is doubt, that local distributors make mistakes during accounting for delivered gas to costumers in regard atmospheric pressure. At the beginning of every investigation, problem has to be located and recognized. Authors are going to collect as much as possible available data, to elaborate and analyze data by scientific methods and to represent conclusions. So, the aim of this work is to diagnose current state and to approve or disapprove above mentioned suspicions. In our region this theme is very interesting, both because of energy efficiency and air pollution control. In this way both consumer and distributor will know, how mush energy they have really spent.

  20. Comparing the Cost-Effectiveness of Campaigns Delivered via Various Combinations of Television and Online Media.

    Science.gov (United States)

    Allom, Vanessa; Jongenelis, Michelle; Slevin, Terry; Keightley, Stacey; Phillips, Fiona; Beasley, Sarah; Pettigrew, Simone

    2018-01-01

    Reflecting the increasing prevalence of online media, many mass media health campaigns are now delivered using both television (TV) and online media formats. The aim of this study was to evaluate a smoking cessation mass media campaign according to the cost-effectiveness of the various combinations of TV and online media formats to inform future media buying decisions. A quasi-experimental interrupted time series approach was employed. The campaign was delivered in seven 1-week bursts using TV, online video (OV), or online display (OD) (e.g., banner ads) formats in isolation and in various combinations over a 13-week period. Campaign bursts were separated by "off-weeks" in which no campaign materials were delivered. Assessed outcomes were the number of campaign response "events" recorded (campaign web page views, calls to a smoking cessation telephone service, and registrations for smoking cessation services). The cost-effectiveness of each individual and combined media format condition in terms of these outcome variables was calculated using attributed production and broadcasting costs. Overall, OD alone was found to be the most cost-effective means of achieving the nominated campaign outcomes, followed by a combination of OV and OD and a combination of TV and OV. The use of TV in isolation was the least cost-effective. The results of this evaluation indicate that online media constitute a promising means of enhancing the cost-effectiveness of smoking cessation campaigns. Future research assessing a broader range of outcomes, especially smoking cessation, is needed to provide a more comprehensive account of the cost-effectiveness of various campaign media.

  1. Delivered Pricing, FOB Pricing, and Collusion in Spatial Markets

    OpenAIRE

    Maria Paz Espinosa

    1992-01-01

    This article examines price discrimination and collusion in spatial markets. The problem is analyzed in the context of a repeated duopoly game. I conclude that the prevailing pricing systems depend on the structural elements of the market. Delivered pricing systems emerge in equilibrium in highly monopolistic and highly competitive industries, while FOB is used in intermediate market structures. The fact driving this result is that delivered pricing policies allow spatial price discrimination...

  2. Individual differences in the attribution of incentive salience to reward-related cues: Implications for addiction.

    Science.gov (United States)

    Flagel, Shelly B; Akil, Huda; Robinson, Terry E

    2009-01-01

    Drugs of abuse acquire different degrees of control over thoughts and actions based not only on the effects of drugs themselves, but also on predispositions of the individual. Those individuals who become addicted are unable to shift their thoughts and actions away from drugs and drug-associated stimuli. Thus in addicts, exposure to places or things (cues) that has been previously associated with drug-taking often instigates renewed drug-taking. We and others have postulated that drug-associated cues acquire the ability to maintain and instigate drug-taking behavior in part because they acquire incentive motivational properties through Pavlovian (stimulus-stimulus) learning. In the case of compulsive behavioral disorders, including addiction, such cues may be attributed with pathological incentive value ("incentive salience"). For this reason, we have recently begun to explore individual differences in the tendency to attribute incentive salience to cues that predict rewards. When discrete cues are associated with the non-contingent delivery of food or drug rewards some animals come to quickly approach and engage the cue even if it is located at a distance from where the reward will be delivered. In these animals the reward-predictive cue itself becomes attractive, eliciting approach towards it, presumably because it is attributed with incentive salience. Animals that develop this type of conditional response are called "sign-trackers". Other animals, "goal-trackers", do not approach the reward-predictive cue, but upon cue presentation they immediately go to the location where food will be delivered (the "goal"). For goal-trackers the reward-predictive cue is not attractive, presumably because it is not attributed with incentive salience. We review here preliminary data suggesting that these individual differences in the tendency to attribute incentive salience to cues predictive of reward may confer vulnerability or resistance to compulsive behavioral disorders

  3. High-power diode-end-pumped Tm:YLF slab laser delivering 189 W at 1890 nm

    CSIR Research Space (South Africa)

    Koen, W

    2010-09-01

    Full Text Available Laser Delivering 189 W at 1890 nm W. Koen, H.J. Strauss, C. Bollig and M.J.D. Esser CSIR National Laser Centre, Meiring Naude Road, Brummeria, Pretoria, 0001 wkoen@csir.co.za Abstract: We present a high-power Tm:YLF slab laser double...

  4. The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation.

    Science.gov (United States)

    Rajaraman, Divya; Travasso, Sandra; Chatterjee, Achira; Bhat, Bhargav; Andrew, Gracy; Parab, Suraj; Patel, Vikram

    2012-05-25

    Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. The intervention was based on the WHO's Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility), the uptake of services (acceptability), and the number of students who received corrective health treatment (evidence of impact). Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility), evaluate acceptability, and gather evidence of positive or negative effects of the programme. Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students' anonymous letter-box; more students self-referring for counselling services over time; and, the perceived need for the programme, as expressed by principals

  5. The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation

    Directory of Open Access Journals (Sweden)

    Rajaraman Divya

    2012-05-01

    Full Text Available Abstract Background Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. Methods The intervention was based on the WHO’s Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility, the uptake of services (acceptability, and the number of students who received corrective health treatment (evidence of impact. Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility, evaluate acceptability, and gather evidence of positive or negative effects of the programme. Results Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students’ anonymous letter-box; more students self-referring for counselling services over time; and, the

  6. Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams

    Directory of Open Access Journals (Sweden)

    Middleton Sandy

    2010-01-01

    Full Text Available Abstract Background Transferring knowledge from research into practice can be challenging, partly because the process involves a change in attitudes, roles and behaviour by individuals and teams. Helping teams to identify then target potential barriers may aid the knowledge transfer process. The aim of this study was to identify barriers and enablers, as perceived by allied health professionals, to delivering an evidence-based (Level 1 outdoor journey intervention for people with stroke. Methods A qualitative design and semi-structured interviews were used. Allied health professionals (n = 13 from two community rehabilitation teams were interviewed, before and after receiving feedback from a medical record audit and attending a training workshop. Interviews allowed participants to identify potential and actual barriers, as well as enablers to delivering the intervention. Qualitative data were analysed using theoretical domains described by Michie and colleagues. Results Two barriers to delivery of the intervention were the social influence of people with stroke and their family, and professionals' beliefs about their capabilities. Other barriers included professionals' knowledge and skills, their role identity, availability of resources, whether professionals remembered to provide the intervention, and how they felt about delivering the intervention. Enablers to delivering the intervention included a belief that they could deliver the intervention, a willingness to expand and share professional roles, procedures that reminded them what to do, and feeling good about helping people with stroke to participate. Conclusions This study represents one step in the quality improvement process. The interviews encouraged reflection by staff. We obtained valuable data which have been used to plan behaviour change interventions addressing identified barriers. Our methods may assist other researchers who need to design similar behaviour change interventions.

  7. Sustainable individual mobility - critical choices for government and industry. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Anon,

    1996-11-01

    The Alliance for Global Sustainability, a partnership between the Massachusetts Institute of Technology, the Tokyo University and the Swiss Federal Institute of Technology, planned the International Conference on `Sustainable Individual Mobility - Critical Choices for Government and Industry` to be held in November, 1996. The conference had to be cancelled. However, nearly all authors delivered their papers which are now published in this volume. The five planned sections dealt with the following topics: sustainable individual mobility, long term worldwide demand scenarios to the year 2020, how to satisfy demand, assessment of impact `supply-demand`, and policies. (author) figs., tabs., refs.

  8. Reducing the Salt Added to Takeaway Food: Within-Subjects Comparison of Salt Delivered by Five and 17 Holed Salt Shakers in Controlled Conditions.

    Directory of Open Access Journals (Sweden)

    Louis Goffe

    Full Text Available To determine if the amount of salt delivered by standard salt shakers commonly used in English independent takeaways varies between those with five and 17 holes; and to determine if any differences are robust to variations in: the amount of salt in the shaker, the length of time spent shaking, and the person serving.Four laboratory experiments comparing the amount of salt delivered by shakers. Independent variables considered were: type of shaker used (five or 17 holes, amount of salt in the shaker before shaking commences (shaker full, half full or nearly empty, time spent shaking (3s, 5s or 10s, and individual serving.Controlled, laboratory, conditions.A quota-based convenience sample of 10 participants (five women aged 18-59 years.Amount of salt delivered by salt shakers.Across all trials, the 17 holed shaker delivered a mean (SD of 7.86g (4.54 per trial, whilst the five holed shaker delivered 2.65g (1.22. The five holed shaker delivered a mean of 33.7% of the salt of the 17 holed shaker. There was a significant difference in salt delivered between the five and 17 holed salt shakers when time spent shaking, amount of salt in the shaker and participant were all kept constant (p<0.001. This difference was robust to variations in the starting weight of shakers, time spent shaking and participant shaking (ps

  9. 40 CFR 1620.2 - Administrative claim; when presented.

    Science.gov (United States)

    2010-07-01

    ... ADMINISTRATIVE CLAIMS ARISING UNDER THE FEDERAL TORT CLAIMS ACT § 1620.2 Administrative claim; when presented. (a... negligence or wrongful act or omission of the CSB or its employees must be mailed or delivered to the Office...

  10. Internet-delivered cognitive therapy for PTSD: a development pilot series

    Directory of Open Access Journals (Sweden)

    Jennifer Wild

    2016-11-01

    Full Text Available Background: Randomised controlled trials have established that face-to-face cognitive therapy for posttraumatic stress disorder (CT-PTSD based on Ehlers and Clark's cognitive model of PTSD is highly effective and feasible with low rates of dropout. Access to evidence-based psychological treatments for PTSD is insufficient. Several studies have shown that therapist-assisted treatment delivery over the Internet is a promising way of improving access to cognitive behavioural therapy interventions. Objective: To develop an Internet version of CT-PTSD that significantly reduces therapist contact time without compromising treatment integrity or retention rates. Methods: We describe the development of an Internet version of CT-PTSD. It implements all the key procedures of face-to-face CT-PTSD, including techniques that focus on the trauma memory, such as memory updating, stimulus discrimination and revisiting the trauma site, as well as restructuring individually relevant appraisals relating to overgeneralisation of danger, guilt, shame or anger, behavioural experiments and planning activities to reclaim quality of life. A cohort of 10 patients meeting DSM-IV criteria for PTSD worked through the programme, with remote guidance from a therapist, and they were assessed at pre- and post-treatment on PTSD outcome, mood, work and social adjustment and process measures. Results: No patients dropped out. Therapists facilitated the treatment with 192 min of contact time per patient, plus 57 min for reviewing the patient's progress and messages. Internet-delivered CT-PTSD was associated with very large improvements on all outcome and process measures, with 80% of patients achieving clinically significant change and remission from PTSD. Conclusions: Internet-delivered cognitive therapy for PTSD (iCT-PTSD appears to be an acceptable and efficacious treatment. Therapist time was reduced to less than 25% of time in face-to-face CT-PTSD. Randomised controlled trials

  11. Delivering construction projects using innovative building technologies

    CSIR Research Space (South Africa)

    Ampofo-Anti, Naalamkai

    2017-07-01

    Full Text Available . Figure 1: IBT delivery flowchart Proceedings 11th Built Environment Conference 6 th August – 8 th August 2017 Delivering construction projects using innovative building technologies Durban, South Africa 5. REFERENCES Ampofo-Anti, N...

  12. Nominal effective radiation doses delivered during clinical trials of boron neutron capture therapy

    International Nuclear Information System (INIS)

    Capala, J.; Diaz, A.Z.; Chanana, A.D.

    1997-01-01

    Boron neutron capture therapy (BNCT) is a binary system that, in theory, should selectively deliver lethal, high linear energy transfer (LET) radiation to tumor cells dispersed within normal tissues. It is based on the nuclear reaction 10-B(n, α)7-Li, which occurs when the stable nucleus of boron-10 captures a thermal neutron. Due to the relatively high cross-section of the 10-B nucleus for thermal neutron capture and short ranges of the products of this reaction, tumor cells in the volume exposed to thermal neutrons and containing sufficiently high concentration of 10-B would receive a much higher radiation dose than the normal cells contained within the exposed volume. Nevertheless, radiation dose deposited in normal tissue by gamma and fast neutron contamination of the neutron beam, as well as neutron capture in nitrogen, 14-N(n,p)14-C, hydrogen, 1-H(n,γ)2-H, and in boron present in blood and normal cells, limits the dose that can be delivered to tumor cells. It is, therefore, imperative for the success of the BNCT the dosed delivered to normal tissues be accurately determined in order to optimize the irradiation geometry and to limit the volume of normal tissue exposed to thermal neutrons. These are the major objectives of BNCT treatment planning

  13. Utah Delivers Opportunities for Career Exploration

    Science.gov (United States)

    Dobson, Kristine; Fischio, Shannon

    2006-01-01

    Providing information and resources to support career exploration is key to the mission of career and technical education (CTE) in Utah. Utah CTE has responded in a variety of ways to meet the career exploration needs of students of all ages. This article discusses how the career and technical education in Utah delivers opportunities for career…

  14. Comparing the Cost-Effectiveness of Campaigns Delivered via Various Combinations of Television and Online Media

    Directory of Open Access Journals (Sweden)

    Vanessa Allom

    2018-03-01

    Full Text Available BackgroundReflecting the increasing prevalence of online media, many mass media health campaigns are now delivered using both television (TV and online media formats. The aim of this study was to evaluate a smoking cessation mass media campaign according to the cost-effectiveness of the various combinations of TV and online media formats to inform future media buying decisions.MethodsA quasi-experimental interrupted time series approach was employed. The campaign was delivered in seven 1-week bursts using TV, online video (OV, or online display (OD (e.g., banner ads formats in isolation and in various combinations over a 13-week period. Campaign bursts were separated by “off-weeks” in which no campaign materials were delivered. Assessed outcomes were the number of campaign response “events” recorded (campaign web page views, calls to a smoking cessation telephone service, and registrations for smoking cessation services. The cost-effectiveness of each individual and combined media format condition in terms of these outcome variables was calculated using attributed production and broadcasting costs.ResultsOverall, OD alone was found to be the most cost-effective means of achieving the nominated campaign outcomes, followed by a combination of OV and OD and a combination of TV and OV. The use of TV in isolation was the least cost-effective.ConclusionThe results of this evaluation indicate that online media constitute a promising means of enhancing the cost-effectiveness of smoking cessation campaigns. Future research assessing a broader range of outcomes, especially smoking cessation, is needed to provide a more comprehensive account of the cost-effectiveness of various campaign media.

  15. An Examination of Peer-Delivered Parenting Skills Programs Across New York State.

    Science.gov (United States)

    Acri, Mary C; Craig, Nancy; Adler, Josh

    2018-03-24

    Peers are an important adjunct to the public mental health service system, and are being increasingly utilized across the country as a cost-effective solution to workforce shortages. Despite the tremendous growth of peer-delivered support over the past two decades, it has only been within the past few years that peer programs have been the subject of empirical inquiry. The purpose of this study was to examine the prevalence and characteristics of peer-delivered parenting programs across the New York State public mental health service system. We surveyed 46 family peer organizations across New York State regarding their delivery of structured peer-delivered parenting programs. Thirty-four (76%) completed the questionnaire, and of them, 18 (53%) delivered a parenting program. Subsequent interviews with seven of the 18 organizations revealed peer organizations had been delivering eight unique parenting programs for upwards of two decades. Additionally, organizations offered multiple supports to families to participate. Training, supervision, and issues around fidelity are discussed, as well as the implications of this study for states utilizing a peer workforce.

  16. An integrated platform for assessing biologics (Conference Presentation)

    Science.gov (United States)

    Schein, Perry; O'Dell, Dakota; Erickson, David

    2016-04-01

    Protein therapeutics are a rapidly growing portion of the pharmaceuticals market and have many significant advantages over traditional small molecule drugs. As this market expands, however, critical regulatory and quality control issues remain, most notably the problem of protein aggregation. Individual target proteins often aggregate into larger masses which trigger an immune response in the body, which can reduce the efficacy of the drug for its intended purpose, or cause serious anaphylactic side-effects. Although detecting and minimizing aggregate formation is critical to ensure an effective product, aggregation dynamics are often highly complicated and there is little hope of reliable prediction and prevention from first principles. This problem is compounded for aggregates in the subvisible range of 100 nm to 10 micrometers where traditional techniques for detecting aggregates have significant limitations. Here, we present an integrated optofluidic platform for detecting nanoscale protein aggregates and characterizing interactions between these aggregates and a reference surface. By delivering light to a solution of proteins with an optical waveguide, scattered light from individual protein aggregates can be detected and analyzed to determine the force profile between each particle and the waveguide surface. Unlike existing methods which only determine size or charge, our label-free screening technique can directly measure the surface interaction forces between single aggregates and the glass substrate. This direct measurement capability may allow for better empirical predictions of the stability of protein aggregates during drug manufacturing and storage.

  17. Delivering Bad News: Attitudes, Feelings, and Practice Characteristics Among Speech-Language Pathologists.

    Science.gov (United States)

    Gold, Rinat; Gold, Azgad

    2018-02-06

    The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news. One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents. Frequency distributions of the responses of the participants were determined, and Pearson correlations were computed to determine the relation between years of occupational experience and the following variables: frequency of delivering bad news, opinions regarding training, and emotions experienced during the process of bad news delivery. Our survey showed that bad news delivery is a task that most participants are confronted with from the very beginning of their careers. Participants regarded training in the subject of delivering bad news as important but, at the same time, reported receiving relatively little training on this subject. In addition, our survey showed that negative emotions are involved in the process of delivering bad news. Training SLPs on specific techniques is required for successfully delivering bad news. The emotional burden associated with breaking bad news in the field of speech-language pathology should be noticed and addressed.

  18. Self-delivered misinformation - Merging the choice blindness and misinformation effect paradigms.

    Science.gov (United States)

    Stille, Lotta; Norin, Emelie; Sikström, Sverker

    2017-01-01

    Choice blindness is the failure to detect a discrepancy between a choice and its outcome. The misinformation effect occurs when the recollection of an event changes because new, misleading information about the event is received. The purpose of this study was to merge the choice blindness and misinformation effect paradigms, and thus examine whether choice blindness can be created for individuals' recollections of a witnessed event, and whether this will affect their later recollections of the event. Thus, as a way of delivering misinformation the participants ostensibly became their own source of the misleading information. The participants watched a short film and filled out a questionnaire about events shown in the film. Some of their answers were then manipulated using reattachable stickers, which allowed alteration of their original answers. The participants gave justifications for their manipulated choices, and later their recollection of the original event was tested through another questionnaire. Choice blindness was created for a majority of the participants. A majority of the choice blind participants later changed their reported recollection of the event in line with the manipulations, whereas only a small minority of the participants in the control condition changed their recollection. This study provides new information about the misinformation effect, suggesting that this effect also can occur when misinformation is given immediately following presentation of the original stimuli, and about choice blindness and its effects on the recollections of events. The results suggest that memory blindness can be created when people inadvertently supply themselves with misleading information about an event, causing a change in their recollection.

  19. Self-delivered misinformation - Merging the choice blindness and misinformation effect paradigms.

    Directory of Open Access Journals (Sweden)

    Lotta Stille

    Full Text Available Choice blindness is the failure to detect a discrepancy between a choice and its outcome. The misinformation effect occurs when the recollection of an event changes because new, misleading information about the event is received. The purpose of this study was to merge the choice blindness and misinformation effect paradigms, and thus examine whether choice blindness can be created for individuals' recollections of a witnessed event, and whether this will affect their later recollections of the event. Thus, as a way of delivering misinformation the participants ostensibly became their own source of the misleading information. The participants watched a short film and filled out a questionnaire about events shown in the film. Some of their answers were then manipulated using reattachable stickers, which allowed alteration of their original answers. The participants gave justifications for their manipulated choices, and later their recollection of the original event was tested through another questionnaire. Choice blindness was created for a majority of the participants. A majority of the choice blind participants later changed their reported recollection of the event in line with the manipulations, whereas only a small minority of the participants in the control condition changed their recollection. This study provides new information about the misinformation effect, suggesting that this effect also can occur when misinformation is given immediately following presentation of the original stimuli, and about choice blindness and its effects on the recollections of events. The results suggest that memory blindness can be created when people inadvertently supply themselves with misleading information about an event, causing a change in their recollection.

  20. Future of Food : Shaping the Food System to Deliver Jobs

    OpenAIRE

    Townsend, Robert; Benfica, Rui Manuel; Prasann, Ashesh; Lee, Maria

    2017-01-01

    Shaping the Food System to Deliver Jobs is the fourth paper in a series on The Future of Food. This paper focuses on how the food system can deliver jobs. It provides a framework for understanding the factors determining the number and quality of jobs in the food system, including inclusion of women and youth. It highlights a set of actions that countries can adopt, adapt, and apply to the...

  1. Delivering service adaptation with 3G technology

    NARCIS (Netherlands)

    Liotta, A.; Yew, A.; Bohoris, C.; Pavlou, G.; Feridun, M.; Kropf, P.G.; Babin, G.

    2002-01-01

    Now that 3G technologies have reached their maturity, newly advanced services can be delivered to the mobile user. These include context- aware services, adaptable services and Virtual Home Environment (VHE)-like services. Important research issues relate, however, to managing such services through

  2. Delivering Key Graduate Attributes via Teams Working in Virtual Space

    Directory of Open Access Journals (Sweden)

    Lyn Brodie

    2011-09-01

    Full Text Available Transferable skills are gaining an increasing emphasis in engineering education. The skills of teamwork, communication, self directed learning and problem solving feature in most of the accrediting agencies criteria. This paper is a case study of a course which uses Problem Based Learning method to deliver key transferable skills to engineering students studying via distance education The students use a range of communication systems including a Learning Management System which offers synchronous and asynchronous communications to work in a team where there is no face to face contact between either the team members or with the supervising academic. The teams solve open ended, contextualised engineering problems. These teams form a learning community which scaffolds individual and team learning goals. Results from a longitudinal study show that students significantly increase their teamwork, communication, problem solving and self directed learning skills. These are key graduate attributes now required by professional accreditation bodies. In addition specific theoretical and technical skills and knowledge are learnt and applied to new problems.

  3. Stellar Presentations (Abstract)

    Science.gov (United States)

    Young, D.

    2015-12-01

    (Abstract only) The AAVSO is in the process of expanding its education, outreach and speakers bureau program. powerpoint presentations prepared for specific target audiences such as AAVSO members, educators, students, the general public, and Science Olympiad teams, coaches, event supervisors, and state directors will be available online for members to use. The presentations range from specific and general content relating to stellar evolution and variable stars to specific activities for a workshop environment. A presentation—even with a general topic—that works for high school students will not work for educators, Science Olympiad teams, or the general public. Each audience is unique and requires a different approach. The current environment necessitates presentations that are captivating for a younger generation that is embedded in a highly visual and sound-bite world of social media, twitter and U-Tube, and mobile devices. For educators, presentations and workshops for themselves and their students must support the Next Generation Science Standards (NGSS), the Common Core Content Standards, and the Science Technology, Engineering and Mathematics (STEM) initiative. Current best practices for developing relevant and engaging powerpoint presentations to deliver information to a variety of targeted audiences will be presented along with several examples.

  4. Conformal intensity-modulated radiotherapy (IMRT) delivered by robotic linac - testing IMRT to the limit?

    International Nuclear Information System (INIS)

    Webb, S.

    1999-01-01

    In this paper it is proposed that intensity-modulated radiotherapy (IMRT) could be delivered optimally by a short-length linac mounted on a robotic arm. The robot would allow the linac to 'plant' narrow pencils of photon radiation with any orientation (excluding zones within which the linac and couch might collide) relative to the planning target volume (PTV). The treatment is specified by the trajectory of the robot and by the number of monitor units (MUs) delivered at each robotic orientation. An inverse-planning method to determine the optimum robotic trajectory is presented. It is shown that for complex PTVs, specifically those with concavities in their outline, the conformality of the treatment is improved by the use of a complex trajectory in comparison with a less complex constrained trajectory and this improvement is quantified. It is concluded that robotic linac delivery would lead to a great flexibility in those IMRT treatments requiring very complicated dose distributions with complex 3D shapes. However, even using very fast computers, the goal of determining whether robotic linac delivery is the ultimate IMRT cannot be conclusively reached at present. (author)

  5. Adaptive brachytherapy of cervical cancer, comparison of conventional point A and CT based individual treatment planning

    International Nuclear Information System (INIS)

    Wanderaas, Anne D.; Langdal, Ingrid; Danielsen, Signe; Frykholm, Gunilla; Marthinsen, Anne B. L; Sundset, Marit

    2012-01-01

    Background. Locally advanced cervical cancer is commonly treated with external radiation therapy combined with local brachytherapy. The brachytherapy is traditionally given based on standard dose planning with prescription of dose to point A. Dosimetric aspects when changing from former standard treatment to individualized treatment plans based on computed tomography (CT) images are here investigated. Material and methods. Brachytherapy data from 19 patients with a total of 72 individual treatment fractions were retrospectively reviewed. Standard library plans were analyzed with respect to doses to organs at risk (OARs), and the result was compared to corresponding delivered individualized plans. The theoretical potential of further optimization based on prescription to target volumes was investigated. The treatments were performed with a Fletcher applicator. Results. For standard treatment planning, the tolerance dose limits were exceeded in the bladder, rectum and sigmoid in 26%, 4% and 15% of the plans, respectively. This was observed most often for the smallest target volumes. The individualized planning of the delivered treatment gave the possibility of controlling the dose to critical organs to below certain limits. The dose was still prescribed to point A. An increase in target dose coverage was achieved when additional individual optimization was performed, while still keeping the dose to the OARs below predefined limits. Relatively low average target coverage, especially for the largest volumes was however seen. Conclusion. The individualized delivered treatment plans ensured that doses to OARs were within acceptable limits. This was not the case in 42% of the corresponding standard plans. Further optimized treatment plans were found to give an overall better dose coverage. In lack of MR capacity, it may be favorable to use CT for planning due to possible protection of OARs. The CT based target volumes were, however, not equivalent to the volumes described

  6. Internet-delivered interpersonal psychotherapy versus internet-delivered cognitive behavioral therapy for adults with depressive symptoms: randomized controlled noninferiority trial.

    Science.gov (United States)

    Donker, Tara; Bennett, Kylie; Bennett, Anthony; Mackinnon, Andrew; van Straten, Annemieke; Cuijpers, Pim; Christensen, Helen; Griffiths, Kathleen M

    2013-05-13

    Face-to-face cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are both effective treatments for depressive disorders, but access is limited. Online CBT interventions have demonstrated efficacy in decreasing depressive symptoms and can facilitate the dissemination of therapies among the public. However, the efficacy of Internet-delivered IPT is as yet unknown. This study examines whether IPT is effective, noninferior to, and as feasible as CBT when delivered online to spontaneous visitors of an online therapy website. An automated, 3-arm, fully self-guided, online noninferiority trial compared 2 new treatments (IPT: n=620; CBT: n=610) to an active control treatment (MoodGYM: n=613) over a 4-week period in the general population. Outcomes were assessed using online self-report questionnaires, the Center for Epidemiological Studies Depression scale (CES-D) and the Client Satisfaction Questionnaire (CSQ-8) completed immediately following treatment (posttest) and at 6-month follow-up. Completers analyses showed a significant reduction in depressive symptoms at posttest and follow-up for both CBT and IPT, and were noninferior to MoodGYM. Within-group effect sizes were medium to large for all groups. There were no differences in clinical significant change between the programs. Reliable change was shown at posttest and follow-up for all programs, with consistently higher rates for CBT. Participants allocated to IPT showed significantly lower treatment satisfaction compared to CBT and MoodGYM. There was a dropout rate of 1294/1843 (70%) at posttest, highest for MoodGYM. Intention-to-treat analyses confirmed these findings. Despite a high dropout rate and lower satisfaction scores, this study suggests that Internet-delivered self-guided IPT is effective in reducing depressive symptoms, and may be noninferior to MoodGYM. The completion rates of IPT and CBT were higher than MoodGYM, indicating some progress in refining Internet-based self

  7. 20 CFR 669.330 - How are services delivered to the customer?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are services delivered to the customer... Farmworker Jobs Program Customers and Available Program Services § 669.330 How are services delivered to the customer? To ensure that all services are focused on the customer's needs, services are provided through a...

  8. Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

    Science.gov (United States)

    Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

    2016-04-01

    Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

  9. Increasing self-regulatory energy using an Internet-based training application delivered by smartphone technology.

    Science.gov (United States)

    Cranwell, Jo; Benford, Steve; Houghton, Robert J; Golembewski, Michael; Golembewksi, Michael; Fischer, Joel E; Hagger, Martin S

    2014-03-01

    Self-control resources can be defined in terms of "energy." Repeated attempts to override desires and impulses can result in a state of reduced self-control energy termed "ego depletion" leading to a reduced capacity to regulate future self-control behaviors effectively. Regular practice or "training" on self-control tasks may improve an individual's capacity to overcome ego depletion effectively. The current research tested the effectiveness of training using a novel Internet-based smartphone application to improve self-control and reduce ego depletion. In two experiments, participants were randomly assigned to either an experimental group, which received a daily program of self-control training using a modified Stroop-task Internet-based application delivered via smartphone to participants over a 4-week period, or a no-training control group. Participants assigned to the experimental group performed significantly better on post-training laboratory self-control tasks relative to participants in the control group. Findings support the hypothesized training effect on self-control and highlight the effectiveness of a novel Internet-based application delivered by smartphone as a practical means to administer and monitor a self-control training program. The smartphone training application has considerable advantages over other means to train self-control adopted in previous studies in that it has increased ecological validity and enables effective monitoring of compliance with the training program.

  10. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35 tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which finished its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. "The production is proceeding well and we expect to be complete in October as previously foreseen," said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have been delivered.

  11. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35-tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which completed its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. 'The production is proceeding well and we expect to be complete in October as foreseen,' said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have already been delivered.

  12. Nosocomial infections of ocular conjunctiva in newborns delivered by cesarian section.

    Science.gov (United States)

    Bezirtzoglou, E; Romond, C

    1991-01-01

    Colonization of the ocular conjunctiva in newborns delivered by cesarian section occurs usually within the first day of life. We have studied the flora of the ocular conjunctiva at birth, from 19 newborns delivered by cesarian section, coming from two different maternity hospitals. Ocular conjunctiva cultures yielded the main predominant flora in both maternity hospitals considered. The most common genus of this flora are: Staphylococcus, Corynebacterium and Propionibacterium acnes. Peptostreptococcus productus, Neisseria, Eubacterium and Clostridium perfringens are isolated occasionally. In newborns delivered by cesarian section, this flora principally acquired may be the consequence of the presence of bacteria in the ambient air, as well as differences in care provided by the nosocomial personnel.

  13. School Nurse-Delivered Adolescent Relationship Abuse Prevention

    Science.gov (United States)

    Raible, Claire A.; Dick, Rebecca; Gilkerson, Fern; Mattern, Cheryl S.; James, Lisa; Miller, Elizabeth

    2017-01-01

    Background: Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office…

  14. Computer-Assisted, Counselor-Delivered Smoking Cessation Counseling for Community College Students: Intervention Approach and Sample Characteristics

    Science.gov (United States)

    Prokhorov, Alexander V.; Fouladi, Rachel T.; de Moor, Carl; Warneke, Carla L.; Luca, Mario; Jones, Mary Mullin; Rosenblum, Carol; Emmons, Karen M.; Hudmon, Karen Suchanek; Yost, Tracey E.; Gritz, Ellen R.

    2007-01-01

    This report presents the experimental approach and baseline findings from "Look at Your Health," an ongoing study to develop and evaluate a computer-assisted, counselor-delivered smoking cessation program for community college students. It describes the expert system software program used for data collection and for provision of tailored feedback,…

  15. Is International Accounting Education Delivering Pedagogical Value?

    Science.gov (United States)

    Patel, Chris; Millanta, Brian; Tweedie, Dale

    2016-01-01

    This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

  16. Internet-delivered attention bias modification training in individuals with social anxiety disorder - a double blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Carlbring Per

    2012-06-01

    Full Text Available Abstract Background Computerized cognitive bias modification for social anxiety disorder has in several well conducted trials shown great promise with as many as 72% no longer fulfilling diagnostic criteria after a 4 week training program. To test if the same program can be transferred from a clinical setting to an internet delivered home based treatment the authors conducted a randomized, double-blind placebo-controlled trial. Methods After a diagnostic interview 79 participants were randomized to one of two attention training programs using a probe detection task. In the active condition the participant was trained to direct attention away from threat, whereas in the placebo condition the probe appeared with equal frequency in the position of the threatening and neutral faces. Results Results were analyzed on an intention-to-treat basis, including all randomized participants. Immediate and 4-month follow-up results revealed a significant time effect on all measured dimensions (social anxiety scales, general anxiety and depression levels, quality of life. However, there were no time x group interactions. The lack of differences in the two groups was also mirrored by the infinitesimal between group effect size both at post test and at 4-month follow-up. Conclusion We conclude that computerized attention bias modification may need to be altered before dissemination for the Internet. Trial registration ISRCTN01715124

  17. Experiences of non-adherence to Internet-delivered cognitive behavior therapy: A qualitative study

    OpenAIRE

    Johansson, Olof; Michel, Teresa; Andersson, Gerhard; Paxling, Björn

    2015-01-01

    Many trials on Internet-delivered psychological treatments have had problems with nonadherence, but not much is known about the subjective reasons for non-adhering. The aim of this study was to explore participants' experiences of non-adherence to Internet-delivered psychological treatment. Grounded theory was used to analyze data from seven in-depth interviews with persons who had non-adhered to a study on Internet-delivered cognitive behavioral therapy for generalized anxiety disorder. The ...

  18. Feasibility of Training and Delivering Compassionate Touch in Long-Term Care.

    Science.gov (United States)

    Han, Areum; Kunik, Mark E

    2017-09-19

    Limited evidence supports the use of therapeutic touch for people with dementia (PWD). Interventions incorporating a person-centered approach to touch delivered by staff may benefit PWD and staff in long-term care settings. The Compassionate Touch ® (CT) program provides skilled human touch and a compassionate presence following a person-centered approach and touch protocol. The purpose of this study was to determine the feasibility of training and delivering CT. An online survey was sent via email to 112 staff who attended the CT coach training. Descriptive statistics and thematic analysis were used to analyze closed-and open-ended questions of the survey. Twenty-four staff members completed the survey and reported positive perspectives about the training, use of the program, and benefits for PWD and themselves. Five themes emerged, including (1) benefits for residents, (2) challenges in using CT, (3) when to use CT, (4) training staff, and (5) needed support. Preliminary findings from the present research show potential benefits of using the CT program for residents, challenges participants faced in using the program and training other staff, and support needed to overcome these challenges. Programs such as CT may benefit PWD and staff in residential care settings.

  19. The Importance of Data Visualization: Incorporating Storytelling into the Scientific Presentation

    Science.gov (United States)

    Babiak-Vazquez, A.; Cornett, A. N.; Wear, M. L.; Sams, C.

    2014-01-01

    From its inception in 2000, one of the primary tasks of the Biomedical Data Reduction Analysis (BDRA) group has been translation of large amounts of data into information that is relevant to the audience receiving it. BDRA helps translate data into an integrated model that supports both operational and research activities. This data integrated model and subsequent visual data presentations have contributed to BDRA's success in delivering the message (i.e., the story) that its customers have needed to communicate. This success has led to additional collaborations among groups that had previously not felt they had much in common until they worked together to develop solutions in an integrated fashion. As more emphasis is placed on working with "big data" and on showing how NASA's efforts contribute to the greater good of the American people and of the world, it becomes imperative to visualize the story of our data to communicate the greater message we need to share. METHODS To create and expand its data integrated model, BDRA has incorporated data from many different collaborating partner labs and other sources. Data are compiled from the repositories of the Lifetime Surveillance of Astronaut Health and the Life Sciences Data Archive, and from the individual laboratories at Johnson Space Center that support collection of data from medical testing, environmental monitoring, and countermeasures, as designated in the Medical Requirements Integration Documents. Ongoing communication with the participating collaborators is maintained to ensure that the message and story of the data are retained as data are translated into information and visual data presentations are delivered in different venues and to different audiences. RESULTS We will describe the importance of storytelling through an integrated model and of subsequent data visualizations in today's scientific presentations and discuss the collaborative methods used. We will illustrate the discussion with examples of

  20. The Use of Modality in In-Vehicle Information Presentation : A Brief Overview

    NARCIS (Netherlands)

    Cao, Y.; Theune, Mariet

    2010-01-01

    In-vehicle information systems (IVIS) are multimodal presentation systems that are designed to assist drivers. The challenge of IVIS information presentation is to deliver information effectively while minimizing the interference with driving. Modality is a presentation factor that has been known to

  1. Delivering a Paper (and other works) at #LowTechLabLondon2016

    OpenAIRE

    O'Connell, Micheal

    2016-01-01

    Performance 'Delivering a Paper' and screened/presented/exhibited other works such as 'How to Buy Nothing' related to author's interventionist art practice at this three-day event.\\ud \\ud #LowTechLabLondon2016 is a project developed by Raúl Marroquín and coordinated by Daniela Medina Poch for the Educational Program of the Saatchi Gallery that will take place on January 15th, 16th and 17th of 2016.\\ud \\ud “‘LowTech means technology that is cheap or free.”\\ud James Wallback, LowTech Manifest f...

  2. Individual Education.

    Science.gov (United States)

    Corsini, Raymond

    1981-01-01

    Paper presented at the 66th Convention of the International Association of Pupil Personnel Workers, October 20, 1980, Baltimore, Maryland, describes individual education based on the principles of Alfred Adler. Defines six advantages of individual education, emphasizing student responsibility, mutual respect, and allowing students to progress at…

  3. Acceptability and feasibility of self-help Cognitive Remediation Therapy for anorexia nervosa delivered in collaboration with carers: a qualitative preliminary evaluation study.

    Science.gov (United States)

    Lang, Katie; Treasure, Janet; Tchanturia, Kate

    2015-02-28

    Anorexia nervosa (AN) is an eating disorder without a recommended first-line treatment. Cognitive Remediation Therapy (CRT) is showing great promise in helping patients reduce cognitive inflexibility and excessive detail focus, thinking styles that could make engaging in psychological therapies difficult. CRT has shown to be effective, feasible and acceptable in both individual and group formats, and positive qualitative data has been gathered from both service users and clinicians. The aim of the current study was to assess the use of CRT as a self-help treatment for individuals with AN delivered in collaboration with carers. Six families underwent a six-week self-help CRT intervention. Feedback was gathered from qualitative interviews and analysed using thematic analysis. Neuropsychological outcomes were also collected. Participant feedback regarding the intervention was generally positive, with participants describing a number of benefits such as it creating a space for families to spend time together outside of the eating disorder, acting as a 'gateway' for more emotional work and helping participants to gain insight into their cognitive profiles. These preliminary findings suggest that self-help CRT delivered in collaboration with carers is an acceptable form of treatment, and adds to the growing literature supporting CRT for AN. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Present status and future plans at the Bonn synchrotron

    International Nuclear Information System (INIS)

    Mecking, B.A.

    1984-01-01

    The electron stretcher ring ELSA presently under construction in Bonn and the associated experimental equipment are described. The ring will deliver electron and photon beams with close to 100% duty cycle for experiments in elementary particle and photonuclear physics. (author)

  5. Modeling patients' acceptance of provider-delivered e-health.

    Science.gov (United States)

    Wilson, E Vance; Lankton, Nancy K

    2004-01-01

    Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

  6. A better way to deliver bad news.

    Science.gov (United States)

    Manzoni, Jean-François

    2002-09-01

    In an ideal world, a subordinate would accept critical feedback from a manager with an open mind. He or she would ask a few clarifying questions, promise to work on certain performance areas, and show signs of improvement over time. But things don't always turn out that way. Such conversations can be unpleasant. Emotions can run high; tempers can flare. Fearing that the employee will become angry and defensive, the boss all too often inadvertently sabotages the meeting by preparing for it in a way that stifles honest discussion. This unintentional--indeed, unconscious--stress-induced habit makes it difficult to deliver corrective feedback effectively. Insead professor Jean-François Manzoni says that by changing the mind-set with which they develop and deliver negative feedback, managers can increase their odds of having productive conversations without damaging relationships. Manzoni describes two behavioral phenomena that color the feedback process--the fundamental attribution error and the false consensus effect--and uses real-world examples to demonstrate how bosses' critiques can go astray. Managers tend to frame difficult situations and decisions in a way that is narrow (alternatives aren't considered) and binary (there are only two possible outcomes--win or lose). And during the feedback discussion, managers' framing of the issues often remains frozen, regardless of the direction the conversation takes. Manzoni advises managers not to just settle on the first acceptable explanation for a behavior or situation they've witnessed. Bosses also need to consider an employee's circumstances rather than just attributing weak performance to a person's disposition. In short, delivering more effective feedback requires an open-minded approach, one that will convince employees that the process is fair and that the boss is ready for an honest conversation.

  7. At loggerheads or in dovetails? The individual and the State from early modern jurisprudence to contemporary international jurisprudence.

    OpenAIRE

    De Lucca, Jean-Paul; Works in Progress Seminars Series

    2012-01-01

    A Works in Progress Seminars Series lecture entitled: At Loggerheads or in dovetails? The individual and the State from early modern jurisprudence to contemporary international jurisprudence. This talk is delivered by Dr Jean Paul De Lucca.

  8. New calibration method for I-scan sensors to enable the precise measurement of pressures delivered by 'pressure garments'.

    Science.gov (United States)

    Macintyre, Lisa

    2011-11-01

    Accurate measurement of the pressure delivered by medical compression products is highly desirable both in monitoring treatment and in developing new pressure inducing garments or products. There are several complications in measuring pressure at the garment/body interface and at present no ideal pressure measurement tool exists for this purpose. This paper summarises a thorough evaluation of the accuracy and reproducibility of measurements taken following both of Tekscan Inc.'s recommended calibration procedures for I-scan sensors; and presents an improved method for calibrating and using I-scan pressure sensors. The proposed calibration method enables accurate (±2.1 mmHg) measurement of pressures delivered by pressure garments to body parts with a circumference ≥30 cm. This method is too cumbersome for routine clinical use but is very useful, accurate and reproducible for product development or clinical evaluation purposes. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  9. Self-reported prenatal oral health-care practices of preterm low birth weight-delivered women belonging to different socioeconomic status: A postnatal survey.

    Science.gov (United States)

    Elangovan, Gayathri Priyadarshni; Muthu, Jananni; Periyasamy, Indra Kumar; Balu, Pratebha; Kumar, R Saravana

    2017-01-01

    The differences in the oral health status between the individuals with a high socioeconomic status (SES) and those with a low SES had markedly increased. There is, however, minimal information available on women understanding the need of dental hygiene for overall health and whether pregnant women comply with the current oral health strategies. In Lieu with the above, the present study aims to assess the awareness, dental hygiene practices, and the frequency of dental visits during pregnancy in postnatal women who delivered preterm low birth weight babies of different SES in and around Puducherry. A total of 200 individuals who visited Rajiv Gandhi Maternity Centre, Puducherry for delivery were selected. Information regarding onset of prenatal care, referral to dentist, and oral hygiene habits such as frequency of brushing, type of brush used, method of brushing, and frequency of brush change were obtained. Periodontal health status was recorded using PSR system. Awareness of oral hygiene practices was more among upper middle class and lower middle class compared to upper lower strata. Visit to dentist during perinatal period was high among upper middle class compared to other socioeconomic strata. The awareness of oral health-care practices and importance of oral care during perinatal period were less among low socioeconomic strata.

  10. Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents.

    Science.gov (United States)

    Fisher, Emma; Law, Emily; Palermo, Tonya M; Eccleston, Christopher

    2015-03-23

    -to-face between therapist and patient from this review. Children and adolescents (0 to 18 years of age) with a primary chronic pain condition were the target of the interventions. Each comparator arm, at each extraction point had to include 10 or more participants. For the analyses, we combined all psychological therapies. We split pain conditions into headache and mixed (non-headache) pain and analysed them separately. Pain, disability, depression, anxiety, and adverse events were extracted as primary outcomes. We also extracted satisfaction with treatment as a secondary outcome. We considered outcomes at two time points: first immediately following the end of treatment (known as 'post-treatment'), and second, any follow-up time point post-treatment between 3 and 12 months (known as 'follow-up'). We assessed all included studies for risk of bias. Eight studies (N = 371) that delivered treatment remotely were identified from our search; five studies investigated children with headache conditions, one study was with children with juvenile idiopathic arthritis, and two studies included mixed samples of children with headache and mixed (i.e. recurrent abdominal pain, musculoskeletal pain) chronic pain conditions. The average age of children receiving treatment was 12.57 years.For headache pain conditions, we found one beneficial effect of remotely delivered psychological therapy. Headache severity was reduced post-treatment (risk ratio (RR) = 2.65, 95% confidence interval (CI) 1.56 to 4.50, z = 3.62,p psychological therapies reduced pain intensity post-treatment (standardised mean difference (SMD) = -0.61, 95% CI -0.96 to -0.25, z = 3.38, p psychological therapies delivered remotely for disability post-treatment and a lack of data at follow-up meant no analyses could be run. Only one analysis could be conducted for depression outcomes. We found no beneficial effect of psychological therapies in reducing depression post-treatment for headache conditions. Only one study presented data

  11. Agrobacterium-delivered virulence protein VirE2 is trafficked inside host cells via a myosin XI-K-powered ER/actin network.

    Science.gov (United States)

    Yang, Qinghua; Li, Xiaoyang; Tu, Haitao; Pan, Shen Q

    2017-03-14

    Agrobacterium tumefaciens causes crown gall tumors on various plants by delivering transferred DNA (T-DNA) and virulence proteins into host plant cells. Under laboratory conditions, the bacterium is widely used as a vector to genetically modify a wide range of organisms, including plants, yeasts, fungi, and algae. Various studies suggest that T-DNA is protected inside host cells by VirE2, one of the virulence proteins. However, it is not clear how Agrobacterium -delivered factors are trafficked through the cytoplasm. In this study, we monitored the movement of Agrobacterium -delivered VirE2 inside plant cells by using a split-GFP approach in real time. Agrobacterium -delivered VirE2 trafficked via the endoplasmic reticulum (ER) and F-actin network inside plant cells. During this process, VirE2 was aggregated as filamentous structures and was present on the cytosolic side of the ER. VirE2 movement was powered by myosin XI-K. Thus, exogenously produced and delivered VirE2 protein can use the endogenous host ER/actin network for movement inside host cells. The A. tumefaciens pathogen hijacks the conserved host infrastructure for virulence trafficking. Well-conserved infrastructure may be useful for Agrobacterium to target a wide range of recipient cells and achieve a high efficiency of transformation.

  12. Comparison of radiation delivered by current diagnostic procedures for herniated disc

    International Nuclear Information System (INIS)

    Gasquet, C.; Drouineau, J.; Goubault, F.; Hurmic, A.; Lavigne, B.; Vandermarcq, P.

    1983-01-01

    Three methods are currently employed for the diagnosis of sciatica due to disc lesions: radiculography, spinal phlebography, and computed tomography. Though their indications vary according to the author, it seemed worthwhile to compare radiation delivered by each of them, because of the often young age of the patients. Dosimetric studies using a Rando Phantom enabled calculation of doses to the skin, spinal cord, and gonads. Results indicated that low doses were delivered by the scanner, relatively high doses by spinal phlebography, and intermediate doses by radiculography. These findings suggest that the initial examination preoperatively in cases of simple sciatica due to herniated disc should be a CT scan whenever possible. Phlebography, on the contrary, and particularly in young women, should be used only exceptionally, as a result of the high doses delivered to the ovaries even during technically simple explorations [fr

  13. A Fetus with Iniencephaly Delivered at the Third Trimester

    Directory of Open Access Journals (Sweden)

    Esra Cinar Tanriverdi

    2015-01-01

    Full Text Available Iniencephaly is an uncommon neural tube defect, having retroflexion of the head without a neck and severe distortion of the spine. Iniencephaly is classified into two groups, iniencephaly apertus (with encephalocele and iniencephaly clausus (without encephalocele. Incidence ranges from 0.1 to 10 in 10.000 pregnancies and it is seen more frequently in girls. Most of the fetuses with this defect die before birth or soon after birth, while those with the milder forms may live through childhood. Recurrence risk is around 1–5%. Family should be offered termination to reduce maternal risks and counseled for folic acid supplementation before the next planned pregnancy. Here we present a rare case of iniencephaly clausus which was diagnosed at 18th week of gestation by ultrasonography and delivered in the third trimester of pregnancy due to rejection of termination.

  14. Externally Delivered Focused Ultrasound for Renal Denervation.

    Science.gov (United States)

    Neuzil, Petr; Ormiston, John; Brinton, Todd J; Starek, Zdenek; Esler, Murray; Dawood, Omar; Anderson, Thomas L; Gertner, Michael; Whitbourne, Rob; Schmieder, Roland E

    2016-06-27

    The aim of this study was to assess clinical safety and efficacy outcomes of renal denervation executed by an externally delivered, completely noninvasive focused therapeutic ultrasound device. Renal denervation has emerged as a potential treatment approach for resistant hypertension. Sixty-nine subjects received renal denervation with externally delivered focused ultrasound via the Kona Medical Surround Sound System. This approach was investigated across 3 consecutive studies to optimize targeting, tracking, and dosing. In the third study, treatments were performed in a completely noninvasive way using duplex ultrasound image guidance to target the therapy. Short- and long-term safety and efficacy were evaluated through use of clinical assessments, magnetic resonance imaging scans prior to and 3 and 24 weeks after renal denervation, and, in cases in which a targeting catheter was used to facilitate targeting, fluoroscopic angiography with contrast. All patients tolerated renal denervation using externally delivered focused ultrasound. Office blood pressure (BP) decreased by 24.6 ± 27.6/9.0 ± 15.0 mm Hg (from baseline BP of 180.0 ± 18.5/97.7 ± 13.7 mm Hg) in 69 patients after 6 months and 23.8 ± 24.1/10.3 ± 13.1 mm Hg in 64 patients with complete 1-year follow-up. The response rate (BP decrease >10 mm Hg) was 75% after 6 months and 77% after 1 year. The most common adverse event was post-treatment back pain, which was reported in 32 of 69 patients and resolved within 72 h in most cases. No intervention-related adverse events involving motor or sensory deficits were reported. Renal function was not altered, and vascular safety was established by magnetic resonance imaging (all patients), fluoroscopic angiography (n = 48), and optical coherence tomography (n = 5). Using externally delivered focused ultrasound and noninvasive duplex ultrasound, image-guided targeting was associated with substantial BP reduction without any major safety signals. Further

  15. Delivering colonoscopy screening for low-income populations in Suffolk County: strategies, outcomes, and benchmarks.

    Science.gov (United States)

    Lane, Dorothy S; Messina, Catherine R; Cavanagh, Mary F; Anderson, Joseph C

    2013-08-01

    Current and pending legislation provides colorectal cancer screening reimbursement for previously uninsured populations. Colonoscopy is currently the screening method most frequently recommended by physicians for insured patients. The experience of the SCOPE (Suffolk County Preventive Endoscopy) demonstration project (Project SCOPE) at Stony Brook University Medical Center provides a model for delivering colonoscopy screening to low-income populations to meet anticipated increasing demands. Project SCOPE, based in the Department of Preventive Medicine, featured internal collaboration with the academic medical center's large gastroenterology practice and external collaboration with the Suffolk County Department of Health Services' network of community health centers. Colonoscopies were performed by faculty gastroenterologists or supervised fellows. Measures of colonoscopy performance were compared with quality indicators and differences between faculty and supervised fellows were identified. During a 40-month screening period, 800 initial colonoscopies were performed. Approximately 21% of women screened were found to have adenomatous polyps compared with 36% of men. Five cancers were detected. The majority of the population screened (70%) were members of minority populations. African American individuals had a higher percentage of proximally located adenomas (78%) compared with white individuals (65%) and Hispanics (49%), based on the location of the most advanced lesion. Hispanic individuals had a 36% lower risk of adenomas compared with white individuals. Performance measures including the percentage of procedures with adequate bowel preparation, cecum reached, scope withdrawal time, and adenoma detection rate met quality benchmarks when performed by either faculty or supervised fellows. Project SCOPE's operational strategies demonstrated a feasible method for an academic medical center to provide high-quality screening colonoscopy for low-income populations.

  16. Power Delivered to Mechanical Systems by Random Vibrations

    Directory of Open Access Journals (Sweden)

    Timothy S. Edwards

    2009-01-01

    Full Text Available This paper develops deformational response power descriptions of multiple degree-of-freedom systems due to stationary random vibration excitation. Two new concepts are developed. The deformational response power density (DRPD can be computed when a structure's natural frequencies and modal masses are available. The DRPD shows the spectral content of the deformational power delivered to a specific structure by the stationary, random excitation. This function can be found through a weighted windowing of the power spectrum of the input acceleration excitation. Deformational response input power spectra (DRIPS, similar to the input energy spectrum and shock response spectrum, give the power delivered to single-degree-of-freedom systems as a function of natural frequency. It is shown that the DRIPS is simply a smoothed version of the power spectrum of the input acceleration excitation. The DRIPS gives rise to a useful power-based data smoothing operation.

  17. Infants delivered in maternity homes run by traditional birth attendants in urban Nigeria: a community-based study.

    Science.gov (United States)

    Olusanya, Bolajoko O; Inem, Victor A; Abosede, Olayinka A

    2011-06-01

    We explored factors associated with traditional maternity/herbal homes (TMHs) run by traditional birth attendants (TBAs) compared with hospital or home delivery in Lagos, Nigeria, and found that infants delivered at TMHs were less likely to have severe hyperbilirubinemia compared with infants delivered in hospitals or residential homes. These infants were also less likely to be preterm compared with those delivered in hospitals or undernourished compared with infants delivered in residential homes. We concluded that infants delivered at TMHs who survive are unlikely to be at greater risks of some adverse perinatal outcomes than those delivered in hospitals or family homes.

  18. Workflow for high-content, individual cell quantification of fluorescent markers from universal microscope data, supported by open source software.

    Science.gov (United States)

    Stockwell, Simon R; Mittnacht, Sibylle

    2014-12-16

    Advances in understanding the control mechanisms governing the behavior of cells in adherent mammalian tissue culture models are becoming increasingly dependent on modes of single-cell analysis. Methods which deliver composite data reflecting the mean values of biomarkers from cell populations risk losing subpopulation dynamics that reflect the heterogeneity of the studied biological system. In keeping with this, traditional approaches are being replaced by, or supported with, more sophisticated forms of cellular assay developed to allow assessment by high-content microscopy. These assays potentially generate large numbers of images of fluorescent biomarkers, which enabled by accompanying proprietary software packages, allows for multi-parametric measurements per cell. However, the relatively high capital costs and overspecialization of many of these devices have prevented their accessibility to many investigators. Described here is a universally applicable workflow for the quantification of multiple fluorescent marker intensities from specific subcellular regions of individual cells suitable for use with images from most fluorescent microscopes. Key to this workflow is the implementation of the freely available Cell Profiler software(1) to distinguish individual cells in these images, segment them into defined subcellular regions and deliver fluorescence marker intensity values specific to these regions. The extraction of individual cell intensity values from image data is the central purpose of this workflow and will be illustrated with the analysis of control data from a siRNA screen for G1 checkpoint regulators in adherent human cells. However, the workflow presented here can be applied to analysis of data from other means of cell perturbation (e.g., compound screens) and other forms of fluorescence based cellular markers and thus should be useful for a wide range of laboratories.

  19. Capacity to deliver pharmaceutical care by community pharmacies ...

    African Journals Online (AJOL)

    Pharmacy practice has transcended from largely a dispensary practice to pharmaceutical care practice. The capacity of community pharmacies to deliver pharmaceutical care was studied using pretested self survey methods. Ninety five percent (95%) of the respondents always educated customers on drug related needs, ...

  20. Individual Psychotherapy ("Talking Therapy"): A Survey of Attitudes among Residents & Specialists in Psychiatry, Israel 2010-2011.

    Science.gov (United States)

    Levi Shachar, Orit; Mendlovic, Shlomo; Hertzberg, Libi; Baruch, Yehuda; Lurie, Ido

    2016-01-01

    Individual psychotherapy is an efficient tool and an integral part of psychiatric treatment. However, its status among psychiatrists in Israel has never been explored. To explore and map the attitudes of psychiatrists in Israel regarding psychotherapy and psychotherapy training during residency, with comparisons between residents vs. specialists, peripheral vs. central institutions and mental health vs. medical centers. We conducted a cross-sectional survey to examine the attitudes toward individual psychotherapy. The questionnaire was delivered via email and direct approach to psychiatrists in Israel. The survey was completed by 229 of 1,502 registered psychiatrists (15.3%). While 96% (n=218) had positive attitudes towards psychotherapy, 93.1% (n=215) thought psychotherapy was less available than pharmacotherapy. Psychiatrists from peripheral institutions prefer cognitive behavioral therapy, while psychiatrists from central institutions prefer dynamic psychotherapy. Psychiatrists from mental health centers use more dynamic psychotherapy compared to psychiatrists from medical centers. The number of dynamic psychotherapy treatments psychiatrists delivered during their residencies has been decreasing over time, meaning residents today deliver fewer dynamic psychotherapy treatments compared to the number of treatments specialists delivered during their residencies. Additionally, 97.4% (n=225) believed psychotherapy training should be included in the psychiatric residency and 87.3% thought that the training should be improved to a great extent. The survey demonstrates mixed but overall positive attitudes towards psychotherapy among psychiatrists in Israel. The findings should be taken into consideration by psychiatrists who design the residency program and by policy makers who are in charge of the mental health reform in Israel, or the psychotherapy usage and therapeutic potential may diminish, as has happened in other countries.

  1. Response to hypothetical social scenarios in individuals with traumatic brain injury who present inappropriate social behavior: a preliminary report.

    Science.gov (United States)

    Gagnon, Jean; Henry, Anne; Decoste, François-Pierre; Ouellette, Michel; McDuff, Pierre; Daelman, Sacha

    2013-03-01

    Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB) post-TBI (traumatic brain injury). To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB), have difficulty anticipating their own feelings of embarrassment and others' angry reactions following an ISB. Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB), 10 presenting with appropriate social behavior (TBI-ASB), and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A) and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B). TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. RESULTS regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. RESULTS suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying mechanisms affecting social behaviors after a TBI.

  2. Response to Hypothetical Social Scenarios in Individuals with Traumatic Brain Injury Who Present Inappropriate Social Behavior: A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Michel Ouellette

    2013-01-01

    Full Text Available Background: Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB post-TBI (traumatic brain injury. Objectives: To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB, have difficulty anticipating their own feelings of embarrassment and others’ angry reactions following an ISB. Methods: Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB, 10 presenting with appropriate social behavior (TBI-ASB, and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B. Results: TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. Results regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. Conclusions: Results suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying

  3. Evolution of a nursing education program delivered to baccalaureate-prepared Haitian nurses.

    Science.gov (United States)

    Lev, Elise L; Lindgren, Teri G; Pearson, Gayle A; Alcindor, Hilda

    2013-01-01

    Haiti has high morbidity and mortality rates, a large proportion of people living in poverty, and a shortage of nurses and nursing faculty members. A partnership program between a US and Haitian university was formed to deliver a certificate program in nursing education. The authors describe their experiences developing, delivering, and evaluating the blended on-site and online program and their future goals.

  4. Delivering mental health awareness training to police officers.

    Science.gov (United States)

    Forni, Carlos; Caswell, Nick; Spicer, Jerina

    Police officers regularly come into contact with people with mental health problems but receive relatively little training on the issue. This article outlines an initiative to deliver awareness training to officers, and explores the benefits of such programmes. It also gives details of the evaluation carried out.

  5. In vitro magnetic stimulation: a simple stimulation device to deliver defined low intensity electromagnetic fields

    Directory of Open Access Journals (Sweden)

    Stephanie Grehl

    2016-11-01

    Full Text Available Non-invasive electromagnetic field brain stimulation (NIBS appears to benefit human neurological and psychiatric conditions, although the optimal stimulation parameters and underlying mechanisms remain unclear. Although in vitro studies have begun to elucidate cellular mechanisms, stimulation is delivered by a range of coils (from commercially available human stimulation coils to laboratory-built circuits so that the electromagnetic fields induced within the tissue to produce the reported effects are ill-defined.Here we develop a simple in vitro stimulation device with plug-and-play features that allow delivery of a range of stimulation parameters. We chose to test low intensity repetitive magnetic stimulation (LI-rMS delivered at 3 frequencies to hindbrain explant cultures containing the olivocerebellar pathway. We used computational modelling to define the parameters of a stimulation circuit and coil that deliver a unidirectional homogeneous magnetic field of known intensity and direction, and therefore a predictable electric field, to the target. We built the coil to be compatible with culture requirements: stimulation within an incubator; a flat surface allowing consistent position and magnetic field direction; location outside the culture plate to maintain sterility and no heating or vibration. Measurements at the explant confirmed the induced magnetic field was homogenous and matched the simulation results. To validate our system we investigated biological effects following LI-rMS at 1 Hz, 10 Hz and biomimetic high frequency (BHFS, which we have previously shown induces neural circuit reorganisation. We found that gene expression was modified by LI-rMS in a frequency-related manner. Four hours after a single 10-minute stimulation session, the number of c-fos positive cells increased, indicating that our stimulation activated the tissue. Also, after 14 days of LI-rMS, the expression of genes normally present in the tissue was differentially

  6. Promised and Delivered Inducements and Contributions: An Integrated View of Psychological Contract Appraisal

    Science.gov (United States)

    Lambert, Lisa Schurer

    2011-01-01

    The reciprocal exchange of employees' work for pay that is central to employment relationships is viewed here through the lens of the psychological contract. A psychological contract involves promised inducements, promised contributions, delivered inducements, and delivered contributions: How an employee cognitively integrates these 4 elements is…

  7. Delivering Left-Skewed Portfolio Payoff Distributions in the Presence of Transaction Costs

    Directory of Open Access Journals (Sweden)

    Jacek B Krawczyk

    2015-08-01

    Full Text Available For pension-savers, a low payoff is a financial disaster. Such investors will most likely prefer left-skewed payoff distributions over right-skewed payoff distributions. We explore how such distributions can be delivered. Cautious-relaxed utility measures are cautious in ensuring that payoffs don’t fall much below a reference value, but relaxed about exceeding it. We find that the payoff distribution delivered by a cautious-relaxed utility measure has appealing features which payoff distributions delivered by traditional utility functions don’t. In particular, cautious-relaxed distributions can have the mass concentrated on the left, hence be left-skewed. However, cautious-relaxed strategies prescribe frequent portfolio adjustments which may be expensive if transaction costs are charged. In contrast, more traditional strategies can be time-invariant. Thus we investigate the impact of transaction costs on the appeal of cautious-relaxed strategies. We find that relatively high transaction fees are required for the cautious-relaxed strategy to lose its appeal. This paper contributes to the literature which compares utility measures by the payoff distributions they produce and finds that a cautious-relaxed utility measure will deliver payoffs that many investors will prefer.

  8. Examining the cost of delivering routine immunization in Honduras.

    Science.gov (United States)

    Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

    2015-05-07

    Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

  9. Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania.

    Science.gov (United States)

    Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A

    2016-07-01

    Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual's area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  10. Foresight begins with FMEA. Delivering accurate risk assessments.

    Science.gov (United States)

    Passey, R D

    1999-03-01

    If sufficient factors are taken into account and two- or three-stage analysis is employed, failure mode and effect analysis represents an excellent technique for delivering accurate risk assessments for products and processes, and for relating them to legal liability. This article describes a format that facilitates easy interpretation.

  11. Portable devices for delivering imagery and modelling interventions ...

    African Journals Online (AJOL)

    The main objective of this study was to investigate the effectiveness of portable devices (MP4) and a stationary device (DVD and fixed point stationary computer) in delivering imagery and modelling training among female netball players, examining the effect on imagery adherence, performance, self-efficacy, and the relative ...

  12. The knowledge and skills gap of medical practitioners delivering ...

    African Journals Online (AJOL)

    The knowledge and skills gap of medical practitioners delivering district hospital ... and quality health services, and also for guiding appropriate undergraduate, ... The uneven skill and knowledge base in aspects of HIV/AIDS management ...

  13. Using technology to deliver quality education in Asia | IDRC ...

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

    2016-06-08

    Jun 8, 2016 ... Using technology to deliver quality education in Asia ... Entrepreneurship has been a major driver of growth and job creation in Southeast Asia. ... to provide access to health services, especially to vulnerable populations.

  14. Individual muscle contributions to push and recovery subtasks during wheelchair propulsion.

    Science.gov (United States)

    Rankin, Jeffery W; Richter, W Mark; Neptune, Richard R

    2011-04-29

    Manual wheelchair propulsion places considerable physical demand on the upper extremity and is one of the primary activities associated with the high prevalence of upper extremity overuse injuries and pain among wheelchair users. As a result, recent effort has focused on determining how various propulsion techniques influence upper extremity demand during wheelchair propulsion. However, an important prerequisite for identifying the relationships between propulsion techniques and upper extremity demand is to understand how individual muscles contribute to the mechanical energetics of wheelchair propulsion. The purpose of this study was to use a forward dynamics simulation of wheelchair propulsion to quantify how individual muscles deliver, absorb and/or transfer mechanical power during propulsion. The analysis showed that muscles contribute to either push (i.e., deliver mechanical power to the handrim) or recovery (i.e., reposition the arm) subtasks, with the shoulder flexors being the primary contributors to the push and the shoulder extensors being the primary contributors to the recovery. In addition, significant activity from the shoulder muscles was required during the transition between push and recovery, which resulted in increased co-contraction and upper extremity demand. Thus, strengthening the shoulder flexors and promoting propulsion techniques that improve transition mechanics have much potential to reduce upper extremity demand and improve rehabilitation outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Bench test evaluation of volume delivered by modern ICU ventilators during volume-controlled ventilation.

    Science.gov (United States)

    Lyazidi, Aissam; Thille, Arnaud W; Carteaux, Guillaume; Galia, Fabrice; Brochard, Laurent; Richard, Jean-Christophe M

    2010-12-01

    During volume-controlled ventilation, part of the volume delivered is compressed into the circuit. To correct for this phenomenon, modern ventilators use compensation algorithms. Humidity and temperature also influence the delivered volume. In a bench study at a research laboratory in a university hospital, we compared nine ICU ventilators equipped with compensation algorithms, one with a proximal pneumotachograph and one without compensation. Each ventilator was evaluated under normal, obstructive, and restrictive conditions of respiratory mechanics. For each condition, three tidal volumes (V (T)) were set (300, 500, and 800 ml), with and without an inspiratory pause. The insufflated volume and the volume delivered at the Y-piece were measured independently, without a humidification device, under ambient temperature and pressure and dry gas conditions. We computed the actually delivered V (T) to the lung under body temperature and pressure and saturated water vapour conditions (BTPS). For target V (T) values of 300, 500, and 800 ml, actually delivered V (T) under BTPS conditions ranged from 261 to 396 ml (-13 to +32%), from 437 to 622 ml (-13 to +24%), and from 681 to 953 ml (-15 to +19%), respectively (p ventilators.

  16. Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

    Science.gov (United States)

    2014-01-01

    Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

  17. Device for delivering cryogen to rotary super-conducting winding of cryogen-cooled electrical machine

    International Nuclear Information System (INIS)

    Filippov, I.F.; Gorbunov, G.S.; Khutoretsky, G.M.; Popov, J.S.; Skachkov, J.V.; Vinokurov, A.A.

    1980-01-01

    A device is disclosed for delivering cryogen to a superconducting winding of a cryogen-cooled electrical machine comprising a pipe articulated along the axis of the electrical machine and intended to deliver cryogen. One end of said pipe is located in a rotary chamber which communicates through channels with the space of the electrical machine, and said space accommodating its superconducting winding. The said chamber accommodates a needle installed along the chamber axis, and the length of said needle is of sufficient length such that in the advanced position of said cryogen delivering pipe said needle reaches the end of the pipe. The layout of the electrical machine increases the reliability and effectiveness of the device for delivering cryogen to the superconducting winding, simplifies the design of the device and raises the efficiency of the electrical machine

  18. A new measure for the assessment of visual awareness in individuals with tunnel vision.

    Science.gov (United States)

    AlSaqr, Ali M; Dickinson, Chris M

    2017-01-01

    Individuals with a restricted peripheral visual field or tunnel vision (TV) have problems moving about and avoiding obstacles. Some individuals adapt better than others and some use assistive optical aids, so measurement of the visual field is not sufficient to describe their performance. In the present study, we developed a new clinical test called the 'Assessment of Visual Awareness (AVA)', which can be used to measure detection of peripheral targets. The participants were 20 patients with TV due to retinitis pigmentosa (PTV) and 50 normally sighted participants with simulated tunnel vision (STV) using goggles. In the AVA test, detection times were measured, when subjects searched for 24 individually presented, one degree targets, randomly positioned in a 60 degrees noise background. Head and eye movements were allowed and the presentation time was unlimited. The test validity was investigated by correlating the detection times with the 'percentage of preferred walking speed' (PPWS) and the 'number of collisions' on an indoor mobility course. In PTV and STV, the detection times had significant negative correlation with the field of view. The detection times had significant positive relations with target location. In the STV, the detection time was significantly negatively correlated with the PPWS and significantly positively correlated with the collisions score on the indoor mobility course. In the PTV, the relationship was not statistically significant. No significant difference in performance of STV was found when repeating the test one to two weeks later. The proposed AVA test was sensitive to the field of view and target location. The test is unique in design, quick, simple to deliver and both repeatable and valid. It could be a valuable tool to test different rehabilitation strategies in patients with TV. © 2016 Optometry Australia.

  19. Self-reported prenatal oral health-care practices of preterm low birth weight-delivered women belonging to different socioeconomic status: A postnatal survey

    Directory of Open Access Journals (Sweden)

    Gayathri Priyadarshni Elangovan

    2017-01-01

    Full Text Available Background: The differences in the oral health status between the individuals with a high socioeconomic status (SES and those with a low SES had markedly increased. There is, however, minimal information available on women understanding the need of dental hygiene for overall health and whether pregnant women comply with the current oral health strategies. In Lieu with the above, the present study aims to assess the awareness, dental hygiene practices, and the frequency of dental visits during pregnancy in postnatal women who delivered preterm low birth weight babies of different SES in and around Puducherry. Materials and Methods: A total of 200 individuals who visited Rajiv Gandhi Maternity Centre, Puducherry for delivery were selected. Information regarding onset of prenatal care, referral to dentist, and oral hygiene habits such as frequency of brushing, type of brush used, method of brushing, and frequency of brush change were obtained. Periodontal health status was recorded using PSR system. Results: Awareness of oral hygiene practices was more among upper middle class and lower middle class compared to upper lower strata. Visit to dentist during perinatal period was high among upper middle class compared to other socioeconomic strata. Conclusions: The awareness of oral health-care practices and importance of oral care during perinatal period were less among low socioeconomic strata.

  20. Experiences of non-adherence to Internet-delivered cognitive behavior therapy: A qualitative study

    Directory of Open Access Journals (Sweden)

    Olof Johansson

    2015-05-01

    Full Text Available Many trials on Internet-delivered psychological treatments have had problems with nonadherence, but not much is known about the subjective reasons for non-adhering. The aim of this study was to explore participants' experiences of non-adherence to Internet-delivered psychological treatment. Grounded theory was used to analyze data from seven in-depth interviews with persons who had non-adhered to a study on Internet-delivered cognitive behavioral therapy for generalized anxiety disorder. The process of non-adherence is described as an interaction between patient factors and treatment factors. A working model theory was generated to illustrate the experience of nonadherence. The model describes a process where treatment features such as workload, text-content complexity and treatment process don't match personal prerequisites regarding daily routines, perceived language skills and treatment expectations respectively, resulting in the decision to nonadhere. Negative effects were also stated as a reason for non-adherence. Several common strategies used for increasing adherence to Internet-delivered therapy in general are by these non-completers regarded as factors directly related to their reason for non-adherence.

  1. Health Law 2015: Individuals and Populations.

    Science.gov (United States)

    Jacobson, Peter D; Dahlen, Rachel

    2016-12-01

    In this article, we assess two particular trends in judicial doctrine that are likely to emerge in the post-ACA era. The first trend is the inevitable emergence of enterprise medical liability (EML) that will supplant tort law's unstable attempt to apportion liability between physicians and institutions. Arguments favoring EML in health law date back to the early 1980s. But health care's ongoing consolidation suggests that the time has arrived for courts or state legislatures to develop legal doctrine that more closely resembles the ways in which health care is now delivered. This would result in a more appropriate allocation of liability to the institutional level. The second judicial trend will be the convergence of health law and public health law concepts. Because the ACA arguably stimulates closer engagement between health systems and public health departments, health systems will have greater responsibility for keeping their communities healthy along with obligations for individual patient care (i.e., individuals and populations). If so, courts will need to incorporate elements from health law and public health law in resolving disputes. Copyright © 2016 by Duke University Press.

  2. Delivering the right dose

    International Nuclear Information System (INIS)

    Shaw, A

    2004-01-01

    For treatment with high intensity focused ultrasound (HIFU), delivering the correct amount of energy to the patient is critical. This paper describes a novel design of sensor based on the pyroelectric principle for monitoring the output power from HIFU transducers of the type used for tissue ablation. The sensor is intended to be minimally perturbing to the ultrasound field, so that it can remain in the ultrasound field throughout treatment and provide a constant monitor of ultrasound power. The main advantages of the technique are: power can be measured or monitored without dismantling the HIFU system, thus reducing equipment downtime; power can be measured immediately before or during every patient treatment, thus ensuring accurate dosimetry; power can be measured at the output levels used for treatment (whereas a radiation force balance may be damaged by overheating); the method uses components which are robust and simple to use compared to radiation force balances or hydrophone scanning systems

  3. Process evaluation of a technology-delivered screening and brief intervention for substance use in primary care.

    Science.gov (United States)

    Ondersma, Steven J; Gryczynski, Jan; Mitchell, Shannon Gwin; O'Grady, Kevin E; Schwartz, Robert P

    2016-05-01

    Psychotherapy process research examines the content of treatment sessions and their association with outcomes in an attempt to better understand the interactions between therapists and clients, and to elucidate mechanisms of behavior change. A similar approach is possible in technology-delivered interventions, which have an interaction process that is always perfectly preserved and rigorously definable. The present study sought to examine the process of participants' interactions with a computer-delivered brief intervention for drug use, from a study comparing computer- and therapist-delivered brief interventions among adults at two primary health care centers in New Mexico. Specifically, we sought to describe the pattern of participants' ( N =178) choices and reactions throughout the computer-delivered brief intervention, and to examine associations between that process and intervention response at 3-month follow-up. Participants were most likely to choose marijuana as the first substance they wished to discuss ( n = 114, 64.0%). Most participants indicated that they had not experienced any problems as a result of their drug use ( n = 108, 60.7%), but nearly a third of these ( n = 32, 29.6%) nevertheless indicated a desire to stop or reduce its use; participants who did report negative consequences were most likely to endorse financial or relationship concerns. However, participant ratings of the importance of change or of the helpfulness of personalized normed feedback were unrelated to changes in substance use frequency. Design of future e-interventions should consider emphasizing possible benefits of quitting rather than the negative consequences of drug use, and-when addressing consequences-should consider focusing on the impacts of substance use on relationship and financial aspects. These findings are an early but important step toward using process evaluation to optimize e-intervention content.

  4. Process evaluation of a technology-delivered screening and brief intervention for substance use in primary care

    Directory of Open Access Journals (Sweden)

    Steven J. Ondersma

    2016-05-01

    Full Text Available Psychotherapy process research examines the content of treatment sessions and their association with outcomes in an attempt to better understand the interactions between therapists and clients, and to elucidate mechanisms of behavior change. A similar approach is possible in technology-delivered interventions, which have an interaction process that is always perfectly preserved and rigorously definable. The present study sought to examine the process of participants' interactions with a computer-delivered brief intervention for drug use, from a study comparing computer- and therapist-delivered brief interventions among adults at two primary health care centers in New Mexico. Specifically, we sought to describe the pattern of participants' (N = 178 choices and reactions throughout the computer-delivered brief intervention, and to examine associations between that process and intervention response at 3-month follow-up. Participants were most likely to choose marijuana as the first substance they wished to discuss (n = 114, 64.0%. Most participants indicated that they had not experienced any problems as a result of their drug use (n = 108, 60.7%, but nearly a third of these (n = 32, 29.6% nevertheless indicated a desire to stop or reduce its use; participants who did report negative consequences were most likely to endorse financial or relationship concerns. However, participant ratings of the importance of change or of the helpfulness of personalized normed feedback were unrelated to changes in substance use frequency. Design of future e-interventions should consider emphasizing possible benefits of quitting rather than the negative consequences of drug use, and—when addressing consequences—should consider focusing on the impacts of substance use on relationship and financial aspects. These findings are an early but important step toward using process evaluation to optimize e-intervention content.

  5. A Randomized Controlled Trial Comparing Integrated Cognitive Behavioral Therapy Versus Individual Addiction Counseling for Co-occurring Substance Use and Posttraumatic Stress Disorders.

    Science.gov (United States)

    McGovern, Mark P; Lambert-Harris, Chantal; Alterman, Arthur I; Xie, Haiyi; Meier, Andrea

    2011-01-01

    OBJECTIVE: Co-occurring posttraumatic stress (PTSD) and substance use disorders provide clinical challenges to addiction treatment providers. Interventions are needed that are effective, well-tolerated by patients, and capable of being delivered by typical clinicians in community settings. This is a randomized controlled trial of integrated cognitive behavioral therapy for co-occurring PTSD and substance use disorders. METHODS: Fifty-three participants sampled from seven community addiction treatment programs were randomized to integrated cognitive behavioral therapy plus standard care or individual addiction counseling plus standard care. Fourteen community therapists employed by these programs delivered both manual-guided therapies. Primary outcomes were PTSD symptoms, substance use symptoms and therapy retention. Participants were assessed at baseline, 3- and 6-month follow-up. RESULTS: Integrated cognitive behavioral therapy was more effective than individual addiction counseling in reducing PTSD re-experiencing symptoms and PTSD diagnosis. Individual addiction counseling was comparably effective to integrated cognitive behavioral therapy in substance use outcomes and on other measures of psychiatric symptom severity. Participants assigned to individual addiction counseling with severe PTSD were less likely to initiate and engage in the therapy than those assigned to integrated cognitive behavioral therapy. In general, participants with severe PTSD were more likely to benefit from integrated cognitive behavioral therapy. CONCLUSIONS: The findings support the promise of efficacy of integrated cognitive behavioral therapy in improving outcomes for persons in addiction treatment with PTSD. Community counselors delivered both interventions with satisfactory adherence and competence. Despite several limitations to this research, a larger randomized controlled trial of integrated cognitive behavioral therapy appears warranted.

  6. Self- and Peer Assessments of Oral Presentations by First-Year University Students

    Science.gov (United States)

    Aryadoust, Vahid

    2015-01-01

    Forty science students received training for 12 weeks on delivering effective presentations and using a tertiary-level English oral presentation scale comprising three subscales (Verbal Communication, Nonverbal Communication, and Content and Organization) measured by 18 items. For their final project, each student was given 10 to 12 min to present…

  7. [Evaluation of tidal volume delivered by ventilators during volume-controlled ventilation].

    Science.gov (United States)

    Zhou, Juan; Yan, Yong; Cao, Desen

    2014-12-01

    To study the ways which ensure the delivery of enough tidal volume to patients under various conditions close to the demand of the physician. The volume control ventilation model was chosen, and the simulation lung type was active servo lung ASL 5000 or Michigan lung 1601. The air resistance, air compliance and lung type in simulation lungs were set. The tidal volume was obtained from flow analyzer PF 300. At the same tidal volume, the displaying values of tidal volume of E5, Servo i, Evital 4, and Evital XL ventilators with different lung types of patient, compliance of gas piping, leakage, gas types, etc. were evaluated. With the same setting tidal volume of a same ventilator, the tidal volume delivered to patients was different with different lung types of patient, compliance of gas piping, leakage, gas types, etc. Reducing compliance and increasing resistance of the patient lungs caused high peak airway pressure, the tidal volume was lost in gas piping, and the tidal volume be delivered to the patient lungs was decreased. If the ventilator did not compensate to leakage, the tidal volume delivered to the patient lungs was decreased. When the setting gas type of ventilator did not coincide with that applying to the patient, the tidal volume be delivered to the patient lungs might be different with the setting tidal volume of ventilator. To ensure the delivery of enough tidal volume to patients close to the demand of the physician, containable factors such as the compliance of gas piping, leakage, and gas types should be controlled.

  8. Older individuals' experiences during the assistive technology device service delivery process.

    Science.gov (United States)

    Gramstad, Astrid; Storli, Sissel Lisa; Hamran, Torunn

    2014-07-01

    Providing assistive technology devices to older individuals living in their ordinary homes is an important intervention to increase and sustain independence and to enable ageing at home. However, little is known about older individuals' experiences and needs in the assistive technology device (ATD) service delivery process. The purpose of this study was to investigate older individuals' experiences during the service delivery process of ATDs. Nine older individuals were interviewed three times each throughout the ATD service delivery process. The interviews were analysed within a hermeneutical phenomenological perspective. The results show that the service delivery process could be interpreted as an enigmatic journey and described using four themes: "hope and optimistic expectations", "managing after delivery or needing additional help", "having available help versus being abandoned", and "taking charge or putting up". The results emphasize the need for occupational therapists to maintain an individualized approach towards older clients throughout the service delivery process. The experiences of older individuals were diverse and related to expectations that were not necessarily articulated to the occupational therapist. The situation when the ATD is delivered to the client was highlighted by the clients as an important event with the potential to facilitate a successful service delivery process.

  9. Extension through Partnerships: Research and Education Center Teams with County Extension to Deliver Programs

    Science.gov (United States)

    Mullahey, J. Jeffrey

    2011-01-01

    Budget reductions have severely affected resources available to deliver agriculture and natural resource Extension programs in Florida. University of Florida/Institute of Food and Agricultural Sciences delivers Extension programming through a unique partnership between research and education centers and county Extension. Science-based information…

  10. Delivering IT and eBusiness value

    CERN Document Server

    Willcocks, Leslie

    2001-01-01

    Delivering Business Value from IT' is focused on the evaluation issue in IT and how IT evaluation can proceed across the life-cycle of any IT investment and be linked positively to improving business performance. .Chapters 1,2 and 3 detail an approach to IT evaluation whilst chapters 4 and 5 build on these by showing two distinctive approaches to linking IT to business performance. The remaining three chapters deal with a range of evaluation issues emerging as important - specifically Internet evaluation, Y2K and beyond, EMU, quality outsourcing, infrastructure, role of benchmarking, and cost

  11. Comparison of use and appreciation of a print-delivered versus CD-ROM-delivered, computer-tailored intervention targeting saturated fat intake: Randomized controlled trial

    NARCIS (Netherlands)

    W. Kroeze (Willemieke); A. Oenema (Anke); M.K. Campbell (Marci); J. Brug (Hans)

    2008-01-01

    textabstractBackground: Computer-tailored health education, a promising health education technique, is increasingly being delivered interactively, for example, over the Internet. It has been suggested that there may be differences in use and appreciation between print and interactive delivery of

  12. Could the Hokusai Impact Have Delivered Mercury's Water Ice?

    Science.gov (United States)

    Ernst, C. M.; Chabot, N. L.; Barnouin, O. S.

    2018-05-01

    Hokusai is the best candidate source crater for Mercury’s water-ice inventory if it was primarily delivered by a single impact event. The Hokusai impact could account for the inventory of water ice on Mercury for impact velocities <30 km/s.

  13. Predictors in Internet-delivered cognitive behavior therapy and behavioral stress management for severe health anxiety.

    Science.gov (United States)

    Hedman, Erik; Andersson, Erik; Lekander, Mats; Ljótsson, Brjánn

    2015-01-01

    Severe health anxiety can be effectively treated with exposure-based Internet-delivered cognitive behavior therapy (ICBT), but information about which factors that predict outcome is scarce. Using data from a recently conducted RCT comparing ICBT (n = 79) with Internet-delivered behavioral stress management (IBSM) (n = 79) the presented study investigated predictors of treatment outcome. Analyses were conducted using a two-step linear regression approach and the dependent variable was operationalized both as end state health anxiety at post-treatment and as baseline-to post-treatment improvement. A hypothesis driven approach was used where predictors expected to influence outcome were based on a previous predictor study by our research group. As hypothesized, the results showed that baseline health anxiety and treatment adherence predicted both end state health anxiety and improvement. In addition, anxiety sensitivity, treatment credibility, and working alliance were significant predictors of health anxiety improvement. Demographic variables, i.e. age, gender, marital status, computer skills, educational level, and having children, had no significant predictive value. We conclude that it is possible to predict a substantial proportion of the outcome variance in ICBT and IBSM for severe health anxiety. The findings of the present study can be of high clinical value as they provide information about factors of importance for outcome in the treatment of severe health anxiety. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Development and validation of a postpartum depression risk score in delivered women, Iran

    Directory of Open Access Journals (Sweden)

    Mohammad R Maracy

    2012-01-01

    Full Text Available Background: Investigators describe a dramatic increase in the incidence of mood disorder after childbirth, with the largest risk in the 90 days after delivery. This study is designed to develop a relatively simple screening tool and validate it from the significant variables associated with postpartum depression (PPD to detect delivered women at high risk of having PPD. Materials and Methods: In the cross-sectional study, 6,627 from a total of 7,300 delivered women, 2-12 months after delivery were recruited and screened for PPD. Split-half validation was used to develop the risk score. The training data set was used to develop the model, and the validation data set was used to validate the developed the risk factors of postpartum depression risk score using multiple logistic regression analysis to compute the β coefficients and odds ratio (OR for the dependent variables associated with possible PPD in this study. Calibration was checked using the Hosmer and Lemeshow test. A score for independent variables contributing to PPD was calculated. Cutoff points using a trade-off between the sensitivity and specificity of risk scores derived from PPD model using the Receiver Operating Characteristic (ROC curve. Results: The predicted and observed PPD were not different (P value = 0.885. The aROC with area under the curve (S.E. of 0.611 (0.008 for predicting PPD using the suggested cut-off point of -0.702, the proportion of participants screening positive for PPD was 70.9% (sensitivity (CI 95%; 69.5, 72.3 while the proportion screening negative was 60.1% (specificity (CI 95%; 58.2, 62.1. Conclusion: Despite of the relatively low sensitivity and specificity in this study, it could be a simple, practical and useful screening tool to identify individual at high risk for PPD in the target population.

  15. A rethink of how policy and social science approach changing individuals' actions on greenhouse gas emissions

    International Nuclear Information System (INIS)

    Young, William; Middlemiss, Lucie

    2012-01-01

    Social scientists from all areas are developing theories and testing practical approaches to change individuals' actions to lower greenhouse gas emissions. In the UK context, policy-makers, local authorities, companies and organisations are using these theories to invest resources to change individual's actions. The problem is that social scientists are delivering fragmented science based on narrow disciplinary views and those using this science are cherry picking whatever theory suits their agenda. We argue that with substantial GHG emission reduction targets to be achieved, a multidisciplinary application and view of social science are urgently needed.

  16. Main communication barriers in the process of delivering bad news to oncological patients - medical perspective.

    Science.gov (United States)

    Zielińska, Paulina; Jarosz, Magdalena; Kwiecińska, Agnieszka; Bętkowska-Korpała, Barbara

    2017-01-01

    Delivering bad news is a major aspect of a doctor's work. The literature most often refers to patient's expectations or needs, and methods of delivering bad news, while medical perspective is often skipped. The purpose of this paper is to examine competencies (knowledge, skills and experience) in delivering bad news by medical specialists in the areas related to the causal and symptomatic treatment of oncological patients; identification of major communication problems and obstacles in this specific situation and evaluation of teaching needs for delivering bad news. The study was performed on a group of 61 medical specialists in the areas related to the causal and symptomatic treatment of oncological patients, using a self-generated questionnaire based on other studies in the literature. Topics that are considered most demanding are: delivering news on the termination of causal treatment and preparing the patient/ close ones for death. The most difficult aspect of such discussions for the respondents was associated with the emotions manifested by the patient. On the other hand, doctors were mostly distressed by the feeling of taking the patient's hope away. The study points to the need for education of doctors in the eld of techniques for delivering bad news, particularly in the area of dealing with the emotions manifested by the patient and giving them real hope. The results encourage to conduct studies on a larger group of doctors.

  17. Partner-delivered reflexology: effects on cancer pain and anxiety.

    Science.gov (United States)

    Stephenson, Nancy L N; Swanson, Melvin; Dalton, Joann; Keefe, Frances J; Engelke, Martha

    2007-01-01

    To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group. Four hospitals in the southeastern United States. 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino. The intervention included a 15- to 30-minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners. Pain and anxiety. Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety. A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention. Hospitals could have qualified professionals offer reflexology as a complementary therapy and teach interested partners the modality.

  18. An online support site for preparation of oral presentations in science and engineering

    Science.gov (United States)

    Kunioshi, Nílson; Noguchi, Judy; Hayashi, Hiroko; Tojo, Kazuko

    2012-12-01

    Oral communication skills are essential for engineers today and, as they are included in accreditation criteria of educational programmes, their teaching and evaluation deserve attention. However, concrete aspects as to what should be taught and evaluated in relation to oral communication skills have not been sufficiently established. In this paper, a method to aid the efficient teaching of oral presentation skills is proposed, from the presentation structure level to word and sentence level choices, through the use of JECPRESE, The Japanese-English Corpus of Presentations in Science and Engineering. As of June 2012, the corpus is composed of transcriptions of 74 presentations delivered in Japanese by students graduating from the Master's programme of various engineering departments and 31 presentations delivered in English, 16 by experienced researchers at an international conference on chemistry, and 15 by undergraduate engineering students of a mid-sized American university. The utterances were classified according to the specific moves (sections of the speech that express specific speaker intent) appearing in the presentations and frequently used words/expressions to express these moves were identified.

  19. Soluble sortilin is present in excess and positively correlates with progranulin in CSF of aging individuals.

    Science.gov (United States)

    Molgaard, Simon; Demontis, Ditte; Nicholson, Alexandra M; Finch, Nicole A; Petersen, Ronald C; Petersen, Claus M; Rademakers, Rosa; Nykjaer, Anders; Glerup, Simon

    2016-11-01

    Mutations in progranulin are a major cause of frontotemporal lobe degeneration (FTLD). Hence, plasma progranulin is an attractive biomarker in FTLD but poorly reflects levels in cerebrospinal fluid (CSF), suggesting tissue-specific regulation of progranulin levels. Sortilin was recently identified as a progranulin scavenger receptor that destines it for lysosomal degradation. Proteolysis or alternative splicing generates soluble sortilin variants that retain progranulin binding and potentially functions as a decoy receptor. In the present study, we analyzed soluble sortilin and progranulin in plasma and CSF in 341 aging individuals. We found that soluble sortilin exists in CSF in ten-fold molar excess compared to progranulin and observed a highly significant positive correlation between soluble sortilin and progranulin levels in CSF but not in plasma. However, carriers of the minor allele of SNP rs646776 in SORT1 encoding sortilin displayed significantly increased soluble sortilin and reduced progranulin specifically in plasma but not in CSF. Taken together, our findings suggest that soluble sortilin may affect progranulin levels in both a tissue-specific and genotype-dependent manner. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Foreword. The Knowledge Economy: The Present Future

    OpenAIRE

    Constantin Bratianu

    2017-01-01

    All the statistics and evaluations show that the Knowledge Economy is our future. However, a close look at the developed economies demonstrates that the Knowledge Economy is already here, shaping our present time. Although there are many definitions of this new economic framework, their core content stresses the importance of data, information, and knowledge in the production of goods and delivering services in creating value for society. For instance, Powell and Snellman (2004, p.1999) defin...

  1. Can the Clean Development Mechanism (CDM) deliver?

    International Nuclear Information System (INIS)

    Subbarao, Srikanth; Lloyd, Bob

    2011-01-01

    The paper investigates whether the Clean Development Mechanism (CDM) under the Kyoto Protocol has played a significant role in the development of rural communities, specifically investigating uptake of small-scale renewable energy projects. The investigation involved an assessment of 500 registered small-scale CDM projects under the Kyoto Protocol in terms of their potential impact on the envisaged sustainable development goals for rural communities. Five case studies from the Indian subcontinent were also examined. The paper concludes that the CDM in its current state and design has typically failed to deliver the promised benefits with regard to development objectives in rural areas. Successful projects were found to have had good community involvement and such projects were typically managed by cooperative ventures rather than money making corporations. The paper puts forward a new framework for the assessment of such benefits in the hope that future projects can be better assessed in this regard. The key problem, however, remains on how to deal with the inherent contradiction between development and sustainability. - Research Highlights: → Role of CDM towards sustainable development of rural communities. → Assessment of 500 registered small-scale CDM projects. → CDM in its current state and design has typically failed to deliver. → A new framework for sustainable development assessment of small-scale CDM projects. → Inherent contradiction between development and sustainability.

  2. Design and Methods for a Pilot Study of a Phone-Delivered, Mindfulness-Based Intervention in Patients with Implantable Cardioverter Defibrillators

    Directory of Open Access Journals (Sweden)

    Elena Salmoirago-Blotcher

    2012-01-01

    Full Text Available Background. Meditation practices are associated with a reduction in adrenergic activity that may benefit patients with severe cardiac arrhythmias. This paper describes the design and methods of a pilot study testing the feasibility of a phone-delivered mindfulness-based intervention (MBI for treatment of anxiety in patients with implantable cardioverter defibrillators (ICDs. Design and Methods. Consecutive, clinically stable outpatients (n=52 will be screened for study eligibility within a month of an ICD-related procedure or ICD shock and will be randomly assigned to MBI or to usual care. MBI patients will receive eight weekly individual phone sessions based on two mindfulness practices (awareness of breath and body scan plus home practice with a CD for 20 minutes daily. Patients assigned to usual care will be offered the standard care planned by the hospital. Assessments will occur at baseline and at the completion of the intervention (between 9 and 12 weeks after randomization. The primary study outcome is feasibility; secondary outcomes include anxiety, mindfulness, and number of administered shocks during the intervention period. Conclusions. If proven feasible and effective, phone-delivered mindfulness-based interventions could improve psychological distress in ICD outpatients with serious cardiovascular conditions.

  3. Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial.

    Science.gov (United States)

    King, Laurie A; Wilhelm, Jennifer; Chen, Yiyi; Blehm, Ron; Nutt, John; Chen, Zunqiu; Serdar, Andrea; Horak, Fay B

    2015-10-01

    Comparative studies of exercise interventions for people with Parkinson disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by (1) home exercise program, (2) individualized physical therapy, or (3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention. Fifty-eight people (age = 63.9 ± 8 years) with PD participated. People were randomized into (1) home exercise program, (2) individual physical therapy, or (3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test. Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS-Motor, and activity of daily living scores were included. Only the individual group significantly improved in the Physical Performance Test. The individual exercise showed the most improvements in functional and balance measures, whereas the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group. An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD, and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A112).

  4. Focal hand dystonia: individualized intervention with repeated application of repetitive transcranial magnetic stimulation.

    Science.gov (United States)

    Kimberley, Teresa Jacobson; Borich, Michael R; Schmidt, Rebekah L; Carey, James R; Gillick, Bernadette

    2015-04-01

    To examine for individual factors that may predict response to inhibitory repetitive transcranial magnetic stimulation (rTMS) in focal hand dystonia (FHD); to present the method for determining optimal stimulation to increase inhibition in a given patient; and to examine individual responses to prolonged intervention. Single-subject design to determine optimal parameters to increase inhibition for a given subject and to use the selected parameters once per week for 6 weeks, with 1-week follow-up, to determine response. Clinical research laboratory. A volunteer sample of subjects with FHD (N = 2). One participant had transcranial magnetic stimulation responses indicating impaired inhibition, and the other had responses within normative limits. There were 1200 pulses of 1-Hz rTMS delivered using 4 different stimulation sites/intensity combinations: primary motor cortex at 90% or 110% of resting motor threshold (RMT) and dorsal premotor cortex (PMd) at 90% or 110% of RMT. The parameters producing the greatest within-session increase in cortical silent period (CSP) duration were then used as the intervention. Response variables included handwriting pressure and velocity, subjective symptom rating, CSP, and short latency intracortical inhibition and facilitation. The individual with baseline transcranial magnetic stimulation responses indicating impaired inhibition responded favorably to the repeated intervention, with reduced handwriting force, an increase in the CSP, and subjective report of moderate symptom improvement at 1-week follow-up. The individual with normative baseline responses failed to respond to the intervention. In both subjects, 90% of RMT to the PMd produced the greatest lengthening of the CSP and was used as the intervention. An individualized understanding of neurophysiological measures can be an indicator of responsiveness to inhibitory rTMS in focal dystonia, with further work needed to determine likely responders versus nonresponders. Copyright

  5. Improvements in recall and food choices using a graphical method to deliver information of select nutrients.

    Science.gov (United States)

    Pratt, Nathan S; Ellison, Brenna D; Benjamin, Aaron S; Nakamura, Manabu T

    2016-01-01

    Consumers have difficulty using nutrition information. We hypothesized that graphically delivering information of select nutrients relative to a target would allow individuals to process information in time-constrained settings more effectively than numerical information. Objectives of the study were to determine the efficacy of the graphical method in (1) improving memory of nutrient information and (2) improving consumer purchasing behavior in a restaurant. Values of fiber and protein per calorie were 2-dimensionally plotted alongside a target box. First, a randomized cued recall experiment was conducted (n=63). Recall accuracy of nutrition information improved by up to 43% when shown graphically instead of numerically. Second, the impact of graphical nutrition signposting on diner choices was tested in a cafeteria. Saturated fat and sodium information was also presented using color coding. Nutrient content of meals (n=362) was compared between 3 signposting phases: graphical, nutrition facts panels (NFP), or no nutrition label. Graphical signposting improved nutrient content of purchases in the intended direction, whereas NFP had no effect compared with the baseline. Calories ordered from total meals, entrées, and sides were significantly less during graphical signposting than no-label and NFP periods. For total meal and entrées, protein per calorie purchased was significantly higher and saturated fat significantly lower during graphical signposting than the other phases. Graphical signposting remained a predictor of calories and protein per calorie purchased in regression modeling. These findings demonstrate that graphically presenting nutrition information makes that information more available for decision making and influences behavior change in a realistic setting. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Hepatitis B virus infection among pregnant women delivering at ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of hepatitis B virus (HBV) carrier and infectivity status among women delivering at Harare Maternity Hospital. Design: A serological survey study of pregnant women admitted for labour and delivery. Setting: Harare Maternity Hospital, Harare, Zimbabwe between June 1996 and June ...

  7. post partum haemorhage among women delivered at mbeya referral

    African Journals Online (AJOL)

    death is among women who deliver at home either alone or with tradition birth attendant. (TBA) [9]. To date, effort to reduce maternal mortality through training TBAs have been disappointing [2]. Study population and Methods: This study was a hospital based descriptive retrospective hospital based cross-sectional.

  8. Delivering on a gendered definition of health needs in local ...

    African Journals Online (AJOL)

    Delivering on a gendered definition of health needs in local government budgeting: ... of financial grants channelled annually from central to local governments. ... does not reflect the broad community-wide understanding of health needs.

  9. A simple circuit to deliver bubbling CPAP.

    Science.gov (United States)

    Kaur, Charanjit; Sema, Akatoli; Beri, Rajbir S; Puliyel, Jacob M

    2008-04-01

    Nasal continuous positive airway pressure (CPAP), especially bubbling CPAP, is known to reduce the need for more invasive ventilation. We here describe a circuit that can deliver bubbling CPAP in resource poor settings. We describe how the oxygen concentration can be altered from 98% to 21% oxygen using this system. Addition of a humidifier in the circuit has the effect of reducing the oxygen concentration by 1 to 5%. The cost of putting together the system is approximately Rs 5000.

  10. Photochemical internalization enhanced macrophage delivered chemotherapy.

    Science.gov (United States)

    Shin, Diane; Christie, Catherine; Ju, David; Nair, Rohit Kumar; Molina, Stephanie; Berg, Kristian; Krasieva, Tatiana B; Madsen, Steen J; Hirschberg, Henry

    2018-03-01

    Macrophage (Ma) vectorization of chemotherapeutic drugs has the advantage for cancer therapy in that it can actively target and maintain an elevated concentration of drugs at the tumor site, preventing their spread into healthy tissue. A potential drawback is the inability to deliver a sufficient number of drug-loaded Ma into the tumor, thus limiting the amount of active drug delivered. This study examined the ability of photochemical internalization (PCI) to enhance the efficacy of released drug by Ma transport. Tumor spheroids consisting of either F98 rat glioma cells or F98 cells combined with a subpopulation of empty or doxorubicin (DOX)-loaded mouse Ma (RAW264.7) were used as in vitro tumor models. PCI was performed with the photosensitizer AlPcS 2a and laser irradiation at 670 nm. RAW264.7 Ma pulsed with DOX released the majority of the incorporated DOX within two hours of incubation. PCI significantly increased the toxicity of DOX either as pure drug or derived from monolayers of DOX-loaded Ma. Significant growth inhibition of hybrid spheroids was also observed with PCI even at subpopulations of DOX-loaded Ma as low as 11% of the total initial hybrid spheroid cell number. Results show that RAW264.7 Ma, pulsed with DOX, could effectively incorporate and release DOX. PCI significantly increased the ability of both free and Ma-released DOX to inhibit the growth of tumor spheroids in vitro. The growth of F98 + DOX loaded Ma hybrid spheroids were synergistically reduced by PCI, compared to either photodynamic therapy or released DOX acting alone. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Temperature of gas delivered from ventilators.

    Science.gov (United States)

    Chikata, Yusuke; Onodera, Mutsuo; Imanaka, Hideaki; Nishimura, Masaji

    2013-01-01

    Although heated humidifiers (HHs) are the most efficient humidifying device for mechanical ventilation, some HHs do not provide sufficient humidification when the inlet temperature to the water chamber is high. Because portable and home-care ventilators use turbines, blowers, pistons, or compressors to inhale in ambient air, they may have higher gas temperature than ventilators with piping systems. We carried out a bench study to investigate the temperature of gas delivered from portable and home-care ventilators, including the effects of distance from ventilator outlet, fraction of inspiratory oxygen (FIO2), and minute volume (MV). We evaluated five ventilators equipped with turbine, blower, piston, or compressor system. Ambient air temperature was adjusted to 24°C ± 0.5°C, and ventilation was set at FIO2 0.21, 0.6, and 1.0, at MV 5 and 10 L/min. We analyzed gas temperature at 0, 40, 80, and 120 cm from ventilator outlet and altered ventilator settings. While temperature varied according to ventilators, the outlet gas temperature of ventilators became stable after, at the most, 5 h. Gas temperature was 34.3°C ± 3.9°C at the ventilator outlet, 29.5°C ± 2.2°C after 40 cm, 25.4°C ± 1.2°C after 80 cm and 25.1°C ± 1.2°C after 120 cm (P < 0.01). FIO2 and MV did not affect gas temperature. Gas delivered from portable and home-care ventilator was not too hot to induce heated humidifier malfunctioning. Gas soon declined when passing through the limb.

  12. Outcomes for engineering students delivering a STEM education and outreach programme

    Science.gov (United States)

    Fitzallen, Noleine; Brown, Natalie Ruth

    2017-11-01

    University science outreach programmes are used to encourage more school students to select science, technology, engineering, and mathematics (STEM) subjects in further education and pursue science-related careers. The benefits of science outreach programmes are often espoused from the perspective of programme participants. Little attention, however, is given to what university students delivering the programmes gain from the experience. This paper seeks to illustrate the benefits of engineering students delivering STEM outreach programmes in schools. It reports on a qualitative case study of the experiences of two STEM Education and Outreach team members from a regional university in Australia. Content analysis of interview data highlighted not only the participants' motivations and perceived benefits of being involved in the STEM programme but also revealed the skills and attributes honed throughout the experience. Involvement in the STEM outreach programme resulted in the development of social and personal responsibility generic graduate attribute skills, evidenced through their motivations to be involved, the demonstration of understanding of teaching and learning, and application of science communication skills. This study demonstrates that designing and delivering STEM outreach programmes assists in the development of skills that will be beneficial when pursuing careers in engineering in the future.

  13. Impact of individualized pain plan on the emergency management of children with sickle cell disease.

    Science.gov (United States)

    Krishnamurti, Lakshmanan; Smith-Packard, Bethanny; Gupta, Ashish; Campbell, Mary; Gunawardena, Sriya; Saladino, Richard

    2014-10-01

    Vaso-occlusive crisis (VOC) the hallmark of sickle cell disease (SCD) is often treated inadequately in the emergency department (ED). We hypothesized that pain management plans individualized for each patient can improve pain management and lead to high levels of patient satisfaction. Starting in 2002, we treated all patients with SCD reporting to Children's Hospital of Pittsburgh (CHP) ED with VOC using a structured algorithm. We recorded regimens used successfully for each patient as an "individualized pain plan" and implemented it during subsequent VOC visits and adjusted it to patient response. We compared rates of hospitalization following an ED visit with VOC and readmission within 1 week after discharge for CHP with that of four comparable hospitals from Pediatric Health Information (PHIS) database. Patients and parents completed surveys of satisfaction with pain management and with care. Between 2002 and 2008 there was a greater decline in the rate of admission of patients presenting to the ED at CHP (78% to 52%) as compared to PHIS (71% to 68%), (P pain score during ED management was 2.0 or more on a Wong Baker scale of 0-5 (P pain management as very good or higher. Individualized pain management plans in the ED are effective in delivering high quality management of VOC and are associated with a high level of patient satisfaction and decreased avoidable hospitalizations. © 2014 Wiley Periodicals, Inc.

  14. Technical Quality of Delivered Care for Patients with Inflammatory Bowel Disease in Tabriz Care Centers

    Directory of Open Access Journals (Sweden)

    Mohammad Hosein Somi

    2015-08-01

    Full Text Available ​Background and objectives : Inflammatory Bowel Disease (IBD is a chronic disease and requires complex treatment. Due to the various treatment options and gradual understanding of specialists about the risks and benefits of different treatments of IBD, delivering care according to the treatment protocols and guidelines is essential. This study was conducted to assess delivered care from the perspective of patients with inflammatory bowel disease. Material and Methods : This cross-sectional study was conducted with 94 participants with IBD selected randomly in Emam Reza hospital and Golgasht clinic in Tabriz. Data were collected by an approved researcher-made questionnaire via interviewing patients. Chi-Squared Test was used to evaluate the relationship between demographic variables and accordance of delivered care with standards. SPSS17 was used for data analysis. Results : The results indicated that "visit by specialist" and "providing dietary recommendation by nutritionist" aspects had highest and lowest degree of accordance with standards, respectively. Furthermore, the aspects of “delivered care in exacerbation status of disease” and “delivered care by other specialists” had only 20 percent compliance with standards. Also, there was a significant relationship between age, job, education status, smoking and compliance with related standards in some care aspects (p Conclusion : The study results indicated that there is a deep gap between delivered cares for patients with inflammatory bowel disease and related standards. These deficiencies showed the parts that need improvement and require healthcare managers and policy makers’ attention.

  15. A Pilot Investigation of Speech Sound Disorder Intervention Delivered by Telehealth to School-Age Children

    Directory of Open Access Journals (Sweden)

    Sue Grogan-Johnson

    2011-05-01

    Full Text Available This article describes a school-based telehealth service delivery model and reports outcomes made by school-age students with speech sound disorders in a rural Ohio school district. Speech therapy using computer-based speech sound intervention materials was provided either by live interactive videoconferencing (telehealth, or conventional side-by-side intervention.  Progress was measured using pre- and post-intervention scores on the Goldman Fristoe Test of Articulation-2 (Goldman & Fristoe, 2002. Students in both service delivery models made significant improvements in speech sound production, with students in the telehealth condition demonstrating greater mastery of their Individual Education Plan (IEP goals. Live interactive videoconferencing thus appears to be a viable method for delivering intervention for speech sound disorders to children in a rural, public school setting. Keywords:  Telehealth, telerehabilitation, videoconferencing, speech sound disorder, speech therapy, speech-language pathology; E-Helper

  16. Rebamipide delivered by brushite cement enhances osteoblast and macrophage proliferation.

    Directory of Open Access Journals (Sweden)

    Michael Pujari-Palmer

    Full Text Available Many of the bioactive agents capable of stimulating osseous regeneration, such as bone morphogenetic protein-2 (BMP-2 or prostaglandin E2 (PGE2, are limited by rapid degradation, a short bioactive half-life at the target site in vivo, or are prohibitively expensive to obtain in large quantities. Rebamipide, an amino acid modified hydroxylquinoline, can alter the expression of key mediators of bone anabolism, cyclo-oxygenase 2 (COX-2, BMP-2 and vascular endothelial growth factor (VEGF, in diverse cell types such as mucosal and endothelial cells or chondrocytes. The present study investigates whether Rebamipide enhances proliferation and differentiation of osteoblasts when delivered from brushite cement. The reactive oxygen species (ROS quenching ability of Rebampide was tested in macrophages as a measure of bioactivity following drug release incubation times, up to 14 days. Rebamipide release from brushite occurs via non-fickian diffusion, with a rapid linear release of 9.70% ± 0.37% of drug per day for the first 5 days, and an average of 0.5%-1% per day thereafter for 30 days. Rebamipide slows the initial and final cement setting time by up to 3 and 1 minute, respectively, but does not significantly reduce the mechanical strength below 4% (weight percentage. Pre-osteoblast proliferation increases by 24% upon exposure to 0.4 uM Rebamipide, and by up to 73% when Rebamipide is delivered via brushite cement. Low doses of Rebamipide do not adversely affect peak alkaline phosphatase activity in differentiating pre-osteoblasts. Rebamipide weakly stimulates proliferation in macrophages at low concentrations (118 ± 7.4% at 1 uM, and quenches ROS by 40-60%. This is the first investigation of Rebamipide in osteoblasts.

  17. A Designed Framework for Delivering Systems Thinking Skills to Small Business Managers

    Directory of Open Access Journals (Sweden)

    Daowei Sun

    2014-06-01

    Full Text Available Many small businesses suffer from inadequate management skills which can lead to poor business performance and unsustainable businesses. Research to date has focused on traditional skills such as communication, time management and people skills, yet critically many business managers have no systems thinking skills. This paper presents a framework targeted at delivering systems thinking skills to managers of small businesses utilizing some key characteristic of small business managers. The design is also based on a systems analysis and guided by both adult learning theory and teaching theory. The quality of a training framework depends on the quality of the content design and the right training delivery methods. The systems thinking skills training framework structured systems thinking knowledge into three modules in order to meet the needs of different levels of managers. The framework advocates blended training delivery methods and it also presents possible pitfalls based on training experiences. Additionally, the framework incorporates a continuous improvement process for ongoing systemic improvement.

  18. 25 CFR 171.310 - Can I use water delivered by BIA for livestock purposes?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Can I use water delivered by BIA for livestock purposes? 171.310 Section 171.310 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER IRRIGATION OPERATION AND MAINTENANCE Water Use § 171.310 Can I use water delivered by BIA for livestock...

  19. Acute severe asthma presenting in late pregnancy.

    Science.gov (United States)

    Holland, S M; Thomson, K D

    2006-01-01

    Asthma is the commonest pre-existing medical condition to complicate pregnancy. Acute severe asthma in pregnancy is rare, but poses difficult problems. In particular, the decision about when and where to deliver the fetus is complex, since maternal response to asthma treatment is unpredictable. We report the successful management of a parturient presenting with acute severe asthma at 37 weeks' gestation. The controversies involved and the importance of adopting a multi-disciplinary team approach to optimise maternal and neonatal outcomes are discussed.

  20. Adherence to COPD guidelines in general practice: impact of an educational programme delivered on location in Danish general practices.

    Science.gov (United States)

    Ulrik, Charlotte Suppli; Sørensen, Tina Brandt; Højmark, Torben Brunse; Olsen, Kim Rose; Vedsted, Peter

    2013-03-01

    The general practitioner (GP) is often the first healthcare contact for patients with chronic obstructive pulmonary disease (COPD). To determine whether participating in a standardised educational programme delivered in the GP's own practice is associated with adherence to COPD guidelines. A nationwide register-based observational before and after study was undertaken with a control group of propensity-matched practices (follow-up period 6 months). COPD was defined as age 40+ years and at least two prescriptions for inhaled medication. The educational programme consisted of a 3-hr teaching lesson with a respiratory specialist and five visits by a representative from the sponsoring pharmaceutical company focusing on assessment and management of patients including written algorithms. A one-to-one propensity-matched control group of practices was selected. Register data were used to compare the rate of spirometry testing, preventive consultations, and influenza vaccinations provided to COPD patients and the rate of spirometry testing in non-COPD individuals, assumed to reflect diagnostic activity. Data for 102 participating GP practices were analysed. Participating clinics had a significant increase in preventive consultations and influenza vaccinations (peducation of GPs and their staff delivered in the GPs' own practices may improve adherence to COPD guidelines, not least for clinics with a high potential for improvement.

  1. Galaxy CloudMan: delivering cloud compute clusters.

    Science.gov (United States)

    Afgan, Enis; Baker, Dannon; Coraor, Nate; Chapman, Brad; Nekrutenko, Anton; Taylor, James

    2010-12-21

    Widespread adoption of high-throughput sequencing has greatly increased the scale and sophistication of computational infrastructure needed to perform genomic research. An alternative to building and maintaining local infrastructure is "cloud computing", which, in principle, offers on demand access to flexible computational infrastructure. However, cloud computing resources are not yet suitable for immediate "as is" use by experimental biologists. We present a cloud resource management system that makes it possible for individual researchers to compose and control an arbitrarily sized compute cluster on Amazon's EC2 cloud infrastructure without any informatics requirements. Within this system, an entire suite of biological tools packaged by the NERC Bio-Linux team (http://nebc.nerc.ac.uk/tools/bio-linux) is available for immediate consumption. The provided solution makes it possible, using only a web browser, to create a completely configured compute cluster ready to perform analysis in less than five minutes. Moreover, we provide an automated method for building custom deployments of cloud resources. This approach promotes reproducibility of results and, if desired, allows individuals and labs to add or customize an otherwise available cloud system to better meet their needs. The expected knowledge and associated effort with deploying a compute cluster in the Amazon EC2 cloud is not trivial. The solution presented in this paper eliminates these barriers, making it possible for researchers to deploy exactly the amount of computing power they need, combined with a wealth of existing analysis software, to handle the ongoing data deluge.

  2. Current situation of doses delivered to the patients in the field of dental radiology

    International Nuclear Information System (INIS)

    Baechler, S.; Monnin, P.; Aroua, A.; Valley, J.F.; Verdun, F.R.; Perrier, M.

    2006-01-01

    The purpose of this paper is to present an overview of the doses delivered to the patients in the field of dental radiology. The technology progress in medical imaging will be discussed from a dose perspective. In this work, patient dosimetry has been performed for intra-oral, panoramic and CT dental examinations. Doses were estimated using appropriate dosimetric indicators such as the entrance surface kerma (ESK) and the kerma area product (KAP). These indicators are easily measurable and enable to estimate the effective dose for a standard patient. KAP values were measured for two intra-oral systems using D and E/F speed dental films, as well as a digital system based on the CCD technology. In addition, the KAP was measured on three ortho-pan-tomograms (OPGs) of various generations. Finally, in order to assess the dose delivered during dental implants planning, the kerma length product (KLP) and the computed tomography dose index (CTDI W ) were determined for a CT scanner using the Dentascan protocol and a new DVT (Digital Volume Tomography) dedicated system. Using E/F speed instead of D speed films allowed to educe the KAP by a factor of 2 without significant loss of image quality. A further dose reduction by a factor of 6 was possible with digital systems but with an important degradation of the spatial resolution (variation of the MTF at 50% from 13 mm -1 to 5 mm -1 ). KAP measurements on OPGs showed that old systems delivered doses three times higher than a more recent devices. The new dedicated tomographic system enabled a reduction of the patient dose by a factor of 18 when compared with the Dentascan CT system. (author)

  3. Caries prevalence in Danish pre-school children delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Barfod, Mette Nelun; Christensen, Lisa Bøge; Twetman, Svante Henrik Agardh

    2012-01-01

    -section had a higher mean value in comparison with those delivered vaginally (dmfs 6.8 vs 3.2), but the difference was not statistically significant. There was a significant relationship between caries prevalence and low family income in the total study group (OR = 5.8, p Within...... study group with complete information consisted of 594 children, 443 delivered vaginally and 151 by C-section. RESULTS: The total caries prevalence was 8% and no significant difference was displayed between the groups. When only the children with caries (dmfs > 0) were compared, those delivered by C...... the limitations of this observational cohort study, caries prevalence in 3-year-old children was not related to the mode of delivery. However, the tendency of more severe caries in the C-section group justifies further studies, preferably with a prospective design....

  4. VET Providers Planning to Deliver Degrees: Good Practice Guide

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2015

    2015-01-01

    This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…

  5. Determination of the delivered hemodialysis dose using standard methods and on-line clearance monitoring

    Directory of Open Access Journals (Sweden)

    Vlatković Vlastimir

    2006-01-01

    Full Text Available Background/aim: Delivered dialysis dose has a cumulative effect and significant influence upon the adequacy of dialysis, quality of life and development of co-morbidity at patients on dialysis. Thus, a great attention is given to the optimization of dialysis treatment. On-line Clearance Monitoring (OCM allows a precise and continuous measurement of the delivered dialysis dose. Kt/V index (K = dialyzer clearance of urea; t = dialysis time; V = patient's total body water, measured in real time is used as a unit for expressing the dialysis dose. The aim of this research was to perform a comparative assessment of the delivered dialysis dose by the application of the standard measurement methods and a module for continuous clearance monitoring. Methods. The study encompassed 105 patients who had been on the chronic hemodialysis program for more than three months, three times a week. By random choice, one treatment per each controlled patient was taken. All the treatments understood bicarbonate dialysis. The delivered dialysis dose was determined by the calculation of mathematical models: Urea Reduction Ratio (URR singlepool index Kt/V (spKt/V and by the application of OCM. Results. Urea Reduction Ratio was the most sensitive parameter for the assessment and, at the same time, it was in the strongest correlation with the other two, spKt/V indexes and OCM. The values pointed out an adequate dialysis dose. The URR values were significantly higher in women than in men, p < 0.05. The other applied model for the delivered dialysis dose measurement was Kt/V index. The obtained values showed that the dialysis dose was adequate, and that, according to this parameter, the women had significantly better dialysis, then the men p < 0.05. According to the OCM, the average value was slightly lower than the adequate one. The women had a satisfactory dialysis according to this index as well, while the delivered dialysis dose was insufficient in men. The difference

  6. An Open Trial of the Anxiety Action Plan (AxAP): A Brief Pediatrician-Delivered Intervention for Anxious Youth

    Science.gov (United States)

    Ginsburg, Golda S.; Drake, Kelly; Winegrad, Heather; Fothergill, Kate; Wissow, Larry

    2016-01-01

    Background Anxiety disorders in youth are among the most common psychiatric disorders, yet the majority of affected youth do not receive treatment. One approach to improving access to care is identification and intervention within the primary care setting. Objective This manuscript presents data from a single group pre-post open trial of the Anxiety Action Plan (AxAP), a brief pediatrician-delivered intervention to reduce anxiety in youth who present in the primary care setting. Methods Eleven pediatricians conducted the intervention with 25 youth (mean age 11.16 years; range 6-18 years) with elevated levels of anxiety in their primary care practice setting. Results Pediatricians’ ratings of the AxAP training were positive (mean overall satisfaction was 4.82 on 5 point scale). Pediatricians and parents also reported high levels of intervention satisfaction and acceptability. Parents (but not children) who completed the intervention reported significant reductions from pre- to post-intervention on measures of child anxiety severity, impairment, and caregiver burden (Cohen's d 1.06, .75, .60, respectively). Conclusions Findings suggest that a brief, pediatrician-delivered intervention in primary care settings appears feasible and beneficial to patients. Additional controlled evaluation of the intervention's efficacy is needed. PMID:27403041

  7. Delivering bad news in emergency care medicine.

    Science.gov (United States)

    Maynard, Douglas W

    2017-01-01

    Forecasting is a strategy for delivering bad news and is compared to two other strategies, stalling and being blunt. Forecasting provides some warning that bad news is forthcoming without keeping the recipient in a state of indefinite suspense (stalling) or conveying the news abruptly (being blunt). Forecasting appears to be more effective than stalling or being blunt in helping a recipient to "realize" the bad news because it involves the deliverer and recipient in a particular social relation. The deliverer of bad news initiates the telling by giving an advance indication of the bad news to come; this allows the recipient to calculate the news in advance of its final presentation, when the deliverer confirms what the recipient has been led to anticipate. Thus, realization of bad news emerges from intimate collaboration, whereas stalling and being blunt require recipients to apprehend the news in a social vacuum. Exacerbating disruption to recipients' everyday world, stalling and being blunt increase the probability of misapprehension (denying, blaming, taking the situation as a joke, etc.) and thereby inhibit rather than facilitate realization. Particular attention is paid to the "perspective display sequence", a particular forecasting strategy that enables both confirming the recipient's perspective and using that perspective to affirm the clinical news. An example from acute or emergency medicine is examined at the close of the paper.

  8. Habitable Worlds: Delivering on the Promises of Online Education

    Science.gov (United States)

    Horodyskyj, Lev B.; Mead, Chris; Belinson, Zack; Buxner, Sanlyn; Semken, Steven; Anbar, Ariel D.

    2018-01-01

    Critical thinking and scientific reasoning are central to higher education in the United States, but many courses (in-person and online) teach students information about science much more than they teach the actual process of science and its associated knowledge and skills. In the online arena specifically, the tools available for course construction exacerbate this problem by making it difficult to build the types of active learning activities that research shows to be the most effective. Here, we present a report on Habitable Worlds, offered by Arizona State University for 12 semesters over the past 6 years. This is a unique online course that uses an array of novel technologies to deliver an active, inquiry-driven learning experience. Learning outcomes and quantitative data from more than 3000 students demonstrate the success of our approach but also identify several remaining challenges. The design and development of this course offers valuable lessons for instructional designers and educators who are interested in fully capitalizing on the capabilities of 21st-century technology to achieve educational goals.

  9. DESIGNS MATTER: Delivering Information Sources for Tourism

    Directory of Open Access Journals (Sweden)

    Margie A. Nolasco

    2016-11-01

    Full Text Available Tourism has benefits not just for travelers, but also to the local economy. Since, Bicol Region has natural and cultural attractions; it is a potential travel destination in the country. Technology in delivering information sources played vital role for the success of the tourism industry in the Region. This allows travel enthusiasts to get more information about various tourist attractions. This paper analyzes the effectiveness of delivering information sources such as web advertisement and desktop publishing for tourist promotion in the Bicol Region. Specifically, it determined the status of tourism, and identified common forms of promotions for tourism development. The study adopted mixed method of research. This method was utilized to confirm and validate findings. Interviews and focus group discussions were used to gather data from the respondents of the selected Local Government Units, Department of Tourism, Travel Agencies and Hotel Agents in the Region. Based on the findings, of the total foreign visitors in the country, only 9.14% visited Bicol Region in 2014. That is why, domestic tourist showed high percentage against foreign visitors with 25.7%. Brochures with EZ maps as most commonly used desktop publishing materials and websites and social media for web advertisement. Thus, there is a need to reevaluate promotional activities by the DOT and other agencies. Adoption suggestive features for creative desktop publishing materials and web services should be considered to increase tourist visitors in the Region.

  10. The ABC's of Delivering A Research-Driven Adventure Learning Program From the Field

    Science.gov (United States)

    Pregont, P.; Porsild, M.

    2008-12-01

    A is for anchoring the delivery of your research to your audience in a standard-aligned curriculum. B is for BGAN Satellite Communication System assisting in delivering real-time authentic media. C is for a collaborative online learning environment to engage learners" Z is for the peaceful sleep you will get once your program is up and running! As part of Team GoNorth! (http://www.PolarHusky.com) it is our job to deliver adventure learning. We set out to do this back when the computer was a 4-foot, 50-lb box powered by a hand-crank where one would have a window of ten minutes in a 24-hour period to catch the satellite (before Al Gore created the Internet!). Every year we review the quantum leaps in what is now possible from the field and in the classroom, and over the years we have wrestled technical issues, solutions and numerous re-structures in the process of our of curriculum development. With this presentation we will provide some basic ABC's on how you can remained focused on your research, yet deliver an adventure learning program for learners to investigate real-world issues within your scientific research. Our scales are most likely different. The volume of our curriculum is an annual production of 4-500 pages to be used from Kindergarden through 12th grade around the world. The framework of our online learning environment must be able to supports millions of users at a time. "In the field" means on a a 3-4 month dogsled expedition - so sending out our live updates involve thawing out the computers and setting up the satellite communication system to work in a ground blizzard! But regardless of the scope and location of your field research, you can probably build on some of our experiences in the planning of an upcoming adventure learning program to engage learners of all or any ages in your scientific explorations!

  11. Designing and delivering facilitated storytelling interventions for chronic disease self-management: a scoping review.

    Science.gov (United States)

    Gucciardi, Enza; Jean-Pierre, Nicole; Karam, Grace; Sidani, Souraya

    2016-07-11

    Little is known about how to develop and deliver storytelling as an intervention to support those managing chronic illnesses. This scoping review aims to describe the core elements of storytelling interventions in order to help facilitate its implementation. A scoping review was conducted in seven databases for articles published up to May 2014 to identify interventions that describe in detail how storytelling was used to support people in disease self-management interventions. Ten articles met all inclusion criteria. Core elements consistently observed across the storytelling interventions were: reflection and interactive meaning-making of experiences; principles of informality and spontaneity; non-directional and non-hierarchical facilitation; development of group norms and conduct to create a community among participants; and both an individual and collective role for participants. Differences were also observed across interventions, such as: the conceptual frameworks that directed the design of the intervention; the type and training of facilitators; intervention duration; and how session topics were selected and stories delivered. Furthermore, evaluation of the intervention and outcome assessment varied greatly across studies. The use of storytelling can be a novel intervention to enhance chronic disease self-management. The core elements identified in the review inform the development of the intervention to be more patient-centred by guiding participants to take ownership of and lead the intervention, which differs significantly from traditional support groups. Storytelling has the potential to provide patients with a more active role in their health care by identifying their specific needs as well as gaps in knowledge and skills, while allowing them to form strong bonds with peers who share similar disease-related experiences. However, measures of impact differed across interventions given the variation in chronic conditions. Our findings can guide future

  12. Effective Presentation Media for Passenger Safety I: Comprehension of Briefing Card Pictorials and Pictograms

    National Research Council Canada - National Science Library

    Corbett, Cynthia L; McLean, Garnet A; Cosper, Donna K

    2008-01-01

    .... The exact content and presentation media used for safety briefings and cards are the responsibility of the airlines to implement, as long as the required minimum safety information is delivered...

  13. Using technology to deliver cost-effective Continuing Professional Development (CPD

    Directory of Open Access Journals (Sweden)

    Kuldeep Singh

    2015-01-01

    Full Text Available The work is based on engineering the audio video contents of the didactic presentations at the Regional Symposium on Sleep Medicine delivered to the target audience at NAMSCON 2013. The audio was extracted and then synchronized with Power Points, re-synthesized as SCORM (Sharable Content Object Reference Model compliant packages and integrated with Moodle (Modular Object-Oriented Dynamic Learning Environment as Learning Management System (LMS. The preliminary evaluation results showed high satisfaction with the content, its short loading time and smooth playback. These attributes were demonstrated to be effective in enhancing learning. The Moodle as LMS also allows tracking the participants' progress, involving them in social groups and open discussion forum for further enriching the online content and also helps in statistical analysis through its inbuilt web analytics. The technology is not only flexible and economical but also an effective delivery method for Continuing Professional Development Programmes.Key words: Continuing Professional Development, Learning Management System

  14. Variation in the costs of delivering routine immunization services in Peru.

    Science.gov (United States)

    Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

    2004-09-01

    Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.

  15. Comparing a telephone- and a group-delivered diabetes prevention program

    DEFF Research Database (Denmark)

    S, Lim; Dunbar, James; Versace, Vin

    2017-01-01

    Aims To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement. Methods Postpartum women participated in a lifestyle modification program delivere...

  16. Optimizing a Drone Network to Deliver Automated External Defibrillators.

    Science.gov (United States)

    Boutilier, Justin J; Brooks, Steven C; Janmohamed, Alyf; Byers, Adam; Buick, Jason E; Zhan, Cathy; Schoellig, Angela P; Cheskes, Sheldon; Morrison, Laurie J; Chan, Timothy C Y

    2017-06-20

    Public access defibrillation programs can improve survival after out-of-hospital cardiac arrest, but automated external defibrillators (AEDs) are rarely available for bystander use at the scene. Drones are an emerging technology that can deliver an AED to the scene of an out-of-hospital cardiac arrest for bystander use. We hypothesize that a drone network designed with the aid of a mathematical model combining both optimization and queuing can reduce the time to AED arrival. We applied our model to 53 702 out-of-hospital cardiac arrests that occurred in the 8 regions of the Toronto Regional RescuNET between January 1, 2006, and December 31, 2014. Our primary analysis quantified the drone network size required to deliver an AED 1, 2, or 3 minutes faster than historical median 911 response times for each region independently. A secondary analysis quantified the reduction in drone resources required if RescuNET was treated as a large coordinated region. The region-specific analysis determined that 81 bases and 100 drones would be required to deliver an AED ahead of median 911 response times by 3 minutes. In the most urban region, the 90th percentile of the AED arrival time was reduced by 6 minutes and 43 seconds relative to historical 911 response times in the region. In the most rural region, the 90th percentile was reduced by 10 minutes and 34 seconds. A single coordinated drone network across all regions required 39.5% fewer bases and 30.0% fewer drones to achieve similar AED delivery times. An optimized drone network designed with the aid of a novel mathematical model can substantially reduce the AED delivery time to an out-of-hospital cardiac arrest event. © 2017 American Heart Association, Inc.

  17. A service model for delivering care closer to home.

    Science.gov (United States)

    Dodd, Joanna; Taylor, Charlotte Elizabeth; Bunyan, Paul; White, Philippa Mary; Thomas, Siân Myra; Upton, Dominic

    2011-04-01

    Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient.This is a practical example of early implementation of the principles underlying the Department of Health's (DH) recent Best Practice Guidance, 'Delivering Care Closer to Home' (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the 'Customer Care' award by 'Management in Practice'. The Surgery was also awarded the 'Practice of the Year' award for this and a number of other customer-focussed projects.

  18. Delivering the Goods for Genome Engineering and Editing.

    Science.gov (United States)

    Skipper, Kristian Alsbjerg; Mikkelsen, Jacob Giehm

    2015-08-01

    A basic understanding of genome evolution and the life and impact of microorganisms, like viruses and bacteria, has been fundamental in the quest for efficient genetic therapies. The expanding tool box for genetic engineering now contains transposases, recombinases, and nucleases, all created from naturally occurring genome-modifying proteins. Whereas conventional gene therapies have sought to establish sustained expression of therapeutic genes, genomic tools are needed only in a short time window and should be delivered to cells ideally in a balanced "hit-and-run" fashion. Current state-of-the-art delivery strategies are based on intracellular production of protein from transfected plasmid DNA or in vitro-transcribed RNA, or from transduced viral templates. Here, we discuss advantages and challenges of intracellular production strategies and describe emerging approaches based on the direct delivery of protein either by transfer of recombinant protein or by lentiviral protein transduction. With focus on adapting viruses for protein delivery, we describe the concept of "all-in-one" lentiviral particles engineered to codeliver effector proteins and donor sequences for DNA transposition or homologous recombination. With optimized delivery methods-based on transferring DNA, RNA, or protein-it is no longer far-fetched that researchers in the field will indeed deliver the goods for somatic gene therapies.

  19. Delivering phonological and phonics training within whole-class teaching.

    Science.gov (United States)

    Shapiro, Laura R; Solity, Jonathan

    2008-12-01

    Early, intensive phonological awareness and phonics training is widely held to be beneficial for children with poor phonological awareness. However, most studies have delivered this training separately from children's normal whole-class reading lessons. We examined whether integrating this training into whole class, mixed-ability reading lessons could impact on children with poor phonological awareness, whilst also benefiting normally developing readers. Teachers delivered the training within a broad reading programme to whole classes of children from Reception to the end of Year 1 (N=251). A comparison group of children received standard teaching methods (N=213). Children's literacy was assessed at the beginning of Reception, and then at the end of each year until 1 year post-intervention. The strategy significantly impacted on reading performance for normally developing readers and those with poor phonological awareness, vastly reducing the incidence of reading difficulties from 20% in comparison schools to 5% in intervention schools. Phonological and phonics training is highly effective for children with poor phonological awareness, even when incorporated into whole-class teaching.

  20. Should we routinely remove the dose delivered by the images of control?

    International Nuclear Information System (INIS)

    Goasduff, G.; Pene Baverez, D.; Pradier, O.; Bouchekoua, M.

    2009-01-01

    The constraints of doses fixed by the international commission on radiation units and measurements (ICRU) for the target volume (95-107% of the prescribed dose) are respected. for the hypo fractionated treatments, it is necessary to control the impact of the dose delivered by the control images for every patient. The dose delivered at the isocenter is estimated between 1 and 3 Gy by control image: this dose depends on the beams size and on the distance-source-skin. Protocols of the patient positioning checking must be implemented on optimizing their frequency to limit the dose received by the patient. (N.C.)

  1. phenoSeeder - A Robot System for Automated Handling and Phenotyping of Individual Seeds.

    Science.gov (United States)

    Jahnke, Siegfried; Roussel, Johanna; Hombach, Thomas; Kochs, Johannes; Fischbach, Andreas; Huber, Gregor; Scharr, Hanno

    2016-11-01

    The enormous diversity of seed traits is an intriguing feature and critical for the overwhelming success of higher plants. In particular, seed mass is generally regarded to be key for seedling development but is mostly approximated by using scanning methods delivering only two-dimensional data, often termed seed size. However, three-dimensional traits, such as the volume or mass of single seeds, are very rarely determined in routine measurements. Here, we introduce a device named phenoSeeder, which enables the handling and phenotyping of individual seeds of very different sizes. The system consists of a pick-and-place robot and a modular setup of sensors that can be versatilely extended. Basic biometric traits detected for individual seeds are two-dimensional data from projections, three-dimensional data from volumetric measures, and mass, from which seed density is also calculated. Each seed is tracked by an identifier and, after phenotyping, can be planted, sorted, or individually stored for further evaluation or processing (e.g. in routine seed-to-plant tracking pipelines). By investigating seeds of Arabidopsis (Arabidopsis thaliana), rapeseed (Brassica napus), and barley (Hordeum vulgare), we observed that, even for apparently round-shaped seeds of rapeseed, correlations between the projected area and the mass of seeds were much weaker than between volume and mass. This indicates that simple projections may not deliver good proxies for seed mass. Although throughput is limited, we expect that automated seed phenotyping on a single-seed basis can contribute valuable information for applications in a wide range of wild or crop species, including seed classification, seed sorting, and assessment of seed quality. © 2016 American Society of Plant Biologists. All Rights Reserved.

  2. Innovative model of delivering quality improvement education for trainees – a pilot project

    Directory of Open Access Journals (Sweden)

    Kannan Ramar

    2015-09-01

    Full Text Available Background: After incorporating quality improvement (QI education as a required curriculum for our trainees in 2010, a need arose to readdress our didactic sessions as they were too long, difficult to schedule, and resulting in a drop in attendance. A ‘flipped classroom’ (FC model to deliver QI education was touted to be an effective delivery method as it allows the trainees to view didactic materials on videos, on their own time, and uses the classroom to clarify concepts and employ learned tools on case-based scenarios including workshops. Methods: The Mayo Quality Academy prepared 29 videos that incorporated the previously delivered 17 weekly didactic sessions, for a total duration of 135 min. The half-day session clarified questions related to the videos, followed by case examples and a hands-on workshop on how to perform and utilize a few commonly used QI tools and methods. Results: Seven trainees participated. There was a significant improvement in knowledge as measured by pre- and post-FC model test results [improvement by 40.34% (SD 16.34, p<0.001]. The survey results were overall positive about the FC model with all trainees strongly agreeing that we should continue with this model to deliver QI education. Conclusions: The pilot project of using the FC model to deliver QI education was successful in a small sample of trainees.

  3. North West Surrey's locality hubs - delivering integrated care

    OpenAIRE

    Compton, Lisa; Wilkinson, Peter; Lawn, Liz

    2017-01-01

    Introduction: North West Surrey CCG (NWSCCG) is establishing Locality Hubs – physical buildings offering a fully integrated GP-led, multi-disciplinary ‘one-stop-shop’ services in the community for a defined cohort of frail elderly patients with multiple core morbidities. Hubs will ultimately deliver proactive and reactive care, available 24 hours a day, 365 days a year.The key drivers are;Ageing population, people living longer & more people living with chronic conditionsCost & demand...

  4. "I Always Vet Things": Navigating Privacy and the Presentation of Self on Health Discussion Boards Among Individuals with Long-Term Conditions.

    Science.gov (United States)

    Brady, Ellen; Segar, Julia; Sanders, Caroline

    2016-10-13

    The ethics of research into online communities is a long-debated issue, with many researchers arguing that open-access discussion groups are publically accessible data and do not require informed consent from participants for their use for research purposes. However, it has been suggested that there is a discrepancy between the perceived and actual privacy of user-generated online content by community members. There has been very little research regarding how privacy is experienced and enacted online. The objective of this study is to address this gap by qualitatively exploring the expectations of privacy on Internet forums among individuals with long-term conditions. Semistructured interviews were conducted with 20 participants with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and 21 participants with type 1 and 2 diabetes mellitus, and were analyzed using thematic analysis. Participants were recruited via online and offline routes, namely forums, email lists, newsletters, and face-to-face support groups. The findings indicate that privacy online is a nebulous concept. Rather than individuals drawing a clear-cut distinction between what they would and would not be comfortable sharing online, it was evident that these situations were contextually dependent and related to a number of unique and individual factors. Interviewees were seen to carefully manage how they presented themselves on forums, filtering and selecting the information that they shared about themselves in order to develop and maintain a particular online persona, while maintaining and preserving an acceptable level of privacy.

  5. Information retrieval and individual differences

    Directory of Open Access Journals (Sweden)

    Polona Vilar

    2008-01-01

    Full Text Available The paper presents individual differences, which are found in studies of information retrieval with emphasis on models of personality traits, cognitive and learning styles. It pays special attention to those models which are most often included in studies of information behaviour,information seeking,perceptions of IR systems, etc., but also brings forward some models which have not yet been included in such studies. Additionally, the relationship between different individual characteristics and individual’s chosen profession or academic area is discussed. In this context,the paper presents how investigation of individual differences can be useful in the design of IR systems.

  6. Using Self-Guided Treatment Software (ePST to Teach Clinicians How to Deliver Problem-Solving Treatment for Depression

    Directory of Open Access Journals (Sweden)

    James A. Cartreine

    2012-01-01

    Full Text Available Problem-solving treatment (PST offers a promising approach to the depression care; however, few PST training opportunities exist. A computer-guided, interactive media program has been developed to deliver PST electronically (ePST, directly to patients. The program is a six-session, weekly intervention modeled on an evidence-based PST protocol. Users are guided through each session by a clinician who is presented via hundreds of branching audio and video clips. Because expert clinician behaviors are modeled in the program, not only does the ePST program have the potential to deliver PST to patients but it may also serve as a training tool to teach clinicians how to deliver PST. Thirteen social workers and trainees used ePST self-instructionally and subsequently attended a day-long workshop on PST. Participants’ PST knowledge level increased significantly from baseline to post-ePST (P=.001 and did not increase significantly further after attending the subsequent workshop. Additionally, attending the workshop did not significantly increase the participants' skill at performing PST beyond the use of the ePST program. Using the ePST program appears to train novices to a sufficient level of competence to begin practicing PST under supervision. This self-instructional training method could enable PST for depression to be widely disseminated, although follow-up supervision is still required.

  7. Variation in Primary Cesarean Delivery Rates by Individual Physician within a Single Hospital Laborist Model

    Science.gov (United States)

    METZ, Torri D.; ALLSHOUSE, Amanda A.; GILBERT, Sara A Babcock; DOYLE, Reina; TONG, Angie; CAREY, J. Christopher

    2016-01-01

    Background Laborist practice models are associated with lower cesarean delivery rates than individual private practice models in several studies; however, this effect is not uniform. Further exploration of laborist models may help us better understand the observed reduction in cesarean delivery rates in some hospitals with implementation of a laborist model. Objective Our objective was to evaluate the degree of variation in primary cesarean delivery rates by individual laborists within a single institution employing a laborist model. In addition, we sought to evaluate whether differences in cesarean delivery rates resulted in different maternal or short-term neonatal outcomes. Study Design At this teaching institution, one laborist (either a generalist or maternal-fetal medicine attending physician) is directly responsible for labor and delivery management during each shift. No patients are followed in a private practice model nor are physicians incentivized to perform deliveries. We retrospectively identified all laborists who delivered nulliparous, term women with cephalic singletons at this institution from 2007-14. Overall and individual primary cesarean delivery rates were reported as percentages with exact Pearson 95% CI. Laborists were grouped by tertile as having low, medium or high cesarean delivery rates. Characteristics of the women delivered, indications for cesarean delivery, and short-term neonatal outcomes were compared between these groups. A binomial regression model of cesarean delivery was estimated, where the relative rates of each laborist compared to the lowest-unadjusted laborist rate were calculated; a second model was estimated to adjust for patient-level maternal characteristics. Results Twenty laborists delivered 2,224 nulliparous, term women with cephalic singletons. The overall cesarean delivery rate was 24.1% (95% CI 21.4-26.8). In an unadjusted binomial model, the overall effect of individual laborist was significant (pcesarean

  8. Effectiveness of online word of mouth on exposure to an Internet-delivered intervention.

    Science.gov (United States)

    Crutzen, Rik; de Nooijer, Jascha; Brouwer, Wendy; Oenema, Anke; Brug, Johannes; de Vries, Nanne

    2009-07-01

    The use of online word of mouth (WOM) seems a promising strategy to motivate young people to visit Internet-delivered interventions. An Internet-delivered intervention aimed at changing implicit attitudes related to alcohol was used in two experiments to test effectiveness of e-mail invitations on a first visit to the intervention. The results of the first experiment (N = 196) showed that an invitation by e-mail from a friend was more effective to attract young adults (aged 18-24 years) to the intervention website than an invitation from an institution. A 2 x 2 design was used in the second experiment (N = 236) to test manipulations of argument strength and the use of peripheral cues in invitations. Results showed that weak arguments were more effective to attract young adults to the intervention website when an incentive was withheld. These results need to be taken into account when using online WOM as a strategy to improve exposure to Internet-delivered interventions.

  9. Medical nutrition therapy: use of sourdough lactic acid bacteria as a cell factory for delivering functional biomolecules and food ingredients in gluten free bread

    LENUS (Irish Health Repository)

    2011-08-30

    Abstract Celiac disease (CD) is an immune-mediated disease, triggered in genetically susceptible individuals by ingesting gluten from wheat, rye, barley, and other closely related cereal grains. Currently, the estimated prevalence of CD is around 1 % of the population in the western world and medical nutritional therapy (MNT) is the only accepted treatment for celiac disease. To date, the replacement of gluten in bread presents a significant technological challenge for the cereal scientist due to the low baking performance of gluten free products (GF). The increasing demand by the consumer for high quality gluten-free (GF) bread, clean labels and natural products is rising. Sourdough has been used since ancient times for the production of rye and wheat bread, its universal usage can be attributed to the improved quality, nutritional properties and shelf life of sourdough based breads. Consequently, the exploitation of sourdough for the production of GF breads appears tempting. This review will highlight how sourdough LAB can be an efficient cell factory for delivering functional biomolecules and food ingredients to enhance the quality of gluten free bread.

  10. Effectiveness of psychological interventions delivered by non-psychologists on low back pain and disability: a qualitative systematic review.

    Science.gov (United States)

    Bostick, Geoff P

    2017-11-01

    Psychological treatments delivered by non-psychologists have been proposed as a way to increase access to care to address important psychological barriers to recovery in people with low back pain (LBP). This review aimed to synthesize randomized controlled trials (RCTs) that assess the effectiveness of psychological interventions delivered by non-psychologists in reducing pain intensity and disability in adults with LBP, compared with usual care. A systematic review without meta-analysis was carried out. Randomized controlled trials including adult patients with all types of musculoskeletal LBP were eligible. Interventions included those based on psychological principles and delivered by non-psychologists. The primary outcomes of interest were self-reported pain intensity and disability. Information sources included Medline, EMBASE, and the Cochrane Central Registrar for Controlled Trials. The Cochrane Collaboration's tool for assessing risk of bias was used for the evaluation of internal validity. There were 1,101 records identified, 159 were assessed for eligibility, 16 were critically appraised, and 11 studies were included. Mild to moderate risk of bias was present in the included studies, with personnel and patient blinding, treatment fidelity, and attrition being the most common sources of bias. Considerable heterogeneity existed for patient population, intervention components, and comparison groups. Although most studies demonstrated statistical and clinical improvements in pain and disability, few were statistically superior to the comparison group. Consistent with the broader psychological literature, psychological interventions delivered by non-psychologists have modest effects on low back pain and disability. Additional high quality research is needed to understand what patients are likely to respond to psychological interventions, the appropriate dose to achieve the desired outcome, the amount of training required to implement psychological

  11. A Minimally Invasive, Translational Method to Deliver Hydrogels to the Heart Through the Pericardial Space

    Directory of Open Access Journals (Sweden)

    Jose R. Garcia, MS

    2017-10-01

    Full Text Available Biomaterials are a new treatment strategy for cardiovascular diseases but are difficult to deliver to the heart in a safe, precise, and translatable way. We developed a method to deliver hydrogels to the epicardium through the pericardial space. Our device creates a temporary compartment for hydrogel delivery and gelation using anatomic structures. The method minimizes risk to patients from embolization, thrombotic occlusion, and arrhythmia. In pigs there were no clinically relevant acute or subacute adverse effects from pericardial hydrogel delivery, making this a translatable strategy to deliver biomaterials to the heart.

  12. The Challenges of Globalisation: Delivering an MBA Programme in Eritrea.

    Science.gov (United States)

    Dence, Roger; O'Toole, John

    1999-01-01

    Describes the experiences of delivering an MBA (Master in Business Administration) program in Eritrea (North East Africa) through the United Kingdom's Open University. Discusses tutoring teams that travel to Eritrea, localizing case examples and assignments, sensitivity to local cultural contexts, writing assignments, student assessment, and…

  13. Delivering a medical school elective with massive open online course (MOOC) technology.

    Science.gov (United States)

    Robinson, Robert

    2016-01-01

    The educational technology of massive open online courses (MOOCs) has been successfully applied in a wide variety of disciplines and are an intense focus of educational research at this time. Educators are now looking to MOOC technology as a means to improve professional medical education, but very little is known about how medical MOOCs compare with traditional content delivery. A retrospective analysis of the course evaluations for the Medicine as a Business elective by fourth-year medical students at Southern Illinois University School of Medicine (SIU-SOM) for the 2012-2015 academic years was conducted. This course was delivered by small group flipped classroom discussions for 2012-2014 and delivered via MOOC technology in 2015. Learner ratings were compared between the two course delivery methods using routinely collected course evaluations. Course enrollment has ranged from 6-19 students per year in the 2012-2015 academic years. Student evaluations of the course are favorable in the areas of effective teaching, accurate course objectives, meeting personal learning objectives, recommending the course to other students, and overall when rated on a 5-point Likert scale. The majority of all student ratings (76-95%) of this elective course are for the highest possible choice (Strongly agree or Excellent) for any criteria, regardless if the course was delivered via a traditional or MOOC format. Statistical analysis of these ratings suggests that the Effective Teacher and Overall Evaluations did not statistically differ between the two delivery formats. Student ratings of this elective course were highly similar when delivered in a flipped classroom format or by using MOOC technology. The primary advantage of this new course format is flexibility of time and place for learners, allowing them to complete the course objectives when convenient for them. The course evaluations suggest this is a change that is acceptable to the target audience. This study suggests that

  14. Delivering Results for Peace and Development

    International Nuclear Information System (INIS)

    Pattison, Hazel

    2013-01-01

    The IAEA’s technical cooperation programme is the primary mechanism for delivering the IAEA’s capacity-building services to its Member States. The programme supports the safe and secure application of nuclear technology for sustainable socioeconomic development in Member States. The overall strategic framework of the TC programme is determined by pertinent provisions laid down in key documents of the IAEA. Strategic direction for the multi-annual TC programme is provided by the Agency’s Members States and, more specifically, by relevant advisory and governance entities. The programme concentrates on: improving human health; supporting agriculture, rural development and food security; advancing water resource management; addressing environmental challenges; helping sustainable energy development, including the use of nuclear power for electricity; and promoting safety and security

  15. Delivering Hubble Discoveries to the Classroom

    Science.gov (United States)

    Eisenhamer, B.; Villard, R.; Weaver, D.; Cordes, K.; Knisely, L.

    2013-04-01

    Today's classrooms are significantly influenced by current news events, delivered instantly into the classroom via the Internet. Educators are challenged daily to transform these events into student learning opportunities. In the case of space science, current news events may be the only chance for educators and students to explore the marvels of the Universe. Inspired by these circumstances, the education and news teams developed the Star Witness News science content reading series. These online news stories (also available in downloadable PDF format) mirror the content of Hubble press releases and are designed for upper elementary and middle school level readers to enjoy. Educators can use Star Witness News stories to reinforce students' reading skills while exposing students to the latest Hubble discoveries.

  16. A Rare Presentation of a Transethmoidal Encephalocele at Birth

    Directory of Open Access Journals (Sweden)

    Anand Vishwanath Upasani

    2014-10-01

    Full Text Available Transethmoidal encephalocele is a very rare condition. Herein, we report the case of a neonate with a transethmoidal encephalocele, who presented with an externally visible intranasal mass at birth. Clinical suspicion of intracranial extension was confirmed by radiological imaging. A bifrontal craniotomy was done to divide the narrow communicating duct. The mass was delivered through the nostril and duraplasty was completed. The postoperative recovery was uneventful.

  17. Individual neutron dosimetry

    International Nuclear Information System (INIS)

    Mauricio, C.L.P.

    1987-01-01

    The most important concepts and development in individual neutron dosimetry are presented, especially the dosimetric properties of the albedo technique. The main problem in albedo dosimetry is to calibrate the dosemeter in the environs of each neutron source. Some of the most used calibration techniques are discussed. The IRD albedo dosemeter used in the routine neutron individual monitoring is described in detail. Its dosimetric properties and calibration methods are discussed. (Author) [pt

  18. Joining forces: collaborating internationally to deliver high-quality, online postgraduate education in pain management.

    Science.gov (United States)

    Devonshire, Elizabeth; Siddall, Philip

    2011-01-01

    The effective management of pain is a complex and costly global issue, requiring a range of innovative educational strategies to enable culturally appropriate and high-quality health care provision. In response to this issue, the Pain Management Research Institute at the University of Sydney (Sydney, Australia) has established several strategic alliances with other overseas universities to deliver online postgraduate education in pain management. The present article discusses the rationale for joining forces, and the approach adopted in creating and maintaining these alliances. It also provides insights into the benefits, challenges and opportunities associated with collaborative educational initiatives of this nature, from institutional, academic and student perspectives.

  19. Gender Differences in the Strategies and Tactics of Self-Presentation

    Directory of Open Access Journals (Sweden)

    Kurysheva Olga Vasilyevna

    2015-09-01

    Full Text Available The article represents the results of empirical study of gender differences in the strategies, tactics, importance and effectiveness of self-presentation. Participants (25 women and 25 men completed self-report measures of self-presentation (self-presentation tactics scale, self-control (self-monitoring scale, importance of self-presentation in various fields of communication. The results indicated that feminine individuals are significantly more likely to use defensive tactics of self-presentation, such as an “apology” and a “supplication”. They also use the strategies of “attractive behavior”. Masculine individuals are more likely to use the strategy “power influence” and the corresponding tactic “intimidation”. Androgynous individuals are significantly more likely to use the strategy “refusal” and some other tactics, such as “excuse”, “justification” and “denying responsibility”. It was revealed that the self-presentation is more important for feminine and androgynous individuals, than masculine individuals. In addition to this, self-presentation in the family is more important for androgynous individuals, while in professional and interpersonal spheres self-presentation is very important for feminine individuals. Gender differences do not affect the effectiveness of self-presentation. The results reflect the stereotypical characteristics and social expectations regarding the conduct of a person of a particular gender.

  20. Influenza nucleoprotein delivered with aluminium salts protects mice from an influenza A virus that expresses an altered nucleoprotein sequence.

    Directory of Open Access Journals (Sweden)

    Megan K L Macleod

    Full Text Available Influenza virus poses a difficult challenge for protective immunity. This virus is adept at altering its surface proteins, the proteins that are the targets of neutralizing antibody. Consequently, each year a new vaccine must be developed to combat the current recirculating strains. A universal influenza vaccine that primes specific memory cells that recognise conserved parts of the virus could prove to be effective against both annual influenza variants and newly emergent potentially pandemic strains. Such a vaccine will have to contain a safe and effective adjuvant that can be used in individuals of all ages. We examine protection from viral challenge in mice vaccinated with the nucleoprotein from the PR8 strain of influenza A, a protein that is highly conserved across viral subtypes. Vaccination with nucleoprotein delivered with a universally used and safe adjuvant, composed of insoluble aluminium salts, provides protection against viruses that either express the same or an altered version of nucleoprotein. This protection correlated with the presence of nucleoprotein specific CD8 T cells in the lungs of infected animals at early time points after infection. In contrast, immunization with NP delivered with alum and the detoxified LPS adjuvant, monophosphoryl lipid A, provided some protection to the homologous viral strain but no protection against infection by influenza expressing a variant nucleoprotein. Together, these data point towards a vaccine solution for all influenza A subtypes.

  1. Procedure for the delivering of personal short-term visitor dosimeters

    CERN Document Server

    2016-01-01

    Update of the administrative procedure for delivering a personal short-term visitor dosimeter to associated members of CERN’s personnel.   Associated members of the CERN personnel may request a short term visitor dosimeter if working only in Supervised Radiation Areas and for a period of less than two months in a calendar year. Such a dosimeter is delivered without the need to provide the usual regular documents: radiation passport, certificate from the home institute or medical certificate. Periodic verification will ensure that holders of these personal dosimeters do not exceed the maximum allowed personal dose for this type of dosimeter, which is the same as the limit for members of the public at 1 mSv per year. From now on, the two-month period can be spread over a calendar year, offering greater flexibility to users coming to CERN for multiple short periods. Please return unused dosimeters Persons leaving CERN for a period of more than one month should return their dosimeter to the D...

  2. Commentary: presenting the value of medical quality to nonclinical senior management and boards of directors.

    Science.gov (United States)

    Fetterolf, Donald E

    2003-01-01

    Many physicians find hospital or health plan boards of directors to be intimidating arenas for medical quality presentations. This essay presents a number of "pearls" gleaned from successful senior clinician managers who have learned to relate to senior management and advance in their careers. This commentary was developed from research and a presentation of the same title delivered at the American College of Medical Quality Annual Meeting held in Las Vegas in October, 2001. It is important that medical directors who work with financial managers convert quality concepts into "business value" concepts. Talking in the language of business, rather than the language of doctors, makes it much easier to communicate with management (although some translation is often in order). As a clinician presenting to financial managers, you should become familiar with financial terms and how they are used. Indeed, the development of a financial model representing clinical activity results in the highest level of success. There are a number of methods for estimating impact that have been found within general business and health services research areas that are acceptable. Successful presenters of information approach their task effectively. Reports are in a more readable format and convey information for action by the corporation rather than as a scholarly treatise. Approaching senior management, one must consider the psychology of individuals in senior positions. Senior medical executives who are successful report similar approaches to their tasks, and offer helpful insight into career advancement.

  3. Present status of the Riken accelerator research facility (RARF)

    International Nuclear Information System (INIS)

    Kase, M.; Goto, A.; Kageyama, T.; Yokoyama, I.; Nagase, M.; Kohara, S.; Nakagawa, T.; Inabe, N.; Ikegami, K.; Kamigaito, O.; Kidera, M.; Fujita, J.; Yoneda, A.; Kobayashi, M.; Yano, Y.

    1999-01-01

    The K540-MeV RIKEN Ring Cyclotron (RRC) celebrated 10 years of successful beam operation in December 1996. The beam intensities have been increased over years to the present levels of about 500 pnA for 135 MeV/nucleon 12 C and of 2000 pnA for 24 MeV/nucleon 40 Ar. The variation of beam has now exceeded one hundred. These beams have been delivered to users in many fields. Improvements are being and will be made to upgrade the present machine to be matched as an injector to the program of the RI beam factory. (authors)

  4. Principles for designing and delivering psychosocial and mental healthcare.

    Science.gov (United States)

    Williams, Richard; Kemp, V

    2018-03-08

    The development of the UK's military policy includes the potential for military organisations to deploy in support of humanitarian aid operations. This paper offers an overview of the risks to people's mental health of their exposure to emergencies, major incidents, disasters, terrorism, displacement, postconflict environments in which humanitarian aid is delivered, and deployments to conflict zones. It summarises the psychosocial approach recommended by many contemporary researchers and practitioners. It differentiates the extremely common experience of distress from the mental disorders that people who are affected may develop and introduces the construct of psychosocial resilience. The authors recognise the importance of trajectories of response in separating people who are distressed and require psychosocial care from those who require mental healthcare. Finally, this paper summarises a strategic approach to designing, planning and providing psychosocial and mental healthcare, provides a model of care and outlines the principles for early psychosocial interventions that do not require training in mental healthcare to deliver them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Assessing the quality of proton PBS treatment delivery using machine log files: comprehensive analysis of clinical treatments delivered at PSI Gantry 2

    International Nuclear Information System (INIS)

    Scandurra, D; Albertini, F; Van der Meer, R; Meier, G; Weber, D C; Bolsi, A; Lomax, A

    2016-01-01

    Pencil beam scanning (PBS) proton therapy requires the delivery of many thousand proton beams, each modulated for position, energy and monitor units, to provide a highly conformal patient treatment. The quality of the treatment is dependent on the delivery accuracy of each beam and at each fraction. In this work we describe the use of treatment log files, which are a record of the machine parameters for a given field delivery on a given fraction, to investigate the integrity of treatment delivery compared to the nominal planned dose. The dosimetry-relevant log file parameters are used to reconstruct the 3D dose distribution on the patient anatomy, using a TPS-independent dose calculation system. The analysis was performed for patients treated at Paul Scherrer Institute on Gantry 2, both for individual fields and per series (or plan), and delivery quality was assessed by determining the percentage of voxels in the log file dose distribution within  +/−  1% of the nominal dose. It was seen that, for all series delivered, the mean pass rate is 96.4%. Furthermore, this work establishes a correlation between the delivery quality of a field and the beam position accuracy. This correlation is evident for all delivered fields regardless of individual patient or plan characteristics. We have also detailed further usefulness of log file analysis within our clinical workflow. In summary, we have highlighted that the integrity of PBS treatment delivery is dependent on daily machine performance and is specifically highly correlated with the accuracy of beam position. We believe this information will be useful for driving machine performance improvements in the PBS field. (paper)

  6. Self-guided internet-delivered cognitive behavior therapy (iCBT for obsessive–compulsive disorder: 12 month follow-up

    Directory of Open Access Journals (Sweden)

    Bethany M. Wootton

    2015-09-01

    Full Text Available Internet-delivered cognitive behavior therapy (iCBT may reduce barriers to treatment faced by people with obsessive–compulsive disorder (OCD. To date, most research on iCBT for OCD has evaluated clinician-guided treatments. However, self-guided treatments, which do not involve contact with a clinician, have considerable public health potential and may be particularly advantageous for those patients who report stigma as a principal barrier to treatment. The findings of a recent trial of self-guided iCBT for symptoms of OCD highlighted the potential of this approach and found large within-group effect sizes from pre- to post-treatment on the YBOCS-SR (d = 1.37, sustained at 3-month follow-up (d = 1.17. In addition, 32% of participants met criteria for clinically significant change at 3-month follow-up. The present study reports the long-term outcomes of that trial (N = 28. Twelve out of 28 participants (43% completed the 12 month follow-up. A large within-group effect size was found on the YBOCS-SR (d = 1.08 and 33% met criteria for clinically significant change at 12-month follow-up. No significant changes in symptoms were found between 3-month follow-up and 12-month follow-up, demonstrating that participants maintained their treatment gains in the long term. These results add to the emerging literature supporting the potential of self-guided iCBT for individuals with symptoms of OCD.

  7. Individual Hearing Loss

    Directory of Open Access Journals (Sweden)

    Sébastien Santurette

    2016-06-01

    Full Text Available It is well-established that hearing loss does not only lead to a reduction of hearing sensitivity. Large individual differences are typically observed among listeners with hearing impairment in a wide range of suprathreshold auditory measures. In many cases, audiometric thresholds cannot fully account for such individual differences, which make it challenging to find adequate compensation strategies in hearing devices. How to characterize, model, and compensate for individual hearing loss were the main topics of the fifth International Symposium on Auditory and Audiological Research (ISAAR, held in Nyborg, Denmark, in August 2015. The following collection of papers results from some of the work that was presented and discussed at the symposium.

  8. Manual for Preparing Individualized Education Programs.

    Science.gov (United States)

    Baylor, Terrill D.

    Presented are guidelines for developing an individualized program and services plan, an individual implementation plan, and daily activity and strategy plans for handicapped students. Instructions are outlined for utilizing forms related to planning and implementation of individualized education programs. Appended are sample forms. (SBH)

  9. A rare presentation of a transethmoidal encephalocele at birth.

    Science.gov (United States)

    Upasani, Anand Vishwanath; Patel, Dhiren Nanjibhai; Chandna, Sudhir Bhisham

    2014-10-01

    Transethmoidal encephalocele is a very rare condition. Herein, we report the case of a neonate with a transethmoidal encephalocele, who presented with an externally visible intranasal mass at birth. Clinical suspicion of intracranial extension was confirmed by radiological imaging. A bifrontal craniotomy was done to divide the narrow communicating duct. The mass was delivered through the nostril and duraplasty was completed. The postoperative recovery was uneventful. Copyright © 2013. Published by Elsevier B.V.

  10. A randomized controlled trial testing an Internet delivered cost-benefit approach to weight loss maintenance.

    Science.gov (United States)

    Leahey, Tricia M; Fava, Joseph L; Seiden, Andrew; Fernandes, Denise; Doyle, Caroline; Kent, Kimberly; La Rue, Molly; Mitchell, Marc; Wing, Rena R

    2016-11-01

    Weight loss maintenance is a significant challenge in obesity treatment. During maintenance the "costs" of adhering to weight management behaviors may outweigh the "benefits." This study examined the efficacy of a novel approach to weight loss maintenance based on modifying the cost-benefit ratio. Individuals who achieved a 5% weight loss (N=75) were randomized to one of three, 10-month maintenance interventions. All interventions were delivered primarily via the Internet. The Standard arm received traditional weight maintenance strategies. To increase benefits, or rewards, for maintenance behaviors, the two cost-benefit intervention conditions received weekly monetary rewards for self-monitoring and social reinforcement via e-coaching. To decrease behavioral costs (boredom) and increase novelty, participants in the cost-benefit conditions also monitored different evidence-based behaviors every two weeks (e.g., Weeks 1 & 2: steps; Week 3 & 4: red foods). The primary difference between the cost-benefit interventions was type of e-coach providing social reinforcement: Professional (CB Pro) or Peer (CB Peer). Study procedures took place in Providence, RI from 2013 to 2014. Retention was 99%. There were significant group differences in weight regain (p=.01). The Standard arm gained 3.5±5.7kg. In contrast, participants in CB Pro and CB Peer lost an additional 1.8±7.0kg and 0.5±6.4kg, respectively. These results suggest that an Internet delivered cost-benefit approach to weight loss maintenance may be effective for long-term weight control. In addition, using peer coaches to provide reinforcement may be a particularly economic alternative to professionals. These data are promising and provide support for a larger, longer trial. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Comparison of nasal continuous positive airway pressure delivered by seven ventilators using simulated neonatal breathing.

    Science.gov (United States)

    Drevhammar, Thomas; Nilsson, Kjell; Zetterström, Henrik; Jonsson, Baldvin

    2013-05-01

    Nasal continuous positive airway pressure (NCPAP) is an established treatment for respiratory distress in neonates. Most modern ventilators are able to provide NCPAP. There have been no large studies examining the properties of NCPAP delivered by ventilators. The aim of this study was to compare pressure stability and imposed work of breathing (iWOB) for NCPAP delivered by ventilators using simulated neonatal breathing. Experimental in vitro study. Research laboratory in Sweden. None. Neonatal breathing was simulated using a mechanical lung simulator. Seven ventilators were tested at different CPAP levels using two breath profiles. Pressure stability and iWOB were determined. Results from three ventilators revealed that they provided a slight pressure support. For these ventilators, iWOB could not be calculated. There were large differences in pressure stability and iWOB between the tested ventilators. For simulations using the 3.4-kg breath profile, the pressure swings around the mean pressure were more than five times greater, and iWOB more than four times higher, for the system with the highest measured values compared with the system with the lowest. Overall, the Fabian ventilator was the most pressure stable system. Evita XL and SERVO-i were found more pressure stable than Fabian in some simulations. The results for iWOB were in accordance with pressure stability for systems that allowed determination of this variable. Some of the tested ventilators unexpectedly provided a minor degree of pressure support. In terms of pressure stability, we have not found any advantages of ventilators as a group compared with Bubble CPAP, Neopuff, and variable flow generators that were tested in our previous study. The variation between individual systems is great within both categories. The clinical importance of these findings needs further investigation.

  12. Combining Technologies to Deliver Distance Education

    Directory of Open Access Journals (Sweden)

    Vicki Freeman

    1999-01-01

    Full Text Available In 1997 a Health Resources and Services Administration (HRSA grant was awarded to the Department of Clinical Laboratory Sciences (CLS at The University of Texas Medical Branch - Galveston (UTMB for support of the Laboratory Education and Advancement Project (LEAP. The project entailed three primary objectives, targeting laboratory practitioners in rural and medically underserved areas of Texas for delivering a bachelor's degree, laboratory-intensive course of study via distance education. Several delivery mechanisms were utilized and evaluated for their effectiveness and friendliness to both the faculty and students. The authors discuss and describe the mechanisms utilized for delivery of courses, the advantages and disadvantages encountered with each mechanism, and subjective evaluation of the effectiveness of the courses. Also discussed are the lessons learned and plans for future development.

  13. Nurse-delivered counselling intervention for parental HIV disclosure: results from a pilot randomized controlled trial in China.

    Science.gov (United States)

    Simoni, Jane M; Yang, Joyce P; Shiu, Cheng-Shi; Chen, Wei-Ti; Udell, Wadiya; Bao, Meijuan; Zhang, Lin; Lu, Hongzhou

    2015-06-01

    The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children. This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms. The study occurred at an outpatient HIV primary care centre in Shanghai, China. Participants were 20 HIV-positive outpatients with at least one child (13-25 years old) who was unaware of the parent's HIV diagnosis. The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays. Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy, and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV. In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a 'large' effect size. Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy.

  14. Operator models for delivering municipal solid waste management services in developing countries. Part A: The evidence base.

    Science.gov (United States)

    Wilson, David C; Kanjogera, Jennifer Bangirana; Soós, Reka; Briciu, Cosmin; Smith, Stephen R; Whiteman, Andrew D; Spies, Sandra; Oelz, Barbara

    2017-08-01

    This article presents the evidence base for 'operator models' - that is, how to deliver a sustainable service through the interaction of the 'client', 'revenue collector' and 'operator' functions - for municipal solid waste management in emerging and developing countries. The companion article addresses a selection of locally appropriate operator models. The evidence shows that no 'standard' operator model is effective in all developing countries and circumstances. Each city uses a mix of different operator models; 134 cases showed on average 2.5 models per city, each applying to different elements of municipal solid waste management - that is, street sweeping, primary collection, secondary collection, transfer, recycling, resource recovery and disposal or a combination. Operator models were analysed in detail for 28 case studies; the article summarises evidence across all elements and in more detail for waste collection. Operators fall into three main groups: The public sector, formal private sector, and micro-service providers including micro-, community-based and informal enterprises. Micro-service providers emerge as a common group; they are effective in expanding primary collection service coverage into poor- or peri-urban neighbourhoods and in delivering recycling. Both public and private sector operators can deliver effective services in the appropriate situation; what matters more is a strong client organisation responsible for municipal solid waste management within the municipality, with stable political and financial backing and capacity to manage service delivery. Revenue collection is also integral to operator models: Generally the municipality pays the operator from direct charges and/or indirect taxes, rather than the operator collecting fees directly from the service user.

  15. Can community care workers deliver a falls prevention exercise program? A feasibility study

    Directory of Open Access Journals (Sweden)

    Burton E

    2018-03-01

    Full Text Available Elissa Burton,1 Gill Lewin,2 Hilary O’Connell,3 Mark Petrich,4,5 Eileen Boyle,1 Keith D Hill1 1School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; 2School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; 3Independent Living Centre Western Australia, Perth, Western Australia, Australia; 4Western Australian Department of Health, Perth, Western Australia, Australia; 5School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia Background: Almost half of older people receiving community care fall each year and this rate has not improved in the last decade. Falls prevention programs targeted at this group are uncommon, and expensively delivered by university trained allied health professionals. Purpose: To investigate the feasibility of community care workers delivering a falls prevention exercise program to older clients, at low or medium risk of falling, as part of an existing service provision. Patients and methods: Community care workers from 10 community care organizations participated in the training for, and delivery to their clients of, an 8-week evidence-based falls prevention exercise program. Community care workers included assessment staff (responsible for identifying the need for community care services through completing an assessment and support workers (responsible for providing support in the home. Clients were surveyed anonymously at the completion of the intervention and workers participated in a semi-structured interview. Results: Twenty-five community care workers participated in the study. The falls prevention program was delivered to 29 clients, with an average age of 82.7 (SD: 8.72 years and consisting of 65.5% female. The intervention was delivered safely with no adverse events recorded, and the eligibility and assessment tools

  16. Delivering on Equity: Implications for Decision-Makers. Issue Brief #1

    Science.gov (United States)

    Stonemeier, Jennifer; Trader, Barb; Richards, Curtis; Blank, Rolf; East, Bill; Toson, Amy

    2013-01-01

    The SWIFT Center will demonstrate how schools can be transformed to provide inclusive educational opportunities for all students. The SWIFT Center will address the key American goal of equal educational opportunity by assisting schools to reorganize in ways that enable them to fully deliver on inclusive, general education for all…

  17. 49 CFR 192.197 - Control of the pressure of gas delivered from high-pressure distribution systems.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Control of the pressure of gas delivered from high-pressure distribution systems. 192.197 Section 192.197 Transportation Other Regulations Relating to... STANDARDS Design of Pipeline Components § 192.197 Control of the pressure of gas delivered from high...

  18. Health service planning and sustainable development: considering what, where and how care is delivered through a pro-environmental lens.

    Science.gov (United States)

    Desmond, Sharon

    2017-03-02

    The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed. What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency. What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency. What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.

  19. Using mHealth to Deliver Behavior Change Interventions Within Prenatal Care at Community Health Centers.

    Science.gov (United States)

    Mauriello, Leanne M; Van Marter, Deborah F; Umanzor, Cindy D; Castle, Patricia H; de Aguiar, Emma L

    2016-09-01

    To test an iPad-delivered multiple behavior tailored intervention (Healthy Pregnancy: Step by Step) for pregnant women that addresses smoking cessation, stress management, and fruit and vegetable consumption. A randomized 2 × 5 factorial repeated measures design was employed with randomization on the individual level stratified on behavior risk. Women completed three sessions during pregnancy and two postpartum at postdelivery months 1 and 4. Women were recruited from six locations of federally funded health centers across three states. Participants (N = 335) were English- and Spanish-speaking women at up to 18 weeks gestation. The treatment group received three interactive sessions focused on two priority health behavior risks. The sessions offered individually tailored and stage-matched change strategies based on the transtheoretical model of behavior change. The usual care group received March of Dimes brochures. The primary outcome was the number of behavior risks. Stage of change and continuous measures for all behaviors also were assessed. Data were analyzed across all time points using generalized estimating equations examining repeated measures effects. Women in the treatment group reported significantly fewer risks than those in usual care at 1 month (.85 vs. 1.20, odds ratio [OR] = .70) and 4 months postpartum (.72 vs. .91, OR = .81). Healthy Pregnancy is an evidence-based and personalized program that assists pregnant women with reducing behavior risks and sustaining healthy lifestyle behaviors. © 2016 by American Journal of Health Promotion, Inc.

  20. Delivering effective science communication: advice from a professional science communicator.

    Science.gov (United States)

    Illingworth, Sam

    2017-10-01

    Science communication is becoming ever more prevalent, with more and more scientists expected to not only communicate their research to a wider public, but to do so in an innovative and engaging manner. Given the other commitments that researchers and academics are required to fulfil as part of their workload models, it is unfair to be expect them to also instantly produce effective science communication events and activities. However, by thinking carefully about what it is that needs to be communicated, and why this is being done, it is possible to develop high-quality activities that are of benefit to both the audience and the communicator(s). In this paper, I present some practical advice for developing, delivering and evaluating effective science communication initiatives, based on over a decade of experience as being a professional science communicator. I provide advice regarding event logistics, suggestions on how to successfully market and advertise your science communication initiatives, and recommendations for establishing effective branding and legacy. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  1. Delivering Sustainability Through Supply Chain Distribution Network Redesign

    Directory of Open Access Journals (Sweden)

    Denise Ravet

    2013-09-01

    Full Text Available Purpose - Companies could gain (cost, service, green/sustainable competitive advantage through the supply chain network. The goal of this article is to study how to deliver sustainability through the supply chain distribution network redesign.Design/methodology/approach - A literature review is conducted to examine research relating to sustainable supply chain strategies and supply chain distribution network redesign.Findings - A study of the supply chain literature reveals the importance to rethink the supply chain distribution network design and to treat sustainability as integral to operations.

  2. Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Ørner Roderick

    2009-01-01

    have shown that psychological treatments for insomnia administered by specialist nurses to groups of patients can be effective within a primary care setting. This will be a pilot study to determine whether an educational intervention aimed at primary care teams to deliver problem focused therapy for insomnia can improve sleep management and outcomes for individual adult patients presenting to general practice. The study will also test procedures and collect information in preparation for a larger definitive cluster-randomised trial. The study is funded by The Health Foundation. Trial Registration ClinicalTrials.gov ID ISRCTN55001433 – http://www.controlled-trials.com/ISRCTN55001433

  3. Individualizing Services, Individualizing Responsibility

    DEFF Research Database (Denmark)

    Garsten, Christina; Hollertz, Katarina; Jacobsson, Kerstin

    possibilities for individual voice, autonomy and self-determination in the local delivery of activation policy? What barriers do specific organisational models and practices imply for clients to choose, determine and access tailor-made programmes and services? What policy technologies are at work in governing......-oriented, and the normative demands placed on individuals appear increasingly totalizing, concerning the whole individual rather than the job-related aspects only. The paper is based on 23 in-depth interviews with individual clients as well as individual caseworkers and other professionals engaged in client-related work...

  4. Internet-delivered cognitive-behavioural therapy for concerned significant others of people with problem gambling: study protocol for a randomised wait-list controlled trial.

    Science.gov (United States)

    Magnusson, Kristoffer; Nilsson, Anders; Hellner Gumpert, Clara; Andersson, Gerhard; Carlbring, Per

    2015-12-09

    About 2.3% of the adult population in Sweden are considered to suffer from problem gambling, and it is estimated that only 5% of those seek treatment. Problem gambling can have devastating effects on the economy, health and relationship, both for the individual who gambles and their concerned significant other (CSO). No empirically supported treatment exists for the CSOs of people with problem gambling. Consequently, the aim of this study is to develop and evaluate a programme aimed at CSOs of treatment-refusing problem gamblers. The programme will be based on principles from cognitive behavioural therapy (CBT) and motivational interviewing. To benefit as many CSOs as possible, the programme will be delivered via the internet with therapist support via encrypted email and short weekly conversations via telephone. This will be a randomised wait-list controlled internet-delivered treatment trial. A CBT programme for the CSOs of people with problem gambling will be developed and evaluated. The participants will work through nine modules over 10 weeks in a secure online environment, and receive support via secure emails and over the telephone. A total of 150 CSOs over 18 years of age will be included. Measures will be taken at baseline and at 3, 6 and 12 months. Primary outcomes concern gambling-related harm. Secondary outcomes include the treatment entry of the individual who gambles, the CSO's levels of depression, anxiety, as well as relationship satisfaction and quality of life. The protocol has been approved by the regional ethics board of Stockholm, Sweden. This study will add to the body of knowledge on how to protect CSOs from gambling-related harm, and how to motivate treatment-refusing individuals to seek professional help for problem gambling. NCT02250586. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Comparative effectiveness of cognitive therapies delivered face-to-face or over the telephone: an observational study using propensity methods.

    Directory of Open Access Journals (Sweden)

    Geoffrey C Hammond

    Full Text Available To compare the clinical and cost-effectiveness of face-to-face (FTF with over-the-telephone (OTT delivery of low intensity cognitive behavioural therapy.Observational study following SROBE guidelines. Selection effects were controlled using propensity scores. Non-inferiority comparisons assessed effectiveness.IAPT (improving access to psychological therapies services in the East of England.39,227 adults referred to IAPT services. Propensity score strata included 4,106 individuals; 147 pairs participated in 1:1 matching.Two or more sessions of computerised cognitive behavioural therapy (CBT.Patient-reported outcomes: Patient Health Questionnaire (PHQ-9 for depression; Generalised Anxiety Disorder questionnaire (GAD-7; Work and Social Adjustment Scale (WSAS. Differences between groups were summarised as standardised effect sizes (ES, adjusted mean differences and minimally important difference for PHQ-9. Cost per session for OTT was compared with FTF.Analysis of covariance controlling for number of assessments, provider site, and baseline PHQ-9, GAD-7 and WSAS indicated statistically significantly greater reductions in scores for OTT treatment with moderate (PHQ-9: ES: 0.14; GAD-7: ES: 0.10 or small (WSAS: ES: 0.03 effect sizes. Non-inferiority in favour of OTT treatment for symptom severity persisted as small to moderate effects for all but individuals with the highest symptom severity. In the most stringent comparison, the one-to-one propensity matching, adjusted mean differences in treatment outcomes indicated non-inferiority between OTT versus FTF treatments for PHQ-9 and GAD-7, whereas the evidence was moderate for WSAS. The per-session cost for OTT was 36.2% lower than FTF.The clinical effectiveness of low intensity CBT-based interventions delivered OTT was not inferior to those delivered FTF except for people with more severe illness where FTF was superior. This provides evidence for better targeting of therapy, efficiencies for patients

  6. Feasibility and preliminary efficacy of remotely delivering cognitive training to people with schizophrenia using tablets

    Directory of Open Access Journals (Sweden)

    Bruno Biagianti

    2017-12-01

    Conclusion: Although underpowered and not randomized, this study demonstrates that delivering CT remotely to people with SZ using tablets is feasible and results in retention rates, adherence, and cognitive and functional outcome improvements that are comparable to those observed when CT is delivered in the laboratory. This has important implications in terms of scalability and dissemination of CT. These results require confirmation in larger samples.

  7. Do new anesthesia ventilators deliver small tidal volumes accurately during volume-controlled ventilation?

    Science.gov (United States)

    Bachiller, Patricia R; McDonough, Joseph M; Feldman, Jeffrey M

    2008-05-01

    During mechanical ventilation of infants and neonates, small changes in tidal volume may lead to hypo- or hyperventilation, barotrauma, or volutrauma. Partly because breathing circuit compliance and fresh gas flow affect tidal volume delivery by traditional anesthesia ventilators in volume-controlled ventilation (VCV) mode, pressure-controlled ventilation (PCV) using a circle breathing system has become a common approach to minimizing the risk of mechanical ventilation for small patients, although delivered tidal volume is not assured during PCV. A new generation of anesthesia machine ventilators addresses the problems of VCV by adjusting for fresh gas flow and for the compliance of the breathing circuit. In this study, we evaluated the accuracy of new anesthesia ventilators to deliver small tidal volumes. Four anesthesia ventilator systems were evaluated to determine the accuracy of volume delivery to the airway during VCV at tidal volume settings of 100, 200, and 500 mL under different conditions of breathing circuit compliance (fully extended and fully contracted circuits) and lung compliance. A mechanical test lung (adult and infant) was used to simulate lung compliances ranging from 0.0025 to 0.03 L/cm H(2)O. Volumes and pressures were measured using a calibrated screen pneumotachograph and custom software. We tested the Smartvent 7900, Avance, and Aisys anesthesia ventilator systems (GE Healthcare, Madison, WI) and the Apollo anesthesia ventilator (Draeger Medical, Telford, PA). The Smartvent 7900 and Avance ventilators use inspiratory flow sensors to control the volume delivered, whereas the Aisys and Apollo ventilators compensate for the compliance of the circuit. We found that the anesthesia ventilators that use compliance compensation (Aisys and Apollo) accurately delivered both large and small tidal volumes to the airway of the test lung under conditions of normal and low lung compliance during VCV (ranging from 95.5% to 106.2% of the set tidal volume

  8. Cooking Healthy, Eating Smart (CHES): Evaluating the feasibility of using volunteers to deliver nutrition and food safety education to rural older adults

    Science.gov (United States)

    Getty, Morgan

    Due to their limited resources, rural, older adults in the United States are at risk for poor diet-related health outcomes. Nutrition education is a key component in improving health outcomes in older adults. Cooking Healthy, Eating Smart (CHES) is a nine-lesson curriculum designed to teach rural, older adults culturally appropriate nutrition and food safety information. Funding to hire health professionals to deliver such a curriculum is limited, presenting the need to explore a less expensive mode of dissemination. In this community-based, participatory research study, a formative evaluation and feasibility study were conducted to examine the use of volunteers to deliver a nutrition and food safety curriculum to rural, older adults in South Carolina. Seven focus groups were conducted with members of the South Carolina Family and Community Leaders (SCFCL) and members of the American Association of Retired Persons (AARP) in the four regions of South Carolina to explore barriers and facilitators of volunteers delivering CHES (N=65 participants). The focus group findings informed the development of the volunteer training manual. A comparative case study method was used to examine the feasibility of a volunteer-based approach by observing and describing the delivery of CHES by two groups of volunteers in SC. The case study findings, including volunteer knowledge change, self-efficacy change, curriculum experience, program experience, and project team observations of volunteers indicated that using volunteers to deliver CHES is a plausible approach with the assistance of paid staff or project team members.

  9. Bursting onto the big stage: Presenting at an international conference for the first time

    OpenAIRE

    Manley, AJ; Meijen, C

    2008-01-01

    Attending a prestigious international conference and contributing to proceedings by delivering a poster or oral presentation is an excellent opportunity for sport and exercise psychology students to gain valuable experience and meet people from different parts of the world. In this article, we will focus on presenting at an international conference for the first time. An international conference presents different challenges compared to annual national and regional conferences. It will often ...

  10. Analysis of XFEL serial diffraction data from individual crystalline fibrils

    Directory of Open Access Journals (Sweden)

    David H. Wojtas

    2017-11-01

    Full Text Available Serial diffraction data collected at the Linac Coherent Light Source from crystalline amyloid fibrils delivered in a liquid jet show that the fibrils are well oriented in the jet. At low fibril concentrations, diffraction patterns are recorded from single fibrils; these patterns are weak and contain only a few reflections. Methods are developed for determining the orientation of patterns in reciprocal space and merging them in three dimensions. This allows the individual structure amplitudes to be calculated, thus overcoming the limitations of orientation and cylindrical averaging in conventional fibre diffraction analysis. The advantages of this technique should allow structural studies of fibrous systems in biology that are inaccessible using existing techniques.

  11. 3D delivered dose assessment using a 4DCT-based motion model

    Energy Technology Data Exchange (ETDEWEB)

    Cai, Weixing; Hurwitz, Martina H.; Williams, Christopher L.; Dhou, Salam; Berbeco, Ross I.; Mishra, Pankaj, E-mail: wcai@lroc.harvard.edu, E-mail: jhlewis@lroc.harvard.edu; Lewis, John H., E-mail: wcai@lroc.harvard.edu, E-mail: jhlewis@lroc.harvard.edu [Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States); Seco, Joao [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02115 (United States)

    2015-06-15

    Purpose: The purpose of this work is to develop a clinically feasible method of calculating actual delivered dose distributions for patients who have significant respiratory motion during the course of stereotactic body radiation therapy (SBRT). Methods: A novel approach was proposed to calculate the actual delivered dose distribution for SBRT lung treatment. This approach can be specified in three steps. (1) At the treatment planning stage, a patient-specific motion model is created from planning 4DCT data. This model assumes that the displacement vector field (DVF) of any respiratory motion deformation can be described as a linear combination of some basis DVFs. (2) During the treatment procedure, 2D time-varying projection images (either kV or MV projections) are acquired, from which time-varying “fluoroscopic” 3D images of the patient are reconstructed using the motion model. The DVF of each timepoint in the time-varying reconstruction is an optimized linear combination of basis DVFs such that the 2D projection of the 3D volume at this timepoint matches the projection image. (3) 3D dose distribution is computed for each timepoint in the set of 3D reconstructed fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach was first validated using two modified digital extended cardio-torso (XCAT) phantoms with lung tumors and different respiratory motions. The estimated doses were compared to the dose that would be calculated for routine 4DCT-based planning and to the actual delivered dose that was calculated using “ground truth” XCAT phantoms at all timepoints. The approach was also tested using one set of patient data, which demonstrated the application of our method in a clinical scenario. Results: For the first XCAT phantom that has a mostly regular breathing pattern, the errors in 95% volume dose (D95) are 0.11% and 0.83%, respectively for 3D fluoroscopic images

  12. 3D delivered dose assessment using a 4DCT-based motion model

    International Nuclear Information System (INIS)

    Cai, Weixing; Hurwitz, Martina H.; Williams, Christopher L.; Dhou, Salam; Berbeco, Ross I.; Mishra, Pankaj; Lewis, John H.; Seco, Joao

    2015-01-01

    Purpose: The purpose of this work is to develop a clinically feasible method of calculating actual delivered dose distributions for patients who have significant respiratory motion during the course of stereotactic body radiation therapy (SBRT). Methods: A novel approach was proposed to calculate the actual delivered dose distribution for SBRT lung treatment. This approach can be specified in three steps. (1) At the treatment planning stage, a patient-specific motion model is created from planning 4DCT data. This model assumes that the displacement vector field (DVF) of any respiratory motion deformation can be described as a linear combination of some basis DVFs. (2) During the treatment procedure, 2D time-varying projection images (either kV or MV projections) are acquired, from which time-varying “fluoroscopic” 3D images of the patient are reconstructed using the motion model. The DVF of each timepoint in the time-varying reconstruction is an optimized linear combination of basis DVFs such that the 2D projection of the 3D volume at this timepoint matches the projection image. (3) 3D dose distribution is computed for each timepoint in the set of 3D reconstructed fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach was first validated using two modified digital extended cardio-torso (XCAT) phantoms with lung tumors and different respiratory motions. The estimated doses were compared to the dose that would be calculated for routine 4DCT-based planning and to the actual delivered dose that was calculated using “ground truth” XCAT phantoms at all timepoints. The approach was also tested using one set of patient data, which demonstrated the application of our method in a clinical scenario. Results: For the first XCAT phantom that has a mostly regular breathing pattern, the errors in 95% volume dose (D95) are 0.11% and 0.83%, respectively for 3D fluoroscopic images

  13. The 5x1 DAFNE study protocol: a cluster randomised trial comparing a standard 5 day DAFNE course delivered over 1 week against DAFNE training delivered over 1 day a week for 5 consecutive weeks

    Directory of Open Access Journals (Sweden)

    Elliott Jackie

    2012-11-01

    Full Text Available Abstract Background Structured education programmes are now established as an essential component to assist effective self-management of diabetes. In the case of Type 1 diabetes, the Dose Adjustment For Normal Eating (DAFNE programme improves both glycaemic control and quality of life. Traditionally delivered over five consecutive days, this format has been cited as a barrier to participation by some patients, such as those who work full-time. Some centres in the UK have organised structured education programmes to be delivered one day a week over several consecutive weeks. This type of format may add benefit by allowing more time in which to practice skills between sessions, but may suffer as a result of weaker peer support being generated compared to that formed over five consecutive days. Methods/design We aim to compare DAFNE delivered over five consecutive days (1 week course with DAFNE delivered one day a week over five weeks (5 week course in a randomised controlled trial. A total of 213 patients were randomised to attend either a 1 week or a 5 week course delivered in seven participating centres. Study outcomes (measured at baseline, 6 and 12 months post-course include HbA1c, weight, self-reported rates of severe hypoglycaemia, psychosocial measures of quality of life, and cost-effectiveness. Generalisability was optimised by recruiting patients from DAFNE waiting lists at each centre, and by mailing eligible patients from hospital clinic lists. The inclusion and exclusion criteria were identical to those used to recruit to a standard DAFNE course (e.g., HbA1c Discussion This trial has been designed to test the hypothesis that the benefits of delivering a structured education programme over 5 weeks are comparable to those observed after a 1 week course. The results of the trial and the qualitative sub-study will both inform the design and delivery of future DAFNE courses, and the development of structured education programmes in other

  14. Analysis of Milk from Mothers Who Delivered Prematurely Reveals Few Changes in Proteases and Protease Inhibitors across Gestational Age at Birth and Infant Postnatal Age.

    Science.gov (United States)

    Demers-Mathieu, Veronique; Nielsen, Søren Drud; Underwood, Mark A; Borghese, Robyn; Dallas, David C

    2017-06-01

    Background: Peptidomics research has demonstrated that protease activity is higher in breast milk from preterm-delivering mothers than from term-delivering mothers. However, to our knowledge, the effect of the degree of prematurity and postnatal age on proteases and protease inhibitors in human milk remains unknown. Objective: We aimed to determine the change of proteases and protease inhibitors in milk from mothers who delivered prematurely across gestational age (GA) and postnatal age. Methods: Milk samples were collected from 18 mothers aged 26-40 y who delivered preterm infants and who lacked mastitis. For analysis, samples were separated into 2 groups: 9 from early GA (EGA) (24-26 wk GA)-delivering mothers and 9 from late GA (LGA) (27-32 wk GA)-delivering mothers. Within the 9 samples in each group, the collection time ranged from postnatal days 2 to 47. The activity and predicted activity of proteases in preterm milk were determined with the use of fluorometric and spectrophotometric assays and peptidomics, respectively. Protease and protease inhibitor concentrations were determined with the use of ELISA. Linear mixed models were applied to compare enzymes across GA and postnatal age. Results: Carboxypeptidase B2, kallikrein, plasmin, elastase, thrombin, and cytosol aminopeptidase were present and active in the milk of preterm-delivering mothers. Most milk protease and antiprotease concentrations did not change with GA or postnatal age. However, the concentration and activity of kallikrein, the most abundant and active protease in preterm milk, increased by 25.4 ng · mL -1 · d -1 and 0.454 μg · mL -1 · d -1 postnatally, respectively, in EGA milk samples while remaining stable in LGA milk samples. Conclusions: This research demonstrates that proteases are active in human milk and begin to degrade milk protein within the mammary gland before consumption by infants. Proteases and protease inhibitors in milk from mothers of premature infants mostly did not

  15. Poster presentations

    OpenAIRE

    1994-01-01

    Grey Literature in Engineering Sciences and Technology and its use pattern in the research institutions in India: The case study of the Karnataka State; Awareness Not Genre Matters: Findings from a Case Study of the Scientific Grey Literature of an Inter-governmental Organization; Delivering Grey Literature with a “Books by Mail” Lending Library; Circulation Improvement of Articles in Journals written by Non-English Language – Development of a Special Journal Titles Translation List...

  16. Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences.

    Science.gov (United States)

    Greer, Joseph A; Park, Elyse R; Green, Alexander R; Betancourt, Joseph R; Weissman, Joel S

    2007-08-01

    Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Cross-sectional, national mail survey of resident physicians in their last year of training. Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

  17. Energy Provider: Delivered Energy Efficiency: A global stock-taking based on case studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-01

    In 2011 the IEA and the Regulatory Assistance Project (RAP) took on a work programme focused on the role of energy providers in delivering energy efficiency to end-users. This work was part of the IEA’s contribution to the PEPDEE Task Group, which falls under the umbrella of the International Partnership on Energy Efficiency Cooperation (IPEEC). In addition to organizing regional dialogues between governments, regulators, and energy providers, the PEPDEE work stream conducted global stock-takings of regulatory mechanisms adopted by governments to obligate or encourage energy providers to delivery energy savings and the energy savings activities of energy providers. For its part the IEA conducted a global review of energy provider-delivered energy savings programmes. The IEA reached out to energy providers to identify the energy savings activities they engaged in. Some 250 energy saving activities were considered, and 41 detailed case studies spanning 18 countries were developed. Geographic balance was a major consideration, and much effort was expended identifying energy provider-delivered energy savings case studies from around the world. Taken together these case studies represent over USD 1 billion in annual spending, or about 8% of estimated energy provider spending on energy efficiency.

  18. Mapping a product-service-system delivering defence avionics availability

    OpenAIRE

    Settanni, E.; Thenent, N.; Newnes, L.; Parry, G.; Goh, Y. M.

    2017-01-01

    Long-term support agreements such as availability-based contracts are often associated with the servitization of business models in such sectors as defence aerospace. In practice, there is no unambiguous way of linking availability and service outcomes from an operational perspective; rather, the focus tends to be placed almost exclusively on product-related metrics. To address this gap, this paper outlines a conceptual model of how advanced service outcomes should be delivered under an avail...

  19. Translation of associative learning models into extinction reminders delivered via mobile phones during cue exposure interventions for substance use.

    Science.gov (United States)

    Rosenthal, M Zachary; Kutlu, Munir G

    2014-09-01

    Despite experimental findings and some treatment research supporting the use of cues as a means to induce and extinguish cravings, interventions using cue exposure have not been well integrated into contemporary substance abuse treatments. A primary problem with exposure-based interventions for addiction is that after learning not to use substances in the presence of addiction cues inside the clinic (i.e., extinction), stimuli in the naturalistic setting outside the clinic may continue to elicit craving, drug use, or other maladaptive conditioned responses. For exposure-based substance use interventions to be efficacious, new approaches are needed that can prevent relapse by directly generalizing learning from the therapeutic setting into naturalistic settings associated with a high risk for relapse. Basic research suggests that extinction reminders (ERs) can be paired with the context of learning new and more adaptive conditioned responses to substance abuse cues in exposure therapies for addiction. Using mobile phones and automated dialing and data collection software, ERs can be delivered in everyday high-risk settings to inhibit conditioned responses to substance-use-related stimuli. In this review, we describe how associative learning mechanisms (e.g., conditioned inhibition) can inform how ERs are conceptualized, learned, and implemented to prevent substance use when delivered via mobile phones. This approach, exposure with portable reminders of extinction, is introduced as an adjunctive intervention that uses brief automated ERs between clinic visits when individuals are in high-risk settings for drug use.

  20. SU-E-CAMPUS-T-01: Analysis of the Precision of Patient Set-Up, and Fidelity of the Delivered Dose Distribution in Proton Therapy of Ocular Tumors

    International Nuclear Information System (INIS)

    Trofimov, A; Carpenter, K; Shih, HA

    2014-01-01

    Purpose: To quantify daily set-up variations in fractionated proton therapy of ocular melanomas, and to assess the effect on the fidelity of delivered distribution to the plan. Methods: In a typical five-fraction course, daily set-up is achieved by matching the position of fiducial markers in orthogonal radiographs to the images generated by treatment planning program. A patient maintains the required gaze direction voluntarily, without the aid of fixation devices. Confirmation radiographs are acquired to assess intrafractional changes. For this study, daily radiographs were analyzed to determine the daily iso-center position and apparent gaze direction, which were then transferred to the planning system to calculate the dose delivered in individual fractions, and accumulated dose for the entire course. Dose-volume metrics were compared between the planned and accumulated distributions for the tumor and organs at risk, for representative cases that varied by location within the ocular globe. Results: The analysis of the first set of cases (3 posterior, 3 transequatorial and 4 anterior tumors) revealed varying dose deviation patterns, depending on the tumor location. For anterior and posterior tumors, the largest dose increases were observed in the lens and ciliary body, while for the equatorial tumors, macula, optic nerve and disk, were most often affected. The iso-center position error was below 1.3 mm (95%-confidence interval), and the standard deviation of daily polar and azimuthal gaze set-up were 1.5 and 3 degrees, respectively. Conclusion: We quantified interfractional and intrafractional set-up variation, and estimated their effect on the delivered dose for representative cases. Current safety margins are sufficient to maintain the target coverage, however, the dose delivered to critical structures often deviates from the plan. The ongoing analysis will further explore the patterns of dose deviation, and may help to identify particular treatment scenarios

  1. SU-E-CAMPUS-T-01: Analysis of the Precision of Patient Set-Up, and Fidelity of the Delivered Dose Distribution in Proton Therapy of Ocular Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Trofimov, A; Carpenter, K; Shih, HA [Massachusetts General Hospital, Boston, MA (United States)

    2014-06-15

    Purpose: To quantify daily set-up variations in fractionated proton therapy of ocular melanomas, and to assess the effect on the fidelity of delivered distribution to the plan. Methods: In a typical five-fraction course, daily set-up is achieved by matching the position of fiducial markers in orthogonal radiographs to the images generated by treatment planning program. A patient maintains the required gaze direction voluntarily, without the aid of fixation devices. Confirmation radiographs are acquired to assess intrafractional changes. For this study, daily radiographs were analyzed to determine the daily iso-center position and apparent gaze direction, which were then transferred to the planning system to calculate the dose delivered in individual fractions, and accumulated dose for the entire course. Dose-volume metrics were compared between the planned and accumulated distributions for the tumor and organs at risk, for representative cases that varied by location within the ocular globe. Results: The analysis of the first set of cases (3 posterior, 3 transequatorial and 4 anterior tumors) revealed varying dose deviation patterns, depending on the tumor location. For anterior and posterior tumors, the largest dose increases were observed in the lens and ciliary body, while for the equatorial tumors, macula, optic nerve and disk, were most often affected. The iso-center position error was below 1.3 mm (95%-confidence interval), and the standard deviation of daily polar and azimuthal gaze set-up were 1.5 and 3 degrees, respectively. Conclusion: We quantified interfractional and intrafractional set-up variation, and estimated their effect on the delivered dose for representative cases. Current safety margins are sufficient to maintain the target coverage, however, the dose delivered to critical structures often deviates from the plan. The ongoing analysis will further explore the patterns of dose deviation, and may help to identify particular treatment scenarios

  2. Individual monitoring: A tool for active ALARA

    International Nuclear Information System (INIS)

    Hoefert, M.

    1989-01-01

    The system of individual monitoring at CERN is presented. Following the substantial decrease of individual doses over the last decade, emphasis is now placed on monitoring rather than on dosimetric aspects. Future developments have to face a possible decrease of dose limits that are difficult to control in view of the lower detection limits for the detectors presently used. One possible solution to the problem is the increase in the wearing time for individual dosemeters. (author)

  3. Delivering care to oncology patients in the community: an innovative integrated approach.

    LENUS (Irish Health Repository)

    Hanan, Terry

    2014-08-01

    A community oncology nursing programme was developed in Ireland between the hospital and community health services for patients receiving systemic cancer therapy, in response to a service need. A robust evaluation of the pilot programme was undertaken, which found that defined clinical procedures traditionally undertaken in hospitals were safely undertaken in the patient\\'s home with no adverse effects. There was a dramatic decrease in hospital attendances for these defined clinical procedures, and hospital capacity was consequently freed up. Patients valued having aspects of their care delivered at home and reported that it improved their quality of life, including reduced hospital visits and travel time. Community nurses expanded their scope of practice and became partners with oncology day-ward nurses in caring for these patients. Community nurses developed the competence and confidence to safely deliver cancer care in the community. This initiative shows that defined elements of acute cancer care can be safely delivered in the community so long as the training and support are provided. The findings and recommendations of the evaluation resulted in university accreditation and approval for national roll-out of the programme. Integration of services between primary and secondary care is a key priority. This innovative programme is a good example of shared integrated care that benefits both patients and health-care providers.

  4. Low-dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized four-way crossover trial with nasal cavity dimension assessment.

    Science.gov (United States)

    Quintana, D S; Westlye, L T; Rustan, Ø G; Tesli, N; Poppy, C L; Smevik, H; Tesli, M; Røine, M; Mahmoud, R A; Smerud, K T; Djupesland, P G; Andreassen, O A

    2015-07-14

    Despite the promise of intranasal oxytocin (OT) for modulating social behavior, recent work has provided mixed results. This may relate to suboptimal drug deposition achieved with conventional nasal sprays, inter-individual differences in nasal physiology and a poor understanding of how intranasal OT is delivered to the brain in humans. Delivering OT using a novel 'Breath Powered' nasal device previously shown to enhance deposition in intranasal sites targeted for nose-to-brain transport, we evaluated dose-dependent effects on social cognition, compared response with intravenous (IV) administration of OT, and assessed nasal cavity dimensions using acoustic rhinometry. We adopted a randomized, double-blind, double-dummy, crossover design, with 16 healthy male adults completing four single-dose treatments (intranasal 8 IU (international units) or 24 IU OT, 1 IU OT IV and placebo). The primary outcome was social cognition measured by emotional ratings of facial images. Secondary outcomes included the pharmacokinetics of OT, vasopressin and cortisol in blood and the association between nasal cavity dimensions and emotional ratings. Despite the fact that all the treatments produced similar plasma OT increases compared with placebo, there was a main effect of treatment on anger ratings of emotionally ambiguous faces. Pairwise comparisons revealed decreased ratings after 8 IU OT in comparison to both placebo and 24 IU OT. In addition, there was an inverse relationship between nasal valve dimensions and anger ratings of ambiguous faces after 8-IU OT treatment. These findings provide support for a direct nose-to-brain effect, independent of blood absorption, of low-dose OT delivered from a Breath Powered device.

  5. The efficacy of internet-delivered treatment for generalized anxiety disorder: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Derek Richards

    2015-09-01

    Full Text Available Generalized Anxiety Disorder (GAD is typically considered a chronic condition characterized by excessive worry. Lifetime prevalence is 4.3–5.9%, yet only a small percentage seeks treatment. GAD is treatable and in recent years internet-delivered treatment interventions have shown promise. This paper aims to systematically search for literature on internet-delivered psychological interventions for the treatment of GAD and conduct a meta-analysis to examine their efficacy. The purpose of the paper is to inform the community of researchers, program developers and practitioners in internet delivered interventions of the current state-of-the-art and research gaps that require attention. A systematic search of the literature was conducted to find all studies of internet-delivered treatments for GAD (N = 20. Using Review Manager 5 all Randomized Controlled Trials (RCTs; n = 11 that met our established eligibility criteria were included into a meta-analysis that calculated effect sizes via the standardized mean difference. Compared to the waiting-list controls, the results demonstrate positive outcomes for GAD symptoms (d = −0.91 and its central construct of pathological worry (d = −0.74. The meta-analysis supports the efficacy of internet-delivered treatments for GAD including the use of disorder-specific (4 studies and transdiagnostic treatment protocols (7 studies. Caution is advised regarding the results as the data is limited and highly heterogeneous, but revealing of what future research might be needed.

  6. Can Trainees Effectively Deliver Dialectical Behavior Therapy for Individuals With Borderline Personality Disorder? Outcomes From a Training Clinic.

    Science.gov (United States)

    Rizvi, Shireen L; Hughes, Christopher D; Hittman, Alexandra D; Vieira Oliveira, Pedro

    2017-12-01

    The aim of the current study was to evaluate the effectiveness of a 6-month course of comprehensive dialectical behavior therapy (DBT) provided in a training clinic with doctoral students as therapists and assessors. Clinical outcomes for 50 individuals with borderline personality disorder (80% female, M age = 29.52 [SD = 9.64]) are reported. Reliable change indices and clinical significance were calculated for measures. Finally, our results were benchmarked against a "gold standard" randomized clinical trial (RCT; McMain et al., 2009). Analyses with both the full sample and the treatment completers indicate significant reductions in mental health symptomatology that were reliable, clinically and statistically significant, and comparable in effect size to the benchmarked RCT. This DBT training clinic produced good outcomes, comparable to that of a large RCT. Results have implications for who can provide DBT treatment, as well as improving access to DBT in community settings where training clinics may be located. © 2017 Wiley Periodicals, Inc.

  7. Effect of circuit class versus individual task specific training on balance in post-stroke patients

    International Nuclear Information System (INIS)

    Basri, R.; Ali, A.; Ullah, S.; Naseem, M.; Haq, Z.U.

    2017-01-01

    Objective: To compare the efficacy of circuit class versus individual, task specific training on balance, in post stroke patients. Methods: From a total of 64 participants, 32 participants were treated in circuit based workstations, while 32 participants were treated individually for 4 weeks. Importantly, both groups were treated with standard balance physiotherapy protocols. The treatment was delivered for 5 days per week with 1.5 hours daily. The patients were evaluated for three outcome measures i.e. berg balance scale, time up and go test and for motor assessment scale at baseline and after treatment. Results: Patients in both groups reported significant improvement after 4 weeks of training program compared to baseline on all outcome measures, except time up and go test that did not significantly improve in individual group. Compared to individual group, circuit group reported more improvement on berg balance scale scores (31.33 versus 37.80), time up and go test (23.13sec versus 16.67sec) and on motor assessment scale scores (18.77 versus 20.63) respectively. Conclusion: Circuit class training is more efficacious in improving balance in stroke patients as compared to individual task specific training. (author)

  8. External cephalic version for breech presentation at term: predictors of success, and impact on the rate of caesarean section.

    Science.gov (United States)

    Hussin, O A; Mahmoud, M A; Abdel-Fattah, M M

    2013-02-01

    The incidence of caesarean section for breech presentation has increased markedly in the last 20 years. A prospective, interventional cohort study was carried out of the success rate of external cephalic version (ECV) and its predictors of as well as its impact on the rate of caesarean section for vaginal breech delivery. All 128 women admitted during the study period to the obstetrics department of a tertiary care military hospital in Taif, Saudi Arabia with breech presentation at term, regardless of age and parity, who accepted ECV were recruited. ECV was successful in 53.9% of the women. Most of the women with successful ECV delivered normally (84.1%) and only 14.5% of them delivered by caesarean section. Conversely, normal vaginal delivery was reported among 8.5% of those who had spontaneous version with failed ECV and approximately two-thirds of them delivered by caesarean section (62.7%). Successful ECV reduced the breech and caesarean section rate.

  9. Parents' Goals for Children: The Dynamic Coexistence of Individualism and Collectivism in Cultures and Individuals

    Science.gov (United States)

    Tamis-LeMonda, Catherine S.; Way, Niobe; Hughes, Diane; Yoshikawa, Hirokazu; Kalman, Ronit Kahana; Niwa, Erika Y.

    2008-01-01

    Current scholarship on the cultural value systems of individualism and collectivism, and the associated developmental goals of autonomy and relatedness, has moved beyond grand divide theories to emphasize variation within individuals and cultures. We present a theoretical model on the dynamic coexistence of cultural value systems (at the macro…

  10. Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes.

    Science.gov (United States)

    Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Miller, Elizabeth

    2018-05-10

    Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches' experiences with program delivery combined with the coaches' and athletes' program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n = 36) explored the implementers' perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n = 39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by

  11. “I Always Vet Things”: Navigating Privacy and the Presentation of Self on Health Discussion Boards Among Individuals with Long-Term Conditions

    Science.gov (United States)

    Segar, Julia; Sanders, Caroline

    2016-01-01

    Background The ethics of research into online communities is a long-debated issue, with many researchers arguing that open-access discussion groups are publically accessible data and do not require informed consent from participants for their use for research purposes. However, it has been suggested that there is a discrepancy between the perceived and actual privacy of user-generated online content by community members. Objective There has been very little research regarding how privacy is experienced and enacted online. The objective of this study is to address this gap by qualitatively exploring the expectations of privacy on Internet forums among individuals with long-term conditions. Methods Semistructured interviews were conducted with 20 participants with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and 21 participants with type 1 and 2 diabetes mellitus, and were analyzed using thematic analysis. Participants were recruited via online and offline routes, namely forums, email lists, newsletters, and face-to-face support groups. Results The findings indicate that privacy online is a nebulous concept. Rather than individuals drawing a clear-cut distinction between what they would and would not be comfortable sharing online, it was evident that these situations were contextually dependent and related to a number of unique and individual factors. Conclusions Interviewees were seen to carefully manage how they presented themselves on forums, filtering and selecting the information that they shared about themselves in order to develop and maintain a particular online persona, while maintaining and preserving an acceptable level of privacy. PMID:27737819

  12. Effectiveness of recruitment to a smartphone-delivered nutrition intervention in New Zealand: analysis of a randomised controlled trial.

    Science.gov (United States)

    Volkova, Ekaterina; Michie, Jo; Corrigan, Callie; Sundborn, Gerhard; Eyles, Helen; Jiang, Yannan; Mhurchu, Cliona Ni

    2017-07-02

    Delivery of interventions via smartphone is a relatively new initiative in public health, and limited evidence exists regarding optimal strategies for recruitment. We describe the effectiveness of approaches used to recruit participants to a smartphone-enabled nutrition intervention trial. Internet and social media advertising, mainstream media advertising and research team networks were used to recruit New Zealand adults to a fully automated smartphone-delivered nutrition labelling trial (no face-to-face visits were required). Recruitment of Māori and Pacific participants was a key focus and ethically relevant recruitment materials and approaches were used where possible. The effectiveness of recruitment strategies was evaluated using Google Analytics, monitoring of study website registrations and randomisations, and self-reported participant data. The cost of the various strategies and associations with participant demographics were assessed. Over a period of 13 months, there were 2448 registrations on the study website, and 1357 eligible individuals were randomised into the study (55%). Facebook campaigns were the most successful recruitment strategy overall (43% of all randomised participants) and for all ethnic groups (Māori 44%, Pacific 44% and other 43%). Significant associations were observed between recruitment strategy and age (psmartphone-delivered trial. These approaches also reached diverse ethnic groups. However, more culturally appropriate recruitment strategies are likely to be necessary in studies where large numbers of participants from specific ethnic groups are sought. ACTRN12614000644662; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Individualized planning target volumes for intrafraction motion during hypofractionated intensity-modulated radiotherapy boost for prostate cancer

    International Nuclear Information System (INIS)

    Cheung, Patrick; Sixel, Katharina; Morton, Gerard; Loblaw, D. Andrew; Tirona, Romeo; Pang, Geordi; Choo, Richard; Szumacher, Ewa; DeBoer, Gerrit; Pignol, Jean-Philippe

    2005-01-01

    Purpose: The objective of the study was to access toxicities of delivering a hypofractionated intensity-modulated radiotherapy (IMRT) boost with individualized intrafraction planning target volume (PTV) margins and daily online correction for prostate position. Methods and materials: Phase I involved delivering 42 Gy in 21 fractions using three-dimensional conformal radiotherapy, followed by a Phase II IMRT boost of 30 Gy in 10 fractions. Digital fluoroscopy was used to measure respiratory-induced motion of implanted fiducial markers within the prostate. Electronic portal images were taken of fiducial marker positions before and after each fraction of radiotherapy during the first 9 days of treatment to calculate intrafraction motion. A uniform 10-mm PTV margin was used for the first phase of treatment. PTV margins for Phase II were patient-specific and were calculated from the respiratory and intrafraction motion data obtained from Phase I. The IMRT boost was delivered with daily online correction of fiducial marker position. Acute toxicity was measured using National Cancer Institute Common Toxicity Criteria, version 2.0. Results: In 33 patients who had completed treatment, the average PTV margin used during the hypofractionated IMRT boost was 3 mm in the lateral direction, 3 mm in the superior-inferior direction, and 4 mm in the anteroposterior direction. No patients developed acute Grade 3 rectal toxicity. Three patients developed acute Grade 3 urinary frequency and urgency. Conclusions: PTV margins can be reduced significantly with daily online correction of prostate position. Delivering a hypofractionated boost with this high-precision IMRT technique resulted in acceptable acute toxicity

  14. Alginate-Based Edible Films Delivering Probiotic Bacteria to Sliced Ham Pretreated with High Pressure Processing

    Directory of Open Access Journals (Sweden)

    Foteini Pavli

    2017-08-01

    Full Text Available The aim of the present work was to evaluate the efficacy of Na-alginate edible films as vehicles for delivering probiotic bacteria to sliced ham with or without pretreatment using high pressure processing (HPP. Three strains of probiotic bacteria were incorporated in Na-alginate forming solution. Ham slices (with or without pretreatment using HPP at 500 MPa for 2 min were packed under vacuum in contact with the films and then stored at 4, 8 and 12 °C for 66, 47 and 40 days, respectively. Microbiological analysis was performed in parallel with pH and color measurements. Sensory characteristics were assessed, while the presence and the relative abundance of each probiotic strain during storage was evaluated using pulsed field gel electrophoresis. In ham slices without HPP treatment, probiotic bacteria were enumerated above 106 CFU/g during storage at all temperatures. Same results were obtained in cases of HPP treated samples, but pH measurements showed differences with the latter ones exhibiting higher values. Sensory evaluation revealed that probiotic samples had a more acidic taste and odor than the control ones, however these characteristics were markedly compromised in samples treated with HPP. Overall, the results of the study are promising since probiotic bacteria were successfully delivered in the products by edible films regardless of the HPP treatment.

  15. Alginate-Based Edible Films Delivering Probiotic Bacteria to Sliced Ham Pretreated with High Pressure Processing.

    Science.gov (United States)

    Pavli, Foteini; Kovaiou, Ioanna; Apostolakopoulou, Georgia; Kapetanakou, Anastasia; Skandamis, Panagiotis; Nychas, George-John E; Tassou, Chrysoula; Chorianopoulos, Nikos

    2017-08-29

    The aim of the present work was to evaluate the efficacy of Na-alginate edible films as vehicles for delivering probiotic bacteria to sliced ham with or without pretreatment using high pressure processing (HPP). Three strains of probiotic bacteria were incorporated in Na-alginate forming solution. Ham slices (with or without pretreatment using HPP at 500 MPa for 2 min) were packed under vacuum in contact with the films and then stored at 4, 8 and 12 °C for 66, 47 and 40 days, respectively. Microbiological analysis was performed in parallel with pH and color measurements. Sensory characteristics were assessed, while the presence and the relative abundance of each probiotic strain during storage was evaluated using pulsed field gel electrophoresis. In ham slices without HPP treatment, probiotic bacteria were enumerated above 10⁶ CFU/g during storage at all temperatures. Same results were obtained in cases of HPP treated samples, but pH measurements showed differences with the latter ones exhibiting higher values. Sensory evaluation revealed that probiotic samples had a more acidic taste and odor than the control ones, however these characteristics were markedly compromised in samples treated with HPP. Overall, the results of the study are promising since probiotic bacteria were successfully delivered in the products by edible films regardless of the HPP treatment.

  16. Health Advocacy Project: Evaluating the Benefits of Service Learning to Nursing Students and Low Income Individuals Involved in a Community-Based Mental Health Promotion Project.

    Science.gov (United States)

    Samuels-Dennis, Joan; Xia, Liudi; Secord, Sandra; Raiger, Amelia

    2016-10-08

    Poverty, along with other factors such as unemployment, work and life stressors, interpersonal violence, and lack of access to high quality health and/or social services all play a role in determining who develops a mental illness and for whom those symptoms persist or worsen. Senior nursing student preparing to enter the field and working in a service learning capacity may be able to influence early recovery and symptom abatement among those most vulnerable to mental illness. A consortium of community stakeholders and researchers collaboratively designed a 10-week mental health promotion project called the Health Advocacy Project (HAP). The project combines case management and system navigation support delivered by trained and highly supervised nursing students to individuals experiencing major depressive disorder (MDD) and/or post-traumatic stress disorder (PTSD). In this article, we present the findings of a qualitative fidelity evaluation that examines the effectiveness of nursing students in delivering the health advocacy intervention at the level and with the intensity originally intended. The findings demonstrate how the services of senior nursing students may be optimized to benefit our healthcare system and populations most at risk for developing MDD and PTSD.

  17. Nurse-delivered counselling intervention for parental HIV disclosure: Results from a pilot randomized controlled trial in China

    Science.gov (United States)

    Simoni, Jane M.; Yang, Joyce P.; Shiu, Cheng-Shi; Chen, Wei-ti; Udell, Wadiya; Bao, Meijuan; Zhang, Lin; Lu, Hongzhou

    2016-01-01

    Objective The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children. Design This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms. Setting The study occurred at an outpatient HIV primary care centre in Shanghai, China. Participants Participants were 20 HIV-positive outpatients with at least one child (13–25 years old) who was unaware of the parent’s HIV diagnosis. Intervention The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays. Main outcome measure(s) Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV. Results In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a ‘large’ effect size. Conclusion Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy. PMID:26049544

  18. Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series.

    Science.gov (United States)

    Pagoto, Sherry L; Waring, Molly E; Schneider, Kristin L; Oleski, Jessica L; Olendzki, Effie; Hayes, Rashelle B; Appelhans, Bradley M; Whited, Matthew C; Busch, Andrew M; Lemon, Stephenie C

    2015-10-23

    Lifestyle interventions are efficacious at reducing risk for diabetes and cardiovascular disease but have not had a significant public health impact given high cost and patient and provider burden. Online social networks may reduce the burden of lifestyle interventions to the extent that they displace in-person visits and may enhance opportunities for social support for weight loss. We conducted an iterative series of pilot studies to evaluate the feasibility and acceptability of using online social networks to deliver a lifestyle intervention. In Study 1 (n=10), obese participants with depression received lifestyle counseling via 12 weekly group visits and a private group formed using the online social network, Twitter. Mean weight loss was 2.3 pounds (SD 7.7; range -19.2 to 8.2) or 1.2% (SD 3.6) of baseline weight. A total of 67% (6/9) of participants completing exit interviews found the support of the Twitter group at least somewhat useful. In Study 2 (n=11), participants were not depressed and were required to be regular users of social media. Participants lost, on average, 5.6 pounds (SD 6.3; range -15 to 0) or 3.0% (SD 3.4) of baseline weight, and 100% (9/9) completing exit interviews found the support of the Twitter group at least somewhat useful. To explore the feasibility of eliminating in-person visits, in Study 3 (n=12), we delivered a 12-week lifestyle intervention almost entirely via Twitter by limiting the number of group visits to one, while using the same inclusion criteria as that used in Study 2. Participants lost, on average, 5.4 pounds (SD 6.4; range -14.2 to 3.9) or 3.0% (SD 3.1) of baseline weight, and 90% (9/10) completing exit interviews found the support of the Twitter group at least somewhat useful. Findings revealed that a private Twitter weight-loss group was both feasible and acceptable for many patients, particularly among regular users of social media. Future research should evaluate the efficacy and cost-effectiveness of online

  19. Brucella lipopolysaccharide reinforced Salmonella delivering Brucella immunogens protects mice against virulent challenge.

    Science.gov (United States)

    Lalsiamthara, Jonathan; Lee, John Hwa

    2017-06-01

    Intracellular pathogen Salmonella exhibits natural infection broadly analogous to Brucella, this phenomenon makes Salmonella a pragmatic choice for an anti-Brucella vaccine delivery platform. In this study we developed and formulated a combination of four attenuated Salmonella Typhimurium live vector strains delivering heterologous Brucella antigens (rBs), namely lumazine synthase, proline racemase subunit A, lipoprotein outer membrane protein-19, and Cu-Zn superoxide dismutase. With an aim to develop a cross-protecting vaccine, Brucella pan-species conserved rBs were selected. The present study compared the efficacy of smooth and rough variants of Salmonella delivery vector and also evaluated the inclusion of purified Brucella lipopolysaccharide (LPS) in the formulation. Immunization of SPF-BALB/c mice with the vaccine combinations significantly (P≤0.05) reduced splenic wild-type Brucella abortus 544 colonization as compared to non-immunized mice as well as Salmonella only immunized mice. Increased induction of Brucella specific-IgG, sIgA production, and antigen-specific splenocyte proliferative responses were observed in the mice immunized with the formulations as compared to naïve or vector only immunized mice. Modulatory effects of rB and LPS on production of interleukin (IL)-4, IL-12, and interferon-γ were detected in splenocytes of mice immunized with the formulation. Rough Salmonella variant in combination with LPS could further enhance the efficacy of the delivery when applied intraperitoneally. Taken together, it is compelling that Brucella LPS-augmented Salmonella vector delivering immunogenic Brucella proteins may be more suitable than the current non-ideal live Brucella abortus vaccine. The vaccine system also provides a basis for the development of cross-protecting vaccine capable of preventing multispecies brucellosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

    Science.gov (United States)

    Park, Elyse R.; Green, Alexander R.; Betancourt, Joseph R.; Weissman, Joel S.

    2007-01-01

    Objective Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents’ perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Design Cross-sectional, national mail survey of resident physicians in their last year of training. Participants Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Results Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Conclusions Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents’ preparedness to provide cross-cultural care. PMID:17516107

  1. Influence of ambient humidity on the current delivered by air-vented ionization chambers revisited

    International Nuclear Information System (INIS)

    Poirier, Aurelie; Douysset, Guilhem

    2006-01-01

    The influence of ambient humidity on the current delivered by a vented ionization chamber has been re-investigated. A Nucletron 077.091 well-type chamber together with a 192 Ir HDR brachytherapy source was enclosed in a climatic test chamber and the current was recorded for various humidity values. Great care has been taken for the design of the experimental setup in order to obtain reliable measurements of currents and humidity values inside the chamber active volume. A ±0.35% linear variation of the measured currents has been observed over a common range of humidities. This result is larger than the expected variation. No formal explanation of such a discrepancy has been found yet, however the present results could lead to a set of recommendations

  2. Influence of ambient humidity on the current delivered by air-vented ionization chambers revisited

    Energy Technology Data Exchange (ETDEWEB)

    Poirier, Aurelie; Douysset, Guilhem [Laboratoire National Henri Becquerel-LNE, CEA Saclay 91191 Gif-sur-Yvette (France)

    2006-10-07

    The influence of ambient humidity on the current delivered by a vented ionization chamber has been re-investigated. A Nucletron 077.091 well-type chamber together with a {sup 192}Ir HDR brachytherapy source was enclosed in a climatic test chamber and the current was recorded for various humidity values. Great care has been taken for the design of the experimental setup in order to obtain reliable measurements of currents and humidity values inside the chamber active volume. A {+-}0.35% linear variation of the measured currents has been observed over a common range of humidities. This result is larger than the expected variation. No formal explanation of such a discrepancy has been found yet, however the present results could lead to a set of recommendations.

  3. Drishti: a volume exploration and presentation tool

    Science.gov (United States)

    Limaye, Ajay

    2012-10-01

    Among several rendering techniques for volumetric data, direct volume rendering is a powerful visualization tool for a wide variety of applications. This paper describes the major features of hardware based volume exploration and presentation tool - Drishti. The word, Drishti, stands for vision or insight in Sanskrit, an ancient Indian language. Drishti is a cross-platform open-source volume rendering system that delivers high quality, state of the art renderings. The features in Drishti include, though not limited to, production quality rendering, volume sculpting, multi-resolution zooming, transfer function blending, profile generation, measurement tools, mesh generation, stereo/anaglyph/crosseye renderings. Ultimately, Drishti provides an intuitive and powerful interface for choreographing animations.

  4. Operational issues of present ATLAS strip detector

    CERN Document Server

    Yacoob, S; The ATLAS collaboration

    2013-01-01

    Current results from the successful operation of the Semi-Conductor Tracker (SCT) Detector at the LHC and its status after three years of operation is presented. This note reports on the operation of the detector including an overview of the issues we encountered and the observation of significant increases in leakage currents from bulk damage due to non-ionising radiation, there have been a small number of significant changes effecting detector operation since the contribution to the previous conference in the series [1]. The main emphasis is given to the tracking performance of the SCT and the data quality during the many months of data-taking (the LHC delivered 47 pb

  5. Exploring Customization in Higher Education: An Experiment in Leveraging Computer Spreadsheet Technology to Deliver Highly Individualized Online Instruction to Undergraduate Business Students

    Science.gov (United States)

    Kunzler, Jayson S.

    2012-01-01

    This dissertation describes a research study designed to explore whether customization of online instruction results in improved learning in a college business statistics course. The study involved utilizing computer spreadsheet technology to develop an intelligent tutoring system (ITS) designed to: a) collect and monitor individual real-time…

  6. Delivering and Receiving Bad News: What School Psychologists Need to Know

    Science.gov (United States)

    Frost, Megan; Rogers, Margaret R.; O'Bryon, Elisabeth C.; Perry, Kimberly Hill

    2010-01-01

    Delivering bad news to students, teachers, and parents is not an uncommon occurrence for school psychologists. Skillfully communicating bad news requires sensitivity, thoughtful wording, and an awareness of the potential effect on the recipients. Despite the importance of this skill, school psychology has devoted little attention to what is…

  7. The efficacy of an intraosseous injection system of delivering local anesthetic.

    Science.gov (United States)

    Leonard, M S

    1995-01-01

    This article describes the clinical testing of a new system for the intraosseous delivery of local anesthesia. The author concluded that the system delivered local anesthetic very effectively (in some situations more effectively than the traditional delivery method), thus offering a great potential advantage to both dentists and patients.

  8. Linking ecological science to decision-making: delivering environmental monitoring information as societal feedback.

    Science.gov (United States)

    Vaughan, Hague; Whitelaw, Graham; Craig, Brian; Stewart, Craig

    2003-01-01

    The paper describes the Ecological Monitoring and Assessment Network's (EMAN) operational and program response to certain challenges of environmental monitoring in Canada, in particular, efforts to improve the ability of the network to deliver relevant information to decision makers. In addition to its familiar roles, environmental monitoring should deliver feedback to society on environmental changes associated with development patterns, trends, processes and interventions. In order for such feedback to be effective, it must be relevant, timely, useful and accessible: all characteristics that are defined by the user, not the provider. Demand driven environmental monitoring is explored through EMAN's experiences with Canada's Biosphere Reserves, the NatureWatch Program and the Canadian Community Monitoring Network.

  9. Femoral venous catheters: a safe alternative for delivering parenteral alimentation.

    Science.gov (United States)

    Friedman, B; Kanter, G; Titus, D

    1994-04-01

    Femoral vein catheterization is an alternative method of obtaining central venous access. Placement of femoral venous catheters (FVCs) is possible in the majority of patients, suitable for most indications, and associated with a low complication rate during insertion. We wished to determine the incidence of infections or other complications resulting when parenteral nutrition was delivered through FVCs. Fifty-two patients were followed from a hospital-wide population including patients in the critical care units. Triple-lumen catheters were placed by using the sterile Seldinger technique, and sites were examined daily for inflammation. Bacteriologic surveillance was accomplished by submitting the catheter tip for semiquantitative cultures. If catheter line sepsis was suspected, blood samples for cultures were drawn through the catheter and peripherally. The rate of occurrence of colonized catheters was 9.6% (five of 52), and catheter sepsis was found in one case (1.9%). Other than inflammation at six (11.5%) of 52 catheter sites, noninfectious complications of FVCs were not found. On the basis of these findings, we consider FVC-delivered parenteral alimentation a safe and effective alternative to other forms of central venous access.

  10. Who delivers where? The effect of obstetric risk on facility delivery in East Africa.

    Science.gov (United States)

    Virgo, Sandra; Gon, Giorgia; Cavallaro, Francesca L; Graham, Wendy; Woodd, Susannah

    2017-09-01

    Skilled attendance at birth is key for the survival of pregnant women. This study investigates whether women at increased risk of maternal and newborn complications in four East African countries are more likely to deliver in a health facility than those at lower risk. Demographic and Health Survey data for Kenya 2014, Rwanda 2014-15, Tanzania 2015-16 and Uganda 2011 were used to study women with a live birth in the three years preceding the survey. A three-level obstetric risk index was created using known risk factors. Generalised linear Poisson regression was used to investigate the association between obstetric risk and facility delivery. We analysed data from 13 119 women across the four countries of whom 42-45% were considered at medium risk and 12-17% at high risk, and the remainder were at low risk. In Rwanda, 93% of all women delivered in facilities but this was lower (59-66%) in the other three countries. There was no association between a woman's obstetric risk level and her place of delivery in any country; greater wealth and more education were, however, independently strongly associated with facility delivery. In four East African countries, women at higher obstetric risk were not more likely to deliver in a facility than those with lower risk. This calls for a renewed focus on antenatal risk screening and improved communication on birth planning to ensure women with an increased chance of maternal and newborn complications are supported to deliver in facilities with skilled care. © 2017 John Wiley & Sons Ltd.

  11. Development and Feasibility of a COPD Self-Management Intervention Delivered with Motivational Interviewing Strategies

    Science.gov (United States)

    Benzo, Roberto; Vickers, Kristin; Ernst, Denise; Tucker, Sharon; McEvoy, Charlene; Lorig, Kate

    2013-01-01

    BACKGROUND Self-management (SM) is proposed as the standard of care in chronic obstructive pulmonary disease (COPD) but details of the process and training required to deliver effective SM are not widely available. In addition, recent data suggest that patient engagement and motivation are critical ingredients for effective self-management. This manuscript carefully describes a self-management intervention using Motivational Interviewing skills, aimed to increase engagement and commitment in severe COPD patients. METHODS The intervention was developed and pilot tested for fidelity to protocol, for patient and interventionist feedback (qualitative) and effect on quality of life. Engagement between patient and interventionists was measured by the Working Alliance Inventory. The intervention was refined based in the results of the pilot study and delivered in the active arm of a prospective randomized study. RESULTS The pilot study suggested improvements in quality of life, fidelity to theory and patient acceptability. The refined self-management intervention was delivered 540 times in the active arm of a randomized study. We observed a retention rate of 86% (patients missing or not available for only 14% the scheduled encounters). CONCLUSIONS A self-management intervention, that includes motivational interviewing as the way if guiding patient into behavior change, is feasible in severe COPD and may increase patient engagement and commitment to self-management. This provides a very detailed description of the SM process for (the specifics of training and delivering the intervention) that facilitates replicability in other settings and could be translated to cardiac rehabilitation. PMID:23434613

  12. IoT-Based Image Recognition System for Smart Home-Delivered Meal Services

    Directory of Open Access Journals (Sweden)

    Hsiao-Ting Tseng

    2017-07-01

    Full Text Available Population ageing is an important global issue. The Taiwanese government has used various Internet of Things (IoT applications in the “10-year long-term care program 2.0”. It is expected that the efficiency and effectiveness of long-term care services will be improved through IoT support. Home-delivered meal services for the elderly are important for home-based long-term care services. To ensure that the right meals are delivered to the right recipient at the right time, the runners need to take a picture of the meal recipient when the meal is delivered. This study uses the IoT-based image recognition system to design an integrated service to improve the management of image recognition. The core technology of this IoT-based image recognition system is statistical histogram-based k-means clustering for image segmentation. However, this method is time-consuming. Therefore, we proposed using the statistical histogram to obtain a probability density function of pixels of a figure and segmenting these with weighting for the same intensity. This aims to increase the computational performance and achieve the same results as k-means clustering. We combined histogram and k-means clustering in order to overcome the high computational cost for k-means clustering. The results indicate that the proposed method is significantly faster than k-means clustering by more than 10 times.

  13. 85 μm core rod fiber amplifier delivering 350 W/m

    DEFF Research Database (Denmark)

    Johansen, Mette Marie; Michieletto, Mattia; Kristensen, Torben

    2016-01-01

    An improved version of the distributed modal filtering (DMF) rod fiber is tested in a high power setup delivering 350 W/m of extracted signal average power limited by the available pump power. The rod fiber is thoroughly tested to record the transverse modal instability (TMI) behavior and also me...

  14. Delivering MBA Programs in Emerging Markets: The Challenge of National Culture

    Science.gov (United States)

    Jones, Stephanie

    2013-01-01

    Increasingly, Western-style MBA programs are being delivered in emerging markets, as the developed countries become more and more saturated with MBAs and related offerings. This article, based on the global experience of the author in teaching and assessing MBA modules including thesis and dissertation research and writing, suggests approaches to…

  15. Can shared care deliver better outcomes for patients undergoing total hip replacement?

    NARCIS (Netherlands)

    Rosendal, H.; Beekum, W.T. van; Nijhof, P.; Witte, L.P. de; Schrijvers, A.J.P.

    2000-01-01

    Objectives: To assess whether shared care for patients undergoing total hip replacement delivers better outcomes compared to care as usual. Design: Prospective, observational cohort study. Setting: Two regions in the Netherlands where different organisational health care models have been

  16. Life cycle assessment perspectives on delivering an infant in the US

    International Nuclear Information System (INIS)

    Campion, Nicole; Thiel, Cassandra L.; DeBlois, Justin; Woods, Noe C.; Landis, Amy E.; Bilec, Melissa M.

    2012-01-01

    This study introduces life cycle assessment as a tool to analyze one aspect of sustainability in healthcare: the birth of a baby. The process life cycle assessment case study presented evaluates two common procedures in a hospital, a cesarean section and a vaginal birth. This case study was conducted at Magee-Womens Hospital of the University of Pittsburgh Medical Center, which delivers over 10,000 infants per year. The results show that heating, ventilation, and air conditioning (HVAC), waste disposal, and the production of the disposable custom packs comprise a large percentage of the environmental impacts. Applying the life cycle assessment tool to medical procedures allows hospital decision makers to target and guide efforts to reduce the environmental impacts of healthcare procedures. - Highlights: ► Life cycle assessment helps identify the environmental impacts of medical procedures. ► Disposable custom packs represent a large portion of environmental impacts of births. ► Electricity loading contributes to global warming potential and respiratory effects. ► Impact improvements should focus on heating, ventilation, and air conditioning and disposable custom packs.

  17. Increased skills usage statistically mediates symptom reduction in self-guided internet-delivered cognitive-behavioural therapy for depression and anxiety: a randomised controlled trial.

    Science.gov (United States)

    Terides, Matthew D; Dear, Blake F; Fogliati, Vincent J; Gandy, Milena; Karin, Eyal; Jones, Michael P; Titov, Nickolai

    2018-01-01

    Cognitive-behavioural therapy (CBT) is an effective treatment for clinical and subclinical symptoms of depression and general anxiety, and increases life satisfaction. Patients' usage of CBT skills is a core aspect of treatment but there is insufficient empirical evidence suggesting that skills usage behaviours are a mechanism of clinical change. This study investigated if an internet-delivered CBT (iCBT) intervention increased the frequency of CBT skills usage behaviours and if this statistically mediated reductions in symptoms and increased life satisfaction. A two-group randomised controlled trial was conducted comparing internet-delivered CBT (n = 65) with a waitlist control group (n = 75). Participants were individuals experiencing clinically significant symptoms of depression or general anxiety. Mixed-linear models analyses revealed that the treatment group reported a significantly higher frequency of skills usage, lower symptoms, and higher life satisfaction by the end of treatment compared with the control group. Results from bootstrapping mediation analyses revealed that the increased skills usage behaviours statistically mediated symptom reductions and increased life satisfaction. Although skills usage and symptom outcomes were assessed concurrently, these findings support the notion that iCBT increases the frequency of skills usage behaviours and suggest that this may be an important mechanism of change.

  18. Individual differences in temperature perception: evidence of common processing of sensation intensity of warmth and cold.

    Science.gov (United States)

    Green, Barry G; Akirav, Carol

    2007-01-01

    The longstanding question of whether temperature is sensed via separate sensory systems for warmth and cold was investigated by measuring individual differences in perception of nonpainful heating and cooling. Sixty-two subjects gave separate ratings of the intensity of thermal sensations (warmth, cold) and nociceptive sensations (burning/stinging/pricking) produced by cooling (29 degrees C) or heating (37 degrees C) local regions of the forearm. Stimuli were delivered via a 4 x 4 array of 8 mm x 8 mm Peltier thermoelectric modules that enabled test temperatures to be presented sequentially to individual modules or simultaneously to the full array. Stimulation of the full array showed that perception of warmth and cold were highly correlated (Pearson r = 0.83, p sensations produced by the two temperatures were also correlated, but to a lesser degree (r = 0.44), and the associations between nociceptive and thermal sensations (r = 0.35 and 0.22 for 37 and 29 degrees C, respectively) were not significant after correction for multiple statistical tests. Intensity ratings for individual modules indicated that the number of responsive sites out of 16 was a poor predictor of temperature sensations but a significant predictor of nociceptive sensations. The very high correlation between ratings of thermal sensations conflicts with the classical view that warmth and cold are mediated by separate thermal modalities and implies that warm-sensitive and cold-sensitive spinothalamic pathways converge and undergo joint modulation in the central nervous system. Integration of thermal stimulation from the skin and body core within the thermoregulatory system is suggested as the possible source of this convergence.

  19. The definition of the individual dose equivalent

    International Nuclear Information System (INIS)

    Ehrlich, Margarete

    1986-01-01

    A brief note examines the choice of the present definition of the individual dose equivalent, the new operational dosimetry quantity for external exposure. The consequences of the use of the individual dose equivalent and the danger facing the individual dose equivalent, as currently defined, are briefly discussed. (UK)

  20. A case report of severe panhypopituitarism in a newborn delivered by a women with Turner syndrome.

    Science.gov (United States)

    Olszewska, Marta; Kiełbasa, Grzegorz; Wójcik, Małgorzata; Zygmunt-Górska, Agata; Starzyk, Jerzy B

    2015-01-01

    Turner syndrome (TS) is a congenital disease caused by absence or structural abnormalities of sex chromosomes resulting in gonadal dysgenesis. Spontaneous pregnancies occur in 2-8% of patients, especially with mosaic kariotypes, however they are associated with increased risk of poor outcome both for mother and fetus. We report a 4-day-old male infant delivered by women with mosaic TS who was admitted to the pediatric intensive care unit and presented with severe panhypopituitarism as the early manifestation of pituitary stalk interruption syndrome (PSIS). To the best of our knowledge this is the first report of severe panhypopituitarism in a newborn borne by women with TS.

  1. A designerly approach to enable organizations to deliver product-service systems

    NARCIS (Netherlands)

    De Lille, C.S.H.; Roscam Abbing, E.; Kleinsmann, M.S.

    2012-01-01

    Design is not only just for products, logo’s or websites anymore. More and more companies are embracing design as a way to enable their organization to adapt to changes in society. One of the challenges many organizations face at the moment is how to create value for their customers by delivering

  2. 76 FR 45334 - Innovative Techniques for Delivering ITS Learning; Request for Information

    Science.gov (United States)

    2011-07-28

    ... adult learners? 5. Are you aware of any ITS training applications that work on a mobile phone or smart... DEPARTMENT OF TRANSPORTATION Research and Innovative Technology Administration Innovative Techniques for Delivering ITS Learning; Request for Information AGENCY: Research and Innovative Technology...

  3. 31 CFR 363.100 - What are the rules for purchasing and delivering gift savings bonds to minors?

    Science.gov (United States)

    2010-07-01

    ... TreasuryDirect Gifts § 363.100 What are the rules for purchasing and delivering gift savings bonds to minors? (a) A TreasuryDirect ® account owner can purchase a savings bond as a gift with a minor as the recipient. (b) An account owner can deliver a bond purchased as a gift to a minor. The account owner must...

  4. Assessment of ulceration risk in diabetic individuals

    Directory of Open Access Journals (Sweden)

    Luz Marina Alfonso Dutra

    Full Text Available ABSTRACT Objective: To identify the risk factors for foot ulceration through the tracing of diabetic peripheral neuropathy and peripheral arterial disease in individuals with type I and II diabetes, who were assisted in reference centers of the Federal District, Brazil. Method: a cross-sectional and analytical study, with the assessment of 117 individuals in outpatient clinics of the Federal District. Continuous variables were compared through Mann-Whitney test, and categorized variables, through Chi-square test for univariate analysis and Logistics regression test for multivariate analysis. Results: painful diabetic peripheral neuropathy was present in 37 (75.5% of the individuals with neuropathy. Deformities and loss of protective plant sensibility were related to neuropathy (p=0.014 and p=0.001, respectively. Of the 40 (34.2% individuals in the sample who presented peripheral arterial disease, 26 (65% presented calcification risk. Conclusion: signs of painful peripheral polyneuropathy, peripheral arterial disease, deformities, loss of protective plantar sensibility, and dry skin were identified as risk factors for ulceration.

  5. Congenital transmesenteric hernia presenting as neonatal ascites

    Directory of Open Access Journals (Sweden)

    Andreia Felizes

    2018-01-01

    Full Text Available Transmesenteric hernia is an internal hernia without sac, which forms through a congenital mesentery defect. Mostly diagnosed intraoperatively, it as a variable prognosis, which can lead to high morbidity and mortality.The authors describe a case of transmesenteric hernia that presented as isolated fetal ascites. A 34 week preterm baby was delivered by forceps, with respiratory compromise due to abdominal distension. Orotracheal intubation and evacuation paracentesis were performed. After excluding major causes of neonatal ascites and persistent bowel loop distension, the newborn underwent an exploratory laparotomy, where a transmesenteric hernia and pellets of meconium were identified. Hernia reduction, enterectomy and enterostomies were performed, with good outcome. Cystic fibrosis was diagnosed during post-operatory period.This is the first reported case of transmesenteric hernia presenting as fetal ascites, without associated morbidity or mortality due to an early intervention. Keywords: Transmesenteric hernia, Fetal ascites, Cystic fibrosis

  6. A Meta-Analysis of the Impact of Universal and Indicated Preventive Technology-Delivered Interventions for Higher Education Students.

    Science.gov (United States)

    Conley, Colleen S; Durlak, Joseph A; Shapiro, Jenna B; Kirsch, Alexandra C; Zahniser, Evan

    2016-08-01

    The uses of technology-delivered mental health treatment options, such as interventions delivered via computer, smart phone, or other communication or information devices, as opposed to primarily face-to-face interventions, are proliferating. However, the literature is unclear about their effectiveness as preventive interventions for higher education students, a population for whom technology-delivered interventions (TDIs) might be particularly fitting and beneficial. This meta-analytic review examines technological mental health prevention programs targeting higher education students either without any presenting problems (universal prevention) or with mild to moderate subclinical problems (indicated prevention). A systematic literature search identified 22 universal and 26 indicated controlled interventions, both published and unpublished, involving 4763 college, graduate, or professional students. As hypothesized, the overall mean effect sizes (ESs) for both universal (0.19) and indicated interventions (0.37) were statistically significant and differed significantly from each other favoring indicated interventions. Skill-training interventions, both universal (0.21) and indicated (0.31), were significant, whereas non-skill-training interventions were only significant among indicated (0.25) programs. For indicated interventions, better outcomes were obtained in those cases in which participants had access to support during the course of the intervention, either in person or through technology (e.g., email, online contact). The positive findings for both universal and indicated prevention are qualified by limitations of the current literature. To improve experimental rigor, future research should provide detailed information on the level of achieved implementation, describe participant characteristics and intervention content, explore the impact of potential moderators and mechanisms of success, collect post-intervention and follow-up data regardless of

  7. 10 CFR 10.22 - Notice to individual.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Notice to individual. 10.22 Section 10.22 Energy NUCLEAR... NATIONAL SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.22 Notice to individual. A... Counsel, and signed by the Director, Office of Administration, must be presented to each individual whose...

  8. An internet survey of the characteristics and physical activity of community-dwelling Australian adults with acquired brain injury: Exploring interest in an internet-delivered self-management program focused on physical activity.

    Science.gov (United States)

    Jones, Taryn M; Dean, Catherine M; Dear, Blake F; Hush, Julia M; Titov, Nickolai

    2016-01-01

    Individuals with acquired brain injury (ABI) are more likely to be physically inactive and experience barriers to accessing services to address inactivity. This study was designed to guide the development of an internet-delivered self-management program to increase physical activity after ABI. The aims of this study were to examine the current physical activity status of community-dwelling Australian adults with ABI, the barriers to physical activity they experience and to explore interest an internet-delivered self-management program aimed at increasing physical activity. An online survey of Australian adults with ABI was used to collect information about demographic characteristics; general health; emotional well-being; mobility and physical activity status, and satisfaction; barriers to physical activity; confidence in overcoming barriers, and; interest in an internet self-management program. Data were analyzed descriptively and correlational analyses examined relationships between variables. Data were analyzed from 59 respondents. Over half were not satisfied with their current physical activity status. The most frequently reported barriers were pain/discomfort, fatigue and fear, and confidence to overcome these barriers was very low. Interest in an internet-delivered self-management program was high (74%) and not related to the amount of physical activity, satisfaction with physical activity and mobility status or total number of barriers. Australian adults with ABI are not satisfied with their activity levels and experience barriers in maintaining their physical activity levels. Participants were interested in accessing an internet-delivered self-management program aimed at improving physical activity levels. Therefore such a program warrants development and evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Perspective of patients, patients' families, and healthcare providers towards designing and delivering hospice care services in a middle income Country.

    Science.gov (United States)

    Azami-Aghdash, Saber; Ghojazadeh, Morteza; Aghaei, Mir Hossein; Naghavi-Behzad, Mohammad; Asgarlo, Zoleikha

    2015-01-01

    In view of the recent surge in chronic disease rates and elderly population in the developing countries, there is an urgent felt need for palliative and hospice care services. The present study investigates the views and attitudes of patients and their families, physicians, nurses, healthcare administrators, and insurers regarding designing and delivering hospice care service in a middle income country. In this qualitative study, the required data was collected using semi structured interviews and was analyzed using thematic analysis. Totally 65 participants from hospitals and Tabriz University of Medical Sciences were selected purposively to achieve data saturation. Analyzing the data, five main themes (barriers, facilitators, strategies, attitudes, and service provider) were extracted. Barriers included financial issues, cultural-religious beliefs, patient and family-related obstacles, and barriers related to healthcare system. Facilitators included family-related issues, cultural-religious beliefs, as well as facilitators associated with patients, healthcare status, and benefits of hospice service. Most participants (79%) had positive attitude towards hospice care service. Participant suggested 10 ways to design and deliver effective and efficient hospice care service. They thought the presence of physicians, nurses, and psychologists and other specialists and clergy were necessary in the hospice care team. Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.

  10. Effects of a DVD-delivered exercise program on patterns of sedentary behavior in older adults: a randomized controlled trial.

    Science.gov (United States)

    Fanning, J; Porter, G; Awick, E A; Wójcicki, T R; Gothe, N P; Roberts, S A; Ehlers, D K; Motl, R W; McAuley, E

    2016-06-01

    In the present study, we examined the influence of a home-based, DVD-delivered exercise intervention on daily sedentary time and breaks in sedentary time in older adults. Between 2010 and 2012, older adults (i.e., aged 65 or older) residing in Illinois (N = 307) were randomized into a 6-month home-based, DVD-delivered exercise program (i.e., FlexToBa; FTB) or a waitlist control. Participants completed measurements prior to the first week (baseline), following the intervention period (month 6), and after a 6 month no-contact follow-up (month 12). Sedentary behavior was measured objectively using accelerometers for 7 consecutive days at each time point. Differences in daily sedentary time and breaks between groups and across the three time points were examined using mixed-factor analysis of variance (mixed ANOVA) and analysis of covariance (ANCOVA). Mixed ANOVA models revealed that daily minutes of sedentary time did not differ by group or time. The FTB condition, however, demonstrated a greater number of daily breaks in sedentary time relative to the control condition (p = .02). ANCOVA models revealed a non-significant effect favoring FTB at month 6, and a significant difference between groups at month 12 (p = .02). While overall sedentary time did not differ between groups, the DVD-delivered exercise intervention was effective for maintaining a greater number of breaks when compared with the control condition. Given the accumulating evidence emphasizing the importance of breaking up sedentary time, these findings have important implications for the design of future health behavior interventions.

  11. Energy Management in Small Commercial Buildings: A Look at How HVAC Contractors Can Deliver Energy Efficiency to this Segment

    Energy Technology Data Exchange (ETDEWEB)

    Hult, Erin; Granderson, Jessica; Mathew, Paul

    2014-07-01

    While buildings smaller than 50,000 sq ft account for nearly half of the energy used in US commercial buildings, energy efficiency programs to-date have primarily focused on larger buildings. Interviews with stakeholders and a review of the literature indicate interest in energy efficiency from the small commercial building sector, provided solutions are simple and low-cost. An approach to deliver energy management to small commercial buildings via HVAC contractors and preliminary demonstration findings are presented. The energy management package (EMP) developed includes five technical elements: benchmarking and analysis of monthly energy use; analysis of interval electricity data (if available), a one-hour onsite walkthrough, communication with the building owner, and checking of results. This data-driven approach tracks performance and identifies low-cost opportunities, using guidelines and worksheets for each element to streamline the delivery process and minimize the formal training required. This energy management approach is unique from, but often complementary to conventional quality maintenance or retrofit-focused programs targeting the small commercial segment. Because HVAC contractors already serve these clients, the transaction cost to market and deliver energy management services can be reduced to the order of hundreds of dollars per year. This business model, outlined briefly in this report, enables the offering to benefit the contractor and client even at the modest expected energy savings in small buildings. Results from a small-scale pilot of this approach validated that the EMP could be delivered by contractors in 4-8 hours per building per year, and that energy savings of 3-5percent are feasible through this approach.

  12. Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

    Science.gov (United States)

    2012-01-01

    Background Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially

  13. Comparison of the efficacy of intensity modulated radiotherapy delivered by competing technologies

    International Nuclear Information System (INIS)

    Seco, Joao Carlos

    2003-01-01

    The project involved the study and comparison of the various intensity-modulated radiation therapy (IMRT) delivery techniques. IMRT can be delivered via (i) the NOMOS MIMiC tomotherapy device, (ii) the dynamic multileaf collimator (DMLC), and (iii) the technique of multiple-static fields (MSF) using a multileaf collimator (MLC). To evaluate the relative benefits and limitations of the different methods of delivering IMRT an inverse-planning simulation code was developed. The simulation uses two distinct beam models: (a) the PEACOCK pencil-beam model based on the double Gaussian convolution for the MIMiC, and (b) the macropencil beam model (with the extended source model included to correct for the output factor) which is used for the DMLC and MSF-MLC delivery techniques. The process of delivering an IMRT treatment may involve various beam-modifying techniques such as multileaf collimators, the NOMOS MIMiC, blocks, wedges, etc. The constraints associated with the IMRT delivery technique are usually neglected in the process of obtaining the 'optimal' inverse treatment plan. Consequently, dose optimization may be significantly reduced when the 'optimal' beam profiles are converted to leaf/diaphragm positions via a leaf-sequencing interpreter. The work developed assessed the effects on the optimum treatment plan of the following leaf-sequencing algorithms: MSF-MLC, DMLC, and NOMOS MIMiC. An increase of 2.5%, 3.7% and 5.7% was observed for the PTV dose, when delivering a fluence profile with the DMLC, MSF, and NOMOS MIMiC techniques, respectively. An intensity-modulated beam optimization algorithm was developed to incorporate the delivery constraints into the optimization cycle. The optimization algorithm was based on the quasi-Newton method of iteratively solving minimization problems. The developed algorithm iteratively corrects the incident, pencil-beam-like fluence to incorporate the delivery constraints. In the case of the DMLC and MSF the optimization converged

  14. Using mobile electronic devices to deliver educational resources in developing countries.

    Science.gov (United States)

    Mazal, Jonathan Robert; Ludwig, Rebecca

    2015-01-01

    Developing countries have far fewer trained radiography professionals than developed countries, which exacerbates the limited access to imaging services. The lack of trained radiographers reflects, in part, limited availability of radiographer-specific educational resources. Historically, organizations that provided such resources in the developing world faced challenges related to the limited stock of current materials as well as expenses associated with shipping and delivery. Four mobile electronic devices (MEDs) were loaded with educational content (e-books, PDFs, and digital applications) spanning major radiography topics. The MEDs were distributed to 4 imaging departments in Ghana, India, Nepal, and Nigeria based on evidence of need for radiography-specific resources, as revealed by survey responses. A cost comparison of postal delivery vs digital delivery of educational content was performed. The effectiveness of delivering additional content via Wi-Fi transmission also was evaluated. Feedback was solicited on users' experience with the MEDs as a delivery tool for educational content. An initial average per e-book expense of $30.05, which included the cost of the device, was calculated for the MED delivery method compared with $15.56 for postal delivery of printed materials. The cost of the MED delivery method was reduced to an average of $10.05 for subsequent e-book deliveries. Additional content was successfully delivered via Wi-Fi transmission to all recipients during the 3-month follow-up period. Overall user feedback on the experience was positive, and ideas for enhancing the MED-based method were identified. Using MEDs to deliver radiography-specific educational content appears to be more cost effective than postal delivery of printed materials on a long-term basis. MEDs are more efficient for providing updates to educational materials. Customization of content to department needs, and using projector devices could enhance the usefulness of MEDs for

  15. Fractured long bones in a term infant delivered by cesarian section

    International Nuclear Information System (INIS)

    Kaplan, M.; Dollberg, M.; Wajntraub, G.; Itzchaki, M.

    1987-01-01

    A term infant was delivered uneventfully by repeat cesarian section. At the age of 1 week there was clinical and radiographic evidence of fractures of the left tibia and right radius. The fractures most likely occurred during the cesarian section. Birth trauma should not be excluded on the basis of cesarian section delivery. (orig.)

  16. Inter-individual Differences in Heart Rate Variability Are Associated with Inter-individual Differences in Empathy and Alexithymia

    Directory of Open Access Journals (Sweden)

    Alexander Lischke

    2018-02-01

    Full Text Available In the present study, we investigated whether inter-individual differences in vagally mediated heart rate variability (vmHRV would be associated with inter-individual differences in empathy and alexithymia. To this end, we determined resting state HF-HRV in 90 individuals that also completed questionnaires assessing inter-individual differences in empathy and alexithymia. Our categorical and dimensional analyses revealed that inter-individual differences in HF-HRV were differently associated with inter-individual differences in empathy and alexithymia. We found that individuals with high HF-HRV reported more empathy and less alexithymia than individuals with low HF-HRV. Moreover, we even found that an increase in HF-HRV was associated with an increase in empathy and a decrease in alexithymia across all participants. Taken together, these findings indicate that individuals with high HF-HRV are more empathetic and less alexithymic than individuals with low HF-HRV. These differences in empathy and alexithymia may explain why individuals with high HF-HRV are more successful in sharing and understanding the mental and emotional states of others than individuals with low HF-HRV.

  17. Internet-delivered cognitive behavior therapy for anxiety disorders is here to stay

    NARCIS (Netherlands)

    Andrews, Gavin; Newby, Jill M; Williams, Alishia D

    Anxiety disorders are common and disabling. Cognitive behavior therapy is the treatment of choice but is often difficult to obtain. Automated, internet-delivered, cognitive behavior therapy (iCBT) courses may be an answer. There are three recent systematic reviews of randomized controlled trials

  18. Orally delivered β-glucans aggravate dextran sulfate sodium (DSS)-induced intestinal inflammation

    NARCIS (Netherlands)

    Heinsbroek, Sigrid E. M.; Williams, David L.; Welting, Olaf; Meijer, Sybren L.; Gordon, Siamon; de Jonge, Wouter J.

    2015-01-01

    β-Glucans have beneficial health effects due to their immune modulatory properties. Oral administration of β-glucans affects tumour growth, microbial infection, sepsis, and wound healing. We hypothesized that pre-treatment with orally delivered soluble and particulate β-glucans could ameliorate the

  19. Design and test of a Microsoft Kinect-based system for delivering adaptive visual feedback to stroke patients during training of upper limb movement.

    Science.gov (United States)

    Simonsen, Daniel; Popovic, Mirjana B; Spaich, Erika G; Andersen, Ole Kæseler

    2017-11-01

    The present paper describes the design and test of a low-cost Microsoft Kinect-based system for delivering adaptive visual feedback to stroke patients during the execution of an upper limb exercise. Eleven sub-acute stroke patients with varying degrees of upper limb function were recruited. Each subject participated in a control session (repeated twice) and a feedback session (repeated twice). In each session, the subjects were presented with a rectangular pattern displayed on a vertical mounted monitor embedded in the table in front of the patient. The subjects were asked to move a marker inside the rectangular pattern by using their most affected hand. During the feedback session, the thickness of the rectangular pattern was changed according to the performance of the subject, and the color of the marker changed according to its position, thereby guiding the subject's movements. In the control session, the thickness of the rectangular pattern and the color of the marker did not change. The results showed that the movement similarity and smoothness was higher in the feedback session than in the control session while the duration of the movement was longer. The present study showed that adaptive visual feedback delivered by use of the Kinect sensor can increase the similarity and smoothness of upper limb movement in stroke patients.

  20. Evaluation of a Telephone-Delivered, Community-Based Collaborative Care Management Program for Caregivers of Older Adults with Dementia.

    Science.gov (United States)

    Mavandadi, Shahrzad; Wray, Laura O; DiFilippo, Suzanne; Streim, Joel; Oslin, David

    2017-09-01

    To evaluate whether a community-based, telephone-delivered, brief patient/caregiver-centered collaborative dementia care management intervention is associated with improved caregiver and care recipient (CR) outcomes. Longitudinal program evaluation of a clinical intervention; assessments at baseline and 3- and 6-month follow-up. General community. Caregivers (N = 440) of older, community-dwelling, low-income CRs prescribed a psychotropic medication by a primary care provider who met criteria for dementia and were enrolled in the SUpporting Seniors Receiving Treatment And INtervention (SUSTAIN) program for older adults. Dementia care management versus clinical evaluation only. Perceived caregiving burden and caregiver general health (primary outcomes); CR neuropsychiatric symptoms and caregiver distress in response to CRs' challenging dementia-related behaviors (secondary outcomes). Caregivers were, on average, 64.0 (SD: 11.8) years old and 62.6% provided care for the CR for 20 or more hours per week. The majority of the sample was female (73.2%), non-Hispanic White (90.2%), and spousal caregivers (72.5%). Adjusted longitudinal models of baseline and 3- and 6-month data suggest that compared with caregivers receiving clinical evaluation only, caregivers receiving care management reported greater reductions in burden over time. Subgroup analyses also showed statistically significant reductions in caregiver-reported frequency of CR dementia-related behaviors and caregiver distress in response to those symptoms at 3-month follow-up. A community-based, telephone-delivered care management program for caregivers of individuals with dementia is associated with favorable caregiver and CR-related outcomes. Findings support replication and further research in the impact of tailored, collaborative dementia care management programs that address barriers to access and engagement. Published by Elsevier Inc.

  1. Collective Functionality through Bacterial Individuality

    Science.gov (United States)

    Ackermann, Martin

    According to the conventional view, the properties of an organism are a product of nature and nurture - of its genes and the environment it lives in. Recent experiments with unicellular organisms have challenged this view: several molecular mechanisms generate phenotypic variation independently of environmental signals, leading to variation in clonal groups. My presentation will focus on the causes and consequences of this microbial individuality. Using examples from bacterial genetic model systems, I will first discuss different molecular and cellular mechanisms that give rise to bacterial individuality. Then, I will discuss the consequences of individuality, and focus on how phenotypic variation in clonal populations of bacteria can promote interactions between individuals, lead to the division of labor, and allow clonal groups of bacteria to cope with environmental uncertainty. Variation between individuals thus provides clonal groups with collective functionality.

  2. The Irish DAFNE study protocol: a cluster randomised trial of group versus individual follow-up after structured education for type 1 diabetes.

    LENUS (Irish Health Repository)

    Dinneen, Seán F

    2009-01-01

    BACKGROUND: Structured education programmes for individuals with Type 1 diabetes have become a recognised means of delivering the knowledge and skills necessary for optimal self-management of the condition. The Dose Adjustment for Normal Eating (DAFNE) programme has been shown to improve biomedical (HbA(1c) and rates of severe hypoglycaemia) and psychosocial outcomes for up to 12 months following course delivery. The optimal way to support DAFNE graduates and maintain the benefits of the programme has not been established. We aimed to compare 2 different methods of follow-up of DAFNE graduates in a pragmatic clinical trial delivered in busy diabetes clinics on the island of Ireland. METHODS: Six participating centres were cluster randomised to deliver either group follow-up or a return to traditional one-to-one clinic visits. In the intervention arm group follow-up was delivered at 6 and 12 months post DAFNE training according to a curriculum developed for the study. In the control arm patients were seen individually in diabetes clinics as part of routine care. Study outcomes included HbA(1c) levels, self-reported rates of severe hypoglycaemia, body weight and measures of diabetes wellbeing and quality of life. These were measured at 6, 12 and 18 months after recruitment. Generalisability (external validity) was maximised by recruiting study participants from existing DAFNE waiting lists in each centre, by using broad inclusion criteria (including HbA(1c) values less than 13 percent with no lower limit) and by using existing clinic staff to deliver the training and follow-up. Internal validity and treatment fidelity were maximised by quality assuring the training of all DAFNE educators, by external peer review of the group follow-up sessions and by striving for full attendance at follow-up visits. Assays of HbA(1c) were undertaken in a central laboratory. DISCUSSION: This pragmatic clinical trial evaluating group follow-up after a structured education programme has

  3. Network governance and capacity of local governments to deliver LED in Uganda

    Directory of Open Access Journals (Sweden)

    Rose B Namara

    2016-02-01

    Full Text Available This paper discusses network governance and its contribution to the capacity of local governments (LGs to deliver local economic development (LED in Uganda. Although a formal LED policy was only established in Uganda in February 2014, there have been LED-inspired practices in the past decade. Various scholars and practitioners have observed that the autonomy and capacity of LGs to deliver LED is limited, but have been hopeful that new governance strategies like network governance would increase the capacities of LGs. However, neither network governance arrangements among LGs, nor their potential to improve governance capacity, have been documented. In a case study of Kyenjojo District, this paper finds that existing network governance arrangements have been fundamental in improving financial autonomy at this LG, delivering some income to invest in LED activities, although no evidence was found of reduced transaction costs in transforming local economies. The study further reveals that network governance arrangements have not led to the development of specialised skills in regulation or law enforcement, and capacity gaps are evident amongst staff and members in understanding the private sector and how it works. On a positive note, there is clear evidence of attempts by the LG to be innovative. Based on these findings, this study recommends that LGs need to consider a multi-pronged or multi-network governance approach to LED, which in turn will require a refocusing of governance mechanisms to become more dynamic and responsive, and offer incentives to the various actors in the development sector.

  4. Collaborative Engagement Approaches For Delivering Sustainable Infrastructure Projects In The AEC Sector

    Directory of Open Access Journals (Sweden)

    Adetola, Alaba

    2011-12-01

    Full Text Available The public sector has traditionally financed and operated infrastructure projects using resources from taxes and various levies (e.g. fuel taxes, road user charges. However, the rapid increase in human population growth coupled with extended globalisation complexities and associated social/political/economic challenges have placed new demands on the purveyors and operators of infrastructure projects. The importance of delivering quality infrastructure has been underlined by the United Nations declaration of the Millennium Development Goals; as has the provision of ‘adequate’ basic structures and facilities necessary for the well-being of urban populations in developing countries. Thus, in an effort to finance developing countries’ infrastructure needs, most countries have adopted some form of public-private collaboration strategy. This paper critically reviews these collaborative engagement approaches, identifies and highlights 10 critical themes that need to be appropriately captured and aligned to existing business models in order to successfully deliver sustainable infrastructure projects. Research findings show that infrastructure services can be delivered in many ways, and through various routes. For example, a purely public approach can cause problems such as slow and ineffective decision-making, inefficient organisational and institutional augmentation, and lack of competition and inefficiency (collectively known as government failure. On the other hand, adopting a purely private approach can cause problems such as inequalities in the distribution of infrastructure services (known as market failure. Thus, to overcome both government and market failures, a collaborative approach is advocated which incorporates the strengths of both of these polarised positions.

  5. Sequentially delivered boost plans are superior to simultaneously delivered plans in head and neck cancer when the boost volume is located further away from the parotid glands

    International Nuclear Information System (INIS)

    Lamers-Kuijper, Emmy; Heemsbergen, Wilma; Mourik, Anke van; Rasch, Coen

    2011-01-01

    Purpose: To find parameters that predict which head and neck patients benefit from a sequentially delivered boost treatment plan compared to a simultaneously delivered plan, with the aim to spare the salivary glands. Methods and materials: We evaluated 50 recently treated head and neck cancer patients. Apart from the clinical plan with a sequentially (SEQ) given boost using an Intensity Modulated Radiotherapy Technique (IMRT), a simultaneous integrated boost (SIB) technique plan was constructed with the same beam set-up. The mean dose to the parotid glands was calculated and compared. The elective nodal areas were bilateral in all cases, with a boost on either one side or both sides of the neck. Results: When the parotid gland volume and the Planning Target Volume (PTV) for the boost overlap there is on average a lower dose to the parotid gland with a SIB technique (-1.2 Gy), which is, however, not significant (p = 0.08). For all parotid glands with no boost PTV overlap, there is a benefit from a SEQ technique compared to a SIB technique for the gland evaluated (on average a 2.5 Gy lower dose to the parotid gland, p < 0.001). When the distance between gland and PTV is 0-1 cm, this difference is on average 0.8 Gy, for 1-2 cm distance 2.9 Gy and for glands with a distance greater than 2 cm, 3.3 Gy. When the lymph nodes on the evaluated side are also included in the boost PTV, however, this relationship between the distance and the gain of a SEQ seems less clear. Conclusions: A sequentially delivered boost technique results in a better treatment plan for most cases, compared to a simultaneous integrated boost IMRT technique, if the boost PTV is more than 1 cm away from at least one parotid gland.

  6. Does cognitive flexibility predict treatment gains in Internet-delivered psychological treatment of social anxiety disorder, depression, or tinnitus?

    Directory of Open Access Journals (Sweden)

    Philip Lindner

    2016-04-01

    Full Text Available Little is known about the individual factors that predict outcomes in Internet-administered psychological treatments. We hypothesized that greater cognitive flexibility (i.e. the ability to simultaneously consider several concepts and tasks and switch effortlessly between them in response to changes in environmental contingencies would provide a better foundation for learning and employing the cognitive restructuring techniques taught and exercised in therapy, leading to greater treatment gains. Participants in three trials featuring Internet-administered psychological treatments for depression (n = 36, social anxiety disorder (n = 115 and tinnitus (n = 53 completed the 64-card Wisconsin Card Sorting Test (WCST prior to treatment. We found no significant associations between perseverative errors on the WCST and treatment gains in any group. We also found low accuracy in the classification of treatment responders. We conclude that lower cognitive flexibility, as captured by perseverative errors on the WCST, should not impede successful outcomes in Internet-delivered psychological treatments.

  7. A SEASONAL AND MONTHLY APPROACH FOR PREDICTING THE DELIVERED ENERGY QUANTITY IN A PHOTOVOLTAIC POWER PLANT IN ROMANIA

    Directory of Open Access Journals (Sweden)

    George Căruțașu

    2016-12-01

    Full Text Available In this paper, we present solutions that facilitate the forecasting of the delivered energy quantity in a photovoltaic power plant using the data measured from the solar panels' sensors: solar irradiation level, present module temperature, environmental temperature, atmospheric pressure and humidity. We have developed and analyzed a series of Artificial Neural Networks (ANNs based on the Levenberg-Marquardt algorithm, using seasonal and monthly approaches. We have also integrated our developed Artificial Neural Networks into callable functions that we have compiled using the Matlab Compiler SDK. Thus, our solution can be accessed by developers through multiple Application Programming Interfaces when programming software that predicts the photovoltaic renewable energy production considering the seasonal particularities of the Romanian weather patterns

  8. SIFT: A method to verify the IMRT fluence delivered during patient treatment using an electronic portal imaging device

    International Nuclear Information System (INIS)

    Vieira, Sandra C.; Dirkx, Maarten L.P.; Heijmen, Ben J.M.; Boer, Hans C.J. de

    2004-01-01

    Purpose: Radiotherapy patients are increasingly treated with intensity-modulated radiotherapy (IMRT) and high tumor doses. As part of our quality control program to ensure accurate dose delivery, a new method was investigated that enables the verification of the IMRT fluence delivered during patient treatment using an electronic portal imaging device (EPID), irrespective of changes in patient geometry. Methods and materials: Each IMRT treatment field is split into a static field and a modulated field, which are delivered in sequence. Images are acquired for both fields using an EPID. The portal dose image obtained for the static field is used to determine changes in patient geometry between the planning CT scan and the time of treatment delivery. With knowledge of these changes, the delivered IMRT fluence can be verified using the portal dose image of the modulated field. This method, called split IMRT field technique (SIFT), was validated first for several phantom geometries, followed by clinical implementation for a number of patients treated with IMRT. Results: The split IMRT field technique allows for an accurate verification of the delivered IMRT fluence (generally within 1% [standard deviation]), even if large interfraction changes in patient geometry occur. For interfraction radiological path length changes of 10 cm, deliberately introduced errors in the delivered fluence could still be detected to within 1% accuracy. Application of SIFT requires only a minor increase in treatment time relative to the standard IMRT delivery. Conclusions: A new technique to verify the delivered IMRT fluence from EPID images, which is independent of changes in the patient geometry, has been developed. SIFT has been clinically implemented for daily verification of IMRT treatment delivery

  9. Telephone delivered interventions for reducing morbidity and mortality in people with HIV infection.

    Science.gov (United States)

    Gentry, Sarah; van-Velthoven, Michelle H M M T; Tudor Car, Lorainne; Car, Josip

    2013-05-31

    This is one of three Cochrane reviews examining the role of the telephone in HIV/AIDS services. Telephone interventions, delivered either by landline or mobile phone, may be useful in the management of people living with HIV (PLHIV) in many situations. Telephone delivered interventions have the potential to reduce costs, save time and facilitate more support for PLHIV. To assess the effectiveness of voice landline and mobile telephone delivered interventions for reducing morbidity and mortality in people with HIV infection. We searched The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed Central, EMBASE, PsycINFO, ISI Web of Science, Cumulative Index to Nursing & Allied Health, World Health Organisation's The Global Health Library and Current Controlled Trials from 1980 to June 2011. We searched the following grey literature sources: Dissertation Abstracts International, Centre for Agriculture Bioscience International Direct Global Health database, The System for Information on Grey Literature Europe, The Healthcare Management Information Consortium database, Google Scholar, Conference on Retroviruses and Opportunistic Infections, International AIDS Society, AIDS Educational Global Information System and reference lists of articles. Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series studies comparing the effectiveness of telephone delivered interventions for reducing morbidity and mortality in persons with HIV infection versus in-person interventions or usual care, regardless of demographic characteristics and in all settings. Both mobile and landline telephone interventions were included, but mobile phone messaging interventions were excluded. Two reviewers independently searched, screened, assessed study quality and extracted data. Primary outcomes were change in behaviour, healthcare uptake or clinical outcomes. Secondary outcomes were appropriateness of the

  10. Internet delivered question and answer column for patients with schizophrenia.

    Science.gov (United States)

    Maijala, Riikka; Anttila, Minna; Koivunen, Marita; Pitkänen, Anneli; Kuosmanen, Lauri; Välimäki, Maritta

    2015-01-01

    The purpose of this study was to describe the use of an Internet delivered question and answer column among patients with schizophrenia. The column was developed for research purposes. The study sample consisted of patients (N = 100) admitted to acute inpatient psychiatric care in two hospital districts. Descriptive data were collected from the column to which a nurse replied within 3 days and analysed using qualitative content analysis. The column had four to five questions weekly. The most common age of users was 18-24 years, and the gender distribution was almost equal. Column use was heaviest among students (44%) and least among unemployed people (19%). Out of 85 questions or comments sent to the column, 25 (29%) were related to program training and the remaining 60 (71%) were related to medication (31%), illness and tests (25%), other questions or comments (9%), daily life and coping with it (4%), and places to receive treatment (2%). An Internet delivered question and answer column can be included in the care of patients with schizophrenia. However, it requires a new type of basic and additional education in the field of mental health care in order for nurses to be able to provide nursing via the Internet forum.

  11. Qualitative assessment of adolescents' views about improving exposure to internet-delivered interventions

    NARCIS (Netherlands)

    Crutzen, R.; de Nooijer, J.; Brouwer, W.; Oenema, A.; Brug, J.

    2008-01-01

    Purpose - The purpose of this paper is to gain first insight into factors which might be associated with exposure to internet-delivered interventions. Design/methodology/approach - Semi-structured focus group interviews were conducted with five groups of Dutch adolescents (n=54), aged 12-17 years.

  12. The Perceived Importance of Youth Educator's Confidence in Delivering Leadership Development Programming

    Science.gov (United States)

    Brumbaugh, Laura; Cater, Melissa

    2016-01-01

    A successful component of programs designed to deliver youth leadership develop programs are youth educators who understand the importance of utilizing research-based information and seeking professional development opportunities. The purpose of this study was to determine youth educator's perceived confidence in leading youth leadership…

  13. Therapist Factors in Internet-Delivered Cognitive Behavioural Therapy for Major Depressive Disorder

    NARCIS (Netherlands)

    Almlov, J.; Carlbring, P.; Berger, T.; Cuijpers, P.; Andersson, G.

    2009-01-01

    Internet-delivered cognitive behavioural therapy (CBT) can be an effective method for treating major depression, but it often works best when therapist support is provided in the form of e-mail support or telephone calls. The authors investigated whether there were any intraclass correlations within

  14. Who Delivers without Water? A Multi Country Analysis of Water and Sanitation in the Childbirth Environment.

    Directory of Open Access Journals (Sweden)

    Giorgia Gon

    Full Text Available Hygiene during childbirth is essential to the health of mothers and newborns, irrespective of where birth takes place. This paper investigates the status of water and sanitation in both the home and facility childbirth environments, and for whom and where this is a more significant problem.We used three datasets: a global dataset, with information on the home environment from 58 countries, and two datasets for each of four countries in Eastern Africa: a healthcare facility dataset, and a dataset that incorporated information on facilities and the home environment to create a comprehensive description of birth environments in those countries. We constructed indices of improved water, and improved water and sanitation combined (WATSAN, for the home and healthcare facilities. The Joint Monitoring Program was used to construct indices for household; we tailored them to the facility context-household and facility indices include different components. We described what proportion of women delivered in an environment with improved WATSAN. For those women who delivered at home, we calculated what proportion had improved WATSAN by socio-economic status, education and rural-urban status.Among women delivering at home (58 countries, coverage of improved WATSAN by region varied from 9% to 53%. Fewer than 15% of women who delivered at home in Sub-Saharan Africa, had access to water and sanitation infrastructure (range 0.1% to 37%. This was worse among the poorest, the less educated and those living in rural areas. In Eastern Africa, where we looked at both the home and facility childbirth environment, a third of women delivered in an environment with improved water in Uganda and Rwanda; whereas, 18% of women in Kenya and 7% in Tanzania delivered with improved water and sanitation. Across the four countries, less than half of the facility deliveries had improved water, or improved water and sanitation in the childbirth environment.Access to water and

  15. Multiplex CARS imaging with spectral notch shaped laser pulses delivered by optical fibers.

    Science.gov (United States)

    Oh, Seung Ryeol; Park, Joo Hyun; Kim, Kyung-Soo; Lee, Jae Yong; Kim, Soohyun

    2017-12-11

    We present an experimental demonstration of single-pulse coherent anti-Stokes Raman spectroscopy (CARS) using a spectrally shaped broadband laser that is delivered by an optical fiber to a sample at its distal end. The optical fiber consists of a fiber Bragg grating component to serve as a narrowband notch filter and a combined large-mode-area fiber to transmit such shaped ultrashort laser pulses without spectral distortion in a long distance. Experimentally, our implementation showed a capability to measure CARS spectra of various samples with molecular vibrations in the fingerprint region. Furthermore, CARS imaging of poly(methyl methacrylate) bead samples was carried out successfully under epi-CARS geometry in which backward-scattered CARS signals were collected into a multimode optical fiber. A compatibility of single-pulse CARS scheme with fiber optics, verified in this study, implies a potential for future realization of compact all-fiber CARS spectroscopic imaging systems.

  16. Moral individualism and elective death.

    Science.gov (United States)

    Prado, C G

    2013-01-01

    Moral individualism (Brooks, 2011; Smith, 2011) is a contemporary interpretation of morality as entirely a matter of personal choice. It is a popular rather than theory-based interpretation and has a number of social generative sources related to present-day preoccupation with individuality and personal distinctiveness. A key generative source is popularization of postmodernism, which prioritizes self-reinvention and provides moral individualism with the appearance of intellectual legitimacy. Moral individualism is a deeply flawed misconception of morality because it abolishes moral communality. My concern in this paper is that in doing so, it seriously jeopardizes productive discussion of the moral permissibility of elective death or choosing to die in despairingly and dire circumstances. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol.

    Science.gov (United States)

    Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

    2016-05-18

    The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. This systematic review addresses the following question: in underserviced populations and low-resource settings (P), does first aid or emergency care training or education for laypeople (I) confer any individual or community health benefit for emergency health conditions (O), in comparison with no training or other forms of education (C)? We restrict this review to studies reporting quantitatively measurable outcomes, and search 12 electronic bibliographic databases and grey literature sources. A team of expert content and methodology reviewers will conduct title and abstract screening and full-text review, using a custom-built online platform. Two investigators will independently extract methodological variables and outcomes related to patient-level morbidity and mortality and community-level effects on resilience or emergency care capacity. Two investigators will independently assess external validity, selection bias, performance bias, measurement bias, attrition bias and confounding. We will summarise the findings using a narrative approach to highlight similarities and differences between the gathered studies. Formal ethical approval is not required. The results will be disseminated through a peer-reviewed publication and knowledge translation strategy. CRD42014009685. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. Fiber-delivered mid-infrared (6-7) laser ablation of retinal tissue under perfluorodecalin

    Science.gov (United States)

    Mackanos, Mark A.; Joos, Karen M.; Jansen, E. Duco

    2003-07-01

    The Er:YAG laser (l=2.94mm) is an effective tool in vitreo-retinal surgery. Pulsed mid-infrared (l=6.45 mm) radiation from the Free Electron Laser has been touted as a potentially superior cutting tool. To date, use of this laser has been limited to applications in an air environment. The goal of this study was: 1) determine feasibility of fiberoptic delivery of 6.45mm using silverhalide fibers (d=700mm); 2) use infrared transparent vitreous substitute (perfluorodecalin) to allow non-contact ablation of the retina at 6.45mm. Fiber damage threshold=7.8J/cm2 (0.54GW/cm2) while transmission loss=0.54dB/m, allowing supra-ablative radiant exposures to the target. FTIR measurements of perfluorodecalin at 6.45mm yielded ma=3mm-1. Pump-probe imaging of ablation of a tissue-phantom through perfluorodecalin showed feasibility of non-contact ablation at l=6.45mm. Ablation of the retinal membranes of enucleated pig eyes was carried out under perfluorodecalin (5 Hz, 1.3 J/cm2). Each eye was cut along its equator to expose the retina. Vitreous was replaced by perfluorodecalin and laser radiation was delivered to the retina via the silverhalide fiber. The eye was rotated (at 2 rpm) using a stepper motor (0.9o/step) to create an ablation circle around the central axis of the retina (50% spot-to-spot overlap). Histological analysis of ablation yield and collateral damage will be presented. We have shown that using l=6.45mm delivered via silver halide fibers through perfluorodecalin allowed non-contact laser ablation. Remote structures are shielded, as the radiant exposure falls below the ablation threshold owing non-negligible absorption of perfluorodecalin at 6.45mm. This may optimize efficacy and safety of laser-based vitreoretinal surgery.

  19. Sex preferences among mothers delivering at Patan Hospital.

    Science.gov (United States)

    Chhetri, U D; Ansari, I; Bandary, S; Adhikari, N

    2011-01-01

    High sex ratios at birth (SRB) are seen in China, Taiwan, South Korea, parts of India and Vietnam. The imbalance is the result of son preference, accentuated by declining fertility. Prenatal sex determination and female feticides are common in many countries. It is reflected in sex ratio To determine reasons for the preferences for different sex; to find out whether there is altered sex ratio at birth and to find out whether female feticide are common among women who had abortion. It is a prospective study. Women who had previous history of abortion and had delivered at Patan Hospital in the year 2066 were interviewed as per questionnaires. Among 560 women with total live births of 965, (462 male and 503 female) during their life time the overall sex ratio was 92 male per 100 female birth; total abortions were 663. Preferences for male were 10%, female 15.4% and either was for 74%. The reason for male preference was to continue family lineage, to bring honor, old age security, and performing funeral rites while the reasons for daughter preferences were that they understand mothers pain, help in household work. The sex ratio of the babies born during the study period was 113 male per 100 female births. The Sex ratio at birth from 1st to 6th deliveries was 61, 79, 101, 210, 286 and 1100 male per 100 female birth respectively. Prenatal sex selection was 8% (by USG) but none had sex selected abortion. Sex ratio of those delivered during the study period was skewed (136 boys per 100 girls) towards male. There was shift in SRB in 4th and subsequent pregnancies in favor of boys. As the male sex ratio increased the number of induced abortion decreased in subsequent pregnancies.

  20. Alternative Models to Deliver Developmental Math: Issues of Use and Student Access

    Science.gov (United States)

    Kosiewicz, Holly; Ngo, Federick; Fong, Kristen

    2016-01-01

    Objective: Changing how community colleges deliver developmental education has become a key policy lever to increase student achievement. Alternative development education models reduce the amount of time a student spends in remediation, provide students with supplemental instruction and support, and contextualize content to align with student…

  1. Dosimetric comparison between fixed and individualized activity in Graves' disease treatment with 131I

    International Nuclear Information System (INIS)

    Melgar Perez, J.; Orellana Salas, A.; Santaella Guardiola, Y.; Arrocha Acevedo, J. F.

    2013-01-01

    A patient-especific method has been used to calculate the therapeutic 1 '3 1 I activity to administer to patients with Graves disease in order to obtain the optimal thyroid dose. The aim of this study was to analyze the dose variation in contrast to the fixed a ctivity regimen. In 30 patients, biokinetic and morfological parameters were estimated from planar scintigraphic images obtained at 4, 24 and 96 hours after injection of 123 I and 131 I activities were calculated to deliver 120 Gy to the thyroid. Comparative dose calculations were carried out assuming that the individual patients had been treated according to 370 MBq activity administration. Activity (or dose) was reduced by an average factor of 2.4 and up to a factor 4.9 for an individual patient. The implemen ted method seeks a balance among the accuracy of the calculations, resource consumption and patient comfort. (Author)

  2. A Summary of the NASA Design Environment for Novel Vertical Lift Vehicles (DELIVER) Project

    Science.gov (United States)

    Theodore, Colin R.

    2018-01-01

    The number of new markets and use cases being developed for vertical take-off and landing vehicles continues to explode, including the highly publicized urban air taxi and package deliver applications. There is an equally exploding variety of novel vehicle configurations and sizes that are being proposed to fill these new market applications. The challenge for vehicle designers is that there is currently no easy and consistent way to go from a compelling mission or use case to a vehicle that is best configured and sized for the particular mission. This is because the availability of accurate and validated conceptual design tools for these novel types and sizes of vehicles have not kept pace with the new markets and vehicles themselves. The Design Environment for Novel Vertical Lift Vehicles (DELIVER) project was formulated to address this vehicle design challenge by demonstrating the use of current conceptual design tools, that have been used for decades to design and size conventional rotorcraft, applied to these novel vehicle types, configurations and sizes. In addition to demonstrating the applicability of current design and sizing tools to novel vehicle configurations and sizes, DELIVER also demonstrated the addition of key transformational technologies of noise, autonomy, and hybrid-electric and all-electric propulsion into the vehicle conceptual design process. Noise is key for community acceptance, autonomy and the need to operate autonomously are key for efficient, reliable and safe operations, and electrification of the propulsion system is a key enabler for these new vehicle types and sizes. This paper provides a summary of the DELIVER project and shows the applicability of current conceptual design and sizing tools novel vehicle configurations and sizes that are being proposed for urban air taxi and package delivery type applications.

  3. Individual differences in the propensity to approach signals vs goals promote different adaptations in the dopamine system of rats.

    Science.gov (United States)

    Flagel, Shelly B; Watson, Stanley J; Robinson, Terry E; Akil, Huda

    2007-04-01

    The way an individual responds to cues associated with rewards may be a key determinant of vulnerability to compulsive behavioral disorders. We studied individual differences in Pavlovian conditioned approach behavior and examined the expression of neurobiological markers associated with the dopaminergic system, the same neural system implicated in incentive motivational processes. Pavlovian autoshaping procedures consisted of the brief presentation of an illuminated retractable lever (conditioned stimulus) followed by the response-independent delivery of a food pellet (unconditioned stimulus), which lead to a Pavlovian conditioned response. In situ hybridization was performed on brains obtained either following the first or last (fifth) day of training. Two phenotypes emerged. Sign-trackers (ST) exhibited behavior that seemed to be largely controlled by the cue that signaled impending reward delivery; whereas goal-trackers (GT) preferentially approached the location where the reward was delivered. Following a single training session, ST showed greater expression of dopamine D1 receptor mRNA relative to GT. After 5 days of training, GT exhibited greater expression levels of tyrosine hydroxylase, dopamine transporter, and dopamine D2 receptor mRNA relative to ST. These findings suggest that the development of approach behavior towards signals vs goal leads to distinct adaptations in the dopamine system. The sign-tracker vs goal-tracker phenotype may prove to be a valuable animal model to investigate individual differences in the way incentive salience is attributed to environmental stimuli, which may contribute to the development of addiction and other compulsive behavioral disorders.

  4. Delivering advanced therapies: the big pharma approach.

    Science.gov (United States)

    Tarnowski, J; Krishna, D; Jespers, L; Ketkar, A; Haddock, R; Imrie, J; Kili, S

    2017-09-01

    After two decades of focused development and some recent clinical successes, cell and gene therapy (CGT) is emerging as a promising approach to personalized medicines. Genetically engineered cells as a medical modality are poised to stand alongside or in combination with small molecule and biopharmaceutical approaches to bring new therapies to patients globally. Big pharma can have a vital role in industrializing CGT by focusing on diseases with high unmet medical need and compelling genetic evidence. Pharma should invest in manufacturing and supply chain solutions that deliver reproducible, high-quality therapies at a commercially viable cost. Owing to the fast pace of innovation in this field proactive engagement with regulators is critical. It is also vital to understand the needs of patients all along the patient care pathway and to establish product pricing that is accepted by prescribers, payers and patients.

  5. Impact of student pharmacist-delivered asthma education on child and caregiver knowledge.

    Science.gov (United States)

    Elliott, Jennifer Padden; Marcotullio, Nicole; Skoner, David P; Lunney, Phil; Gentile, Deborah A

    2014-12-15

    To evaluate the effectiveness of asthma education delivered by student pharmacists and to assess the impact of child and caregiver baseline asthma knowledge on asthma control in children. Student pharmacists developed and implemented asthma self-management education interventions for children and their caregivers and performed asthma screenings for children at a series of asthma camps. Eighty-seven children, ages 5-17 years, and their caregivers were enrolled in this study. A previously validated asthma questionnaire was modified to assess asthma knowledge among children and adults. Asthma knowledge increased significantly in children following participation in the education intervention (pasthma. A significant association was observed between caregiver baseline asthma knowledge and better asthma control in their children (p=0.019). The results of this study demonstrate that student pharmacist-delivered asthma education can positively impact asthma knowledge in children, and that caregivers' knowledge of asthma is strongly correlated with better asthma control in their children.

  6. Infectious polymorphic toxins delivered by outer membrane exchange discriminate kin in myxobacteria.

    Science.gov (United States)

    Vassallo, Christopher N; Cao, Pengbo; Conklin, Austin; Finkelstein, Hayley; Hayes, Christopher S; Wall, Daniel

    2017-08-18

    Myxobacteria are known for complex social behaviors including outer membrane exchange (OME), in which cells exchange large amounts of outer membrane lipids and proteins upon contact. The TraA cell surface receptor selects OME partners based on a variable domain. However, traA polymorphism alone is not sufficient to precisely discriminate kin. Here, we report a novel family of OME-delivered toxins that promote kin discrimination of OME partners. These SitA lipoprotein toxins are polymorphic and widespread in myxobacteria. Each sitA is associated with a cognate sitI immunity gene, and in some cases a sitB accessory gene. Remarkably, we show that SitA is transferred serially between target cells, allowing the toxins to move cell-to-cell like an infectious agent. Consequently, SitA toxins define strong identity barriers between strains and likely contribute to population structure, maintenance of cooperation, and strain diversification. Moreover, these results highlight the diversity of systems evolved to deliver toxins between bacteria.

  7. Differences in reach and attrition between Web-based and print-delivered tailored interventions among adults over 50 years of age: clustered randomized trial.

    Science.gov (United States)

    Peels, Denise Astrid; Bolman, Catherine; Golsteijn, Rianne Henrica Johanna; De Vries, Hein; Mudde, Aart Nicolaas; van Stralen, Maartje Marieke; Lechner, Lilian

    2012-12-17

    The Internet has the potential to provide large populations with individual health promotion advice at a relatively low cost. Despite the high rates of Internet access, actual reach by Web-based interventions is often disappointingly low, and differences in use between demographic subgroups are present. Furthermore, Web-based interventions often have to deal with high rates of attrition. This study aims to assess user characteristics related to participation and attrition when comparing Web-based and print-delivered tailored interventions containing similar content and thereby to provide recommendations in choosing the appropriate delivery mode for a particular target audience. We studied the distribution of a Web-based and a print-delivered version of the Active Plus intervention in a clustered randomized controlled trial (RCT). Participants were recruited via direct mailing within the participating Municipal Health Council regions and randomized to the printed or Web-based intervention by their region. Based on the answers given in a prior assessment, participants received tailored advice on 3 occasions: (1) within 2 weeks after the baseline, (2) 2 months after the baseline, and (3) within 4 months after the baseline (based on a second assessment at 3 months). The baseline (printed or Web-based) results were analyzed using ANOVA and chi-square tests to establish the differences in user characteristics between both intervention groups. We used logistic regression analyses to study the interaction between the user characteristics and the delivery mode in the prediction of dropout rate within the intervention period. The printed intervention resulted in a higher participation rate (19%) than the Web-based intervention (12%). Participants of the Web-based intervention were significantly younger (PWeb-based intervention group (53%) compared to the print-delivered intervention (39%, PWeb-based and the printed intervention was not explained by user characteristics. The

  8. Delivering new physics at impressive speed

    CERN Multimedia

    2010-01-01

    The speed with which the heavy ion run at the LHC is delivering new physics is impressive not only for the insights it is bringing to the early Universe, but also for the clear demonstration it gives of the value of competition and complementarity between the experiments.   ALICE was the first off the mark to publish papers from the ion run, as you’d expect from the LHC’s dedicated ion experiment, but results emerging from ATLAS and CMS are bringing new understanding in their own right. Each collaboration’s result plays to the strengths of its detector, and it is by taking all the results together that our knowledge advances. The creation, observation and understanding of the hot dense matter that would have existed in the early Universe, normally known as Quark Gluon Plasma (QGP), is complex science and one of the ion programme’s key goals. Many signals for QGP exist, and like pieces of a puzzle, we must assemble all of them to get the full picture. At th...

  9. Dual-Functional Nanoparticles Targeting CXCR4 and Delivering Antiangiogenic siRNA Ameliorate Liver Fibrosis.

    Science.gov (United States)

    Liu, Chun-Hung; Chan, Kun-Ming; Chiang, Tsaiyu; Liu, Jia-Yu; Chern, Guann-Gen; Hsu, Fu-Fei; Wu, Yu-Hsuan; Liu, Ya-Chi; Chen, Yunching

    2016-07-05

    The progression of liver fibrosis, an intrinsic response to chronic liver injury, is associated with hepatic hypoxia, angiogenesis, abnormal inflammation, and significant matrix deposition, leading to the development of cirrhosis and hepatocellular carcinoma (HCC). Due to the complex pathogenesis of liver fibrosis, antifibrotic drug development has faced the challenge of efficiently and specifically targeting multiple pathogenic mechanisms. Therefore, CXCR4-targeted nanoparticles (NPs) were formulated to deliver siRNAs against vascular endothelial growth factor (VEGF) into fibrotic livers to block angiogenesis during the progression of liver fibrosis. AMD3100, a CXCR4 antagonist that was incorporated into the NPs, served dual functions: it acted as a targeting moiety and suppressed the progression of fibrosis by inhibiting the proliferation and activation of hepatic stellate cells (HSCs). We demonstrated that CXCR4-targeted NPs could deliver VEGF siRNAs to fibrotic livers, decrease VEGF expression, suppress angiogenesis and normalize the distorted vessels in the fibrotic livers in the carbon tetrachloride (CCl4) induced mouse model. Moreover, blocking SDF-1α/CXCR4 by CXCR4-targeted NPs in combination with VEGF siRNA significantly prevented the progression of liver fibrosis in CCl4-treated mice. In conclusion, the multifunctional CXCR4-targeted NPs delivering VEGF siRNAs provide an effective antifibrotic therapeutic strategy.

  10. Enhancing Foreign Language Learning through Listening Strategies Delivered in L1: An Experimental Study

    Directory of Open Access Journals (Sweden)

    Hitendra Pillay

    2013-01-01

    Full Text Available Listening used in language teaching refers to a complex process that allows us to understand spoken language. The current study, conducted in Iran with an experimental design, investigated the effectiveness of teaching listening strategies delivered in L1 (Persian and its effect on listening comprehension in L2. Five listening strategies: Guessing, making inferences, identifying topics, repetition, and note-taking were taught over 14 weeks during a semester. Sixty lower intermediate female participants came from two EFL classrooms in an English language institute. The experimental class (n = 30 who listened to their classroom activities performed better (t value = 10.083 than the control class using a methodology that led learners through five listening strategies in Persian. The same teacher taught the students in the control class (n = 30, who listened to the same classroom listening activities without any of the above listening strategies. A pre and post listening test made by a group of experts in the language institute assessed the effect of teaching listening strategies delivered in L1. Results gathered on the post intervention listening test revealed that listening strategies delivered in L1 led to a statistically significant improvement in their discrete listening scores compared with the control group.

  11. Bringing loyalty to e-Health: theory validation using three internet-delivered interventions.

    Science.gov (United States)

    Crutzen, Rik; Cyr, Dianne; de Vries, Nanne K

    2011-09-24

    Internet-delivered interventions can effectively change health risk behaviors, but the actual use of these interventions by the target group once they access the website is often very low (high attrition, low adherence). Therefore, it is relevant and necessary to focus on factors related to use of an intervention once people arrive at the intervention website. We focused on user perceptions resulting in e-loyalty (ie, intention to visit an intervention again and to recommend it to others). A background theory for e-loyalty, however, is still lacking for Internet-delivered interventions. The objective of our study was to propose and validate a conceptual model regarding user perceptions and e-loyalty within the field of eHealth. We presented at random 3 primary prevention interventions aimed at the general public and, subsequently, participants completed validated measures regarding user perceptions and e-loyalty. Time on each intervention website was assessed by means of server registrations. Of the 592 people who were invited to participate, 397 initiated the study (response rate: 67%) and 351 (48% female, mean age 43 years, varying in educational level) finished the study (retention rate: 88%). Internal consistency of all measures was high (Cronbach alpha > .87). The findings demonstrate that the user perceptions regarding effectiveness (beta(range) .21-.41) and enjoyment (beta(range) .14-.24) both had a positive effect on e-loyalty, which was mediated by active trust (beta(range) .27-.60). User perceptions and e-loyalty had low correlations with time on the website (r(range) .04-.18). The consistent pattern of findings speaks in favor of their robustness and contributes to theory validation regarding e-loyalty. The importance of a theory-driven solution to a practice-based problem (ie, low actual use) needs to be stressed in view of the importance of the Internet in terms of intervention development. Longitudinal studies are needed to investigate whether people

  12. THE SELLER'S OBLIGATION TO DELIVER THE GOODS ACCORDING TO CISG

    Directory of Open Access Journals (Sweden)

    Dan VELICU

    2017-05-01

    Full Text Available This article aims to analyze the seller's obligations under the Convention on International Sale of Goods (CISG and in particular the obligation to deliver the goods showing the main issues that arise in an international sale. We also wish to point the major innovations or improvements brought by the CISG in comparison to the European civil codes regulation and to conclude if the CSIG managed to revolutionize the tradition view on this issue.

  13. DOING OTHER PEOPLE’S TRAINING PRESENTATIONS - a guide for teachers in implementing a scheme

    OpenAIRE

    Neal, Ian

    2008-01-01

    Often, experienced teachers in schools and colleges are asked to present training packs written by others. The assumption is that since they are experienced teachers, making training presentations to their colleagues will be easy. They often find that it is not. Usually, the material has been designed to be delivered using a model where one person within a school or college will make themselves responsible for familiarising themselves with Trainer's Notes, the Teachers' Guide and the rest of ...

  14. Controlling torque and cutting costs: steerable drill bits deliver in Latin America

    Energy Technology Data Exchange (ETDEWEB)

    Barton, Steve; Garcia, Alexis; Amorim, Dalmo [ReedHycalog, Stonehouse (United Kingdom); Iramina, Wilson [University of Sao Paulo (USP), SP (Brazil); Herrera, Gabriel

    2008-07-01

    Tool face Control is widely regarded as one of the greatest directional drilling challenges with a Fixed Cutter (FC) drill bit on a Steerable Motor assembly. Tool face offset is proportional to the torque generated by the bit, and by nature, FC bits are capable of generating high levels of torque. If large changes in downhole torque are produced while drilling, this will cause rotation of the drill string, and loss of tool face orientation. This results in inefficient drilling and increases risk of bit and downhole tool damage. This paper examines the effect of various FC drill bit components to determine the key design requirements to deliver a smooth torque response and an improved directional performance. Included is a review of the results from comprehensive laboratory testing to determine the effectiveness of a number of different configurations of removable Torque Controlling Components (TCC). These, in combination with specific cutting structure layouts, combine to provide predictable torque response while optimized for high rates of penetration. In addition, unique gauge geometry is disclosed that was engineered to reduce drag and deliver improved borehole quality. This gauge design produces less torque when sliding and beneficial gauge pad interaction with the borehole when in rotating mode. Field performance studies from within Latin America clearly demonstrate that matching TCC, an optimized cutting structure, and gauge geometry to a steerable assembly delivers smooth torque response and improved directional control. Benefits with regard to improved stability are also discussed. Successful application has resulted in significant time and cost savings for the operator, demonstrating that Stability and Steerability improvements can be achieved with an increase in penetration rate. (author)

  15. Effects of a Home-Based DVD-Delivered Physical Activity Program on Self-Esteem in Older Adults: Results From a Randomized Controlled Trial.

    Science.gov (United States)

    Awick, Elizabeth Ann; Ehlers, Diane; Fanning, Jason; Phillips, Siobhan M; Wójcicki, Thomas; Mackenzie, Michael J; Motl, Robert; McAuley, Edward

    2017-01-01

    Although center-based supervised physical activity interventions have proved to be successful in attenuating health declines in older adults, such methods can be costly and have limited reach. In the present study, we examined the effects of a DVD-delivered exercise intervention on self-esteem and its subdomains and the extent to which these effects were maintained. In addition, we examined whether psychological, demographic, and biological factors acted as determinants of self-esteem. Low-active, older adults (n = 307; mean [standard deviation] age =71.0 [5.1] years) were randomly assigned to a 6-month, home-based exercise program consisting of a DVD-delivered exercise intervention focused on increasing flexibility, toning, and balance (FlexToBa) or an attentional control DVD condition focused on healthy aging. Physical self-worth and three subdomains of self-esteem, global self-esteem, and self-efficacy were assessed at baseline, 6 months, and 12 months. There was a differential effect of time for the two groups for physical self-worth (F interaction(2,530.10) = 4.17, p = .016) and perception of physical condition (F interaction(1,630.77) = 8.31, p = .004). Self-efficacy, sex, body mass index, and age were significant predictors of changes in physical self-worth and perception of physical condition. Our findings suggest that a DVD-delivered exercise intervention is efficacious for improving and maintaining subdomain and domain levels of self-esteem in older adults. In addition, self-efficacy was the strongest predictor of changes in physical self-worth and perceptions of physical condition. This innovative method of delivering an exercise training program via DVD is practical and effective and has the potential for broad reach and dissemination. Clinicaltrials.govidentifier:NCT01030419.

  16. Effects of a Home-Based DVD-Delivered Physical Activity Program on Self-Esteem in Older Adults: Results from A Randomized Controlled Trial

    Science.gov (United States)

    Awick, Elizabeth A; Ehlers, Diane; Fanning, Jason; Phillips, Siobhan M; Wójcicki, Thomas; Mackenzie, Michael J; Motl, Robert; McAuley, Edward

    2016-01-01

    Objective Although center-based supervised physical activity interventions have proven to be successful in attenuating health declines in older adults, such methods can be costly and have limited reach. In the present study, we examined the effects of a DVD-delivered exercise intervention on self-esteem and its subdomains and the extent to which these effects were maintained. In addition, we examined whether psychological, demographic, and biological factors acted as determinants of self-esteem. Methods Low active, older adults (N=307 ; Mean age =71.0 [SD=5.1] years) were randomly assigned to a six-month, home-based exercise program consisting of a DVD-delivered exercise intervention focused on increasing flexibility, toning, and balance (FlexToBa) or an attentional control DVD condition focused on healthy aging. Physical self-worth, three subdomains of self-esteem, global self-esteem, and self-efficacy were assessed at baseline, six months, and 12 months. Results There was a differential effect of time for the two groups for physical self-worth [F interaction (2, 530.10) = 4.17, p = 0.016] and perception of physical condition [F(2, 630.77) = 8.31, p = 0.004]. Self-efficacy, sex, body mass index (BMI), and age were significant predictors of changes in physical self-worth and perception of physical condition. Conclusion Our findings suggest a DVD-delivered exercise intervention is efficacious for improving and maintaining subdomain and domain levels of self-esteem in older adults. Additionally, self-efficacy was the strongest predictor of changes in physical self-worth and perceptions of physical condition. This innovative method of delivering an exercise training program via DVD is practical, effective, and has the potential for broad reach and dissemination. Trial Registration clinicaltrials.gov identifier NCT01030419 PMID:27359182

  17. Development of a video-delivered relaxation treatment of late-life anxiety for veterans.

    Science.gov (United States)

    Gould, Christine E; Zapata, Aimee Marie L; Bruce, Janine; Bereknyei Merrell, Sylvia; Wetherell, Julie Loebach; O'Hara, Ruth; Kuhn, Eric; Goldstein, Mary K; Beaudreau, Sherry A

    2017-10-01

    Behavioral treatments reduce anxiety, yet many older adults may not have access to these efficacious treatments. To address this need, we developed and evaluated the feasibility and acceptability of a video-delivered anxiety treatment for older Veterans. This treatment program, BREATHE (Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment), combines psychoeducation, diaphragmatic breathing, and progressive muscle relaxation training with engagement in activities. A mixed methods concurrent study design was used to examine the clarity of the treatment videos. We conducted semi-structured interviews with 20 Veterans (M age = 69.5, SD = 7.3 years; 55% White, Non-Hispanic) and collected ratings of video clarity. Quantitative ratings revealed that 100% of participants generally or definitely could follow breathing and relaxation video instructions. Qualitative findings, however, demonstrated more variability in the extent to which each video segment was clear. Participants identified both immediate benefits and motivation challenges associated with a video-delivered treatment. Participants suggested that some patients may need encouragement, whereas others need face-to-face therapy. Quantitative ratings of video clarity and qualitative findings highlight the feasibility of a video-delivered treatment for older Veterans with anxiety. Our findings demonstrate the importance of ensuring patients can follow instructions provided in self-directed treatments and the role that an iterative testing process has in addressing these issues. Next steps include testing the treatment videos with older Veterans with anxiety disorders.

  18. How natural capital delivers ecosystem services: A typology derived from a systematic review

    CSIR Research Space (South Africa)

    Smith, Andrew C

    2017-08-01

    Full Text Available There is no unified evidence base to help decision-makers understand how the multiple components of natural capital interact to deliver ecosystem services. We systematically reviewed 780 papers, recording how natural capital attributes (29 biotic...

  19. The Two Rivers of Public Education: Why Our Representative Democracy Relies on Both Individualism and Community to Be Delivered through Its Public Schools

    Science.gov (United States)

    Draayer, Donald

    2011-01-01

    America is blessed with two river systems that feed and nourish the country by their periodic flooding. One mighty river is "individualism" (the entrepreneurial drive to advance and make a difference). The other river is "community" (wherein communal interests strengthen the whole community over the parts). Monitoring and regulating these two…

  20. Body Dissatisfaction in Individuals with Obesity Compared to Normal-Weight Individuals: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Natascha-Alexandra Weinberger

    2016-12-01

    Full Text Available Background: Body dissatisfaction has been identified as a psychological correlate of obesity that is related to disordered eating, poor self-esteem, and depression. However, not all individuals with obesity are equally vulnerable to these correlates, and ‘normative discontent' is present in individuals with normal weight, too. In this light, the complex relationship of body image and individual weight status seems like a worthwhile direction of research inquiry. As such, this review aims to systematically explore the degree of body dissatisfaction in individuals with obesity compared to normal-weight individuals. Methods: A systematic literature search was conducted. All quantitative studies of adult samples reporting results regarding differences in body dissatisfaction between individuals with normal weight and obesity were included. Results: 17 articles were found. Across studies, individuals with obesity reported higher body dissatisfaction than normal-weight individuals (questionnaires: d = 0.89, 95% CI = 0.63-1.16, p Conclusion: The findings underline the severity of body dissatisfaction among individuals with obesity and especially among women. Future research recommendations are discussed.

  1. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: A randomized trial.

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; Sorbi, M.J.; van Straten, A.

    2013-01-01

    Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants

  2. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: A randomized trial

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; Sorbi, M.J.; van Straten, A.

    2013-01-01

    Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants

  3. Life cycle assessment perspectives on delivering an infant in the US

    Energy Technology Data Exchange (ETDEWEB)

    Campion, Nicole [University of Pittsburgh, 949 Benedum Hall, Pittsburgh, PA 15261 (United States); Thiel, Cassandra L., E-mail: clt31@pitt.edu [University of Pittsburgh, 949 Benedum Hall, Pittsburgh, PA 15261 (United States); DeBlois, Justin [University of Pittsburgh, 949 Benedum Hall, Pittsburgh, PA 15261 (United States); Woods, Noe C. [Magee-Womens Hospital of UPMC, 300 Halket Street, Pittsburgh, PA 15235 (United States); Landis, Amy E. [Arizona State University, P.O. Box 875306, Tempe, AZ 85287-5306 (United States); Bilec, Melissa M. [University of Pittsburgh, 949 Benedum Hall, Pittsburgh, PA 15261 (United States)

    2012-05-15

    This study introduces life cycle assessment as a tool to analyze one aspect of sustainability in healthcare: the birth of a baby. The process life cycle assessment case study presented evaluates two common procedures in a hospital, a cesarean section and a vaginal birth. This case study was conducted at Magee-Womens Hospital of the University of Pittsburgh Medical Center, which delivers over 10,000 infants per year. The results show that heating, ventilation, and air conditioning (HVAC), waste disposal, and the production of the disposable custom packs comprise a large percentage of the environmental impacts. Applying the life cycle assessment tool to medical procedures allows hospital decision makers to target and guide efforts to reduce the environmental impacts of healthcare procedures. - Highlights: Black-Right-Pointing-Pointer Life cycle assessment helps identify the environmental impacts of medical procedures. Black-Right-Pointing-Pointer Disposable custom packs represent a large portion of environmental impacts of births. Black-Right-Pointing-Pointer Electricity loading contributes to global warming potential and respiratory effects. Black-Right-Pointing-Pointer Impact improvements should focus on heating, ventilation, and air conditioning and disposable custom packs.

  4. The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India

    Directory of Open Access Journals (Sweden)

    Balaji Madhumitha

    2012-02-01

    Full Text Available Abstract Background Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community based intervention in three sites in India. This paper describes how the intervention was developed systematically, following the MRC framework for the development of complex interventions. Methods We reviewed the lierature on the burden of schizophrenia and the treatment gap in low and middle income countries and the evidence for community based treatments, and identified intervention components. We then evaluated the acceptability and feasibility of this package of care through formative case studies with individuals with schizophrenia and their primary caregivers and piloted its delivery with 30 families. Results Based on the reviews, our intervention comprised five components (psycho-education; adherence management; rehabilitation; referral to community agencies; and health promotion to be delivered by trained lay health workers supervised by specialists. The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and

  5. The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India.

    Science.gov (United States)

    Balaji, Madhumitha; Chatterjee, Sudipto; Koschorke, Mirja; Rangaswamy, Thara; Chavan, Animish; Dabholkar, Hamid; Dakshin, Lilly; Kumar, Pratheesh; John, Sujit; Thornicroft, Graham; Patel, Vikram

    2012-02-16

    Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community based intervention in three sites in India. This paper describes how the intervention was developed systematically, following the MRC framework for the development of complex interventions. We reviewed the lierature on the burden of schizophrenia and the treatment gap in low and middle income countries and the evidence for community based treatments, and identified intervention components. We then evaluated the acceptability and feasibility of this package of care through formative case studies with individuals with schizophrenia and their primary caregivers and piloted its delivery with 30 families. Based on the reviews, our intervention comprised five components (psycho-education; adherence management; rehabilitation; referral to community agencies; and health promotion) to be delivered by trained lay health workers supervised by specialists. The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and expected them to have knowledge about the subject matter

  6. Technology's Past: America's Industrial Revolution and the People Who Delivered the Goods.

    Science.gov (United States)

    Karwatka, Dennis

    This book presents illustrated profiles of 76 individuals and 2 notable vehicles (the winner of the first around-the-world car race in 1908 and the first steam locomotive in the United States). It includes such recognized innovators as Alexander Graham Bell (inventor of the telephone), George Washington Carver (agricultural products innovator),…

  7. Radiochromic film for individual patient QA in extracranial stereotactic lung radiotherapy

    International Nuclear Information System (INIS)

    Kron, T.; Clements, N.; Aarons, Y.; Dunn, L.; Chesson, B.; Miller, J.; Roozen, K.; Ball, D.

    2011-01-01

    Introduction: Modern radiotherapy is characterised by increasingly complex radiation delivery such as Intensity Modulated Radiation Therapy (IMRT) or extracranial stereotactic radiotherapy (ESR). It has become common practice to verify the delivery for each patient in IMRT, however, no such methods have been defined to date for ESR. It was the aim of the present work to develop a method to verify the dose distribution for ESR in a moving phantom using radiochromic film. Methods: Radiochromic film (ISP EBT2) was used in a cylindrical film cassette fitted into a QUASAR phantom (Modus Medical). The cassette can be moved forwards and backwards with motion patterns that can mimic the breathing of individual patients. The radiotherapy treatment plans of four patients were re-planned for the phantom. Between 8 and 10 radiation fields of 6 MV photons from a Varian Trilogy linear accelerator were used to deliver target doses between 18 and 26 Gy per fraction. In order to allow for measurements with EBT2 film all monitor units were divided by 3 or 4 resulting in maximum doses not exceeding 10 Gy. The film was evaluated using a transmission scan on an Epson Perfection V700 scanner with 50 dpi spatial resolution (3 colors, 48bit). A calibration curve was used to convert either the red or green component of the scan to dose. Results: Qualitative film analysis found no discernible discrepancies from planned isodose distributions in the stationary images. The dose distribution in the moving phantom was used successfully to confirm the appropriateness of the ITV construction in the planning process. Conclusions: We have developed a QA procedure that accounts for breathing patterns of individual patients in ESR for lung cancer. Radiochromic film was found to be easy to adapt to this process.

  8. Individual differences in change blindness

    OpenAIRE

    Bergmann, Katharina Verena

    2016-01-01

    The present work shows the existence of systematic individual differences in change blindness. It can be concluded that the sensitivity for changes is a trait. That is, persons differ in their ability to detect changes, independent from the situation or the measurement method. Moreover, there are two explanations for individual differences in change blindness: a) capacity differences in visual selective attention that may be influenced by top-down activated attention helping to focus attentio...

  9. Delivering Science from Big Data

    Science.gov (United States)

    Quinn, Peter Joseph

    2015-08-01

    The SKA will be capable of producing a stream of science data products that are Exa-scale in terms of their storage and processing requirements. This Google-scale enterprise is attracting considerable international interest and excitement from within the industrial and academic communities. In this paper we examine the data flow, storage and processing requirements of a number of key SKA survey science projects to be executed on the baseline SKA1 configuration. Based on a set of conservative assumptions about trends for HPC and storage costs, and the data flow process within the SKA Observatory, it is apparent that survey projects of the scale proposed will potentially drive construction and operations costs beyond the current anticipated SKA1 budget. This implies a sharing of the resources and costs to deliver SKA science between the community and what is contained within the SKA Observatory. A similar situation was apparent to the designers of the LHC more than 10 years ago. We propose that it is time for the SKA project and broader community to consider the effort and process needed to design and implement a distributed science data system that leans on the lessons of other projects and looks to recent developments in Cloud technologies to ensure an affordable, effective and global achievement of science goals.

  10. Use of retroviral-mediated gene transfer to deliver and test function of chimeric antigen receptors in human T-cells

    Directory of Open Access Journals (Sweden)

    Ana C. Parente-Pereira

    2014-07-01

    Full Text Available Chimeric antigen receptors (CARs are genetically delivered fusion molecules that elicit T-cell activation upon binding of a native cell surface molecule. These molecules can be used to generate a large number of memory and effector T-cells that are capable of recognizing and attacking tumor cells. Most commonly, stable CAR expression is achieved in T-cells using retroviral vectors. In the method described here, retroviral vectors are packaged in a two-step procedure. First, H29D human retroviral packaging cells (a derivative of 293 cells are transfected with the vector of interest, which is packaged transiently in vesicular stomatitis virus (VSV G pseudotyped particles. These particles are used to deliver the vector to PG13 cells, which achieve stable packaging of gibbon ape leukaemia virus (GALV-pseudotyped particles that are suitable for infection of human T-cells. The key advantage of the method reported here is that it robustly generates polyclonal PG13 cells that are 100% positive for the vector of interest. This means that efficient gene transfer may be repeatedly achieved without the need to clone individual PG13 cells for experimental pre-clinical testing. To achieve T-cell transduction, cells must first be activated using a non-specific mitogen. Phytohemagglutinin (PHA provides an economic and robust stimulus to achieve this. After 48-72 h, activated T-cells and virus-conditioned medium are mixed in RetroNectin-coated plasticware, which enhances transduction efficiency. Transduced cells are analyzed for gene transfer efficiency by flow cytometry 48 h following transduction and may then be tested in several assays to evaluate CAR function, including target-dependent cytotoxicity, cytokine production and proliferation.

  11. Quelques conceptions juives de l’individu Some Jewish Conceptions of the Individual

    Directory of Open Access Journals (Sweden)

    Alessandro Guetta

    2011-10-01

    Full Text Available Is there a Jewish conception of the individual subject? The issue is quite problematic, for several reasons: 1 it is difficult to speak of Judaism in a monolithic manner, because Judaism is a multifaceted reality, varying according to different epochs and places, to the point that we should speak of “Judaisms”, in the plural; 2 if the question of the individual subject is connected to the vision that the Western (meaning, European, essentially Christian culture has constructed, Judaism can hardly be defined as “Occidental” or “Oriental”. After a short analysis of these two points, we present the conceptions of the individual subject as developed by two major Jewish thinkers of the twentieth century: Martin Buber (1878-1965 and Erich Fromm (1900-1980. Both based their visions on traditional Jewish sources (Bible, Talmud but attributed them a universal value.

  12. Systems analysis of clinical incidents as a basis for improvement the quality of medical care delivered to patients with arterial hypertension

    OpenAIRE

    Posnenkova O.M.; Kiselev A.R.; Popova Y.V.; Volkova E.N.; Gridnev V.I.

    2014-01-01

    Background — Systems analysis of clinical incidents – is a relatively novel approach to medical care quality improvement. Its basis is studying of healthcare system with use of modeling. The purpose of the present work was to compare the potential value of different modeling methods, which implemented in systems analysis of clinical incidents, and form the basis for improvement the quality of medical care delivered to patients with arterial hypertension (AH). Material and Methods — Thre...

  13. Individual cognitive-behavioral therapy and behavioral couples therapy in alcohol use disorder: a comparative evaluation in community-based addiction treatment centers.

    Science.gov (United States)

    Vedel, Ellen; Emmelkamp, Paul M G; Schippers, Gerard M

    2008-01-01

    Alcohol abuse serves as a chronic stressor between partners and has a deleterious effect on relationship functioning. Behavioral Couples Therapy (BCT) for alcohol dependence, studied as an adjunct to individual outpatient counseling, has shown to be effective in decreasing alcohol consumption and enhancing marital functioning, but no study has directly tested the comparative effectiveness of stand-alone BCT versus an individually focused cognitive-behavioral therapy (CBT) in a clinical community sample. The present study is a randomized clinical trial evaluating the effectiveness of stand-alone BCT (n = 30) compared to individual CBT (n = 34) in the treatment of alcohol use disorders in community treatment centers in Dutch male and female alcoholics and their partners. Results show both BCT and CBT to be effective in changing drinking behavior after treatment. BCT was not found to be superior to CBT. Marital satisfaction of the spouse increased significantly in the BCT condition but not in the CBT condition, the differences being significant at the post-test. Patients' self-efficacy to withstand alcohol-related high-risk situations increased significantly in both treatment conditions, but more so in CBT than in BCT after treatment. Treatment involvement of the spouse did not increase retention. Regular practitioners in community treatment centers can effectively deliver both treatments. Stand-alone BCT is as effective as CBT in terms of reduced drinking and to some extent more effective in terms of enhancing relationship satisfaction. However, BCT is a more costly intervention, given that treatment sessions lasted almost twice as long as individual CBT sessions. Copyright 2008 S. Karger AG, Basel.

  14. Direct visualization of Agrobacterium-delivered VirE2 in recipient cells

    Science.gov (United States)

    Li, Xiaoyang; Yang, Qinghua; Tu, Haitao; Lim, Zijie; Pan, Shen Q

    2014-01-01

    Agrobacterium tumefaciens is a natural genetic engineer widely used to deliver DNA into various recipients, including plant, yeast and fungal cells. The bacterium can transfer single-stranded DNA molecules (T–DNAs) and bacterial virulence proteins, including VirE2. However, neither the DNA nor the protein molecules have ever been directly visualized after the delivery. In this report, we adopted a split-GFP approach: the small GFP fragment (GFP11) was inserted into VirE2 at a permissive site to create the VirE2-GFP11 fusion, which was expressed in A. tumefaciens; and the large fragment (GFP1–10) was expressed in recipient cells. Upon delivery of VirE2-GFP11 into the recipient cells, GFP fluorescence signals were visualized. VirE2-GFP11 was functional like VirE2; the GFP fusion movement could indicate the trafficking of Agrobacterium-delivered VirE2. As the natural host, all plant cells seen under a microscope received the VirE2 protein in a leaf-infiltration assay; most of VirE2 moved at a speed of 1.3–3.1 μm sec−1 in a nearly linear direction, suggesting an active trafficking process. Inside plant cells, VirE2-GFP formed filamentous structures of different lengths, even in the absence of T-DNA. As a non-natural host recipient, 51% of yeast cells received VirE2, which did not move inside yeast. All plant cells seen under a microscope transiently expressed the Agrobacterium-delivered transgene, but only 0.2% yeast cells expressed the transgene. This indicates that Agrobacterium is a more efficient vector for protein delivery than T-DNA transformation for a non-natural host recipient: VirE2 trafficking is a limiting factor for the genetic transformation of a non-natural host recipient. The split-GFP approach could enable the real-time visualization of VirE2 trafficking inside recipient cells. PMID:24299048

  15. A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis

    OpenAIRE

    Hillier-Brown, Frances C.; Summerbell, Carolyn D.; Moore, Helen J.; Wrieden, Wendy L.; Adams, Jean; Abraham, Charles; Adamson, Ashley; Ara?jo-Soares, Vera; White, Martin; Lake, Amelia A.

    2017-01-01

    $\\textbf{Background:}$ Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. $\\...

  16. Delivering energy efficiency and carbon reduction schemes in England: Lessons from Green Deal Pioneer Places

    International Nuclear Information System (INIS)

    Marchand, Robert D.; Koh, S.C. Lenny; Morris, Jonathan C.

    2015-01-01

    Against a background of growing international and national carbon reduction legislation, the UK government introduced the “Green Deal” to deliver a significant increase in housing energy efficiency and reduction in carbon emissions. This paper reflects on one English local authority's experience delivering a programme intended to foster local interest in the Green Deal. Drawing on social surveys and pre and post Green Deal intervention interviews with five demonstrator homes (households that applied to receive a Green Deal package fully funded by the scheme, providing a test bed for the Green Deal recruitment and installation process), this paper shows that awareness and understanding of the Green Deal scheme is low. There is opposition to the cost of finance offered but a strong interest in improving household warmth and for funding improvements through payments added to the electricity bill. Demonstrator home residents perceived Green Deals had improved the warmth and quality of their home, but saving money was the primary motivator for their involvement, not increasing warmth. Whilst Green Deal has not delivered the level of success that was hoped, much can be learned from the scheme to improve future energy efficiency schemes that will be necessary to deliver emission reduction commitments. -- Highlights: •Resident awareness and understanding of the Green Deal is low. •Green Deal assessment costs and loan interest rates are biggest barriers to uptake. •Funding energy improvements via a charge on electricity bill welcomed by residents. •Saving money rather than increasing warmth main motivator for scheme involvement. •Insights from this work should be used to inform future emission reduction schemes

  17. Experiences of instructors delivering the Mental Health First Aid training programme: a descriptive qualitative study.

    Science.gov (United States)

    Terry, J

    2010-09-01

    Mental health literacy among the public is often poor, and although people frequently encounter others experiencing mental distress in their workplace, families and communities, they may be ill-equipped to provide appropriate support. 'Mental Health First Aid' (MHFA), a 12-h mental health promotion programme seeks to address this, training people in the knowledge and skills needed to engage with someone experiencing mental health problems. Research relating to the MHFA programme has centred on course attendees, with a paucity of research surrounding the delivery of basic mental health training programmes. Understanding experiences of instructors delivering such programmes is key to the success of future delivery. This study sought to identify the views and experiences of instructors delivering the MHFA programme in Wales. Fourteen MHFA instructors participated in semi-structured audio-recorded interviews, with the transcripts analysed to identify key themes. This paper explores two of the identified themes namely prerequisite skills and support required by instructors. The study highlighted that because of the ensuing emotional labour experienced by instructors, universal mental health training programmes must put in place a clear infrastructure to train, support and monitor those delivering them, for programme roll-out to be effective.

  18. Feasibility and Acceptability of Delivering a Postpartum Weight Loss Intervention via Facebook: A Pilot Study.

    Science.gov (United States)

    Waring, Molly E; Moore Simas, Tiffany A; Oleski, Jessica; Xiao, Rui S; Mulcahy, Julie A; May, Christine N; Pagoto, Sherry L

    2018-01-01

    To evaluate the feasibility and acceptability of a Facebook-delivered postpartum weight loss intervention. Overweight and obese postpartum women received a 12-week weight loss intervention via Facebook. Feasibility outcomes were recruitment, retention, engagement, and acceptability. Weight loss was an exploratory outcome. Participants (n = 19) were 3.5 (SD 2.2) months postpartum with a baseline body mass index of 30.1 (SD 4.2) kg/m 2 . Retention was 95%. Forty-two percent of participants visibly engaged on the last day of the intervention, and 100% in the last 4 weeks; 88% were likely or very likely to participate again and 82% were likely or very likely to recommend the program to a postpartum friend. Average 12-week weight loss was 4.8% (SD 4.2%); 58% lost ≥5%. Findings suggested that this Facebook-delivered intervention is feasible and acceptable and supports research to test efficacy for weight loss. Research is needed to determine how best to engage participants in social network-delivered weight loss interventions. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  19. Diagnosis and therapy of cutaneous radiation syndrome. Individual radiosensitivity assessment in patients undergoing medical exposures presenting severe cutaneous radiation induced lesions

    International Nuclear Information System (INIS)

    Di Giorgio, Marina; Vallerga, Maria B.; Perez, Maria R.; Portas, Mercedes

    2007-01-01

    Hospital de Quemados del Gobierno de la Ciudad de Buenos Aires (Burn Center) is one of the reference hospitals of the Medical Radiological Emergency Response Network of Argentina. In the frame of an agreement between the Burn Center and the Nuclear Regulatory Authority of Argentina, a research project for an approach based on diagnosis and therapy of cutaneous radiation induced lesions is in progress. Individual radiosensitivity assessment was conducted in patients included in this research protocol that showed acute and/or late cutaneous reactions with grades 3 and 4 of the Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European organization for research and treatment of cancer (EORTC). DNA repair capacity and its kinetics were evaluated in human peripheral blood lymphocytes using alkaline comet assay and micronucleus test. In this paper, two representative cases, in which the research protocol was applied, are presented. Therapeutic response and its correlation with radiosensitivity test results are described. Case 1: female patient undergoing external radiotherapy for invasive ductal breast cancer that presented acute cutaneous radiotoxicity, grade 3 (confluent moist epithelitis, )that led to treatment break. Case 2: male patient undergoing coronary angioplasty (interventional radiology), which developed late cutaneous radiotoxicity, grade 4 (ulceration at the dorsal region). Patients were treated with: topic administration of trolamine and silver sulfadiazine with lidocaine, associated with systemic administration of pentoxiphiline and anti-oxidants. The therapeutic response was evaluated through clinical follow-up, serial photographic record and complementary tests (tele thermography and high frequency ultrasonography). Case 1 response was positive (favorable) with early local recovery and complete remission of signs and symptoms after 5 months. Both MN frequencies and comet assay showed values compatible with normal radiosensitivity

  20. Digital television: a new way to deliver information

    Science.gov (United States)

    Huang, Samson

    1998-12-01

    Digital television (DTV) is a new way to deliver video, audio, and other data. Why should TV be converted to digital? How does DTV work? What can we do with it? This paper provides some introduction about DTV, its history, and its roll-out plan. It then compares DTV with analog TV, and describes how DTV works. It also describes why the computer industry, as well as the consumer electronics industry, are both very interested I the DTV market. Next, it describes what Intel has done on DTV, including how we build a PC- based DTV, its test evaluation results, its new applications, and Intel's DTV station DMRL. This paper also describes remaining issues, our roadmap, vision, and future directions.

  1. Creating a spiritual tapestry: nurses' experiences of delivering spiritual care to patients in an Irish hospice.

    LENUS (Irish Health Repository)

    Bailey, Maria E

    2009-01-01

    This study aims to describe nurses\\' experiences of delivering spiritual support in a palliative care setting in the Republic of Ireland. The authors conducted semi-structured interviews with 22 nurses working in the area of specialist palliative care. A content analysis of the transcriptions revealed five sub-themes: understanding spirituality; the art of nursing in spiritual care; education and learning; the challenge of spiritual caring; and the dimensions of time. The resulting creation of a spiritual tapestry provided an overall theme. Nurses in this study were spiritually self-aware and placed a high value on the spiritual element of their caring role. Nurses described their individual understanding of spirituality and discussed how they recognized and addressed a patient\\'s spiritual needs. Time was described as essential to the provision of spiritual support and appeared to be a significant resource challenge to the provision of spiritual care. The challenges of assessing spiritual needs and measuring outcomes of care were also reported. Participants in this study described the creation of a spiritual tapestry that \\'weaves\\' together care and compassion with skills and knowledge in their nursing practice.

  2. Encounter Probability of Individual Wave Height

    DEFF Research Database (Denmark)

    Liu, Z.; Burcharth, H. F.

    1998-01-01

    wave height corresponding to a certain exceedence probability within a structure lifetime (encounter probability), based on the statistical analysis of long-term extreme significant wave height. Then the design individual wave height is calculated as the expected maximum individual wave height...... associated with the design significant wave height, with the assumption that the individual wave heights follow the Rayleigh distribution. However, the exceedence probability of such a design individual wave height within the structure lifetime is unknown. The paper presents a method for the determination...... of the design individual wave height corresponding to an exceedence probability within the structure lifetime, given the long-term extreme significant wave height. The method can also be applied for estimation of the number of relatively large waves for fatigue analysis of constructions....

  3. Which Individual Therapist Behaviors Elicit Client Change Talk and Sustain Talk in Motivational Interviewing?

    Science.gov (United States)

    Apodaca, Timothy R; Jackson, Kristina M; Borsari, Brian; Magill, Molly; Longabaugh, Richard; Mastroleo, Nadine R; Barnett, Nancy P

    2016-02-01

    To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions. Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral). Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p=.013), open question (pmotivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability.

    Science.gov (United States)

    Stapleton, Jerod L; Manne, Sharon L; Day, Ashley K; Levonyan-Radloff, Kristine; Pagoto, Sherry L

    2018-02-20

    There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within an interactive social media format. The findings

  5. Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability

    Science.gov (United States)

    Manne, Sharon L; Day, Ashley K; Levonyan-Radloff, Kristine; Pagoto, Sherry L

    2018-01-01

    Background There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. Objective To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Methods Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. Results The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). Conclusions This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within

  6. Does Practice Make Perfect? Role of Training and Feedback in Improving Scientists' Presentation Skills

    Science.gov (United States)

    Tankersley, R. A.; Bourexis, P.; Kaser, J. S.

    2011-12-01

    that use of the PSP alone does not guarantee communication growth or competence. To achieve significant gains in presentation skills, a three pronged approach is required: (1) formal training in best-practices and techniques for preparing and delivering presentations (e.g., Presentation Boot Camp), (2) frequent opportunities to practice and hone presentation skills (e.g., presentations at professional meetings, informal science centers, and K-12 classrooms), and (3) regular, individualized and structured feedback (e.g., Presentations Skill Protocol).

  7. Non-Classroom Use of "Presentation Software" in Accelerated Classes: Student Use and Perceptions of Value

    Science.gov (United States)

    Davies, Thomas; Korte, Leon; Cornelsen, Erin

    2016-01-01

    Numerous articles found in education literature discuss the advantages and disadvantages of using "presentation" software to deliver critical course content to students. Frequently the perceived value of the use of software such as PowerPoint is dependent upon how it is used, for instance, the extent to which bells and whistles are…

  8. Acceptability of Interventions Delivered Online and Through Mobile Phones for People Who Experience Severe Mental Health Problems: A Systematic Review.

    Science.gov (United States)

    Berry, Natalie; Lobban, Fiona; Emsley, Richard; Bucci, Sandra

    2016-05-31

    Psychological interventions are recommended for people with severe mental health problems (SMI). However, barriers exist in the provision of these services and access is limited. Therefore, researchers are beginning to develop and deliver interventions online and via mobile phones. Previous research has indicated that interventions delivered in this format are acceptable for people with SMI. However, a comprehensive systematic review is needed to investigate the acceptability of online and mobile phone-delivered interventions for SMI in depth. This systematic review aimed to 1) identify the hypothetical acceptability (acceptability prior to or without the delivery of an intervention) and actual acceptability (acceptability where an intervention was delivered) of online and mobile phone-delivered interventions for SMI, 2) investigate the impact of factors such as demographic and clinical characteristics on acceptability, and 3) identify common participant views in qualitative studies that pinpoint factors influencing acceptability. We conducted a systematic search of the databases PubMed, Embase, PsycINFO, CINAHL, and Web of Science in April 2015, which yielded a total of 8017 search results, with 49 studies meeting the full inclusion criteria. Studies were included if they measured acceptability through participant views, module completion rates, or intervention use. Studies delivering interventions were included if the delivery method was online or via mobile phones. The hypothetical acceptability of online and mobile phone-delivered interventions for SMI was relatively low, while actual acceptability tended to be high. Hypothetical acceptability was higher for interventions delivered via text messages than by emails. The majority of studies that assessed the impact of demographic characteristics on acceptability reported no significant relationships between the two. Additionally, actual acceptability was higher when participants were provided remote online

  9. Increasing Customer Service Behaviors Using Manager-Delivered Task Clarification and Social Praise

    Science.gov (United States)

    Rice, Anna; Austin, John; Gravina, Nicole

    2009-01-01

    This project assessed an intervention to improve employee customer service behaviors (correct greetings and closing behaviors). A combination of task clarification and manager-delivered social praise resulted in increased correct greeting from 11.5% to 66% and correct closing from 8% to 70%. The effect was maintained at a 48-week follow-up for…

  10. Innovative interventions to promote behavioral change in overweight or obese individuals: A review of the literature.

    Science.gov (United States)

    Okorodudu, Daniel E; Bosworth, Hayden B; Corsino, Leonor

    2015-05-01

    The overweight and obesity trends have risen over the past few decades, placing significant burdens on health care in terms of increased morbidity and cost. Behavioral change therapy is an effective treatment strategy and includes goal setting, self-monitoring, problem solving, and reinforcement tactics. Traditionally, behavior change therapy has been delivered using face-to-face counseling along with paper and pen recording of dietary intake and physical activity. The current advances in technology provide opportunities to deliver interventions using cellphones, internet, and active video games. These new methods to deliver behavior change for the management and prevention of obesity are being developed in order to increase access, improve convenience, decrease cost, and increase participant engagement. In this review, we present new approaches to promote behavior changes in the management of obesity. Currently available data show promising results. However, future research is needed to address study limitations and implementation challenges of these innovative interventions.

  11. Gestational age and birth weight centiles of singleton babies delivered normally following spontaneous labor, in Southern Sri Lanka

    Science.gov (United States)

    Attanayake, K; Munasinghe, S; Goonewardene, M; Widanapathirana, P; Sandeepani, I; Sanjeewa, L

    2018-03-31

    To estimate the gestational age and birth weight centiles of babies delivered normally, without any obstetric intervention, in women with uncomplicated singleton pregnancies establishing spontaneous onset of labour. Consecutive women with uncomplicated singleton pregnancies, attending the Academic Obstetrics and Gynecology Unit of the Teaching Hospital Mahamodara Galle, Sri Lanka, with confirmed dates and establishing spontaneous onset of labor and delivering vaginally between gestational age of 34 - 41 weeks, without any obstetric intervention , during the period September 2013 to February 2014 were studied. The gestational age at spontaneous onset of labor and vaginal delivery and the birth weights of the babies were recorded. There were 3294 consecutive deliveries during this period, and of them 1602 (48.6%) met the inclusion criteria. Median gestational age at delivery was 275 days (range 238-291 days, IQR 269 to 280 days) and the median birth weight was 3000 g (range1700g - 4350g; IQR 2750-3250g). The 10th, 50th and 90th birth weight centiles of the babies delivered at a gestational age of 275 days were approximately 2570g, 3050g and 3550g respectively. The median gestational age among women with uncomplicated singleton pregnancies who established spontaneous onset of labor and delivered vaginally, without any obstetric intervention, was approximately five days shorter than the traditionally accepted 280 days. At a gestational age of 275 days, the mean birth weight was approximately 3038g and the 50th centile of the birth weight of the babies delivered was approximately 3050g.

  12. Individual differences in individualism and collectivism predict ratings of virtual cities' liveability and environmental quality.

    Science.gov (United States)

    Rubin, Mark; Morrison, Tessa

    2014-01-01

    The present research investigated individual differences in individualism and collectivism as predictors of people's reactions to cities. Psychology undergraduate students (N = 148) took virtual guided tours around historical cities. They then evaluated the cities' liveability and environmental quality and completed measures of individualism and collectivism. Mediation analyses showed that people who scored high in self-responsibility (individualism) rated the cities as more liveable because they perceived them to be richer and better resourced. In contrast, people who scored high in collectivism rated the cities as having a better environmental quality because they perceived them to (1) provide a greater potential for community and social life and (2) allow people to express themselves. These results indicate that people's evaluations of virtual cities are based on the degree to which certain aspects of the cities are perceived to be consistent with individualist and collectivist values.

  13. A Comparison of Early Maladaptive Schemas in Crystal Addicted Individuals and Normal Individuals

    Directory of Open Access Journals (Sweden)

    Zahra Asadi

    2011-02-01

    Full Text Available Objective: The aim of present research was to compare early maladaptive schemas in crystal addicted individuals and normal individuals. Method: In this ex post facto research, two groups of subjects (normal adolescent=30 and addicted adolescent=30 were selected via cluster sampling and convenience sampling respectively. Yang early maladaptive schemas questionnaire were conducted, then data were analyzed using multiple analysis of variance. Results: The results revealed that there was significant difference between both groups in early maladaptive schemas. Conclusion: The findings provided empirical support for the proposition that early maladaptive schemas may influence on tendency of adolescent toward substance abuse.

  14. Total cysteine and glutathione determination in hemolymph of individual adult D. melanogaster

    Energy Technology Data Exchange (ETDEWEB)

    Borra, Srivani, E-mail: sborra3@uic.edu [Department of Chemistry, University of Illinois at Chicago, 845 West Taylor Street, 4323 SES, MC 111, Chicago, IL 60607 (United States); Featherstone, David E., E-mail: def@uic.edu [Department of Biological Sciences, University of Illinois at Chicago, 840 West Taylor Street, SEL 4311, M/C 067, Chicago, IL 60607 (United States); Laboratory of Integrative Neuroscience, University of Illinois at Chicago, 840 West Taylor Street, SEL 4311, M/C 067, Chicago, IL 60607 (United States); Shippy, Scott A., E-mail: sshippy@uic.edu [Department of Chemistry, University of Illinois at Chicago, 845 West Taylor Street, 5417 SES, MC 111, Chicago, IL 60607 (United States); Laboratory of Integrative Neuroscience, University of Illinois at Chicago, 840 West Taylor Street, SEL 4311, M/C 067, Chicago, IL 60607 (United States)

    2015-01-01

    Highlights: • Method for highly volume variant, nL sample assay of biological relevant thiols. • Defined capillary lengths used to deliver nL sample and reagent volumes. • Optimized reagent concentrations, reaction times and temperatures for thiol assay. • Total cysteine and glutathione measured from hemolymph of individual fruit flies. - Abstract: Determination of thiols, glutathione (GSH) and cysteine (Cys) are important due to their roles in oxidative stress and aging. Oxidants such as soluble O{sub 2} and H{sub 2}O{sub 2} promote oxidation of thiols to disulfide (-S-S-) bonded dimers affecting quantitation accuracy. The method presented here reduces disulfide-bonded species followed by fluorescence labelling of the 29.5 (±18.2) nL hemolymph volumes of individual adult Drosophila Melanogaster. The availability of only tens of nanoliter (nL) samples that are also highly volume variant requires efficient sample handling to improve thiol measurements while minimizing sample dilution. The optimized method presented here utilizes defined lengths of capillaries to meter tris(2-carboxyethyl)phosphine reducing reagent and monobromobimane derivatizing reagent volumes enabling Cys and GSH quantitation with only 20-fold dilution. The nL assay developed here was optimized with respect to reagent concentrations, sample dilution, reaction times and temperatures. Separation and identification of the nL thiol mixtures were obtained with capillary electrophoresis-laser induced fluorescence. To demonstrate the capability of this method total Cys and total GSH were measured in the hemolymph collected from individual adult D. Melanogaster. The thiol measurements were used to compare a mutant fly strain with a non-functional cystine–glutamate transporter (xCT) to its background control. The mutant fly, genderblind (gb), carries a non-functional gene for a protein similar to mammalian xCT whose function is not fully understood. Average concentrations obtained for mutant

  15. Speech fluency profile on different tasks for individuals with Parkinson's disease.

    Science.gov (United States)

    Juste, Fabiola Staróbole; Andrade, Claudia Regina Furquim de

    2017-07-20

    To characterize the speech fluency profile of patients with Parkinson's disease. Study participants were 40 individuals of both genders aged 40 to 80 years divided into 2 groups: Research Group - RG (20 individuals with diagnosis of Parkinson's disease) and Control Group - CG (20 individuals with no communication or neurological disorders). For all of the participants, three speech samples involving different tasks were collected: monologue, individual reading, and automatic speech. The RG presented a significant larger number of speech disruptions, both stuttering-like and typical dysfluencies, and higher percentage of speech discontinuity in the monologue and individual reading tasks compared with the CG. Both groups presented reduced number of speech disruptions (stuttering-like and typical dysfluencies) in the automatic speech task; the groups presented similar performance in this task. Regarding speech rate, individuals in the RG presented lower number of words and syllables per minute compared with those in the CG in all speech tasks. Participants of the RG presented altered parameters of speech fluency compared with those of the CG; however, this change in fluency cannot be considered a stuttering disorder.

  16. Acceptability and Feasibility of Delivering Pentavalent Vaccines in a Compact, Prefilled, Autodisable Device in Vietnam and Senegal.

    Directory of Open Access Journals (Sweden)

    Elise Guillermet

    Full Text Available Prefilled syringes are the standard in developed countries but logistic and financial barriers prevent their widespread use in developing countries. The current study evaluated use of a compact, prefilled, autodisable device (CPAD to deliver pentavalent vaccine by field actors in Senegal and Vietnam.We conducted a logistic, programmatic, and anthropological study that included a interviews of immunization staff at different health system levels and parents attending immunization sessions; b observation of immunization sessions including CPAD use on oranges; and c document review.Respondents perceived that the CPAD would improve safety by being non-reusable and preventing needle and vaccine exposure during preparation. Preparation was considered simple and may reduce immunization time for staff and caretakers. CPAD impact on cold storage requirements depended on the current pentavalent vaccine being used; in both countries, CPAD would reduce the weight and volume of materials and safety boxes thereby potentially improving outreach strategies and waste disposal. CPAD also would reduce stock outages by bundling vaccine and syringes and reduce wastage by using a non-breakable plastic presentation. Respondents also cited potential challenges including ability to distinguish between CPAD and other pharmaceuticals delivered via a similar mechanism (such as contraceptives, safety, and concerns related to design and ease of administration (such as activation, ease of delivery, and needle diameter and length.Compared to current pentavalent vaccine presentations in Vietnam and Senegal, CPAD technology will address some of the main barriers to vaccination, such as supply chain issues and safety concerns among health workers and families. Most of the challenges we identified can be addressed with health worker training, minor design modifications, and health messaging targeting parents and communities. Potentially the largest remaining barrier is the

  17. [Umbilical blood-gas status at cesarean section for breech presentation: a comparison with vertex presentation].

    Science.gov (United States)

    Haruta, M; Saeki, N; Naka, Y; Funato, T; Ohtsuki, Y

    1989-10-01

    Umbilical blood-gas status at elective cesarean section with oxygen inhalation for breech presentation (25 cases) was compared with that for vertex presentation (25 cases), so as to confirm the security of full-term breech fetuses delivered by cesarean section under spinal anesthesia. Umbilical arterial oxygen levels were significantly lower in the breech group (Mean PO2:18.9 mmHg; SO2:37.3%; Oxygen content:7.6 ml/dl). The number of hypoxemic fetuses was significantly higher in the breech group (the breech: 7; the vertex; 0). The other umbilical blood-gas values revealed no significant differences between the breech and vertex groups, and were within normal limits in both groups. Oxygen extraction in the breech (Mean: 49.0%) was higher than that in the vertex (32.9%). Therefore decreased umbilical blood flow in the breech was suggested. The incidence of depression at 1 minute after delivery in the breech infants (24%) was significantly higher than that in the vertex infants (0%). It became obvious in the breech that as the interval between the uterine incision and delivery increased, umbilical arterial blood tended to acidosis and the 1 minute Apgar score decreased. Cesarean section for breech presentation requires sufficient and optimal incisions of the abdominal wall and uterus as well as a skillful manual delivery technique, because the fetus or neonate should be protected against asphyxia resulting from umbilical compression and prolonged delivery interval.

  18. Mobile Phone-Delivered Cognitive Behavioral Therapy for Insomnia : A Randomized Waitlist Controlled Trial

    NARCIS (Netherlands)

    Horsch, C.H.G.; Lancee, J.; Griffioen-Both, F.; Spruit, S.; Fitrianie, S.; Neerincx, M.A.; Beun, R.J.; Brinkman, W.-P.

    Background: This study is one of the first randomized controlled trials investigating cognitive behavioral therapy for insomnia (CBT-I) delivered by a fully automated mobile phone app. Such an app can potentially increase the accessibility of insomnia treatment for the 10% of people who have

  19. Mobile Phone-Delivered Cognitive Behavioral Therapy for Insomnia : A Randomized Waitlist Controlled Trial

    NARCIS (Netherlands)

    Horsch, C.H.G.; Lancee, J; Griffioen-Both, Fiemke; Spruit, Sandor; Fitrianie, S.; Neerincx, M.A.; Beun, RJ; Brinkman, W.P.

    2017-01-01

    Background: This study is one of the first randomized controlled trials investigating cognitive behavioral therapy for insomnia (CBT-I) delivered by a fully automated mobile phone app. Such an app can potentially increase the accessibility of insomnia treatment for the 10% of people who have

  20. Australian nursing and midwifery educators delivering evidence-based education in Tanzania: A qualitative study.

    Science.gov (United States)

    Gower, Shelley; van den Akker, Jose; Jones, Mark; Dantas, Jaya A R; Duggan, Ravani

    2016-05-01

    Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based continuing education to Tanzanian health professionals. Despite thorough preparation before departure, differences in local resource levels and available facilities have necessitated impromptu adaptation of curriculum content and delivery methods to ensure an effective program was delivered. This study explored the personal, cultural and teaching strategies utilised by Western Australian nursing and midwifery educators in Tanzania and examined if the transferability of education packages was influenced by the educators' cultural competence. Using a qualitative exploratory approach, data was collected from 15 Western Australian nursing and midwifery educators using a demographic survey and in-depth individual semi-structured interviews. The core themes identified from the analysis were Determination to learn, Assessing needs, Communication skills and Greater understanding. These findings are described using the conceptual framework of Campinha-Bacote's The Process of Cultural Competence in the Delivery of Healthcare Services. With appropriate levels of cultural competence, international health professionals can be effective at providing ongoing professional development to colleagues in developing country contexts, which may help address difficulties with retention and motivation of staff. It is essential that prior to departure cultural competence training is provided to educators to enhance their teaching capacity and effectiveness in international settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. 29 CFR 570.106 - “Ship or deliver for shipment in commerce”.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false âShip or deliver for shipment in commerceâ. 570.106 Section 570.106 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS CHILD LABOR REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION General Statements of Interpretation of the Child Labor Provisions of...

  2. Views of Freshmen Students on Foreign Language Courses Delivered via E-Learning

    Science.gov (United States)

    Ozudogru, Fatma; Hismanoglu, Murat

    2016-01-01

    With the increasing number of foreign language courses via e-learning in higher education institutions, it is important to investigate whether the quality of e-learning is up to the standard. This study aimed at finding out the views of freshmen students on foreign language courses delivered via e-learning and revealing whether there were any…

  3. Short-Term Effectiveness of Psychotherapy Treatments Delivered at a University Counselling Service

    Science.gov (United States)

    Monti, Fiorella; Tonetti, Lorenzo; Ricci Bitti, Pio Enrico

    2016-01-01

    This work aimed to evaluate the short-term effectiveness of psychotherapy delivered at the counselling service of the University of Bologna (Italy), by means of a single group longitudinal study including a 6-months follow-up. To this end, sixty-six students completed the 6-months follow-up and filled in the Symptom Questionnaire (SQ) three times,…

  4. An efficacy trial of brief lifestyle intervention delivered by generalist community nurses (CN SNAP trial

    Directory of Open Access Journals (Sweden)

    Fanaian Mahnaz

    2010-02-01

    Full Text Available Abstract Background Lifestyle risk factors, in particular smoking, nutrition, alcohol consumption and physical inactivity (SNAP are the main behavioural risk factors for chronic disease. Primary health care (PHC has been shown to be an effective setting to address lifestyle risk factors at the individual level. However much of the focus of research to date has been in general practice. Relatively little attention has been paid to the role of nurses working in the PHC setting. Community health nurses are well placed to provide lifestyle intervention as they often see clients in their own homes over an extended period of time, providing the opportunity to offer intervention and enhance motivation through repeated contacts. The overall aim of this study is to evaluate the impact of a brief lifestyle intervention delivered by community nurses in routine practice on changes in clients' SNAP risk factors. Methods/Design The trial uses a quasi-experimental design involving four generalist community nursing services in NSW Australia. Services have been randomly allocated to an 'early intervention' group or 'late intervention' (comparison group. 'Early intervention' sites are provided with training and support for nurses in identifying and offering brief lifestyle intervention for clients during routine consultations. 'Late intervention site' provide usual care and will be offered the study intervention following the final data collection point. A total of 720 generalist community nursing clients will be recruited at the time of referral from participating sites. Data collection consists of 1 telephone surveys with clients at baseline, three months and six months to examine change in SNAP risk factors and readiness to change 2 nurse survey at baseline, six and 12 months to examine changes in nurse confidence, attitudes and practices in the assessment and management of SNAP risk factors 3 semi-structured interviews/focus with nurses, managers and clients

  5. Individual Building Extraction from TerraSAR-X Images Based on Ontological Semantic Analysis

    Directory of Open Access Journals (Sweden)

    Rong Gui

    2016-08-01

    Full Text Available Accurate building information plays a crucial role for urban planning, human settlements and environmental management. Synthetic aperture radar (SAR images, which deliver images with metric resolution, allow for analyzing and extracting detailed information on urban areas. In this paper, we consider the problem of extracting individual buildings from SAR images based on domain ontology. By analyzing a building scattering model with different orientations and structures, the building ontology model is set up to express multiple characteristics of individual buildings. Under this semantic expression framework, an object-based SAR image segmentation method is adopted to provide homogeneous image objects, and three categories of image object features are extracted. Semantic rules are implemented by organizing image object features, and the individual building objects expression based on an ontological semantic description is formed. Finally, the building primitives are used to detect buildings among the available image objects. Experiments on TerraSAR-X images of Foshan city, China, with a spatial resolution of 1.25 m × 1.25 m, have shown the total extraction rates are above 84%. The results indicate the ontological semantic method can exactly extract flat-roof and gable-roof buildings larger than 250 pixels with different orientations.

  6. Delivering affordable cancer care in high-income countries.

    Science.gov (United States)

    Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

    2011-09-01

    The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies

  7. Targeted decorin gene therapy delivered with adeno-associated virus effectively retards corneal neovascularization in vivo.

    Directory of Open Access Journals (Sweden)

    Rajiv R Mohan

    Full Text Available Decorin, small leucine-rich proteoglycan, has been shown to modulate angiogenesis in nonocular tissues. This study tested a hypothesis that tissue-selective targeted decorin gene therapy delivered to the rabbit stroma with adeno-associated virus serotype 5 (AAV5 impedes corneal neovascularization (CNV in vivo without significant side effects. An established rabbit CNV model was used. Targeted decorin gene therapy in the rabbit stroma was delivered with a single topical AAV5 titer (100 µl; 5×10(12 vg/ml application onto the stroma for two minutes after removing corneal epithelium. The levels of CNV were examined with stereomicroscopy, H&E staining, lectin, collagen type IV, CD31 immunocytochemistry and CD31 immunoblotting. Real-time PCR quantified mRNA expression of pro- and anti-angiogenic genes. Corneal health in live animals was monitored with clinical, slit-lamp and optical coherence tomography biomicroscopic examinations. Selective decorin delivery into stroma showed significant 52% (p<0.05, 66% (p<0.001, and 63% (p<0.01 reduction at early (day 5, mid (day 10, and late (day 14 stages of CNV in decorin-delivered rabbit corneas compared to control (no decorin delivered corneas in morphometric analysis. The H&E staining, lectin, collagen type IV, CD31 immunostaining (57-65, p<0.5, and CD31 immunoblotting (62-67%, p<0.05 supported morphometric findings. Quantitative PCR studies demonstrated decorin gene therapy down-regulated expression of VEGF, MCP1 and angiopoietin (pro-angiogenic and up-regulated PEDF (anti-angiogenic genes. The clinical, biomicroscopy and transmission electron microscopy studies revealed that AAV5-mediated decorin gene therapy is safe for the cornea. Tissue-targeted AAV5-mediated decorin gene therapy decreases CNV with no major side effects, and could potentially be used for treating patients.

  8. Individualization of music-based rhythmic auditory cueing in Parkinson's disease.

    Science.gov (United States)

    Bella, Simone Dalla; Dotov, Dobromir; Bardy, Benoît; de Cock, Valérie Cochen

    2018-06-04

    Gait dysfunctions in Parkinson's disease can be partly relieved by rhythmic auditory cueing. This consists in asking patients to walk with a rhythmic auditory stimulus such as a metronome or music. The effect on gait is visible immediately in terms of increased speed and stride length. Moreover, training programs based on rhythmic cueing can have long-term benefits. The effect of rhythmic cueing, however, varies from one patient to the other. Patients' response to the stimulation may depend on rhythmic abilities, often deteriorating with the disease. Relatively spared abilities to track the beat favor a positive response to rhythmic cueing. On the other hand, most patients with poor rhythmic abilities either do not respond to the cues or experience gait worsening when walking with cues. An individualized approach to rhythmic auditory cueing with music is proposed to cope with this variability in patients' response. This approach calls for using assistive mobile technologies capable of delivering cues that adapt in real time to patients' gait kinematics, thus affording step synchronization to the beat. Individualized rhythmic cueing can provide a safe and cost-effective alternative to standard cueing that patients may want to use in their everyday lives. © 2018 New York Academy of Sciences.

  9. BoHV-4-based vector delivering Ebola virus surface glycoprotein

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    Alfonso Rosamilia

    2016-11-01

    Full Text Available Abstract Background Ebola virus (EBOV is a Category A pathogen that is a member of Filoviridae family that causes hemorrhagic fever in humans and non-human primates. Unpredictable and devastating outbreaks of disease have recently occurred in Africa and current immunoprophylaxis and therapies are limited. The main limitation of working with pathogens like EBOV is the need for costly containment. To potentiate further and wider opportunity for EBOV prophylactics and therapies development, innovative approaches are necessary. Methods In the present study, an antigen delivery platform based on a recombinant bovine herpesvirus 4 (BoHV-4, delivering a synthetic EBOV glycoprotein (GP gene sequence, BoHV-4-syEBOVgD106ΔTK, was generated. Results EBOV GP was abundantly expressed by BoHV-4-syEBOVgD106ΔTK transduced cells without decreasing viral replication. BoHV-4-syEBOVgD106ΔTK immunized goats produced high titers of anti-EBOV GP antibodies and conferred a long lasting (up to 6 months, detectable antibody response. Furthermore, no evidence of BoHV-4-syEBOVgD106ΔTK viremia and secondary localization was detected in any of the immunized animals. Conclusions The BoHV-4-based vector approach described here, represents: an alternative antigen delivery system for vaccination and a proof of principle study for anti-EBOV antibodies generation in goats for potential immunotherapy applications.

  10. A technician-delivered 'virtual clinic' for triaging low-risk glaucoma referrals.

    Science.gov (United States)

    Kotecha, A; Brookes, J; Foster, P J

    2017-06-01

    PurposeThe purpose of this study is to describe the outcomes of a technician-delivered glaucoma referral triaging service with 'virtual review' of resultant data by a consultant ophthalmologist.Patients and methodsThe Glaucoma Screening Clinic reviewed new optometrist or GP-initiated glaucoma suspect referrals into a specialist ophthalmic hospital. Patients underwent testing by three ophthalmic technicians in a dedicated clinical facility. Data were reviewed at a different time and date by a consultant glaucoma ophthalmologist. Approximately 10% of discharged patients were reviewed in a face-to-face consultant-led clinic to examine the false-negative rate of the service.ResultsBetween 1 March 2014 and 31 March 2016, 1380 patients were seen in the clinic. The number of patients discharged following consultant virtual review was 855 (62%). The positive predictive value of onward referrals was 84%. Three of the 82 patients brought back for face-to-face review were deemed to require treatment, equating to negative predictive value of 96%.ConclusionsOur technician-delivered glaucoma referral triaging clinic incorporates consultant 'virtual review' to provide a service model that significantly reduces the number of onward referrals into the glaucoma outpatient department. This model may be an alternative to departments where there are difficulties in implementing optometrist-led community-based referral refinement schemes.

  11. Dust Rains Deliver Diverse Assemblages of Microorganisms to the Eastern Mediterranean

    Science.gov (United States)

    Itani, Ghida Nouhad; Smith, Colin Andrew

    2016-03-01

    Dust rains may be particularly effective at delivering microorganisms, yet their biodiversities have been seldom examined. During 2011 and 2012 in Beirut, Lebanon, 16 of 21 collected rainfalls appeared dusty. Trajectory modelling of air mass origins was consistent with North African sources and at least one Southwest Asian source. As much as ~4 g particulate matter, ~20 μg DNA, and 50 million colony forming units were found deposited per square meter during rainfalls each lasting less than one day. Sequencing of 93 bacteria and 25 fungi cultured from rain samples revealed diverse bacterial phyla, both Gram positive and negative, and Ascomycota fungi. Denaturing Gradient Gel Electrophoresis of amplified 16S rDNA of 13 rains revealed distinct and diverse assemblages of bacteria. Dust rain 16S libraries yielded 131 sequences matching, in decreasing order of abundance, Betaproteobacteria, Alphaproteobacteria, Firmicutes, Actinobacteria, Bacteroidetes, Cyanobacteria, Epsilonproteobacteria, Gammaproteobacteria, and Deltaproteobacteria. Clean rain 16S libraries yielded 33 sequences matching only Betaproteobacteria family Oxalobacteraceae. Microbial composition varied between dust rains, and more diverse and different microbes were found in dust rains than clean rains. These results show that dust rains deliver diverse communities of microorganisms that may be complex products of revived desert soil species and fertilized cloud species.

  12. A qualitative evaluation of a physician-delivered pedometer-based step count prescription strategy with insight from participants and treating physicians.

    Science.gov (United States)

    Cooke, Alexandra B; Pace, Romina; Chan, Deborah; Rosenberg, Ellen; Dasgupta, Kaberi; Daskalopoulou, Stella S

    2018-05-01

    The integration of pedometers into clinical practice has the potential to enhance physical activity levels in patients with chronic disease. Our SMARTER randomized controlled trial demonstrated that a physician-delivered step count prescription strategy has measurable effects on daily steps, glycemic control, and insulin resistance in patients with type 2 diabetes and/or hypertension. In this study, we aimed to understand perceived barriers and facilitators influencing successful uptake and sustainability of the strategy, from patient and physician perspectives. Qualitative in-depth interviews were conducted in a purposive sample of physicians (n = 10) and participants (n = 20), including successful and less successful cases in terms of pedometer-assessed step count improvements. Themes that achieved saturation in either group through thematic analysis are presented. All participants appreciated the pedometer-based monitoring combined with step count prescriptions. Accountability to physicians and support offered by the trial coordinator influenced participant motivation. Those who increased step counts adopted strategies to integrate more steps into their routines and were able to overcome weather-related barriers by finding indoor alternative options to outdoor steps. Those who decreased step counts reported difficulty in overcoming weather-related challenges, health limitations and work constraints. Physicians indicated the strategy provided a framework for discussing physical activity and motivating patients, but emphasized the need for support from allied professionals to help deliver the strategy in busy clinical settings. A physician-delivered step count prescription strategy was feasibly integrated into clinical practice and successful in engaging most patients; however, continual support is needed for maximal engagement and sustained use. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Internet-Delivered Exposure Therapy for Fibromyalgia: A Randomized Controlled Trial.

    Science.gov (United States)

    Hedman-Lagerlöf, Maria; Hedman-Lagerlöf, Erik; Axelsson, Erland; Ljótsson, Brjánn; Engelbrektsson, Johanna; Hultkrantz, Sofia; Lundbäck, Karolina; Björkander, Daniel; Wicksell, Rikard K; Flink, Ida; Andersson, Erik

    2018-06-01

    Fibromyalgia (FM) is a common and disabling chronic pain disorder, for which existing pharmacological and psychological treatments have yet yielded insufficient effects. Previous literature has shown that exposure therapy may be an effective treatment for chronic pain. This study constitutes the first randomized controlled trial evaluating exposure therapy for FM. A total of 140 participants with diagnosed FM were randomized to a 10-week Internet-delivered exposure treatment (iExp; n=70) or a waitlist control condition (WLC; n=70). Primary outcome measure were FM symptoms and impact, and secondary outcome measures were fatigue, disability, quality of life, pain-related distress and avoidance behaviors, insomnia, depression, and anxiety. Data retention was high (100% data completion at posttreatment for primary outcome, 96% at 6-month follow-up and 94% at 12-month follow-up). Results showed that participants in the iExp group made large and superior improvements compared with WLC on FM symptoms and impact (B, -1.93; z, -10.14; P<0.001, between-group Cohen d=0.90), as well as all secondary outcomes (between-group Cohen d ranging from 0.44 to 1.38) with sustained results. We conclude that iExp seems to be an efficacious treatment for FM compared with no treatment, and the results also highlight the potential increase of accessibility by using the Internet format to deliver psychological treatments for these patients. Future trials with active control conditions are warranted.

  14. The Biological Basis of Learning and Individuality.

    Science.gov (United States)

    Kandel, Eric R.; Hawkins, Robert D.

    1992-01-01

    Describes the biological basis of learning and individuality. Presents an overview of recent discoveries that suggest learning engages a simple set of rules that modify the strength of connection between neurons in the brain. The changes are cited as playing an important role in making each individual unique. (MCO)

  15. Individual Differences in Susceptibility to Inattentional Blindness

    Science.gov (United States)

    Seegmiller, Janelle K.; Watson, Jason M.; Strayer, David L.

    2011-01-01

    Inattentional blindness refers to the finding that people do not always see what appears in their gaze. Though inattentional blindness affects large percentages of people, it is unclear if there are individual differences in susceptibility. The present study addressed whether individual differences in attentional control, as reflected by…

  16. Mindfulness-Based Cognitive Therapy for Cancer Patients Delivered via Internet: Qualitative Study of Patient and Therapist Barriers and Facilitators.

    Science.gov (United States)

    Compen, Félix R; Bisseling, Else M; Schellekens, Melanie Pj; Jansen, Ellen Tm; van der Lee, Marije L; Speckens, Anne Em

    2017-12-18

    The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT. This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists. Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT. Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics. The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found. ©Félix R Compen, Else M Bisseling, Melanie PJ Schellekens, Ellen TM

  17. Presenting Science in a Video-Delivered, Web-based Format: Comparing Learning Settings To Get the Most Out of Teaching.

    Science.gov (United States)

    Urven, Lance E.; Yin, L. Roger; Eshelman, Bruce D.; Bak, John D.

    2000-01-01

    Describes a high school course entitled "Science Technology in Society". High school students use live video presentations and world wide web courseware. Concludes that distance learning students performed as well as traditionally instructed students. (SAH)

  18. European Society of Cardiology Heart Failure Association Standards for delivering heart failure care

    NARCIS (Netherlands)

    McDonagh, Theresa A.; Blue, Lynda; Clark, Andrew L.; Dahlstroem, Ulf; Ekman, Inger; Lainscak, Mitja; McDonald, Kenneth; Ryder, Mary; Stroemberg, Anna; Jaarsma, Tiny

    The management of heart failure (HF) is complex. As a consequence, most cardiology society guidelines now state that HF care should be delivered in a multiprofessional manner. The evidence base for this approach now means that the establishment of HF management programmes is a priority. This

  19. A comparison of labour and birth experiences of women delivering in a birthing centre and at home in the Netherlands.

    NARCIS (Netherlands)

    Borquez, H.A.; Wiegers, T.A.

    2006-01-01

    OBJECTIVE: to compare the labour and birth experiences of women who delivered at home without complications with the experiences of women who delivered in a birth centre without complications. DESIGN: a descriptive study using postal questionnaires at 1-6 months after birth of a consecutive sample

  20. Group treatments for sensitive health care problems : a randomised controlled trial of group versus individual physiotherapy sessions for female urinary incontinence

    OpenAIRE

    Lamb, S. E. (Sallie E.); Pepper, Jo; Lall, Ranjit; Jørstad-Stein , Ellen C.; Clark, M. D. (Michael D.); Hill, Lesley; Fereday Smith, Jan

    2009-01-01

    Abstract Background The aim was to compare effectiveness of group versus individual sessions of physiotherapy in terms of symptoms, quality of life, and costs, and to investigate the effect of patient preference on uptake and outcome of treatment. Methods A pragmatic, multi-centre randomised controlled trial in five British National Health Service physiotherapy departments. 174 women with stress and/or urge incontinence were randomised to receive treatment from a physiotherapist delivered in ...