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Sample records for multiple difficulties including

  1. The multiple sclerosis work difficulties questionnaire: translation and cross-cultural adaptation to Turkish and assessment of validity and reliability.

    Science.gov (United States)

    Kahraman, Turhan; Özdoğar, Asiye Tuba; Honan, Cynthia Alison; Ertekin, Özge; Özakbaş, Serkan

    2018-05-09

    To linguistically and culturally adapt the Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) for use in Turkey, and to examine its reliability and validity. Following standard forward-back translation of the MSWDQ-23, it was administered to 124 people with multiple sclerosis (MS). Validity was evaluated using related outcome measures including those related to employment status and expectations, disability level, fatigue, walking, and quality of life. Randomly selected participants were asked to complete the MSWDQ-23 again to assess test-retest reliability. Confirmatory factor analysis on the MSWDQ-23 demonstrated a good fit for the data, and the internal consistency of each subscale was excellent. The test-retest reliability for the total score, psychological/cognitive barriers, physical barriers, and external barriers subscales were high. The MSWDQ-23 and its subscales were positively correlated with the employment, disability level, walking, and fatigue outcome measures. This study suggests that the Turkish version of MSWDQ-23 has high reliability and adequate validity, and it can be used to determine the difficulties faced by people with multiple sclerosis in workplace. Moreover, the study provides evidence about the test-retest reliability of the questionnaire. Implications for rehabilitation Multiple sclerosis affects young people of working age. Understanding work-related problems is crucial to enhance people with multiple sclerosis likelihood of maintaining their job. The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a valid and reliable measure of perceived workplace difficulties in people with multiple sclerosis: we presented its validation to Turkish. Professionals working in the field of vocational rehabilitation may benefit from using the MSWDQ-23 to predict the current work outcomes and future employment expectations.

  2. Older age, higher perceived disability and depressive symptoms predict the amount and severity of work-related difficulties in persons with multiple sclerosis.

    Science.gov (United States)

    Raggi, Alberto; Giovannetti, Ambra Mara; Schiavolin, Silvia; Brambilla, Laura; Brenna, Greta; Confalonieri, Paolo Agostino; Cortese, Francesca; Frangiamore, Rita; Leonardi, Matilde; Mantegazza, Renato Emilio; Moscatelli, Marco; Ponzio, Michela; Torri Clerici, Valentina; Zaratin, Paola; De Torres, Laura

    2018-04-16

    This cross-sectional study aims to identify the predictors of work-related difficulties in a sample of employed persons with multiple sclerosis as addressed with the Multiple Sclerosis Questionnaire for Job Difficulties. Hierarchical linear regression analysis was conducted to identify predictors of work difficulties: predictors included demographic variables (age, formal education), disease duration and severity, perceived disability and psychological variables (cognitive dysfunction, depression and anxiety). The targets were the questionnaire's overall score and its six subscales. A total of 177 participants (108 females, aged 21-63) were recruited. Age, perceived disability and depression were direct and significant predictors of the questionnaire total score, and the final model explained 43.7% of its variation. The models built on the questionnaire's subscales show that perceived disability and depression were direct and significant predictors of most of its subscales. Our results show that, among patients with multiple sclerosis, those who were older, with higher perceived disability and higher depression symptoms have more and more severe work-related difficulties. The Multiple Sclerosis Questionnaire for Job Difficulties can be fruitfully exploited to plan tailored actions to limit the likelihood of near-future job loss in persons of working age with multiple sclerosis. Implications for rehabilitation Difficulties with work are common among people with multiple sclerosis and are usually addressed in terms of unemployment or job loss. The Multiple Sclerosis Questionnaire for Job Difficulties is a disease-specific questionnaire developed to address the amount and severity of work-related difficulties. We found that work-related difficulties were associated to older age, higher perceived disability and depressive symptoms. Mental health issues and perceived disability should be consistently included in future research targeting work-related difficulties.

  3. Plasma Cell Neoplasms (Including Multiple Myeloma)—Patient Version

    Science.gov (United States)

    Plasma cell neoplasms occur when abnormal plasma cells form cancerous tumors. When there is only one tumor, the disease is called a plasmacytoma. When there are multiple tumors, it is called multiple myeloma. Start here to find information on plasma cell neoplasms treatment, research, and statistics.

  4. Stages of Plasma Cell Neoplasms (Including Multiple Myeloma)

    Science.gov (United States)

    ... cancer treatment is also called biotherapy or immunotherapy. Immunomodulators are a type of biologic therapy. Thalidomide , lenalidomide , and pomalidomide are immunomodulators used to treat multiple myeloma and other plasma ...

  5. Treatment Options for Plasma Cell Neoplasms (Including Multiple Myeloma)

    Science.gov (United States)

    ... cancer treatment is also called biotherapy or immunotherapy. Immunomodulators are a type of biologic therapy. Thalidomide , lenalidomide , and pomalidomide are immunomodulators used to treat multiple myeloma and other plasma ...

  6. A review of multiple stressor studies that include ionising radiation

    International Nuclear Information System (INIS)

    Vanhoudt, Nathalie; Vandenhove, Hildegarde; Real, Almudena; Bradshaw, Clare; Stark, Karolina

    2012-01-01

    Studies were reviewed that investigated the combined effects of ionising radiation and other stressors on non-human biota. The aim was to determine the state of research in this area of science, and determine if a review of the literature might permit a gross generalization as to whether the combined effects of multi-stressors and radiation are fundamentally additive, synergistic or antagonistic. A multiple stressor database was established for different organism groups. Information was collected on species, stressors applied and effects evaluated. Studies were mostly laboratory based and investigated two-component mixtures. Interactions declared positive occurred in 58% of the studies, while 26% found negative interactions. Interactions were dependent on dose/concentration, on organism's life stage and exposure time and differed among endpoints. Except for one study, none of the studies predicted combined effects following Concentration Addition or Independent Action, and hence, no justified conclusions can be made about synergism or antagonism. - This review on multiple stressor studies involving radiation, highlights that most experimental designs used did not allow to deduce the nature of the interactive effects.

  7. Multiple imaging procedures including MRI for the bladder cancer

    International Nuclear Information System (INIS)

    Mikata, Noriharu; Suzuki, Makoto; Takeuchi, Takumi; Kunisawa, Yositaka; Fukutani, Keiko; Kawabe, Kazuki

    1986-01-01

    Endoscopic photography, double contrast cystography, transurethral echography, X-ray CT scan, and MRI (magnetic resonance imaging) were utilized for the staging diagnosis of the four patients with carcinoma of the bladder. In the first case, a 70-year-old man, since all of the five imaging procedures suggested a superficial and pedunculated tumor, his bladder cancer was considered T1. The classification of stage T3 carcinoma was made for the second 86-year-old male. Because all of his imaging examinations showed a tumor infiltrating deep muscle and penetrating the bladder wall. The third case was a 36-year-old male. His clinical stage was diagnosed as T2 or T3a by cystophotography, double contrast cystogram, ultrasonography, and X-ray CT scan. However, MRI showed only thickened bladder wall and the infiltrating tumor could not be distinguished from the hypertrophic wall. The last patient, a 85-year-old female, had a smaller Ta cancer. Her double contrast cystography revealed the small tumor at the lateral bladder wall. But, the tumor could not be detected by transaxial, sagittal and coronal scans. Multiple imaging procedures combining MRI and staging diagnosis of the bladder carcinoma were discussed. (author)

  8. Solution of neutron slowing down equation including multiple inelastic scattering

    International Nuclear Information System (INIS)

    El-Wakil, S.A.; Saad, A.E.

    1977-01-01

    The present work is devoted the presentation of an analytical method for the calculation of elastically and inelastically slowed down neutrons in an infinite non absorbing homogeneous medium. On the basis of the Central limit theory (CLT) and the integral transform technique the slowing down equation including inelastic scattering in terms of the Green function of elastic scattering is solved. The Green function is decomposed according to the number of collisions. A formula for the flux at any lethargy O (u) after any number of collisions is derived. An equation for the asymptotic flux is also obtained

  9. The influence of multiple sensory impairments on functional balance and difficulty with falls among U.S. adults.

    Science.gov (United States)

    Wilson, Samuel J; Garner, John C; Loprinzi, Paul D

    2016-06-01

    Studies have looked at the individual associations of sensory impairment on balance, but no population-based studies have examined their combined association on balance and difficulty with falls. Thus, the purpose of this study was to examine both the independent associations and combined associations of visual impairment, peripheral neuropathy, and self-reported hearing loss with the odds of reporting difficulty with falls and functional balance. Data from the 2003-2004 National Health and Nutrition Examination Survey were used. Vision and peripheral neuropathy were objectively measured, and hearing was self-reported. Balance testing consisted of a modified Romberg test. After exclusions, 1662 (40-85years of age) participants provided complete data on the study variables. Sensory impairment was associated with perceived difficulty of falls and functional balance. Participants who presented a single sensory impairment had 29% reduced odds of having functional balance (95% CI=0.54-0.93, p=0.01) and increased odds of reporting difficulty with falls by 61% (95% CI=0.99-2.60, p=0.05). Moreover, our multisensory models showed some evidence of a dose-response relationship, in that sensory impairment of multiple sensory systems was associated with worse balance (OR =0.59, CI=0.35-1.00, p=0.05) and perceived difficulty of falls (OR =5.02, 95% CI=1.99-12.66, p=0.002) when compared to those with less sensory impairment. Multiple sensory impairment is associated with significantly higher odds of both reporting difficulty with falls and balance dysfunction, which may lead to a subsequent fall, ultimately compromising the individual's health. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Multiple Family Groups for Child Behavior Difficulties: Retention Among Child Welfare-Involved Caregivers

    Science.gov (United States)

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P.

    2015-01-01

    Purpose: The Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders has shown promise in engaging child welfare-involved families. This qualitative study examines caregivers' perceptions of factors that influence retention in MFGs among child welfare-involved families. Methods: Twenty-five…

  11. Model for CO2 leakage including multiple geological layers and multiple leaky wells.

    Science.gov (United States)

    Nordbotten, Jan M; Kavetski, Dmitri; Celia, Michael A; Bachu, Stefan

    2009-02-01

    Geological storage of carbon dioxide (CO2) is likely to be an integral component of any realistic plan to reduce anthropogenic greenhouse gas emissions. In conjunction with large-scale deployment of carbon storage as a technology, there is an urgent need for tools which provide reliable and quick assessments of aquifer storage performance. Previously, abandoned wells from over a century of oil and gas exploration and production have been identified as critical potential leakage paths. The practical importance of abandoned wells is emphasized by the correlation of heavy CO2 emitters (typically associated with industrialized areas) to oil and gas producing regions in North America. Herein, we describe a novel framework for predicting the leakage from large numbers of abandoned wells, forming leakage paths connecting multiple subsurface permeable formations. The framework is designed to exploit analytical solutions to various components of the problem and, ultimately, leads to a grid-free approximation to CO2 and brine leakage rates, as well as fluid distributions. We apply our model in a comparison to an established numerical solverforthe underlying governing equations. Thereafter, we demonstrate the capabilities of the model on typical field data taken from the vicinity of Edmonton, Alberta. This data set consists of over 500 wells and 7 permeable formations. Results show the flexibility and utility of the solution methods, and highlight the role that analytical and semianalytical solutions can play in this important problem.

  12. 42 CFR 137.327 - May multiple projects be included in a single construction project agreement?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May multiple projects be included in a single construction project agreement? 137.327 Section 137.327 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF...-GOVERNANCE Construction Project Assumption Process § 137.327 May multiple projects be included in a single...

  13. Plasma Cell Neoplasms (Including Multiple Myeloma)—Health Professional Version

    Science.gov (United States)

    There are several types of plasma cell neoplasms, including monoclonal gammopathy of undetermined significance (MGUS), isolated plasmacytoma of the bone, extramedullary plasmacytoma, and multiple myeloma. Find evidence-based information on plasma cell neoplasms treatment, research, and statistics.

  14. Exact multiple scattering theory of two-nucleus collisions including the Pauli principle

    International Nuclear Information System (INIS)

    Gurvitz, S.A.

    1981-01-01

    Exact equations for two-nucleus scattering are derived in which the effects of the Pauli principle are fully included. Our method exploits a modified equation for the scattering of two identical nucleons, which is obtained at the beginning. Considering proton-nucleus scattering we found that the resulting amplitude has two components, one resembling a multiple scattering series for distinguishable particles, and the other a distorted (A-1) nucleon cluster exchange. For elastic pA scattering the multiple scattering amplitude is found in the form of an optical potential expansion. We show that the Kerman-McManus-Thaler theory of the optical potential could be easily modified to include the effects of antisymmetrization of the projectile with the target nucleons. Nucleus-nucleus scattering is studied first for distinguishable target and beam nucleus. Afterwards the Pauli principle is included, where only the case of deuteron-nucleus scattering is discussed in detail. The resulting amplitude has four components. Two of them correspond to modified multiple scattering expansions and the others are distorted (A-1)- and (A-2)- nucleon cluster exchange. The result for d-A scattering is extended to the general case of nucleus-nucleus scattering. The equations are simple to use and as such constitute an improvement over existing schemes

  15. Induced Systemic Tolerance to Multiple Stresses Including Biotic and Abiotic Factors by Rhizobacteria

    Directory of Open Access Journals (Sweden)

    Sung-Je Yoo

    2017-06-01

    Full Text Available Recently, global warming and drastic climate change are the greatest threat to the world. The climate change can affect plant productivity by reducing plant adaptation to diverse environments including frequent high temperature; worsen drought condition and increased pathogen transmission and infection. Plants have to survive in this condition with a variety of biotic (pathogen/pest attack and abiotic stress (salt, high/low temperature, drought. Plants can interact with beneficial microbes including plant growth-promoting rhizobacteria, which help plant mitigate biotic and abiotic stress. This overview presents that rhizobacteria plays an important role in induced systemic resistance (ISR to biotic stress or induced systemic tolerance (IST to abiotic stress condition; bacterial determinants related to ISR and/or IST. In addition, we describe effects of rhizobacteria on defense/tolerance related signal pathway in plants. We also review recent information including plant resistance or tolerance against multiple stresses (bioticabiotic. We desire that this review contribute to expand understanding and knowledge on the microbial application in a constantly varying agroecosystem, and suggest beneficial microbes as one of alternative environment-friendly application to alleviate multiple stresses.

  16. Item difficulty of multiple choice tests dependant on different item response formats – An experiment in fundamental research on psychological assessment

    Directory of Open Access Journals (Sweden)

    KLAUS D. KUBINGER

    2007-12-01

    Full Text Available Multiple choice response formats are problematical as an item is often scored as solved simply because the test-taker is a lucky guesser. Instead of applying pertinent IRT models which take guessing effects into account, a pragmatic approach of re-conceptualizing multiple choice response formats to reduce the chance of lucky guessing is considered. This paper compares the free response format with two different multiple choice formats. A common multiple choice format with a single correct response option and five distractors (“1 of 6” is used, as well as a multiple choice format with five response options, of which any number of the five is correct and the item is only scored as mastered if all the correct response options and none of the wrong ones are marked (“x of 5”. An experiment was designed, using pairs of items with exactly the same content but different response formats. 173 test-takers were randomly assigned to two test booklets of 150 items altogether. Rasch model analyses adduced a fitting item pool, after the deletion of 39 items. The resulting item difficulty parameters were used for the comparison of the different formats. The multiple choice format “1 of 6” differs significantly from “x of 5”, with a relative effect of 1.63, while the multiple choice format “x of 5” does not significantly differ from the free response format. Therefore, the lower degree of difficulty of items with the “1 of 6” multiple choice format is an indicator of relevant guessing effects. In contrast the “x of 5” multiple choice format can be seen as an appropriate substitute for free response format.

  17. The relationship between multiple developmental difficulties in very low birth weight children at 3½ years of age and the need for learning support at 5 years of age

    NARCIS (Netherlands)

    Verkerk, Gijs; Jeukens-Visser, Martine; van Wassenaer-Leemhuis, Aleid; Kok, Joke; Nollet, Frans

    2014-01-01

    This study investigated whether multiple developmental difficulties are more frequent in very low birth weight (VLBW) children than in those born full term. The association between multiple developmental difficulties assessed at 3½ years of age and educational provision for the child at 5½ years was

  18. Cerebellar abnormalities contribute to disability including cognitive impairment in multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Katrin Weier

    Full Text Available The cerebellum is known to be involved not only in motor but also cognitive and affective processes. Structural changes in the cerebellum in relation to cognitive dysfunction are an emerging topic in the field of neuro-psychiatric disorders. In Multiple Sclerosis (MS cerebellar motor and cognitive dysfunction occur in parallel, early in the onset of the disease, and the cerebellum is one of the predilection sites of atrophy. This study is aimed at determining the relationship between cerebellar volumes, clinical cerebellar signs, cognitive functioning and fatigue in MS. Cerebellar volumetry was conducted using T1-weighted MPRAGE magnetic resonance imaging of 172 MS patients. All patients underwent a clinical and brief neuropsychological assessment (information processing speed, working memory, including fatigue testing. Patients with and without cerebellar signs differed significantly regarding normalized cerebellar total volume (nTCV, normalized brain volume (nBV and whole brain T2 lesion volume (LV. Patients with cerebellar dysfunction likewise performed worse in cognitive tests. A regression analysis indicated that age and nTCV explained 26.3% of the variance in SDMT (symbol digit modalities test performance. However, only age, T2 LV and nBV remained predictors in the full model (r(2 = 0.36. The full model for the prediction of PASAT (Paced Auditory Serial Addition Test scores (r(2 = 0.23 included age, cerebellar and T2 LV. In the case of fatigue, only age and nBV (r(2 = 0.17 emerged as significant predictors. These data support the view that cerebellar abnormalities contribute to disability, including cognitive impairment in MS. However, this contribution does not seem to be independent of, and may even be dominated by wider spread MS pathology as reflected by nBV and T2 LV.

  19. Thermoelectric material including a multiple transition metal-doped type I clathrate crystal structure

    Science.gov (United States)

    Yang, Jihui [Lakeshore, CA; Shi, Xun [Troy, MI; Bai, Shengqiang [Shanghai, CN; Zhang, Wenqing [Shanghai, CN; Chen, Lidong [Shanghai, CN; Yang, Jiong [Shanghai, CN

    2012-01-17

    A thermoelectric material includes a multiple transition metal-doped type I clathrate crystal structure having the formula A.sub.8TM.sub.y.sub.1.sup.1TM.sub.y.sub.2.sup.2 . . . TM.sub.y.sub.n.sup.nM.sub.zX.sub.46-y.sub.1.sub.-y.sub.2.sub.- . . . -y.sub.n.sub.-z. In the formula, A is selected from the group consisting of barium, strontium, and europium; X is selected from the group consisting of silicon, germanium, and tin; M is selected from the group consisting of aluminum, gallium, and indium; TM.sup.1, TM.sup.2, and TM.sup.n are independently selected from the group consisting of 3d, 4d, and 5d transition metals; and y.sub.1, y.sub.2, y.sub.n and Z are actual compositions of TM.sup.1, TM.sup.2, TM.sup.n, and M, respectively. The actual compositions are based upon nominal compositions derived from the following equation: z=8q.sub.A-|.DELTA.q.sub.1|y.sub.1-|.DELTA.q.sub.2|y.sub.2- . . . -|.DELTA.q.sub.n|y.sub.n, wherein q.sub.A is a charge state of A, and wherein .DELTA.q.sub.1, .DELTA.q.sub.2, .DELTA.q.sub.n are, respectively, the nominal charge state of the first, second, and n-th TM.

  20. The “incredible” difficulty of proving “incredibility” – Example of fire-induced multiple spurious operations

    International Nuclear Information System (INIS)

    Gallucci, Raymond H.V.

    2016-01-01

    “Risk-informed” regulation is often an alternative to “deterministically-based” regulation that offers relaxation in criteria for acceptability while possibly requiring greater analytical effort. “Risk-informed determinism” is an attempt to meld the best of both worlds by using risk information to set deterministic acceptance criteria a priori. A recent joint effort by the US Nuclear Regulatory Commission’s Office of Nuclear Regulatory Research (RES) and Electric Power Research Institute (EPRI) originally endeavored to do this for several examples involving fire-induced multiple spurious operations (MSOs) in electrical circuits at nuclear power plants. While a noble effort, this did not consider the actual distributions involved in the events, originally limiting the analysis to mean values and, in some cases, qualitative considerations. A much more comprehensive and defensible approach is performed here where the probabilistic distributions for all the factors are considered via simulation to meet quantitative acceptance criteria related to the concept of “incredibility” that is often the figure of merit that must be met in a deterministic world. The effort demonstrates that it can be “incredibly” difficult to prove “incredibility” in this context.

  1. The “incredible” difficulty of proving “incredibility” – Example of fire-induced multiple spurious operations

    Energy Technology Data Exchange (ETDEWEB)

    Gallucci, Raymond H.V., E-mail: Ray.Gallucci@nrc.gov

    2016-11-15

    “Risk-informed” regulation is often an alternative to “deterministically-based” regulation that offers relaxation in criteria for acceptability while possibly requiring greater analytical effort. “Risk-informed determinism” is an attempt to meld the best of both worlds by using risk information to set deterministic acceptance criteria a priori. A recent joint effort by the US Nuclear Regulatory Commission’s Office of Nuclear Regulatory Research (RES) and Electric Power Research Institute (EPRI) originally endeavored to do this for several examples involving fire-induced multiple spurious operations (MSOs) in electrical circuits at nuclear power plants. While a noble effort, this did not consider the actual distributions involved in the events, originally limiting the analysis to mean values and, in some cases, qualitative considerations. A much more comprehensive and defensible approach is performed here where the probabilistic distributions for all the factors are considered via simulation to meet quantitative acceptance criteria related to the concept of “incredibility” that is often the figure of merit that must be met in a deterministic world. The effort demonstrates that it can be “incredibly” difficult to prove “incredibility” in this context.

  2. Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Plasma cell neoplasms occur when abnormal plasma cells or myeloma cells form tumors in the bones or soft tissues of the body. Multiple myeloma, plasmacytoma, lymphoplasmacytic lymphoma, and monoclonal gammopathy of undetermined significance (MGUS) are different types of plasma cell neoplasms. Find out about risk factors, symptoms, diagnostic tests, prognosis, and treatment for these diseases.

  3. Automatic treatment of multiple wound coils in 3D finite element problems including multiply connected regions

    Energy Technology Data Exchange (ETDEWEB)

    Leonard, P.J.; Lai, H.C.; Eastham, J.F.; Al-Akayshee, Q.H. [Univ. of Bath (United Kingdom)

    1996-05-01

    This paper describes an efficient scheme for incorporating multiple wire wound coils into 3D finite element models. The scheme is based on the magnetic scalar representation with an additional basis for each coil. There are no restrictions on the topology of coils with respect to ferromagnetic and conductor regions. Reduced scalar regions and cuts are automatically generated.

  4. A Case Study of Tack Tiles[R] Literacy Instruction for a Student with Multiple Disabilities Including Congenital Blindness

    Science.gov (United States)

    Klenk, Jessicia A.; Pufpaff, Lisa A.

    2011-01-01

    Research on literacy instruction for students with multiple disabilities is limited. Empirical research on braille instruction for students with multiple disabilities that include congenital blindness is virtually nonexistent. This case study offers initial insight into possible methods of early braille literacy instruction for a student with…

  5. Clinical problems of multiple primary cancers including head and neck cancers. From the viewpoint of radiotherapy

    International Nuclear Information System (INIS)

    Nishio, Masamichi; Myojin, Miyako; Nishiyama, Noriaki; Taguchi, Hiroshi; Takagi, Masaru; Tanaka, Katsuhiko

    2003-01-01

    A total of 2144 head and neck cancers were treated by radiotherapy at the National Sapporo Hospital between 1974 and 2001. Of these, 313 (14.6%) were found to have other primary cancers besides head and neck cancer, in which double cancers were 79% and triple or more cancers were 21%. Frequency according to primary site of the first head and neck cancer was oral cavity: 107/603 (17.7%), epipharynx cancer: 7/117 (6.0%), oropharyngeal cancer: 63/257 (24.5%), hypopharyngeal cancer: 65/200 (32.5%), laryngeal cancer: 114/558 (20.4%), and nose/paranasal sinus: 4.9% respectively. Esophageal cancer, head and neck cancer, lung cancer and gastric cancer were very frequent as other primary sites combined with the head and neck. The first onset region was the head and neck in 233 out of 313 cases with multiple primary cancers. The five-year survival rate from the onset of head and neck cancers is 52%, 10-year: 30%, and 5-year cause-specific survival rate 82%, and 10-year: 78%, respectively. The treatment possibilities in multiple primary cancers tend to be limited because the treatment areas are sometimes overlapped. New approaches to the treatment of multiple primary cancers should be considered in the future. (author)

  6. Multiple shooting applied to robust reservoir control optimization including output constraints on coherent risk measures

    DEFF Research Database (Denmark)

    Codas, Andrés; Hanssen, Kristian G.; Foss, Bjarne

    2017-01-01

    The production life of oil reservoirs starts under significant uncertainty regarding the actual economical return of the recovery process due to the lack of oil field data. Consequently, investors and operators make management decisions based on a limited and uncertain description of the reservoir....... In this work, we propose a new formulation for robust optimization of reservoir well controls. It is inspired by the multiple shooting (MS) method which permits a broad range of parallelization opportunities and output constraint handling. This formulation exploits coherent risk measures, a concept...

  7. Multiple Crack Growth Prediction in AA2024-T3 Friction Stir Welded Joints, Including Manufacturing Effects

    DEFF Research Database (Denmark)

    Carlone, Pierpaolo; Citarella, Roberto; Sonne, Mads Rostgaard

    2016-01-01

    A great deal of attention is currently paid by several industries toward the friction stir welding process to realize lightweight structures. Within this aim, the realistic prediction of fatigue behavior of welded assemblies is a key factor. In this work an integrated finite element method - dual...... boundary element method (FEM-DBEM) procedure, coupling the welding process simulation to the subsequent crack growth assessment, is proposed and applied to simulate multiple crack propagation, with allowance for manufacturing effects. The friction stir butt welding process of the precipitation hardened AA...... on a notched specimen. The whole procedure was finally tested comparing simulation outcomes with experimental data. The good agreement obtained highlights the predictive capability of the method. The influence of the residual stress distribution on crack growth and the mutual interaction between propagating...

  8. The dyad palindromic glutathione transferase P enhancer binds multiple factors including AP1.

    Science.gov (United States)

    Diccianni, M B; Imagawa, M; Muramatsu, M

    1992-10-11

    Glutathione Transferase P (GST-P) gene expression is dominantly regulated by an upstream enhancer (GPEI) consisting of a dyad of palindromically oriented imperfect TPA (12-O-tetradecanoyl-phorbol-13-acetate)-responsive elements (TRE). GPEI is active in AP1-lacking F9 cells as well in AP1-containing HeLa cells. Despite GPEI's similarity to a TRE, c-jun co-transfection has only a minimal effect on transactivation. Antisense c-jun and c-fos co-transfection experiments further demonstrate the lack of a role for AP1 in GPEI mediated trans-activation in F9 cells, although endogenously present AP1 can influence GPEI in HeLa cells. Co-transfection of delta fosB with c-jun, which forms an inactive c-Jun/delta FosB heterodimer that binds TRE sequences, inhibits GPEI-mediated transcription in AP1-lacking F9 cells as well as AP1-containing HeLa cells. These data suggest novel factor(s) other than AP1 are influencing GPEI. Binding studies reveal multiple nucleoproteins bind to GPEI. These factors are likely responsible for the high level of GPEI-mediated transcription observed in the absence of AP1 and during hepatocarcinogenesis.

  9. GWAS of clinically defined gout and subtypes identifies multiple susceptibility loci that include urate transporter genes

    NARCIS (Netherlands)

    Nakayama, A.; Nakaoka, H.; Yamamoto, K.; Sakiyama, M.; Shaukat, A.; Toyoda, Y.; Okada, Y.; Kamatani, Y.; Nakamura, T.; Takada, T.; Inoue, K.; Yasujima, T.; Yuasa, H.; Shirahama, Y.; Nakashima, H.; Shimizu, S.; Higashino, T.; Kawamura, Y.; Ogata, H.; Kawaguchi, M.; Ohkawa, Y.; Danjoh, I.; Tokumasu, A.; Ooyama, K.; Ito, T.; Kondo, T.; Wakai, K.; Stiburkova, B.; Pavelka, K.; Stamp, L.K.; Dalbeth, N.; Sakurai, Y.; Suzuki, H; Hosoyamada, M.; Fujimori, S.; Yokoo, T.; Hosoya, T.; Inoue, I.; Takahashi, A.; Kubo, M.; Ooyama, H.; Shimizu, T.; Ichida, K.; Shinomiya, N.; Merriman, T.R.; Matsuo, H.; Andres, M; Joosten, L.A.; Janssen, M.C.H.; Jansen, T.L.; Liote, F.; Radstake, T.R.; Riches, P.L.; So, A.; Tauches, A.K.

    2017-01-01

    OBJECTIVE: A genome-wide association study (GWAS) of gout and its subtypes was performed to identify novel gout loci, including those that are subtype-specific. METHODS: Putative causal association signals from a GWAS of 945 clinically defined gout cases and 1213 controls from Japanese males were

  10. Using Photovoice to Include People with Profound and Multiple Learning Disabilities in Inclusive Research

    Science.gov (United States)

    Cluley, Victoria

    2017-01-01

    Background: It is now expected that projects addressing the lives of people with learning disabilities include people with learning disabilities in the research process. In the past, such research often excluded people with learning disabilities, favouring the opinions of family members, carers and professionals. The inclusion of the voices of…

  11. Prospective evaluation of dermatologic surgery complications including patients on multiple antiplatelet and anticoagulant medications.

    Science.gov (United States)

    Bordeaux, Jeremy S; Martires, Kathryn J; Goldberg, Dori; Pattee, Sean F; Fu, Pingfu; Maloney, Mary E

    2011-09-01

    Few prospective studies have evaluated the safety of dermatologic surgery. We sought to determine rates of bleeding, infection, flap and graft necrosis, and dehiscence in outpatient dermatologic surgery, and to examine their relationship to type of repair, anatomic location of repair, antibiotic use, antiplatelet use, or anticoagulant use. Patients presenting to University of Massachusetts Medical School Dermatology Clinic for surgery during a 15-month period were prospectively entered. Medications, procedures, and complications were recorded. Of the 1911 patients, 38% were on one anticoagulant or antiplatelet medication, and 8.0% were on two or more. Risk of hemorrhage was 0.89%. Complex repair (odds ratio [OR] = 5.80), graft repair (OR = 7.58), flap repair (OR = 11.93), and partial repair (OR = 43.13) were more likely to result in bleeding than intermediate repair. Patients on both clopidogrel and warfarin were 40 times more likely to have bleeding complications than all others (P = .03). Risk of infection was 1.3%, but was greater than 3% on the genitalia, scalp, back, and leg. Partial flap necrosis occurred in 1.7% of flaps, and partial graft necrosis occurred in 8.6% of grafts. Partial graft necrosis occurred in 20% of grafts on the scalp and 10% of grafts on the nose. All complications resolved without sequelae. The study was limited to one academic dermatology practice. The rate of complications in dermatologic surgery is low, even when multiple oral anticoagulant and antiplatelet medications are continued, and prophylactic antibiotics are not used. Closure type and use of warfarin or clopidogrel increase bleeding risk. However, these medications should be continued to avoid adverse thrombotic events. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  12. Identification of Multiple Novel Viruses, Including a Parvovirus and a Hepevirus, in Feces of Red Foxes

    Science.gov (United States)

    van der Giessen, Joke; Haagmans, Bart L.; Osterhaus, Albert D. M. E.; Smits, Saskia L.

    2013-01-01

    Red foxes (Vulpes vulpes) are the most widespread members of the order of Carnivora. Since they often live in (peri)urban areas, they are a potential reservoir of viruses that transmit from wildlife to humans or domestic animals. Here we evaluated the fecal viral microbiome of 13 red foxes by random PCR in combination with next-generation sequencing. Various novel viruses, including a parvovirus, bocavirus, adeno-associated virus, hepevirus, astroviruses, and picobirnaviruses, were identified. PMID:23616657

  13. GWAS of clinically defined gout and subtypes identifies multiple susceptibility loci that include urate transporter genes

    OpenAIRE

    Nakayama, Akiyoshi; Nakaoka, Hirofumi; Yamamoto, Ken; Sakiyama, Masayuki; Shaukat, Amara; Toyoda, Yu; Okada, Yukinori; Kamatani, Yoichiro; Nakamura, Takahiro; Takada, Tappei; Inoue, Katsuhisa; Yasujima, Tomoya; Yuasa, Hiroaki; Shirahama, Yuko; Nakashima, Hiroshi

    2016-01-01

    Objective A genome-wide association study (GWAS) of gout and its subtypes was performed to identify novel gout loci, including those that are subtype-specific. Methods Putative causal association signals from a GWAS of 945 clinically defined gout cases and 1213 controls from Japanese males were replicated with 1396 cases and 1268 controls using a custom chip of 1961 single nucleotide polymorphisms (SNPs). We also first conducted GWASs of gout subtypes. Replication with Caucasian and New Zeala...

  14. GWAS of clinically defined gout and subtypes identifies multiple susceptibility loci that include urate transporter genes.

    Science.gov (United States)

    Nakayama, Akiyoshi; Nakaoka, Hirofumi; Yamamoto, Ken; Sakiyama, Masayuki; Shaukat, Amara; Toyoda, Yu; Okada, Yukinori; Kamatani, Yoichiro; Nakamura, Takahiro; Takada, Tappei; Inoue, Katsuhisa; Yasujima, Tomoya; Yuasa, Hiroaki; Shirahama, Yuko; Nakashima, Hiroshi; Shimizu, Seiko; Higashino, Toshihide; Kawamura, Yusuke; Ogata, Hiraku; Kawaguchi, Makoto; Ohkawa, Yasuyuki; Danjoh, Inaho; Tokumasu, Atsumi; Ooyama, Keiko; Ito, Toshimitsu; Kondo, Takaaki; Wakai, Kenji; Stiburkova, Blanka; Pavelka, Karel; Stamp, Lisa K; Dalbeth, Nicola; Sakurai, Yutaka; Suzuki, Hiroshi; Hosoyamada, Makoto; Fujimori, Shin; Yokoo, Takashi; Hosoya, Tatsuo; Inoue, Ituro; Takahashi, Atsushi; Kubo, Michiaki; Ooyama, Hiroshi; Shimizu, Toru; Ichida, Kimiyoshi; Shinomiya, Nariyoshi; Merriman, Tony R; Matsuo, Hirotaka

    2017-05-01

    A genome-wide association study (GWAS) of gout and its subtypes was performed to identify novel gout loci, including those that are subtype-specific. Putative causal association signals from a GWAS of 945 clinically defined gout cases and 1213 controls from Japanese males were replicated with 1396 cases and 1268 controls using a custom chip of 1961 single nucleotide polymorphisms (SNPs). We also first conducted GWASs of gout subtypes. Replication with Caucasian and New Zealand Polynesian samples was done to further validate the loci identified in this study. In addition to the five loci we reported previously, further susceptibility loci were identified at a genome-wide significance level (pgout cases, and NIPAL1 and FAM35A for the renal underexcretion gout subtype. While NIPAL1 encodes a magnesium transporter, functional analysis did not detect urate transport via NIPAL1, suggesting an indirect association with urate handling. Localisation analysis in the human kidney revealed expression of NIPAL1 and FAM35A mainly in the distal tubules, which suggests the involvement of the distal nephron in urate handling in humans. Clinically ascertained male patients with gout and controls of Caucasian and Polynesian ancestries were also genotyped, and FAM35A was associated with gout in all cases. A meta-analysis of the three populations revealed FAM35A to be associated with gout at a genome-wide level of significance (p meta =3.58×10 -8 ). Our findings including novel gout risk loci provide further understanding of the molecular pathogenesis of gout and lead to a novel concept for the therapeutic target of gout/hyperuricaemia. 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/.

  15. Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis.

    Science.gov (United States)

    Broggi, G; Ferroli, P; Franzini, A; Servello, D; Dones, I

    2000-01-01

    To examine surgical findings and results of microvascular decompression (MVD) for trigeminal neuralgia (TN), including patients with multiple sclerosis, to bring new insight about the role of microvascular compression in the pathogenesis of the disorder and the role of MVD in its treatment. Between 1990 and 1998, 250 patients affected by trigeminal neuralgia underwent MVD in the Department of Neurosurgery of the "Istituto Nazionale Neurologico C Besta" in Milan. Limiting the review to the period 1991-6, to exclude the "learning period" (the first 50 cases) and patients with less than 1 year follow up, surgical findings and results were critically analysed in 148 consecutive cases, including 10 patients with multiple sclerosis. Vascular compression of the trigeminal nerve was found in all cases. The recurrence rate was 15.3% (follow up 1-7 years, mean 38 months). In five of 10 patients with multiple sclerosis an excellent result was achieved (follow up 12-39 months, mean 24 months). Patients with TN for more than 84 months did significantly worse than those with a shorter history (p<0.05). There was no mortality and most complications occurred in the learning period. Surgical complications were not related to age of the patients. Aetiopathogenesis of trigeminal neuralgia remains a mystery. These findings suggest a common neuromodulatory role of microvascular compression in both patients with or without multiple sclerosis rather than a direct causal role. MVD was found to be a safe and effective procedure to relieve typical TN in patients of all ages. It should be proposed as first choice surgery to all patients affected by TN, even in selected cases with multiple sclerosis, to give them the opportunity of pain relief without sensory deficits.

  16. Multiple time-scale optimization scheduling for islanded microgrids including PV, wind turbine, diesel generator and batteries

    DEFF Research Database (Denmark)

    Xiao, Zhao xia; Nan, Jiakai; Guerrero, Josep M.

    2017-01-01

    A multiple time-scale optimization scheduling including day ahead and short time for an islanded microgrid is presented. In this paper, the microgrid under study includes photovoltaics (PV), wind turbine (WT), diesel generator (DG), batteries, and shiftable loads. The study considers the maximum...... efficiency operation area for the diesel engine and the cost of the battery charge/discharge cycle losses. The day-ahead generation scheduling takes into account the minimum operational cost and the maximum load satisfaction as the objective function. Short-term optimal dispatch is based on minimizing...

  17. Reliability analysis of the auxiliary feedwater system of Angra-1 including common cause failures using the multiple greek letter model

    International Nuclear Information System (INIS)

    Lapa, Celso Marcelo Franklin.

    1996-05-01

    The use of redundancy to increase the reliability of industrial systems make them subject to the occurrence of common cause events. The industrial experience and the results of safety analysis studies have indicated that common cause failures are the main contributors to the unreliability of plants that have redundant systems, specially in nuclear power plants. In this Thesis procedures are developed in order to include the impact of common cause failures in the calculation of the top event occurrence probability of the Auxiliary Feedwater System in a typical two-loop Nuclear Power Plant (PWR). For this purpose the Multiple Greek Letter Model is used. (author). 14 refs., 10 figs., 11 tabs

  18. Comparison and clinical utility evaluation of four multiple allergen simultaneous tests including two newly introduced fully automated analyzers

    Directory of Open Access Journals (Sweden)

    John Hoon Rim

    2016-04-01

    Full Text Available Background: We compared the diagnostic performances of two newly introduced fully automated multiple allergen simultaneous tests (MAST analyzers with two conventional MAST assays. Methods: The serum samples from a total of 53 and 104 patients were tested for food panels and inhalant panels, respectively, in four analyzers including AdvanSure AlloScreen (LG Life Science, Korea, AdvanSure Allostation Smart II (LG Life Science, PROTIA Allergy-Q (ProteomeTech, Korea, and RIDA Allergy Screen (R-Biopharm, Germany. We compared not only the total agreement percentages but also positive propensities among four analyzers. Results: Evaluation of AdvanSure Allostation Smart II as upgraded version of AdvanSure AlloScreen revealed good concordance with total agreement percentages of 93.0% and 92.2% in food and inhalant panel, respectively. Comparisons of AdvanSure Allostation Smart II or PROTIA Allergy-Q with RIDA Allergy Screen also showed good concordance performance with positive propensities of two new analyzers for common allergens (Dermatophagoides farina and Dermatophagoides pteronyssinus. The changes of cut-off level resulted in various total agreement percentage fluctuations among allergens by different analyzers, although current cut-off level of class 2 appeared to be generally suitable. Conclusions: AdvanSure Allostation Smart II and PROTIA Allergy-Q presented favorable agreement performances with RIDA Allergy Screen, although positive propensities were noticed in common allergens. Keywords: Multiple allergen simultaneous test, Automated analyzer

  19. Compound K, a Ginsenoside Metabolite, Inhibits Colon Cancer Growth via Multiple Pathways Including p53-p21 Interactions

    Directory of Open Access Journals (Sweden)

    Eugene B. Chang

    2013-01-01

    Full Text Available Compound K (20-O-beta-D-glucopyranosyl-20(S-protopanaxadiol, CK, an intestinal bacterial metabolite of ginseng protopanaxadiol saponins, has been shown to inhibit cell growth in a variety of cancers. However, the mechanisms are not completely understood, especially in colorectal cancer (CRC. A xenograft tumor model was used first to examine the anti-CRC effect of CK in vivo. Then, multiple in vitro assays were applied to investigate the anticancer effects of CK including antiproliferation, apoptosis and cell cycle distribution. In addition, a qPCR array and western blot analysis were executed to screen and validate the molecules and pathways involved. We observed that CK significantly inhibited the growth of HCT-116 tumors in an athymic nude mouse xenograft model. CK significantly inhibited the proliferation of human CRC cell lines HCT-116, SW-480, and HT-29 in a dose- and time-dependent manner. We also observed that CK induced cell apoptosis and arrested the cell cycle in the G1 phase in HCT-116 cells. The processes were related to the upregulation of p53/p21, FoxO3a-p27/p15 and Smad3, and downregulation of cdc25A, CDK4/6 and cyclin D1/3. The major regulated targets of CK were cyclin dependent inhibitors, including p21, p27, and p15. These results indicate that CK inhibits transcriptional activation of multiple tumor-promoting pathways in CRC, suggesting that CK could be an active compound in the prevention or treatment of CRC.

  20. Infants Prospectively Control Reaching Based on the Difficulty of Future Actions: To What Extent Can Infants' Multiple-Step Actions Be Explained by Fitts' Law?

    Science.gov (United States)

    Gottwald, Janna M.; De Bortoli Vizioli, Aurora; Lindskog, Marcus; Nyström, Pär; L. Ekberg, Therese; von Hofsten, Claes; Gredebäck, Gustaf

    2017-01-01

    Prospective motor control, a key element of action planning, is the ability to adjust one's actions with respect to task demands and action goals in an anticipatory manner. The current study investigates whether 14-month-olds can prospectively control their reaching actions based on the difficulty of the subsequent action. We used a reach-to-place…

  1. Applicability of bioanalysis of multiple analytes in drug discovery and development: review of select case studies including assay development considerations.

    Science.gov (United States)

    Srinivas, Nuggehally R

    2006-05-01

    The development of sound bioanalytical method(s) is of paramount importance during the process of drug discovery and development culminating in a marketing approval. Although the bioanalytical procedure(s) originally developed during the discovery stage may not necessarily be fit to support the drug development scenario, they may be suitably modified and validated, as deemed necessary. Several reviews have appeared over the years describing analytical approaches including various techniques, detection systems, automation tools that are available for an effective separation, enhanced selectivity and sensitivity for quantitation of many analytes. The intention of this review is to cover various key areas where analytical method development becomes necessary during different stages of drug discovery research and development process. The key areas covered in this article with relevant case studies include: (a) simultaneous assay for parent compound and metabolites that are purported to display pharmacological activity; (b) bioanalytical procedures for determination of multiple drugs in combating a disease; (c) analytical measurement of chirality aspects in the pharmacokinetics, metabolism and biotransformation investigations; (d) drug monitoring for therapeutic benefits and/or occupational hazard; (e) analysis of drugs from complex and/or less frequently used matrices; (f) analytical determination during in vitro experiments (metabolism and permeability related) and in situ intestinal perfusion experiments; (g) determination of a major metabolite as a surrogate for the parent molecule; (h) analytical approaches for universal determination of CYP450 probe substrates and metabolites; (i) analytical applicability to prodrug evaluations-simultaneous determination of prodrug, parent and metabolites; (j) quantitative determination of parent compound and/or phase II metabolite(s) via direct or indirect approaches; (k) applicability in analysis of multiple compounds in select

  2. A nonlinear model for fluid flow in a multiple-zone composite reservoir including the quadratic gradient term

    International Nuclear Information System (INIS)

    Wang, Xiao-Lu; Fan, Xiang-Yu; Nie, Ren-Shi; Huang, Quan-Hua; He, Yong-Ming

    2013-01-01

    Based on material balance and Darcy's law, the governing equation with the quadratic pressure gradient term was deduced. Then the nonlinear model for fluid flow in a multiple-zone composite reservoir including the quadratic gradient term was established and solved using a Laplace transform. A series of standard log–log type curves of 1-zone (homogeneous), 2-zone and 3-zone reservoirs were plotted and nonlinear flow characteristics were analysed. The type curves governed by the coefficient of the quadratic gradient term (β) gradually deviate from those of a linear model with time elapsing. Qualitative and quantitative analyses were implemented to compare the solutions of the linear and nonlinear models. The results showed that differences of pressure transients between the linear and nonlinear models increase with elapsed time and β. At the end, a successful application of the theoretical model data against the field data shows that the nonlinear model will be a good tool to evaluate formation parameters more accurately. (paper)

  3. Enhanced peripheral visual processing in congenitally deaf humans is supported by multiple brain regions, including primary auditory cortex

    Directory of Open Access Journals (Sweden)

    Gregory D. Scott

    2014-03-01

    Full Text Available Brain reorganization associated with altered sensory experience clarifies the critical role of neuroplasticity in development. An example is enhanced peripheral visual processing associated with congenital deafness, but the neural systems supporting this have not been fully characterized. A gap in our understanding of deafness-enhanced peripheral vision is the contribution of primary auditory cortex. Previous studies of auditory cortex that use anatomical normalization across participants were limited by inter-subject variability of Heschl’s gyrus. In addition to reorganized auditory cortex (cross-modal plasticity, a second gap in our understanding is the contribution of altered modality-specific cortices (visual intramodal plasticity in this case, as well as supramodal and multisensory cortices, especially when target detection is required across contrasts. Here we address these gaps by comparing fMRI signal change for peripheral versus perifoveal visual stimulation (11-15° vs. 2°-7° in congenitally deaf and hearing participants in a blocked experimental design with two analytical approaches: a Heschl’s gyrus region of interest analysis and a whole brain analysis. Our results using individually-defined primary auditory cortex (Heschl’s gyrus indicate that fMRI signal change for more peripheral stimuli was greater than perifoveal in deaf but not in hearing participants. Whole-brain analyses revealed differences between deaf and hearing participants for peripheral versus perifoveal visual processing in extrastriate visual cortex including primary auditory cortex, MT+/V5, superior-temporal auditory and multisensory and/or supramodal regions, such as posterior parietal cortex, frontal eye fields, anterior cingulate, and supplementary eye fields. Overall, these data demonstrate the contribution of neuroplasticity in multiple systems including primary auditory cortex, supramodal and multisensory regions, to altered visual processing in

  4. Klotho: a humeral mediator in CSF and plasma that influences longevity and susceptibility to multiple complex disorders, including depression.

    Science.gov (United States)

    Pavlatou, M G; Remaley, A T; Gold, P W

    2016-08-30

    Klotho is a hormone secreted into human cerebrospinal fluid (CSF), plasma and urine that promotes longevity and influences the onset of several premature senescent phenotypes in mice and humans, including atherosclerosis, cardiovascular disease, stroke and osteoporosis. Preliminary studies also suggest that Klotho possesses tumor suppressor properties. Klotho's roles in these phenomena were first suggested by studies demonstrating that a defect in the Klotho gene in mice results in a significant decrease in lifespan. The Klotho-deficient mouse dies prematurely at 8-9 weeks of age. At 4-5 weeks of age, a syndrome resembling human ageing emerges consisting of atherosclerosis, osteoporosis, cognitive disturbances and alterations of hippocampal architecture. Several deficits in Klotho-deficient mice are likely to contribute to these phenomena. These include an inability to defend against oxidative stress in the central nervous system and periphery, decreased capacity to generate nitric oxide to sustain normal endothelial reactivity, defective Klotho-related mediation of glycosylation and ion channel regulation, increased insulin/insulin-like growth factor signaling and a disturbed calcium and phosphate homeostasis accompanied by altered vitamin D levels and ectopic calcification. Identifying the mechanisms by which Klotho influences multiple important pathways is an emerging field in human biology that will contribute significantly to understanding basic physiologic processes and targets for the treatment of complex diseases. Because many of the phenomena seen in Klotho-deficient mice occur in depressive illness, major depression and bipolar disorder represent illnesses potentially associated with Klotho dysregulation. Klotho's presence in CSF, blood and urine should facilitate its study in clinical populations.

  5. Mortality from Musculoskeletal Disorders Including Rheumatoid Arthritis in Southern Sweden: A Multiple-cause-of-death Analysis, 1998-2014.

    Science.gov (United States)

    Kiadaliri, Aliasghar A; Turkiewicz, Aleksandra; Englund, Martin

    2017-05-01

    To assess mortality related to musculoskeletal (MSK) disorders and rheumatoid arthritis (RA), specifically, among adults (aged ≥ 20 yrs) in southern Sweden using the multiple-cause-of-death approach. All death certificates (DC; n = 201,488) from 1998 to 2014 for adults in the region of Skåne were analyzed when mortality from MSK disorders and RA was listed as the underlying and nonunderlying cause of death (UCD/NUCD). Trends in age-standardized mortality rates (ASMR) were evaluated using joinpoint regression, and associated causes were identified by age- and sex-adjusted observed/expected ratios. MSK (RA) was mentioned on 2.8% (0.8%) of all DC and selected as UCD in 0.6% (0.2%), with higher values among women. Proportion of MSK disorder deaths from all deaths increased from 2.7% in 1998 to 3.1% in 2014, and declined from 0.9% to 0.5% for RA. The mean age at death was higher in DC with mention of MSK/RA than in DC without. The mean ASMR for MSK (RA) was 15.5 (4.3) per 100,000 person-years and declined by 1.1% (3.8%) per year during 1998-2014. When MSK/RA were UCD, pneumonia and heart failure were the main NUCD. When MSK/RA were NUCD, the leading UCD were ischemic heart disease and neoplasms. The greatest observed/expected ratios were seen for infectious diseases (including sepsis) and blood diseases. We observed significant reduction in MSK and RA mortality rates and increase in the mean age at death. Further analyses are required to investigate determinants of these improvements in MSK/RA survival and their potential effect on the Swedish healthcare systems.

  6. Auxiliary variables in multiple imputation in regression with missing X: a warning against including too many in small sample research

    Directory of Open Access Journals (Sweden)

    Hardt Jochen

    2012-12-01

    Full Text Available Abstract Background Multiple imputation is becoming increasingly popular. Theoretical considerations as well as simulation studies have shown that the inclusion of auxiliary variables is generally of benefit. Methods A simulation study of a linear regression with a response Y and two predictors X1 and X2 was performed on data with n = 50, 100 and 200 using complete cases or multiple imputation with 0, 10, 20, 40 and 80 auxiliary variables. Mechanisms of missingness were either 100% MCAR or 50% MAR + 50% MCAR. Auxiliary variables had low (r=.10 vs. moderate correlations (r=.50 with X’s and Y. Results The inclusion of auxiliary variables can improve a multiple imputation model. However, inclusion of too many variables leads to downward bias of regression coefficients and decreases precision. When the correlations are low, inclusion of auxiliary variables is not useful. Conclusion More research on auxiliary variables in multiple imputation should be performed. A preliminary rule of thumb could be that the ratio of variables to cases with complete data should not go below 1 : 3.

  7. iStimulation: Apple iPad Use with Children Who Are Visually Impaired, Including Those with Multiple Disabilities

    Science.gov (United States)

    Campaña, Laura V.; Ouimet, Donald A.

    2015-01-01

    Since its creation in the early 1980s, Light Box, a product developed by the American Printing House for the Blind (APH) that is designed for working on functional vision tasks with children who have visual impairments or multiple disabilities, has been an effective tool to help teach children with visual impairments to locate and track items…

  8. Nontypeable pneumococci can be divided into multiple cps types, including one type expressing the novel gene pspK.

    Science.gov (United States)

    Park, In Ho; Kim, Kyung-Hyo; Andrade, Ana Lucia; Briles, David E; McDaniel, Larry S; Nahm, Moon H

    2012-01-01

    Although virulence of Streptococcus pneumoniae is associated with its capsule, some pathogenic S. pneumoniae isolates lack capsules and are serologically nontypeable (NT). We obtained 64 isolates that were identified as NT "pneumococci" (i.e., bacteria satisfying the conventional definition but without the multilocus sequence typing [MLST]-based definition of S. pneumoniae) by the traditional criteria. All 64 were optochin sensitive and had lytA, and 63 had ply. Twelve isolates had cpsA, suggesting the presence of a conventional but defective capsular polysaccharide synthesis (cps) locus. The 52 cpsA-negative isolates could be divided into three null capsule clades (NCC) based on aliC (aliB-like ORF1), aliD (aliB-like ORF2), and our newly discovered gene, pspK, in their cps loci. pspK encodes a protein with a long alpha-helical region containing an LPxTG motif and a YPT motif known to bind human pIgR. There were nine isolates in NCC1 (pspK(+) but negative for aliC and aliD), 32 isolates in NCC2 (aliC(+) aliD(+) but negative for pspK), and 11 in NCC3 (aliD(+) but negative for aliC and pspK). Among 52 cpsA-negative isolates, 41 were identified as S. pneumoniae by MLST analysis. All NCC1 and most NCC2 isolates were S. pneumoniae, whereas all nine NCC3 and two NCC2 isolates were not S. pneumoniae. Several NCC1 and NCC2 isolates from multiple individuals had identical MLST and cps regions, showing that unencapsulated S. pneumoniae can be infectious among humans. Furthermore, NCC1 and NCC2 S. pneumoniae isolates could colonize mice as well as encapsulated S. pneumoniae, although S. pneumoniae with an artificially disrupted cps locus did not. Moreover, an NCC1 isolate with pspK deletion did not colonize mice, suggesting that pspK is critical for colonization. Thus, PspK may provide pneumococci a means of surviving in the nasopharynx without capsule. IMPORTANCE The presence of a capsule is critical for many pathogenic bacteria, including pneumococci. Reflecting the

  9. Ca analysis: an Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis.

    Science.gov (United States)

    Greensmith, David J

    2014-01-01

    Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. Copyright © 2013 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

  10. Ca analysis: An Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis☆

    Science.gov (United States)

    Greensmith, David J.

    2014-01-01

    Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. PMID:24125908

  11. Stepped-wedge cluster randomised controlled trials: a generic framework including parallel and multiple-level designs.

    Science.gov (United States)

    Hemming, Karla; Lilford, Richard; Girling, Alan J

    2015-01-30

    Stepped-wedge cluster randomised trials (SW-CRTs) are being used with increasing frequency in health service evaluation. Conventionally, these studies are cross-sectional in design with equally spaced steps, with an equal number of clusters randomised at each step and data collected at each and every step. Here we introduce several variations on this design and consider implications for power. One modification we consider is the incomplete cross-sectional SW-CRT, where the number of clusters varies at each step or where at some steps, for example, implementation or transition periods, data are not collected. We show that the parallel CRT with staggered but balanced randomisation can be considered a special case of the incomplete SW-CRT. As too can the parallel CRT with baseline measures. And we extend these designs to allow for multiple layers of clustering, for example, wards within a hospital. Building on results for complete designs, power and detectable difference are derived using a Wald test and obtaining the variance-covariance matrix of the treatment effect assuming a generalised linear mixed model. These variations are illustrated by several real examples. We recommend that whilst the impact of transition periods on power is likely to be small, where they are a feature of the design they should be incorporated. We also show examples in which the power of a SW-CRT increases as the intra-cluster correlation (ICC) increases and demonstrate that the impact of the ICC is likely to be smaller in a SW-CRT compared with a parallel CRT, especially where there are multiple levels of clustering. Finally, through this unified framework, the efficiency of the SW-CRT and the parallel CRT can be compared. © 2014 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  12. Nonadiabatic dynamics of electron transfer in solution: Explicit and implicit solvent treatments that include multiple relaxation time scales

    International Nuclear Information System (INIS)

    Schwerdtfeger, Christine A.; Soudackov, Alexander V.; Hammes-Schiffer, Sharon

    2014-01-01

    The development of efficient theoretical methods for describing electron transfer (ET) reactions in condensed phases is important for a variety of chemical and biological applications. Previously, dynamical dielectric continuum theory was used to derive Langevin equations for a single collective solvent coordinate describing ET in a polar solvent. In this theory, the parameters are directly related to the physical properties of the system and can be determined from experimental data or explicit molecular dynamics simulations. Herein, we combine these Langevin equations with surface hopping nonadiabatic dynamics methods to calculate the rate constants for thermal ET reactions in polar solvents for a wide range of electronic couplings and reaction free energies. Comparison of explicit and implicit solvent calculations illustrates that the mapping from explicit to implicit solvent models is valid even for solvents exhibiting complex relaxation behavior with multiple relaxation time scales and a short-time inertial response. The rate constants calculated for implicit solvent models with a single solvent relaxation time scale corresponding to water, acetonitrile, and methanol agree well with analytical theories in the Golden rule and solvent-controlled regimes, as well as in the intermediate regime. The implicit solvent models with two relaxation time scales are in qualitative agreement with the analytical theories but quantitatively overestimate the rate constants compared to these theories. Analysis of these simulations elucidates the importance of multiple relaxation time scales and the inertial component of the solvent response, as well as potential shortcomings of the analytical theories based on single time scale solvent relaxation models. This implicit solvent approach will enable the simulation of a wide range of ET reactions via the stochastic dynamics of a single collective solvent coordinate with parameters that are relevant to experimentally accessible

  13. Improvement in genetic evaluation of female fertility in dairy cattle using multiple-trait models including milk production traits

    DEFF Research Database (Denmark)

    Sun, C; Madsen, P; Lund, M S

    2010-01-01

    This study investigated the improvement in genetic evaluation of fertility traits by using production traits as secondary traits (MILK = 305-d milk yield, FAT = 305-d fat yield, and PROT = 305-d protein yield). Data including 471,742 records from first lactations of Denmark Holstein cows, covering...... the years of inseminations during first lactations from 1995 to 2004, were analyzed. Six fertility traits (i.e., interval in days from calving to first insemination, calving interval, days open, interval in days from first to last insemination, numbers of inseminations per conception, and nonreturn rate...... stability and predictive ability than single-trait models for all the fertility traits, except for nonreturn rate within 56 d after first service. The stability and predictive ability for the model including MILK or PROT were similar to the model including all 3 milk production traits and better than...

  14. Study Modules for Calculus-Based General Physics. [Includes Modules 3-5: Planar Motion; Newton's Laws; and Vector Multiplication].

    Science.gov (United States)

    Fuller, Robert G., Ed.; And Others

    This is part of a series of 42 Calculus Based Physics (CBP) modules totaling about 1,000 pages. The modules include study guides, practice tests, and mastery tests for a full-year individualized course in calculus-based physics based on the Personalized System of Instruction (PSI). The units are not intended to be used without outside materials;…

  15. Multiple Beneficial Lipids Including Lecithin Detected in the Edible Invasive Mollusk Crepidula fornicata from the French Northeastern Atlantic Coast

    Science.gov (United States)

    Dagorn, Flore; Buzin, Florence; Couzinet-Mossion, Aurélie; Decottignies, Priscilla; Viau, Michèle; Rabesaotra, Vony; Barnathan, Gilles; Wielgosz-Collin, Gaëtane

    2014-01-01

    The invasive mollusk Crepidula fornicata, occurring in large amounts in bays along the French Northeastern Atlantic coasts, may have huge environmental effects in highly productive ecosystems where shellfish are exploited. The present study aims at determining the potential economic value of this marine species in terms of exploitable substances with high added value. Lipid content and phospholipid (PL) composition of this mollusk collected on the Bourgneuf Bay were studied through four seasons. Winter specimens contained the highest lipid levels (5.3% dry weight), including 69% of PLs. Phosphatidylcholine (PC) was the major PL class all year, accounting for 63.9% to 88.9% of total PLs. Consequently, the winter specimens were then investigated for PL fatty acids (FAs), and free sterols. Dimethylacetals (DMAs) were present (10.7% of PL FA + DMA mixture) revealing the occurrence of plasmalogens. More than forty FAs were identified, including 20:5n-3 (9.4%) and 22:6n-3 (7.3%) acids. Fourteen free sterols were present, including cholesterol at 31.3% of the sterol mixture and about 40% of phytosterols. These data on lipids of C. fornicata demonstrate their positive attributes for human nutrition and health. The PL mixture, rich in PC and polyunsaturated FAs, offers an interesting alternative source of high value-added marine lecithin. PMID:25532566

  16. Multiple beneficial lipids including lecithin detected in the edible invasive mollusk Crepidula fornicata from the French Northeastern Atlantic coast.

    Science.gov (United States)

    Dagorn, Flore; Buzin, Florence; Couzinet-Mossion, Aurélie; Decottignies, Priscilla; Viau, Michèle; Rabesaotra, Vony; Barnathan, Gilles; Wielgosz-Collin, Gaëtane

    2014-12-22

    The invasive mollusk Crepidula fornicata, occurring in large amounts in bays along the French Northeastern Atlantic coasts, may have huge environmental effects in highly productive ecosystems where shellfish are exploited. The present study aims at determining the potential economic value of this marine species in terms of exploitable substances with high added value. Lipid content and phospholipid (PL) composition of this mollusk collected on the Bourgneuf Bay were studied through four seasons. Winter specimens contained the highest lipid levels (5.3% dry weight), including 69% of PLs. Phosphatidylcholine (PC) was the major PL class all year, accounting for 63.9% to 88.9% of total PLs. Consequently, the winter specimens were then investigated for PL fatty acids (FAs), and free sterols. Dimethylacetals (DMAs) were present (10.7% of PL FA + DMA mixture) revealing the occurrence of plasmalogens. More than forty FAs were identified, including 20:5n-3 (9.4%) and 22:6n-3 (7.3%) acids. Fourteen free sterols were present, including cholesterol at 31.3% of the sterol mixture and about 40% of phytosterols. These data on lipids of C. fornicata demonstrate their positive attributes for human nutrition and health. The PL mixture, rich in PC and polyunsaturated FAs, offers an interesting alternative source of high value-added marine lecithin.

  17. Blink activity and task difficulty.

    Science.gov (United States)

    Tanaka, Y; Yamaoka, K

    1993-08-01

    This study investigated the relationship between task difficulty and blink activity, which includes blink rate, blink amplitude, and blink duration. Two kinds of tasks established two levels of difficulty. In Exp. 1, a mental arithmetic task was used to examine the relationship. Analysis showed that blink rate for a difficult task was significantly higher than that for an easier one. In Exp. 2, a letter-search task (hiragana Japanese alphabet) was used while the other conditions were the same as those in Exp. 1; however, the results of this experiment were not influenced by the difficulty of the task. As results indicate that blink rate is related to not only difficulty but also the nature of the task, the nature of the task is probably dependent on a mechanism in information processing. The results for blink amplitude and blink duration showed no systematic change during either experiment.

  18. Mathematics difficulties & classroom leadership

    DEFF Research Database (Denmark)

    Schmidt, Maria Christina Secher

    2016-01-01

    This article investigates possible links between inclusion, students, for whom mathematics is extensively difficult, and classroom leadership through a case study on teaching strategies and student participation in four classrooms at two different primary schools in Denmark. Three sets of results...... are presented: 1) descriptions of the teachers’ classroom leadership to include all their students in the learning community, 2) the learning community produced by stated and practiced rules for teaching and learning behavior, 3) the classroom behavior of students who experience difficulties with mathematics....... The findings suggest that the teachers’ pedagogical choices and actions support an active learning environment for students in diverse learning needs, and that the teachers practise dimensions of inclusive classroom leadership that are known to be successful for teaching mathematics to all students. Despite...

  19. Evaluation and Comparison of Multiple Test Methods, Including Real-time PCR, for Legionella Detection in Clinical Specimens

    Science.gov (United States)

    Peci, Adriana; Winter, Anne-Luise; Gubbay, Jonathan B.

    2016-01-01

    Legionella is a Gram-negative bacterium that can cause Pontiac fever, a mild upper respiratory infection and Legionnaire’s disease, a more severe illness. We aimed to compare the performance of urine antigen, culture, and polymerase chain reaction (PCR) test methods and to determine if sputum is an acceptable alternative to the use of more invasive bronchoalveolar lavage (BAL). Data for this study included specimens tested for Legionella at Public Health Ontario Laboratories from 1st January, 2010 to 30th April, 2014, as part of routine clinical testing. We found sensitivity of urinary antigen test (UAT) compared to culture to be 87%, specificity 94.7%, positive predictive value (PPV) 63.8%, and negative predictive value (NPV) 98.5%. Sensitivity of UAT compared to PCR was 74.7%, specificity 98.3%, PPV 77.7%, and NPV 98.1%. Out of 146 patients who had a Legionella-positive result by PCR, only 66 (45.2%) also had a positive result by culture. Sensitivity for culture was the same using either sputum or BAL (13.6%); sensitivity for PCR was 10.3% for sputum and 12.8% for BAL. Both sputum and BAL yield similar results regardless testing methods (Fisher Exact p-values = 1.0, for each test). In summary, all test methods have inherent weaknesses in identifying Legionella; therefore, more than one testing method should be used. Obtaining a single specimen type from patients with pneumonia limits the ability to diagnose Legionella, particularly when urine is the specimen type submitted. Given ease of collection and similar sensitivity to BAL, clinicians are encouraged to submit sputum in addition to urine when BAL submission is not practical from patients being tested for Legionella. PMID:27630979

  20. Evaluation and comparison of multiple test methods, including real-time PCR, for Legionella detection in clinical specimens.

    Directory of Open Access Journals (Sweden)

    Adriana Peci

    2016-08-01

    Full Text Available Legionella is a gram-negative bacterium that can cause Pontiac fever, a mild upper respiratory infection and Legionnaire’s disease, a more severe illness. We aimed to compare the performance of urine antigen, culture and PCR test methods and to determine if sputum is an alternative to the use of more invasive bronchoalveolar lavage (BAL. Data for this study included specimens tested for Legionella at PHOL from January 1, 2010 to April 30, 2014, as part of routine clinical testing. We found sensitivity of UAT compared to culture to be 87%, specificity 94.7%, positive predictive value (PPV 63.8% and negative predictive value (NPV 98.5%. Sensitivity of UAT compared to PCR was 74.7%, specificity 98.3%, PPV 77.7% and NPV 98.1%. Of 146 patients who had a Legionella positive result by PCR, only 66(45.2% also had a positive result by culture. Sensitivity for culture was the same using either sputum or BAL (13.6%; sensitivity for PCR was 10.3% for sputum and 12.8% for BAL. Both sputum and BAL yield similar results despite testing methods (Fisher Exact p-values=1.0, for each test. In summary, all test methods have inherent weaknesses in identifying Legionella; thereforemore than one testing method should be used. Obtaining a single specimen type from patients with pneumonia limits the ability to diagnose Legionella, particularly when urine is the specimen type submitted. Given ease of collection, and similar sensitivity to BAL, clinicians are encouraged to submit sputum in addition to urine when BAL submission is not practical, from patients being tested for Legionella.

  1. Airborne electromagnetic detection of shallow seafloor topographic features, including resolution of multiple sub-parallel seafloor ridges

    Science.gov (United States)

    Vrbancich, Julian; Boyd, Graham

    2014-05-01

    The HoistEM helicopter time-domain electromagnetic (TEM) system was flown over waters in Backstairs Passage, South Australia, in 2003 to test the bathymetric accuracy and hence the ability to resolve seafloor structure in shallow and deeper waters (extending to ~40 m depth) that contain interesting seafloor topography. The topography that forms a rock peak (South Page) in the form of a mini-seamount that barely rises above the water surface was accurately delineated along its ridge from the start of its base (where the seafloor is relatively flat) in ~30 m water depth to its peak at the water surface, after an empirical correction was applied to the data to account for imperfect system calibration, consistent with earlier studies using the same HoistEM system. A much smaller submerged feature (Threshold Bank) of ~9 m peak height located in waters of 35 to 40 m depth was also accurately delineated. These observations when checked against known water depths in these two regions showed that the airborne TEM system, following empirical data correction, was effectively operating correctly. The third and most important component of the survey was flown over the Yatala Shoals region that includes a series of sub-parallel seafloor ridges (resembling large sandwaves rising up to ~20 m from the seafloor) that branch out and gradually decrease in height as the ridges spread out across the seafloor. These sub-parallel ridges provide an interesting topography because the interpreted water depths obtained from 1D inversion of TEM data highlight the limitations of the EM footprint size in resolving both the separation between the ridges (which vary up to ~300 m) and the height of individual ridges (which vary up to ~20 m), and possibly also the limitations of assuming a 1D model in areas where the topography is quasi-2D/3D.

  2. Biallelic germline and somatic mutations in malignant mesothelioma: multiple mutations in transcription regulators including mSWI/SNF genes.

    Science.gov (United States)

    Yoshikawa, Yoshie; Sato, Ayuko; Tsujimura, Tohru; Otsuki, Taiichiro; Fukuoka, Kazuya; Hasegawa, Seiki; Nakano, Takashi; Hashimoto-Tamaoki, Tomoko

    2015-02-01

    We detected low levels of acetylation for histone H3 tail lysines in malignant mesothelioma (MM) cell lines resistant to histone deacetylase inhibitors. To identify the possible genetic causes related to the low histone acetylation levels, whole-exome sequencing was conducted with MM cell lines established from eight patients. A mono-allelic variant of BRD1 was common to two MM cell lines with very low acetylation levels. We identified 318 homozygous protein-damaging variants/mutations (18-78 variants/mutations per patient); annotation analysis showed enrichment of the molecules associated with mammalian SWI/SNF (mSWI/SNF) chromatin remodeling complexes and co-activators that facilitate initiation of transcription. In seven of the patients, we detected a combination of variants in histone modifiers or transcription factors/co-factors, in addition to variants in mSWI/SNF. Direct sequencing showed that homozygous mutations in SMARCA4, PBRM1 and ARID2 were somatic. In one patient, homozygous germline variants were observed for SMARCC1 and SETD2 in chr3p22.1-3p14.2. These exhibited extended germline homozygosity and were in regions containing somatic mutations, leading to a loss of BAP1 and PBRM1 expression in MM cell line. Most protein-damaging variants were heterozygous in normal tissues. Heterozygous germline variants were often converted into hemizygous variants by mono-allelic deletion, and were rarely homozygous because of acquired uniparental disomy. Our findings imply that MM might develop through the somatic inactivation of mSWI/SNF complex subunits and/or histone modifiers, including BAP1, in subjects that have rare germline variants of these transcription regulators and/or transcription factors/co-factors, and in regions prone to mono-allelic deletion during oncogenesis. © 2014 UICC.

  3. More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests.

    Science.gov (United States)

    Thompson, Matthew; Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

    2016-01-01

    Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests.

  4. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand...... in a healthcare system. From our perspective, further sociological and pedagogical investigations in educational cultures across settings and specialties could inform our understanding of and knowledge about pitfalls in residents’ and doctors’ socialization into the healthcare system....

  5. Efficient Time-Domain Ray-Tracing Technique for the Analysis of Ultra-Wideband Indoor Environments including Lossy Materials and Multiple Effects

    Directory of Open Access Journals (Sweden)

    F. Saez de Adana

    2009-01-01

    Full Text Available This paper presents an efficient application of the Time-Domain Uniform Theory of Diffraction (TD-UTD for the analysis of Ultra-Wideband (UWB mobile communications for indoor environments. The classical TD-UTD formulation is modified to include the contribution of lossy materials and multiple-ray interactions with the environment. The electromagnetic analysis is combined with a ray-tracing acceleration technique to treat realistic and complex environments. The validity of this method is tested with measurements performed inside the Polytechnic building of the University of Alcala and shows good performance of the model for the analysis of UWB propagation.

  6. Energy taxation difficulties

    International Nuclear Information System (INIS)

    Landsberg, H.H.

    1993-01-01

    This paper assesses what may be the underlying reasons for the Clinton administration's recent failure to pass the Btu Tax on energy sources and the current difficulties that this Administration is experiencing in acquiring nation wide consensus on a gasoline tax proposal. Two difficulties stand out - regional differences in climate and thus winter heating requirements, and the differences from state to state in transportation system preferences. The paper cites the positive aspects of energy taxation by noting the petroleum industry's efforts to develop a new less polluting reformulated gasoline

  7. Prediction of preterm birth in multiple pregnancies: development of a multivariable model including cervical length measurement at 16 to 21 weeks' gestation.

    Science.gov (United States)

    van de Mheen, Lidewij; Schuit, Ewoud; Lim, Arianne C; Porath, Martina M; Papatsonis, Dimitri; Erwich, Jan J; van Eyck, Jim; van Oirschot, Charlotte M; Hummel, Piet; Duvekot, Johannes J; Hasaart, Tom H M; Groenwold, Rolf H H; Moons, Karl G M; de Groot, Christianne J M; Bruinse, Hein W; van Pampus, Maria G; Mol, Ben W J

    2014-04-01

    To develop a multivariable prognostic model for the risk of preterm delivery in women with multiple pregnancy that includes cervical length measurement at 16 to 21 weeks' gestation and other variables. We used data from a previous randomized trial. We assessed the association between maternal and pregnancy characteristics including cervical length measurement at 16 to 21 weeks' gestation and time to delivery using multivariable Cox regression modelling. Performance of the final model was assessed for the outcomes of preterm and very preterm delivery using calibration and discrimination measures. We studied 507 women, of whom 270 (53%) delivered models for preterm and very preterm delivery had a c-index of 0.68 (95% CI 0.63 to 0.72) and 0.68 (95% CI 0.62 to 0.75), respectively, and showed good calibration. In women with a multiple pregnancy, the risk of preterm delivery can be assessed with a multivariable model incorporating cervical length and other predictors.

  8. Early Identification of Reading Difficulties

    DEFF Research Database (Denmark)

    Poulsen, Mads; Nielsen, Anne-Mette Veber; Juul, Holger

    2017-01-01

    Early screening for reading difficulties before the onset of instruction is desirable because it allows intervention that is targeted at prevention rather than remediation of reading difficulties. However, early screening may be too inaccurate to effectively allocate resources to those who need...... them. The present study compared the accuracy of early screening before the onset of formal reading instruction with late screening six months into the first year of instruction. The study followed 164 Danish students from the end of Grade 0 to the end of Grade 2. Early screening included measures...... of phonemic awareness, rapid naming, letter knowledge, paired associate learning, and reading. Late screening included only reading. Results indicated that reading measures improved substantially as predictors over the first six months of Grade 1, to the point where late reading measures alone provided...

  9. Difficulty scaling through incongruity

    NARCIS (Netherlands)

    Lankveld, van G.; Spronck, P.; Rauterberg, G.W.M.; Mateas, M.; Darken, C.

    2008-01-01

    In this paper we discuss our work on using the incongruity measure from psychological literature to scale the difficulty level of a game online to the capabilities of the human player. Our approach has been implemented in a small game called Glove.

  10. Breathing difficulty - lying down

    Science.gov (United States)

    ... other conditions that lead to it) Panic disorder Sleep apnea Snoring Home Care Your health care provider may recommend self-care measures. For example, weight loss may be suggested if you are obese. When to Contact a Medical Professional If you have any unexplained difficulty in breathing ...

  11. The rank-heat plot is a novel way to present the results from a network meta-analysis including multiple outcomes.

    Science.gov (United States)

    Veroniki, Areti Angeliki; Straus, Sharon E; Fyraridis, Alexandros; Tricco, Andrea C

    2016-08-01

    To present a novel and simple graphical approach to improve the presentation of the treatment ranking in a network meta-analysis (NMA) including multiple outcomes. NMA simultaneously compares many relevant interventions for a clinical condition from a network of trials, and allows ranking of the effectiveness and/or safety of each intervention. There are numerous ways to present the NMA results, which can challenge their interpretation by research users. The rank-heat plot is a novel graph that can be used to quickly recognize which interventions are most likely the best or worst interventions with respect to their effectiveness and/or safety for a single or multiple outcome(s) and may increase interpretability. Using empirical NMAs, we show that the need for a concise and informative presentation of results is imperative, particularly as the number of competing treatments and outcomes in an NMA increases. The rank-heat plot is an efficient way to present the results of ranking statistics, particularly when a large amount of data is available, and it is targeted to users from various backgrounds. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Veganism: Motivations and Difficulties

    OpenAIRE

    Beck, Mathilde Therese Claudine; Harvey, John Carr; Trauth, Christina

    2017-01-01

    An increasing number of people are adopting a vegan lifestyle, which means to stop consuming products, that are made from or based on animals, like meat, dairy or eggs. However, the number of research concerning veganism is limited. As the existing research is mainly concentrating on the process of adopting a vegan lifestyle and the view of vegans, these findings shall be examined further with the question, What are the motivation and difficulties about adopting a plant based vegan diet in We...

  13. Idiopathic chondrolysis - diagnostic difficulties

    International Nuclear Information System (INIS)

    Kozlowski, K.; Scougall, J.; Royal Alexandra Hospital for Children, Sydney

    1984-01-01

    Four cases of idiopathic chondrolysis of the hip in three white girls and one Maori girl are reported. The authors stress the causes why a disease with characteristic clinical and radiographic appearances and normal biochemical findings presents diagnostic difficulties. It is suspected that idiopathic chondrolysis is a metabolic disorder of chondrocytes, triggered by environment circumstances in susceptible individuals. Idiopathic chondrolysis is probably one of the most common causes of coxarthrosis in women. (orig.)

  14. MiR-7 triggers cell cycle arrest at the G1/S transition by targeting multiple genes including Skp2 and Psme3.

    Directory of Open Access Journals (Sweden)

    Noelia Sanchez

    Full Text Available MiR-7 acts as a tumour suppressor in many cancers and abrogates proliferation of CHO cells in culture. In this study we demonstrate that miR-7 targets key regulators of the G1 to S phase transition, including Skp2 and Psme3, to promote increased levels of p27(KIP and temporary growth arrest of CHO cells in the G1 phase. Simultaneously, the down-regulation of DNA repair-specific proteins via miR-7 including Rad54L, and pro-apoptotic regulators such as p53, combined with the up-regulation of anti-apoptotic factors like p-Akt, promoted cell survival while arrested in G1. Thus miR-7 can co-ordinate the levels of multiple genes and proteins to influence G1 to S phase transition and the apoptotic response in order to maintain cellular homeostasis. This work provides further mechanistic insight into the role of miR-7 as a regulator of cell growth in times of cellular stress.

  15. Activator Gcn4 employs multiple segments of Med15/Gal11, including the KIX domain, to recruit mediator to target genes in vivo.

    Science.gov (United States)

    Jedidi, Iness; Zhang, Fan; Qiu, Hongfang; Stahl, Stephen J; Palmer, Ira; Kaufman, Joshua D; Nadaud, Philippe S; Mukherjee, Sujoy; Wingfield, Paul T; Jaroniec, Christopher P; Hinnebusch, Alan G

    2010-01-22

    Mediator is a multisubunit coactivator required for initiation by RNA polymerase II. The Mediator tail subdomain, containing Med15/Gal11, is a target of the activator Gcn4 in vivo, critical for recruitment of native Mediator or the Mediator tail subdomain present in sin4Delta cells. Although several Gal11 segments were previously shown to bind Gcn4 in vitro, the importance of these interactions for recruitment of Mediator and transcriptional activation by Gcn4 in cells was unknown. We show that interaction of Gcn4 with the Mediator tail in vitro and recruitment of this subcomplex and intact Mediator to the ARG1 promoter in vivo involve additive contributions from three different segments in the N terminus of Gal11. These include the KIX domain, which is a critical target of other activators, and a region that shares a conserved motif (B-box) with mammalian coactivator SRC-1, and we establish that B-box is a critical determinant of Mediator recruitment by Gcn4. We further demonstrate that Gcn4 binds to the Gal11 KIX domain directly and, by NMR chemical shift analysis combined with mutational studies, we identify the likely binding site for Gcn4 on the KIX surface. Gcn4 is distinctive in relying on comparable contributions from multiple segments of Gal11 for efficient recruitment of Mediator in vivo.

  16. Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease

    Directory of Open Access Journals (Sweden)

    Denis Bernardi Bichuetti

    2013-05-01

    Full Text Available Although neuromyelitis optica (NMO is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS, few studies comparing both conditions in a single center have been done. Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062 with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013 and progression index (0.9 versus 0.6, p≪0.0001, with more patients reaching expanded disability status scale (EDSS 6.0 (39 versus 17%, p=0.0036. The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

  17. Psychosocial difficulties from the perspective of persons with neuropsychiatric disorders.

    Science.gov (United States)

    Coenen, Michaela; Cabello, Maria; Umlauf, Silvia; Ayuso-Mateos, José Luis; Anczewska, Marta; Tourunen, Jouni; Leonardi, Matilde; Cieza, Alarcos

    2016-01-01

    The objective of this study is to determine whether persons with neuropsychiatric disorders experience a common set of psychosocial difficulties using qualitative data from focus groups and individual interviews. The study was performed in five European countries (Finland, Italy, Germany, Poland and Spain) using the focus groups and individual interviews with persons with nine neuropsychiatric disorders (dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke and substance dependence). Digitally recorded sessions were analysed using a step-by-step qualitative and quantitative methodology resulting in the compilation of a common set of psychosocial difficulties using the International Classification of Functioning, Disability and Health (ICF) as a framework. Sixty-seven persons participated in the study. Most persons with neuropsychiatric disorders experience difficulties in emotional functions, sleeping, carrying out daily routine, working and interpersonal relationships in common. Sixteen out of 33 psychosocial difficulties made up the common set. This set includes mental functions, pain and issues addressing activities and participation and provides first evidence for the hypothesis of horizontal epidemiology of psychosocial difficulties in neuropsychiatric disorders. This study provides information about psychosocial difficulties that should be covered in the treatment and rehabilitation of persons with neuropsychiatric disorders regardless of clinical diagnoses. Emotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity. Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders. The effects of medication and social environment on patient's daily life should be considered in all the

  18. Student difficulties with Gauss' law

    Science.gov (United States)

    Kanim, Stephen

    2000-09-01

    Many students in introductory courses have difficulty solving Gauss' law problems. Through interviews with students and analysis of solutions to homework and examination questions we have identified some specific conceptual difficulties that often contribute to students' inability to solve quantitative Gauss' law problems. We give examples of common difficulties and discuss instructional implications.

  19. Hydrology under difficulties

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1964-08-15

    An unusual hydrological investigation is being carried out in Kenya by IAEA, at Lake Chala, a volcanic crater with no visible inlet or outlet. The problem is to determine whether the lake has any connection with a number of springs near Taveta, some six miles distant: this relationship is important in assessing the possibility of expanding the Taveta irrigation scheme. Questions of water rights and utilization are involved, since the lake is situated on the Tanganyikan border. The method adopted is that of labelling the waters of the lake with small quantities of water containing radioactive hydrogen (tritium). There are some special features in this instance, one being the difficulty of access. The lake is entirely surrounded by steep cliffs. A track was cut by British Army engineers, and the boat and all supplies were taken down by this route. Another problem was presented by the depth of the lake, which amounts to 300 feet. It is necessary to ensure the regular mixing of the tritium throughout. This has been done by means of hundreds of plastic bottles, which were dropped from the boat at regular intervals as it made a series of carefully-plotted traverses. Each bottle had a weight attached, and was perforated by two small holes. By this means, as the bottle sank the contents were progressively released until it reached the bottom, thus ensuring an even diffusion of tritium throughout the lake.

  20. [Difficulties in learning mathematics].

    Science.gov (United States)

    Rebollo, M A; Rodríguez, A L

    2006-02-13

    To discuss our concern for some aspects of mathematics learning disorders related to the nomenclature employed and their diagnosis; these aspects refer to the term 'dyscalculia' and to its diagnosis (especially syndromatic diagnosis). We also intend to propose a classification that could help to define the terminology. Lastly we are going to consider the different aspects of diagnosis and to determine which of them are indispensable in the diagnosis of primary and secondary disorders. As far as the nomenclature is concerned, we refer to the term 'dyscalculia'. The origins of the term are analysed along with the reasons why it should not be used in children with difficulties in learning mathematics. We propose a classification and denominations for the different types that should undoubtedly be discussed. With respect to the diagnosis, several problems related to the syndromatic diagnosis are considered, since in our country there are no standardised tests with which to study performance in arithmetic and geometry. This means that criterion reference tests are conducted to try to establish current and potential performance. At this stage of the diagnosis pedagogical and psychological studies must be conducted. The important factors with regard to the topographical and aetiological diagnoses are prior knowledge, results from the studies that have been carried out and findings from imaging studies. The importance of a genetic study must be defined in the aetiological diagnosis. We propose a nomenclature to replace the term 'dyscalculia'. Standardised tests are needed for the diagnosis. The need to establish current and potential performance is hierarchized. With regard to the topographical diagnosis, we highlight the need for more information about geometry, and in aetiological studies the analyses must be conducted with greater numbers of children.

  1. Problemas multiplicativos envolvendo combinatória: estratégias de resolução empregadas por alunos do Ensino Fundamental público Multiplicative problems including combinatorics: solving strategies adopted by Public Elementary School students

    Directory of Open Access Journals (Sweden)

    Leny R. M. Teixeira

    2011-01-01

    was better in problems with two variables and factors with low values. There was no alteration in the performance among the 6th and 9th graders. In general, the difficulties found were related to: 1 intuitive models students have when dealing with multiplication (especially the one including repeated addition; 2 the semantic structure of the problem; 3 numerical preferences regarding the quantity of numerical digits, ways of representing the problem and interpretation of verbal problem statements. Because multiplication is a very complex operation involving abstract cognitive processes in its solution, we believe that the teacher needs to know them to facilitate students' learning.

  2. Upper-division student difficulties with the Dirac delta function

    Directory of Open Access Journals (Sweden)

    Bethany R. Wilcox

    2015-03-01

    Full Text Available The Dirac delta function is a standard mathematical tool that appears repeatedly in the undergraduate physics curriculum in multiple topical areas including electrostatics, and quantum mechanics. While Dirac delta functions are often introduced in order to simplify a problem mathematically, students still struggle to manipulate and interpret them. To characterize student difficulties with the delta function at the upper-division level, we examined students’ responses to traditional exam questions and a standardized conceptual assessment, and conducted think-aloud interviews. Our analysis was guided by an analytical framework that focuses on how students activate, construct, execute, and reflect on the Dirac delta function in the context of problem solving in physics. Here, we focus on student difficulties using the delta function to express charge distributions in the context of junior-level electrostatics. Common challenges included invoking the delta function spontaneously, translating a description of a charge distribution into a mathematical expression using delta functions, integrating 3D or non-Cartesian delta function expressions, and recognizing that the delta function can have units. We also briefly discuss implications of these difficulties for instruction.

  3. Conservative two-step procedure including uterine artery embolization with embosphere and surgical myomectomy for the treatment of multiple fibroids: Preliminary experience

    International Nuclear Information System (INIS)

    Malartic, Cécile; Morel, Olivier; Fargeaudou, Yann; Le Dref, Olivier; Fazel, Afchine; Barranger, Emmanuel; Soyer, Philippe

    2012-01-01

    Objective: To evaluate the feasibility and safety of combined uterine artery embolization (UAE) using embosphere and surgical myomectomy as an alternative to radical hysterectomy in premenopausal women with multiple fibroids. Materials and methods: Mid-term clinical outcome (mean, 25 months) of 12 premenopausal women (mean age, 38 years) with multiple and large symptomatic fibroids who desired to retain their uterus and who were treated using combined UAE and surgical myomectomy were retrospectively analyzed. In all women, UAE alone was contraindicated because of large (>10 cm) or subserosal or submucosal fibroids and myomectomy alone was contraindicated because of too many (>10) fibroids. Results: UAE and surgical myomectomy were successfully performed in all women. Myomectomy was performed using laparoscopy (n = 6), open laparotomy (n = 3), hysteroscopy (n = 2), or laparoscopy and hysteroscopy (n = 1). Mean serum hemoglobin level drop was 0.97 g/dL and no blood transfusion was needed. No immediate complications were observed and all women reported resumption of normal menses. During a mean follow-up period of 25 months (range, 14–37 months), complete resolution of initial symptoms along with decrease in uterine volume (mean, 48%) was observed in all women. No further hysterectomy was required in any woman. Conclusion: In premenopausal women with multiple fibroids, the two-step procedure is safe and effective alternative to radical hysterectomy, which allows preserving the uterus. Further prospective studies, however, should be done to determine the actual benefit of this combined approach on the incidence of subsequent pregnancies.

  4. A Theoretical Framework towards Understanding of Emotional and Behavioural Difficulties

    Science.gov (United States)

    Poulou, Maria S.

    2014-01-01

    Children's emotional and behavioural difficulties are the result of multiple individual, social and contextual factors working in concert. The current paper proposes a theoretical framework to interpret students' emotional and behavioural difficulties in schools, by taking into consideration teacher-student relationships, students'…

  5. Dysphagia (Difficulty Swallowing)

    Science.gov (United States)

    ... Some of the causes of esophageal dysphagia include: Achalasia. When your lower esophageal muscle (sphincter) doesn't ... into your esophagus and cause frequent heartburn. Radiation therapy. This cancer treatment can lead to inflammation and ...

  6. Report of Increasing Overdose Deaths that include Acetyl Fentanyl in Multiple Counties of the Southwestern Region of the Commonwealth of Pennsylvania in 2015-2016.

    Science.gov (United States)

    Dwyer, Jessica B; Janssen, Jennifer; Luckasevic, Todd M; Williams, Karl E

    2018-01-01

    Acetyl fentanyl is a Schedule I controlled synthetic opioid that is becoming an increasingly detected "designer drug." Routine drug screening procedures in local forensic toxicology laboratories identified a total of 41 overdose deaths associated with acetyl fentanyl within multiple counties of the southwestern region of the state of Pennsylvania. The range, median, mean, and standard deviation of blood acetyl fentanyl concentrations for these 41 cases were 0.13-2100 ng/mL, 11 ng/mL, 169.3 ng/mL, and 405.3 ng/mL, respectively. Thirty-six individuals (88%) had a confirmed history of substance abuse, and all but one case (96%) were ruled multiple drug toxicities. This report characterizes this localized trend of overdose deaths associated with acetyl fentanyl and provides further evidence supporting an alarmingly concentrated opiate and opioid epidemic of both traditional and novel drugs within this region of the United States. © 2017 American Academy of Forensic Sciences.

  7. The difficulties of Biocommunication

    Directory of Open Access Journals (Sweden)

    Borrelli Eugenio

    2002-09-01

    Full Text Available Communicating modern biotechnologies is certainly no easy task. To tackle such a complex and future-oriented assignment, help may arrive, paradoxically, from the past, from ancient rhetorical tradition, and in particular from Aristotle, the most renowned rhetoric teacher of all time. In his Rhetoric, Aristotle suggested that to be persuasive speakers should make use of widely accepted opinions (endoxa, i.e. the common sense shared by all. Common sense is expressed in common truths and value-laden maxims. Common sense, however, is not flat but dialectical, in that it includes contrasting subjects. While reasoning, orators do not just passively report a conception of an unchanging world, but they reproduce the contrasting conceptions included in common sense. In the case of the debate about Biotechnologies, the contrasting conceptions can be found in the Natural/Artificial dualism, in the dichotomy between an attitude marked by obscurantism and suspicion of scientific and technological innovation and that of a scientistic attitude

  8. Fitting and Phenomenology in Type IA Supernova Cosmology: Generalized Likelihood Analyses for Multiple Evolving Populations and Observations of Near-Infrared Lightcurves Including Host Galaxy Properties

    Science.gov (United States)

    Ponder, Kara A.

    In the late 1990s, Type Ia supernovae (SNeIa) led to the discovery that the Universe is expanding at an accelerating rate due to dark energy. Since then, many different tracers of acceleration have been used to characterize dark energy, but the source of cosmic acceleration has remained a mystery. To better understand dark energy, future surveys such as the ground-based Large Synoptic Survey Telescope and the space-based Wide-Field Infrared Survey Telescope will collect thousands of SNeIa to use as a primary dark energy probe. These large surveys will be systematics limited, which makes it imperative for our insight regarding systematics to dramatically increase over the next decade for SNeIa to continue to contribute to precision cosmology. I approach this problem by improving statistical methods in the likelihood analysis and collecting near infrared (NIR) SNeIa with their host galaxies to improve the nearby data set and search for additional systematics. Using more statistically robust methods to account for systematics within the likelihood function can increase accuracy in cosmological parameters with a minimal precision loss. Though a sample of at least 10,000 SNeIa is necessary to confirm multiple populations of SNeIa, the bias in cosmology is ˜ 2 sigma with only 2,500 SNeIa. This work focused on an example systematic (host galaxy correlations), but it can be generalized for any systematic that can be represented by a distribution of multiple Gaussians. The SweetSpot survey gathered 114 low-redshift, NIR SNeIa that will act as a crucial anchor sample for the future high redshift surveys. NIR observations are not as affected by dust contamination, which may lead to increased understanding of systematics seen in optical wavelengths. We obtained spatially resolved spectra for 32 SweetSpot host galaxies to test for local host galaxy correlations. For the first time, we probe global host galaxy correlations with NIR brightnesses from the current literature

  9. EPR spectroscopy of MRI-related Gd(III) complexes: simultaneous analysis of multiple frequency and temperature spectra, including static and transient crystal field effects.

    Science.gov (United States)

    Rast, S; Borel, A; Helm, L; Belorizky, E; Fries, P H; Merbach, A E

    2001-03-21

    For the first time, a very general theoretical method is proposed to interpret the full electron paramagnetic resonance (EPR) spectra at multiple temperatures and frequencies in the important case of S-state metal ions complexed in liquid solution. This method is illustrated by a careful analysis of the measured spectra of two Gd3+ (S = 7/2) complexes. It is shown that the electronic relaxation mechanisms at the origin of the EPR line shape arise from the combined effects of the modulation of the static crystal field by the random Brownian rotation of the complex and of the transient zero-field splitting. A detailed study of the static crystal field mechanism shows that, contrarily to the usual global models involving only second-order terms, the fourth and sixth order terms can play a non-negligible role. The obtained parameters are well interpreted in the framework of the physics of the various underlying relaxation processes. A better understanding of these mechanisms is highly valuable since they partly control the efficiency of paramagnetic metal ions in contrast agents for medical magnetic resonance imaging (MRI).

  10. Infantile Feeding Difficulties

    Directory of Open Access Journals (Sweden)

    Laura C. McCarthy DO

    2014-10-01

    Full Text Available Background. Gastric volvulus refers to a torsion of all or part of the stomach that may cause an obstruction of the foregut. The clinical symptoms of gastric volvulus range from asymptomatic to life-threatening and thus must be rapidly diagnosed. However, the presenting symptoms of gastric volvulus vary widely, which may cause diagnosis to be delayed or missed. Objective. Describe varying presentations of gastric volvulus (including a case report of a rare presentation, pathophysiology of the entity, and how to diagnose/treat the phenomenon. Design/Method. Article review and case presentation. Results. Our patient was taken to the operating room for a gastropexy and G-tube placement. During surgery, the stomach was redundant and large, but not currently torsed, consistent with intermittent organoaxial volvulus. There are several approaches to classifying gastric volvulus as well as different theories on how to treat the volvulus based on type and degree of rotation that this article aims to detail more thoroughly. Conclusion. There are a growing number of case reports describing gastric volvulus, which had historically been viewed as a rare finding. The presenting symptoms of gastric volvulus commonly mimic other, more benign newborn diagnoses, and thus can be difficult to diagnose. We present our patient as well as an article review of other cases to highlight the diverse presentations of gastric volvulus so this potentially devastating disease can be diagnosed quickly with prompt treatment initiation.

  11. Cumulative risk effects for the development of behaviour difficulties in children and adolescents with special educational needs and disabilities.

    Science.gov (United States)

    Oldfield, Jeremy; Humphrey, Neil; Hebron, Judith

    2015-01-01

    Research has identified multiple risk factors for the development of behaviour difficulties. What have been less explored are the cumulative effects of exposure to multiple risks on behavioural outcomes, with no study specifically investigating these effects within a population of young people with special educational needs and disabilities (SEND). Furthermore, it is unclear whether a threshold or linear risk model better fits the data for this population. The sample included 2660 children and 1628 adolescents with SEND. Risk factors associated with increases in behaviour difficulties over an 18-month period were summed to create a cumulative risk score, with this explanatory variable being added into a multi-level model. A quadratic term was then added to test the threshold model. There was evidence of a cumulative risk effect, suggesting that exposure to higher numbers of risk factors, regardless of their exact nature, resulted in increased behaviour difficulties. The relationship between risk and behaviour difficulties was non-linear, with exposure to increasing risk having a disproportionate and detrimental impact on behaviour difficulties in child and adolescent models. Interventions aimed at reducing behaviour difficulties need to consider the impact of multiple risk variables. Tailoring interventions towards those exposed to large numbers of risks would be advantageous. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Mathematics Difficulties: Does One Approach Fit All?

    Science.gov (United States)

    Gifford, Sue; Rockliffe, Freda

    2012-01-01

    This article reviews the nature of learning difficulties in mathematics and, in particular, the nature and prevalence of dyscalculia, a condition that affects the acquisition of arithmetical skills. The evidence reviewed suggests that younger children (under the age of 10) often display a combination of problems, including minor physical…

  13. NEW CONTRIBUTIONS TO READING DIFFICULTIES INTERVENTION

    Directory of Open Access Journals (Sweden)

    VÍCTOR SANTIUSTE BERMEJO

    2005-01-01

    Full Text Available This article presents a synthesis of the intervention programs and strategies to treat reading difficulties. The synthesisincludes a review of the last published articles on the issue, both in Spanish and English. It also presents the visits todifferent Language Rehabilitation Centers in the Community of Madrid including the approaches applied in thesecenters. Besides the description of the general intervention strategies applied to reading problems, some of theprograms to treat specific difficulties of words decoding and recognizing are explained, and the programs to treatreading comprehension and fluidity.

  14. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...

  15. Workplace bullying and sleep difficulties

    DEFF Research Database (Denmark)

    Hansen, Åse Marie; Hogh, Annie; Garde, Anne Helene

    2014-01-01

    PURPOSE: The aims of the present study were to investigate whether being subjected to bullying and witnessing bullying at the workplace was associated with concurrent sleep difficulties, whether frequently bullied/witnesses have more sleep difficulties than occasionally bullied....../witnesses, and whether there were associations between being subjected to bullying or witnessing bullying at the workplace and subsequent sleep difficulties. METHODS: A total of 3,382 respondents (67 % women and 33 % men) completed a baseline questionnaire about their psychosocial work environment and health....... The overall response rate was 46 %. At follow-up 2 years later, 1671 of those responded to a second questionnaire (49 % of the 3,382 respondents at baseline). Sleep difficulties were measured in terms of disturbed sleep, awakening problems, and poor quality of sleep. RESULTS: Bullied persons and witnesses...

  16. Novel interstitial deletion of 10q24.3-25.1 associated with multiple congenital anomalies including lobar holoprosencephaly, cleft lip and palate, and hypoplastic kidneys.

    Science.gov (United States)

    Peltekova, Iskra T; Hurteau-Millar, Julie; Armour, Christine M

    2014-12-01

    Chromosome 10q deletions are rare and phenotypically diverse. Such deletions differ in length and occur in numerous regions on the long arm of chromosome 10, accounting for the wide clinical variability. Commonly reported findings include dysmorphic facial features, microcephaly, developmental delay, and genitourinary abnormalities. Here, we report on a female patient with a novel interstitial 5.54 Mb deletion at 10q24.31-q25.1. This patient had findings in common with a previously reported patient with an overlapping deletion, including renal anomalies and an orofacial cleft, but also demonstrated lobar holoprosencephaly and a Dandy-Walker malformation, features which have not been previously reported with 10q deletions. An analysis of the region deleted in our patient showed numerous genes, such as KAZALD1, PAX2, SEMA4G, ACTRA1, INA, and FGF8, whose putative functions may have played a role in the phenotype seen in our patient. © 2014 Wiley Periodicals, Inc.

  17. Desirable difficulties in vocabulary learning

    OpenAIRE

    Bjork, RA; Kroll, JF

    2015-01-01

    © 2015 by the Board of Trustees of the University of Illinois. In this article we discuss the role of desirable difficulties in vocabulary learning from two perspectives, one having to do with identifying conditions of learning that impose initial challenges to the learner but then benefit later retention and transfer, and the other having to do with the role of certain difficulties that are intrinsic to language processes, are engaged during word learning, and reflect how language is underst...

  18. Epigenetic profiling of cutaneous T-cell lymphoma: promoter hypermethylation of multiple tumor suppressor genes including BCL7a, PTPRG, and p73.

    Science.gov (United States)

    van Doorn, Remco; Zoutman, Willem H; Dijkman, Remco; de Menezes, Renee X; Commandeur, Suzan; Mulder, Aat A; van der Velden, Pieter A; Vermeer, Maarten H; Willemze, Rein; Yan, Pearlly S; Huang, Tim H; Tensen, Cornelis P

    2005-06-10

    To analyze the occurrence of promoter hypermethylation in primary cutaneous T-cell lymphoma (CTCL) on a genome-wide scale, focusing on epigenetic alterations with pathogenetic significance. DNA isolated from biopsy specimens of 28 patients with CTCL, including aggressive CTCL entities (transformed mycosis fungoides and CD30-negative large T-cell lymphoma) and an indolent entity (CD30-positive large T-cell lymphoma), were investigated. For genome-wide DNA methylation screening, differential methylation hybridization using CpG island microarrays was applied, which allows simultaneous detection of the methylation status of 8640 CpG islands. Bisulfite sequence analysis was applied for confirmation and detection of hypermethylation of eight selected tumor suppressor genes. The DNA methylation patterns of CTCLs emerging from differential methylation hybridization analysis included 35 CpG islands hypermethylated in at least four of the 28 studied CTCL samples when compared with benign T-cell samples. Hypermethylation of the putative tumor suppressor genes BCL7a (in 48% of CTCL samples), PTPRG (27%), and thrombospondin 4 (52%) was confirmed and demonstrated to be associated with transcriptional downregulation. BCL7a was hypermethylated at a higher frequency in aggressive (64%) than in indolent (14%) CTCL entities. In addition, the promoters of the selected tumor suppressor genes p73 (48%), p16 (33%), CHFR (19%), p15 (10%), and TMS1 (10%) were hypermethylated in CTCL. Malignant T cells of patients with CTCL display widespread promoter hypermethylation associated with inactivation of several tumor suppressor genes involved in DNA repair, cell cycle, and apoptosis signaling pathways. In view of this, CTCL may be amenable to treatment with demethylating agents.

  19. Electrophysiological heterogeneity of pacemaker cells in the rabbit intercaval region, including the SA node: insights from recording multiple ion currents in each cell.

    Science.gov (United States)

    Monfredi, Oliver; Tsutsui, Kenta; Ziman, Bruce; Stern, Michael D; Lakatta, Edward G; Maltsev, Victor A

    2018-03-01

    Cardiac pacemaker cells, including cells of the sinoatrial node, are heterogeneous in size, morphology, and electrophysiological characteristics. The exact extent to which these cells differ electrophysiologically is unclear yet is critical to understanding their functioning. We examined major ionic currents in individual intercaval pacemaker cells (IPCs) sampled from the paracristal, intercaval region (including the sinoatrial node) that were spontaneously beating after enzymatic isolation from rabbit hearts. The beating rate was measured at baseline and after inhibition of the Ca 2+ pump with cyclopiazonic acid. Thereafter, in each cell, we consecutively measured the density of funny current ( I f ), delayed rectifier K + current ( I K ) (a surrogate of repolarization capacity), and L-type Ca 2+ current ( I Ca,L ) using whole cell patch clamp . The ionic current densities varied to a greater extent than previously appreciated, with some IPCs demonstrating very small or zero I f . The density of none of the currents was correlated with cell size, while I Ca,L and I f densities were related to baseline beating rates. I f density was correlated with I K density but not with that of I Ca,L . Inhibition of Ca 2+ cycling had a greater beating rate slowing effect in IPCs with lower I f densities. Our numerical model simulation indicated that 1) IPCs with small (or zero) I f or small I Ca,L can operate via a major contribution of Ca 2+ clock, 2) I f -Ca 2+ -clock interplay could be important for robust pacemaking function, and 3) coupled I f - I K function could regulate maximum diastolic potential. Thus, we have demonstrated marked electrophysiological heterogeneity of IPCs. This heterogeneity is manifested in basal beating rate and response to interference of Ca 2+ cycling, which is linked to I f . NEW & NOTEWORTHY In the present study, a hitherto unrecognized range of heterogeneity of ion currents in pacemaker cells from the intercaval region is demonstrated

  20. A de novo 1q22q23.1 Interstitial Microdeletion in a Girl with Intellectual Disability and Multiple Congenital Anomalies Including Congenital Heart Defect.

    Science.gov (United States)

    Aleksiūnienė, Beata; Preiksaitiene, Egle; Morkūnienė, Aušra; Ambrozaitytė, Laima; Utkus, Algirdas

    2018-01-01

    Many studies have shown that molecular karyotyping is an effective diagnostic tool in individuals with developmental delay/intellectual disability. We report on a de novo interstitial 1q22q23.1 microdeletion, 1.6 Mb in size, detected in a patient with short stature, microcephaly, hypoplastic corpus callosum, cleft palate, minor facial anomalies, congenital heart defect, camptodactyly of the 4-5th fingers, and intellectual disability. Chromosomal microarray analysis revealed a 1.6-Mb deletion in the 1q22q23.1 region, arr[GRCh37] 1q22q23.1(155630752_157193893)×1. Real-time PCR analysis confirmed its de novo origin. The deleted region encompasses 50 protein-coding genes, including the morbid genes APOA1BP, ARHGEF2, LAMTOR2, LMNA, NTRK1, PRCC, RIT1, SEMA4A, and YY1AP1. Although the unique phenotype observed in our patient can arise from the haploinsufficiency of the dosage-sensitive LMNA gene, the dosage imbalance of other genes implicated in the rearrangement could also contribute to the phenotype. Further studies are required for the delineation of the phenotype associated with this rare chromosomal alteration and elucidation of the critical genes for manifestation of the specific clinical features. © 2018 S. Karger AG, Basel.

  1. Multiple factors, including non-motor impairments, influence decision making with regard to exercise participation in Parkinson's disease: a qualitative enquiry.

    Science.gov (United States)

    O'Brien, Christine; Clemson, Lindy; Canning, Colleen G

    2016-01-01

    To explore how the meaning of exercise and other factors interact and influence the exercise behaviour of individuals with Parkinson's disease (PD) enrolled in a 6-month minimally supervised exercise program to prevent falls, regardless of whether they completed the prescribed exercise or not. This qualitative study utilised in-depth semi-structured interviews analysed using grounded theory methodology. Four main themes were constructed from the data: adapting to change and loss, the influence of others, making sense of the exercise experience and hope for a more active future. Participation in the PD-specific physiotherapy program involving group exercise provided an opportunity for participants to reframe their identity of their "active" self. Three new influences on exercise participation were identified and explored: non-motor impairments of apathy and fatigue, the belief in a finite energy quota, and the importance of feedback. A model was developed incorporating the themes and influences to explain decision-making for exercise participation in this group. Complex and interacting issues, including non-motor impairments, need to be considered in order to enhance the development and ongoing implementation of effective exercise programmes for people with PD. Exercise participation can assist individuals to reframe their identity as they are faced with losses associated with Parkinson's disease and ageing. Non-motor impairments of apathy and fatigue may influence exercise participation in people with Parkinson's disease. Particular attention needs to be paid to the provision of feedback in exercise programs for people with Parkinson's disease as it important for their decision-making about continuing exercise.

  2. [IgE myeloma. Laboratory typing difficulties].

    Science.gov (United States)

    Bovone, Nora S; Fuente, María Cristina; Gastiazoro, Ana María; Alfonso, Graciela; Freitas, María Josefina

    2014-01-01

    The IgE multiple myeloma is a rare neoplasm of plasma cell accounting for 0.01% of all plasma cell dyscrasias. They are generally of more aggressive development and to date there are no more than 50 cases published in current literature. Laboratory studies are, in these cases, essential for the classification of the monoclonal component in serum and urine. The aim of this presentation is to report a patient diagnosed with IgE myeloma and to point out that the laboratory difficulties noted in these rare cases can lead to an erroneous report.

  3. Adolescent Bullying and Sleep Difficulties

    Directory of Open Access Journals (Sweden)

    Simon C. Hunter

    2014-11-01

    Full Text Available This study evaluated whether adolescents who report having been bullied, being bullies, or report both being a bully and being bullied experience more sleep difficulties than children uninvolved in bullying. The study drew upon cognitive theories of insomnia, investigating whether the extent to which young people report worrying about bullying can moderate associations between victimization and sleep difficulties. Participants were 5420 adolescents who completed a self-report questionnaire. Pure Victims (OR = 1.72, 95% CI [1.07, 2.75], Pure Bullies (OR = 1.80, 95% CI [1.16, 2.81], and Bully-Victims (OR = 2.90, 95% CI [1.17, 4.92] were all more likely to experience sleep difficulties when compared to uninvolved young people. The extent to which young people reported worrying about being bullied did not moderate the links between victimization and sleep difficulties. In this way, bullying is clearly related to sleep difficulties among adolescents but the conceptual reach of the cognitive model of insomnia in this domain is questioned.

  4. Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties.

    Science.gov (United States)

    Slopen, Natalie; Williams, David R

    2014-01-01

    To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. Cross-sectional probability sample. Chicago, IL. There were 2,983 black, Hispanic, and white adults. Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P discrimination attributed to race/ethnicity and sleep duration (β = -0.09, P discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P discrimination (P > 0.05). Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep.

  5. [Central diabetes insipidus: diagnostic difficulties].

    Science.gov (United States)

    Matoussi, N; Aissa, K; Fitouri, Z; Hajji, M; Makni, S; Bellagha, I; Ben Becher, S

    2008-06-01

    Central diabetes insipidus is rare in children. Characteristic features include polyuria and polydipsia due to arginine vasopressin deficiency. The differential diagnosis of polyuric states may be difficult. Etiologic diagnosis of central diabetes insipidus may be an equally difficult task. To specify the difficulties encountered in the diagnosis of central diabetes insipidus and to point out features of the etiologic work-up and of long-term follow-up of children with idiopathic central diabetes insipidus. A retrospective study of 12 children admitted with a polyuria/polydipsia syndrome to the pediatric - consultation and emergency unit of the children's hospital of Tunis between 1988 and 2005. Children with acquired nephrogenic central diabetes insipidus were excluded. Fourteen-hour fluid restriction test and/or desmopressin test were used without plasma vasopressin measurement. Eight patients were classified as having central diabetes insipidus, which was severe in seven children and partial in one girl. One patient was classified as having primary polydipsia. The diagnosis remains unclear in three patients. The etiological work-up in eight patients with central diabetes insipidus enabled the identification of Langerhan's-cell histiocytosis in two patients and neurosurgical trauma in one. The cause was considered idiopathic in five patients. The median follow-up of the five patients with idiopathic central diabetes insipidus was five years two months plus or minus six years seven months (range five months, 14.5 years). During this follow-up, neither brain magnetic resonance imaging scans findings nor anterior pituitary function have changed. Fluid restriction and desmopressin tests did not enable an accurate distinction between partial diabetes insipidus and primary polydipsia. Regular surveillance is warranted in patients with idiopathic central diabetes insipidus to identify potential etiologies.

  6. Feeding Difficulties in Children with Esophageal Atresia.

    Science.gov (United States)

    Mahoney, Lisa; Rosen, Rachel

    2016-06-01

    The current available literature evaluating feeding difficulties in children with esophageal atresia was reviewed. The published literature was searched through PubMed using a pre-defined search strategy. Feeding difficulties are commonly encountered in children and adults with repaired esophageal atresia [EA]. The mechanism for abnormal feeding includes both esophageal and oropharyngeal dysphagia. Esophageal dysphagia is commonly reported in patients with EA and causes include dysmotility, anatomic lesions, esophageal outlet obstruction and esophageal inflammation. Endoscopic evaluation, esophageal manometry and esophograms can be useful studies to evaluate for causes of esophageal dysphagia. Oropharyngeal dysfunction and aspiration are also important mechanisms for feeding difficulties in patients with EA. These patients often present with respiratory symptoms. Videofluoroscopic swallow study, salivagram, fiberoptic endoscopic evaluation of swallowing and high-resolution manometry can all be helpful tools to identify aspiration. Once diagnosed, management goals include reduction of aspiration during swallowing, reducing full column reflux into the oropharynx and continuation of oral feeding to maintain skills. We review specific strategies which can be used to reduce aspiration of gastric contents, including thickening feeds, changing feeding schedule, switching formula, trialing transpyloric feeds and fundoplication. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Multi-criteria decision analysis: Limitations, pitfalls, and practical difficulties

    Energy Technology Data Exchange (ETDEWEB)

    Kujawski, Edouard

    2003-02-01

    The 2002 Winter Olympics women's figure skating competition is used as a case study to illustrate some of the limitations, pitfalls, and practical difficulties of Multi-Criteria Decision Analysis (MCDA). The paper compares several widely used models for synthesizing the multiple attributes into a single aggregate value. The various MCDA models can provide conflicting rankings of the alternatives for a common set of information even under states of certainty. Analysts involved in MCDA need to deal with the following challenging tasks: (1) selecting an appropriate analysis method, and (2) properly interpreting the results. An additional trap is the availability of software tools that implement specific MCDA models that can beguile the user with quantitative scores. These conclusions are independent of the decision domain and they should help foster better MCDA practices in many fields including systems engineering trade studies.

  8. Difficulties in emotion regulation in patients with eating disorders.

    Science.gov (United States)

    Ruscitti, Catherine; Rufino, Katrina; Goodwin, Natalie; Wagner, Rebecca

    2016-01-01

    A defining characteristic of eating disorders (EDs) is difficulty with emotion regulation (ER). Previous research indicates that ED subtypes demonstrate differing ER difficulties. Specifically, individuals with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) show greater impairment in their ability to regulate emotions in areas such as achieving goals while upset, reacting impulsively to distress, and effectively using coping strategies, as compared to those with Binge Eating Disorder (BED). However, limited research includes the diagnostic category of Eating Disorder, Not Otherwise Specified (EDNOS). The aim of this study was to better understand ER difficulties for all ED diagnoses, especially EDNOS. It was hypothesized that patients with EDs will demonstrate similar ER difficulties as psychiatric patients without EDs and that patients with EDNOS will be similar in their total level of ER difficulties but will differ in their specific types of difficulties in ER as compared to patients with other EDs. Participants included 404 adults presenting to an inpatient psychiatric hospital. Psychiatric diagnoses, including EDs, were determined using the Structured Clinical Interview for DSM Disorders. Differences in specific and overall difficulties with ER were examined across psychiatric patients using the multidimensional Difficulties in Emotion Regulation Scale. Results of this study indicate that individuals with EDs have greater ER difficulties in most domains of ER and that those with BED and EDNOS demonstrate the most significant differences in ER as compared to psychiatric patients without EDs. Additionally, it was found that ED subtypes typically did not differ in terms of specific difficulties in ER. One exception emerged indicating that individuals with BED demonstrated significantly greater difficulty on the Limited Access to Emotion Regulation Strategies subscale as compared to those with EDNOS. Researchers were able to clarify difficulties in ER across ED

  9. Determinants of footwear difficulties in people with plantar heel pain.

    Science.gov (United States)

    Sullivan, Justin; Pappas, Evangelos; Adams, Roger; Crosbie, Jack; Burns, Joshua

    2015-01-01

    Plantar heel pain is a common foot disorder aggravated by weight-bearing activity. Despite considerable focus on therapeutic interventions such as orthoses, there has been limited investigation of footwear-related issues in people with plantar heel pain. The aim of this study was to investigate whether people with plantar heel pain experience footwear-related difficulties compared to asymptomatic individuals, as well as identifying factors associated with footwear comfort, fit and choice. The footwear domain of the Foot Health Status Questionnaire (FHSQ) was assessed in 192 people with plantar heel pain and 69 asymptomatic controls. The plantar heel pain group was also assessed on a variety of measures including: foot posture, foot strength and flexibility, pedobarography and pain level. A univariate analysis of covariance, with age as the covariate, was used to compare the heel pain and control groups on the FHSQ footwear domain score. A multiple regression model was then constructed to investigate factors associated with footwear scores among participants with plantar heel pain. When compared to asymptomatic participants, people with plantar heel pain reported lower FHSQ footwear domain scores (mean difference -24.4; p footwear scores were associated with maximum force beneath the postero-lateral heel during barefoot walking, toe flexor strength and gender. People with plantar heel pain experience difficulty with footwear comfort, fit and choice. Reduced heel loading during barefoot walking, toe flexor weakness and female gender are all independently associated with reports of footwear difficulties in people with heel pain. Increased focus, in both clinical and research settings, is needed to address footwear-related issues in people with plantar heel pain.

  10. School Success for Kids with Dyslexia and Other Reading Difficulties

    Science.gov (United States)

    Dunson, Walter E.

    2012-01-01

    "School Success for Kids With Dyslexia and Other Reading Difficulties" provides parents and teachers with goals that will meet the needs of students who are struggling with reading, leading them to work through their difficulties and enjoy reading. It includes information, assessments, and techniques that parents, teachers, and school…

  11. EXPLORING STUDENTS‟ DIFFICULTIES IN READING ACADEMIC TEXTS

    Directory of Open Access Journals (Sweden)

    Ira Ernawati

    2017-04-01

    Full Text Available Academic texts play an important role for university students. However, those texts are considered difficult. This study is intended to investigate students‘ difficulties in reading academic texts. The qualitative approach was employed in this study. The design was a case study. The participants were ten students from fifth semester of CLS: EE (Classroom Language and Strategy: Explaining and Exemplifying class who were selected by using purposive sampling. The data were gathered from students‘ journal reflections, observation, and interview. The finding shows that the students encountered reading difficulties in area of textual factors, namely vocabulary, comprehending specific information, text organization, and grammar and human factors including background knowledge, mood, laziness, and time constraint.

  12. Workplace-based assessments of junior doctors: do scores predict training difficulties?

    Science.gov (United States)

    Mitchell, Colin; Bhat, Sarita; Herbert, Anne; Baker, Paul

    2011-12-01

    Workplace-based assessment (WPBA) is an increasingly important part of postgraduate medical training and its results may be used as evidence of professional competence. This study evaluates the ability of WPBA to distinguish UK Foundation Programme (FP) doctors with training difficulties and its effectiveness as a surrogate marker for deficiencies in professional competence. We conducted a retrospective observational study using anonymised records for 1646 trainees in a single UK postgraduate deanery. Data for WPBAs conducted from August 2005 to April 2009 were extracted from the e-portfolio database. These data included all scores submitted by trainees in FP years 1 and 2 on mini-clinical evaluation exercise (mini-CEX), case-based discussion (CbD), direct observation of procedural skills (DOPS) and mini-peer assessment tool (mini-PAT) assessments. Records of trainees in difficulty, as identified by their educational supervisors, were tagged as index cases. Main outcome measures were odds ratios (ORs) for associations between mean WPBA scores and training difficulties. Further analyses by the reported aetiology of the training difficulty (health-, conduct- or performance-related) were performed. Of the 1646 trainees, 92 had been identified as being in difficulty. Mean CbD and mini-CEX scores were lower for trainees in difficulty and an association was found between identified training difficulties and average scores on the mini-CEX (OR = 0.54; p = 0.034) and CbD (OR = 0.39; p = 0.002). A receiver operator characteristic curve analysis of mean WPBA scores for diagnosing 'in difficulty' status yielded an area under the curve of 0.64, indicating weak predictive value. There was no statistical evidence that mean scores on DOPS and mini-PAT assessments differed between the two groups. Analysis of a large dataset of WPBA scores revealed significant associations between training difficulties and lower mean scores on both the mini-CEX and CbD. Models show that using WPBA

  13. Discrimination, Other Psychosocial Stressors, and Self-Reported Sleep Duration and Difficulties

    Science.gov (United States)

    Slopen, Natalie; Williams, David R.

    2014-01-01

    Objectives: To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. Design: Cross-sectional probability sample. Setting: Chicago, IL. Participants: There were 2,983 black, Hispanic, and white adults. Measurements and Results: Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (β = 0.04) and non-racial (β = 0.05) everyday discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P 0.05). Conclusions: Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep. Citation: Slopen N; Williams DR. Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties. SLEEP 2014;37(1):147-156. PMID:24381373

  14. DIFFICULTY OF AMENDMENT AND INTERPRETATIVE CHOICE

    Directory of Open Access Journals (Sweden)

    Andrew Coan

    2016-01-01

    Full Text Available The extreme difficulty of amending the U.S. Constitution plays a central but largely unexamined role in theoretical debates over interpretive choice. In particular, conventional wisdom assumes that the extreme difficulty of Article V amendment weakens the case for originalism. This view might ultimately be correct, but it is not the freestanding argument against originalism it is often presumed to be. Rather, it depends on contestable normative and empirical premises that require defense. If those premises are wrong, the stringency of Article V might actually strengthen the case for originalism. Or Article V might have no impact on that case one way or another. This “complexity thesis” highlights and clarifies the role that difficulty of amendment plays across a range of significant interpretive debates, including those surrounding writtenness, John Hart Ely’s representation-reinforcement theory, interpretive pluralism, and originalism as a theory of positive law. It also has important implications for the under-studied relations between statutory and constitutional interpretation and federal and state constitutional interpretation.

  15. Common Factors Among Family Medicine Residents Who Encounter Difficulty.

    Science.gov (United States)

    Binczyk, Natalia M; Babenko, Oksana; Schipper, Shirley; Ross, Shelley

    2018-04-01

    Residents in difficulty are costly to programs in both time and resources, and encountering difficulty can be emotionally harmful to residents. Approximately 10% of residents will encounter difficulty at some point in training. While there have been several studies looking at common factors among residents who encounter difficulty, some of the findings are inconsistent. The objective of this study was to determine whether there are common factors among the residents who encounter difficulty during training in a large Canadian family medicine residency program. Secondary data analysis was performed on archived resident files from a Canadian family medicine residency program. Residents who commenced an urban family medicine residency program between the years of 2006 and 2014 were included in the study. Five hundred nine family medicine residents were included in data analysis. Residents older than 30 years were 2.33 times (95% CI: 1.27-4.26) more likely to encounter difficulty than residents aged 30 years or younger. Nontransfer residents were 8.85 times (95% CI: 1.17-66.67) more likely to encounter difficulty than transfer residents. The effects of sex, training site, international medical graduate status, and rotation order on the likelihood of encountering difficulty were nonsignificant. Older and nontransfer residents may be facing unique circumstances and may benefit from additional support from the program.

  16. Ghosts, Troubles, Difficulties, and Challenges

    DEFF Research Database (Denmark)

    Raahauge, Kirsten Marie

    2016-01-01

    not consider ‘ghosts’ or ‘haunting’ as a possible explanation. This causes difficulties when they narrate and contextualise their experience, and typically they present ambiguous narratives and stress their disbelief at and bewilderment with the experiences. Still, as I will try to show in my article......, their bewilderment and the way they use the notions ‘ghost’ and ‘haunting’ point to possible reinterpretations of these notions, so that the narrative mediation shapes not only the experience but also the ways that ‘ghosts’ and ‘haunting’ are reinterpreted in contemporary Denmark....

  17. Students' Conceptual Difficulties in Quantum Mechanics: Potential Well Problems

    Science.gov (United States)

    Ozcan, Ozgur; Didis, Nilufer; Tasar, Mehmet Fatih

    2009-01-01

    In this study, students' conceptual difficulties about some basic concepts in quantum mechanics like one-dimensional potential well problems and probability density of tunneling particles were identified. For this aim, a multiple choice instrument named Quantum Mechanics Conceptual Test has been developed by one of the researchers of this study…

  18. Student Difficulties Regarding Symbolic and Graphical Representations of Vector Fields

    Science.gov (United States)

    Bollen, Laurens; van Kampen, Paul; Baily, Charles; Kelly, Mossy; De Cock, Mieke

    2017-01-01

    The ability to switch between various representations is an invaluable problem-solving skill in physics. In addition, research has shown that using multiple representations can greatly enhance a person's understanding of mathematical and physical concepts. This paper describes a study of student difficulties regarding interpreting, constructing,…

  19. Intervention program efficacy for spelling difficulties.

    Science.gov (United States)

    Sampaio, Maria Nobre; Capellini, Simone Aparecida

    2014-01-01

    To develop an intervention procedure for spelling difficulties and to verify the effectiveness of the intervention program in students with lower spelling performance. We developed an intervention program for spelling difficulties, according to the semiology of the errors. The program consisted of three modules totaling 16 sessions. The study included 40 students of the third to fifth grade of public elementary education of the city of Marilia (SP), of both genders, in aged of eight to 12 years old, being distributed in the following groups: GI (20 students with lower spelling performance) and GII (20 students with higher spelling performance). In situation of pre and post-testing, all groups were submitted to the Pro-Orthography. The results statistically analyzed showed that, in general, all groups had average of right that has higher in post-testing, reducing the types of errors second semiologycal classification, mainly related to natural spelling errors. However, the results also showed that the groups submitted to the intervention program showed better performance on spelling tests in relation to not submitted. The intervention program developed was effective once the groups submitted showed better performance on spelling tests in relation to not submitted. Therefore, the intervention program can help professionals in the Health and Education to minimize the problems related to spelling, giving students an intervention that is effective for the development of the spelling knowledge.

  20. Perception of difficulty and glucose control: Effects on academic performance in youth with type I diabetes.

    Science.gov (United States)

    Potts, Tiffany M; Nguyen, Jacqueline L; Ghai, Kanika; Li, Kathy; Perlmuter, Lawrence

    2015-04-15

    To investigate whether perceptions of task difficulty on neuropsychological tests predicted academic achievement after controlling for glucose levels and depression. Participants were type 1 diabetic adolescents, with a mean age = 12.5 years (23 females and 16 males), seen at a northwest suburban Chicago hospital. The sample population was free of co-morbid clinical health conditions. Subjects completed a three-part neuropsychological battery including the Digit Symbol Task, Trail Making Test, and Controlled Oral Word Association test. Following each task, individuals rated task difficulty and then completed a depression inventory. Performance on these three tests is reflective of neuropsychological status in relation to glucose control. Blood glucose levels were measured immediately prior to and after completing the neuropsychological battery using a glucose meter. HbA1c levels were obtained from medical records. Academic performance was based on self-reported grades in Math, Science, and English. Data was analyzed using multiple regression models to evaluate the associations between academic performance, perception of task difficulty, and glucose control. Perceptions of difficulty on a neuropsychological battery significantly predicted academic performance after accounting for glucose control and depression. Perceptions of difficulty on the neuropsychological tests were inversely correlated with academic performance (r = -0.48), while acute (blood glucose) and long-term glucose levels increased along with perceptions of task difficulty (r = 0.47). Additionally, higher depression scores were associated with poorer academic performance (r = -0.43). With the first regression analysis, perception of difficulty on the neuropsychological tasks contributed to 8% of the variance in academic performance after controlling for peripheral blood glucose and depression. In the second regression analysis, perception of difficulty accounted for 11% of the variance after

  1. Identifying and addressing student difficulties with the ideal gas law

    Science.gov (United States)

    Kautz, Christian Hans

    This dissertation reports on an in-depth investigation of student understanding of the ideal gas law. The research and curriculum development were mostly conducted in the context of algebra- and calculus-based introductory physics courses and a sophomore-level thermal physics course. Research methods included individual demonstration interviews and written questions. Student difficulties with the quantities: pressure, volume, temperature, and the number of moles were identified. Data suggest that students' incorrect and incomplete microscopic models about gases contribute to the difficulties they have in answering questions posed in macroscopic terms. In addition, evidence for general reasoning difficulties is presented. These research results have guided the development of curriculum to address the student difficulties that have been identified.

  2. Undergraduate Students’ Difficulties in Reading and Constructing Phylogenetic Tree

    Science.gov (United States)

    Sa'adah, S.; Tapilouw, F. S.; Hidayat, T.

    2017-02-01

    Representation is a very important communication tool to communicate scientific concepts. Biologists produce phylogenetic representation to express their understanding of evolutionary relationships. The phylogenetic tree is visual representation depict a hypothesis about the evolutionary relationship and widely used in the biological sciences. Phylogenetic tree currently growing for many disciplines in biology. Consequently, learning about phylogenetic tree become an important part of biological education and an interesting area for biology education research. However, research showed many students often struggle with interpreting the information that phylogenetic trees depict. The purpose of this study was to investigate undergraduate students’ difficulties in reading and constructing a phylogenetic tree. The method of this study is a descriptive method. In this study, we used questionnaires, interviews, multiple choice and open-ended questions, reflective journals and observations. The findings showed students experiencing difficulties, especially in constructing a phylogenetic tree. The students’ responds indicated that main reasons for difficulties in constructing a phylogenetic tree are difficult to placing taxa in a phylogenetic tree based on the data provided so that the phylogenetic tree constructed does not describe the actual evolutionary relationship (incorrect relatedness). Students also have difficulties in determining the sister group, character synapomorphy, autapomorphy from data provided (character table) and comparing among phylogenetic tree. According to them building the phylogenetic tree is more difficult than reading the phylogenetic tree. Finding this studies provide information to undergraduate instructor and students to overcome learning difficulties of reading and constructing phylogenetic tree.

  3. Rehabilitation in multiple sclerosis.

    Science.gov (United States)

    Kubsik-Gidlewska, Anna M; Klimkiewicz, Paulina; Klimkiewicz, Robert; Janczewska, Katarzyna; Woldańska-Okońska, Marta

    2017-07-01

    The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

  4. Parents' difficulties with decisions about childhood immunisation.

    Science.gov (United States)

    Austin, Helen; Campion-Smith, Charles; Thomas, Sarah; Ward, William

    2008-10-01

    Uptake of childhood immunisation fluctuates in the UK. Convenience, access and parents' relationships with professionals influence uptake. This study explores the decision-making by parents about their children's immunisation through focus groups with analysis to identify categories of concern. Issues raised in focus groups included fear, risk, anger, worry and guilt, confusion, difficulty of decision-making and trust of professionals. The parents of completely and incompletely immunised children shared areas of concern, but there were also significant differences. There was a subset of parents of incompletely immunised children who had decided that their children would not have full immunisation, and this group had little trust in information provided by healthcare professionals. Simply providing more information is unlikely to change their decision.

  5. Phonological Storage and Executive Function Deficits in Children with Mathematics Difficulties

    Science.gov (United States)

    Peng, Peng; Congying, Sun; Beilei, Li; Sha, Tao

    2012-01-01

    Children with mathematics difficulties suffer from working memory deficits. This study investigated the deficit profile of phonological storage and executive functions in working memory among children with mathematics difficulties. Based on multiple instruments and two assessment points, 68 children were screened out of 805 fifth graders. Of these…

  6. The Curriculum for Children with Severe and Profound Learning Difficulties at Stephen Hawking School

    Science.gov (United States)

    Rayner, Matthew

    2011-01-01

    The increasing number of children with profound and multiple learning difficulties means that many schools for children with severe learning difficulties are having to review the curriculum that they offer. In addition, these schools are continuing to question whether a subject-based approach, in line with the National Curriculum, is the most…

  7. A de novo 1.58 Mb deletion, including MAP2K6 and mapping 1.28 Mb upstream to SOX9, identified in a patient with Pierre Robin sequence and osteopenia with multiple fractures.

    Science.gov (United States)

    Smyk, Marta; Roeder, Elizabeth; Cheung, Sau Wai; Szafranski, Przemyslaw; Stankiewicz, Paweł

    2015-08-01

    Defects of long-range regulatory elements of dosage-sensitive genes represent an under-recognized mechanism underlying genetic diseases. Haploinsufficiency of SOX9, the gene essential for development of testes and differentiation of chondrocytes, results in campomelic dysplasia, a skeletal malformation syndrome often associated with sex reversal. Chromosomal rearrangements with breakpoints mapping up to 1.6 Mb up- and downstream to SOX9, and disrupting its distant cis-regulatory elements, have been described in patients with milder forms of campomelic dysplasia, Pierre Robin sequence, and sex reversal. We present an ∼1.58 Mb deletion mapping ∼1.28 Mb upstream to SOX9 that encompasses its putative long-range cis-regulatory element(s) and MAP2K6 in a patient with Pierre Robin sequence and osteopenia with multiple fractures. Low bone mass panel testing using massively parallel sequencing of 23 nuclear genes, including COL1A1 and COL1A2 was negative. Based on the previous mouse model of Map2k6, suggesting that Sox9 is likely a downstream target of the p38 MAPK pathway, and our previous chromosome conformation capture-on-chip (4C) data showing potential interactions between SOX9 promoter and MAP2K6, we hypothesize that deletion of MAP2K6 might have affected SOX9 expression and contributed to our patient's phenotype. © 2015 Wiley Periodicals, Inc.

  8. Kosovo’s Experience for Children with Feeding Difficulties after Cardiac Surgery for Congenital Heart Defect

    Directory of Open Access Journals (Sweden)

    Ramush Bejiqi

    2017-11-01

    CONCLUSION: Feeding disorder is often and a frequent long-term sequel in children after neonatal or early infancy heart surgery. Patients with chromosomal and associated anomalies who underwent multiple cardiac surgeries are at risk of developing feeding difficulties.

  9. The behaviour and self-esteem of children with specific speech and language difficulties.

    Science.gov (United States)

    Lindsay, G; Dockrell, J

    2000-12-01

    Children with specific speech and language difficulties (SSLD) may have associated difficulties that impair their access to the curriculum, and their social relationships at home and in school. (i) To identify the range of additional problems experienced by children with SSLD in different educational contexts; (ii) to consider the relationship between these problems and the child's current language status and (iii) to consider the child's self-esteem and the extent to which self-esteem is associated with the primary language problem or other associated difficulties. Sixty-nine children (17 girls, 52 boys) aged 7-8 years (Year 3) who had been identified as having SSLD, 59 from two local education authorities and 10 from regional special schools for children with severe speech and language difficulties. The children were assessed on a range of cognitive, language and educational measures; children and teachers completed a measure of the children's self-esteem (Pictorial Scale of Perceived Competence and Social Acceptance); teachers and parents completed a behavioural questionnaire (Strengths and Difficulties Questionnaire (SDQ); teachers also completed a further rating scale which included a behaviour subscale (Junior Rating Scale: JRS). The children's behaviour was rated as significantly different from the norm on both the SDQ and JRS, with the parents more likely to rate the child as having problems, but also as having prosocial behaviour. Both teachers and parents tended to rate the boys as having more problems than girls on the SDQ, with significant differences for the parents' ratings occurring on the total score and the hyperactivity and conduct problems scales. The children had positive self perceptions, which were comparable to the standardisation sample, and generally significantly higher than those of the teachers. The language and educational attainment scores of the children in special and mainstream schools were generally not significantly different, but

  10. Regulatory difficulties in a developing country

    International Nuclear Information System (INIS)

    Jacobs, W.R. Jr.

    1978-01-01

    The regulatory agency assigned the task of regulating the initial entry into the field of nuclear power generation by a developing country has a very difficult job. Based on the authors' experience during the start-up and initial operation of Ko-Ri Unit I, the first power reactor in the Republic of Korea, observations on regulatory difficulties and recommendations for improved regulatory effectiveness are offered. The problem areas can be loosely grouped into three general categories: (1) Lack of adequate technical knowledge which is the basis for all effective regulation; (2) Difficulties with understanding and utilization of the required regulatory documentation; (3) Failure to establish the proper regulatory environment. Examples are cited from actual experience during the Ko-Ri Unit I start-up to demonstrate the impact that regulatory activities can have on a plant construction and testing programme. The problems encountered are not unique to developing countries but also exist in the United States of America. Recommendations are offered which should be beneficial to either newly formed regulatory agencies or agencies wishing to improve their abilities and effectiveness. These include: (1) Additional training of regulatory inspectors in plant operations; (2) Additional experience gained by participation in regulatory activities in other countries; (3) Increased attention given to regulatory documents, especially plant technical specifications; (4) Establishment of formal lines of communication between the utility and the regulatory agency; (5) Clear definition of regulatory responsibilities to avoid areas of overlapping jurisdiction; (6) Active participation by the regulatory staff very early in the project. It is hoped that these and other recommendations offered will greatly improve regulatory effectiveness and at the same time demonstrate that when the decision is made to 'go nuclear', a strong commitment must be made to develop and support a technically

  11. Postoperative Feeding Difficulties after Repair of Congenital ...

    African Journals Online (AJOL)

    Of these, 24 (37.5%) developed feeding difficulties in the immediate post operative period. The causes of the feeding difficulties were Gastro-oesophageal reflux (GOR) 9, Recurrent diaphragmatic hernia 8, Adhesive intestinal obstruction 4, Poor intestinal motility 2, Campylobacter enteritis, 1, Hypertrophic pyloric stenosis, 1.

  12. Students’ difficulties in probabilistic problem-solving

    Science.gov (United States)

    Arum, D. P.; Kusmayadi, T. A.; Pramudya, I.

    2018-03-01

    There are many errors can be identified when students solving mathematics problems, particularly in solving the probabilistic problem. This present study aims to investigate students’ difficulties in solving the probabilistic problem. It focuses on analyzing and describing students errors during solving the problem. This research used the qualitative method with case study strategy. The subjects in this research involve ten students of 9th grade that were selected by purposive sampling. Data in this research involve students’ probabilistic problem-solving result and recorded interview regarding students’ difficulties in solving the problem. Those data were analyzed descriptively using Miles and Huberman steps. The results show that students have difficulties in solving the probabilistic problem and can be divided into three categories. First difficulties relate to students’ difficulties in understanding the probabilistic problem. Second, students’ difficulties in choosing and using appropriate strategies for solving the problem. Third, students’ difficulties with the computational process in solving the problem. Based on the result seems that students still have difficulties in solving the probabilistic problem. It means that students have not able to use their knowledge and ability for responding probabilistic problem yet. Therefore, it is important for mathematics teachers to plan probabilistic learning which could optimize students probabilistic thinking ability.

  13. Researching Learning Difficulties: A Guide for Practitioners

    Science.gov (United States)

    Porter, Jill; Lacey, Penny

    2005-01-01

    The aim of this book is to provide a source for teachers and other professionals working with children and adults with learning difficulties and disabilities that will enable them to: (1) access selected recent and relevant research in the field of learning difficulties, drawn from a range of disciplines and groups of people; (2) reflect on…

  14. Do dyslexics have auditory input processing difficulties?

    DEFF Research Database (Denmark)

    Poulsen, Mads

    2011-01-01

    Word production difficulties are well documented in dyslexia, whereas the results are mixed for receptive phonological processing. This asymmetry raises the possibility that the core phonological deficit of dyslexia is restricted to output processing stages. The present study investigated whether....... The finding suggests that input processing difficulties are associated with the phonological deficit, but that these difficulties may be stronger above the level of phoneme perception.......Word production difficulties are well documented in dyslexia, whereas the results are mixed for receptive phonological processing. This asymmetry raises the possibility that the core phonological deficit of dyslexia is restricted to output processing stages. The present study investigated whether...... a group of dyslexics had word level receptive difficulties using an auditory lexical decision task with long words and nonsense words. The dyslexics were slower and less accurate than chronological age controls in an auditory lexical decision task, with disproportionate low performance on nonsense words...

  15. The Relationship between Older Adults' Risk for a Future Fall and Difficulty Performing Activities of Daily Living.

    Science.gov (United States)

    Mamikonian-Zarpas, Ani; Laganá, Luciana

    2015-12-01

    Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984-1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with walking

  16. The Relationship between Older Adults’ Risk for a Future Fall and Difficulty Performing Activities of Daily Living

    Science.gov (United States)

    Mamikonian-Zarpas, Ani; Laganá, Luciana

    2016-01-01

    Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984–1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with

  17. Preoperative ultrasonography and prediction of technical difficulties during laparoscopic cholecystectomy.

    Science.gov (United States)

    Daradkeh, S S; Suwan, Z; Abu-Khalaf, M

    1998-01-01

    A prospective study was carried out to investigate the value of preoperative ultrasound findings for predicting difficulties encountered during laparoscopic cholecystectomy (LC). Altogether 160 consecutive patients with symptomatic gallbladder (GB) disease (130 females, 30 males) referred to the Jordan University Hospital were recruited for the purpose of this study. All patients underwent detailed ultrasound examination 24 hours prior to LC. The overall difficulty score (ODS), as a dependent variable, was based on the following operative parameters: duration of surgery, bleeding, dissection of Calot's triangle, dissection of gallbladder wall, adhesions, spillage of bile, spillage of stone, and difficulty of gallbladder extraction. Multiple regression analysis was used to assess the significance of the following preoperative ultrasound variables (independent) for predicting the variation in the ODS: size of the GB, number of GB stones, size of stones, location of GB stones, thickness of GB wall, common bile duct (CBD) diameter, and liver size. Only thickness of GB wall and CBD diameter were found to be significant predictors of the variation in the ODS (adjusted R2 = 0.25). We conclude that the preoperative ultrasound examination is of value for predicting difficulties encountered during LC, but it is not the sole predictor.

  18. Respiratory difficulties and breathing disorders in achondroplasia.

    Science.gov (United States)

    Afsharpaiman, S; Saburi, A; Waters, Karen A

    2013-12-01

    Respiratory difficulties and breathing disorders in achondroplasia are thought to underlie the increased risk for sudden infant death and neuropsychological deficits seen in this condition. This review evaluates literature regarding respiratory dysfunctions and their sequelae in patients with achondroplasia. The limited number of prospective studies of respiratory disease in achondroplasia means that observational studies and case series provide a large proportion of the data regarding the spectrum of respiratory diseases in achondroplasia and their treatments. Amongst clinical respiratory problems described, snoring is the commonest observed abnormality, but the reported incidence of obstructive sleep apnoea (OSA) shows wide variance (10% to 75%). Reported treatments of OSA include adenotonsillectomy, the use of CPAP, and surgical improvement of the airway, including mid-face advancement. Otolaryngologic manifestations are also common. Respiratory failure due to small thoracic volumes is reported, but uncommon. Mortality rate at all ages was 2.27 (CI: 1.7-3.0) with age-specific mortality increased at all ages. Sudden death was most common in infants and children. Cardiovascular events are the main cause of mortality in adults. Despite earlier recognition and treatment of respiratory complications of achondroplasia, increased mortality rates and other complications remain high. Future and ongoing evaluation of the prevalence and impact of respiratory disorders, particularly OSA, in achondroplasia is recommended. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  19. Visual Annual Reviews: How to Include Pupils with Learning Difficulties in their Educational Reviews

    Science.gov (United States)

    Hayes, Julia

    2004-01-01

    The challenge for schools, following the Green Paper Every Child Matters (HM Treasury, 2003) and the Special Educational Needs Code of Practice (DfES, 2001), is to enable young people to give their views about matters affecting their lives. Whilst these recommendations are a welcome step to enable the effective inclusion of all young people,…

  20. The difficulties of systematic reviews.

    Science.gov (United States)

    Westgate, Martin J; Lindenmayer, David B

    2017-10-01

    The need for robust evidence to support conservation actions has driven the adoption of systematic approaches to research synthesis in ecology. However, applying systematic review to complex or open questions remains challenging, and this task is becoming more difficult as the quantity of scientific literature increases. We drew on the science of linguistics for guidance as to why the process of identifying and sorting information during systematic review remains so labor intensive, and to provide potential solutions. Several linguistic properties of peer-reviewed corpora-including nonrandom selection of review topics, small-world properties of semantic networks, and spatiotemporal variation in word meaning-greatly increase the effort needed to complete the systematic review process. Conversely, the resolution of these semantic complexities is a common motivation for narrative reviews, but this process is rarely enacted with the rigor applied during linguistic analysis. Therefore, linguistics provides a unifying framework for understanding some key challenges of systematic review and highlights 2 useful directions for future research. First, in cases where semantic complexity generates barriers to synthesis, ecologists should consider drawing on existing methods-such as natural language processing or the construction of research thesauri and ontologies-that provide tools for mapping and resolving that complexity. These tools could help individual researchers classify research material in a more robust manner and provide valuable guidance for future researchers on that topic. Second, a linguistic perspective highlights that scientific writing is a rich resource worthy of detailed study, an observation that can sometimes be lost during the search for data during systematic review or meta-analysis. For example, mapping semantic networks can reveal redundancy and complementarity among scientific concepts, leading to new insights and research questions. Consequently

  1. Difficulty buying food, BMI, and eating habits in young children.

    Science.gov (United States)

    Fuller, Anne; Maguire, Jonathon L; Carsley, Sarah; Chen, Yang; Lebovic, Gerald; Omand, Jessica; Parkin, Patricia; Birken, Catherine S

    2018-01-22

    To determine whether parent report of difficulty buying food was associated with child body mass index (BMI) z-score or with eating habits in young children. This was a cross-sectional study in primary care offices in Toronto, Ontario. Subjects were children aged 1-5 years and their caregivers, recruited through the TARGet Kids! Research Network from July 2008 to August 2011. Regression models were developed to test the association between parent report of difficulty buying food because of cost and the following outcomes: child BMI z-score, parent's report of child's intake of fruit and vegetables, fruit juice and sweetened beverages, and fast food. Confounders included child's age, sex, birth weight, maternal BMI, education, ethnicity, immigration status, and neighbourhood income. The study sample consisted of 3333 children. Data on difficulty buying food were available for 3099 children, and 431 of these (13.9%) were from households reporting difficulty buying food. There was no association with child BMI z-score (p = 0.86). Children from households reporting difficulty buying food (compared with never having difficulty buying food) had increased odds of consuming three or fewer servings of fruits and vegetables per day (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.03-1.69), more than one serving of fruit juice/sweetened beverage per day (OR: 1.60, 95% CI: 1.28-2.00), and, among children 1-2 years old, one or more servings of fast food per week (OR: 2.91, 95% CI: 1.67-5.08). Parental report of difficulty buying food is associated with less optimal eating habits in children but not with BMI z-score.

  2. Mastoidectomy: anatomical parameters x surgical difficulty

    Directory of Open Access Journals (Sweden)

    Pereira Júnior, Anastácio Rodrigues

    2012-01-01

    Full Text Available Introduction: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy. Objective: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy. Method: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n=30. Form of study: Contemporary cohort transverse. Results: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2 or temporal meninges prolapse (n = 7 or both (n = 1. In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm. Conclusion: The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.

  3. Motor and Coordination Difficulties in Children with Emotional and Behavioural Difficulties

    Science.gov (United States)

    Hill, Elisabeth; Pratt, Michelle L; Kanji, Zara; Bartoli, Alice Jones

    2017-01-01

    To date, very few studies have explored the incidence of motor impairment amongst children with social, emotional and behavioural difficulties (social, emotional and mental health (SEMH); formerly SEBD in England). Following research that suggests an increase in motor difficulties in young children and adolescents with SEMH difficulties, this…

  4. LEARNING DIFFICULTIES: AN ANALYSIS BASED ON VIGOTSKY

    Directory of Open Access Journals (Sweden)

    Adriane Cenci

    2010-06-01

    Full Text Available We aimed, along the text, to bring a reflection upon learning difficulties based on Socio-Historical Theory, relating what is observed in schools to what has been discussed about learning difficulties and the theory proposed by Vygotsky in the early XX century. We understand that children enter school carrying experiences and knowledge from their cultural group and that school ignores such knowledge very often. Then, it is in such disengagement that emerges what we started to call learning difficulties. One cannot forget to see a child as a whole – a student is a social being constituted by culture, language and specific values to which one must be attentive.

  5. Magnetic order in graphite: Experimental evidence, intrinsic and extrinsic difficulties

    International Nuclear Information System (INIS)

    Esquinazi, P.; Barzola-Quiquia, J.; Spemann, D.; Rothermel, M.; Ohldag, H.; Garcia, N.; Setzer, A.; Butz, T.

    2010-01-01

    We discuss recently obtained data using different experimental methods including magnetoresistance measurements that indicate the existence of metal-free high-temperature magnetic order in graphite. Intrinsic as well as extrinsic difficulties to trigger magnetic order by irradiation of graphite are discussed in view of recently published theoretical work.

  6. Visual difficulty and employment status in the world.

    Directory of Open Access Journals (Sweden)

    Hanen Harrabi

    Full Text Available PURPOSE: Using a world-wide, population-based dataset, we sought to examine the relationship between visual difficulty and employment status. METHODS: The World Health Survey was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design. Far vision was assessed by asking about the level of difficulty in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters. Responses included none, mild, moderate, severe, or extreme/unable. Participants were asked about their current job, and if they were not working, the reason why (unable to find job, ill health, homemaker, studies, unpaid work, other. The occupation in the last 12 months was obtained. Multinomial regression was used accounting for the complex survey design. RESULTS: Of those who wanted to work, 79% of those with severe visual difficulty and 64% of those with extreme visual difficulty were actually working. People who had moderate, severe, or extreme visual difficulty had a higher odds of not working due to an inability to find a job and of not working due to ill health after adjusting for demographic and health factors (P<0.05. CONCLUSIONS: As the major causes of visual impairment in the world are uncorrected refractive error and cataract, countries are losing a great deal of labor productivity by failing to provide for the vision health needs of their citizens and failing to help them integrate into the workforce.

  7. Visual difficulty and employment status in the world.

    Science.gov (United States)

    Harrabi, Hanen; Aubin, Marie-Josee; Zunzunegui, Maria Victoria; Haddad, Slim; Freeman, Ellen E

    2014-01-01

    Using a world-wide, population-based dataset, we sought to examine the relationship between visual difficulty and employment status. The World Health Survey was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design. Far vision was assessed by asking about the level of difficulty in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters). Responses included none, mild, moderate, severe, or extreme/unable. Participants were asked about their current job, and if they were not working, the reason why (unable to find job, ill health, homemaker, studies, unpaid work, other). The occupation in the last 12 months was obtained. Multinomial regression was used accounting for the complex survey design. Of those who wanted to work, 79% of those with severe visual difficulty and 64% of those with extreme visual difficulty were actually working. People who had moderate, severe, or extreme visual difficulty had a higher odds of not working due to an inability to find a job and of not working due to ill health after adjusting for demographic and health factors (P<0.05). As the major causes of visual impairment in the world are uncorrected refractive error and cataract, countries are losing a great deal of labor productivity by failing to provide for the vision health needs of their citizens and failing to help them integrate into the workforce.

  8. Speech comprehension difficulties in chronic tinnitus and its relation to hyperacusis

    Directory of Open Access Journals (Sweden)

    Veronika Vielsmeier

    2016-12-01

    Full Text Available AbstractObjectiveMany tinnitus patients complain about difficulties regarding speech comprehension. In spite of the high clinical relevance little is known about underlying mechanisms and predisposing factors. Here, we performed an exploratory investigation in a large sample of tinnitus patients to (1 estimate the prevalence of speech comprehension difficulties among tinnitus patients, to (2 compare subjective reports of speech comprehension difficulties with objective measurements in a standardized speech comprehension test and to (3 explore underlying mechanisms by analyzing the relationship between speech comprehension difficulties and peripheral hearing function (pure tone audiogram, as well as with co-morbid hyperacusis as a central auditory processing disorder. Subjects and MethodsSpeech comprehension was assessed in 361 tinnitus patients presenting between 07/2012 and 08/2014 at the Interdisciplinary Tinnitus Clinic at the University of Regensburg. The assessment included standard audiological assessment (pure tone audiometry, tinnitus pitch and loudness matching, the Goettingen sentence test (in quiet for speech audiometric evaluation, two questions about hyperacusis, and two questions about speech comprehension in quiet and noisy environments (How would you rate your ability to understand speech?; How would you rate your ability to follow a conversation when multiple people are speaking simultaneously?. Results Subjectively reported speech comprehension deficits are frequent among tinnitus patients, especially in noisy environments (cocktail party situation. 74.2% of all investigated patients showed disturbed speech comprehension (indicated by values above 21.5 dB SPL in the Goettingen sentence test. Subjective speech comprehension complaints (both in general and in noisy environment were correlated with hearing level and with audiologically-assessed speech comprehension ability. In contrast, co-morbid hyperacusis was only correlated

  9. [Increasing difficulties for scientific publication in Venezuela].

    Science.gov (United States)

    Ryder, Elena

    2014-03-01

    A very important increase in the costs of the edition of scientific journals has taken place in Venezuela, due to difficulties in obtaining imported free acid paper and other materials used for handling documents. Like other journals, Investigaci6n Clinica has been considering switching completely to a digital publication format; however there are several reasons that prevent us to doing it at this time: the journal is distributed in printed form to many national institutions, which do not have immediate access to digital information. In addition, there exists a commitment of shipment of printed issues for some international indices and in exchange with other national and foreign journals, whose printed format we receive. Another important aspect is that our University maintains a weak technological platform that makes difficult the immediacy required for the interchange with authors and consulted referees of received papers; and there is a latent danger of limitations in the use of digital technologies, due to current national politic problems. Consequently, we need to continue with the printed format, but must reduce the amount of printed issues, so as not to limit the number of papers published in each edition. Nevertheless, there is an ever increasing number of contributions from foreign researches and Investigaci6n Clinica has been recently included in two new international indices, the SEIIC from Argentina and the Infobase Index from India, reasons that obligate us to maintain our levels of excellence and commitment to our authors and readers.

  10. Evidence-based interventions for reading and language difficulties: creating a virtuous circle.

    Science.gov (United States)

    Snowling, Margaret J; Hulme, Charles

    2011-03-01

    BACKGROUND. Children may experience two very different forms of reading problem: decoding difficulties (dyslexia) and reading comprehension difficulties. Decoding difficulties appear to be caused by problems with phonological (speech sound) processing. Reading comprehension difficulties in contrast appear to be caused by problems with 'higher level' language difficulties including problems with semantics (including deficient knowledge of word meanings) and grammar (knowledge of morphology and syntax). AIMS. We review evidence concerning the nature, causes of, and treatments for children's reading difficulties. We argue that any well-founded educational intervention must be based on a sound theory of the causes of a particular form of learning difficulty, which in turn must be based on an understanding of how a given skill is learned by typically developing children. Such theoretically motivated interventions should in turn be evaluated in randomized controlled trials (RCTs) to establish whether they are effective, and for whom. RESULTS. There is now considerable evidence showing that phonologically based interventions are effective in ameliorating children's word level decoding difficulties, and a smaller evidence base showing that reading and oral language (OL) comprehension difficulties can be ameliorated by suitable interventions to boost vocabulary and broader OL skills. CONCLUSIONS. The process of developing theories about the origins of children's educational difficulties and evaluating theoretically motivated treatments in RCTs, produces a 'virtuous circle' whereby theory informs practice, and the evaluation of effective interventions in turn feeds back to inform and refine theories about the nature and causes of children's reading and language difficulties. ©2010 The British Psychological Society.

  11. Examining the model structure of the strengths and difficulties questionnaire (SDQ)

    OpenAIRE

    Azzopardi, Lara Marie; Camilleri, Liberato; Sammut, Fiona; Cefai, Carmel

    2016-01-01

    The Strengths and Difficulties questionnaire (SDQ), proposed by Goodman 1997, has been used by researchers to measure social, emotional and behaviour difficulties in children. The SDQ includes four difficulty subscales, measuring emotional, conduct, hyperactivity and peer problems. It also includes a fifth subscale, measuring prosocial behaviour. Dickey 2004 suggested that the SDQ factor structure can be reduced to three dimensions comprising the prosocial, externalisation and internalisation...

  12. Player Modeling for Intelligent Difficulty Adjustment

    Science.gov (United States)

    Missura, Olana; Gärtner, Thomas

    In this paper we aim at automatically adjusting the difficulty of computer games by clustering players into different types and supervised prediction of the type from short traces of gameplay. An important ingredient of video games is to challenge players by providing them with tasks of appropriate and increasing difficulty. How this difficulty should be chosen and increase over time strongly depends on the ability, experience, perception and learning curve of each individual player. It is a subjective parameter that is very difficult to set. Wrong choices can easily lead to players stopping to play the game as they get bored (if underburdened) or frustrated (if overburdened). An ideal game should be able to adjust its difficulty dynamically governed by the player’s performance. Modern video games utilise a game-testing process to investigate among other factors the perceived difficulty for a multitude of players. In this paper, we investigate how machine learning techniques can be used for automatic difficulty adjustment. Our experiments confirm the potential of machine learning in this application.

  13. The Relationship of Behavioral Activation and Inhibition Systems (BAS/BIS, Difficulty of Emotional Regulation, Metacognition with Worry

    Directory of Open Access Journals (Sweden)

    S. Soltan Mohammadlou

    2014-11-01

    Full Text Available Worry is a popular phenomenon and a common feature of many disorders, especially anxiety disorders. The objective of the study was to predict worry by using three predictive factors related to biological, emotional and cognition areas. In this study, behavioral inhibition, behavioral activation system, difficulties in emotion regulation and metacognition were examined as predictive variables. In a correlation cross-sectional design, 234 Medical Group students [BA and MA] of Tehran University of Medical Sciences participated in this study by using cluster sampling. The students completed these scales: Behavioral Inhibition and Behavioral Activation Systems (BAS/BIS, Difficulty of Emotion Regulation Scale (DERS, Metacognition Questionnaire-30 (MCQ-30 and Penn State Worry Questionnaire (PSWQ. Behavioral inhibition system, difficulty of emotion rgulation and metacognition variables were significantly positively correlated with worry (P<0/0 1(. Behavioral activation system variable was not significantly associated with worry. Stepwise multiple regression analysis indicated a predictive model for worry in which behavioral inhibition system, difficulty of emotional regulation and metacognition were its components respectively. Behavioral activation system was not included in the model. The findings of this study that worry should be studied in different biological, emotional, and metacognitive aspects. The results also emphasize the role of behavioral inhibition system as a temperamental and biological factor in psychopathology of worry in adult population.

  14. Students’ difficulties in solving linear equation problems

    Science.gov (United States)

    Wati, S.; Fitriana, L.; Mardiyana

    2018-03-01

    A linear equation is an algebra material that exists in junior high school to university. It is a very important material for students in order to learn more advanced mathematics topics. Therefore, linear equation material is essential to be mastered. However, the result of 2016 national examination in Indonesia showed that students’ achievement in solving linear equation problem was low. This fact became a background to investigate students’ difficulties in solving linear equation problems. This study used qualitative descriptive method. An individual written test on linear equation tasks was administered, followed by interviews. Twenty-one sample students of grade VIII of SMPIT Insan Kamil Karanganyar did the written test, and 6 of them were interviewed afterward. The result showed that students with high mathematics achievement donot have difficulties, students with medium mathematics achievement have factual difficulties, and students with low mathematics achievement have factual, conceptual, operational, and principle difficulties. Based on the result there is a need of meaningfulness teaching strategy to help students to overcome difficulties in solving linear equation problems.

  15. Numerical Magnitude Representation in Children With Mathematical Difficulties With or Without Reading Difficulties.

    Science.gov (United States)

    Tobia, Valentina; Fasola, Anna; Lupieri, Alice; Marzocchi, Gian Marco

    2016-01-01

    This study aimed to explore the spatial numerical association of response codes (SNARC), the flanker, and the numerical distance effects in children with mathematical difficulties. From a sample of 720 third, fourth, and fifth graders, 60 children were selected and divided into the following three groups: typically developing children (TD; n = 29), children with mathematical difficulties only (MD only; n = 21), and children with mathematical and reading difficulties (MD+RD; n = 10). Children were tested with a numerical Eriksen task that was built to assess SNARC, numerical distance, and flanker (first and second order congruency) effects. Children with MD only showed stronger SNARC and second order congruency effects than did TD children, whereas the numerical distance effects were similar across the three groups. Finally, the first order congruency effect was associated with reading difficulties. These results showed that children with mathematical difficulties with or without reading difficulties were globally more impaired when spatial incompatibilities were presented. © Hammill Institute on Disabilities 2014.

  16. Multiple homicides.

    Science.gov (United States)

    Copeland, A R

    1989-09-01

    A study of multiple homicides or multiple deaths involving a solitary incident of violence by another individual was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during 1983-1987. A total of 107 multiple homicides were studied: 88 double, 17 triple, one quadruple, and one quintuple. The 236 victims were analyzed regarding age, race, sex, cause of death, toxicologic data, perpetrator, locale of the incident, and reason for the incident. This article compares this type of slaying with other types of homicide including those perpetrated by serial killers. Suggestions for future research in this field are offered.

  17. Working Memory in Students with Mathematical Difficulties

    Science.gov (United States)

    Nur, I. R. D.; Herman, T.; Ningsih, S.

    2018-04-01

    Learning process is the activities that has important role because this process is one of the all factors that establish students success in learning. oftentimes we find so many students get the difficulties when they study mathematics. This condition is not only because of the outside factor but also it comes from the inside. The purpose of this research is to analyze and give the representation how students working memory happened in physical education students for basic statistics subjects which have mathematical difficulties. The subjects are 4 students which have a mathematical difficulties. The research method is case study and when the describe about students working memory are explanated deeply with naturalistic observation. Based on this research, it was founded that 4 students have a working memory deficit in three components. The components are phonological loop, visuospatial sketchpad, dan episodic buffer.

  18. Tinnitus and Sleep Difficulties After Cochlear Implantation.

    Science.gov (United States)

    Pierzycki, Robert H; Edmondson-Jones, Mark; Dawes, Piers; Munro, Kevin J; Moore, David R; Kitterick, Pádraig T

    To estimate and compare the prevalence of and associations between tinnitus and sleep difficulties in a sample of UK adult cochlear implant users and those identified as potential candidates for cochlear implantation. The study was conducted using the UK Biobank resource, a population-based cohort of 40- to 69-year olds. Self-report data on hearing, tinnitus, sleep difficulties, and demographic variables were collected from cochlear implant users (n = 194) and individuals identified as potential candidates for cochlear implantation (n = 211). These "candidates" were selected based on (i) impaired hearing sensitivity, inferred from self-reported hearing aid use and (ii) impaired hearing function, inferred from an inability to report words accurately at negative signal to noise ratios on an unaided closed-set test of speech perception. Data on tinnitus (presence, persistence, and related distress) and on sleep difficulties were analyzed using logistic regression models controlling for gender, age, deprivation, and neuroticism. The prevalence of tinnitus was similar among implant users (50%) and candidates (52%; p = 0.39). However, implant users were less likely to report that their tinnitus was distressing at its worst (41%) compared with candidates (63%; p = 0.02). The logistic regression model suggested that this difference between the two groups could be explained by the fact that tinnitus was less persistent in implant users (46%) compared with candidates (72%; p reported difficulties with sleep were similar among implant users (75%) and candidates (82%; p = 0.28), but participants with tinnitus were more likely to report sleep difficulties than those without (p explanation is supported by the similar prevalence of sleep problems among implant users and potential candidates for cochlear implantation, despite differences between the groups in tinnitus persistence and related emotional distress. Cochlear implantation may therefore not be an appropriate intervention

  19. The association of sleep difficulties with health-related quality of life among patients with fibromyalgia.

    Science.gov (United States)

    Wagner, Jan-Samuel; DiBonaventura, Marco D; Chandran, Arthi B; Cappelleri, Joseph C

    2012-10-17

    Difficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM. The current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables. Of the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population. Among the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted.

  20. Efficacy of melflufen, a peptidase targeted therapy, and dexamethasone in an ongoing open-label phase 2a study in patients with relapsed and relapsed-refractory multiple myeloma (RRMM) including an initial report on progression free survival

    DEFF Research Database (Denmark)

    Voorhees, P. M.; Magarotto, V.; Sonneveld, P.

    2015-01-01

    to DNA or is readily metabolized by intracellular peptidases into hydrophilic alkylating metabolites. With targeted delivery of alkylating metabolites to tumor cells in vitro (such as multiple myeloma that are rich in activating peptidase), melflufen exerts a 20-100 fold higher anti-tumor potency...... and produces a 20 fold higher intracellular concentration of alkylating moieties compared with melphalan. Methods: Melflufen is evaluated in combination with dexamethasone (dex) 40 mg weekly in an ongoing Phase 1/2a study. RRMM patients with measurable disease and at least 2 prior lines of therapy are eligible......%) and constipation and epistaxis (13%). Treatment-related Grade 3 or 4 AEs were reported in 27 patients (87%). Those occurring in >5% of patients were thrombocytopenia (68%), neutropenia (55%), anemia (42%), leukopenia (32%) and febrile neutropenia, fatigue, pyrexia, asthenia and hyperglycemia each occurred in 6...

  1. Stress and suicidal ideation among adolescents having academic difficulty

    Directory of Open Access Journals (Sweden)

    Priti Arun

    2017-01-01

    Full Text Available Background and Objectives: Academically typically achieving adolescents were compared with students having academic difficulty on stress and suicidal ideas. Materials and Methods: In a cross-sectional study, 75 academically typically achieving adolescents were compared with 105 students with academic difficulty and 52 students with specific learning disability (SLD. Academic functioning was assessed using teacher's screening instrument, intelligence quotient, and National Institute of Mental Health and Neurosciences index for SLD. Stress and suicidal ideas were assessed using general health questionnaire, suicide risk-11, and Mooney Problem Checklist (MPC. Appropriate statistical methods were applied. Results: Three groups were comparable on age, gender, mother's working status, being only child, nuclear family, self-reported academic decline, and type of school. About half of adolescents reported psychological problems on General Health Questionnaire (mean score >3 in all the groups. Academically typically achieving adolescents showed higher stressors in peer relationships, planning for future and suicidal ideation compared to adolescents with academic difficulty. Adolescents face stress regarding worry about examinations, family not understanding what child has to do in school, unfair tests, too much work in some subjects, afraid of failure in school work, not spending enough time in studies, parental expectations, wanting to be more popular, worried about a family member, planning for the future, and fear of the future. Significant positive correlation was seen between General Health Questionnaire scores and all four subscales of MPC. Suicidal ideas showed a negative correlation with MPC. Interpretations and Conclusions: Adolescents experience considerable stress in multiple areas irrespective of their academic ability and performance. Hence, assessment and management of stress among adolescents must extend beyond academic difficulties.

  2. Sleep difficulties and academic performance in Norwegian higher education students.

    Science.gov (United States)

    Hayley, Amie C; Sivertsen, Børge; Hysing, Mari; Vedaa, Øystein; Øverland, Simon

    2017-12-01

    Sleep difficulties are common among university students and may detrimentally affect academic outcomes. Despite this, remarkably little information is currently available during this critical developmental period of early adulthood, and thus, the direct effect on measurable domains of academic ability and proficiency is equivocal. To evaluate the associations between difficulties initiating and maintaining sleep (DIMS) and subjective and objective academic performance in a large sample of university students. A total of 12,915 students who participated in large student survey in Norway from 24 February 2014 to 27 March 2014. DIMS was assessed by the Hopkins Symptoms Checklist (HSCL-25), and academic outcomes included failed examinations, delayed study progress, and school-related self-efficacy (General Self-Efficacy Scale). Difficulties initiating and maintaining sleep was independently associated with increased odds for poor school performance for all academic outcomes. Reporting 'extreme' DIMS was associated with increased odds of reporting delayed study progress (adjusted odds ratio [OR] = 1.25, 95% CI 1.01-1.57, p academic outcomes as well as poorer self-rated academic proficiency among higher education students. Amelioration of sleep difficulties may improve overall academic performance and health outcomes in affected students. © 2017 The British Psychological Society.

  3. Multiple inflation

    International Nuclear Information System (INIS)

    Murphy, P.J.

    1987-01-01

    The Theory of Inflation, namely, that at some point the entropy content of the universe was greatly increased, has much promise. It may solve the puzzles of homogeneity and the creation of structure. However, no particle physics model has yet been found that can successfully drive inflation. The difficulty in satisfying the constraint that the isotropy of the microwave background places on the effective potential of prospective models is immense. In this work we have codified the requirements of such models in a most general form. We have carefully calculated the amounts of inflation the various problems of the Standard Model need for their solution. We have derived a completely model independent upper bond on the inflationary Hubble parameter. We have developed a general notation with which to probe the possibilities of Multiple Inflation. We have shown that only in very unlikely circumstances will any evidence of an earlier inflation, survive the de Sitter period of its successor. In particular, it is demonstrated that it is most unlikely that two bouts of inflation will yield high amplitudes of density perturbations on small scales and low amplitudes on large. We conclude that, while multiple inflation will be of great theoretical interest, it is unlikely to have any observational impact

  4. Difficulties in Initial Algebra Learning in Indonesia

    Science.gov (United States)

    Jupri, Al; Drijvers, Paul; van den Heuvel-Panhuizen, Marja

    2014-01-01

    Within mathematics curricula, algebra has been widely recognized as one of the most difficult topics, which leads to learning difficulties worldwide. In Indonesia, algebra performance is an important issue. In the Trends in International Mathematics and Science Study (TIMSS) 2007, Indonesian students' achievement in the algebra domain was…

  5. Communication difficulties between radiobiologists and radiotherapists

    International Nuclear Information System (INIS)

    Revesz, L.

    1977-01-01

    The communication difficulties between radiobiologists and radiotherapists are attributable to the existence of two cultures in radiology, separated by different philosophies, values, standards and attitudes. Integrated education in the separate branches of science and joint experimental ventures are proposed in order to develop unifying concepts. (author)

  6. Fractions Learning in Children with Mathematics Difficulties

    Science.gov (United States)

    Tian, Jing; Siegler, Robert S.

    2017-01-01

    Learning fractions is difficult for children in general and especially difficult for children with mathematics difficulties (MD). Recent research on developmental and individual differences in fraction knowledge of children with MD and typically achieving (TA) children has demonstrated that U.S. children with MD start middle school behind their TA…

  7. Difficulties in initial algebra learning in Indonesia

    NARCIS (Netherlands)

    Jupri, Al; Drijvers, Paulus; van den Heuvel - Panhuizen, Marja

    2014-01-01

    Within mathematics curricula, algebra has been widely recognized as one of the most difficult topics, which leads to learning difficulties worldwide. In Indonesia, algebra performance is an important issue. In the Trends in International Mathematics and Science Study (TIMSS) 2007, Indonesian

  8. Infrared difficulties with thermal quantum field theories

    International Nuclear Information System (INIS)

    Grandou, T.

    1997-01-01

    Reviewing briefly the two main difficulties encountered in thermal quantum field theories at finite temperature when dealing with the Braaten-Pisarski (BP) resummation program, the motivation is introduced of an analysis relying on the bare perturbation theory, right from the onset. (author)

  9. Binomial test models and item difficulty

    NARCIS (Netherlands)

    van der Linden, Willem J.

    1979-01-01

    In choosing a binomial test model, it is important to know exactly what conditions are imposed on item difficulty. In this paper these conditions are examined for both a deterministic and a stochastic conception of item responses. It appears that they are more restrictive than is generally

  10. Time Estimation Deficits in Childhood Mathematics Difficulties

    Science.gov (United States)

    Hurks, Petra P. M.; van Loosbroek, Erik

    2014-01-01

    Time perception has not been comprehensively examined in mathematics difficulties (MD). Therefore, verbal time estimation, production, and reproduction were tested in 13 individuals with MD and 16 healthy controls, matched for age, sex, and intellectual skills. Individuals with MD performed comparably to controls in time reproduction, but showed a…

  11. Students' Difficulties with Vector Calculus in Electrodynamics

    Science.gov (United States)

    Bollen, Laurens; van Kampen, Paul; De Cock, Mieke

    2015-01-01

    Understanding Maxwell's equations in differential form is of great importance when studying the electrodynamic phenomena discussed in advanced electromagnetism courses. It is therefore necessary that students master the use of vector calculus in physical situations. In this light we investigated the difficulties second year students at KU Leuven…

  12. Difficulties in Learning Inheritance and Polymorphism

    Science.gov (United States)

    Liberman, Neomi; Beeri, Catriel; Kolikant, Yifat Ben-David

    2011-01-01

    This article reports on difficulties related to the concepts of inheritance and polymorphism, expressed by a group of 22 in-service CS teachers with an experience with the procedural paradigm, as they coped with a course on OOP. Our findings are based on the analysis of tests, questionnaires that the teachers completed in the course, as well as on…

  13. Learning Difficulties and Nutrition: Pills or Pedagogy?

    Science.gov (United States)

    Evans, Roy

    1999-01-01

    Examines the efforts to find effective ameliorative measures for literacy difficulties such as dyslexia and dyspraxia, focusing on noneducational techniques found in holistic medicine, complementary therapies, and nutritional supplements. Maintains that dyslexia has become big business for drug companies and that the appropriate research regarding…

  14. Quantization and hall effect: necessities and difficulties

    International Nuclear Information System (INIS)

    Ahmed Bouketir; Hishamuddin Zainuddin

    1999-01-01

    The quantization procedure is a necessary tool for a proper understanding of many interesting quantum phenomena in modern physics. In this note, we focus on geometrical framework for such procedures, particularly the group-theoretic approach and their difficulties. Finally we look through the example of Hall effect as a quantized macroscopic phenomenon with group-theoretic quantization approach. (author)

  15. Pupils' Difficulties: What Can the Teacher Do?

    Science.gov (United States)

    Dawson, C. J.

    1978-01-01

    Discusses how the teacher can deal with difficulties pupils of varying ages have in understanding certain chemical ideas. The article does not support using a Piagetian model for science courses in secondary schools. It suggests that Ausubel's learning theory is of much more use to the practicing teacher. (HM)

  16. Older Adults Have Difficulty in Decoding Sarcasm

    Science.gov (United States)

    Phillips, Louise H.; Allen, Roy; Bull, Rebecca; Hering, Alexandra; Kliegel, Matthias; Channon, Shelley

    2015-01-01

    Younger and older adults differ in performance on a range of social-cognitive skills, with older adults having difficulties in decoding nonverbal cues to emotion and intentions. Such skills are likely to be important when deciding whether someone is being sarcastic. In the current study we investigated in a life span sample whether there are…

  17. Early Identification of Reading Comprehension Difficulties

    Science.gov (United States)

    Catts, Hugh W.; Nielsen, Diane Corcoran; Bridges, Mindy Sittner; Liu, Yi-Syuan

    2016-01-01

    Most research on early identification of reading disabilities has focused on word reading problems and little attention has been given to reading comprehension difficulties. In this study, we investigated whether measures of language ability and/or response to language intervention in kindergarten uniquely predicted reading comprehension…

  18. Measuring Difficulty in English-Chinese Translation: Towards a General Model of Translation Difficulty

    Science.gov (United States)

    Sun, Sanjun

    2012-01-01

    Accurate assessment of a text's level of translation difficulty is critical for translator training and accreditation, translation research, and the language industry as well. Traditionally, people rely on their general impression to gauge a text's translation difficulty level. If the evaluation process is to be more effective and the…

  19. Memory Abilities in Children with Mathematical Difficulties: Comorbid Language Difficulties Matter

    Science.gov (United States)

    Reimann, Giselle; Gut, Janine; Frischknecht, Marie-Claire; Grob, Alexander

    2013-01-01

    The present study investigated cognitive abilities in children with difficulties in mathematics only (n = 48, M = 8 years and 5 months), combined mathematical and language difficulty (n = 27, M = 8 years and 1 month) and controls (n = 783, M = 7 years and 11 months). Cognitive abilities were measured with seven subtests, tapping visual perception,…

  20. Communication difficulties in teenagers with health impairments

    Directory of Open Access Journals (Sweden)

    Samokhvalova, Anna G.

    2016-09-01

    Full Text Available Contemporary psychological and pedagogical studies pay special attention to the socialization of physically impaired children, inclusive education and methods of providing such children with a safe environment to assist in their development. However, difficulties in interpersonal communication experienced by children with health impairments have remained beyond the research scope. The authors conducted a comparative analysis of communication difficulties in typically developed teenagers aged 12-13 years (n = 100 and the problems faced by their peers with visual (n = 30, auditory (n = 30, speech (n = 25 and motor (n = 15 impairments. Actual communication difficulties in teenagers were studied in two ways: the subjective component of impaired communication was registered through a content analysis of a sentence completion test and the objective manifestations of impaired communication were identified through expert evaluation of children’s communicative behavior (educators and psychologists who had been in close contact with the teenagers acted as experts. First, the authors identified typical standard communication problems that were characteristic of teenagers aged 12-13 years, that is, problems with aggression, tolerance, the ability to admit wrongdoing and make concessions, empathy, self-control, self-analysis and self-expression in communication. Second, typical communication difficulties characteristic of physically impaired children were revealed: failure to understand meaning; feelings of awkwardness and shame of oneself; expectations of a negative attitude toward oneself; gelotophobia; and manifestations of despotism, petulance and egotism as defensive reactions in situations of impaired communication. Third, the authors described specific communication difficulties in teenagers with auditory, visual, speech and motor impairments.

  1. CDW-EIS calculations for multiple ionization of Ne, Ar, Kr and Xe by the impact of H{sup +} and He{sup +}, including post-collisional electron emission

    Energy Technology Data Exchange (ETDEWEB)

    Montanari, C C; Miraglia, J E [Instituto de AstronomIa y FIsica del Espacio, casilla de correo 67, sucursal 28, C1428EGA, Buenos Aires (Argentina); Montenegro, E C, E-mail: mclaudia@iafe.uba.a [Instituto de FIsica, Universidade Federal de Rio de Janeiro, Caixa Postal 68528, Rio de Janeiro 21945-970, RJ (Brazil)

    2010-08-28

    We present theoretical single to quintuple ionization cross sections for Ne, Ar, Kr and Xe bombarded by H{sup +} and He{sup +}. Post-collisional contributions due to Auger-like processes are taken into account using recent photoionization data. The present continuum distorted wave-eikonal initial state (CDW-EIS) and first Born approximation results are compared with the experimental data available in the energy range of 50-10 000 keV amu{sup -1} for H{sup +} on Ne and Ar, and 50-1000 keV amu{sup -1} for the other cases. In general, the combination of the CDW-EIS with the post-collisional branching ratios describes well the multiple ionization data above 300 keV amu{sup -1}, showing a clear tendency to coalesce with the first Born approximation at high energies. The surprising result of this work is the good performance of the first Born approximation which describes rather well the experimental data of double and triple ionization, even in the intermediate energy range (50-300 keV amu{sup -1}), where direct ionization is the dominant contribution.

  2. Managing PBL difficulties in an industrial engineering and management program

    Directory of Open Access Journals (Sweden)

    Anabela Alves

    2016-08-01

    Full Text Available Purpose: Project-Based Learning (PBL is considered to be an active learning methodology which can be used to develop both technical and transversal competences in engineering programs. This methodology demands a great deal of work effort from the students and also from the teachers and it requires a meticulous plan and a well-managed project as well. These activities go far beyond the normal activities in traditional lectures, enabling to outpace the difficulties that spur along the way that may be both complex and demotivating. This methodology has been implemented in the Integrated Master Degree on Industrial Engineering and Management (IEM, at one public university in Portugal, since the 2004/2005 academic year. The aim of this paper is to identify and discuss the main difficulties of the implementation of PBL, mainly from the teachers’ perspectives. Additionally, some effective strategies will be recommended to overcome such difficulties. Design/methodology/approach: The perceptions of the teachers were collected through a survey based on six main themes. The participants in the study include eight teachers from the five courses of the first semester of the first year of the IEM program involved in the 2012/2013 and 2013/2014 editions. Findings: Integration of courses in the project; student assessment; growing number of students in each team and the need of physical spaces for them; and compartmentalized knowledge has emerged as the main difficulties. To overcome these difficulties some key strategies were recommended. Originality/value: A new perspective based on course teachers' views and experiences will deepen the understanding of the problems and provide inputs for the development of strategies that may improve the effectiveness of PBL and introduce changes for its successful implementation. These strategies are intended to be transferable to other contexts, as most of the problems and constraints are common to other active learning

  3. Handwriting difficulties in juvenile idiopathic arthritis: a pilot study.

    Science.gov (United States)

    Haberfehlner, Helga; Visser, Bart; Daffertshofer, Andreas; van Rossum, Marion Aj; Roorda, Leo D; van der Leeden, Marike; Dekker, Joost; Hoeksma, Agnes F

    2011-01-01

    The aim of the present study was to describe handwriting difficulties of primary school children with juvenile idiopathic arthritis (JIA), and to investigate possible correlations with hand function and writing performance. In a cross-sectional approach, 15 children with JIA and reported handwriting difficulties were included together with 15 healthy matched controls. Impairments (signs of arthritis or tenosynovitis, reduced grip force and limited range of motion of the wrist (wrist-ROM)), activity limitations (reduced quality and speed of handwriting, pain during handwriting), and participation restrictions (perceived handwriting difficulties at school) were assessed and analysed. Although selected by the presence of handwriting difficulties, the majority of the JIA children (73%) had no active arthritis of the writing hand, and only minor hand impairments were found. Overall, the JIA children performed well during the short handwriting test, but the number of letters they wrote per minute decreased significantly during the 5-minute test, compared to the healthy controls. JIA patients had significantly higher pain scores on a 100 mm Visual Analogue Scale, compared to the healthy controls. The actual presence of arthritis, and limitation in grip force and wrist-ROM did not correlate with reported participation restrictions with regard to handwriting at school. The JIA children reported pain during handwriting, and inability to sustain handwriting for a longer period of time. The results of this pilot study show that JIA children with handwriting difficulties, experience their restrictions mainly through pain and the inability to sustain handwriting for a longer period of time. No correlations could be found with impairments.

  4. Managing PBL difficulties in an industrial engineering and management program

    International Nuclear Information System (INIS)

    Alves, A.; Sousa, R.; Moreira, F.; Carvalho, M.A.; Cardoso, E.; Pimenta, P.; Malheiro, T.; Brito, I.; Fernandes, S.; Mesquita, D.

    2016-01-01

    Project-Based Learning (PBL) is considered to be an active learning methodology which can be used to develop both technical and transversal competences in engineering programs. This methodology demands a great deal of work effort from the students and also from the teachers and it requires a meticulous plan and a well-managed project as well. These activities go far beyond the normal activities in traditional lectures, enabling to outpace the difficulties that spur along the way that may be both complex and demotivating. This methodology has been implemented in the Integrated Master Degree on Industrial Engineering and Management (IEM), at one public university in Portugal, since the 2004/2005 academic year. The aim of this paper is to identify and discuss the main difficulties of the implementation of PBL, mainly from the teachers’ perspectives. Additionally, some effective strategies will be recommended to overcome such difficulties. Design/methodology/approach: The perceptions of the teachers were collected through a survey based on six main themes. The participants in the study include eight teachers from the five courses of the first semester of the first year of the IEM program involved in the 2012/2013 and 2013/2014 editions. Findings: Integration of courses in the project; student assessment; growing number of students in each team and the need of physical spaces for them; and compartmentalized knowledge has emerged as the main difficulties. To overcome these difficulties some key strategies were recommended. Originality/value: A new perspective based on course teachers' views and experiences will deepen the understanding of the problems and provide inputs for the development of strategies that may improve the effectiveness of PBL and introduce changes for its successful implementation. These strategies are intended to be transferable to other contexts, as most of the problems and constraints are common to other active learning approaches. (Author)

  5. Managing PBL difficulties in an industrial engineering and management program

    Energy Technology Data Exchange (ETDEWEB)

    Alves, A.; Sousa, R.; Moreira, F.; Carvalho, M.A.; Cardoso, E.; Pimenta, P.; Malheiro, T.; Brito, I.; Fernandes, S.; Mesquita, D.

    2016-07-01

    Project-Based Learning (PBL) is considered to be an active learning methodology which can be used to develop both technical and transversal competences in engineering programs. This methodology demands a great deal of work effort from the students and also from the teachers and it requires a meticulous plan and a well-managed project as well. These activities go far beyond the normal activities in traditional lectures, enabling to outpace the difficulties that spur along the way that may be both complex and demotivating. This methodology has been implemented in the Integrated Master Degree on Industrial Engineering and Management (IEM), at one public university in Portugal, since the 2004/2005 academic year. The aim of this paper is to identify and discuss the main difficulties of the implementation of PBL, mainly from the teachers’ perspectives. Additionally, some effective strategies will be recommended to overcome such difficulties. Design/methodology/approach: The perceptions of the teachers were collected through a survey based on six main themes. The participants in the study include eight teachers from the five courses of the first semester of the first year of the IEM program involved in the 2012/2013 and 2013/2014 editions. Findings: Integration of courses in the project; student assessment; growing number of students in each team and the need of physical spaces for them; and compartmentalized knowledge has emerged as the main difficulties. To overcome these difficulties some key strategies were recommended. Originality/value: A new perspective based on course teachers' views and experiences will deepen the understanding of the problems and provide inputs for the development of strategies that may improve the effectiveness of PBL and introduce changes for its successful implementation. These strategies are intended to be transferable to other contexts, as most of the problems and constraints are common to other active learning approaches. (Author)

  6. Identifying predictors of physics item difficulty: A linear regression approach

    Science.gov (United States)

    Mesic, Vanes; Muratovic, Hasnija

    2011-06-01

    Large-scale assessments of student achievement in physics are often approached with an intention to discriminate students based on the attained level of their physics competencies. Therefore, for purposes of test design, it is important that items display an acceptable discriminatory behavior. To that end, it is recommended to avoid extraordinary difficult and very easy items. Knowing the factors that influence physics item difficulty makes it possible to model the item difficulty even before the first pilot study is conducted. Thus, by identifying predictors of physics item difficulty, we can improve the test-design process. Furthermore, we get additional qualitative feedback regarding the basic aspects of student cognitive achievement in physics that are directly responsible for the obtained, quantitative test results. In this study, we conducted a secondary analysis of data that came from two large-scale assessments of student physics achievement at the end of compulsory education in Bosnia and Herzegovina. Foremost, we explored the concept of “physics competence” and performed a content analysis of 123 physics items that were included within the above-mentioned assessments. Thereafter, an item database was created. Items were described by variables which reflect some basic cognitive aspects of physics competence. For each of the assessments, Rasch item difficulties were calculated in separate analyses. In order to make the item difficulties from different assessments comparable, a virtual test equating procedure had to be implemented. Finally, a regression model of physics item difficulty was created. It has been shown that 61.2% of item difficulty variance can be explained by factors which reflect the automaticity, complexity, and modality of the knowledge structure that is relevant for generating the most probable correct solution, as well as by the divergence of required thinking and interference effects between intuitive and formal physics knowledge

  7. Identifying predictors of physics item difficulty: A linear regression approach

    Directory of Open Access Journals (Sweden)

    Hasnija Muratovic

    2011-06-01

    Full Text Available Large-scale assessments of student achievement in physics are often approached with an intention to discriminate students based on the attained level of their physics competencies. Therefore, for purposes of test design, it is important that items display an acceptable discriminatory behavior. To that end, it is recommended to avoid extraordinary difficult and very easy items. Knowing the factors that influence physics item difficulty makes it possible to model the item difficulty even before the first pilot study is conducted. Thus, by identifying predictors of physics item difficulty, we can improve the test-design process. Furthermore, we get additional qualitative feedback regarding the basic aspects of student cognitive achievement in physics that are directly responsible for the obtained, quantitative test results. In this study, we conducted a secondary analysis of data that came from two large-scale assessments of student physics achievement at the end of compulsory education in Bosnia and Herzegovina. Foremost, we explored the concept of “physics competence” and performed a content analysis of 123 physics items that were included within the above-mentioned assessments. Thereafter, an item database was created. Items were described by variables which reflect some basic cognitive aspects of physics competence. For each of the assessments, Rasch item difficulties were calculated in separate analyses. In order to make the item difficulties from different assessments comparable, a virtual test equating procedure had to be implemented. Finally, a regression model of physics item difficulty was created. It has been shown that 61.2% of item difficulty variance can be explained by factors which reflect the automaticity, complexity, and modality of the knowledge structure that is relevant for generating the most probable correct solution, as well as by the divergence of required thinking and interference effects between intuitive and formal

  8. Estimating the Difficulty Level of EFL Texts: Applying Bloom’s Taxonomy of Educational Objectives

    Directory of Open Access Journals (Sweden)

    Natasha Pourdana

    2013-11-01

    Full Text Available The purpose of the present study was to explore the impact of difficulty level of texts on EFL learners’ reading comprehension through the application of Bloom’s cognitive taxonomy. The researchers’ primary assumption was that reading EFL texts would become more difficult as the learners’ performance proceeds from a text targeting their Knowledge abilities through the texts tapping on their Comprehension, Application, Analysis, Synthesis to Evaluation abilities. To fulfil the ultimate purpose of the research, 32 undergraduate students majoring in English translation at Islamic Azad University, Karaj Branch, Iran took part in this investigation in 2011. In addition to Comprehensive English Language Test (CELT, the participants were given a teacher–made reading comprehension test, included six short reading passages from 154 to 166 ranges of words and 30 multiple- choice items which compiled and constructed based on the six levels in the hierarchy of Bloom’s cognitive taxonomy. Analysis of Variance (ANOVA proved that except for the fifth level, the Synthesis text, the EFL learners’ performance was graded properly based on the difficulty levels expected and explored in Bloom’s levels of Cognitive Domain. The findings in this study are considerably practical in developing EFL materials and teaching reading skills and strategies.

  9. A Review of the Approaches Investigating the Post-16 Transition of Young Adults with Learning Difficulties

    Science.gov (United States)

    Carroll, Catherine

    2015-01-01

    Investigations into the lives and transition from compulsory schooling of young adults with a disability, including a learning difficulty (LD), are increasing. The emerging consensus is one which points to this group of young people experiencing greater difficulties and poorer outcomes compared to the general population. How these investigations…

  10. Identifying and addressing specific student difficulties in advanced thermal physics

    Science.gov (United States)

    Smith, Trevor I.

    As part of an ongoing multi-university research study on student understanding of concepts in thermal physics at the upper division, I identified several student difficulties with topics related to heat engines (especially the Carnot cycle), as well as difficulties related to the Boltzmann factor. In an effort to address these difficulties, I developed two guided-inquiry worksheet activities (a.k.a. tutorials) for use in advanced undergraduate thermal physics courses. Both tutorials seek to improve student understanding of the utility and physical background of a particular mathematical expression. One tutorial focuses on a derivation of Carnot's theorem regarding the limit on thermodynamic efficiency, starting from the Second Law of Thermodynamics. The other tutorial helps students gain an appreciation for the origin of the Boltzmann factor and when it is applicable; focusing on the physical justification of its mathematical derivation, with emphasis on the connections between probability, multiplicity, entropy, and energy. Student understanding of the use and physical implications of Carnot's theorem and the Boltzmann factor was assessed using written surveys both before and after tutorial instruction within the advanced thermal physics courses at the University of Maine and at other institutions. Classroom tutorial sessions at the University of Maine were videotaped to allow in-depth scrutiny of student successes and failures following tutorial prompts. I also interviewed students on various topics related to the Boltzmann factor to gain a more complete picture of their understanding and inform tutorial revisions. Results from several implementations of my tutorials at the University of Maine indicate that students did not have a robust understanding of these physical principles after lectures alone, and that they gain a better understanding of relevant topics after tutorial instruction; Fisher's exact tests yield statistically significant improvement at the

  11. Subjective executive difficulties – a study using the Dysexecutive Questionnaire

    Directory of Open Access Journals (Sweden)

    Ewa Małgorzata Szepietowska

    2018-03-01

    Full Text Available Introduction: Subjective executive difficulties, understood as a sense of disruption of planning, control and correction of one’s own activity, is often reported by healthy as well as clinical individuals. Self-report measures such as the Dysexecutive Questionnaire (DEX-S are used to assess the severity of this feeling. The diagnostic value of this method is debated due to the numerous factors affecting the beliefs on executive deficits. Aim of the study: With reference to inconclusive data concerning the underlying factors of subjective executive deficits and the value of self-report measures the following aims of the present study were established: a determination of the demographic, clinical and cognitive characteristics of individuals with various levels of subjective executive difficulties, b finding which of these variables contribute to the risk of subjective executive difficulties increase. Material and methods: The study included 213 adult individuals. DEX-S as well as measures of cognitive assessment (Montreal Cognitive Assessment, MoCA; subtests of the Wechsler Adult Intelligence Scale-Revised, WAIS-R and depressive mood assessment [Geriatric Depression Scale (Short Form, GDS-15] were used. Demographic variables (age, gender and educational level as well as clinical variables (lack of/presence of central nervous system disease history, including lateralised brain pathology were also taken into consideration. Based on DEX-S results a cluster analysis was performed and two groups of subjects with a different level of subjective executive difficulties were identified: low-severity group (individuals reporting no complaints regarding executive deficits and high-severity group (individuals with complaints. Group comparisons demonstrated that individuals complaining about executive deficits have a higher depressive mood index and lower scores on some subtests used to assess cognitive functions. The results of logistic regression analysis

  12. How specific are specific comprehension difficulties?

    DEFF Research Database (Denmark)

    Rønberg, Louise Flensted-Jensen; Petersen, Dorthe Klint

    2016-01-01

    as measured on a phonological coding measure. However, the proportion was smaller than the often reported 10-15 % and even smaller when average sight word recognition was also set as a criterion for word reading ability. Compared to average comprehenders, the poor comprehenders’ sight word recognition......This study explores the occurrence of poor comprehenders, i.e., children identified with reading comprehension difficulties in spite of age-appropriate word reading skills. It supports the findings that some children do show poor reading comprehension in spite of age-appropriate word reading...... and daily reading of literary texts were significantly below that of average readers. This study indicates that a lack of reading experience and, likewise, a lack of fluent word reading may be important factors in understanding nine-year-old poor comprehenders’ difficulties....

  13. Multiple Sclerosis.

    Science.gov (United States)

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on multiple sclerosis is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are then…

  14. The curation of genetic variants: difficulties and possible solutions.

    Science.gov (United States)

    Pandey, Kapil Raj; Maden, Narendra; Poudel, Barsha; Pradhananga, Sailendra; Sharma, Amit Kumar

    2012-12-01

    The curation of genetic variants from biomedical articles is required for various clinical and research purposes. Nowadays, establishment of variant databases that include overall information about variants is becoming quite popular. These databases have immense utility, serving as a user-friendly information storehouse of variants for information seekers. While manual curation is the gold standard method for curation of variants, it can turn out to be time-consuming on a large scale thus necessitating the need for automation. Curation of variants described in biomedical literature may not be straightforward mainly due to various nomenclature and expression issues. Though current trends in paper writing on variants is inclined to the standard nomenclature such that variants can easily be retrieved, we have a massive store of variants in the literature that are present as non-standard names and the online search engines that are predominantly used may not be capable of finding them. For effective curation of variants, knowledge about the overall process of curation, nature and types of difficulties in curation, and ways to tackle the difficulties during the task are crucial. Only by effective curation, can variants be correctly interpreted. This paper presents the process and difficulties of curation of genetic variants with possible solutions and suggestions from our work experience in the field including literature support. The paper also highlights aspects of interpretation of genetic variants and the importance of writing papers on variants following standard and retrievable methods. Copyright © 2012. Published by Elsevier Ltd.

  15. Difficulties in radiodiagnosis of children's tumors

    International Nuclear Information System (INIS)

    Kolinova, E.; Zitkova, M.; Suchmova, M.; Jirasek, M.

    1984-01-01

    Some problems of current radiodiagnosis in pediatric oncology are discussed. The main cause of errors in diagnosis and of difficulties barring timely correct diagnosis is the relatively small number of tumors in children and the ensuing lack of knowledge and experience in diagnosis. The situation can only be improved by the disciplined observance of purposeful diagnostic procedures and the centralization of these procedures at specialized departments. (author)

  16. Identification of children with reading difficulties: Cheap can be adequate

    DEFF Research Database (Denmark)

    Poulsen, Mads; Nielsen, Anne-Mette Veber

    Classification of reading difficulties: Cheap screening can be accurate Purpose: Three factors are important for identification of students in need of remedial instruction: accuracy, timeliness, and cost. The identification has to be accurate to be of any use, the identification has to be timely......, inexpensive testing. The present study investigated the classification accuracy of three screening models varying in timeliness and cost. Method: We compared the ROC statistics of three logistic models for predicting end of Grade 2 reading difficulties in a sample of 164 students: 1) an early, comprehensive...... model using a battery of Grade 0 tests, including phoneme awareness, rapid naming, and paired associate learning, 2) a late, comprehensive model adding reading measures from January of Grade 1, and 3) a late, inexpensive model using only group-administered reading measures from January of Grade 1...

  17. ERRORS AND DIFFICULTIES IN TRANSLATING LEGAL TEXTS

    Directory of Open Access Journals (Sweden)

    Camelia, CHIRILA

    2014-11-01

    Full Text Available Nowadays the accurate translation of legal texts has become highly important as the mistranslation of a passage in a contract, for example, could lead to lawsuits and loss of money. Consequently, the translation of legal texts to other languages faces many difficulties and only professional translators specialised in legal translation should deal with the translation of legal documents and scholarly writings. The purpose of this paper is to analyze translation from three perspectives: translation quality, errors and difficulties encountered in translating legal texts and consequences of such errors in professional translation. First of all, the paper points out the importance of performing a good and correct translation, which is one of the most important elements to be considered when discussing translation. Furthermore, the paper presents an overview of the errors and difficulties in translating texts and of the consequences of errors in professional translation, with applications to the field of law. The paper is also an approach to the differences between languages (English and Romanian that can hinder comprehension for those who have embarked upon the difficult task of translation. The research method that I have used to achieve the objectives of the paper was the content analysis of various Romanian and foreign authors' works.

  18. Impact of Psychosocial Environment on Young Children's Emotional and Behavioral Difficulties.

    Science.gov (United States)

    Grazuleviciene, Regina; Andrusaityte, Sandra; Petraviciene, Inga; Balseviciene, Birute

    2017-10-24

    Objective: The impact of maternal psychosocial stress on young children's mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4-6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children's mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4-6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51-3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children's emotional and behavioral difficulties.

  19. Impact of Psychosocial Environment on Young Children’s Emotional and Behavioral Difficulties

    Directory of Open Access Journals (Sweden)

    Regina Grazuleviciene

    2017-10-01

    Full Text Available Objective: The impact of maternal psychosocial stress on young children’s mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4–6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children’s mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4–6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51–3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children’s emotional and behavioral difficulties.

  20. Forensic comparison and matching of fingerprints: using quantitative image measures for estimating error rates through understanding and predicting difficulty.

    Directory of Open Access Journals (Sweden)

    Philip J Kellman

    Full Text Available Latent fingerprint examination is a complex task that, despite advances in image processing, still fundamentally depends on the visual judgments of highly trained human examiners. Fingerprints collected from crime scenes typically contain less information than fingerprints collected under controlled conditions. Specifically, they are often noisy and distorted and may contain only a portion of the total fingerprint area. Expertise in fingerprint comparison, like other forms of perceptual expertise, such as face recognition or aircraft identification, depends on perceptual learning processes that lead to the discovery of features and relations that matter in comparing prints. Relatively little is known about the perceptual processes involved in making comparisons, and even less is known about what characteristics of fingerprint pairs make particular comparisons easy or difficult. We measured expert examiner performance and judgments of difficulty and confidence on a new fingerprint database. We developed a number of quantitative measures of image characteristics and used multiple regression techniques to discover objective predictors of error as well as perceived difficulty and confidence. A number of useful predictors emerged, and these included variables related to image quality metrics, such as intensity and contrast information, as well as measures of information quantity, such as the total fingerprint area. Also included were configural features that fingerprint experts have noted, such as the presence and clarity of global features and fingerprint ridges. Within the constraints of the overall low error rates of experts, a regression model incorporating the derived predictors demonstrated reasonable success in predicting objective difficulty for print pairs, as shown both in goodness of fit measures to the original data set and in a cross validation test. The results indicate the plausibility of using objective image metrics to predict expert

  1. Forensic comparison and matching of fingerprints: using quantitative image measures for estimating error rates through understanding and predicting difficulty.

    Science.gov (United States)

    Kellman, Philip J; Mnookin, Jennifer L; Erlikhman, Gennady; Garrigan, Patrick; Ghose, Tandra; Mettler, Everett; Charlton, David; Dror, Itiel E

    2014-01-01

    Latent fingerprint examination is a complex task that, despite advances in image processing, still fundamentally depends on the visual judgments of highly trained human examiners. Fingerprints collected from crime scenes typically contain less information than fingerprints collected under controlled conditions. Specifically, they are often noisy and distorted and may contain only a portion of the total fingerprint area. Expertise in fingerprint comparison, like other forms of perceptual expertise, such as face recognition or aircraft identification, depends on perceptual learning processes that lead to the discovery of features and relations that matter in comparing prints. Relatively little is known about the perceptual processes involved in making comparisons, and even less is known about what characteristics of fingerprint pairs make particular comparisons easy or difficult. We measured expert examiner performance and judgments of difficulty and confidence on a new fingerprint database. We developed a number of quantitative measures of image characteristics and used multiple regression techniques to discover objective predictors of error as well as perceived difficulty and confidence. A number of useful predictors emerged, and these included variables related to image quality metrics, such as intensity and contrast information, as well as measures of information quantity, such as the total fingerprint area. Also included were configural features that fingerprint experts have noted, such as the presence and clarity of global features and fingerprint ridges. Within the constraints of the overall low error rates of experts, a regression model incorporating the derived predictors demonstrated reasonable success in predicting objective difficulty for print pairs, as shown both in goodness of fit measures to the original data set and in a cross validation test. The results indicate the plausibility of using objective image metrics to predict expert performance and

  2. Implementing Applied Behavior Analysis for Effective Orientation and Mobility Instruction of Students with Multiple Disabilities

    Science.gov (United States)

    O'Mea, Melanie L.

    2013-01-01

    Working with children who have multiple disabilities that include visual impairments can be especially challenging. Many disabling conditions manifest into behavioral difficulties that may take away from learning. Acting out may be a student's way of expressing a lack of healthy coping mechanisms in relation to his or her environment. Implementing…

  3. Influence of burnout and sleep difficulties on the quality of life among medical students.

    Science.gov (United States)

    Pagnin, Daniel; de Queiroz, Valéria

    2015-01-01

    This study assessed the influence of burnout dimensions and sleep difficulties on the quality of life among preclinical-phase medical school students. Data were collected from 193 students through their completion of the World Health Organization Quality of Life Instrument, the Maslach Burnout Inventory-Student Survey, the Mini-Sleep Questionnaire, the Social Readjustment Rating Scale, and the Beck Depression Inventory. This survey performed hierarchical multiple regressions to quantify the effects of emotional exhaustion, cynicism, academic efficacy, and sleep difficulties on the physical, psychological, social, and environmental components of an individual's quality of life. The influence of confounding variables, such as gender, stress load, and depressive symptoms, were controlled in the statistical analyses. Physical health decreased when emotional exhaustion and sleep difficulties increased. Psychological well-being also decreased when cynicism and sleep difficulties increased. Burnout and sleep difficulties together explained 22 and 21 % of the variance in the physical and psychological well-being, respectively. On the other hand, physical health, psychological well-being, and social relationships increased when the sense of academic efficacy increased. Physical and psychological well-being are negatively associated with emotional exhaustion, cynicism, and sleep difficulties in students in the early phase of medical school. To improve the quality of life of these students, a significant effort should be directed towards burnout and sleep difficulties.

  4. Analysis of Students’ Difficulties about Rotational Dynamic Topic Based on Resource Theory

    Directory of Open Access Journals (Sweden)

    I. Rahmawati

    2017-04-01

    Full Text Available Students’ difficulties commonly are analyzed based on misconception theory. This paper aimed to analyze students’ difficulties on the rotational dynamic based on resource theory. The subject of research consisted of 108 first-year undergraduate students of Physics Education, State University of Malang. Firstly, the students were asked to solve 15 multiple-choice questions and gave open explanation. We then implemened a constant comparative method to identify and categorize some resources that students employed in solving several problems that most the students failed to respond correctly. The results indicated that the students had difficulties in solving problems related to the torque and the equilibrium of rigid body. The students’ difficulties were not merely caused by the lack of correct knowledge. Instead, they have the correct knowledge or resources but they activated them on inappropriate context. The students will be successfully used the resources to solve problems if they activated them in the right context.

  5. Modelling Question Difficulty in an A Level Physics Examination

    Science.gov (United States)

    Crisp, Victoria; Grayson, Rebecca

    2013-01-01

    "Item difficulty modelling" is a technique used for a number of purposes such as to support future item development, to explore validity in relation to the constructs that influence difficulty and to predict the difficulty of items. This research attempted to explore the factors influencing question difficulty in a general qualification…

  6. Multiple transcription factors directly regulate Hox gene lin-39 expression in ventral hypodermal cells of the C. elegans embryo and larva, including the hypodermal fate regulators LIN-26 and ELT-6.

    Science.gov (United States)

    Liu, Wan-Ju; Reece-Hoyes, John S; Walhout, Albertha J M; Eisenmann, David M

    2014-05-13

    Hox genes encode master regulators of regional fate specification during early metazoan development. Much is known about the initiation and regulation of Hox gene expression in Drosophila and vertebrates, but less is known in the non-arthropod invertebrate model system, C. elegans. The C. elegans Hox gene lin-39 is required for correct fate specification in the midbody region, including the Vulval Precursor Cells (VPCs). To better understand lin-39 regulation and function, we aimed to identify transcription factors necessary for lin-39 expression in the VPCs, and in particular sought factors that initiate lin-39 expression in the embryo. We used the yeast one-hybrid (Y1H) method to screen for factors that bound to 13 fragments from the lin-39 region: twelve fragments contained sequences conserved between C. elegans and two other nematode species, while one fragment was known to drive reporter gene expression in the early embryo in cells that generate the VPCs. Sixteen transcription factors that bind to eight lin-39 genomic fragments were identified in yeast, and we characterized several factors by verifying their physical interactions in vitro, and showing that reduction of their function leads to alterations in lin-39 levels and lin-39::GFP reporter expression in vivo. Three factors, the orphan nuclear hormone receptor NHR-43, the hypodermal fate regulator LIN-26, and the GATA factor ELT-6 positively regulate lin-39 expression in the embryonic precursors to the VPCs. In particular, ELT-6 interacts with an enhancer that drives GFP expression in the early embryo, and the ELT-6 site we identified is necessary for proper embryonic expression. These three factors, along with the factors ZTF-17, BED-3 and TBX-9, also positively regulate lin-39 expression in the larval VPCs. These results significantly expand the number of factors known to directly bind and regulate lin-39 expression, identify the first factors required for lin-39 expression in the embryo, and hint at a

  7. Student difficulties regarding symbolic and graphical representations of vector fields

    Directory of Open Access Journals (Sweden)

    Laurens Bollen

    2017-08-01

    Full Text Available The ability to switch between various representations is an invaluable problem-solving skill in physics. In addition, research has shown that using multiple representations can greatly enhance a person’s understanding of mathematical and physical concepts. This paper describes a study of student difficulties regarding interpreting, constructing, and switching between representations of vector fields, using both qualitative and quantitative methods. We first identified to what extent students are fluent with the use of field vector plots, field line diagrams, and symbolic expressions of vector fields by conducting individual student interviews and analyzing in-class student activities. Based on those findings, we designed the Vector Field Representations test, a free response assessment tool that has been given to 196 second- and third-year physics, mathematics, and engineering students from four different universities. From the obtained results we gained a comprehensive overview of typical errors that students make when switching between vector field representations. In addition, the study allowed us to determine the relative prevalence of the observed difficulties. Although the results varied greatly between institutions, a general trend revealed that many students struggle with vector addition, fail to recognize the field line density as an indication of the magnitude of the field, confuse characteristics of field lines and equipotential lines, and do not choose the appropriate coordinate system when writing out mathematical expressions of vector fields.

  8. Student difficulties regarding symbolic and graphical representations of vector fields

    Science.gov (United States)

    Bollen, Laurens; van Kampen, Paul; Baily, Charles; Kelly, Mossy; De Cock, Mieke

    2017-12-01

    The ability to switch between various representations is an invaluable problem-solving skill in physics. In addition, research has shown that using multiple representations can greatly enhance a person's understanding of mathematical and physical concepts. This paper describes a study of student difficulties regarding interpreting, constructing, and switching between representations of vector fields, using both qualitative and quantitative methods. We first identified to what extent students are fluent with the use of field vector plots, field line diagrams, and symbolic expressions of vector fields by conducting individual student interviews and analyzing in-class student activities. Based on those findings, we designed the Vector Field Representations test, a free response assessment tool that has been given to 196 second- and third-year physics, mathematics, and engineering students from four different universities. From the obtained results we gained a comprehensive overview of typical errors that students make when switching between vector field representations. In addition, the study allowed us to determine the relative prevalence of the observed difficulties. Although the results varied greatly between institutions, a general trend revealed that many students struggle with vector addition, fail to recognize the field line density as an indication of the magnitude of the field, confuse characteristics of field lines and equipotential lines, and do not choose the appropriate coordinate system when writing out mathematical expressions of vector fields.

  9. Difficulties in Balint groups: a qualitative study of leaders' experiences.

    Science.gov (United States)

    Kjeldmand, Dorte; Holmström, Inger

    2010-11-01

    Balint groups (BGs) are a means of enhancing competence in the physician-patient relationship and are also regarded as beneficial for GPs' mental health. However, voluntary BGs are still few, some members terminate their participation, and problems are reported in obligatory groups in residency programmes. This raises questions about possible negative aspects of BGs. To examine difficulties in BGs as experienced by BG leaders. Qualitative study using interviews. Eight BG leaders from five countries were interviewed. The interviews focused on the informants' experiences of difficulties in their groups and were analysed with a systematic text-condensation method. Three categories of difficulties emerged from the analysis: 1) the individual physician having needs, vulnerabilities, and defences; 2) the group (including the leader) having problems of hidden agendas, rivalries, and frames; and 3) the surrounding environment defining the conditions of the group. BGs were found to fit into modern theories of small groups as complex systems. They are submitted to group dynamics that are sometimes malicious, and are exposed to often tough environmental conditions. Professionally conducted BGs seem to be a gentle, efficient method to train physicians, but with limitations. Participation of a member demands psychological stability and an open mind. BGs need support from the leadership of healthcare organisations in order to exist.

  10. On the study and difficulties of mathematics

    CERN Document Server

    De Morgan, Augustus

    2005-01-01

    One of the twentieth century's most eminent mathematical writers, Augustus De Morgan enriched his expositions with insights from history and psychology. On the Study and Difficulties of Mathematics represents some of his best work, containing points usually overlooked by elementary treatises, and written in a fresh and natural tone that provides a refreshing contrast to the mechanical character of common textbooks.Presuming only a knowledge of the rules of algebra and Euclidean theorems, De Morgan begins with some introductory remarks on the nature and objects of mathematics. He discusses the

  11. NECCESITY AND DIFFICULTY OF R D PERFORMANCEMEASUREMENT

    Directory of Open Access Journals (Sweden)

    MariaFekete-Farkas

    2012-07-01

    Full Text Available We are living in a globalized world with increasing population which is facingsevere global economic and financial crises as well as serious environmentalproblems. The possibilities to overcome these difficulties can be interpreted asthe need for sustainable development calling for innovation, increased R Dspending with increased R D effectiveness and efficiency. Besides greaterattentionforthe need of deeper understanding of the innovation process and therole of R D in it, this paper has discussed the many analytical problems thatconfront a researcher in this area, and additionally calls for research oncollaboration between universities and industry. Among other conclusions thispaper also provides a new way of thinking for policy makers and performancemonitoring committees.

  12. Effects of Semantic Ambiguity Detection Training on Reading Comprehension Achievement of English Learners with Learning Difficulties

    Science.gov (United States)

    Jozwik, Sara L.; Douglas, Karen H.

    2016-01-01

    This study examined how explicit instruction in semantic ambiguity detection affected the reading comprehension and metalinguistic awareness of five English learners (ELs) with learning difficulties (e.g., attention deficit/hyperactivity disorder, specific learning disability). A multiple probe across participants design (Gast & Ledford, 2010)…

  13. Understanding Test-Takers' Perceptions of Difficulty in EAP Vocabulary Tests: The Role of Experiential Factors

    Science.gov (United States)

    Oruç Ertürk, Nesrin; Mumford, Simon E.

    2017-01-01

    This study, conducted by two researchers who were also multiple-choice question (MCQ) test item writers at a private English-medium university in an English as a foreign language (EFL) context, was designed to shed light on the factors that influence test-takers' perceptions of difficulty in English for academic purposes (EAP) vocabulary, with the…

  14. Difficulties in avoiding exposure to allergens in cosmetics

    DEFF Research Database (Denmark)

    Larsen, Kristian

    2007-01-01

    The aim of the study is to describe the ability of patients with allergic contact dermatitis to avoid exposure to allergens in cosmetics. The study is a questionnaire survey among 382 patients with contact allergy to preservatives and fragrances, included from 3 dermatological clinics. The questi......The aim of the study is to describe the ability of patients with allergic contact dermatitis to avoid exposure to allergens in cosmetics. The study is a questionnaire survey among 382 patients with contact allergy to preservatives and fragrances, included from 3 dermatological clinics....... The questionnaire included questions about the level of difficulty in reading labels of ingredients on cosmetics and about patients' strategies to avoid substances they were allergic to. It also included questions about eczema severity as well as about educational level. 46% of the patients found it difficult...... or extremely difficult to read the ingredient labelling of cosmetics, and this finding was significantly related to low educational level. Patients allergic to formaldehyde and methyldibromo glutaronitrile experienced the worst difficulties, while patients with fragrance allergy found ingredient label reading...

  15. Sensory processing difficulties in school-age children born very preterm : An exploratory study

    NARCIS (Netherlands)

    Bröring, Tinka; Königs, Marsh; Oostrom, Kim J.; Lafeber, Harrie N.; Brugman, Anniek; Oosterlaan, Jaap

    Background Very preterm birth has a detrimental impact on the developing brain, including widespread white matter brain abnormalities that threaten efficient sensory processing. Yet, sensory processing difficulties in very preterm children are scarcely studied, especially at school age. Aims To

  16. Treatment Option Overview (Plasma Cell Neoplasms Including Multiple Myeloma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on the ... going up even though treatment is given. Treatment Option Overview Key Points There are different types of ...

  17. Response selection difficulty modulates the behavioral impact of rapidly learnt action effects.

    Directory of Open Access Journals (Sweden)

    Uta eWolfensteller

    2014-12-01

    Full Text Available It is well established that we can pick up action effect associations when acting in a free-choice intentional mode. However, it is less clear whether and when action effect associations are learnt and actually affect behavior if we are acting in a forced-choice mode, applying a specific stimulus-response (S-R rule. In the present study, we investigated whether response selection difficulty imposed by S-R rules influences the initial rapid learning and the behavioral expression of previously learnt but weakly practiced action effect associations when those are re-activated by effect exposure. Experiment 1 showed that the rapid acquisition of action effect associations is not directly influenced by response selection difficulty. By contrast, the behavioral expression of re-activated action effect associations is prevented when actions are directly activated by highly over-learnt response cues and thus response selection difficulty is low. However, all three experiments showed that if response selection difficulty is sufficiently high during re-activation, the same action effect associations do influence behavior. Experiment 2 and 3 revealed that the effect of response selection difficulty cannot be fully reduced to giving action effects more time to prime an action, but seems to reflect competition during response selection. Finally, the present data suggest that when multiple novel rules are rapidly learnt in succession, which requires a lot of flexibility, action effect associations continue to influence behavior only if response selection difficulty is sufficiently high. Thus, response selection difficulty might modulate the impact of experiencing multiple learning episodes on action effect expression and learning, possibly via inducing different strategies.

  18. FAD: Filtering, Analyzing, and Diagnosing Reading Difficulties

    Science.gov (United States)

    Mokhtari, Kouider; Niederhauser, Dale S.; Beschorner, Elizabeth A.; Edwards, Patricia A.

    2011-01-01

    In this article, the authors introduce a data analysis procedure, abbreviated as FAD, to help literacy professionals who work with children in clinical or classroom settings identify and interpret patterns of assessment data with the goal of determining children's literacy strengths and needs. The procedure uses data from multiple literacy…

  19. Factors protecting against the development of adjustment difficulties in young adults exposed to childhood sexual abuse.

    Science.gov (United States)

    Lynskey, M T; Fergusson, D M

    1997-12-01

    The aims of this study were to identify the factors which discriminated young people exposed to childhood sexual abuse (CSA) who developed psychiatric disorder or adjustment difficulties in young adulthood from those young people exposed to CSA who did not develop psychiatric disorder or adjustment difficulties by age 18. Data were gathered on a birth cohort of 1,025 New Zealand children studied from birth to the age of 18 on (a) exposure to CSA; (b) patterns of psychiatric disorder and adjustment difficulties at age 18 years; (c) factors that may have influenced responses to CSA including characteristics of the abuse, parental bonding, parental characteristics, and adolescent peer affiliations. Just over 10% of the cohort reported CSA. Those reporting CSA were at increased risks of a range of difficulties at age 18 (depression, anxiety, conduct disorder, alcohol abuse/dependence, other substance abuse/dependence, post sexual abuse trauma, attempted suicide). However, not all of those exposed to CSA developed difficulties and approximately a quarter of those exposed to CSA did not meet criteria for any adjustment difficulty. Further analysis suggested that the extent of adjustment difficulties in those exposed to CSA was influenced by two additional factors: (a) the extent of affiliations with delinquent or substance using peers in adolescence; and (b) the extent of paternal care or support in childhood. The findings of this study suggest that while young people exposed to CSA are at increased risks of psychiatric disorder and adjustment difficulties in young adulthood, not all individuals exposed to CSA will develop adjustment difficulties. Important factors protecting against the development of adjustment difficulties in young people experiencing CSA appear to be the nature and quality of peer and family relationships.

  20. A qualitative investigation of eating difficulties in adolescents with chronic fatigue syndrome/myalgic encephalomyelitis.

    Science.gov (United States)

    Harris, Sarah; Gilbert, Matthew; Beasant, Lucy; Linney, Catherine; Broughton, Jessica; Crawley, Esther

    2017-01-01

    An estimated 10% of children and adolescents with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) experience eating difficulties; however, little is known about why these difficulties develop, what the impact is or how to manage them. Semi-structured interviews were conducted with adolescents (aged 12-17 years) attending a specialist service who have a primary diagnosis of CFS/ME and experience nausea, abdominal pain and/or eating difficulties. A total of 11 adolescents were interviewed (eight female, mean age: 15 years). Transcripts were analysed thematically using techniques of constant comparison which commenced soon after data collection and informed further interview protocols. Adolescents perceived their eating difficulties were caused by abdominal symptoms, being too fatigued to eat and changes to their senses of taste and smell. Some of the adolescents recognised how their eating difficulties were exacerbated and maintained by psychological factors of low mood and anxiety. The adolescents eating difficulties had a negative impact on their weight, fatigue, socialising and family life. They perceived helpful interventions to include modifying their diets, families adjusting and also medical interventions (e.g. medication). Adolescents identified that early education and support about diet and eating habits would have been helpful. If adolescents diagnosed with CFS/ME develop eating difficulties, this has a significant impact on their quality of life, illness and on their families. Not eating increases fatigue, low mood and anxiety which further exacerbates the eating difficulties. Clinicians should screen for eating difficulties in those with symptoms of nausea and abdominal pain, warn adolescents and their families of the risk of developing eating difficulties and provide interventions and support as early as possible.

  1. The effects of task difficulty and resource requirements on attention strategies

    Science.gov (United States)

    King, Teresa

    1991-01-01

    The patterns of attention strategies for task difficulty/resource tasks for which experimental results are presented and analyzed support the hypothesis that subjects may adopt an alternating (rather than concurrent one) when compelled to do so by either the size or the complexity of a visual display. According to the multiple resource model, if subjects had been performing the two tasks concurrently, the cost of this strategy would have been shown by a decrement in the spatial format, rather than the verbal format, due to competition for the same resource. Subjects may apply different strategies as a function of task difficulty and/or resource demand.

  2. Associations among attitudes, perceived difficulty of learning science, gender, parents' occupation and students' scientific competencies

    Science.gov (United States)

    Chi, ShaoHui; Wang, Zuhao; Liu, Xiufeng; Zhu, Lei

    2017-11-01

    This study investigated the associations among students' attitudes towards science, students' perceived difficulty of learning science, gender, parents' occupations and their scientific competencies. A sample of 1591 (720 males and 871 females) ninth-grade students from 29 junior high schools in Shanghai completed a scientific competency test and a Likert scale questionnaire. Multiple regression analysis revealed that students' general interest of science, their parents' occupations and perceived difficulty of science significantly associated with their scientific competencies. However, there was no gender gap in terms of scientific competencies.

  3. Rural mental health workforce difficulties: a management perspective.

    Science.gov (United States)

    Moore, T; Sutton, K; Maybery, D

    2010-01-01

    The recruitment, retention and training of mental health workers is of major concern in rural Australia, and the Gippsland region of Victoria is no exception. Previous studies have identified a number of common factors in these workforce difficulties, including rurality, difficulties of access to professional development and training, and professional and personal isolation. However, those previous studies have often focused on medicine and been based on the perspectives of practitioners, and have almost ignored the perspectives of managers of rural mental health services. The study reported in this article sought to contribute to the development of a more sustainable and effective regional mental health workforce by complementing earlier insights with those of leading administrators, managers and senior clinicians in the field. The study took a qualitative approach. It conducted semi-structured in-person interviews with 24 managers of health/mental-health services and senior administrators and clinicians working in organisations of varying sizes in the public and private sectors. Thematic content analysis of the transcribed interviews identified core difficulties these managers experienced in the recruitment, retention and training of employees. The study found that some of the issues commonly resulting in difficulties in recruiting, retaining and developing a trained workforce in rural areas, such as rurality (implying personal and professional isolation, distances to deliver service and small organisations) and a general shortage of trained personnel, are significant in Gippsland. Through its focus on the perspectives of leaders in the management of rural mental health services, however, the study found other key issues that contribute to workforce difficulties. Many, including the unattractive nature of mental health work, the fragmented administration of the mental health system, short-term and tied funding, and shortcomings in training are external to

  4. New seismograph includes filters

    Energy Technology Data Exchange (ETDEWEB)

    1979-11-02

    The new Nimbus ES-1210 multichannel signal enhancement seismograph from EG and G geometrics has recently been redesigned to include multimode signal fillers on each amplifier. The ES-1210F is a shallow exploration seismograph for near subsurface exploration such as in depth-to-bedrock, geological hazard location, mineral exploration, and landslide investigations.

  5. Status of Muslim Immigrants' Children with Learning Difficulties in Vienna

    Science.gov (United States)

    Mohsin, M. Naeem; Shabbir, Muhammad; Saeed, Wizra; Mohsin, M. Saleem

    2013-01-01

    The study was conducted to know the status of Muslim immigrants' children with learning difficulties and importance of parents' involvement for the education whose children are with learning difficulties, and the factors responsible for the learning difficulties among immigrants' children. There were 81 immigrant children with learning…

  6. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, Mohammad Akbar Hosain

    2014-12-04

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green\\'s function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green\\'s function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green\\'s function and renders the higher order internal multiple image for display on a display device.

  7. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, Mohammad Akbar Hosain; Alkhalifah, Tariq

    2014-01-01

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green's function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green's function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green's function and renders the higher order internal multiple image for display on a display device.

  8. Difficulties with True Interoperability in Modeling & Simulation

    Science.gov (United States)

    2011-12-01

    Standards in M&S cover multiple layers of technical abstraction. There are middleware specifica- tions, such as the High Level Architecture (HLA) ( IEEE Xplore ... IEEE Xplore Digital Library. 2010. 1516-2010 IEEE Standard for Modeling and Simulation (M&S) High Level Architecture (HLA) – Framework and Rules...using different communication protocols being able to allow da- 2642978-1-4577-2109-0/11/$26.00 ©2011 IEEE Report Documentation Page Form ApprovedOMB No

  9. FAMILY BUSINESSES AND THE DIFFICULTIES ENCOUNTERED BY

    Directory of Open Access Journals (Sweden)

    Alessandra Martins

    2009-05-01

    Full Text Available There are few family owned businesses that survive to the next generation. In general, 30% of these businesses are passed on to second generation families and less than 15% survive to third generation families. There has been little research done on third generation family businesses. Therefore the main purpose of this paper is to identify the principal difficulties of passing on managerial skills to the third generation owners. This study uses a case study of a Brazilian family organization composed of twelve enterprises. The instrument to collect data was an individually guided recorded interview with all of the family managers (1ª, 2ª e 3ª generation. The technique applied, was suggested for Miles & Huberman (1994 to group the data in analytical categories to facilitate the analyzed speeches contained in the 49 blocks of responses. As a result, the transition the business to the third generation owners has been strongly associated with the relation between family and business by the following factors: a the succession process influenced by emotional and family values; b conflicts, rivalries and divergences of strategic visions and business goals between the family generations; c lack of professional criteria to hire relatives; and d fragility of communication and consequent asymmetry of information among the family members.

  10. Fractions Learning in Children With Mathematics Difficulties.

    Science.gov (United States)

    Tian, Jing; Siegler, Robert S

    Learning fractions is difficult for children in general and especially difficult for children with mathematics difficulties (MD). Recent research on developmental and individual differences in fraction knowledge of children with MD and typically achieving (TA) children has demonstrated that U.S. children with MD start middle school behind their TA peers in fraction understanding and fall further behind during middle school. In contrast, Chinese children, who like the MD children in the United States score in the bottom one third of the distribution in their country, possess reasonably good fraction understanding. We interpret these findings within the framework of the integrated theory of numerical development. By emphasizing the importance of fraction magnitude knowledge for numerical understanding in general, the theory proved useful for understanding differences in fraction knowledge between MD and TA children and for understanding how knowledge can be improved. Several interventions demonstrated the possibility of improving fraction magnitude knowledge and producing benefits that generalize to fraction arithmetic learning among children with MD. The reasonably good fraction understanding of Chinese children with MD and several successful interventions with U.S. students provide hope for the improvement of fraction knowledge among American children with MD.

  11. Multidisciplinary intervention for childhood feeding difficulties.

    Science.gov (United States)

    Marshall, Jeanne; Hill, Rebecca J; Ware, Robert S; Ziviani, Jenny; Dodrill, Pamela

    2015-05-01

    The aim of the study was to determine whether operant conditioning (OC) or systematic desensitization (SysD) intervention resulted in more improvements in dietary variety/intake, and more reductions in difficult mealtime behaviors. Children 2 to 6 years with autism spectrum disorder or with a nonmedically complex history were recruited. Feeding difficulties were confirmed based on clinical assessment. Participants were randomized to receive 10 OC or SysD sessions (parents could opt for intervention once per week, or intensively within a week). Immersive parent education was delivered across both arms. A 3-month review was provided to measure outcomes postintervention. In total, 68 participants (87%) completed the study. There were no significant differences in outcome measures between the OC and SysD intervention groups from baseline to 3-month review. When the data were combined across both groups, however, significant improvements in primary outcome measures were observed (P education, these 2 intervention approaches are effective. Further research is required in exploring these interventions across other subgroups, and examining outcomes for longer periods.

  12. [Difficulties in psychology and sexual behavior].

    Science.gov (United States)

    1973-01-01

    After an introduction by S. Kepes (Fertilite Orthogenie 4(4): 174-177,1972) the participants and audience discussed general topics such as the physician-patient relationship, unconscious motives, attitudes of male partners and physicians, and treatment of minors. Resistance by male partners toward contraception was considered due to fear of inadequacy in the face of female sexuality or to adherence to a double moral standard for wives. A gynecologist claimed that high school students are more likely to request contraception and use it effectively than they were 5 years ago; a midwife said that less privileged adolescents frequently become pregnant. Opinions were expressed that it is inappropriate to consider contraception from a psychological viewpoint, since it is part of a revolution toward a better life; that some psychological difficulties come from the doctor having preferences for certain methods; that the pill does not cause frigidity but is often blamed for preexisting problems; that the press frightens women away from taking the pill; that physicians should prescribe contraception to minors without seeking parental consent (unlawful in France).

  13. Analytic device including nanostructures

    KAUST Repository

    Di Fabrizio, Enzo M.; Fratalocchi, Andrea; Totero Gongora, Juan Sebastian; Coluccio, Maria Laura; Candeloro, Patrizio; Cuda, Gianni

    2015-01-01

    A device for detecting an analyte in a sample comprising: an array including a plurality of pixels, each pixel including a nanochain comprising: a first nanostructure, a second nanostructure, and a third nanostructure, wherein size of the first nanostructure is larger than that of the second nanostructure, and size of the second nanostructure is larger than that of the third nanostructure, and wherein the first nanostructure, the second nanostructure, and the third nanostructure are positioned on a substrate such that when the nanochain is excited by an energy, an optical field between the second nanostructure and the third nanostructure is stronger than an optical field between the first nanostructure and the second nanostructure, wherein the array is configured to receive a sample; and a detector arranged to collect spectral data from a plurality of pixels of the array.

  14. Saskatchewan resources. [including uranium

    Energy Technology Data Exchange (ETDEWEB)

    1979-09-01

    The production of chemicals and minerals for the chemical industry in Saskatchewan are featured, with some discussion of resource taxation. The commodities mentioned include potash, fatty amines, uranium, heavy oil, sodium sulfate, chlorine, sodium hydroxide, sodium chlorate and bentonite. Following the successful outcome of the Cluff Lake inquiry, the uranium industry is booming. Some developments and production figures for Gulf Minerals, Amok, Cenex and Eldorado are mentioned.

  15. Stigmatization towards persons with mental and intellectual difficulties

    Directory of Open Access Journals (Sweden)

    Popić Mia

    2013-01-01

    Full Text Available Persons with mental and intellectual difficulties are the most stigmatized social groups of all. Consequences of stigma towards these people present themselves in a wide range including social withdrawal; feelings of loneliness; low self-esteem; failure to take care of oneself; avoidance of seeking help; low enrolment in any kind of treatment; financial poverty and total social marginalization. Although most of the attempts to overcome stigmatization towards this population have shown a very pessimistic perspective, it is important to overcome our own helplessness in treating this issue and continue with the efforts to combat stigma. The only way to succeed is through continuous and careful analysis of the factors that contribute to a human tendency to stigmatize that could then be utilized as the ground base in development of mechanisms to battle this issue. This paper summarizes ways that the stigmatization of persons with mental and intellectual difficulties is manifested as well as the negative influences it has on the people who are stigmatized. Factors that contribute to the stigmatization of persons are carefully considered, as well as possible mechanisms that could be utilized as part of efforts to combat stigma.

  16. Uncovering Portuguese teachers’ difficulties in implementing sciences curriculum

    Directory of Open Access Journals (Sweden)

    Clara Vasconcelos

    2015-12-01

    Full Text Available Many countries recognize the positive and effective results of improving science education through the introduction of reforms in the sciences curriculum. However, some important issues are generally neglected like, for example, the involvement of the teachers in the reform process. Taking the sciences curriculum reform under analysis and benefitting from 10 years of teachers’ experiences in teaching sciences based on this curriculum, 19 semi-structure interviews were applied so as to identify the major difficulties felt by science teachers when implementing the Portuguese sciences curriculum in the third cycle of middle school (pupils’ age range of 12–15. Some of the difficulties depicted by the data analysis include: length of the curriculum, lack of time, unsuitable laboratory facilities, insufficient means and materials for experimental work, pupils’ indiscipline and little interest in learning sciences. Although less frequently mentioned, the lack of professional development was also referred to as a constraint that seems to play an essential role in this process. Some recommendations for improving the success of sciences curriculum reforms’ implementation are given: defining and conceptualizing curricular policies by relating the reality of both the schools and the science classrooms; reorganizing and restructuring pre-service teachers’ courses; organizing professional development courses for in-service teachers.

  17. Upper-Division Student Difficulties with the Dirac Delta Function

    Science.gov (United States)

    Wilcox, Bethany R.; Pollock, Steven J.

    2015-01-01

    The Dirac delta function is a standard mathematical tool that appears repeatedly in the undergraduate physics curriculum in multiple topical areas including electrostatics, and quantum mechanics. While Dirac delta functions are often introduced in order to simplify a problem mathematically, students still struggle to manipulate and interpret them.…

  18. Prevalence of multiple birth in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Ahmad Yazdekhasti

    2018-01-01

    Full Text Available Background: According to increasing rate of using assisted reproductive technology (ART which result in higher rates of multiple birth and natal difficulties, we aimed to determine the prevalence rate of multiple birth pregnancies. Materials and Methods: A descriptive cross-sectional study evaluating birth files in 2009–2010 of main hospitals of Isfahan, Iran. Results: Among 31640 files' studies, 614 cases of multiple birth pregnancies were investigated. The product of these pregnancies were 1286 (50.2% females infants including 557 twins (17.6/1000, 56 triplets (1.8/1000, and one case of quadruple (0.03/1000. Infants weigh <2500 g were 84.9% of all. Mothers had a mean age of 27.9 ± 4.9 which 30.4% of them had a positive history of using ART. Conclusion: The prevalence of multiple birth pregnancies is growing. The need for more mother and child care is important. Using ART world wide is leading more multiple birth which could be a cause for more complicated pregnancies.

  19. Being Included and Excluded

    DEFF Research Database (Denmark)

    Korzenevica, Marina

    2016-01-01

    Following the civil war of 1996–2006, there was a dramatic increase in the labor mobility of young men and the inclusion of young women in formal education, which led to the transformation of the political landscape of rural Nepal. Mobility and schooling represent a level of prestige that rural...... politics. It analyzes how formal education and mobility either challenge or reinforce traditional gendered norms which dictate a lowly position for young married women in the household and their absence from community politics. The article concludes that women are simultaneously excluded and included from...... community politics. On the one hand, their mobility and decision-making powers decrease with the increase in the labor mobility of men and their newly gained education is politically devalued when compared to the informal education that men gain through mobility, but on the other hand, schooling strengthens...

  20. Difficulties in Learning English Faced By Visually Impaired Students at Center of Language Development (P2B in State Islamic University (UIN Sunan Kalijaga

    Directory of Open Access Journals (Sweden)

    Widya Aryanti

    2014-12-01

    The result shows that there are some difficulties faced by VIS. These difficulties can be put into two different categories: internal and external difficulties. Internal difficulties come from the VIS themselves which relates to VIS’ sight conditions and their learning strategies. External difficulties come from the learning environment including difficulties from the lecturer, friends, materials and the facilities.VIS have different learning strategies. The lecturer should discuss some classroom adaptations such as seating arrangement, friends’ assistance and peer teaching, adapted facilities and exam accommodation, for instance exam assistance, longer exam time, inclusive examination and larger print for low vision students. Finally, the lecturer should choose appropriate teaching strategies, media and teaching aids.

  1. Measurement of functional task difficulty during motor learning: What level of difficulty corresponds to the optimal challenge point?

    Science.gov (United States)

    Akizuki, Kazunori; Ohashi, Yukari

    2015-10-01

    The relationship between task difficulty and learning benefit was examined, as was the measurability of task difficulty. Participants were required to learn a postural control task on an unstable surface at one of four different task difficulty levels. Results from the retention test showed an inverted-U relationship between task difficulty during acquisition and motor learning. The second-highest level of task difficulty was the most effective for motor learning, while learning was delayed at the most and least difficult levels. Additionally, the results indicate that salivary α-amylase and the performance dimension of the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) are useful indices of task difficulty. Our findings suggested that instructors may be able to adjust task difficulty based on salivary α-amylase and the performance dimension of the NASA-TLX to enhance learning. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Food Allergy To Wheat Proteins. Diagnostic And Treatment Difficulties

    Directory of Open Access Journals (Sweden)

    E. A. Vishneva

    2015-01-01

    Full Text Available The article is dedicated to the problem of food allergy in children. The number of patients with this pathology continues to rise, which can be explained by multiple factors, which speaks for the relevance and the social importance of the matter. For food allergy, the causesignificant allergens are both simple and complex food proteins. Wheat is one of the most prevalent source of food allergens not only for children, but for adults too. The article contains the main information concerning the ley characteristics of this product; the protein content and the different roles of individual components in forming allergic reactions and cross activity are thoroughly investigated. The authors provide recommendations for the diagnostics and treatment of wheat protein allergy, and various difficulties in different clinical cases are examined. The article also contains main treatment approaches, which are relevant to the modern data. An individual approach in each case means regular monitoring of the main figures, preventing the negative consequences of an eliminative diet at wheat protein allergy through using specialized gluten-free products.

  3. Teaching weight to explicitly address language ambiguities and conceptual difficulties

    Science.gov (United States)

    Taibu, Rex; Schuster, David; Rudge, David

    2017-06-01

    Language ambiguities in concept meanings can exacerbate student learning difficulties and conceptual understanding of physics concepts. This is especially true for the concept of "weight," which has multiple meanings in both scientific and everyday usage. The term weight has been defined in several different ways, with nuances, but in textbooks and teaching the term is almost always defined in one of two ways: operationally either as the contact force between an object and a measuring scale or as the gravitational force on an object due to some other body such as Earth. The use of the same name for different concepts leads to much confusion, especially in accelerating situations, and to conflicting notions of "weightlessness" in free fall situations. In the present paper, we share an innovative approach that initially avoids the term weight entirely while teaching the physics of each situation, and then teaches the language ambiguities explicitly. We developed an instructional module with this approach and implemented it over two terms in three sections of an introductory physics course for preservice elementary teachers. Learning gains for content understanding were assessed using pretests and post-tests. Participants achieved remarkably high gains for both static and accelerating situations. Surveys pre- and postinstruction showed substantially improved appreciation of language issues and ambiguities associated with weight, weightlessness, and free fall. Interviews with instructors teaching the module provided additional insight into the advantages and teaching demands of the new approach.

  4. Multiple Perspectives / Multiple Readings

    Directory of Open Access Journals (Sweden)

    Simon Biggs

    2005-01-01

    Full Text Available People experience things from their own physical point of view. What they see is usually a function of where they are and what physical attitude they adopt relative to the subject. With augmented vision (periscopes, mirrors, remote cameras, etc we are able to see things from places where we are not present. With time-shifting technologies, such as the video recorder, we can also see things from the past; a time and a place we may never have visited.In recent artistic work I have been exploring the implications of digital technology, interactivity and internet connectivity that allow people to not so much space/time-shift their visual experience of things but rather see what happens when everybody is simultaneously able to see what everybody else can see. This is extrapolated through the remote networking of sites that are actual installation spaces; where the physical movements of viewers in the space generate multiple perspectives, linked to other similar sites at remote locations or to other viewers entering the shared data-space through a web based version of the work.This text explores the processes involved in such a practice and reflects on related questions regarding the non-singularity of being and the sense of self as linked to time and place.

  5. Why do depressed individuals have difficulties in their parenting role?

    Science.gov (United States)

    Psychogiou, L; Parry, E

    2014-05-01

    Although existing research has shown that depression in parents has a negative effect on parent-child interactions, the mechanisms underpinning impaired parenting are still unknown. In this editorial, we review core difficulties that have been noted in depressed individuals including reduced positive and increased negative affect, poor emotion regulation, executive function deficits, reduced motivation and rumination, and discuss how each of these can alter parenting. We suggest that these causal processes are inter-related and can interact with one another in affecting parenting. We conclude that an improved understanding of these processes will have implications for the development of more specific and potentially more effective treatments that have the potential to break the intergenerational transmission of psychopathology.

  6. Air Bag Momentum Force Including Aspiration

    Directory of Open Access Journals (Sweden)

    Guy Nusholtz

    1995-01-01

    Full Text Available A gas-jet momentum force drives the air bag into position during a crash. The magnitude of this force can change as a result of aspiration. To determine the potential magnitude of the effect on the momentum force and mass flow rate in an aspirated system, a series of experiments and simulations of those experiments was conducted. The simulation consists of a two-dimensional unsteady isentropic CFD model with special “infinite boundaries”. One of the difficulties in simulating the gas-jet behavior is determining the mass flow rate. To improve the reliability of the mass flow rate input to the simulation, a sampling procedure involving multiple tests was used, and an average of the tests was adopted.

  7. Radiologic percutaneous gastrostomy and gastroenterostomy: Indications, results, and difficulties

    International Nuclear Information System (INIS)

    Casola, G.; Van Sonnenberg, E.; Sukthankar, R.; Varney, R.A.; Stavas, J.; Cohen, M.; Christensen, R.A.; Wittich, G.R.

    1987-01-01

    This paper summarizes the authors' experience with 130 radiologic percutaneous gastrostomies (PG) and percutaneous gastroenterostomies (PGE). Procedures were accomplished successfully in 127 of 130 candidates. One case was unsuccessful and two were unfeasible. Indications were for feeding, decompression, or both. Underlying diseases included neurologic disorders, head and neck and esophageal tumors, pelvic and abdominal malignancies, trauma, and a variety of other diseases. Various guidance systems, techniques, and catheters were used. Complications occurred in 8%, most being minor. Three patients were operated on after PG/PGE-two had peritonitis, one due to tube dislodgment. Difficulties were encountered at different portions of the procedure. During catheter insertion the following problems were most common: (1) the access route was difficult because of overlying colon, (2) inability to insert a nasogastric tube in patients with esophageal carcinoma or large head and neck tumors, (3) inability to keep the stomach distended in patients with increased motility and those with surgical gastroenterostomies (Billroth I or II), (4) high position of the residual stomach in patients with hemigastrectomy, (5) the presence of ascites or peritoneal tumor anterior to the stomach in patients with ovarian carcinoma, and (6) tenting or herniation of the anterior wall of the stomach during dilatation. Difficulties that were encountered following catheter insertion included (1) chemical peritonitis from leakage of gastric juices, (2) peritonities from leakage of gastric feedings, (3) leakage around the skin entry site in patients with ascites, (4) catheters backing out and forming an intraperitorial loop, (5) catheters kinking and becoming occluded, and (6) catheters being pulled out

  8. Influence of burnout and sleep difficulties on the quality of life among medical students

    OpenAIRE

    Pagnin, Daniel; de Queiroz, Val?ria

    2015-01-01

    This study assessed the influence of burnout dimensions and sleep difficulties on the quality of life among preclinical-phase medical school students. Data were collected from 193 students through their completion of the World Health Organization Quality of Life Instrument, the Maslach Burnout Inventory?Student Survey, the Mini-Sleep Questionnaire, the Social Readjustment Rating Scale, and the Beck Depression Inventory. This survey performed hierarchical multiple regressions to quantify the e...

  9. How does difficulty communicating affect the social relationships of older adults? An exploration using data from a national survey.

    Science.gov (United States)

    Palmer, Andrew D; Newsom, Jason T; Rook, Karen S

    2016-01-01

    Healthy social relationships are important for maintaining mental and physical health in later life. Less social support, smaller social networks, and more negative social interactions have been linked to depression, poorer immune functioning, lower self-rated health, increased incidence of disease, and higher mortality. Overwhelming evidence suggests that communication disorders adversely affect social relationships. Much less is known about whether some or all aspects of social relationships are negatively affected by a communication disorder. The relative impact of a communication disorder on social relationships, as compared to other kinds of disability, is also poorly understood. Data were analyzed from a representative national sample of community-dwelling adults aged 65 and older living in the continental United States (n=742). Results from multiple regressions indicated that difficulty communicating was significantly associated with several parameters of social relationships even after controlling for age, gender, partnership status, health, functional limitations, and visual impairment. Communication difficulty was a significant predictor of smaller social network size, fewer positive social exchanges, less frequent participation in social activities, and higher levels of loneliness, but was not a significant predictor of negative social exchanges. These findings suggest that communication disorders may place older adults at increased risk for mental and physical health problems because of social isolation, reduced social participation, and higher rates of loneliness. In addition, it appears that communication disorders may have a greater impact on positive, rather than negative, aspects of social relationships. As a result of this activity, the following learning outcomes will be realized: Readers will be able to (1) describe changes in the social relationships of older adults that occur as part of normal aging, (2) identify the aspects of social

  10. Creating a supportive learning environment for students with learning difficulties

    OpenAIRE

    Grah, Jana

    2013-01-01

    Co-building of supporting learning environment for the learners with learning difficulties is one of the 21st century inclusive school’s elements. Since the physical presence of learners with learning difficulties in the classroom does not self-evidently lead to an effective co-operation and implementation of 21st century inclusive school, I have dedicated my doctor thesis to the establishment of supporting learning environment for the learners with learning difficulties in primary school wit...

  11. Prediction and Stability of Mathematics Skill and Difficulty

    OpenAIRE

    Martin, Rebecca B.; Cirino, Paul T.; Barnes, Marcia A.; Ewing-Cobbs, Linda; Fuchs, Lynn S.; Stuebing, Karla K.; Fletcher, Jack M.

    2012-01-01

    The present study evaluated the stability of math learning difficulties over a 2-year period and investigated several factors that might influence this stability (categorical vs. continuous change, liberal vs. conservative cut point, broad vs. specific math assessment); the prediction of math performance over time and by performance level was also evaluated. Participants were 144 students initially identified as having a math difficulty (MD) or no learning difficulty according to low achievem...

  12. Grammatical Templates: Improving Text Difficulty Evaluation for Language Learners

    OpenAIRE

    Wang, Shuhan; Andersen, Erik

    2016-01-01

    Language students are most engaged while reading texts at an appropriate difficulty level. However, existing methods of evaluating text difficulty focus mainly on vocabulary and do not prioritize grammatical features, hence they do not work well for language learners with limited knowledge of grammar. In this paper, we introduce grammatical templates, the expert-identified units of grammar that students learn from class, as an important feature of text difficulty evaluation. Experimental clas...

  13. Late Emerging Reading Difficulties in English Language Learners

    OpenAIRE

    Garcia, Nicole Marie

    2015-01-01

    Research has identified a group of students who do not begin to exhibit reading difficulties until fourth or fifth grade, suggesting late-emerging reading difficulties. Considering that these students do not show signs of reading difficulties in early grades, attempting to identify these students early becomes problematic. Additionally, little is known regarding the characteristics of late-emerging reading deficits within English language learner (ELL) populations. The purpose of this study w...

  14. Feeding difficulties in children with food protein-induced gastrointestinal allergies.

    Science.gov (United States)

    Meyer, Rosan; Rommel, Nathalie; Van Oudenhove, Lukas; Fleming, Catharine; Dziubak, Robert; Shah, Neil

    2014-10-01

    There is paucity of data on the prevalence of feeding difficulties in Food Protein-Induced Gastrointestinal Allergies (FPIGA) and their clinical characteristics. However, it is a commonly reported problem by clinicians. We set out to establish the occurrence of feeding difficulties in children with FPIGA, the association with gastrointestinal and extra-intestinal symptoms and number of foods eliminated from the diet. This retrospective observational analysis was performed in patients seen between 2002 and 2009 at Great Ormond Street Children's Hospital, Gastroenterology Department, London. Medical records where FPIGA was documented using the terms from the National Institute of Allergy and Infectious Disease and National Institute of Clinical Excellence and confirmed using an elimination diet, followed by a challenge were included. Feeding difficulties were assessed using a criteria previously used in healthy toddlers in the UK. Data from 437 children (203 female) were collected. Significantly more children with feeding difficulties presented with abdominal distention and bloating (P = 0.002), vomiting (P foods eliminated from the diet in the children with/without feeding difficulties (P = 0.028). Clinical manifestations like vomiting, constipation, rectal bleeding, weight loss, and the presence of extra-intestinal manifestations in addition to the number of foods avoided are in our FPIGA population linked to feeding difficulties. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  15. Multiple-Ring Digital Communication Network

    Science.gov (United States)

    Kirkham, Harold

    1992-01-01

    Optical-fiber digital communication network to support data-acquisition and control functions of electric-power-distribution networks. Optical-fiber links of communication network follow power-distribution routes. Since fiber crosses open power switches, communication network includes multiple interconnected loops with occasional spurs. At each intersection node is needed. Nodes of communication network include power-distribution substations and power-controlling units. In addition to serving data acquisition and control functions, each node acts as repeater, passing on messages to next node(s). Multiple-ring communication network operates on new AbNET protocol and features fiber-optic communication.

  16. Mobility Modification Alleviates Environmental Influence on Incident Mobility Difficulty among Community-Dwelling Older People: A Two-Year Follow-Up Study

    Science.gov (United States)

    Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Rantanen, Taina

    2016-01-01

    Background Environmental barriers increase risk for mobility difficulties in old age. Mobility difficulty is preceded by a phase where people try to postpone a difficulty through mobility modification. We studied whether perceived environmental mobility barriers outdoors correlate with mobility modification and mobility difficulty, predict development of mobility difficulty over a two-year follow-up, and whether mobility modification alleviates the risk for difficulty. Methods At baseline, 848 people aged 75–90 were interviewed face-to-face. Telephone follow-up interviews were conducted one (n = 816) and two years (n = 761) later. Environmental barriers to mobility were self-reported using a15-item structured questionnaire at baseline, summed and divided into tertiles (0, 1 and 2 or more barriers). Mobility difficulty was assessed as self-reported ability to walk 2 km at all assessment points and categorized into ‘no difficulty’, ‘no difficulty but mobility modifications’ (reducing frequency, stopping walking, using an aid, slowing down or resting during the performance) and ‘difficulty’. Results At baseline, 212 participants reported mobility modifications and 356 mobility difficulties. Those reporting one or multiple environmental barriers had twice the odds for mobility modifications and up to five times the odds for mobility difficulty compared to those reporting no environmental barriers. After multiple adjustments for health and functioning, reporting multiple environmental barriers outdoors continued to predict the development of incident mobility difficulty over the two-year follow-up. Mobility modifications attenuated the association. Conclusion For older people who successfully modify their performance, environmental influence on incident mobility difficulty can be diminished. Older people use mobility modification to alleviate environmental press on mobility. PMID:27104750

  17. Psychological Problems of Children with Learning Difficulties.

    Science.gov (United States)

    Shaughnessy, Michael F.; Scott, Patricia Carol

    The paper presents tips for parents of children with learning problems. It describes the emotional side effects of low achievement which may include low self-esteem, clinical depression, "learned helplessness," suicidal ideation, acting out behavior, low frustration tolerance, guilt feelings, interpersonal problems, withdrawal, running away,…

  18. Difficulties in emotion regulation and risky driving among Lithuanian drivers.

    Science.gov (United States)

    Šeibokaitė, Laura; Endriulaitienė, Auksė; Sullman, Mark J M; Markšaitytė, Rasa; Žardeckaitė-Matulaitienė, Kristina

    2017-10-03

    Risky driving is a common cause of traffic accidents and injuries. However, there is no clear evidence of how difficulties in emotion regulation contribute to risky driving behavior, particularly in small post-Soviet countries. The present study aimed to investigate the relationship between difficulties in emotion regulation and self-reported risky driving behavior in a sample of Lithuanian drivers. A total of 246 nonprofessional Lithuanian drivers participated in a cross-sectional survey. Difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004), and risky driving behavior was assessed using the Manchester Driver Behaviour Questionnaire (DBQ; Lajunen et al. 2004). Males scored higher than females in aggressive violations and ordinary violations. Females scored higher for the nonacceptance of emotional responses, whereas males had more difficulties with emotional awareness than females. More difficulties in emotion regulation were positively correlated with driving errors, lapses, aggressive violations, and ordinary violations for both males and females. Structural equation modeling showed that difficulties in emotion regulation explained aggressive and ordinary violations more clearly than lapses and errors. When controlling for interactions among the distinct regulation difficulties, difficulties with impulse control and difficulties engaging in goal-directed behavior predicted risky driving. Furthermore, nonacceptance of emotional responses and limited access to emotion regulation strategies were related to less violations and more driving errors. Emotion regulation difficulties were associated with the self-reported risky driving behaviors of Lithuanian drivers. This provides useful hints for improving driver training programs in order to prevent traffic injuries.

  19. Multiple sclerosis

    Science.gov (United States)

    ... indwelling catheter Osteoporosis or thinning of the bones Pressure sores Side effects of medicines used to treat the ... Daily bowel care program Multiple sclerosis - discharge Preventing pressure ulcers Swallowing problems Images Multiple sclerosis MRI of the ...

  20. Practical difficulties in raising finance for windfarms

    International Nuclear Information System (INIS)

    Johns, J.H.

    1995-01-01

    This paper highlights factors that have influenced the financial structure of windfarms, and considers the attitude of financiers, the returns to equity investors, innovations is the tax regime, and the challenges posed by the NFF03. The appendices lists the factors affecting the financial structures under previous versions of NFFOs, and key elements of successful schemes, and includes a diagram of the model windfarm. (Author)

  1. Difficulties in laparoscopic cholecystectomy: conversion versus surgeon's failure

    International Nuclear Information System (INIS)

    Ali, A.; Saeed, S.; Khawaja, R.; Samnani, S.S

    2017-01-01

    Laparoscopic cholecystectomy is considered to be gold standard treatment for symptomatic gall stones. Despite several benefits there are still disadvantages of laparoscopic cholecystectomy in difficult cases where anatomy is disturbed even in experienced hand. Aim of this study is to identify advantages of early conversion to open cholecystectomy in difficult cases and how it should not be associated with surgeon's failure. Methods: Observational study was conducted at tertiary care hospital of Karachi, Pakistan from January 2012 till June 2015. All patients who presented to general surgery department with symptomatic gall stones and planned for laparoscopic cholecystectomy was included in the study. Demographic data was collected. Preoperative workup includes baselines investigations with liver profile test and imaging study (ultrasound scan). All patient underwent laparoscopic cholecystectomy at first. Operative difficulties, incidence of conversion, reason for conversion and complication intra-operative or postoperative were recorded. Data was analyzed using SPSS 20. Results: Out of 1026 patients, 78.26 percent (803) were female. Mean age of patients were 41.30+-8.43 years (range 26-68 years). Common presenting symptoms were pain at upper abdomen and dyspepsia. Most of the patients had multiple gall stones (93.85 percent). Nine hundred and ninety-two patients (96.68 percent) of patients underwent successful laparoscopic cholecystectomy. This includes patients in whom dissections were difficult because of disturbed anatomy of calots triangle. Only 3.13 percent of patients were converted to open cholecystectomy. There was a significant difference (<0.05) in complications observed between completed and converted cholecystectomies. Conclusion: Conversion from laparoscopic to open procedure should be done in cases of technically difficult situations to avoid significant mortality and morbidity. Surgeons experience had a pivotal role in determining its need and

  2. People with Hemianopia Report Difficulty with TV, Computer, Cinema Use, and Photography.

    Science.gov (United States)

    Costela, Francisco M; Sheldon, Sarah S; Walker, Bethany; Woods, Russell L

    2018-05-01

    Our survey found that participants with hemianopia report more difficulties watching video in various formats, including television (TV), on computers, and in a movie theater, compared with participants with normal vision (NV). These reported difficulties were not as marked as those reported by people with central vision loss. The aim of this study was to survey the viewing experience (e.g., frequency, difficulty) of viewing video on TV, computers and portable visual display devices, and at the cinema of people with hemianopia and NV. This information may guide vision rehabilitation. We administered a cross-sectional survey to investigate the viewing habits of people with hemianopia (n = 91) or NV (n = 192). The survey, consisting of 22 items, was administered either in person or in a telephone interview. Descriptive statistics are reported. There were five major differences between the hemianopia and NV groups. Many participants with hemianopia reported (1) at least "some" difficulty watching TV (39/82); (2) at least "some" difficulty watching video on a computer (16/62); (3) never attending the cinema (30/87); (4) at least some difficulty watching movies in the cinema (20/56), among those who did attend the cinema; and (5) never taking photographs (24/80). Some people with hemianopia reported methods that they used to help them watch video, including video playback and head turn. Although people with hemianopia report more difficulty with viewing video on TV and at the cinema, we are not aware of any rehabilitation methods specifically designed to assist people with hemianopia to watch video. The results of this survey may guide future vision rehabilitation.

  3. The global burden of visual difficulty in low, middle, and high income countries.

    Directory of Open Access Journals (Sweden)

    Ellen E Freeman

    Full Text Available Using a world-wide, population-based dataset of adults, we sought to determine the frequency of far visual difficulty and its associated risk factors.The World Health Survey (WHS was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design of adults ages 18 years and older. Far vision was assessed by asking "In the last 30 days, how much difficulty did you have in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters?". Responses included none, mild, moderate, severe, or extreme/unable. The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank. Prevalence and regression estimates were adjusted to account for the complex sample design.21% of adults reported any visual difficulty. The rate varied by the income status of the country with the percentage who had any visual difficulty being 24%, 23%, and 13% in low, middle, and high income countries, respectively. Five percent of people reported severe or extreme visual difficulty with rates in low, middle, and high income countries of 6%, 5%, and 2% respectively. Risk factors for visual difficulty included older age, female sex, poorer socioeconomic status, little to no formal education, and diabetes (P<0.05.One out of five adults in the WHS reported some degree of far visual difficulty. Given the importance of vision to living an independent life, better access to quality eye care services and life course factors affecting vision health (e.g. repeated eye infections, diet lacking vitamin A must receive adequate attention and resources, especially in low and middle income countries.

  4. Emotional Intelligence, Personality Traits and Career Decision Difficulties

    Science.gov (United States)

    Di Fabio, Annamaria; Palazzeschi, Letizia

    2009-01-01

    This study aims to take an in-depth look at the role of emotional intelligence and personality traits in relation to career decision difficulties. The Italian version of the Career Decision Difficulties Questionnaire (CDDQ), the Bar-On Emotional Quotient Inventory: Short (Bar-On EQ-i: S), and the Big Five Questionnaire (BFQ) were administered to…

  5. Learner's Learning Experiences & Difficulties towards (ESL) among UKM Undergraduates

    Science.gov (United States)

    Maarof, Nooreiny; Munusamy, Indira Malani A/P

    2015-01-01

    This paper aims to investigate the learners learning experiences and difficulties of ESL among the UKM undergraduates. This study will be focusing on identifying the factors behind Malaysian undergraduate's experiences and also their difficulties in the English as Second Language (ESL) classroom. This paper discusses some of the issues of English…

  6. The role of sensorimotor difficulties in autism spectrum conditions

    Directory of Open Access Journals (Sweden)

    Penelope Hannant

    2016-08-01

    Full Text Available AbstractIn addition to difficulties in social communication, current diagnostic criteria for autism spectrum conditions (ASC also incorporate sensorimotor difficulties; repetitive motor movements and atypical reactivity to sensory input (APA, 2013. This paper explores whether sensorimotor difficulties are associated with the development and maintenance of symptoms in ASC. Firstly, studies have shown difficulties coordinating sensory input into planning and executing movement effectively in ASC. Secondly, studies have shown associations between sensory reactivity and motor coordination with core ASC symptoms, suggesting these areas each strongly influence the development of social and communication skills. Thirdly, studies have begun to demonstrate that sensorimotor difficulties in ASC could account for reduced social attention early in development, with a cascading effect on later social, communicative and emotional development. These results suggest that sensorimotor difficulties not only contribute to non-social difficulties such as narrow circumscribed interests, but also to the development of social behaviours such as effectively coordinating eye contact with speech and gesture, interpreting others’ behaviour and responding appropriately. Further research is needed to explore the link between sensory and motor difficulties in ASC, and their contribution to the development and maintenance of ASC.

  7. Assessment of Pragmatic Difficulties and Socioemotional Adjustment in Practice

    Science.gov (United States)

    Farmer, Marion; Oliver, Alice

    2005-01-01

    Background: In professional practice, psychologists and other professionals such as therapists and teachers receive referrals of many children who present with social, emotional and behavioural difficulties that are difficult to understand and assess. The problems of some of these children may stem from pragmatic difficulties in communication.…

  8. Graphical modeling for item difficulty in medical faculty exams

    African Journals Online (AJOL)

    . Conclusion: The ... difficulty criteria. Key words: Item difficulty, quality control, statistical process control, variable control charts ..... assumed that 68% of the values fall in the interval ± 1.S; .... The balance of the construction of items of exam has ...

  9. Early Writing Deficits in Preschoolers with Oral Language Difficulties

    Science.gov (United States)

    Puranik, Cynthia S.; Lonigan, Christopher J.

    2012-01-01

    The purpose of this study was to investigate whether preschool children with language impairments (LI), a group with documented reading difficulties, also experience writing difficulties. In addition, a purpose was to examine if the writing outcomes differed when children had concomitant cognitive deficits in addition to oral language problems. A…

  10. Learning Difficulty and Learner Identity: A Symbiotic Relationship

    Science.gov (United States)

    Hirano, Eliana

    2009-01-01

    This paper reports on a longitudinal case study of an adult EFL learner who perceived himself as having difficulty learning English. Both learning difficulty and learner identity are viewed as being constructed in discursive interactions throughout one's life and, hence, amenable to reconstruction. Data collected from classroom interactions,…

  11. Motor and sensory alalia: diagnostic difficulties

    Directory of Open Access Journals (Sweden)

    M. Yu. Bobylova

    2017-01-01

    Full Text Available Alalia is a speech disorder that develops due to organic brain damage in children with normal hearing and intelligence during the first three year of life. Systemic speech underdevelopment in alalia is characterized by violations in the phonetic, phonemic, lexical, and grammatical structure. Patients with alalia can also have non-speech related impairments, including motor (impaired movement and coordination, sensory (impaired sensitivity and perception, and psychopathological disorders. There are three types of alalia: motor, sensory, and mixed. Children with motor alalia have expressive language disorders, speech praxis, poor speech fluency, impaired articulation, and other focal neurological symptoms; however, they understand speech directed to them. Patients with motor alalia are often left-handed. Regional slowing and epileptiform activity are often detected on their electroencephalogram.  Children with sensory alalia are characterized by poor speech understanding (despite normal hearing resulting in secondary underdevelopment of their own speech. These patients have problems with the analysis of sounds, including speech sounds (impaired speech gnosis, which prevents the development of association between the sound image and the object. Therefore, the child hears, but does not understand the speech directed at him/her (auditory agnosia. Differential diagnosis of alalia is challenging and may require several months of observation. It also implies the exclusion of hearing loss and mental disorders.

  12. MULTIPLE OBJECTS

    Directory of Open Access Journals (Sweden)

    A. A. Bosov

    2015-04-01

    Full Text Available Purpose. The development of complicated techniques of production and management processes, information systems, computer science, applied objects of systems theory and others requires improvement of mathematical methods, new approaches for researches of application systems. And the variety and diversity of subject systems makes necessary the development of a model that generalizes the classical sets and their development – sets of sets. Multiple objects unlike sets are constructed by multiple structures and represented by the structure and content. The aim of the work is the analysis of multiple structures, generating multiple objects, the further development of operations on these objects in application systems. Methodology. To achieve the objectives of the researches, the structure of multiple objects represents as constructive trio, consisting of media, signatures and axiomatic. Multiple object is determined by the structure and content, as well as represented by hybrid superposition, composed of sets, multi-sets, ordered sets (lists and heterogeneous sets (sequences, corteges. Findings. In this paper we study the properties and characteristics of the components of hybrid multiple objects of complex systems, proposed assessments of their complexity, shown the rules of internal and external operations on objects of implementation. We introduce the relation of arbitrary order over multiple objects, we define the description of functions and display on objects of multiple structures. Originality.In this paper we consider the development of multiple structures, generating multiple objects.Practical value. The transition from the abstract to the subject of multiple structures requires the transformation of the system and multiple objects. Transformation involves three successive stages: specification (binding to the domain, interpretation (multiple sites and particularization (goals. The proposed describe systems approach based on hybrid sets

  13. Re-examining the link between prenatal maternal anxiety and child emotional difficulties, using a sibling design.

    Science.gov (United States)

    Bekkhus, Mona; Lee, Yunsung; Nordhagen, Rannveig; Magnus, Per; Samuelsen, Sven O; Borge, Anne I H

    2018-02-01

    Prenatal exposure to maternal anxiety has been associated with child emotional difficulties in a number of epidemiological studies. One key concern, however, is that this link is vulnerable to confounding by pleiotropic genes or environmental family factors. Data on 82 383 mothers and children from the population-based Mother and Child Cohort Study and data on 21 980 siblings were used in this study. Mothers filled out questionnaires for each unique pregnancy, for infant difficulties at 6 months and for emotional difficulties at 36 months. The link between prenatal maternal anxiety and child difficulties were examined using logistic regression analyses and multiple linear regression analyses for the full study sample and the sibling sample. In the conventional full-cohort analyses, prenatal exposure to maternal anxiety was associated with child difficulties at both 6 months [odds ratio (OR) = 2.1 (1.94-2.27)] and 36 months [OR = 2.72 (2.47-2.99)]. The findings were essentially the same whether we examined difficulties at 6 months or at 36 months. However, these associations were no longer present once we controlled for potential social and genetic confounders in the sibling comparison analyses, either at 6 months [OR = 1.32 (0.91-1.90)] or at 36 months [OR = 1.28 (0.63-2.60)]. Findings from multiple regression analyses with continuous measures were essentially the same. Our finding lends little support for there being an independent prenatal effect on child emotional difficulties; rather, our findings suggest that the link between prenatal maternal anxiety and child difficulties could be confounded by pleiotropic genes or environmental family factors. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

  14. Cross-cultural acceptability and utility of the strengths and difficulties questionnaire: views of families

    Directory of Open Access Journals (Sweden)

    Paula Kersten

    2016-10-01

    Full Text Available Abstract Background Screening children for behavioural difficulties requires the use of a tool that is culturally valid. We explored the cross-cultural acceptability and utility of the Strengths and Difficulties Questionnaire for pre-school children (aged 3–5 as perceived by families in New Zealand. Methods A qualitative interpretive descriptive study (focus groups and interviews in which 65 participants from five key ethnic groups (New Zealand European, Māori, Pacific, Asian and other immigrant parents took part. Thematic analysis using an inductive approach, in which the themes identified are strongly linked to the data, was employed. Results Many parents reported they were unclear about the purpose of the tool, affecting its perceived value. Participants reported not understanding the context in which they should consider the questions and had difficulty understanding some questions and response options. Māori parents generally did not support the questionnaire based approach, preferring face to face interaction. Parents from Māori, Pacific Island, Asian, and new immigrant groups reported the tool lacked explicit consideration of children in their cultural context. Parents discussed the importance of timing and multiple perspectives when interpreting scores from the tool. Conclusions In summary, this study posed a number of challenges to the use of the Strengths and Difficulties Questionnaire in New Zealand. Further work is required to develop a tool that is culturally appropriate with good content validity.

  15. Cross-cultural acceptability and utility of the strengths and difficulties questionnaire: views of families.

    Science.gov (United States)

    Kersten, Paula; Dudley, Margaret; Nayar, Shoba; Elder, Hinemoa; Robertson, Heather; Tauroa, Robyn; McPherson, Kathryn M

    2016-10-12

    Screening children for behavioural difficulties requires the use of a tool that is culturally valid. We explored the cross-cultural acceptability and utility of the Strengths and Difficulties Questionnaire for pre-school children (aged 3-5) as perceived by families in New Zealand. A qualitative interpretive descriptive study (focus groups and interviews) in which 65 participants from five key ethnic groups (New Zealand European, Māori, Pacific, Asian and other immigrant parents) took part. Thematic analysis using an inductive approach, in which the themes identified are strongly linked to the data, was employed. Many parents reported they were unclear about the purpose of the tool, affecting its perceived value. Participants reported not understanding the context in which they should consider the questions and had difficulty understanding some questions and response options. Māori parents generally did not support the questionnaire based approach, preferring face to face interaction. Parents from Māori, Pacific Island, Asian, and new immigrant groups reported the tool lacked explicit consideration of children in their cultural context. Parents discussed the importance of timing and multiple perspectives when interpreting scores from the tool. In summary, this study posed a number of challenges to the use of the Strengths and Difficulties Questionnaire in New Zealand. Further work is required to develop a tool that is culturally appropriate with good content validity.

  16. Interventions for Primary School Children With Difficulties in Mathematics.

    Science.gov (United States)

    Dowker, Ann

    2017-01-01

    Difficulty with arithmetic is a common problem for children and adults, though there has been some work on the topic for a surprisingly long time. This chapter will review some of the research that has been done over the years on interventions with primary school children. Interventions can be of various levels of intensiveness, ranging from whole-class approaches that take account of individual differences through small-group and limited-time individual interventions to extended-time individual interventions. Interventions discussed here include those involving peer tuition and group collaboration; those involving board and computer games; and those that involve assessing children's strengths and weaknesses in different components of mathematics; and targeting remedial activities to the assessed weaknesses. Most of the interventions discussed in this chapter specifically involve mathematics (usually mainly arithmetic), but there is also some discussion of attempts to improve mathematics by training children in domain-general skills, including Piagetian operations, metacognition, and executive functions. © 2017 Elsevier Inc. All rights reserved.

  17. Determining Which Introductory Physics Topics Pre-Service Physics Teachers Have Difficulty Understanding and What Accounts for These Difficulties

    Science.gov (United States)

    Sahin, Esin; Yagbasan, Rahmi

    2012-01-01

    This study aims at diagnosing which subjects pre-service physics teachers have difficulty understanding in introductory physics courses and what accounts for these difficulties. A questionnaire consisting of two qualitative questions was used to collect data for this study. The questionnaire was administered to 101 pre-service physics teachers who…

  18. University Students with Reading Difficulties: Do Perceived Supports and Comorbid Difficulties Predict Well-being and GPA?

    Science.gov (United States)

    Stack-Cutler, Holly L.; Parrila, Rauno K.; Torppa, Minna

    2016-01-01

    We examined the impact of the number of comorbid difficulties, social support, and community support on life satisfaction and academic achievement among 120 university students or recent graduates with self-reported reading difficulties. Participants completed a questionnaire assessing perceived social support, perceived community support, the…

  19. CONCEPTUAL DIFFICULTIES AND THE FEASIBILITY OF POLICIES

    Directory of Open Access Journals (Sweden)

    Feleaga Liliana

    2008-05-01

    Full Text Available Goodwill represents a financial indicator which serves as an evaluation tool for the quality of the company’s production structures. The evaluation and the recognition of the Goodwill raises may controversies, as for example: Is the Goodwill an asset or not? Is it kept within the assets part or is it subtracted out of the company owner’s equity? Is it depreciated or it is sufficient to be included in the provisions? Therefore, the stakes for choosing one solution, or the other, should not be neglected. It is necessary to analyse the factors that influence the managerial decisions, when choosing a way to record the Goodwill. In this analysis we may use the theory of the Contract Costs. In its own path to eliminate the manipulation options for the published information, the international referential has supported within the past years, numerous revises and modifications regarding the Goodwill accounting treatment. Goodwill in the context of the international accounting convergence processes.

  20. Difficulties in radon measurements at workplaces

    International Nuclear Information System (INIS)

    Kavasi, Norbert; Kovacs, Tibor; Nemeth, Csaba; Szabo, Tibor; Gorjanacz, Zoran; Varhegyi, Andras; Hakl, Jozsef; Somlai, Janos

    2006-01-01

    Different legislation systems can be found in the world concerning radon levels at workplaces. Following the European Union suggestion, a reference level for radon concentration in the air at workplaces was established in several European countries. In Hungary, the relevant legislation has come into effect on 1 January 2003. The determination of average radon concentration might present a problem, especially in places where the monthly average concentrations vary to a great extent. For example, the monthly averages measured in a hospital cave used for treating respiratory diseases showed a 24-fold difference depending on the chosen month. In such cases, attention should be paid when choosing the months and using the results of measurements for dose assessment. Another uncertainty emerges when estimating the annual dose, based on the data coming from long-term measurements, usually using integrated methods such as track detectors. There is a considerable difference between the averages measured during the working hours and over the total time (including nights and weekends), mostly in the cases of rooms with frequent air change like schools, kindergartens and ventilated workplaces. This can lead to a significant overestimation in dose calculation. Special attention needs to be paid to workplaces such as mines, tunnels and open air uranium tailings sites. This paper discusses the possible inaccuracies caused by the improper selection of time periods and methods in the measurements of the average radon concentration at workplaces

  1. Visual performance on detection tasks with double-targets of the same and different difficulty.

    Science.gov (United States)

    Chan, Alan H S; Courtney, Alan J; Ma, C W

    2002-10-20

    This paper reports a study of measurement of horizontal visual sensitivity limits for 16 subjects in single-target and double-targets detection tasks. Two phases of tests were conducted in the double-targets task; targets of the same difficulty were tested in phase one while targets of different difficulty were tested in phase two. The range of sensitivity for the double-targets test was found to be smaller than that for single-target in both the same and different target difficulty cases. The presence of another target was found to affect performance to a marked degree. Interference effect of the difficult target on detection of the easy one was greater than that of the easy one on the detection of the difficult one. Performance decrement was noted when correct percentage detection was plotted against eccentricity of target in both the single-target and double-targets tests. Nevertheless, the non-significant correlation found between the performance for the two tasks demonstrated that it was impossible to predict quantitatively ability for detection of double targets from the data for single targets. This indicated probable problems in generalizing data for single target visual lobes to those for multiple targets. Also lobe area values obtained from measurements using a single-target task cannot be applied in a mathematical model for situations with multiple occurrences of targets.

  2. International Semiotics: Item Difficulty and the Complexity of Science Item Illustrations in the PISA-2009 International Test Comparison

    Science.gov (United States)

    Solano-Flores, Guillermo; Wang, Chao; Shade, Chelsey

    2016-01-01

    We examined multimodality (the representation of information in multiple semiotic modes) in the context of international test comparisons. Using Program of International Student Assessment (PISA)-2009 data, we examined the correlation of the difficulty of science items and the complexity of their illustrations. We observed statistically…

  3. Unconscious and Unnoticed Professional Practice within an Outstanding School for Children and Young People with Complex Learning Difficulties and Disabilities

    Science.gov (United States)

    Crombie, Richard; Sullivan, Lesley; Walker, Kate; Warnock, Rebecca

    2014-01-01

    This article describes a three-year project undertaken at Pear Tree School for children and young people with severe and multiple and profound learning difficulties. Lesley Sullivan, the school's head teacher, believed that much of the value within the work of this outstanding school went unidentified by existing approaches to planning, monitoring…

  4. The Effects of Self-Regulation on Science Vocabulary Acquisition of English Language Learners with Learning Difficulties

    Science.gov (United States)

    Kim, Woori; Linan-Thompson, Sylvia

    2013-01-01

    This multiple-probe study examined the effects of self-regulation on the acquisition of science vocabulary by four third-grade English language learners (ELLs) with learning difficulties. The students were provided only direct vocabulary instruction in a baseline phase, followed by intervention and maintenance phases into which self-regulation…

  5. Understanding alcoholics’ “difficulty in life”: An empirical comparison of alcoholics and nonalcoholics

    Directory of Open Access Journals (Sweden)

    Keiko Ito

    2017-01-01

    Full Text Available The Japanese success rate for alcoholism treatment is approximately 30%, indicating high relapse rates. Although “difficulty in life” is thought to contribute to alcoholics’ relapse, the characteristics of the phenomenon are unknown. This study examined the factors contributing to alcoholics’ difficulty in life. Alcoholic self-help group members, who indicated the extent of their difficulty in life and described the factors that contributed to this difficulty, completed a self-administered questionnaire. Participants’ hypersensitivity/grandiosity traits were also examined. A control group of nonalcoholic men also completed the questionnaire. Simple tabulation, descriptive statistics, Mann-Whitney U tests, and multivariate analyses were used to compare data between groups. Ultimately, 574 and 512 valid responses were received from the alcoholic (response rate: 27.1% and nonalcoholic (response rate: 33.1% groups, respectively. The proportion of alcoholics (54% who indicated that they found life difficult was significantly higher relative to that of nonalcoholics (39.9%. Alcoholics’ mean hypersensitivity score was significantly higher (2.67 relative to that observed for nonalcoholics (2.44. Significant between-group differences were observed for the following factors: building and maintaining relationships, satisfaction with life, self-distrust, cognitive bias, loneliness, empathic understanding, and self-acceptance. Multivariate logistic regression identified cognitive bias and building and maintaining relationships as factors contributing to alcoholics’ difficulty in life. Alcoholics’ social contexts, including broken families, social instability, and cross addiction, also contributed to this difficulty. Personal characteristics, such as hypersensitive-type narcissistic tendencies, relationship problems, and cognitive bias, were also associated with alcoholics’ difficulty in life.

  6. Validating office-based screening for psychosocial strengths and difficulties among youths in foster care.

    Science.gov (United States)

    Jee, Sandra H; Szilagyi, Moira; Conn, Anne-Marie; Nilsen, Wendy; Toth, Sheree; Baldwin, Constance D; Szilagyi, Peter G

    2011-05-01

    To assess the effectiveness of social-emotional screening in the primary care setting for youths in foster care. The setting was a primary care practice for all youth in home-based foster care in 1 county. Subjects were youths, aged 11 to 17 years, and their foster parents; both completed a Strengths and Difficulties Questionnaire at well-child visits. The Strengths and Difficulties Questionnaire is a previously validated 25-item tool that has 5 domains: emotional symptoms; conduct problems; hyperactivity/inattention; peer problems; and prosocial behaviors and an overall total difficulties score. We first compared youth versus parent Strengths and Difficulties Questionnaire scores and then assessed the accuracy of these Strengths and Difficulties Questionnaire scores by comparing them in a subsample of youths (n = 50) with results of home-based structured clinical interviews using the Children's Interview for Psychiatric Syndromes. Of 138 subjects with both youth and parent reports, 78% had prosocial behaviors (strengths), and 70% had 1 or more social-emotional problems. Parents reported significantly more conduct problems (38% vs 16%; P youth. The Strengths and Difficulties Questionnaire had better agreement with the Children's Interview for Psychiatric Syndromes (n = 50) for any Strengths and Difficulties Questionnaire-identified problem for combined youth and foster-parent reports (93%), compared with youth report alone (54%) or parent report alone (71%). Although most youths in foster care have social-emotional problems, most have strengths as well. Youth and foster-parent perspectives on these problems differ. Systematic social-emotional screening in primary care that includes both youth and parent reports can identify youths who may benefit from services.

  7. The Prevalence of Reading Difficulties among Children in Scholar Age

    Directory of Open Access Journals (Sweden)

    Maria Rosita Cecilia

    2014-10-01

    Full Text Available The study investigates the prevalence of reading difficulties among children in scholar age and analyses the socio-demographic characteristics of learners who presented reading difficulties in central Italy. A sample of 623 students 7-11 aged, was assessed with the Italian MT standardized tests. Information on gender, age, handedness, and other socio-demographic variables were also gathered. The study showed that 11% of learners presented poor comprehension skills. The reading speed difficulties were more common than the reading correctness problems: about 7% of children vs 1% were dyslexics due to slow reading. There were no significant differences regarding gender, age. However, dominant hand and the school location seemed to affect the speed difficulties and the comprehension problems. The analyses showed that attending a school located in a rural area was statistically associated with the reading difficulties. Left-handed children were more likely to be slow decoders and/or poor comprehenders. These findings may be used in the early diagnosis of poor readers. These difficulties often have a chronic progression with substantial psychosocial limitations and psychological stress, so children with reading difficulties should be identified as early as possible.

  8. Exploring communication difficulties in pediatric hematology: oncology nurses.

    Science.gov (United States)

    Citak, Ebru Akgun; Toruner, Ebru Kilicarslan; Gunes, Nebahat Bora

    2013-01-01

    Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses. This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties. It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis. Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues. Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.

  9. Eating difficulties among stroke patients in the acute state: a descriptive, cross-sectional, comparative study.

    Science.gov (United States)

    Medin, Jörgen; Windahl, Jenny; von Arbin, Magnus; Tham, Kerstin; Wredling, Regina

    2011-09-01

    To examine eating difficulties among stroke patients - a comparison between women and men. Gender differences have been reported in studies of stroke, but the findings are inconclusive and few of these studies have specifically focused on gender differences in eating difficulties. This study was a descriptive, cross-sectional, comparative study. Patients with stroke were recruited at a general hospital in Sweden. To detect eating difficulties, individual observations of the patients were made during one meal using a structured observation protocol. Assessment also included measurements of nutritional and oral status, degree of independence, stroke severity, neglect and well-being. One hundred and four patients (53·8% women) were included in the study. The proportion of stroke patients with one or more eating difficulties was 81·7%. The most common eating difficulties were 'managing food on the plate' (66·3%), 'food consumption' (54·8%) and 'sitting position' (45·2%). Women had lower 'food consumption', more severe stroke (p = 0·003), worse functional status (p = 0·001) and lower quality of life (QoL) (p=0·038) than men. More women than men were malnourished and living alone. After adjustment for functional status and motor arm, the odds ratio of having difficulties with food consumption was four times higher among women than men (1·7-9·4, confidence interval 95%). More women than men with stroke suffered from inadequate food consumption. The women had more severe strokes, experienced poorer QoL and showed lower functional status than the men. In the rehabilitation process of women with stroke, these factors should be taken into consideration. Structured observation of meals, including assessment of food consumption, might be necessary in acute stroke care to detect patients, especially women, who might need closer supervision and nutritional intervention. © 2011 Blackwell Publishing Ltd.

  10. Multiplicative Effects of Social and Psychological Risk Factors on College Students’ Suicidal Behaviors

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2018-05-01

    Full Text Available Less is known about the multiplicative effects of social and psychological risk and protective factors of suicidality on college campuses. The current study aimed to investigate the multiplicative effects of social (identifying oneself as gay/lesbian, financial difficulty, violence victimization, and religiosity and psychological (anxiety, depression, problem alcohol use, drug use and risk/protective factors on suicidal behaviors among college students in the United States. Using a cross-sectional design, the Healthy Mind Study (HMS; 2016–2017, is a national online survey of college students in the United States. Social (identifying oneself as gay/lesbian, violence victimization, financial difficulty, and religiosity and psychological (anxiety, depression, problem alcohol use, and drug use risk/protective factors were assessed among 27,961 individuals. Three aspects of suicidality, including ideation, plan, and attempt, were also assessed. Logistic regression models were used for data analysis. Financial difficulty, violence victimization, identifying oneself as gay/lesbian, anxiety, depression, and drug use increased, while religiosity reduced the odds of suicidal behaviors. Multiplicative effects were found between the following social and psychological risk factors: (1 financial difficulty and anxiety; (2 financial difficulty and depression; (3 depression and drug use; (4 problem alcohol use and drug use; and (5 depression and problem alcohol use. There is a considerable overlap in the social and psychological processes, such as financial stress, mood disorders, and substance use problems, on risk of suicide in college students. As social and psychological risk factors do not operate independently, comprehensive suicidal risk evaluations that simultaneously address multiple social and psychological risk factors may be superior to programs that only address a single risk factor.

  11. Multiple Hereditary Osteochondromatosis: A Case Report

    OpenAIRE

    K???kesmen, ?i?dem; ?zen, Bu?ra; Ak?am, Mustafa

    2007-01-01

    Objectives Common carious lesions owing to vomiting are not widespread in children. In this case, we aimed to report an 11-years-old male patient with common carious lesions due to repeated vomitings, chewing and eating difficulty and retarded growth with Multiple Hereditary Osteochondromatosis (MHO). Case Report An 11-years-old boy was referred to Department of Pediatric Dentistry in Faculty of Dentistry because of eating difficulty owing to common carious lesions. It was seen that the patie...

  12. Superconductivity: a quasiclassical theory of multiple interface geometry

    International Nuclear Information System (INIS)

    Rameshwar, Rudra; Prashant, Sagar; Prasad, Jagdish

    2005-01-01

    In many cases of interests such as a multilayer mesoscopic structure or the grain boundaries network in high technologies, one deal with the situation where multiple interfaces should be treated simultaneously on equal footing. In this paper we have focused on theoretically concept, i.e. even an isolated interface poses certain difficulties. Since abrupt changes violate the quasiclassical condition, the standard theory of superconductivity in terms of the quasiclassical matrix Green function g R is invalid at interfaces. The interface is included via the boundary condition derived by Zaitsev a cubic matrix relation in superconductivity. (author)

  13. Mathematical Interventions for Secondary Students with Learning Disabilities and Mathematics Difficulties: A Meta-Analysis

    Science.gov (United States)

    Jitendra, Asha K.; Lein, Amy E.; Im, Soo-hyun; Alghamdi, Ahmed A.; Hefte, Scott B.; Mouanoutoua, John

    2018-01-01

    This meta-analysis is the first to provide a quantitative synthesis of empirical evaluations of mathematical intervention programs implemented in secondary schools for students with learning disabilities and mathematics difficulties. Included studies used a treatment-control group design. A total of 19 experimental and quasi-experimental studies…

  14. Examining Primary Pre-Service Teachers' Difficulties of Mathematics Teaching with the Micro-Teaching Method

    Science.gov (United States)

    Savas Basturk; Tastepe, Mehtap

    2015-01-01

    The purpose of the study was to examine primary pre-service teachers' difficulties of the teaching of mathematics with micro-teaching method. The participants of the study were 15 third grade pre-service teachers from the department of primary education in the faculty of education. In this grade which includes four sections, there were…

  15. Academic Reading Difficulties Encountered by International Graduate Students in a Malaysian University

    Science.gov (United States)

    Alghail, Ali Abdullah Ali; Mahfoodh, Omer Hassan Ali

    2016-01-01

    This study examines how international graduate students in a Malaysian public university perceive and overcome academic reading difficulties. The target population included all graduate students from Yemen, an Arab country, studying at Universiti Sains Malaysia. Data were collected using questionnaires, focus group interviews, and journal writing.…

  16. Keldysh theory of strong field ionization: history, applications, difficulties and perspectives

    International Nuclear Information System (INIS)

    V Popruzhenko, S

    2014-01-01

    The history and current status of the Keldysh theory of strong field ionization are reviewed. The focus is on the fundamentals of the theory, its most important applications and those aspects which still raise difficulties and remain under discussion. The Keldysh theory is compared with other nonperturbative analytic methods of strong field atomic physics and its important generalizations are discussed. Among the difficulties, the gauge invariance problem, the tunneling time concept, the conditions of applicability and the application of the theory to ionization of systems more complex than atoms, including molecules and dielectrics, are considered. Possible prospects for the future development of the theory are also discussed. (review article)

  17. Difficulties with pitch discrimination influences pitch memory performance: evidence from congenital amusia.

    Science.gov (United States)

    Jiang, Cunmei; Lim, Vanessa K; Wang, Hang; Hamm, Jeff P

    2013-01-01

    Music processing is influenced by pitch perception and memory. Additionally these features interact, with pitch memory performance decreasing as the perceived distance between two pitches decreases. This study examined whether or not the difficulty of pitch discrimination influences pitch retention by testing individuals with congenital amusia. Pitch discrimination difficulty was equated by determining an individual's threshold with a two down one up staircase procedure and using this to create conditions where two pitches (the standard and the comparison tones) differed by 1x, 2x, and 3x the threshold setting. For comparison with the literature a condition that employed a constant pitch difference of four semitones was also included. The results showed that pitch memory performance improved as the discrimination between the standard and the comparison tones was made easier for both amusic and control groups, and more importantly, that amusics did not show any pitch retention deficits when the discrimination difficulty was equated. In contrast, consistent with previous literature, amusics performed worse than controls when the physical pitch distance was held constant at four semitones. This impaired performance has been interpreted as evidence for pitch memory impairment in the past. However, employing a constant pitch distance always makes the difference closer to the discrimination threshold for the amusic group than for the control group. Therefore, reduced performance in this condition may simply reflect differences in the perceptual difficulty of the discrimination. The findings indicate the importance of equating the discrimination difficulty when investigating memory.

  18. Difficulties with pitch discrimination influences pitch memory performance: evidence from congenital amusia.

    Directory of Open Access Journals (Sweden)

    Cunmei Jiang

    Full Text Available Music processing is influenced by pitch perception and memory. Additionally these features interact, with pitch memory performance decreasing as the perceived distance between two pitches decreases. This study examined whether or not the difficulty of pitch discrimination influences pitch retention by testing individuals with congenital amusia. Pitch discrimination difficulty was equated by determining an individual's threshold with a two down one up staircase procedure and using this to create conditions where two pitches (the standard and the comparison tones differed by 1x, 2x, and 3x the threshold setting. For comparison with the literature a condition that employed a constant pitch difference of four semitones was also included. The results showed that pitch memory performance improved as the discrimination between the standard and the comparison tones was made easier for both amusic and control groups, and more importantly, that amusics did not show any pitch retention deficits when the discrimination difficulty was equated. In contrast, consistent with previous literature, amusics performed worse than controls when the physical pitch distance was held constant at four semitones. This impaired performance has been interpreted as evidence for pitch memory impairment in the past. However, employing a constant pitch distance always makes the difference closer to the discrimination threshold for the amusic group than for the control group. Therefore, reduced performance in this condition may simply reflect differences in the perceptual difficulty of the discrimination. The findings indicate the importance of equating the discrimination difficulty when investigating memory.

  19. Empowering Learners to Choose the Difficulty Level of Problems Based on Their Learning Needs

    Directory of Open Access Journals (Sweden)

    Janet Mannheimer Zydney

    2010-08-01

    Full Text Available Research has found that increasing learner control offers several benefits, including increased motivation, attitude, and learning. The goal of the present study was to determine how prior math achievement influences students' selection of the difficulty level of problems within Math Pursuits, a hypermedia learning program. Math Pursuits was designed to help children understand mathematics by discovering how it relates to the world around them. The program presented each learner with an adjustable level of challenge, along with the necessary scaffolding to support success. The researchers hypothesized that students with lower math skills would choose to start with a lower difficultly level; whereas, students with higher math skills would begin the program by choosing a question with a higher level of difficulty. Results supported these hypotheses. This research also examined the motivational framework guiding students' selection of problem difficulty.

  20. [Children with developmental coordination disorder have difficulty with action representation].

    Science.gov (United States)

    Gabbard, Carl; Cacola, Priscila

    The study of children with developmental coordination disorder (DCD) has emerged as a vibrant line of inquiry over the last two decades. The literature indicates quite clearly that children with DCD display deficits with an array of perceptual-motor and daily living skills. The movements of children with DCD are often described as clumsy and uncoordinated and lead to difficulties with performing many of the activities of daily living and sports that typically developing children perform easily. It has been hypothesized, based on limited research, that an underlying problem is a deficit in generating and/or monitoring an action representation termed the internal modeling deficit hypothesis. According to the hypothesis, children with DCD have significant limitations in their ability to accurately generate and utilize internal models of motor planning and control. The focus of this review is on one of the methods used to examine action representation-motor imagery, which theorists argue provides a window into the process of action representation. Included are research methods and possible brain structures involved. An addition, a paradigm unique with this population-estimation of reachability (distance) via motor imagery, will be described.

  1. The Strengths and Difficulties Questionnaire in the Nordic countries.

    Science.gov (United States)

    Obel, Carsten; Heiervang, Einar; Rodriguez, Alina; Heyerdahl, Sonja; Smedje, Hans; Sourander, André; Guethmundsson, Olafur O; Clench-Aas, Jocelyne; Christensen, Else; Heian, Frode; Mathiesen, Kristin S; Magnússon, Páll; Njarethvík, Urethur; Koskelainen, Merja; Rønning, John A; Stormark, Kjell Morten; Olsen, Jørn

    2004-01-01

    The Strengths and Difficulties Questionnaire (SDQ) has been translated into the different Nordic languages between 1996 and 2003. During the past few years, SDQs have been completed for nearly 100,000 children and adolescents in population-based studies as well as in clinical samples. The largest studies have been performed in Norway and Denmark, and in these countries the diagnostic interview DAWBA has also been used in conjunction with the SDQ. In addition to a brief overview of past and ongoing SDQ work in Sweden, Finland, Norway, Denmark, and Iceland, we present scale means and standard deviations from selected community studies with comparable age groups, including parental reports for 7, 9 and 11 year-old children and self-reports of 13 and 15 year-olds. The descriptive statistics suggest that the distributions of SDQ scores are very similar across the Nordic countries. Further collaborative efforts in establishing norms and evaluating the validity of the SDQ as a screening instrument are encouraged.

  2. [Detection and specific studies in procedural learning difficulties].

    Science.gov (United States)

    Magallón, S; Narbona, J

    2009-02-27

    The main disabilities in non-verbal learning disorder (NLD) are: the acquisition and automating of motor and cognitive processes, visual spatial integration, motor coordination, executive functions, difficulty in comprehension of the context, and social skills. AIMS. To review the research to date on NLD, and to discuss whether the term 'procedural learning disorder' (PLD) would be more suitable to refer to NLD. A considerable amount of research suggests a neurological correlate of PLD with dysfunctions in the 'posterior' attention system, or the right hemisphere, or the cerebellum. Even if it is said to be difficult the delimitation between NLD and other disorders or syndromes like Asperger syndrome, certain characteristics contribute to differential diagnosis. Intervention strategies for the PLD must lead to the development of motor automatisms and problem solving strategies, including social skills. The basic dysfunction in NLD affects to implicit learning of routines, automating of motor skills and cognitive strategies that spare conscious resources in daily behaviours. These limitations are partly due to a dysfunction in non-declarative procedural memory. Various dimensions of language are also involved: context comprehension, processing of the spatial and emotional indicators of verbal language, language inferences, prosody, organization of the inner speech, use of language and non-verbal communication; this is why the diagnostic label 'PLD' would be more appropriate, avoiding the euphemistic adjective 'non-verbal'.

  3. Perceived challenges of working in a fertility clinic: a qualitative analysis of work stressors and difficulties working with patients.

    Science.gov (United States)

    Boivin, Jacky; Bunting, Laura; Koert, Emily; Ieng U, Chin; Verhaak, Christianne

    2017-02-01

    'Misinformation and lack of knowledge' (27.8%, e.g. Dr Google). Finally, the topics participants would be willing to address in Workshops were 'Communicating and Counselling with Patients' (24.9%), 'Dealing with Patient-related sources' (19.6%) and 'Clinical topics' (19.6%). Three general themes emerged. First, a theme of 'time and time trade-offs' expressed the oft-mentioned need to trade-off time spent on one activity (e.g. managing patient demands) against another activity (e.g. clinical workload, administration) with stress level dependent on the efficacy of trading-off. Second, the theme of 'multifactorial causes' of challenging patient interactions that embodied the many sources of difficulties working with patients. What staff would be willing to address in workshops was indicated by the final general theme of 'a little of everything', which linked to the need for multiple workshops addressing the multifactorial nature of challenges in fertility clinics. Only about 10% of members receiving the survey participated. The work was limited to the stressful and difficult aspects of working in fertility clinics, which may give a more negative impression than if questions about the rewards and benefits had also been included. The nature of stressors and difficulties of working in a fertility clinic are consistent with models of occupational stress and patient complexity. Specialized psychologists, management consultants and other occupational experts could assist fertility teams in overcoming many of the challenges. More research is required on the effect of encountered work stressors and perceived sources of difficulties in working with patients on staff and patient outcomes. None declared. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Task Number and Cognitive Complexity as Determinants of Difficulty ...

    African Journals Online (AJOL)

    PROF. O. E. OSUAGWU

    2013-09-01

    Sep 1, 2013 ... amenable to item analysis and are sample- ... as item difficulty, item discrimination, and .... The aim of this study is to determine: ... and then evaluators will have to pay significant ... calculated and the test statistics were used to.

  5. Teaching chemistry to students with learning difficulties: exemplary ...

    African Journals Online (AJOL)

    Teaching chemistry to students with learning difficulties: exemplary adaptive instructional practices of experienced teachers. ... Arguably, today's science classrooms are witnessing a situation in which students experience a special learning ...

  6. Brain injury and severe eating difficulties at admission

    DEFF Research Database (Denmark)

    Kjærsgaard, Annette; Kaae Kristensen, Hanne

    Objective: The objective of this pilot study was to explore and interpret the way that individuals with acquired brain injury, admitted to inpatient neurorehabilitation with severe eating difficulties, experienced eating nine to fifteen months after discharge. Methods: Four individuals with acqui......Objective: The objective of this pilot study was to explore and interpret the way that individuals with acquired brain injury, admitted to inpatient neurorehabilitation with severe eating difficulties, experienced eating nine to fifteen months after discharge. Methods: Four individuals...... with acquired brain injury were interviewed via qualitative semi-structured interviews. An explorative study was conducted to study eating difficulties. Qualitative content analysis was used. Results: Four main themes emerged from the analysis: personal values related to eating, swallowing difficulties, eating......-of-life. The preliminary findings provide knowledge regarding the patient perspective of adapting to and developing new strategies for activities related to eating, however, further prospective, longitudinal research in a larger scale and with repeated interviews is needed....

  7. Individual difficulties faced by persons with mobility impairments

    CSIR Research Space (South Africa)

    Greeff, M

    2007-07-01

    Full Text Available Disabled persons are experiencing additional difficulties when interacting with systems, applications or devices and also have their own unique requirements that enable them to use a system. If the design of the system does not support...

  8. Reading Comprehension Difficulties among French Students of the ...

    African Journals Online (AJOL)

    Reading Comprehension Difficulties among French Students of the University of Education, Winneba: ... The quality of work done depends so much on the level of understanding of the reading text by students. ... AJOL African Journals Online.

  9. The effectiveness of anger management's training on difficulty of ...

    African Journals Online (AJOL)

    Journal of Fundamental and Applied Sciences ... The purpose of this research is the effect of anger management training on adolescents' emotional regulation. ... Keywords: Anger management, Difficulty in emotion regulation, Adolescent ...

  10. From bureaucratic tot post-bureaucratic: the difficulties of transition

    NARCIS (Netherlands)

    Josserand, E.; Teo, S.; Clegg, S.R.

    2006-01-01

    Purpose - Modern bureaucracies are under reconstruction, bureaucracy being no longer "modern"; they are becoming "post" bureaucratic. Defining the post-bureaucratic organization as a hybrid form provides insight into the intrinsic difficulties involved in the refurbishment of large complex

  11. Orthogonally Evolved AI to Improve Difficulty Adjustment in Video Games

    DEFF Research Database (Denmark)

    Hintze, Arend; Olson, Randal; Lehman, Joel Anthony

    2016-01-01

    Computer games are most engaging when their difficulty is well matched to the player's ability, thereby providing an experience in which the player is neither overwhelmed nor bored. In games where the player interacts with computer-controlled opponents, the difficulty of the game can be adjusted...... not only by changing the distribution of opponents or game resources, but also through modifying the skill of the opponents. Applying evolutionary algorithms to evolve the artificial intelligence that controls opponent agents is one established method for adjusting opponent difficulty. Less-evolved agents...... (i.e. agents subject to fewer generations of evolution) make for easier opponents, while highly-evolved agents are more challenging to overcome. In this publication we test a new approach for difficulty adjustment in games: orthogonally evolved AI, where the player receives support from collaborating...

  12. Parental depressive symptoms and childhood cancer: the importance of financial difficulties.

    Science.gov (United States)

    Creswell, Paul D; Wisk, Lauren E; Litzelman, Kristin; Allchin, Adelyn; Witt, Whitney P

    2014-02-01

    Research suggests a relationship between caring for a child with cancer and psychological distress in caregivers. Less evident is the role which financial difficulties might play in this relationship. We sought to determine if caring for a child with cancer was related to clinically relevant depressive symptoms among parents, whether or not financial difficulties mediated this relationship, and if financial difficulties were independently associated with symptoms of depression among parents of children with cancer. Data are from 215 parents of children diagnosed with cancer or brain tumors (n = 75) and a comparison group of parents of healthy children (n = 140). Multiple logistic regression analyses were used to assess the factors associated with reporting clinically relevant depressive symptoms. Caring for a child with cancer was associated with increased odds of clinically relevant depressive symptoms in parents (OR = 4.93; 95 % CI 1.97-12.30), controlling for covariates. The mediating effect of financial burden on this relationship was not statistically significant. However, among parents of children with cancer, negative financial life events increased the likelihood of reporting symptoms of depression (OR = 4.89; 95 % CI 1.26-18.96). Caring for a child with cancer was associated with depressive symptoms for parents. Financial difficulties were the strongest correlate of these symptoms among parents of children with cancer. Our results suggest that it may not only be the burden of caring for the child with cancer but also the associated financial difficulties that contribute to a higher likelihood of depressive symptoms in parents.

  13. Multiple sclerosis

    International Nuclear Information System (INIS)

    Grunwald, I.Q.; Kuehn, A.L.; Backens, M.; Papanagiotou, P.; Shariat, K.; Kostopoulos, P.

    2008-01-01

    Multiple sclerosis is the most common chronic inflammatory disease of myelin with interspersed lesions in the white matter of the central nervous system. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and monitoring of white matter diseases. This article focuses on key findings in multiple sclerosis as detected by MRI. (orig.) [de

  14. Communication difficulties in children identified with psychiatric problems

    OpenAIRE

    Helland, Wenche Andersen

    2010-01-01

    Several studies have pointed to an overlap between different developmental psychopathological conditions and language impairments, and difficulties with communication have been identified in children of various diagnostic backgrounds. This thesis is based on three empirical studies, and the purposes are to investigate communication difficulties as reported by parents, in children identified with psychiatric problems as well as to evaluate a Norwegian adaptation of the Children’...

  15. Difficulties in emotion regulation in patients with eating disorders

    OpenAIRE

    Ruscitti, Catherine; Rufino, Katrina; Goodwin, Natalie; Wagner, Rebecca

    2016-01-01

    Background A defining characteristic of eating disorders (EDs) is difficulty with emotion regulation (ER). Previous research indicates that ED subtypes demonstrate differing ER difficulties. Specifically, individuals with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) show greater impairment in their ability to regulate emotions in areas such as achieving goals while upset, reacting impulsively to distress, and effectively using coping strategies, as compared to those with Binge Eating Disorde...

  16. DIFFICULTIeS OF TOTAL HIP REPLACEMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS (case report

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2016-01-01

    Full Text Available A distinctive feature of patients with ankylosing spondylitis is the formation of hip ankylosis in an extremely unfavorable functional position combined with upset of sagittal balance of the body along with a thoracolumbar kyphosis. Treatment of these patients poses considerable technical difficulties and is often associated with complications. The authors report a clinical case of a female 40 years old patient with confirmed rhizomelic spondylitis. The patient mainly complained of fixed malposition of the right lower extremity (hip ankylosis in extreme 1450 flexion and 1500 abduction combined with a severe fixed spine deformity (thoracic kyphosis 920, lumbar lordosis 170. Considering significant sagittal balance disorder it was decided to go for a two-stage procedure. Total hip arthroplasty of the right joint was performed at the first stage. At the second stage the authors corrected thoracolumbar spinal deformity by Th12 (type PSO 4 and L2 (type PSO 3 wedge resections and converging resected vertebral bodies by a multilevel fixation system with transpedicular support elements. The interval between the stages was 11 months. Two-stage treatment of this patient al-lowed to avoid adverse postoperative complications and to achieve a significant functional improvement in one year after treatment started. The sum of points before and after the treat-ment amounted respectively to 46 and 79 on Harris Hip Score, 17 and 38 points on Oxford Hip Score (OHS. To summarize, comprehensive treatment with planning of all subsequent steps prior to hip replacement is the method of choice for avoidance of postoperative complications in patients with ankylosing spondylitis accompanied by a significant upset of sagittal balance.

  17. Managing social difficulties: roles and responsibilities of patients and staff.

    Science.gov (United States)

    Wright, Penny; Bingham, Laura; Taylor, Sally; Hanif, Naheed; Podmore, Emma; Velikova, Galina

    2012-01-01

    Implementation of guidance on assessment and management of psychosocial and supportive-care problems or needs will be successful only if consideration is given to existing skills, experience and expectations of staff and patients. This study examines the roles and responsibilities of staff, patients and families in relation to management of social difficulties and proposes a pathway for response. A qualitative study was performed using staff and patient interviews. Seventeen doctors and 16 nurses were interviewed using patient scenarios and a support service questionnaire. Patients (n = 41) completed a screening questionnaire (the Social Difficulties Inventory) and were interviewed. Interviews were audio-recorded, transcribed and subjected to a Framework analysis. Analysis examined (1) actions taken by staff and patients in response to social difficulties, (2) reasons given for action taken and (3) perceptions of staff and patients of who was responsible for taking action. Staff were confident concerning clinically related issues (i.e. mobility) but more hesitant concerning difficulties related to money, work and family concerns. Patients liked to cope with problems on their own where possible, would have liked information or support from staff but were uncertain how to access this. Results led to development of a hierarchy of interventions in response to detected social difficulties. For routine assessment of social difficulties, patients, nurses and doctors will have to work collaboratively, with nurses taking a lead in discussion. For specific clinically related problems doctors would play a more primary role. Copyright © 2010 John Wiley & Sons, Ltd.

  18. Review of student difficulties in upper-level quantum mechanics

    Directory of Open Access Journals (Sweden)

    Chandralekha Singh

    2015-09-01

    Full Text Available [This paper is part of the Focused Collection on Upper Division Physics Courses.] Learning advanced physics, in general, is challenging not only due to the increased mathematical sophistication but also because one must continue to build on all of the prior knowledge acquired at the introductory and intermediate levels. In addition, learning quantum mechanics can be especially challenging because the paradigms of classical mechanics and quantum mechanics are very different. Here, we review research on student reasoning difficulties in learning upper-level quantum mechanics and research on students’ problem-solving and metacognitive skills in these courses. Some of these studies were multiuniversity investigations. The investigations suggest that there is large diversity in student performance in upper-level quantum mechanics regardless of the university, textbook, or instructor, and many students in these courses have not acquired a functional understanding of the fundamental concepts. The nature of reasoning difficulties in learning quantum mechanics is analogous to reasoning difficulties found via research in introductory physics courses. The reasoning difficulties were often due to overgeneralizations of concepts learned in one context to another context where they are not directly applicable. Reasoning difficulties in distinguishing between closely related concepts and in making sense of the formalism of quantum mechanics were common. We conclude with a brief summary of the research-based approaches that take advantage of research on student difficulties in order to improve teaching and learning of quantum mechanics.

  19. Maternal worries, home safety behaviors, and perceived difficulties.

    Science.gov (United States)

    Hendrickson, Sherry Garrett

    2008-01-01

    The aim of the study was to explore the worries, safety behaviors, and perceived difficulties in keeping children safe at home in a purposive sample of low-income, predominantly non-English speaking mothers as a foundation for later nursing interventions. This study was a qualitative, descriptive design with content analysis to identify maternal concerns, behaviors, and perceptions of home safety as part of a larger study. Eighty-two mothers, 64% of whom were monolingual Spanish-speakers, responded in writing to three semistructured interview questions. When mothers were unable to read and write the researcher wrote the responses, then read the content aloud for verification. A standardized probe for each question was posed to obtain richer responses. Data management included use of the software program NUD*IST and coding analyses following the Miles and Huberman guidelines (1994). Interpretations were translated into English for this report. The major worries were falling, health, kidnapping, and being hit by a car. The leading maternal behaviors were coded as being physically, verbally, and environmentally preventive. Mothers said that it was their role to provide safety, and that this role could be wearisome, such that constant supervision was difficult. Low-income mothers described their worries for their 1 to 4 year-old children, explored their behaviors for preventing injury, and discussed what made keeping children from harm difficult. Understanding how mothers keep children safe, the barriers to home safety, and effective safety behaviors are important to the health of children. The clinical relevance of this study includes building trust as clinicians plan assessment, intervention and evaluation of home safety to encourage dialog about concerns, safety behaviors, and barriers to keeping children from injury.

  20. Cumulative effects in Swedish EIA practice - difficulties and obstacles

    International Nuclear Information System (INIS)

    Waernbaeck, Antoienette; Hilding-Rydevik, Tuija

    2009-01-01

    The importance of considering cumulative effects (CE) in the context of environmental assessment is manifested in the EU regulations. The demands on the contents of Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) documents explicitly ask for CE to be described. In Swedish environmental assessment documents CE are rarely described or included. The aim of this paper is to look into the reasons behind this fact in the Swedish context. The paper describes and analyse how actors implementing the EIA and SEA legislation in Sweden perceive the current situation in relation to the legislative demands and the inclusion of cumulative effects. Through semi-structured interviews the following questions have been explored: Is the phenomenon of CE discussed and included in the EIA/SEA process? What do the actors include in and what is their knowledge of the term and concept of CE? Which difficulties and obstacles do these actors experience and what possibilities for inclusion of CE do they see in the EIA/SEA process? A large number of obstacles and hindrances emerged from the interviews conducted. It can be concluded from the analysis that the will to act does seem to exist. A lack of knowledge in respect of how to include cumulative effects and a lack of clear regulations concerning how this should be done seem to be perceived as the main obstacles. The knowledge of the term and the phenomenon is furthermore quite narrow and not all encompassing. They experience that there is a lack of procedures in place. They also seem to lack knowledge of methods in relation to how to actually work, in practice, with CE and how to include CE in the EIA/SEA process. It can be stated that the existence of this poor picture in relation to practice concerning CE in the context of impact assessment mirrors the existing and so far rather vague demands in respect of the inclusion and assessment of CE in Swedish EIA and SEA legislation, regulations, guidelines and

  1. Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications scale.

    Science.gov (United States)

    Tulsky, David S; Kisala, Pamela A; Tate, Denise G; Spungen, Ann M; Kirshblum, Steven C

    2015-05-01

    To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Bladder Management Difficulties and Bowel Management Difficulties item banks and Bladder Complications scale. Using a mixed-methods design, a pool of items assessing bladder and bowel-related concerns were developed using focus groups with individuals with spinal cord injury (SCI) and SCI clinicians, cognitive interviews, and item response theory (IRT) analytic approaches, including tests of model fit and differential item functioning. Thirty-eight bladder items and 52 bowel items were tested at the University of Michigan, Kessler Foundation Research Center, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters VA Medical Center, Bronx, NY. Seven hundred fifty-seven adults with traumatic SCI. The final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI=0.965; RMSEA=0.093; Bowel Management Difficulties CFI=0.955; RMSEA=0.078) and acceptable fit to a graded response IRT model. The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items. Additionally, 5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI=0.992, RMSEA=0.050) and were thus retained as a separate scale. The SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks are psychometrically robust and are available as computer adaptive tests or short forms. The SCI-QOL Bladder Complications scale is a brief, fixed-length outcomes instrument for individuals with a UTI.

  2. Multiple Sclerosis and Vitamin D

    Science.gov (United States)

    ... Editors David C. Spencer, MD Steven Karceski, MD Multiple sclerosis and vitamin D Andrew J. Solomon, MD WHAT ... caused by improper immune responses (autoimmune diseases), including multiple sclerosis (MS). A recent Patient Page in Neurology provided ...

  3. Reading comprehension difficulties in children with rolandic epilepsy.

    Science.gov (United States)

    Currie, Nicola K; Lew, Adina R; Palmer, Tom M; Basu, Helen; De Goede, Christian; Iyer, Anand; Cain, Kate

    2018-03-01

    Difficulties in reading comprehension can arise from either word reading or listening comprehension difficulties, or a combination of the two. We sought to determine whether children with rolandic epilepsy had poor reading comprehension relative to typically developing comparison children, and whether such difficulties were associated with word reading and/or general language comprehension difficulties. In this cross-sectional study, children with rolandic epilepsy (n=25; 16 males, 9 females; mean age 9y 1mo, SD 1y 7mo) and a comparison group (n=39; 25 males, 14 females; mean age 9y 1mo, SD 1y 3mo) completed assessments of reading comprehension, listening comprehension, word/non-word reading, speech articulation, and Non-verbal IQ. Reading comprehension and word reading were worse in children with rolandic epilepsy (F 1,61 =6.89, p=0.011, ηp2=0.10 and F 1,61 =6.84, p=0.011, ηp2=0.10 respectively), with listening comprehension being marginal (F 1,61 =3.81, p=0.055, ηp2=0.06). Word reading and listening comprehension made large and independent contributions to reading comprehension, explaining 70% of the variance. Children with rolandic epilepsy may be at risk of reading comprehension difficulties. Thorough assessment of individual children is required to ascertain whether the difficulties lie with decoding text, or with general comprehension skills, or both. Children with rolandic epilepsy may be at risk of poor reading comprehension. This was related to poor word reading, poor listening comprehension, or both. Reading comprehension interventions should be tailored to the profile of difficulties. © 2017 Mac Keith Press.

  4. Lung Metastases from Bile Duct Adenocarcinoma Mimicking Chronic Airway Infection and Causing Diagnostic Difficulty.

    Science.gov (United States)

    Sato, Mitsuo; Okachi, Shotaro; Fukihara, Jun; Shimoyama, Yoshie; Wakahara, Keiko; Sakakibara, Toshihiro; Hase, Tetsunari; Onishi, Yasuharu; Ogura, Yasuhiro; Maeda, Osamu; Hasegawa, Yoshinori

    2018-05-15

    We herein report a case of lung metastases with unusual radiological appearances that mimicked those of chronic airway infection, causing diagnostic difficulty. A 60-year-old woman who underwent liver transplantation from a living donor was incidentally diagnosed with bile duct adenocarcinoma after a histopathological analysis of her explanted liver. Six months later, chest computed tomography (CT) revealed bilateral bronchogenic dissemination that had gradually worsened, suggesting chronic airway infection. A biopsy with bronchoscopy from a mass lesion beyond a segmental bronchus revealed adenocarcinoma identical to that of her bile duct adenocarcinoma, leading to the diagnosis of multiple lung metastases from bile duct adenocarcinoma.

  5. Prevalence and predictors of difficulty accessing the mouths of intubated critically ill adults to deliver oral care: An observational study.

    Science.gov (United States)

    Dale, Craig M; Smith, Orla; Burry, Lisa; Rose, Louise

    2018-04-01

    Oral care of intubated patients is essential to the prevention of infection and patient discomfort. However, barriers to oral access and delivery of oral care have received little attention. To determine prevalence and predictors of oral access difficulty. A prospective, observational, multi-center study. Four intensive care units in Toronto, Canada. Adult patients orally intubated for ≥48 h. We screened consecutive admissions once a week to identify eligible participants. We observed each patient and asked the patient's nurse about presence or absence of difficulty accessing the mouth to deliver oral care across three categories: (1) visualizing inside the mouth; (2) obtaining patient cooperation, or (3) inserting instruments for delivery of oral care. We asked nurses to identify presence of patient behaviors contributing to oral access difficulty and perceived level of difficulty on a Likert response scale. We examined patient and treatment characteristics associated with extreme difficulty (i.e., difficulty in all 3 categories) using a generalized estimating equation regression model. A total of 428 patients were observed, 58% admitted with a medical diagnosis. More than half (57%) had ≥2 oral devices up to maximum of 4. Oral care difficulty was identified in 83% of patients and rated as moderate to high for 217 (51%). Difficulty concerned visibility (74%), patient cooperation (55%), and space to insert instruments (53%). Patient behaviors contributing difficulty included coughing/gagging (60%), mouth closing (49%), biting (45%) and localizing (27%) during care. Variables associated with extreme difficulty included neurological (OR 1.92, 95% CI 1.42-2.60) or trauma admission (OR 1.83, 95% CI 1.16-2.89), lack of pain assessment or treatment in the 4 h prior to oral care (OR 1.43, 95% CI 1.14-1.80), more oral devices (OR 1.40, 95% CI 1.05-1.87), and duration of intubation (OR 1.05, 95% CI 1.01-1.10). Absence of documented agitation in the 4 h prior to

  6. The impact of senior medical students' personal difficulties on their communication patterns in breaking bad news.

    Science.gov (United States)

    Meitar, Dafna; Karnieli-Miller, Orit; Eidelman, Shmuel

    2009-11-01

    To evaluate the possible influence of personal difficulties and barriers that are within the news bearer and his or her self-awareness (SA) of them, on the patterns of communication during encounters involving breaking bad news (BBN). Following an intensive BBN course in 2004, 103 senior medical students at the Sackler School of Medicine, Tel Aviv University, were evaluated for BBN competencies by the analysis of their written descriptions of how they visualized their manner of delivering bad news to a patient described in a challenging vignette. The students were further asked to reflect on their own difficulties and barriers that surfaced in response to reading the narrative presented in the vignette and in delivering the bad news. Using an immersion crystallization narrative analysis method, the authors analyzed the relationship between the students' BBN strategies and their self-perceived barriers and difficulties. Four types of communicators were identified and related to 45 different personal and professional barriers that the students, through self-reflection, found in themselves. These perceived barriers as well as the ability to self-reflect on them influenced their patterns of communication in their envisioned and written-down encounters, including the level of emotional connectedness, information provided, and the chosen focus-of-care paradigm (physician-centered, patient-centered, or relationship-centered). These findings empirically demonstrate that intrapersonal difficulties within the communicator and his or her level of SA about them influenced the manner and content of the communication during the encounter. This finding suggests that enhancing SA and addressing personal and professional difficulties could help physicians' capability to cope with challenging communication tasks. The authors propose a working tool (the Preparatory SPIKES) to facilitate the integration of self-reflection (by identifying personal difficulties) into day-by-day planning

  7. Multiple Sclerosis

    Science.gov (United States)

    Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down ...

  8. Multiple myeloma.

    LENUS (Irish Health Repository)

    Collins, Conor D

    2012-02-01

    Advances in the imaging and treatment of multiple myeloma have occurred over the past decade. This article summarises the current status and highlights how an understanding of both is necessary for optimum management.

  9. Multiple mononeuropathy

    Science.gov (United States)

    ... with multiple mononeuropathy are prone to new nerve injuries at pressure points such as the knees and elbows. They should avoid putting pressure on these areas, for example, by not leaning on the elbows, crossing the knees, ...

  10. Hearing loss and speech perception in noise difficulties in Fanconi anemia.

    Science.gov (United States)

    Verheij, Emmy; Oomen, Karin P Q; Smetsers, Stephanie E; van Zanten, Gijsbert A; Speleman, Lucienne

    2017-10-01

    Fanconi anemia is a hereditary chromosomal instability disorder. Hearing loss and ear abnormalities are among the many manifestations reported in this disorder. In addition, Fanconi anemia patients often complain about hearing difficulties in situations with background noise (speech perception in noise difficulties). Our study aimed to describe the prevalence of hearing loss and speech perception in noise difficulties in Dutch Fanconi anemia patients. Retrospective chart review. A retrospective chart review was conducted at a Dutch tertiary care center. All patients with Fanconi anemia at clinical follow-up in our hospital were included. Medical files were reviewed to collect data on hearing loss and speech perception in noise difficulties. In total, 49 Fanconi anemia patients were included. Audiograms were available in 29 patients and showed hearing loss in 16 patients (55%). Conductive hearing loss was present in 24.1%, sensorineural in 20.7%, and mixed in 10.3%. A speech in noise test was performed in 17 patients; speech perception in noise was subnormal in nine patients (52.9%) and abnormal in two patients (11.7%). Hearing loss and speech perception in noise abnormalities are common in Fanconi anemia. Therefore, pure tone audiograms and speech in noise tests should be performed, preferably already at a young age, because hearing aids or assistive listening devices could be very valuable in developing language and communication skills. 4. Laryngoscope, 127:2358-2361, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Who helps the leaders? Difficulties experienced by cancer support group leaders.

    Science.gov (United States)

    Kirsten, Laura; Butow, Phyllis; Price, Melanie; Hobbs, Kim; Sunquist, Kendra

    2006-07-01

    Cancer support groups are an important source of support for cancer patients, yet little is known about the challenges and training needs of both professionally trained and untrained leaders. The aim of this study was to discover the difficulties experienced and training desired by cancer support group leaders. Twenty-seven leaders of 34 cancer support groups participated in focus groups or individual interviews. Groups were purposively selected as representative of 173 support groups identified in New South Wales which were for adults with cancer and/or their adult carers and were not therapeutic or education-only groups. Difficulties identified included dealing with people's different communication styles and needs; dealing with recurrence, metastases and death; practical issues, including resources, setting the programme and funding security; maintaining personal balance and preventing burn out; establishing group credibility; dealing with group cycles; and leading groups in rural areas. Leaders also identified benefits and rewards from group leadership such as contributing to others' well-being, self-development and insight into others' lives. Non-professionally trained leaders experienced more difficulties, particularly in dealing with group process and practical issues. Difficulties identified were related both to working with a cancer population specifically and to working with groups in general. While some issues were common to both health professionals and non-health professionals, non-health professionals reported greater supportive needs. Clear guidelines, targeted training and development of better methods of support to reduce the stress and burn out experienced by group leaders are needed.

  12. Do People With Psychosis Have Specific Difficulties Regulating Emotions?

    Science.gov (United States)

    Lincoln, Tania M; Hartmann, Maike; Köther, Ulf; Moritz, Steffen

    2015-01-01

    Difficulties in emotion regulation (ER) are present in psychotic disorders, but their precise nature is not yet fully understood and it is unclear which difficulties are unique to psychosis compared with other disorders. This study investigated whether ER difficulties in psychosis are more prominent for the ability to modify emotions or for the ability to tolerate and accept them. Furthermore, it investigated whether ER difficulties occur for sadness, anxiety, anger and shame likewise. ER skills were assessed in participants with psychotic disorders (n = 37), participants with depression (n = 30) and healthy controls (n = 28) using the Emotion Regulation Skill Questionnaire that asks participants to rate the intensity of different emotions over the past week and the skills employed to handle each of them. Compared with healthy controls, participants with psychosis showed reduced skills related to awareness, understanding and acceptance of potentially distressing emotions, but not in the ability to modify them. These differences remained significant after controlling for depression. Participants with psychosis showed reduced ER skills in regard to all of the assessed emotions compared with the healthy controls, despite the fact that they only reported sadness as being significantly more intense. The participants with depression showed a similar pattern of ER skills to the psychosis sample, although with a tendency towards even more pronounced difficulties. It is concluded that psychosis is characterized by difficulties in using specific ER skills related to awareness, understanding and acceptance to regulate anger, shame, anxiety and sadness. These difficulties are not unique to psychosis but nevertheless present a promising treatment target. The participants with psychosis found it more difficult to be aware of their emotions, to understand them and to accept them than the healthy control group. However, they reported equal skills when it came to

  13. Hearing difficulties, ear-related diagnoses and sickness absence or disability pension--a systematic literature review.

    Science.gov (United States)

    Friberg, Emilie; Gustafsson, Klas; Alexanderson, Kristina

    2012-09-12

    Hearing difficulties is a large public health problem, prognosticated to be the ninth leading burden of disease in 2030, and may also involve large consequences for work capacity. However, research regarding sickness absence and disability pension in relation to hearing difficulties is scarce. The aim was to gain knowledge about hearing difficulties or other ear-related diagnoses and sickness absence and disability pension through conducting a systematic literature review of published studies. Studies presenting empirical data on hearing difficulties or ear-related diagnoses and sick leave or disability pension, published in scientific peer-reviewed journals, were included. Studies were sought for in three ways: in literature databases (Pub-Med, Embase, PsycInfo, SSCI, and Cochrane) through March 2011, through scrutinising lists of references, and through contacts. Identified publications were assessed for relevance and data was extracted from the studies deemed relevant. A total of 18 studies were assessed as relevant and included in this review, regardless of scientific quality. Fourteen studies presented empirical data on hearing difficulties/ear diagnoses and sick leave and six on these conditions and disability pension. Only two studies presented rate ratios or odds ratios regarding associations between hearing difficulties and sick leave, and only two on hearing difficulties and risk of disability pension. Both measures of hearing difficulties and of sick leave varied considerable between the studies. Remarkably few studies on hearing difficulties in relation to sickness absence or disability pension were identified. The results presented in them cannot provide evidence for direction or magnitude of potential associations.

  14. Hypertensive diabetic patients: guidelines for conduct and their difficulties

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    Weimar K. S. Barroso

    2003-08-01

    Full Text Available OBJECTIVE: To assess the effect of blood pressure (BP control and other cardiovascular risk factors in patients with diabetes mellitus in a referral service for the treatment of hypertension. METHODS: A retrospective study where diabetic patients (at least 2 fasting glucose levels above 126 mg/dL, use of hypoglycemic agents or insulin, or both of these were included. They were evaluated at the first appointment (M1 and at the last appointment (M2, regarding blood pressure, body mass index (BMI, use of hypertensive drugs, glycemia, total cholesterol (TC, creatinine, and potassium. RESULTS: Of 1,032 patients studied, 146 patients with a mean age of 61.6 years had diabetes, and 27 were men (18.5%. Mean follow-up was 5.5 years. BP values were 161.6 x 99.9 mmHg in M1 and 146.3 x 89.5 mmHg in M2. In M1, 10.4% of the patients did not use medications, 50.6% used just 1 drug, 30.8% used 2 drugs, and 8.2% used 3 or more drugs. In M2, these values were 10.9%, 39%, 39.7%, and 10.4%, respectively. Diuretics were the most commonly used medication, whereas angiotensin-converting enzyme inhibitors (ACE inhibitors were those drugs which presented greater increase when comparing M1 to M2 (24.6% and 41.7%, respectively. Only 17,1% reached the recommended goal (BP<130x85 mmhg. The other cardiovascular risk factors did not change significantly. CONCLUSION: Our data reinforce the necessity of a more aggressive approach in the treatment of these patients, despite the social and economic difficulties in adhering to treatment.

  15. Difficulty of carrier generation in orthorhombic PbO

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Min; Takemoto, Seiji; Toda, Yoshitake; Tada, Tomofumi [Materials Research Center for Element Strategy, Tokyo Institute of Technology, Yokohama 226-8503 (Japan); Xiao, Zewen; Kamiya, Toshio; Hosono, Hideo, E-mail: hosono@msl.titech.ac.jp [Materials Research Center for Element Strategy, Tokyo Institute of Technology, Yokohama 226-8503 (Japan); Materials and Structures Laboratory, Tokyo Institute of Technology, Yokohama 226-8503 (Japan); Ueda, Shigenori [Synchrotron X-ray Station at SPring-8, National Institute for Materials Science, Hyogo 679-5148 (Japan); Quantum Beam Unit, National Institute for Materials Science, Tsukuba 305-0047 (Japan)

    2016-04-28

    Polycrystalline β-PbO films were grown by pulsed laser deposition in atmospheres ranging from oxygen-poor (the oxygen pressure of 0.01 Pa) to oxygen-rich (13 Pa) conditions, and the oxygen chemical potential was further enhanced by ozone annealing to examine hole doping. It was found that each of the as-grown β-PbO films showed poor electrical conductivity, σ < 1.4 × 10{sup −7} S cm{sup −1}, regardless of the oxygen pressure. The density functional calculations revealed that native defects including Pb and O vacancies have deep transition levels and extremely high formation enthalpies, which indicates difficulty of carrier generation in β-PbO and explains the experimentally observed poor electrical conductivity. The analysis of the electronic structures showed that the interaction between Pb 6s and O 2p orbitals is weak due to the deep energy level of Pb 6s and does not raise the valence band maximum (VBM) level unlike that observed in SnO, which is also supported by ultraviolet photoemission spectroscopy measurements. The deep acceptor transition levels of the native defects are attributed to the deep VBM of β-PbO. On the other hand, annealing β-PbO films in reactive oxygen-containing atmospheres (i.e., O{sub 3}) led to a significantly enhanced electrical conductivity (i.e., σ > 7.1 × 10{sup 2} S cm{sup −1}) but it is the result of the formation of an n-type PbO{sub 2} phase because oxygen chemical potential exceeded the phase boundary limit. The striking difference in carrier generation between PbO and SnO is discussed based on the electronic structures calculated by density functional theory.

  16. PRE-SCHOOL UPBRINGING OF CHILDREN WITH DEVELOPMENTAL DIFFICULTIES-CONDITION FOR SUCCESSFUL INTEGRATIONAL EDUCATION

    Directory of Open Access Journals (Sweden)

    Zora JACOVA

    1997-12-01

    Full Text Available Preschool upbringing of children with developmental difficulties is the first link in the system of education and upbringing and at the same time the utmost segment in the system of integrational rehabilitation.Initiating the process of preschool upbringing and adequate organized treatment at early age, permits support of the development and maximum usage of the remained capabilities of children with developmental difficulties.The newest world experiences show that the upbringing and educational integration of children with developmental difficulties as asegment of the social integration, should set the main conditions in the frames of upbringing education and rehabilitational continuity and support the minimal restrictive environment for their development.In the pre-school institutions that function on the territory of the Republic of Macedonia, an indifferent attitude towards the children with developmental difficulties is present, due to the uninformed educators for the characteristics and capabilities of these children and their believes for the negative influence of the children with developmental difficulties on the children without impairments, that implicates involvement of subsidery defectological education of present employed staff in the mainstream preschool institutions, also including defectologists in kindergartens for work with children with special difficulties in their development. Also, the data about the educator’s attitude in the mainstream preschool institutions is disturbing, so that they put the accent on the obligation for reducing of the program for work with handicapped children, not taking into consideration that subsidery, special forms and methods are needed beside the programs that are for the main stream group.The goal of our paper is to point out the need of involving of children with light developmental difficulties; the existence of special team in the preschool institutions when involving children with

  17. Minding the gap: Children's difficulty conceptualizing spatial intervals as linear measurement units.

    Science.gov (United States)

    Solomon, Tracy L; Vasilyeva, Marina; Huttenlocher, Janellen; Levine, Susan C

    2015-11-01

    Understanding measurement units is critical to mathematics and science learning, but it is a topic that American students find difficult. In 3 studies, we investigated the challenges underlying this difficulty in kindergarten and second grade by comparing performance on different versions of a linear measurement task. Children measured crayons that were either aligned or shifted relative to the left edge of either a continuous ruler or a row of discrete units. The alignment (aligned, shifted) and the measuring tool (ruler, discrete units) were crossed to form 4 types of problems. Study 1 showed good performance in both grades on both types of aligned problems as well as on the shifted problems with discrete units. In contrast, performance was at chance on the shifted ruler problems. Study 2 showed that performance on shifted discrete unit problems declined when numbers were placed on the units, particularly for kindergarteners, suggesting that on the shifted ruler problems, the presence of numbers may have contributed to children's difficulty. However, Study 3 showed that the difficulty on the shifted ruler problems persisted even when the numbers were removed from the ruler. Taken together, these findings suggest that there are multiple challenges to understanding measurement, but that a key challenge is conceptualizing the ruler as a set of countable spatial interval units. (c) 2015 APA, all rights reserved).

  18. The assessment of math learning difficulties in a primary grade-4 child with high support needs: Mixed methods approach

    Directory of Open Access Journals (Sweden)

    Lawrence Mundia

    2012-03-01

    Full Text Available This mixed-methods study incorporated elements of survey, case study and action research approaches in investigating an at-risk child. Using an in-take interview, a diagnostic test, an error analysis, and a think-aloud clinical interview, the study identified the child’s major presenting difficulties. These included: inability to use the four arithmetic operations (addition, subtraction, multiplication, division efficiently; not understanding the relationship between units, tens and hundreds; using any two of the four arithmetic processes (+, - , x, ÷ in combination within one operation; treating each column as a separate problem; place value problems / wrong alignment of numbers; poor eye-hand coordination leading to dysgraphia; and memory lapses. The other problems that became apparent through this investigation and implied in the findings include possible causal factors such as dyscalculia, dyslexia, low self-esteem, low self-efficacy, and math anxiety. Further assessment, intervention and research are recommended to address problems of this vulnerable child.

  19. The Assessment of Math Learning Difficulties in a Primary Grade-4 Child with High Support Needs: Mixed Methods Approach

    Directory of Open Access Journals (Sweden)

    Lawrence Mundia

    2012-03-01

    Full Text Available This mixed-methods study incorporated elements of survey, case study and action research approaches in investigating an at-risk child. Using an in-take interview, a diagnostic test, an error analysis, and a think-aloud clinical interview, the study identified the child’s major presenting difficulties. These included: inability to use the four arithmetic operations (addition, subtraction, multiplication, division efficiently; not understanding the relationship between units, tens and hundreds; using any two of the four arithmetic processes (+, - , x, ÷ in combination within one operation; treating each column as a separate problem; place value problems / wrong alignment of numbers; poor eye-hand coordination leading to dysgraphia; and memory lapses. The other problems that became apparent through this investigation and implied in the findings include possible causal factors such as dyscalculia, dyslexia, low self-esteem, low self-efficacy, and math anxiety. Further assessment, intervention and research are recommended to address problems of this vulnerable child.

  20. Difficulties concerning Diabetes Mellitus Type 1 in children and adolescents

    Directory of Open Access Journals (Sweden)

    Tatiana Rebouças Moreira

    2016-01-01

    Full Text Available Objective: to evaluate the knowledge on diabetes in children and adolescents and the difficulties regarding the disease. Methods: a quantitative study with 40 patients from 6 to 17 years older who were subjected on a questionnaire based on self-care behaviors proposed by the American Association of Diabetes Educators. Results: the average age was 11.6 years with predominance of the female gender (57.5%, most attending grade school (80.0%, naming the parents as primary caregivers (72.5%. Regarding the knowledge about the disease, the item with the highest percentage of errors was about the pathophysiology of Diabetes Mellitus type 1. On the difficulties related to the treatment, food control and application of insulin had higher frequency. Conclusion:the study revealed a high percentage of correct answers among the participants, suggesting knowledge about the disease. Nevertheless, they reported food control and insulin therapy as the main difficulties related to treatment.

  1. DIFFICULTIES IN TEACHING AND LEARNING GRAMMAR IN AN EFL CONTEXT

    Directory of Open Access Journals (Sweden)

    Abdu Mohammed Al-Mekhlafi

    2011-07-01

    Full Text Available The role of grammar instruction in an ESL/EFL context has been for decades a major issue for students and teachers alike. Researchers have debated whether grammar should be taught in the classroom and students, for their part, have generally looked upon grammar instruction as a necessary evil at best, and an avoidable burden at worst. The paper reports a study undertaken to investigate the difficulties teachers face in teaching grammar to EFL students as well as those faced by students in learning it, in the teachers' perception. The study aimed to find out whether there are significant differences in teachers' perceptions of difficulties in relation to their gender, qualification, teaching experience, and the level they teach in school, thus providing insights into their own and their students' difficulties. Mean scores and t-test were used to interpret the data. The main findings are reported with implications.

  2. Divided attention: an undesirable difficulty in memory retention.

    Science.gov (United States)

    Gaspelin, Nicholas; Ruthruff, Eric; Pashler, Harold

    2013-10-01

    How can we improve memory retention? A large body of research has suggested that difficulty encountered during learning, such as when practice sessions are distributed rather than massed, can enhance later memory performance (see R. A. Bjork & E. L. Bjork, 1992). Here, we investigated whether divided attention during retrieval practice can also constitute a desirable difficulty. Following two initial study phases and one test phase with Swahili-English word pairs (e.g., vuvi-snake), we manipulated whether items were tested again under full or divided attention. Two days later, participants were brought back for a final cued-recall test (e.g., vuvi-?). Across three experiments (combined N = 122), we found no evidence that dividing attention while practicing retrieval enhances memory retention. This finding raises the question of why many types of difficulty during practice do improve long-term retention, but dividing attention does not.

  3. A case-control study of the difficulties in daily functioning experienced by children with depressive disorder.

    Science.gov (United States)

    Usami, Masahide; Iwadare, Yoshitaka; Watanabe, Kyota; Ushijima, Hirokage; Kodaira, Masaki; Okada, Takashi; Sasayama, Daimei; Sugiyama, Nobuhiro; Saito, Kazuhiko

    2015-07-01

    The parent-assessed children-with-difficulties questionnaire (Questionnaire-Children with Difficulties; QCD) is designed to evaluate a child׳s difficulties in functioning during specific periods of the day. This study aimed to use the QCD to evaluate the difficulties in daily functioning experienced by children with depressive disorders. A case-control design was used. The cases comprised 90 junior high school students with depressive disorder, whereas a community sample of 363 junior high school students was enrolled as controls. Behaviors were assessed using the QCD, Depression Self-Rating Scale (DSRS), Tokyo Autistic Behavior Scale (TABS), attention deficit hyperactivity disorder-rating scale (ADHD-RS), and Oppositional Defiant Behavior Inventory (ODBI). We then analyzed the effects of sex and diagnosis on the QCD scores as well as the correlation coefficients between the QCD and the other questionnaires. We included 90 cases (33 boys, 57 girls) with depressive disorders and 363 controls (180 boys, 183 girls). The QCD scores for the children with depressive disorders were significantly lower compared with those from the community sample (Pdepressive disorders and truancy problems than for those with depressive disorders alone (Pdepressive disorders experienced greater difficulties in completing basic daily activities compared with community controls. These difficulties were dependent on sex, symptoms, and the time of day. The use of QCD to assess children with depressive disorders enables clinicians to clarify the time periods at which the children face difficulties. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Young people at risk of psychosis: a user-led exploration of interpersonal relationships and communication of psychological difficulties.

    Science.gov (United States)

    Byrne, Rory; Morrison, Anthony P

    2010-05-01

    The aim of the present study was to qualitatively explore experiences and perceptions of interpersonal relationships and interpersonal communication among young people at risk of psychosis. Semi-structured interviews were conducted using a qualitative grounded theory approach. Participants had entered into a service providing psychological interventions for young people assessed to be at a high risk of developing psychosis (Northwest UK). Our sample comprised one female and seven male participants (n = 8), ranging in age from 16 to 28 years, with a mean age of 22.4 years. Analyses identified three central themes: difficulty with interpersonal relationships and reduced opportunities for helpful communication, difficulty talking to others about psychological problems, and experiences of talking to others about psychological problems. Individuals at risk of psychosis may have experienced significant difficulties with interpersonal relationships. Such difficulties may contribute directly to the development of unusual psychological experiences, and to an inability or reluctance to communicate these to others. In addition, commonly held stigmatizing ideas associated with unusual psychological experiences may contribute to a fear among at-risk individuals that they are 'going mad', and this may lead to concealment of their difficulties, and to delayed help-seeking. For at-risk individuals, helpful communication of psychological distress offers significant benefits, including improved psychological and emotional well-being and reduced risk of psychosis. Thus, while concealment of distress may directly impact on the development of unusual psychological difficulties, communication of such difficulties may be central to recovery.

  5. [Multiple meningiomas].

    Science.gov (United States)

    Terrier, L-M; François, P

    2016-06-01

    Multiple meningiomas (MMs) or meningiomatosis are defined by the presence of at least 2 lesions that appear simultaneously or not, at different intracranial locations, without the association of neurofibromatosis. They present 1-9 % of meningiomas with a female predominance. The occurrence of multiple meningiomas is not clear. There are 2 main hypotheses for their development, one that supports the independent evolution of these tumors and the other, completely opposite, that suggests the propagation of tumor cells of a unique clone transformation, through cerebrospinal fluid. NF2 gene mutation is an important intrinsic risk factor in the etiology of multiple meningiomas and some exogenous risk factors have been suspected but only ionizing radiation exposure has been proven. These tumors can grow anywhere in the skull but they are more frequently observed in supratentorial locations. Their histologic types are similar to unique meningiomas of psammomatous, fibroblastic, meningothelial or transitional type and in most cases are benign tumors. The prognosis of these tumors is eventually good and does not differ from the unique tumors except for the cases of radiation-induced multiple meningiomas, in the context of NF2 or when diagnosed in children where the outcome is less favorable. Each meningioma lesion should be dealt with individually and their multiple character should not justify their resection at all costs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Childhood maltreatment severity and alcohol use in adult psychiatric inpatients: The mediating role of emotion regulation difficulties.

    Science.gov (United States)

    Dutcher, Christina D; Vujanovic, Anka A; Paulus, Daniel J; Bartlett, Brooke A

    2017-09-01

    Emotion regulation difficulties are a potentially key mechanism underlying the association between childhood maltreatment and alcohol use in adulthood. The current study examined the mediating role of emotion regulation difficulties in the association between childhood maltreatment severity (i.e., Childhood Trauma Questionnaire total score) and past-month alcohol use severity, including alcohol consumption frequency and alcohol-related problems (i.e., number of days of alcohol problems, ratings of "bother" caused by alcohol problems, ratings of treatment importance for alcohol problems). Participants included 111 acute-care psychiatric inpatients (45.0% female; Mage=33.5, SD=10.6), who reported at least one DSM-5 posttraumatic stress disorder Criterion A traumatic event, indexed via the Life Events Checklist for DSM-5. Participants completed questionnaires regarding childhood maltreatment, emotion regulation difficulties, and alcohol use. A significant indirect effect of childhood maltreatment severity via emotion regulation difficulties in relation to alcohol use severity (β=0.07, SE=0.04, 99% CI [0.01, 0.21]) was documented. Specifically, significant indirect effects were found for childhood maltreatment severity via emotion regulation difficulties in relation to alcohol problems (β's between 0.05 and 0.12; all 99% bootstrapped CIs with 10,000 resamples did not include 0) but not alcohol consumption. Emotion regulation difficulties may play a significant role in the association between childhood maltreatment severity and alcohol outcomes. Clinical implications are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Analysis of potential dynamic concealed factors in the difficulty of lower third molar extraction.

    Science.gov (United States)

    Singh, P; Ajmera, D-H; Xiao, S-S; Yang, X-Z; Liu, X; Peng, B

    2016-11-01

    The purpose of this study was to identify potential concealed variables associated with the difficulty of lower third molar (M3) extractions. To address the research purpose, we implemented a prospective study and enrolled a sample of subjects presenting for M3 removal. Predictor variables were categorized into Group-I and Group-II, based on predetermined criteria. The primary outcome variable was the difficulty of extraction, measured as extraction time. Appropriate univariate and multivariate statistics were computed using ordinal logistic regression. The sample comprised of 1235 subjects with a mean age of 29.49 +/- 8.92 years in Group-I and 26.20 +/- 11.55 years in Group-II subjects. The mean operating time per M3 extraction was 21.24 +/- 12.80 and 20.24 +/- 12.50 minutes for Group-I and Group-II subjects respectively. Three linear parameters including B-M2 height (distance between imaginary point B on the inferior border of mandibular body, and M2), lingual cortical thickness, bone density and one angular parameter including Rc-Cs angle (angle between ramus curvature and curve of spee), in addition to patient's age, profile type, facial type, cant of occlusal plane, and decreased overbite, were found to be statistically associated ( p < or = 0.05) with extraction difficulty under regression models. In conclusion, our study indicates that the difficulty of lower M3 extractions is possibly governed by morphological and biomechanical factors with substantial influence of myofunctional factors. Preoperative evaluation of dynamic concealed factors may not only help in envisaging the difficulty and planning of surgical approach but might also help in better time management in clinical practice.

  8. Subjective Word-Finding Difficulty Reduces Engagement in Social Leisure Activities in Alzheimer’s Disease

    Science.gov (United States)

    Farrell, Meagan T.; Zahodne, Laura B.; Stern, Yaakov; Dorrejo, Jhedy; Yeung, Philip; Cosentino, Stephanie

    2014-01-01

    Objectives To assess the influence of subjective word-finding difficulty on Alzheimer’s disease (AD) patients’ likelihood of engaging in social leisure activities. Design Analysis of data collected from the second cohort of the Multicenter Study of Predictors of Disease Course in Alzheimer’s disease. Setting Four study sites in the U.S. and France. Participants Individuals diagnosed with mild to moderate AD (N = 236) Measurements On separate questionnaires, patients were asked to 1) report whether had trouble finding the right word when speaking (subjective word-finding difficulty), and 2) rate their frequency and enjoyment of both social and nonsocial leisure activities. Objective language measures included object naming and verbal fluency. Measures of dependence, depression, cognitive status, age, sex, and education were also included as covariates in regression analyses. Results Over half (52%) of the sample reported word-finding difficulty, and subjective complaints were correlated with poorer verbal fluency scores. Subjective word-finding difficulty was uniquely related to social activity measures. Endorsers of word-finding difficulty reported reduced frequency and enjoyment of social leisure activities, controlling for covariates. In contrast, engagement in nonsocial activities was associated with higher age and depression scores, but was not related to word-finding complaints. These results were corroborated by the caregivers’ reports, and occurred above and beyond the effect of objective word-finding ability. Conclusion AD patients who are aware of increasing word-finding failures are less likely to participate in and enjoy socially-oriented leisure activities. This finding may have significant implications for clinical and health outcomes in AD. A failure to evaluate subjective language complaints could result in social withdrawal symptoms, thereby threatening the patient’s quality of life as well as increasing caregiver burden. Importantly

  9. Older Adults' Experiences of Sexual Difficulties: Qualitative Findings From the English Longitudinal Study on Ageing (ELSA).

    Science.gov (United States)

    Hinchliff, Sharron; Tetley, Josie; Lee, David; Nazroo, James

    2018-02-01

    There is a growing body of evidence demonstrating that sexual activity is important to the quality of life of older adults, and that it can be influenced by physical, psychological, and social factors. However, older adults' experiences of sexual difficulties remain relatively unexplored. This article draws on qualitative data collected as part of the English Longitudinal Study of Ageing (ELSA). Participants answered a Sexual Relationships and Activities Questionnaire (SRA-Q), which included an open comment box for further details, 1,084 (1/7) of which were completed. These data were analyzed using Template Analysis, and findings on the experiences of sexual difficulties are presented in this article. Sexual difficulties were contextualized within the couple relationship and could be detrimental to the relationship, particularly if the partner would not seek professional help. Participants reported that sexual difficulties could also have a negative impact on psychological well-being, described mainly as frustration, depression, and sadness. For some participants the supportive nature of their relationship buffered these impacts. Few had sought professional help; those who had reported helpful and unhelpful experiences. These findings add to the limited evidence base and have implications for health care in the context of global aging and a growing recognition of older adults' sexual rights.

  10. Meta-analysis of fluid intelligence tests of children from the Chinese mainland with learning difficulties.

    Science.gov (United States)

    Tong, Fang; Fu, Tong

    2013-01-01

    To evaluate the differences in fluid intelligence tests between normal children and children with learning difficulties in China. PubMed, MD Consult, and other Chinese Journal Database were searched from their establishment to November 2012. After finding comparative studies of Raven measurements of normal children and children with learning difficulties, full Intelligent Quotation (FIQ) values and the original values of the sub-measurement were extracted. The corresponding effect model was selected based on the results of heterogeneity and parallel sub-group analysis was performed. Twelve documents were included in the meta-analysis, and the studies were all performed in mainland of China. Among these, two studies were performed at child health clinics, the other ten sites were schools and control children were schoolmates or classmates. FIQ was evaluated using a random effects model. WMD was -13.18 (95% CI: -16.50- -9.85). Children with learning difficulties showed significantly lower FIQ scores than controls (Pintelligence of children with learning difficulties was lower than that of normal children. Delayed development in sub-items of C, D, and E was more obvious.

  11. History of the treatment of persons with psychological difficulties and the abuse of their civil rights

    Directory of Open Access Journals (Sweden)

    Petrović Nikola M.

    2013-01-01

    Full Text Available Treatment of persons with psychological difficulties varied in different historical periods, but in its essence remained similar until today. It included an inhumane relationship towards these persons, involuntary treatment through torture, and isolation from society as a kind of punishment for their diversity. It was not until the late 19th century that the relationship of society towards these individuals started to improve gradually, but in the 21st century isolation of these individuals still remained the dominant form of acceptable social solution for the “problem”, with a somewhat more humane attitude towards them and less cruel treatment. Serbia has followed the trends of treatment of the persons with psychological difficulties from the rest of Europe for centuries, but is still lagging behind the world in the introduction of new methods of treatment. Indeed the first legal solution to regulate the human rights of these people is currently in the process of implementation. The subject of this paper is the treatment of persons with psychological difficulties and the violation of their civil rights. In a subject specific context the goal of the analysis was the historical review of the treatment towards persons with psychological difficulties by doctors, other practicioners and the community in general, with reference to the current situation regarding their treatment within the psychiatric institutions, as well as the legal regulations and the protection of their civil rights.

  12. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, Egon; Stenager, E N; Knudsen, Lone

    1994-01-01

    In a cross-sectional study of 117 randomly selected patients (52 men, 65 women) with definite multiple sclerosis, it was found that 76 percent were married or cohabitant, 8 percent divorced. Social contacts remained unchanged for 70 percent, but outgoing social contacts were reduced for 45 percent......, need for structural changes in home and need for pension became greater with increasing physical handicap. No significant differences between gender were found. It is concluded that patients and relatives are under increased social strain, when multiple sclerosis progresses to a moderate handicap...

  13. Prospective Evaluation of Magnetic Resonance Imaging and [18F]Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography at Diagnosis and Before Maintenance Therapy in Symptomatic Patients With Multiple Myeloma Included in the IFM/DFCI 2009 Trial: Results of the IMAJEM Study.

    Science.gov (United States)

    Moreau, Philippe; Attal, Michel; Caillot, Denis; Macro, Margaret; Karlin, Lionel; Garderet, Laurent; Facon, Thierry; Benboubker, Lotfi; Escoffre-Barbe, Martine; Stoppa, Anne-Marie; Laribi, Kamel; Hulin, Cyrille; Perrot, Aurore; Marit, Gerald; Eveillard, Jean-Richard; Caillon, Florence; Bodet-Milin, Caroline; Pegourie, Brigitte; Dorvaux, Veronique; Chaleteix, Carine; Anderson, Kenneth; Richardson, Paul; Munshi, Nikhil C; Avet-Loiseau, Herve; Gaultier, Aurelie; Nguyen, Jean-Michel; Dupas, Benoit; Frampas, Eric; Kraeber-Bodere, Françoise

    2017-09-01

    Purpose Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) are important imaging techniques in multiple myeloma (MM). We conducted a prospective trial in patients with MM aimed at comparing MRI and PET-CT with respect to the detection of bone lesions at diagnosis and the prognostic value of the techniques. Patients and Methods One hundred thirty-four patients received a combination of lenalidomide, bortezomib, and dexamethasone (RVD) with or without autologous stem-cell transplantation, followed by lenalidomide maintenance. PET-CT and MRI were performed at diagnosis, after three cycles of RVD, and before maintenance therapy. The primary end point was the detection of bone lesions at diagnosis by MRI versus PET-CT. Secondary end points included the prognostic impact of MRI and PET-CT regarding progression-free (PFS) and overall survival (OS). Results At diagnosis, MRI results were positive in 127 of 134 patients (95%), and PET-CT results were positive in 122 of 134 patients (91%; P = .33). Normalization of MRI after three cycles of RVD and before maintenance was not predictive of PFS or OS. PET-CT became normal after three cycles of RVD in 32% of the patients with a positive evaluation at baseline, and PFS was improved in this group (30-month PFS, 78.7% v 56.8%, respectively). PET-CT normalization before maintenance was described in 62% of the patients who were positive at baseline. This was associated with better PFS and OS. Extramedullary disease at diagnosis was an independent prognostic factor for PFS and OS, whereas PET-CT normalization before maintenance was an independent prognostic factor for PFS. Conclusion There is no difference in the detection of bone lesions at diagnosis when comparing PET-CT and MRI. PET-CT is a powerful tool to evaluate the prognosis of de novo myeloma.

  14. Managing treatment fatigue in patients with multiple sclerosis on long-term therapy: the role of multiple sclerosis nurses

    Directory of Open Access Journals (Sweden)

    Crawford A

    2014-08-01

    Full Text Available Ann Crawford, Sally Jewell,* Holly Mara, Laura McCatty, Regina Pelfrey The Lash Group; Frisco, TX, USA *Sally Jewell is now retired Abstract: This article discusses the many ways that nurses can address the factors that lead to treatment fatigue in patients with multiple sclerosis (MS on long-term disease-modifying therapy, ultimately helping to preserve the patient’s health and quality of life. Patients with MS on long-term therapy may suffer from treatment fatigue and poor adherence due to a variety of different factors, including difficulties with injections, anxiety/depression, financial problems, and inaccurate beliefs about the MS disease process. Because MS nurses have regular interactions with patients, they are ideally situated to help patients cope with these and other factors that may limit adherence. Keywords: multiple sclerosis, disease-modifying therapy, injection, nurse

  15. Determining which introductory physics topics pre-service physics teachers have difficulty understanding and what accounts for these difficulties

    International Nuclear Information System (INIS)

    Şahin, Esin; Yağbasan, Rahmi

    2012-01-01

    This study aims at diagnosing which subjects pre-service physics teachers have difficulty understanding in introductory physics courses and what accounts for these difficulties. A questionnaire consisting of two qualitative questions was used to collect data for this study. The questionnaire was administered to 101 pre-service physics teachers who have completed the courses Physics 1 (Mechanics 1), Physics 2 (Mechanics 2), Physics 3 (Electricity) and Physics 4 (Magnetism). Of the pre-service physics teachers 28 were second year, 26 were third year, 27 were fourth year and 20 were fifth year students. The results of the data analysis indicated that the percentage of students who think that Magnetism has the most difficult subjects is the highest compared to the others. The reasons why the pre-service physics teachers experience difficulty in understanding the subjects have been grouped into four categories. (paper)

  16. Fission neutron multiplicity calculations

    International Nuclear Information System (INIS)

    Maerten, H.; Ruben, A.; Seeliger, D.

    1991-01-01

    A model for calculating neutron multiplicities in nuclear fission is presented. It is based on the solution of the energy partition problem as function of mass asymmetry within a phenomenological approach including temperature-dependent microscopic energies. Nuclear structure effects on fragment de-excitation, which influence neutron multiplicities, are discussed. Temperature effects on microscopic energy play an important role in induced fission reactions. Calculated results are presented for various fission reactions induced by neutrons. Data cover the incident energy range 0-20 MeV, i.e. multiple chance fission is considered. (author). 28 refs, 13 figs

  17. A multiplicity jump trigger using silicon planes

    International Nuclear Information System (INIS)

    Alexopoulos, T.; Erwin, A.R.

    1993-01-01

    Since silicon tracking planes are already present in a B decay experiment, it is an attractive idea to use these as part of a multiplicity jump detector. Two average B decays would produce a multiplicity jump of around 10 in the final state. Such a trigger has been tried for a fixed target Charm experiment with disappointing success. The failure was attributed to the difficulty in adequately controlling the gains of a large number of microstrip amplifies

  18. Multiple myeloma

    International Nuclear Information System (INIS)

    Sohn, Jeong Ick; Ha, Choon Ho; Choi, Karp Shik

    1994-01-01

    Multiple myeloma is a malignant plasma cell tumor that is thought to originate proliferation of a single clone of abnormal plasma cell resulting production of a whole monoclonal paraprotein. The authors experienced a case of multiple myeloma with severe mandibular osteolytic lesions in 46-year-old female. As a result of careful analysis of clinical, radiological, histopathological features, and laboratory findings, we diagnosed it as multiple myeloma, and the following results were obtained. 1. Main clinical symptoms were intermittent dull pain on the mandibular body area, abnormal sensation of lip and pain due to the fracture on the right clavicle. 2. Laboratory findings revealed M-spike, reversed serum albumin-globulin ratio, markedly elevated ESR and hypercalcemia. 3. Radiographically, multiple osteolytic punched-out radiolucencies were evident on the skull, zygoma, jaw bones, ribs, clavicle and upper extremities. Enlarged liver and increased uptakes on the lesional sites in RN scan were also observed. 4. Histopathologically, markedly hypercellular marrow with sheets of plasmoblasts and megakaryocytes were also observed.

  19. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Jensen, K

    1988-01-01

    Forty-two (12%) of a total of 366 patients with multiple sclerosis (MS) had psychiatric admissions. Of these, 34 (81%) had their first psychiatric admission in conjunction with or after the onset of MS. Classification by psychiatric diagnosis showed that there was a significant positive correlation...

  20. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Knudsen, L; Jensen, K

    1991-01-01

    In a cross-sectional investigation of 116 patients with multiple sclerosis, the social and sparetime activities of the patient were assessed by both patient and his/her family. The assessments were correlated to physical disability which showed that particularly those who were moderately disabled...

  1. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Jensen, K

    1990-01-01

    An investigation on the correlation between ability to read TV subtitles and the duration of visual evoked potential (VEP) latency in 14 patients with definite multiple sclerosis (MS), indicated that VEP latency in patients unable to read the TV subtitles was significantly delayed in comparison...

  2. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Knudsen, L; Jensen, K

    1994-01-01

    In a cross-sectional study of 94 patients (42 males, 52 females) with definite multiple sclerosis (MS) in the age range 25-55 years, the correlation of neuropsychological tests with the ability to read TV-subtitles and with the use of sedatives is examined. A logistic regression analysis reveals...

  3. Parenting Multiples

    Science.gov (United States)

    ... when your babies do. Though it can be hard to let go of the thousand other things you need to do, remember that your well-being is key to your ability to take care of your babies. What Problems Can Happen? It may be hard to tell multiple babies apart when they first ...

  4. Needs, Difficulties and Coping Mechanisms of Women as Professionals and as Managers of Households

    Directory of Open Access Journals (Sweden)

    Perlita C. Custodio

    2017-05-01

    Full Text Available The study examined the needs, difficulties and coping mechanisms of women professionals. A researcher-made questionnaire was utilized and administered to women professionals in selected private schools in the Philippines. Five hundred thirty-four usable questionnaires were retrieved and analyzed using frequency, percentage, mean, simple ranking and analysis of variance (ANOVA. Findings indicate that respondents consider spiritual and aesthetic needs, intellectual or cognitive needs and social needs to be their primary concerns. Difficulties that they encounter as they juggle the demands of career and home responsibilities included managing relationships, time and personal rest and recreation. Coping mechanisms most often employed by women to mitigate the impact of pressures of maintaining work-life balance included praying, eating and watching movies which are adaptive, emotion-focused coping behaviours. Recommendations are put forward to help women cope with expectations required of their dual role of career and motherhood.

  5. Delayed Self-Recognition in Autism: A Unique Difficulty?

    Science.gov (United States)

    Dunphy-Lelii, Sarah; Wellman, Henry M.

    2012-01-01

    Achieving a sense of self is a crucial task of ordinary development. With which aspects of self do children with autism have particular difficulty? Two prior studies concluded that children with autism are unimpaired in delayed self-recognition; we confirm and clarify this conclusion by examining it in conjunction with another key aspect of self…

  6. Linear Algebra Revisited: An Attempt to Understand Students' Conceptual Difficulties

    Science.gov (United States)

    Britton, Sandra; Henderson, Jenny

    2009-01-01

    This article looks at some of the conceptual difficulties that students have in a linear algebra course. An overview of previous research in this area is given, and the various theories that have been espoused regarding the reasons that students find linear algebra so difficult are discussed. Student responses to two questions testing the ability…

  7. On the difficulties of acquiring mathematical experience: Case rural education

    DEFF Research Database (Denmark)

    Booss-Bavnbek, Bernhelm

    2014-01-01

    Based on a variety of philosophical approaches and my own work for decades in pure and applied mathematics teaching and research, I explain my view upon the basic difficulties of acquiring the “Mathematical Experience” (in the sense of P.J. Davis and R. Hersh 1981) and submit a list of claims how...

  8. Communication difficulties perceived by parents of children with developmental disorders.

    Science.gov (United States)

    Sun, Ingrid Ya I; Fernandes, Fernanda Dreux Miranda

    2014-01-01

    The child's inclusion in his/her social-cultural context is very important to his/her adaptation and well-being. The family has a major role as a facilitator of this process. Therefore the difficulties of these families in communicating with children with communication disorders are an important issue to be assessed in order to support orientations to families. The present study aimed to identify and compare communication difficulties perceived by parents of children with Down Syndrome (DS), Autism Spectrum Disorders (ASD) and Specific Language Impairment (SLI). Information was gathered with the use of a questionnaire with 24 questions regarding the perception of parents about their child communication disorders and the difficulties they identify. The questions were divided into four domains: 1 - Parents' personal difficulties; 2 - Parents' impression about themselves regarding their child; 3 - Parents' impressions about other persons' reactions to their child and 4 - Parents' impression about their child. Sixty parents were the subjects of this study: 20 had children with DS, 20 with SLI and 20 with ASD. All children had ages between 6 and 12 years. It was possible to observe that there was significant difference between the parents of ASD children with those of DS and SLI on the second, third and fourth domains. The questionnaire is effective to the identification of the communication disorders of ASD children based on their parents' reports but not to other developmental disorders.

  9. Determining Difficulty of Questions in Intelligent Tutoring Systems

    Science.gov (United States)

    Gunel, Korhan; Asliyan, Rifat

    2009-01-01

    The object of this study is to model the level of a question difficulty by a differential equation at a pre-specified domain knowledge, to be used in an educational support system. For this purpose, we have developed an intelligent tutoring system for mathematics education. Intelligent Tutoring Systems are computer systems designed for improvement…

  10. The Strengths and Difficulties Questionnaire in the Nordic countries

    DEFF Research Database (Denmark)

    Obel, Carsten; Heiervang, Einar; Rodriguez, Alina

    2004-01-01

    BACKGROUND: The Strengths and Difficulties Questionnaire (SDQ) has been translated into the different Nordic languages between 1996 and 2003. During the past few years, SDQs have been completed for nearly 100,000 children and adolescents in population-based studies as well as in clinical samples...

  11. Beyond Stigmatization of Children with Difficulties in Learning

    Science.gov (United States)

    Hido, Margarita; Shehu, Irena

    2010-01-01

    In the Albanian schools settings does not exist religious discrimination, neither gender discrimination, but there exists a discrimination, as unfair against children called "difficulty". The children who drop out of school are by far less numerous compared with those who start school, but who are not properly treated, so that they can…

  12. DYSPNEA ASSOCIATED WITH ANXIETY: MISTAKES AND DIFFICULTIES IN THE DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    L. I. Tyukalova

    2013-01-01

    Full Text Available Two clinical cases that demonstrate the difficulties diagnosing the causes of shortness of breath, coupled with anxiety, are analyzed. From the standpoint of modern neurophysiology it explains the relationship of these conditions. There were revealed typical diagnostic mistakes: «the effect of precocious focusing", "the negative effect of the narrow specialization

  13. Eye Movements Reveal How Task Difficulty Moulds Visual Search

    Science.gov (United States)

    Young, Angela H.; Hulleman, Johan

    2013-01-01

    In two experiments we investigated the relationship between eye movements and performance in visual search tasks of varying difficulty. Experiment 1 provided evidence that a single process is used for search among static and moving items. Moreover, we estimated the functional visual field (FVF) from the gaze coordinates and found that its size…

  14. Common difficulties experienced by grade 12 students in learning ...

    African Journals Online (AJOL)

    The objective of this study was to examine the nature and causes of common difficulties experienced by grade twelve students in learning chemistry in Ebinat preparatory school. A qualitative method was employed to investigate the questions, which used interviews and questionnaires with students and teachers. The key ...

  15. Brain Regions Underlying Word Finding Difficulties in Temporal Lobe Epilepsy

    Science.gov (United States)

    Trebuchon-Da Fonseca, Agnes; Guedj, Eric; Alario, F-Xavier; Laguitton, Virginie; Mundler, Olivier; Chauvel, Patrick; Liegeois-Chauvel, Catherine

    2009-01-01

    Word finding difficulties are often reported by epileptic patients with seizures originating from the language dominant cerebral hemisphere, for example, in temporal lobe epilepsy. Evidence regarding the brain regions underlying this deficit comes from studies of peri-operative electro-cortical stimulation, as well as post-surgical performance.…

  16. Are Difficulties Balancing Work and Family Associated with Subsequent Fertility?

    Science.gov (United States)

    Liu, Siwei; Hynes, Kathryn

    2012-01-01

    Despite considerable interest in the causes and consequences of work-family conflict, and the frequent suggestion in fertility research that difficulty in balancing work and family is one of the factors leading to low fertility rates in several developed countries, little research uses longitudinal data to examine whether women who report…

  17. Difficulties on the road to a liberalized energy market

    International Nuclear Information System (INIS)

    Koevoet, H.

    2001-01-01

    Starting January 1, 2002 about 55,000 consumers of electricity and 2,100 consumers of natural gas (small and medium-sized businesses) in the Netherlands can choose their own supplier. Some of the constraints and difficulties with respect to the liberalized energy market in the Netherlands are discussed

  18. Interdisciplinary collaboration and conflict about inclusion and children in difficulties

    DEFF Research Database (Denmark)

    Røn Larsen, Maja

    My paper builds on the “sub-project C” concerned with: Legislation and administration as institutional conditions for interdisciplinary collaboration about children in difficulties in school. I have been doing the research together within, Stine Jørgensen, who is a researcher at the faculty of law...

  19. Addressing the Difficulties of Learners in the Reading Class ...

    African Journals Online (AJOL)

    This study evaluates reading comprehension instruction at senior high schools in Accra. Classroom observation was used to identify the techniques used by teachers in the reading class and questionnaire was used to collect information from learners about the difficulties they have in understanding text. It reports that the ...

  20. Financial difficulties lead OPEC countries on the prices correction way

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    The financial difficulties of OPEC countries are going to lead them to correct the petroleum prices. In front of a decreasing since 1992, it is necessary to make them grow of about $1 the barrel. It is the principal conclusion of Bali meeting for next months even perhaps for next years

  1. Sleep Difficulties and Academic Performance in Norwegian Higher Education Students

    Science.gov (United States)

    Hayley, Amie C.; Sivertsen, Børge; Hysing, Mari; Vedaa, Øystein; Øverland, Simon

    2017-01-01

    Background: Sleep difficulties are common among university students and may detrimentally affect academic outcomes. Despite this, remarkably little information is currently available during this critical developmental period of early adulthood, and thus, the direct effect on measurable domains of academic ability and proficiency is equivocal.…

  2. Tracking Change in Children with Severe and Persisting Speech Difficulties

    Science.gov (United States)

    Newbold, Elisabeth Joy; Stackhouse, Joy; Wells, Bill

    2013-01-01

    Standardised tests of whole-word accuracy are popular in the speech pathology and developmental psychology literature as measures of children's speech performance. However, they may not be sensitive enough to measure changes in speech output in children with severe and persisting speech difficulties (SPSD). To identify the best ways of doing this,…

  3. Handwriting difficulties in juvenile idiopathic arthritis: a pilot study

    NARCIS (Netherlands)

    Haberfehlner, Helga; Visser, Bart; Daffertshofer, Andreas; van Rossum, Marion Aj; Roorda, Leo D.; van der Leeden, Marike; Dekker, Joost; Hoeksma, Agnes F.

    2011-01-01

    The aim of the present study was to describe handwriting difficulties of primary school children with juvenile idiopathic arthritis (JIA), and to investigate possible correlations with hand function and writing performance. In a cross-sectional approach, 15 children with JIA and reported handwriting

  4. Career Decision-Making Difficulties of Turkish Adolescents

    Science.gov (United States)

    Bacanli, Feride

    2016-01-01

    The purposes of this study are (1) to adapt the Career Decision-Making Difficulties Questionnaire (CDDQ) to Turkish high school students and (2) to examine gender differences, grade differences, and differences between "decided" and "undecided" students. The sample consisted of 2509 adolescent students. The results showed that…

  5. Fast and Efficient Discrimination of Traveling Salesperson Problem Stimulus Difficulty

    Science.gov (United States)

    Dry, Matthew J.; Fontaine, Elizabeth L.

    2014-01-01

    The Traveling Salesperson Problem (TSP) is a computationally difficult combinatorial optimization problem. In spite of its relative difficulty, human solvers are able to generate close-to-optimal solutions in a close-to-linear time frame, and it has been suggested that this is due to the visual system's inherent sensitivity to certain geometric…

  6. Using Student Performance to Judge the Difficulty of Examinations

    Science.gov (United States)

    Roegner, Katherine

    2015-01-01

    This contribution focuses on a scheme developed to characterize the level of difficulty of an examination in the course "Linear Algebra for Engineers" and on the transfer of the underlying idea to a similar scheme for examinations in the course "Analysis I for Engineers". Using these schemes, it is possible to define standards…

  7. Difficulties in Learning and Teaching Statistics: Teacher Views

    Science.gov (United States)

    Koparan, Timur

    2015-01-01

    The purpose of this study is to define teacher views about the difficulties in learning and teaching middle school statistics subjects. To serve this aim, a number of interviews were conducted with 10 middle school maths teachers in 2011-2012 school year in the province of Trabzon. Of the qualitative descriptive research methods, the…

  8. Specific Learning Difficulties--What Teachers Need to Know

    Science.gov (United States)

    Hudson, Diana

    2015-01-01

    This book clearly explains what Specific Learning Difficulties (SpLD) are, and describes the symptoms of conditions most commonly encountered in the mainstream classroom: dyslexia, dyspraxia, dyscalculia, dysgraphia, Autism Spectrum Disorder, ADHD, and OCD. The author provides an overview of the strengths and weaknesses commonly associated with…

  9. Investigating Difficulties of Learning Computer Programming in Saudi Arabia

    Science.gov (United States)

    Alakeel, Ali M.

    2015-01-01

    Learning computer programming is one of the main requirements of many educational study plans in higher education. Research has shown that many students face difficulties acquiring reasonable programming skills during their first year of college. In Saudi Arabia, there are twenty-three state-owned universities scattered around the country that…

  10. Could Specific Braille Reading Difficulties Result from Developmental Dyslexia?

    Science.gov (United States)

    Veispak, Anneli; Ghesquiere, Pol

    2010-01-01

    A proportion of children with visual impairments have specific reading difficulties that cannot be easily explained. This article reviews the data on problems with braille reading and interprets them from the framework of the temporal-processing deficit theory of developmental dyslexia.

  11. DIFFICULTIES TO LEARN AND TO TEACH MODERN PHYSICS.

    Directory of Open Access Journals (Sweden)

    R. Antonowiski

    2017-08-01

    Full Text Available Physics is engaged in scientific and technological development in several areas, however, its learning in high school has high failure rates that demonstrate a low level of use. It is a science that allows us to understand the nature of the macroscopic and atomic matter, but it is taught in a disjointed manner, upon presentation of concepts, laws and mathematical sentences, repetitive exercises that have taken the preparatory character for college entrance. Thus, the student gets stuck sentences featuring a partial knowledge and disposable. This study aimed to analyze the main difficulties that undergraduate students in Physics have in Modern Physics learning. Point out the difficulties in teaching and learning Physics is not an easy task and to identify them comes the difficulty of how to solve them. After analysis of several hypotheses we can conclude that there is no single factor responsible for the difficulty of the teaching and learning of Modern Physics. The lack of time to work and developed since middle school, stimulating the curiosity of students, adequately trained teachers, lack of structure offered by the government, parents' responsibilities and students in learning, among others, constitute a major challenge for successful teaching and learning of Modern Physics

  12. Hunting down the chimera of multiple disciplinarity in conservation science.

    Science.gov (United States)

    Pooley, Simon P; Mendelsohn, J Andrew; Milner-Gulland, E J

    2014-02-01

    The consensus is that both ecological and social factors are essential dimensions of conservation research and practice. However, much of the literature on multiple disciplinary collaboration focuses on the difficulties of undertaking it. This review of the challenges of conducting multiple disciplinary collaboration offers a framework for thinking about the diversity and complexity of this endeavor. We focused on conceptual challenges, of which 5 main categories emerged: methodological challenges, value judgments, theories of knowledge, disciplinary prejudices, and interdisciplinary communication. The major problems identified in these areas have proved remarkably persistent in the literature surveyed (c.1960-2012). Reasons for these failures to learn from past experience include the pressure to produce positive outcomes and gloss over disagreements, the ephemeral nature of many such projects and resulting lack of institutional memory, and the apparent complexity and incoherence of the endeavor. We suggest that multiple disciplinary collaboration requires conceptual integration among carefully selected multiple disciplinary team members united in investigating a shared problem or question. We outline a 9-point sequence of steps for setting up a successful multiple disciplinary project. This encompasses points on recruitment, involving stakeholders, developing research questions, negotiating power dynamics and hidden values and conceptual differences, explaining and choosing appropriate methods, developing a shared language, facilitating on-going communications, and discussing data integration and project outcomes. Although numerous solutions to the challenges of multiple disciplinary research have been proposed, lessons learned are often lost when projects end or experienced individuals move on. We urge multiple disciplinary teams to capture the challenges recognized, and solutions proposed, by their researchers while projects are in process. A database of well

  13. Financial well-being of older Australians with multiple health conditions.

    Science.gov (United States)

    Temple, Jeromey B; Williams, Ruth

    2018-02-10

    Given recent rises in out-of-pocket health expenses, we examined the financial well-being of older Australians with multiple health conditions and disabilities. The 2014 General Social Survey was used to measure the: (i) current financial position; (ii) propensity to experience financial difficulties; and (iii) types of behaviours older people with multiple health conditions engage in to improve financial resilience. Compared to older Australians with no health conditions, respondents with multiple health conditions had lower incomes and assets and a higher propensity to hold consumer debt (once controls were included). They were at a higher risk of cash flow difficulties, dissaving to meet day-to-day living expenses and exclusion from financial providers. However, the majority of people with multiple health conditions engaged in financially resilient behaviours. Many older Australians with multiple health conditions were in a financially precarious situation with implications for the ability to afford ongoing increases in out-of-pocket health-care costs. © 2018 AJA Inc.

  14. Social Difficulties As Risk and Maintaining Factors in Anorexia Nervosa: A Mixed-Method Investigation

    Directory of Open Access Journals (Sweden)

    Valentina Cardi

    2018-02-01

    Full Text Available Anorexia nervosa (AN is a serious psychiatric disorder characterized by severe restriction of energy intake and dangerously low body weight. Other domains of functioning are affected, including social functioning. Although difficulties within this domain have started to be acknowledged by the literature, some important gaps remain to be filled. Do social difficulties predate the onset of the illness? What difficulties in particular are relevant for the development and maintenance of the illness? The aim of this study is to combine the use of quantitative and qualitative methods to answer these questions. Ninety participants with lifetime AN (88 women and 2 men completed an online survey assessing memories of involuntary submissiveness within the family, fear of negative evaluation from others, perceived lack of social competence, feelings of social belonging, eating disorder symptoms, and work and social adjustment. Participants also answered three open questions regarding their experience of social relationships before and after the illness onset. The findings provided support for the hypothesized relationships between the study variables. Involuntary submissiveness and fear of negative evaluation predicted eating disorder symptoms and these associations were partially mediated by perceived lack of social competence. Two-thirds of the sample recalled early social difficulties before illness onset and recognized that these had played a role in the development of the illness. A larger proportion of participants stated that the eating disorder had affected their social relationships in a negative way. This study sheds some light on patients’ perspective on the predisposing and maintaining role that social difficulties play in AN and identifies key psychological variables that could be targeted in treatment.

  15. Social Difficulties As Risk and Maintaining Factors in Anorexia Nervosa: A Mixed-Method Investigation.

    Science.gov (United States)

    Cardi, Valentina; Mallorqui-Bague, Núria; Albano, Gaia; Monteleone, Alessio Maria; Fernandez-Aranda, Fernando; Treasure, Janet

    2018-01-01

    Anorexia nervosa (AN) is a serious psychiatric disorder characterized by severe restriction of energy intake and dangerously low body weight. Other domains of functioning are affected, including social functioning. Although difficulties within this domain have started to be acknowledged by the literature, some important gaps remain to be filled. Do social difficulties predate the onset of the illness? What difficulties in particular are relevant for the development and maintenance of the illness? The aim of this study is to combine the use of quantitative and qualitative methods to answer these questions. Ninety participants with lifetime AN (88 women and 2 men) completed an online survey assessing memories of involuntary submissiveness within the family, fear of negative evaluation from others, perceived lack of social competence, feelings of social belonging, eating disorder symptoms, and work and social adjustment. Participants also answered three open questions regarding their experience of social relationships before and after the illness onset. The findings provided support for the hypothesized relationships between the study variables. Involuntary submissiveness and fear of negative evaluation predicted eating disorder symptoms and these associations were partially mediated by perceived lack of social competence. Two-thirds of the sample recalled early social difficulties before illness onset and recognized that these had played a role in the development of the illness. A larger proportion of participants stated that the eating disorder had affected their social relationships in a negative way. This study sheds some light on patients' perspective on the predisposing and maintaining role that social difficulties play in AN and identifies key psychological variables that could be targeted in treatment.

  16. The effect of preinjury sleep difficulties on neurocognitive impairment and symptoms after sport-related concussion.

    Science.gov (United States)

    Sufrinko, Alicia; Pearce, Kelly; Elbin, R J; Covassin, Tracey; Johnson, Eric; Collins, Michael; Kontos, Anthony P

    2015-04-01

    Researchers have reported that sleep duration is positively related to baseline neurocognitive performance. However, researchers have yet to examine the effect of preinjury sleep difficulties on postconcussion impairments. To compare neurocognitive impairment and symptoms of athletes with preinjury sleep difficulties to those without after a sport-related concussion (SRC). Cohort study; Level of evidence, 3. The sample included 348 adolescent and adult athletes (age, mean ± SD, 17.43 ± 2.34 years) with a diagnosed SRC. The sample was divided into 2 groups: (1) 34 (10%) participants with preinjury sleep difficulties (sleeping less as well as having trouble falling asleep; SLEEP SX) and (2) 231 (66%) participants without preinjury sleep difficulties (CONTROL). The remaining 84 (24%) participants with minimal sleep difficulties (1 symptom) were excluded. Participants completed the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and Postconcussion Symptom Scale (PCSS) at baseline and 3 postinjury intervals (2, 5-7, and 10-14 days after injury). A series of repeated-measures analyses of covariance with Bonferroni correction, controlling for baseline non-sleep-related symptoms, were conducted to compare postinjury neurocognitive performance between groups. Follow-up exploratory t tests examined between-group differences at each time interval. A series of analyses of variance were used to examine total PCSS score, sleep-related, and non-sleep-related symptoms across time intervals between groups. Groups differed significantly in PCSS scores across postinjury intervals for reaction time (P SLEEP SX group performing worse than controls at 5-7 days (mean ± SD, 0.70 ± 0.32 [SLEEP SX], 0.60 ± 0.14 [CONTROL]) and 10-14 days (0.61 ± 0.17 [SLEEP SX]; 0.57 ± 0.10 [CONTROL]) after injury. Groups also differed significantly on verbal memory performance (P = .04), with the SLEEP SX (68.21 ± 18.64) group performing worse than the CONTROL group (76.76 ± 14

  17. Difficulty and independence in shopping among older Americans: more than just leaving the house.

    Science.gov (United States)

    Brenner, Allison B; Clarke, Philippa J

    2017-11-09

    The built, social and economic environments are associated with disability, but knowledge of how these environmental characteristics simultaneously influence older adults' ability to shop independently is limited. We investigated cross-sectional associations between the outdoor home, local neighborhood and macrosocioeconomic levels of the environment and shopping difficulty and interactions between environmental factors and shopping difficulty. Using nationally representative data from a study of Medicare-eligible adults, we conducted a cross-sectional secondary data analysis to examine associations between the environment and difficulty shopping (N = 5504). Sidewalk conditions, broken steps, neighborhood social cohesion and neighborhood socioeconomic disadvantage were associated with more difficulty shopping, although health factors partially accounted for associations between broken steps and disadvantage and shopping difficulty. The association between social cohesion and shopping difficulty also depended on the degree of socioeconomic disadvantage in the neighborhood. Overall, results suggest that factors in the outdoor and local neighborhood environment influence the ability to shop independently for older adults, but that it also may depend on the socioeconomic context of the neighborhood. Interventions aimed at improving the built environment directly outside of older adults' homes and helping increase social cohesion among neighbors, has the potential to reduce difficulty in carrying out this important activity. Implications for rehabilitation Built features of the outdoor home environment including sidewalks and broken steps influence whether older adults are able to safely leave their home to conduct daily activities such as shopping, so it is important that clinicians and rehabilitation professionals are aware of these challenges when helping their patients resume daily activities such as shopping. The physical condition and safety of the immediate

  18. Difficulties in getting treatment for injuries in rural Vietnam.

    Science.gov (United States)

    Hang, H M; Byass, P

    2009-01-01

    Knowledge about the health-seeking behaviour of injury patients is important for the improvement of community health services. The aims of this study were: (1) to describe the healthcare-seeking behaviour of injury patients; (2) to examine factors associated with injury patients seeking care at health facilities; and (3) to describe the costs of health care for injury patients. This study took place in Bavi District, northern Vietnam within a longitudinal community surveillance site (FilaBavi). All non-fatal unintentional injuries occurring in a sample of 24,776 people during 2000 were recorded. The injury questionnaire included information on care-seeking behaviour, severity and consequences of injury. Both univariate and multivariate logistic regression models were used to find associations between sociodemographic factors and utilization of any health services, as well as for each type of health service used, compared with the group who did not use any health services. Of 24,776 persons living in the study area, 1917 reported 2079 new non-fatal debilitating injuries during the four 3-month periods of observation. Health-seeking behaviour relating to the first 1917 injuries was analysed. Self-treatment was most common (51.7%), even in cases of severe injury. There was low usage of public health services (23.2%) among injury patients. Long distances, poor economic status and residence in difficult geographic areas such as highlands and mountains were barriers for seeking health services. A large proportion of household income was spent on treating injury patients. Poor people spent a greater proportion of their income on health care than the rich, and often used less qualified or untrained private providers. These results demonstrate the logistical and financial difficulties associated with the treatment of injuries in rural Vietnam. This suggests the need to make public health subsidies available more efficiently and equitably. Whilst this study looked at the

  19. The Effects of a Tier 3 Intervention on the Mathematics Performance of Second Grade Students With Severe Mathematics Difficulties.

    Science.gov (United States)

    Bryant, Brian R; Bryant, Diane Pedrotty; Porterfield, Jennifer; Dennis, Minyi Shih; Falcomata, Terry; Valentine, Courtney; Brewer, Chelsea; Bell, Kathy

    2016-01-01

    The purpose of this study was to determine the effectiveness of a systematic, explicit, intensive Tier 3 (tertiary) intervention on the mathematics performance of students in second grade with severe mathematics difficulties. A multiple-baseline design across groups of participants showed improved mathematics performance on number and operations concepts and procedures, which are the foundation for later mathematics success. In the previous year, 12 participants had experienced two doses (first and second semesters) of a Tier 2 intervention. In second grade, the participants continued to demonstrate low performance, falling below the 10th percentile on a researcher-designed universal screener and below the 16th percentile on a distal measure, thus qualifying for the intensive intervention. A project interventionist, who met with the students 5 days a week for 10 weeks (9 weeks for one group), conducted the intensive intervention. The intervention employed more intensive instructional design features than the previous Tier 2 secondary instruction, and also included weekly games to reinforce concepts and skills from the lessons. Spring results showed significantly improved mathematics performance (scoring at or above the 25th percentile) for most of the students, thus making them eligible to exit the Tier 3 intervention. © Hammill Institute on Disabilities 2014.

  20. Multiple sclerosis

    International Nuclear Information System (INIS)

    Sadashima, Hiromichi; Kusaka, Hirofumi; Imai, Terukuni; Takahashi, Ryosuke; Matsumoto, Sadayuki; Yamamoto, Toru; Yamasaki, Masahiro; Maya, Kiyomi

    1986-01-01

    Eleven patients with a definite diagnosis of multiple sclerosis were examined in terms of correlations between the clinical features and the results of cranial computed tomography (CT), and magnetic resonance imaging (MRI). Results: In 5 of the 11 patients, both CT and MRI demonstrated lesions consistent with a finding of multiple sclerosis. In 3 patients, only MRI demonstrated lesions. In the remaining 3 patients, neither CT nor MRI revealed any lesion in the brain. All 5 patients who showed abnormal findings on both CT and MRI had clinical signs either of cerebral or brainstem - cerebellar lesions. On the other hand, two of the 3 patients with normal CT and MRI findings had optic-nerve and spinal-cord signs. Therefore, our results suggested relatively good correlations between the clinical features, CT, and MRI. MRI revealed cerebral lesions in two of the four patients with clinical signs of only optic-nerve and spinal-cord lesions. MRI demonstrated sclerotic lesions in 3 of the 6 patients whose plaques were not detected by CT. In conclusion, MRI proved to be more helpful in the demonstration of lesions attributable to chronic multiple sclerosis. (author)

  1. Mind-Reading Difficulties in the Siblings of People with Asperger's Syndrome: Evidence for a Genetic Influence in the Abnormal Development of a Specific Cognitive Domain

    Science.gov (United States)

    Dorris, L.; Espie, C. A. E.; Knott, F.; Salt, J.

    2004-01-01

    Background: Previous research suggests that the phenotype associated with Asperger's syndrome (AS) includes difficulties in understanding the mental states of others, leading to difficulties in social communication and social relationships. It has also been suggested that the first-degree relatives of those with AS can demonstrate similar…

  2. Obesity Prevention in Early Child Care Settings: A Bistate (Minnesota and Wisconsin) Assessment of Best Practices, Implementation Difficulty, and Barriers

    Science.gov (United States)

    Nanney, Marilyn S.; LaRowe, Tara L.; Davey, Cynthia; Frost, Natasha; Arcan, Chrisa; O'Meara, Joyce

    2017-01-01

    Background: Long-term evaluation studies reveal that high-quality early care and education (ECE) programs that include a lifestyle component predict later adult health outcomes. The purpose of this article is to characterize the nutrition and physical activity (PA) practices, including implementation difficulty and barriers, of licensed center-…

  3. Recombination pattern reanalysis of some HIV-1 circulating recombination forms suggest the necessity and difficulty of revision.

    Directory of Open Access Journals (Sweden)

    Lei Jia

    Full Text Available Recombination is one of the major mechanisms underlying the generation of HIV-1 variability. Currently 61 circulating recombinant forms of HIV-1 have been identified. With the development of recombination detection techniques and accumulation of HIV-1 reference stains, more accurate mosaic structures of circulating recombinant forms (CRFs, like CRF04 and CRF06, have undergone repeated analysis and upgrades. Such revisions may also be necessary for other CRFs. Unlike previous studies, whose results are based primarily on a single recombination detection program, the current study was based on multiple recombination analysis, which may have produced more impartial results.Representative references of 3 categories of intersubtype recombinants were selected, including BC recombinants (CRF07 and CRF08, BG recombinants (CRF23 and CRF24, and BF recombinants (CRF38 and CRF44. They were reanalyzed in detail using both the jumping profile hidden Markov model and RDP3.The results indicate that revisions and upgrades are very necessary and the entire re-analysis suggested 2 types of revision: (i length of inserted fragments; and (ii number of inserted fragments. The reanalysis also indicated that determination of small regions of about 200 bases or fewer should be performed with more caution.Results indicated that the involvement of multiple recombination detection programs is very necessary. Additionally, results suggested two major challenges, one involving the difficulty of accurately determining the locations of breakpoints and the second involving identification of small regions of about 200 bases or fewer with greater caution. Both indicate the complexity of HIV-1 recombination. The resolution would depend critically on development of a recombination analysis algorithm, accumulation of HIV-1 stains, and a higher sequencing quality. With the changes in recombination pattern, phylogenetic relationships of some CRFs may also change. All these results may

  4. A new cognitive rehabilitation programme for patients with multiple sclerosis: the 'MS-line! Project'.

    Science.gov (United States)

    Gich, Jordi; Freixenet, Jordi; Garcia, Rafael; Vilanova, Joan Carles; Genís, David; Silva, Yolanda; Montalban, Xavier; Ramió-Torrentà, Lluís

    2015-09-01

    Cognitive rehabilitation is often delayed in multiple sclerosis (MS). To develop a free and specific cognitive rehabilitation programme for MS patients to be used from early stages that does not interfere with daily living activities. MS-line!, cognitive rehabilitation materials consisting of written, manipulative and computer-based materials with difficulty levels developed by a multidisciplinary team. Mathematical, problem-solving and word-based exercises were designed. Physical materials included spatial, coordination and reasoning games. Computer-based material included logic and reasoning, working memory and processing speed games. Cognitive rehabilitation exercises that are specific for MS patients have been successfully developed. © The Author(s), 2014.

  5. Multiple constant multiplication optimizations for field programmable gate arrays

    CERN Document Server

    Kumm, Martin

    2016-01-01

    This work covers field programmable gate array (FPGA)-specific optimizations of circuits computing the multiplication of a variable by several constants, commonly denoted as multiple constant multiplication (MCM). These optimizations focus on low resource usage but high performance. They comprise the use of fast carry-chains in adder-based constant multiplications including ternary (3-input) adders as well as the integration of look-up table-based constant multipliers and embedded multipliers to get the optimal mapping to modern FPGAs. The proposed methods can be used for the efficient implementation of digital filters, discrete transforms and many other circuits in the domain of digital signal processing, communication and image processing. Contents Heuristic and ILP-Based Optimal Solutions for the Pipelined Multiple Constant Multiplication Problem Methods to Integrate Embedded Multipliers, LUT-Based Constant Multipliers and Ternary (3-Input) Adders An Optimized Multiple Constant Multiplication Architecture ...

  6. Working memory resources in young children with mathematical difficulties.

    Science.gov (United States)

    Kyttälä, Minna; Aunio, Pirjo; Hautamäki, Jarkko

    2010-02-01

    Working memory (WM) (Baddeley, 1986, 1997) is argued to be one of the most important cognitive resources underlying mathematical competence (Geary, 2004). Research has established close links between WM deficits and mathematical difficulties. This study investigated the possible deficits in WM, language and fluid intelligence that seem to characterize 4- to 6-year-old children with poor early mathematical skills before formal mathematics education. Children with early mathematical difficulties showed poor performance in both verbal and visuospatial WM tasks as well as on language tests and a fluid intelligence test indicating a thoroughly lower cognitive base. Poor WM performance was not moderated by fluid intelligence, but the extent of WM deficits was related to language skills. The educational implications are discussed.

  7. Current nuclear employees with psychological difficulties: prevalence, assessment, and disposition

    International Nuclear Information System (INIS)

    Sajwaj, T.; Chardos, S.; Lavin, P.; Ford, T.; McGee, R.K.

    1987-01-01

    Although industry standards and federal regulations require employees of nuclear power plants to demonstrate psychological stability and sound judgment before being initially granted unescorted access to the plant, it is obvious that emotional difficulties can develop subsequently. The development of emotional problems in current plant employees raises concerns about the safety of the public and the plant, the effectiveness of the organizations, the loss of important technical skills and experience, and the human cost to the employee and his/her family. This paper reports the experience of the Tennessee Valley Authority (TVA) in cases of reconsideration of psychological clearance of unescorted access, i.e., the review of psychological clearances of nuclear plant employees who have developed psychological difficulties

  8. Research on Difficulty in Indonesia Students Learning Chinese Language

    Directory of Open Access Journals (Sweden)

    Lydia Anggreani

    2013-05-01

    Full Text Available Chinese has become the world’s second language. Each language has its own law, as is the Chinese. Indonesian students have difficulty in learning Chinese which are are not surprising. Every language has various characteristics, so do Chinese and Bahasa Indonesia. Article analyzes difficulties to learn Chinese, especially for Indonesian students, those are tone, grammar, sounds of “er hua” such as Alice retroflex. The respondents are 100 Indonesian students who are randomly selected for testing samples analyzed. Since there is no tone in Bahasa Indonesia, it makes a lot of Indonesian students in the learning process often appear in Chinese foreign accent phenomenon. This article expects to explore the problem by studying the formation of the causes and solutions. Indonesian students learning Chinese was designed to provide some teaching and learning strategies.

  9. The Affective Dimensions of Mathematical Difficulties in Schoolchildren

    Directory of Open Access Journals (Sweden)

    Morena Lebens

    2011-01-01

    Full Text Available Mathematical difficulties (MDs are frequently characterised by cognitive deficits such as ineffective problem solving strategies and a lack of computational fluency. The established literature indicates that mathematical achievement is not only a function of cognitive factors but it also points to the importance of affective factors for the development of mathematical achievement. In the light of this evidence, the exploration of children's affective responses towards mathematics becomes a central issue. Whereas previous studies tended to research affective motivational constructs such as self-efficacy in isolation from other related constructs, the literature suffers from a shortage of research on the relationship between different affective motivational variables and their impact on mathematical achievement in different age and achievement bands. The present paper aims to address this aim by employing a newly developed instrument to measure affective motivational variables. Overall, the present findings support the assumption that children of average ability are less influenced by affective factors than children with mathematical difficulties.

  10. [Efficacy of decoding training for children with difficulty reading hiragana].

    Science.gov (United States)

    Uchiyama, Hitoshi; Tanaka, Daisuke; Seki, Ayumi; Wakamiya, Eiji; Hirasawa, Noriko; Iketani, Naotake; Kato, Ken; Koeda, Tatsuya

    2013-05-01

    The present study aimed to clarify the efficacy of decoding training focusing on the correspondence between written symbols and their readings for children with difficulty reading hiragana (Japanese syllabary). Thirty-five children with difficulty reading hiragana were selected from among 367 first-grade elementary school students using a reading aloud test and were then divided into intervention (n=15) and control (n=20) groups. The intervention comprised 5 minutes of decoding training each day for a period of 3 weeks using an original program on a personal computer. Reading time and number of reading errors in the reading aloud test were compared between the groups. The intervention group showed a significant shortening of reading time (F(1,33)=5.40, phiragana.

  11. Luck is Hard to Beat: The Difficulty of Sports Prediction

    OpenAIRE

    Aoki, Raquel YS; Assuncao, Renato M; de Melo, Pedro OS Vaz

    2017-01-01

    Predicting the outcome of sports events is a hard task. We quantify this difficulty with a coefficient that measures the distance between the observed final results of sports leagues and idealized perfectly balanced competitions in terms of skill. This indicates the relative presence of luck and skill. We collected and analyzed all games from 198 sports leagues comprising 1503 seasons from 84 countries of 4 different sports: basketball, soccer, volleyball and handball. We measured the competi...

  12. Player Modeling Using HOSVD towards Dynamic Difficulty Adjustment in Videogames

    OpenAIRE

    Anagnostou , Kostas; Maragoudakis , Manolis

    2012-01-01

    Part 3: Second International Workshop on Computational Intelligence in Software Engineering (CISE 2012); International audience; In this work, we propose and evaluate a Higher Order Singular Value Decomposition (HOSVD) of a tensor as a means to classify player behavior and adjust game difficulty dynamically. Applying this method to player data collected during a plethora of game sessions resulted in a reduction of the dimensionality of the classification problem and a robust classification of...

  13. An Educational Application of Online Games for Learning Difficulties

    OpenAIRE

    M. Margoudi; Z. Smyrnaiou

    2015-01-01

    The current paper presents the results of a conducted case study. During the past few years the number of children diagnosed with Learning Difficulties has drastically augmented and especially the cases of ADHD (Attention Deficit Hyperactivity Disorder). One of the core characteristics of ADHD is a deficit in working memory functions. The review of the literature indicates a plethora of educational software that aim at training and enhancing the working memory. Neverthele...

  14. Managing social, emotional and behavioural difficulties in schools in the Netherlands

    Directory of Open Access Journals (Sweden)

    Ed Smeets

    2009-04-01

    Full Text Available Three key aspects of the school environment are crucial for the prevention and management of social, emotional, and behavioural difficulties (SEBD in schools. These include an adequate instructional environment, a supportive social-emotional climate, and a systematic process of identification and intervention. This paper addresses these critical aspects by presenting results from two studies in primary education in The Netherlands. According to teachers, one in six pupils in mainstream primary schools exhibits some kind of SEBD. Severe cases of aggressive behaviour or ADHD present the greatest difficulties for teachers. The focus in mainstream schools is on the provision of a supportive social-emotional environment and on the identification of SEBD, with little attention to an adequate instructional environment or consistent interventions. This paper describes a systematic approach to the prevention and early intervention of SEBD which will address this issue.

  15. Technical difficulties and solutions of direct transesterification process of microbial oil for biodiesel synthesis.

    Science.gov (United States)

    Yousuf, Abu; Khan, Maksudur Rahman; Islam, M Amirul; Wahid, Zularisam Ab; Pirozzi, Domenico

    2017-01-01

    Microbial oils are considered as alternative to vegetable oils or animal fats as biodiesel feedstock. Microalgae and oleaginous yeast are the main candidates of microbial oil producers' community. However, biodiesel synthesis from these sources is associated with high cost and process complexity. The traditional transesterification method includes several steps such as biomass drying, cell disruption, oil extraction and solvent recovery. Therefore, direct transesterification or in situ transesterification, which combines all the steps in a single reactor, has been suggested to make the process cost effective. Nevertheless, the process is not applicable for large-scale biodiesel production having some difficulties such as high water content of biomass that makes the reaction rate slower and hurdles of cell disruption makes the efficiency of oil extraction lower. Additionally, it requires high heating energy in the solvent extraction and recovery stage. To resolve these difficulties, this review suggests the application of antimicrobial peptides and high electric fields to foster the microbial cell wall disruption.

  16. Maternal abuse history and self-regulation difficulties in preadolescence.

    Science.gov (United States)

    Delker, Brianna C; Noll, Laura K; Kim, Hyoun K; Fisher, Philip A

    2014-12-01

    Although poor parenting is known to be closely linked to self-regulation difficulties in early childhood, comparatively little is understood about the role of other risk factors in the early caregiving environment (such as a parent's own experiences of childhood abuse) in developmental pathways of self-regulation into adolescence. Using a longitudinal design, this study aimed to examine how a mother's history of abuse in childhood relates to her offspring's self-regulation difficulties in preadolescence. Maternal controlling parenting and exposure to intimate partner aggression in the child's first 24-36 months were examined as important early social and environmental influences that may explain the proposed connection between maternal abuse history and preadolescent self-regulation. An ethnically diverse sample of mothers (N=488) who were identified as at-risk for child maltreatment was recruited at the time of their children's birth. Mothers and their children were assessed annually from the child's birth through 36 months, and at age 9-11 years. Structural equation modeling and bootstrap tests of indirect effects were conducted to address the study aims. Findings indicated that maternal abuse history indirectly predicted their children's self-regulation difficulties in preadolescence mainly through maternal controlling parenting in early childhood, but not through maternal exposure to aggression by an intimate partner. Maternal history of childhood abuse and maternal controlling parenting in her child's early life may have long-term developmental implications for child self-regulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Multisensory perceptual learning is dependent upon task difficulty.

    Science.gov (United States)

    De Niear, Matthew A; Koo, Bonhwang; Wallace, Mark T

    2016-11-01

    There has been a growing interest in developing behavioral tasks to enhance temporal acuity as recent findings have demonstrated changes in temporal processing in a number of clinical conditions. Prior research has demonstrated that perceptual training can enhance temporal acuity both within and across different sensory modalities. Although certain forms of unisensory perceptual learning have been shown to be dependent upon task difficulty, this relationship has not been explored for multisensory learning. The present study sought to determine the effects of task difficulty on multisensory perceptual learning. Prior to and following a single training session, participants completed a simultaneity judgment (SJ) task, which required them to judge whether a visual stimulus (flash) and auditory stimulus (beep) presented in synchrony or at various stimulus onset asynchronies (SOAs) occurred synchronously or asynchronously. During the training session, participants completed the same SJ task but received feedback regarding the accuracy of their responses. Participants were randomly assigned to one of three levels of difficulty during training: easy, moderate, and hard, which were distinguished based on the SOAs used during training. We report that only the most difficult (i.e., hard) training protocol enhanced temporal acuity. We conclude that perceptual training protocols for enhancing multisensory temporal acuity may be optimized by employing audiovisual stimuli for which it is difficult to discriminate temporal synchrony from asynchrony.

  18. Reading Comprehension Difficulties in Chinese-English Bilingual Children.

    Science.gov (United States)

    Tong, Xiuhong; McBride, Catherine; Shu, Hua; Ho, Connie Suk-Han

    2018-02-01

    The co-occurrence of reading comprehension difficulties for first language (L1) Chinese and second language (L2) English and associated longitudinal cognitive-linguistic correlates in each language were investigated. Sixteen poor comprehenders in English and 16 poor comprehenders in Chinese, 18 poor readers in both, and 18 children with normal performance in both were identified at age 10. The prevalence rate for being poor in both was 52.94%, suggesting that approximately half of children who are at risk for Chinese reading comprehension difficulty are also at risk for English reading comprehension difficulty. Chinese word reading, phonological, and morphological awareness were longitudinal correlates of poor comprehension in Chinese. English word reading and vocabulary were longitudinal correlates of poor comprehension in English. Chinese phonological awareness was an additional correlate of poor comprehension in English. Moreover, poor comprehenders in both Chinese and English showed slower rapid automatized naming scores than the other groups. Findings highlight some factors that might be critical for reading comprehension in L1 Chinese and L2 English; fluency is likely to be a critical part of reading comprehension across languages. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Access to care for children with emotional/behavioral difficulties.

    Science.gov (United States)

    Henning-Smith, Carrie; Alang, Sirry

    2016-06-01

    Emotional/behavioral difficulties (EBDs) are increasingly diagnosed in children, constituting some of the most common chronic childhood conditions. Left untreated, EBDs pose long-term individual and population-level consequences. There is a growing evidence of disparities in EBD prevalence by various demographic characteristics. This article builds on this research by examining disparities in access to medical care for children with EBD. From 2008 to 2011, using data from the US National Health Interview Survey (N = 31,631) on sample children aged 4-17, we investigate (1) whether having EBD affects access to care (modeled as delayed care due to cost and difficulty making an appointment) and (2) the role demographic characteristics, health insurance coverage, and frequency of service use play in access to care for children with EBD. Results indicate that children with EBD experience issues in accessing care at more than twice the rate of children without EBD, even though they are less likely to be uninsured than their counterparts without EBD. In multivariable models, children with EBD are still more likely to experience delayed care due to cost and difficulty making a timely appointment, even after adjusting for frequency of health service use, insurance coverage, and demographic characteristics. © The Author(s) 2015.

  20. Effects of Fact Retrieval Tutoring on Third-Grade Students with Math Difficulties with and without Reading Difficulties.

    Science.gov (United States)

    Powell, Sarah R; Fuchs, Lynn S; Fuchs, Douglas; Cirino, Paul T; Fletcher, Jack M

    2009-01-01

    The purpose of this study was to assess the efficacy of fact retrieval tutoring as a function of math difficulty (MD) subtype, that is, whether students have MD alone (MD-only) or have concurrent difficulty with math and reading (MDRD). Third graders (n = 139) at two sites were randomly assigned, blocking by site and MD subtype, to four tutoring conditions: fact retrieval practice, conceptual fact retrieval instruction with practice, procedural computation/estimation instruction, and control (no tutoring). Tutoring occurred for 45 sessions over 15weeks for 15-25 minutes per session. Results provided evidence of an interaction between tutoring condition and MD subtype status for assessment of fact retrieval. For MD-only students, students in both fact retrieval conditions achieved comparably and outperformed MD-only students in the control group as well as those in the procedural computation/estimation instruction group. By contrast, for MDRD students, there were no significant differences among intervention conditions.

  1. Difficulties in diagnosis and treatment of Paget’s disease

    Directory of Open Access Journals (Sweden)

    Aleksandra Kawalec

    2016-12-01

    Full Text Available Paget’s disease is a rare finding in Poland. It is a disorder of the osteoarticular system, which, in adults, mostly affects people over 55 years of age. The clinical picture varies, depending on the location of the lesions, making the diagnosis difficult, sometimes taking many years for a correct diagnosis to be made. In etiopathogenesis, genetic predispositions as well as viral infections play an important role. From the genetic point of view, Paget’s disease is heterogeneous, as numerous mutations are known, and the genotype to phenotype relationship is unclear. The first phase of the disease is characterized by an increased osteocytes activity, due to morphologically changed and RANKL overstimulated osteocytes. This leads to an intensification of ossification processes that occur in a chaotic manner. Therefore, the resulting bone is weak, extensively vascularized and there is an increased risk of fracture or deformity. Clinical manifestations of Paget’s disease might include pain, excessive warmth, bone deformations, degenerative lesions in the adjacent joints, compression of the neural structures, hearing loss, and dilated cardiomiopathy. Other possible complications include the development of benign and malignant bone tumors and hypercalcaemia in the case of immobilization. An elevated level of serum alkaline phosphatase, bone x-ray and bone scintigraphy are crucial in making the diagnosis. The disease should be distinguished from osteomalacia, osteoporosis, hyperparathyroidism and multiple myeloma. Bisphosphonates at doses higher than those applied for osteoporosis are an effective treatment. The occurrence of orthopedic, neurological and laryngological complications is often a reason for surgical intervention.

  2. Meta-analysis of fluid intelligence tests of children from the Chinese mainland with learning difficulties.

    Directory of Open Access Journals (Sweden)

    Fang Tong

    Full Text Available OBJECTIVE: To evaluate the differences in fluid intelligence tests between normal children and children with learning difficulties in China. METHOD: PubMed, MD Consult, and other Chinese Journal Database were searched from their establishment to November 2012. After finding comparative studies of Raven measurements of normal children and children with learning difficulties, full Intelligent Quotation (FIQ values and the original values of the sub-measurement were extracted. The corresponding effect model was selected based on the results of heterogeneity and parallel sub-group analysis was performed. RESULTS: Twelve documents were included in the meta-analysis, and the studies were all performed in mainland of China. Among these, two studies were performed at child health clinics, the other ten sites were schools and control children were schoolmates or classmates. FIQ was evaluated using a random effects model. WMD was -13.18 (95% CI: -16.50- -9.85. Children with learning difficulties showed significantly lower FIQ scores than controls (P<0.00001; Type of learning difficulty and gender differences were evaluated using a fixed-effects model (I² = 0%. The sites and purposes of the studies evaluated here were taken into account, but the reasons of heterogeneity could not be eliminated; The sum IQ of all the subgroups showed considerable heterogeneity (I² = 76.5%. The sub-measurement score of document A showed moderate heterogeneity among all documents, and AB, B, and E showed considerable heterogeneity, which was used in a random effect model. Individuals with learning difficulties showed heterogeneity as well. There was a moderate delay in the first three items (-0.5 to -0.9, and a much more pronounced delay in the latter three items (-1.4 to -1.6. CONCLUSION: In the Chinese mainland, the level of fluid intelligence of children with learning difficulties was lower than that of normal children. Delayed development in sub-items of C, D

  3. Kosovo’s Experience for Children with Feeding Difficulties after Cardiac Surgery for Congenital Heart Defect

    Science.gov (United States)

    Bejiqi, Ramush; Retkoceri, Ragip; Bejiqi, Hana; Maloku, Arlinda; Vuçiterna, Armend; Zeka, Naim; Gerguri, Abdurrahim; Bejiqi, Rinor

    2017-01-01

    BACKGROUND: A feeding disorder in infancy and during childhood is a complex condition involving different symptoms such as food refusal and faddiest, both leading to a decreased food intake. AIM: We aimed to assess the prevalence and predictor factors of feeding difficulties in children who underwent cardiac open heart surgery in neonatal period and infancy. We address selected nutritional and caloric requirements for children after cardiac surgery and explore nutritional interdependence with other system functions. METHODS: This was a retrospective study in a tertiary referral hospital, and prior approval from the institutional ethics committee was obtained. Information for 78 children (42 male and 36 female) was taken from patients charts. Data were analysed with descriptive statistics and logistic regression. RESULTS: From a cohort of analysed children with feeding problems we have occurred in 23% of such cases. At the time of the study, refusal to eat or poor appetite was reported as a significant problem in 19 children and subnormal height and weight were recorded in 11 children. Early neonatal intervention and reoperation were identified as risk factors for latter feeding difficulties or inadequate intake. Children with feeding problems also tended to eat less than children without feeding problems. There was a trend towards more feeding problems in patients with chromosomal abnormalities or other associated anomalies. CONCLUSION: Feeding disorder is often and a frequent long-term sequel in children after neonatal or early infancy heart surgery. Patients with chromosomal and associated anomalies who underwent multiple cardiac surgeries are at risk of developing feeding difficulties. PMID:29362619

  4. Workplace-based assessments in Foundation Programme training: do trainees in difficulty use them differently?

    Science.gov (United States)

    Mitchell, Colin; Bhat, Sarita; Herbert, Anne; Baker, Paul

    2013-03-01

    Trainee-led workplace-based assessment (WPBA) is increasingly used in postgraduate medical training. Trainees in difficulty are known to behave differently from their peers; these differences may be reflected in their use of WPBAs and may give new insights into the behaviour and assessment of struggling trainees. Data were extracted for 76 115 assessments, completed by 1900 UK Foundation Programme (FP) trainees. Of these 1900 trainees, 95 (5%) were FP trainees in difficulty (FTiDs). We analysed aspects of the use of WPBAs, using multiple logistic regressions, to compare the behaviours of FTiDs with those of their peers. Of 48 possible comparisons, only two (i.e. the rate expected to occur by chance) showed statistically significant differences: relative to their peers, FTiDs were more likely to choose nurse assessors in direct observations of procedural skills (odds ratio [OR] 7.05, 95% confidence interval [CI] 1.23-40.43) and more likely to choose non-clinical assessors for assessments using the mini-peer assessment tool (OR 30.44, 95% CI 1.34-689.29). Key features of assessor choice for FTiDs are familiarity and likelihood of receiving a positive assessment. This analysis has not demonstrated that FTiDs use WPBAs any differently from their peers who are not in difficulty, although it does suggest associations and trends that require further exploration. These null results are interesting and raise hypotheses for prospective confirmation or disproof, and for further qualitative work investigating how struggling trainees use WPBAs in order to guide the future implementation of WPBAs in postgraduate training. © Blackwell Publishing Ltd 2013.

  5. (including travel dates) Proposed itinerary

    Indian Academy of Sciences (India)

    Ashok

    31 July to 22 August 2012 (including travel dates). Proposed itinerary: Arrival in Bangalore on 1 August. 1-5 August: Bangalore, Karnataka. Suggested institutions: Indian Institute of Science, Bangalore. St Johns Medical College & Hospital, Bangalore. Jawaharlal Nehru Centre, Bangalore. 6-8 August: Chennai, TN.

  6. The Mediator Role of Emotion Regulation Difficulties in Relationship between Alexithymia and Disordered Eating Behaviors among Students Allameh Tabataba’i University, Iran.

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Khodabakhsh

    2016-05-01

    Full Text Available Abstract Background and Objectives: Emotion regulation difficulties predicts disordered eating, but how emotion regulation difficulties lead to disordered eating remains an unanswered question. In this research, the role of alexithymia and emotion regulation difficulties was investigated in the prediction of disordered eating behaviors among students. Methods: This descriptive study was performed on 264 students of Allameh Tabataba’i University, who were selected by multiple cluster sampling. Data were collected using Toronto Alexithymia Scale, Eating Attitudes Test, and Emotion Regulation Questionnaire. Analysis of data was performed using Pearson correlation coefficient and stepwise regression. The significance level was considered to be p<0.01. Results: Results showed that there was a significant correlation among emotion regulation difficulties, alexithymia, and disordered eating behaviors (p<0.01. The results of stepwise regression analysis indicated that alexithymia and emotion regulation difficulties significantly predicted disoredered eating behaviors (p<0.01 and emotion regulation difficulties has a mediator role in the relationship between alexithymia and disordered eating behaviors (p<0.01. Conclusion: The results of this study is indicative of the importance of emotion regulation difficulties and alexithymia in the prediction of disordered eating behaviors, and these factors can explain the high rate of disordered eating behaviors variance.

  7. Managing cognitive difficulties after traumatic brain injury: a review of online resources for families.

    Science.gov (United States)

    Poulin, Valérie; Dawson, Deirdre R; Bottari, Carolina; Verreault, Cynthia; Turcotte, Samantha; Jean, Alexandra

    2018-03-22

    To identify and critically appraise the content, readability, reliability and usability of websites providing information for managing cognitive difficulties in everyday life for the families of adults with moderate to severe traumatic brain injury. Systematic searches on the Internet for relevant websites were conducted using five search engines, and through consultation of the lists of resources published on websites of traumatic brain injury organizations. Two team members assessed eligibility of the websites. To be included, they had to provide information related to management of cognitive difficulties following moderate to severe traumatic brain injury, to be in English or French and available free of charge. Two reviewers evaluated each website according to: (1) its readability using Flesch-Kincaid Grade Level; (2) the quality of its content using a checklist of eight recommendations for managing memory, attention and executive function problems; (3) its usability (e.g., clear design) and reliability (e.g., currency of information) using the Minervation Validation Instrument for Health Care Web Sites. Of the 38 websites included, 10 provide specific tips for families that cover several domains of cognitive function, including memory, attention and executive function. The most frequent recommendations focused on the use of environmental supports for memory problems (n = 33 websites). The readability of information is below the recommended grade 7 for only nine of the websites. All sites show acceptable usability, but their quality is variable in terms of reliability of the information. This review provides useful information for selecting online resources to educate families about the management of cognitive difficulties following moderate to severe traumatic brain injury, as a complement to information and training provided by the rehabilitation team. Implications for rehabilitation This review describes standardized criteria for the evaluation of the

  8. Vaccines and multiple sclerosis

    DEFF Research Database (Denmark)

    Frederiksen, J. L.; Topsøe Mailand, M.

    2017-01-01

    An association between certain vaccinations and onset or relapse of multiple sclerosis (MS) has been debated. Based on PubMed, we made a thorough literature review and included all relevant studies, 51 on MS and 15 on optic neuritis (ON). Case studies were excluded. With the exception of a live...

  9. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, M. A. H.

    2014-08-05

    Internal multiples deteriorate the image when the imaging procedure assumes only single scattering, especially if the velocity model does not have sharp contrasts to reproduce such scattering in the Green’s function through forward modeling. If properly imaged, internal multiples (internally scattered energy) can enhance the seismic image. Conventionally, to image internal multiples, accurate, sharp contrasts in the velocity model are required to construct a Green’s function with all the scattered energy. As an alternative, we have developed a generalized internal multiple imaging procedure that images any order internal scattering using the background Green’s function (from the surface to each image point), constructed from a smooth velocity model, usually used for conventional imaging. For the first-order internal multiples, the approach consisted of three steps, in which we first back propagated the recorded surface seismic data using the background Green’s function, then crosscorrelated the back-propagated data with the recorded data, and finally crosscorrelated the result with the original background Green’s function. This procedure images the contribution of the recorded first-order internal multiples, and it is almost free of the single-scattering recorded energy. The cost includes one additional crosscorrelation over the conventional single-scattering imaging application. We generalized this method to image internal multiples of any order separately. The resulting images can be added to the conventional single-scattering image, obtained, e.g., from Kirchhoff or reverse-time migration, to enhance the image. Application to synthetic data with reflectors illuminated by multiple scattering (double scattering) demonstrated the effectiveness of the approach.

  10. Job quality and inequality: parents' jobs and children's emotional and behavioural difficulties.

    Science.gov (United States)

    Strazdins, Lyndall; Shipley, Megan; Clements, Mark; Obrien, Léan V; Broom, Dorothy H

    2010-06-01

    In the context of high and rising rates of parental employment in Australia, we investigated whether poor quality jobs (without security, control, flexibility or paid family leave) could pose a health risk to employed parents' children. We examined the extent to which both mothers' and fathers' jobs matter, and whether disadvantaged children are more vulnerable than others. Multiple regression modelling was used to analyse cross-sectional data for 2004 from the Growing Up in Australia study, a nationally representative sample of 4-5 year old children and their families (N = 2373 employed mothers; 3026 employed fathers). Results revealed that when parents held poor quality jobs their children showed more emotional and behavioural difficulties. The associations with child difficulties were independent of income, parent education, family structure and work hours, and were evident for both mothers' and fathers' jobs. Further, the associations tended to be stronger for children in low-income households and lone-mother families. Thus job quality may be another mechanism underlying the intergenerational transmission of health inequality. Our findings also support the argument that a truly family-friendly job must not erode children's health. Copyright 2010 Elsevier Ltd. All rights reserved.

  11. Temperament and character effects on late adolescents’ well-being and emotional-behavioural difficulties

    Directory of Open Access Journals (Sweden)

    Cristiano Crescentini

    2018-03-01

    Full Text Available Background Research on adults points to personality as a crucial determinant of well-being. The present study investigates the question of personality’s relation to well-being and psychosocial adjustment in adolescence. Methods We assessed the role of temperament and character (Temperament and Character Inventory, TCI-125, on psychological well-being (PWB; Psychological Well-Being scales, subjective well-being (SWB; Positive and Negative Affect, PA and NA, respectively, and psychosocial adjustment (emotional-behavioural problems measured by the Strengths and Difficulties Questionnaire for Adolescents, SDQ-A, in 72 Italian late adolescents (aged 17.5 ± 0.75. Multiple regressions were conducted to predict PWB, SWB, and SDQ-A scores using TCI-125 scales as predictors. Results Character maturity, and in particular Self-Directedness, had a widespread protective effect on well-being and psychosocial adjustment, while different strengths and emotional-behavioural difficulties were associated to specific temperamental and character traits. For example, Harm-Avoidance and Novelty-Seeking positively predicted internalized and externalized problems, respectively. Discussion The present results suggest the usefulness of continuing to evaluate temperament and, in particular, character dimensions in investigations focused on adolescents’ well-being and psychosocial functioning, especially in the contexts of potential interventions aimed at enhancing development of adolescents’ character dimensions at the intrapersonal, interpersonal, and transpersonal levels.

  12. Temperament and character effects on late adolescents' well-being and emotional-behavioural difficulties.

    Science.gov (United States)

    Crescentini, Cristiano; Garzitto, Marco; Paschetto, Andrea; Brambilla, Paolo; Fabbro, Franco

    2018-01-01

    Research on adults points to personality as a crucial determinant of well-being. The present study investigates the question of personality's relation to well-being and psychosocial adjustment in adolescence. We assessed the role of temperament and character (Temperament and Character Inventory, TCI-125), on psychological well-being (PWB; Psychological Well-Being scales), subjective well-being (SWB; Positive and Negative Affect, PA and NA, respectively), and psychosocial adjustment (emotional-behavioural problems measured by the Strengths and Difficulties Questionnaire for Adolescents, SDQ-A), in 72 Italian late adolescents (aged 17.5 ± 0.75). Multiple regressions were conducted to predict PWB, SWB, and SDQ-A scores using TCI-125 scales as predictors. Character maturity, and in particular Self-Directedness, had a widespread protective effect on well-being and psychosocial adjustment, while different strengths and emotional-behavioural difficulties were associated to specific temperamental and character traits. For example, Harm-Avoidance and Novelty-Seeking positively predicted internalized and externalized problems, respectively. The present results suggest the usefulness of continuing to evaluate temperament and, in particular, character dimensions in investigations focused on adolescents' well-being and psychosocial functioning, especially in the contexts of potential interventions aimed at enhancing development of adolescents' character dimensions at the intrapersonal, interpersonal, and transpersonal levels.

  13. Using the Genetics Concept Assessment to document persistent conceptual difficulties in undergraduate genetics courses.

    Science.gov (United States)

    Smith, Michelle K; Knight, Jennifer K

    2012-05-01

    To help genetics instructors become aware of fundamental concepts that are persistently difficult for students, we have analyzed the evolution of student responses to multiple-choice questions from the Genetics Concept Assessment. In total, we examined pretest (before instruction) and posttest (after instruction) responses from 751 students enrolled in six genetics courses for either majors or nonmajors. Students improved on all 25 questions after instruction, but to varying degrees. Notably, there was a subgroup of nine questions for which a single incorrect answer, called the most common incorrect answer, was chosen by >20% of students on the posttest. To explore response patterns to these nine questions, we tracked individual student answers before and after instruction and found that particular conceptual difficulties about genetics are both more likely to persist and more likely to distract students than other incorrect ideas. Here we present an analysis of the evolution of these incorrect ideas to encourage instructor awareness of these genetics concepts and provide advice on how to address common conceptual difficulties in the classroom.

  14. The difficulties experienced by nurses and healthcare staff involved in the process of breaking bad news.

    Science.gov (United States)

    Warnock, Clare; Buchanan, Jean; Tod, Angela Mary

    2017-07-01

    The aim of this study was to explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news. The challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or participants. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice. The study used a descriptive survey design involving self-reported written accounts and framework analysis. Data were collected using a structured questionnaire containing a free text section that asked participants to describe a difficult experience they had encountered when involved in the process of breaking bad news. Data were collected from healthcare staff from hospital, community, hospice and care home settings attending training days on breaking bad news between April 2011 and April 2014. Multiple inter-related factors presented challenges to staff engaging in activities associated with breaking bad news. Traditional subjects such as diagnostic and treatment information were described but additional topics were identified such as the impact of illness and care at the end of life. A descriptive framework was developed that summarizes the factors that contribute to creating difficult experiences for staff when breaking bad news. The framework provides insights into the scope of the challenges faced by staff when they engage in the process of breaking bad news. This provides the foundation for developing interventions to support staff that more closely matches their experiences in clinical practice. © 2017 John Wiley & Sons Ltd.

  15. Perceptual difficulty in source memory encoding and retrieval: prefrontal versus parietal electrical brain activity.

    Science.gov (United States)

    Kuo, Trudy Y; Van Petten, Cyma

    2008-01-01

    It is well established that source memory retrieval--remembering relationships between a core item and some additional attribute of an event--engages prefrontal cortex (PFC) more than simple item memory. In event-related potentials (ERPs), this is manifest in a late-onset difference over PFC between studied items which mandate retrieval of a second attribute, and unstudied items which can be immediately rejected. Although some sorts of attribute conjunctions are easier to remember than others, the role of source retrieval difficulty on prefrontal activity has received little attention. We examined memory for conjunctions of object shape and color when color was an integral part of the depicted object, and when monochrome objects were surrounded by colored frames. Source accuracy was reliably worse when shape and color were spatially separated, but prefrontal activity did not vary across the object-color and frame-color conditions. The insensitivity of prefrontal ERPs to this perceptual manipulation of difficulty stands in contrast to their sensitivity to encoding task: deliberate voluntary effort to integrate objects and colors during encoding reduced prefrontal activity during retrieval, but perceptual organization of stimuli did not. The amplitudes of ERPs over parietal cortex were larger for frame-color than object-color stimuli during both study and test phases of the memory task. Individual variability in parietal ERPs was strongly correlated with memory accuracy, which we suggest reflects a contribution of visual working memory to long-term memory. We discuss multiple bottlenecks for source memory performance.

  16. Parent-reported indicators for detecting feeding and swallowing difficulties and undernutrition in preschool-aged children with cerebral palsy.

    Science.gov (United States)

    Benfer, Katherine A; Weir, Kelly A; Ware, Robert S; Davies, Peter S W; Arvedson, Joan; Boyd, Roslyn N; Bell, Kristie L

    2017-11-01

    To determine the most accurate parent-reported indicators for detecting (1) feeding/swallowing difficulties and (2) undernutrition in preschool-aged children with cerebral palsy (CP). This was a longitudinal, population-based study, involving 179 children with CP, aged 18 to 60 months (mean 34.1mo [SD 11.9] at entry, 111 males, 68 females [Gross Motor Function Classification System level I, 84; II, 23; III, 28; IV, 18; V, 26], 423 data points). Feeding/swallowing difficulties were determined by the Dysphagia Disorders Survey and 16 signs suggestive of pharyngeal phase impairment. Undernutrition was indicated by height-weight and skinfold composite z-scores less than -2. Primary parent-reported indicators included mealtime duration, mealtime stress, concern about growth, and respiratory problems. Other indicators were derived from a parent feeding questionnaire, including 'significant difficulty eating and drinking'. Data were analysed using multilevel mixed-effects regression and diagnostic statistics. Primary parent-reported indicators associated with feeding/swallowing were 'moderate-severe parent stress' (odds ratio [OR]=3.2 [95% confidence interval {CI} 1.3-7.8]; ppalsy. Most accurate screening questions were 0-10 scales for 'difficulty eating' and 'difficulty drinking'. Supplementation of these scales with additional indicators would improve detection. © 2017 Mac Keith Press.

  17. Stimulating the development of coordination in pupils with developmental difficulties in elementary school

    Directory of Open Access Journals (Sweden)

    Maksimović Jasna

    2015-01-01

    Full Text Available The paper deals with the effects of specially programmed types of physical activities on the development of coordination of the pupils with developmental difficulties in regular elementary schools. The method of pedagogical research with parallel groups was used in the research which included 135 junior elementary-school pupils. Among them 90 pupils had one of developmental difficulties (intellectual disability, visual and hearing disturbances and they were divided into an experimental and a control group 1, while other pupils had typical development and they formed the control group 2 (n=45. Besides regular classes of physical education the experimental group was engaged in a special programme, devised and implemented into the Individual Educational Plan, as one of the types of intervention within the system of inclusive education. The research lasted for three months during which the groups were tested by the tests of coordination and the data obtained at the beginning and the end of the research period were processed by the application of univariant analysis of covariance and the T-test of the paired samples. The results show that the pupils with developmental difficulties can considerably progress in the development of coordination if their individual characteristics are recognized and optimal conditions are provided.

  18. Feasibility and Acceptability of Smartphone Assessment in Older Adults with Cognitive and Emotional Difficulties.

    Science.gov (United States)

    Ramsey, Alex T; Wetherell, Julie Loebach; Depp, Colin; Dixon, David; Lenze, Eric

    Ecological momentary assessment (EMA) has several advantages in clinical research yet little is known about the feasibility of collecting EMA data with mobile technologies in older adults, particularly those with emotional or cognitive difficulties. The aim of this feasibility study was to assess perceived acceptability, adherence rates, and reasons for non-adherence to smartphone-based EMA. At two sites, participants ( n =103) aged 65 years or older with a DSM-IV-defined anxiety or depressive disorder and cognitive concerns responded three times daily to smartphone-based EMA questions assessing clinical outcomes for two 10-day periods. Quantitative and qualitative measures assessed acceptability, adherence, and reasons for non-adherence following both 10-day EMA periods. Participants were moderately satisfied with and comfortable using smartphone-based EMA. Overall, 76% of participants completed surveys on ≥10 of the 20 assessment days, and 70% of participants completed at least 30% of the total surveys. Reasons for non-adherence included technical (malfunction), logistical (competing demands), physiological (hearing difficulties), and cognitive (forgetting) issues. Smartphone-based EMA is feasible in older adults with cognitive and emotional difficulties. EMA tools should be responsive to the needs and preferences of participants to ensure adequate acceptability and adherence in this population. Our findings can inform the design, development, and implementation of mobile technologies in older adults in research and clinical contexts.

  19. RANKING THE SPECTATORS’ DIFFICULTIES IN PURCHASING ELECTRONIC TICKETS OF FOOTBALL PREMIER LEAGUE

    Directory of Open Access Journals (Sweden)

    Ahmad Narimani

    2017-04-01

    Full Text Available This study aimed to rank the spectators’ difficulties in buying electronic tickets of football premier league matches at Azadi stadium. The population consisted of all spectators of Esteghlal-Persepolis match in the fifteenth league at Azadi stadium (N= 100000. According to Morgan table and using simple random sampling method, 500 participants were selected as sample. A researcher-made questionnaire was used for collecting the data; its face validity was confirmed by 15 experts and performing a pilot study on 30 subjects, its Cronbach’s alpha was calculated to be 0.86. Using SPSS 22, the descriptive and inferential (including Friedman test statistics was applied for analyzing the data. The findings showed that there was a significant difference between rankings of difficulties in buying electronic tickets of Football premier league matches at Azadi Stadium. The difficulties were ranked as: problem in ticket systems, early selling out of electronic tickets, lack of confidence to electronic ticket sale, lack of skill to work with the internet, low speed of internet, and lack of access to the internet

  20. Association between fine motor skills and binocular visual function in children with reading difficulties.

    Science.gov (United States)

    Niechwiej-Szwedo, Ewa; Alramis, Fatimah; Christian, Lisa W

    2017-12-01

    Performance of fine motor skills (FMS) assessed by a clinical test battery has been associated with reading achievement in school-age children. However, the nature of this association remains to be established. The aim of this study was to assess FMS in children with reading difficulties using two experimental tasks, and to determine if performance is associated with reduced binocular function. We hypothesized that in comparison to an age- and sex-matched control group, children identified with reading difficulties will perform worse only on a motor task that has been shown to rely on binocular input. To test this hypothesis, motor performance was assessed using two tasks: bead-threading and peg-board in 19 children who were reading below expected grade and age-level. Binocular vision assessment included tests for stereoacuity, fusional vergence, amplitude of accommodation, and accommodative facility. In comparison to the control group, children with reading difficulties performed significantly worse on the bead-threading task. In contrast, performance on the peg-board task was similar in both groups. Accommodative facility was the only measure of binocular function significantly associated with motor performance. Findings from our exploratory study suggest that normal binocular vision may provide an important sensory input for the optimal development of FMS and reading. Given the small sample size tested in the current study, further investigation to assess the contribution of binocular vision to the development and performance of FMS and reading is warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Relationship of cognitive function and adjustment difficulties among children and adolescents with dissociative disorder.

    Science.gov (United States)

    Ranjan, Rajeev; Mehta, Manju; Sagar, Rajesh; Sarkar, Siddharth

    2016-01-01

    Although it has been suggested that children and adolescents with dissociative disorder have some cognitive deficits, the association of these cognitive impairments with adjustment difficulties has not been evaluated. The present study aimed to assess the relationship between cognitive functioning and adjustment difficulties in children and adolescents with dissociative disorder. This cross-sectional, descriptive assessment was carried out in the outpatient setting of child and adolescent psychiatric service in a tertiary care hospital. Fifty newly diagnosed children and adolescents with dissociative disorder were included. The cognitive functions were assessed by varied neuropsychological tests, and Bell's adjustment inventory was used for assessing various domains of adjustment. The mean age of the sample which comprised 40% males was 13.0 (±2.4) years. The mean intelligence quotient (IQ) of the sample was 90.6. Impairment in cognitive test was maximum for verbal working memory followed by sustained attention, visual learning and memory, and verbal retention and recall. Adjustment difficulties were greatest in the domains of self, followed by domains of health, school, and family. Significant association was found between the IQ and adjustment in school; visual learning and memory and adjustments in school and overall adjustment; and sustained attention and adjustment of health. Dissociative children have poor cognitive ability which may be related to poor adjustment scores.

  2. Relationship of cognitive function and adjustment difficulties among children and adolescents with dissociative disorder

    Directory of Open Access Journals (Sweden)

    Rajeev Ranjan

    2016-01-01

    Full Text Available Background and Aims: Although it has been suggested that children and adolescents with dissociative disorder have some cognitive deficits, the association of these cognitive impairments with adjustment difficulties has not been evaluated. The present study aimed to assess the relationship between cognitive functioning and adjustment difficulties in children and adolescents with dissociative disorder. Methods: This cross-sectional, descriptive assessment was carried out in the outpatient setting of child and adolescent psychiatric service in a tertiary care hospital. Fifty newly diagnosed children and adolescents with dissociative disorder were included. The cognitive functions were assessed by varied neuropsychological tests, and Bell's adjustment inventory was used for assessing various domains of adjustment. Results: The mean age of the sample which comprised 40% males was 13.0 (±2.4 years. The mean intelligence quotient (IQ of the sample was 90.6. Impairment in cognitive test was maximum for verbal working memory followed by sustained attention, visual learning and memory, and verbal retention and recall. Adjustment difficulties were greatest in the domains of self, followed by domains of health, school, and family. Significant association was found between the IQ and adjustment in school; visual learning and memory and adjustments in school and overall adjustment; and sustained attention and adjustment of health. Conclusions: Dissociative children have poor cognitive ability which may be related to poor adjustment scores.

  3. An exploration of implications for the development of Pilates instructor system through identification of instructors' difficulties.

    Science.gov (United States)

    Roh, Su Yeon

    2016-08-01

    This study is aimed at exploring ideas for the development of Pilates instructor qualification system by identifying a range of difficulties Pilates instructors are experiencing. Open-ended questionnaires and semi-structured interviews were conducted to collect data before they were analyzed with inductive content analysis method. In consideration of the difficulties Pilates instructors experience during three qualification stages (before-during-after qualification education), three key categories were incorporated in the collected data: (1) lack of information on Pilates qualification system, (2) difficulties in understanding the human anatomy related with the diverse movements taught in Pilates classes and its application to Pilates practice, (3) need for professional development through retraining. Based on these findings, a need for rethinking the monitoring and evaluation process for Pilates qualification system and Pilates education in Korea was identified. In addition, we need to summarize and offer information on a range of Pilates qualifications. And the quality of Pilates instructor education program should be improved as well by proving them a range of teaching methods including microteaching, discussion-based lessons as well as reading and writing sessions and other necessary teaching media.

  4. An exploration of implications for the development of Pilates instructor system through identification of instructors’ difficulties

    Science.gov (United States)

    Roh, Su Yeon

    2016-01-01

    This study is aimed at exploring ideas for the development of Pilates instructor qualification system by identifying a range of difficulties Pilates instructors are experiencing. Open-ended questionnaires and semi-structured interviews were conducted to collect data before they were analyzed with inductive content analysis method. In consideration of the difficulties Pilates instructors experience during three qualification stages (before-during-after qualification education), three key categories were incorporated in the collected data: (1) lack of information on Pilates qualification system, (2) difficulties in understanding the human anatomy related with the diverse movements taught in Pilates classes and its application to Pilates practice, (3) need for professional development through retraining. Based on these findings, a need for rethinking the monitoring and evaluation process for Pilates qualification system and Pilates education in Korea was identified. In addition, we need to summarize and offer information on a range of Pilates qualifications. And the quality of Pilates instructor education program should be improved as well by proving them a range of teaching methods including microteaching, discussion-based lessons as well as reading and writing sessions and other necessary teaching media. PMID:27656634

  5. Sleep in childhood and adolescence: age-specific sleep characteristics, common sleep disturbances and associated difficulties.

    Science.gov (United States)

    Barclay, Nicola L; Gregory, Alice M

    2014-01-01

    Sleep changes throughout the lifespan, with particularly salient alterations occurring during the first few years of life, as well as during the transition from childhood to adolescence. Such changes are partly the result of brain maturation; complex changes in the organisation of the circadian system; as well as changes in daily routine, environmental demands and responsibilities. Despite the automaticity of sleep, given that it is governed by a host of complex mechanisms, there are times when sleep becomes disturbed. Sleep disturbances in childhood are common and may stem from behavioural difficulties or abnormalities in physiological processes-and, in some cases manifest into diagnosable sleep disorders. As well as occurring exclusively, childhood sleep disturbances often co-occur with other difficulties. The purpose of this chapter is to outline the neurobiology of typical sleep/wake processes, and describe changes in sleep physiology and architecture from birth to adulthood. Furthermore, common childhood sleep disorders are described as are their associations with other traits, including all of the syndromes presented in this handbook: ASDs, ADHD, schizophrenia and emotional/behavioural difficulties. Throughout, we attempt to explain possible mechanisms underlying these disorders and their associations.

  6. Precursors of Reading Difficulties in Czech and Slovak Children At-Risk of Dyslexia.

    Science.gov (United States)

    Moll, Kristina; Thompson, Paul A; Mikulajova, Marina; Jagercikova, Zuzana; Kucharska, Anna; Franke, Helena; Hulme, Charles; Snowling, Margaret J

    2016-05-01

    Children with preschool language difficulties are at high risk of literacy problems; however, the nature of the relationship between delayed language development and dyslexia is not understood. Three hundred eight Slovak and Czech children were recruited into three groups: family risk of dyslexia, speech/language difficulties and controls, and were assessed three times from kindergarten until Grade 1. There was a twofold increase in probability of reading problems in each risk group. Precursors of 'dyslexia' included difficulties in oral language and code-related skills (phoneme awareness, letter-knowledge and rapid automatized naming); poor performance in phonological memory and vocabulary was observed in both affected and unaffected high-risk peers. A two-group latent variable path model shows that early language skills predict code-related skills, which in turn predict literacy skills. Findings suggest that dyslexia in Slavic languages has its origins in early language deficits, and children who succumb to reading problems show impaired code-related skills before the onset of formal reading instruction. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. An evaluation of clinical treatment of convergence insufficiency for children with reading difficulties

    Directory of Open Access Journals (Sweden)

    Dusek Wolfgang A

    2011-08-01

    Full Text Available Abstract Background The present study investigates two different treatment options for convergence insufficiency CI for a group of children with reading difficulties referred by educational institutes to a specialist eye clinic in Vienna. Methods One hundred and thirty four subjects (aged 7-14 years with reading difficulties were referred from an educational institute in Vienna, Austria for visual assessment. Each child was given either 8Δ base-in reading spectacles (n = 51 or computerised home vision therapy (HTS (n = 51. Thirty two participants refused all treatment offered (clinical control group. A full visual assessment including reading speed and accuracy were conducted pre- and post-treatment. Results Factorial analyses demonstrated statistically significant changes between results obtained for visits 1 and 2 for total reading time, reading error score, amplitude of accommodation and binocular accommodative facility (within subjects effects (p Conclusions Reading difficulties with no apparent intellectual or psychological foundation may be due to a binocular vision anomaly such as convergence insufficiency. Both the HTS and prismatic correction are highly effective treatment options for convergence insufficiency. Prismatic correction can be considered an effective alternative to HTS.

  8. Optimization of perceptual learning: effects of task difficulty and external noise in older adults.

    Science.gov (United States)

    DeLoss, Denton J; Watanabe, Takeo; Andersen, George J

    2014-06-01

    Previous research has shown a wide array of age-related declines in vision. The current study examined the effects of perceptual learning (PL), external noise, and task difficulty in fine orientation discrimination with older individuals (mean age 71.73, range 65-91). Thirty-two older subjects participated in seven 1.5-h sessions conducted on separate days over a three-week period. A two-alternative forced choice procedure was used in discriminating the orientation of Gabor patches. Four training groups were examined in which the standard orientations for training were either easy or difficult and included either external noise (additive Gaussian noise) or no external noise. In addition, the transfer to an untrained orientation and noise levels were examined. An analysis of the four groups prior to training indicated no significant differences between the groups. An analysis of the change in performance post-training indicated that the degree of learning was related to task difficulty and the presence of external noise during training. In addition, measurements of pupil diameter indicated that changes in orientation discrimination were not associated with changes in retinal illuminance. These results suggest that task difficulty and training in noise are factors important for optimizing the effects of training among older individuals. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Theory including future not excluded

    DEFF Research Database (Denmark)

    Nagao, K.; Nielsen, H.B.

    2013-01-01

    We study a complex action theory (CAT) whose path runs over not only past but also future. We show that, if we regard a matrix element defined in terms of the future state at time T and the past state at time TA as an expectation value in the CAT, then we are allowed to have the Heisenberg equation......, Ehrenfest's theorem, and the conserved probability current density. In addition,we showthat the expectation value at the present time t of a future-included theory for large T - t and large t - T corresponds to that of a future-not-included theory with a proper inner product for large t - T. Hence, the CAT...

  10. Emotion regulation difficulties in disordered eating: Examining the psychometric properties of the Difficulties in Emotion Regulation Scale among Spanish adults and its interrelations with personality and eating disorder severity

    Directory of Open Access Journals (Sweden)

    Ines eWolz

    2015-06-01

    Full Text Available Objective: The aims of the study were to 1 validate the Difficulties in Emotion Regulation Scale (DERS in a sample of Spanish adults with and without eating disorders, and 2 explore the role of emotion regulation difficulties in eating disorders, including its mediating role in the relation between key personality traits and ED severity Methods: 134 patients (121 female, mean age = 29 years with anorexia nervosa (n = 30, bulimia nervosa (n = 54, binge eating (n = 20, or Other Specified Feeding or Eating Disorders (n = 30 and 74 healthy control participants (51 female, mean age = 21 years reported on general psychopathology, eating disorder severity, personality traits and difficulties in emotion regulation. Exploratory and confirmatory factor analyses were conducted to examine the psychometrics of the DERS in this Spanish sample (Aim 1. Additionally, to examine the role of emotion regulation difficulties in eating disorders (Aim 2, differences in emotion regulation difficulties across eating disorder subgroups were examined and structural equation modeling was used to explore the interrelations among emotion regulation, personality traits, and eating disorder severity. Results: Results support the validity and reliability of the DERS within this Spanish adult sample and suggest that this measure has a similar factor structure in this sample as in the original sample. Moreover, emotion regulation difficulties were found to differ as a function of eating disorder subtype and to mediate the relation between two specific personality traits (i.e., high harm avoidance and low self-directedness and eating disorder severity. Conclusions: Personality traits of high harm avoidance and low self-directedness may increase vulnerability to eating disorder pathology indirectly, through emotion regulation difficulties.

  11. BIOETHICAL SENSIBILITY OF THE LAW ON PROTECTION OF PERSONS WITH MENTAL DIFFICULTIES

    Directory of Open Access Journals (Sweden)

    Velinka Grozdanić

    2017-01-01

    Full Text Available A more and more obvious gap between the human spiritual development, which mostly stagnates, and often even regresses, and the technological development of society, which intensively and unstoppably grows, has been the initiation of numerous bioethical discussions that cover a wide range of topics, i.e. from a concern for a man and his health to a concern for nature and preservation of life in general. No matter the fact that numerous ethical discussions, which highlighted the last decade, have resulted with commonly accepted principles, several ethical issues were left without clear and unambiguous solutions. Within this context, the legal regulations expected to protect persons from unacceptable and harmful actions, but at the same time not to present an obstacle to scientific and technological development of society, have gained a special meaning. This is a significant challenge due to the fact that through statutory provisions we need to reach a balance between the freedom of scientific research and protection of a man. Although ethical dilemmas follow almost every field of human actions, bioethical contents are especially associated with the unimaginable technological achievements in medicine. Thereby, persons with mental difficulties, as one of the most vulnerable groups of patients, demand a highlighted bioethical sensibility within the meaning of humanity, understanding and enhanced awareness when ethically questionable medical procedures are applied on them, and especially when these patients are included in, sometimes even hazardous, biomedical researches. A basic protective mechanism for this category of persons in the Republic of Croatia is the Law on Protection of Persons with Mental Difficulties. The Law establishes a clear legal framework to proceed with actions designated for persons with mental difficulties, and certain legal provisions embodied within the Law could be considered a quite concrete answer to numerous ethical

  12. Development of cognitive processes inschoolchildren with learning difficulties inthe light ofanalysis ofWISC-R results

    Directory of Open Access Journals (Sweden)

    Joanna Mazurkiewicz-Gronowska

    2012-09-01

    Full Text Available For several years now, noticeable has been a significant increase in the interest of psychologists – practitioners and scientists, of parents and teachers in the issues of dyslexia, dyscalculia, and other developmental disorders. Specific learning difficulties constitute one of the most prevalent causes of reporting children to psychological and pedagogic outpatient departments. The results of the performed studies enable inter- and intra-group comparisons as well as a global analysis of the structure of intellectual development in children with various learning difficulties. This leads to interesting conclusions and allows for comprehensive scientific discussions. The subject of the article is presentation of the results of studies and conclusions formulated according to them, about the structure of intellectual development of children with learning difficulties diagnosed in two psychological-pedagogic outpatient departments in Lublin region (Psychological-Pedagogic Outpatient Department No 5 in Lublin and PsychologicalPedagogic Outpatient Department No 2 in Zamość. Analysed were the results of the WISC-R scale obtained by schoolchildren from forms IV-VI of elementary schools and junior secondary schools in Lublin and schools of Zamość county. As scholastic difficulties constitute quite a comprehensive term, generally perceived as problems in acquisition of information and mastering school skills, in our study we take into account the following three groups of schoolchildren: with developmental dyslexia, intelligence lower than average, and specific disorders in arithmetic skills. The performed analyses are aimed at familiarization with the developmental level of the schoolchildren’s cognitive functions and their intellectual skills structure based on a three-factor analysis. Our studies continue earlier analyses, including more comprehensive research areas with larger groups.

  13. Difficulties of adaptation to Order 453 by radiology services

    International Nuclear Information System (INIS)

    Padilha Filho, L.G.; Chernicharo, C.C.; Montone Junior, V.; Lenine, R.C.; Berquo, F.R.; Koch, H.A.; Costa, V.C.M. da; Rodrigues, I.V.; Duarte, N.S.; Silva, M.O. da

    2001-01-01

    This work has as its objective to present some difficulties of adaptation of a Radiological Service to Order 453, of Health Ministry. The Order 453, gives regulations to use of radiodiagnostic techniques and require the implementation of Quality Assurance Programs in all institution that make use of ionizing radiation. A survey of functioning conditions of General Hospital - Radiological Service of Santa Casa de Misericordia do Rio de Janeiro, was performed with basis on Order 453. After analysis of these conditions, were noticed some needs as, improvement of professional competence about radiation protection and implementation of a Quality Assurance Program in radiological unit of this hospital

  14. CONTRIBUTING FACTORS TOWARDS DIFFICULTIES IN GENERATING IDEAS AMONG TECHNICAL STUDENTS

    OpenAIRE

    Yee Mei Heong

    2013-01-01

    Idea is a thought or collection of thoughts that are important to decision making and problem solving.  The purpose of this research was to analysis the factors contributing to difficulty in generating ideas among technical students.  A total of 375 technical students from four technical universities in Malaysia were randomly selected as samples.  A set of questionnaires was developed and used as research instrument.  The findings indicated that a total of 319 (85.1%) technical students faced...

  15. Colombian Artists and Digital Music Platforms: Some Difficulties

    Directory of Open Access Journals (Sweden)

    Marcela Palacio Puerta

    2017-12-01

    Full Text Available The Internet provides new business opportunities for the music industry, especially for both independent artists and record companies. The reason of the latter is the great proliferation and growth of digital music platforms. However, contrary to statistics, artists have not been able to benefit of such opportunities in the expected manner. The academic development on this subject is in its beginnings especially with respect to the Colombian panorama, therefore for the first time in the literature, this paper draws some of the difficulties that the Colombian artists face in the world of the digital music.

  16. Difficulties with Prenatal Diagnosis of the Walker-Warburg Syndrome

    International Nuclear Information System (INIS)

    Low, A.S.C.; Lee, S.L.; Tan, A.S.A.; Chan, D.K.L.; Chan, L.L.

    2005-01-01

    We describe a postnatally diagnosed case of Walker-Warburg syndrome - a form of congenital muscular dystrophy with lissencephaly and eye abnormalities. We reviewed the literature to highlight its clinico-radiological diagnostic features and discuss the difficulties encountered with prenatal diagnosis, especially in cases with no positive family history. An increased awareness of this rare but lethal condition, and a high index of suspicion during routine antenatal ultrasound, could prompt further advanced fetal ultrasonography and magnetic resonance imaging, and aid in timely prenatal diagnosis, management, and counseling. Brain/brainstem, congenital, magnetic resonance imaging, obstetrics, pediatrics, ultrasound

  17. ADULTS’ LEARNING IN A MULTILEVEL GROUP: DIFFICULTIES AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    Salamatina, I.I.

    2017-12-01

    Full Text Available One of the necessary conditions of modernization of higher education system of the Russian Federation is to increase the level of academic mobility of the teaching community of Russian Universities. To solve this problem in 2014 in the State University of Humanities and Social Studies it was made the decision to organize the biennial English language courses for teachers of non-linguistic specialties, to enhance their level of proficiency. The greatest difficulty in teaching was because of different levels of language proficiency, so the teacher had to develop an effective methodology of teaching English for different levels of students.

  18. [Double localization of pancreatic insulinoma. Diagnostic and therapeutic difficulties].

    Science.gov (United States)

    Ungureanu, C D; David, L; Braşoveanu, V; Herlea, V; Coculescu, M; Popescu, I

    2005-01-01

    Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism. Because most of insulinomas are less than 2 cm in size and rarely they not may be visible by CT scan or transabdominal ultrasonography. Intraoperative ultrasonography may be a solution. Although as surgical method is preferred enucleation because operative time is shorter and easier and the low frequency postoperative complications, pancreaticoduodenectomy Whipple is indicated in selected cases. We report a case of double insulinoma located in the head of the pancreas in which the diagnosis and surgical treatment presented difficulties which determined a particular clinical evolution.

  19. Difficulties in modeling dispersed-flow film boiling

    International Nuclear Information System (INIS)

    Andreani, M.; Yadigaroglu, G.

    1991-01-01

    Dispersed Flow Film Boiling (DFFB) is characterized by important departures from thermal and velocity equilibrium that make it suitable for modeling with two-fluid models. The fundamental limitations and difficulties imposed by the one-dimensional nature of these models are extensively discussed. The validity of the assumptions and empirical laws used to close the system of conservation equations is critically reviewed, in light of the multidimensional aspects of the problem. Modifications that could improve the physics of the models are identified. (orig.) [de

  20. A web-based endodontic case difficulty assessment tool.

    Science.gov (United States)

    Shah, P K; Chong, B S

    2018-01-25

    To develop a web-based tool to facilitate identification, evaluation and management of teeth requiring endodontic treatment. Following a literature search and thorough analysis of existing case difficulty assessment forms, the web-based tool was developed using an online survey builder (Qualtrics, Qualtrics Lab, UT, USA). Following feedback from a pilot study, it was refined and improved. A study was performed, using the updated version (EndoApp) on a cohort (n = 53) of dental professionals and dental students. The participants were e-mailed instructions detailing the assessment of five test cases using EndoApp, followed by completion of a structured feedback form. Analysis of the EndoApp responses was used to evaluate usage times, whereas the results of the feedback forms were used to assess user experience and relevance, other potential applications and comments on further improvement/s. The average usage time was 2 min 7 s; the average times needed for the last three (Cases 3-5) were significantly less than the preceding two (Cases 1 & 2) test cases. An overwhelming majority of participants expressed favourable views on user experience and relevance of the web-based case difficulty assessment tool. Only two participants (4%) were unlikely or very unlikely to use EndoApp again. The potential application of EndoApp as an 'educational tool' and for 'primary care triage' was deemed the most popular features and of greater importance than the secondary options of 'fee setting' and as a 'dento-legal justification tool'. Within the study limitations, owing to its ability to quantify the level of difficulty and provide guidance, EndoApp was considered user-friendly and helped facilitate endodontic case difficulty assessment. From the feedback, further improvements and the development of a Smartphone App version are in progress. EndoApp may facilitate treatment planning, improve treatment cost-effectiveness and reduce frequency of procedural errors by providing

  1. [Difficulties at work and work motivation of ulcerative colitis suffers].

    Science.gov (United States)

    Nasu, Ayami; Yamada, Kazuko; Morioka, Ikuharu

    2015-01-01

    Because ulcerative colitis (UC) repeats remission and relapse, it is necessary to keep the condition at the relapse time in mind when considering support to provide UC suffers with at the workplace. The aim of this survey was to clarify the difficulties at work and work motivation that UC suffers feel at present and experience at the worsening time, and the factors for maintaining work motivation. We carried out an anonymous questionnaire survey of patients with present or past work experience. The difficulties at work (17 items) and work motivation (4 items) in the past week and at the time when the symptoms were most intensive during work were investigated using a newly designed questionnaire. We regarded the time in the past week as the present, and the time when the symptoms were most intensive during work as the worsening time. There were 70 respondents (response rate 32.0%). Their mean age was 43.8 years, and their mean age at onset was 33.8 years. All subjects, except 2 subjects after surgery, took medicine. Fifty-three (75.7%) of the subjects were in remission at the present, and most of them (91.4%) managed their physical condition well. Difficulties at work that many subjects worried about at the present were relevant to work conditions, such as "Others at workplace do not understand having an intractable and relapsing disease" (41.4%) or "Feel delayed or lack of chance of promotion or career advancement due to the disease" (38.6%). At the worsening time, the management of physical condition went wrong, and the frequency of hospital visits was increased, but few subjects consulted with superiors or colleagues at workplace. Difficulties at work that many subjects underwent at the worsening time were relevant to symptoms, such as "Feel physically tired" (80.0%) or "Decline foods or alcoholic beverages offered at business parties" (72.9%). Those who maintained work motivation even at the worsening time received no work-related consideration and had an

  2. Adjusting game difficulty level through Formal Concept Analysis

    Science.gov (United States)

    Gómez-Martín, Marco A.; Gómez-Martín, Pedro P.; Gonzâlez-Calero, Pedro A.; Díaz-Agudo, Belén

    In order to reach as many players as possible, videogames usually allow the user to choose the difficulty level. To do it, game designers have to decide the values that some game parameters will have depending on that decision. In simple videogames this is almost trivial: minesweeper is harder with longer board sizes and number of mines. In more complex games, game designers may take advantage of data mining to establish which of all the possible parameters will affect positively to the player experience. This paper describes the use of Formal Concept Analysis to help to balance the game using the logs obtained in the tests made prior the release of the game.

  3. Psychological Characteristics of Personality in Students with Learning Difficulties

    Directory of Open Access Journals (Sweden)

    T A Shilova

    2014-12-01

    Full Text Available The article presents the research of the psychological characteristics of the personality of a student with learning difficulties from the position of the mismatch of mental development in operational sphere. The article considers the system of methods of research with the personality-oriented approach. The influence of certain psychological characteristics of a personality on the outcome of the study is revealed. The ways of building correctional-developing programmes for psychological preparation of junior schoolchildren for successful learning are shown.

  4. Difficulties with Prenatal Diagnosis of the Walker-Warburg Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Low, A.S.C.; Lee, S.L.; Tan, A.S.A.; Chan, D.K.L.; Chan, L.L. [Singapore General Hospital (Singapore). Depts. of Diagnostic Radiology, Obstetrics and Gynecology and Neonatology

    2005-10-01

    We describe a postnatally diagnosed case of Walker-Warburg syndrome - a form of congenital muscular dystrophy with lissencephaly and eye abnormalities. We reviewed the literature to highlight its clinico-radiological diagnostic features and discuss the difficulties encountered with prenatal diagnosis, especially in cases with no positive family history. An increased awareness of this rare but lethal condition, and a high index of suspicion during routine antenatal ultrasound, could prompt further advanced fetal ultrasonography and magnetic resonance imaging, and aid in timely prenatal diagnosis, management, and counseling. Brain/brainstem, congenital, magnetic resonance imaging, obstetrics, pediatrics, ultrasound.

  5. Multiple Sclerosis

    Science.gov (United States)

    ... you are at higher risk of developing the disease. Certain infections. A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis. Race. White ...

  6. Investigating Simulated Driving Errors in Amnestic Single- and Multiple-Domain Mild Cognitive Impairment.

    Science.gov (United States)

    Hird, Megan A; Vesely, Kristin A; Fischer, Corinne E; Graham, Simon J; Naglie, Gary; Schweizer, Tom A

    2017-01-01

    The areas of driving impairment characteristic of mild cognitive impairment (MCI) remain unclear. This study compared the simulated driving performance of 24 individuals with MCI, including amnestic single-domain (sd-MCI, n = 11) and amnestic multiple-domain MCI (md-MCI, n = 13), and 20 age-matched controls. Individuals with MCI committed over twice as many driving errors (20.0 versus 9.9), demonstrated difficulty with lane maintenance, and committed more errors during left turns with traffic compared to healthy controls. Specifically, individuals with md-MCI demonstrated greater driving difficulty compared to healthy controls, relative to those with sd-MCI. Differentiating between different subtypes of MCI may be important when evaluating driving safety.

  7. Increased Difficulties in Managing Stairs in Visually Impaired Older Adults: A Community-Based Survey.

    Directory of Open Access Journals (Sweden)

    Chen-Wei Pan

    Full Text Available Managing stairs is a challenging aspect of daily activities of living for older people. We assessed whether older adults with visual impairment (VI have greater difficulties of managing stairs in daily lives.The study was designed as a community-based cross-sectional study based on a Chinese cohort aged 60 years and older in rural China. Visual acuity (VA was measured in both eyes using a retro-illuminated Snellen chart with tumbling-E optotypes. VI (including blindness was defined as presenting VA of worse than 20/60 in either eye. Having any difficulties in managing stairs was self-reported based on a question drawn from the Barthel Index. Information on participants' socioeconomic status, lifestyle-related factors, diseases histories and medication intake was collected using a questionnaire.The Barthel Index, Activities of Daily Living questionnaire was completed by 4597 (99.7% participants including 2218 men and 2379 women. The age of the participants ranged from 60 to 93 years with a mean of 67.6 ± 6.3 years. In age and gender adjusted models, adults with VI had a higher likelihood of having difficulties in managing stairs (odds ratio [OR] = 2.7; 95% confidence interval [CI] 2.0, 3.7 compared with those without. The association of VI with the likelihood of having difficulties in managing stairs was stronger in older adults who lived alone (OR = 3.2; 95%CI 1.8, 4.5 compared with those who lived with other family members (OR = 2.0; 95%CI 1.3, 4.3. Compared with hypertension, diabetes, obesity and cognitive dysfunction, VI had the greatest impact on people's abilities of managing stairs.VI was associated with an increased likelihood of having difficulties in managing stairs, especially in those who lived alone. However, whether the finding could be extrapolated to other populations warrants further studies as different environmental exposures such as illumination and types of stairs may alter the association observed in this study.

  8. Space technology transfer to developing countries: opportunities and difficulties

    Science.gov (United States)

    Leloglu, U. M.; Kocaoglan, E.

    Space technology, with its implications on science, economy and security, is mostly chosen as one of the priority areas for technological development by developing countries. Most nations aspiring to begin playing in the space league prefer technology transfer programs as a first step. Decreasing initial costs by small satellite technology made this affordable for many countries. However, there is a long way from this first step to establishment of a reliable space industry that can both survive in the long term with limited financial support from the government and meet national needs. This is especially difficult when major defense companies of industrialized countries are merging to sustain their competitiveness. The prerequisites for the success are implementation of a well-planned space program and existence of industrialization that can support basic testing and manufacturing activities and supply qualified manpower. In this study, the difficulties to be negotiated and the vicious circles to be broken for latecomers, that is, developing countries that invest on space technologies are discussed. Especially, difficulties in the technology transfer process itself, brain drain from developing countries to industrialized countries, strong competition from big space companies for domestic needs, costs of establishing and maintaining an infrastructure necessary for manufacturing and testing activities, and finally, the impact of export control will be emphasized. We will also try to address how and to what extent collaboration can solve or minimize these problems. In discussing the ideas mentioned above, lessons learned from the BILSAT Project, a technology transfer program from the UK, will be referred.

  9. Emotional regulation difficulties and premenstrual symptoms among Israeli students.

    Science.gov (United States)

    Reuveni, Inbal; Dan, Rotem; Segman, Ronen; Evron, Ron; Laufer, Sofia; Goelman, Gadi; Bonne, Omer; Canetti, Laura

    2016-12-01

    Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) reported to affect 3-8 % of women of reproductive age and resulting in marked emotional and occupational impairment. Despite its prevalence, the etiology of PMDD is largely unknown, and patients remain mostly undiagnosed and poorly treated. It has been suggested that PMDD is a manifestation of underlying depressive disorder which is associated with the inability to regulate emotions in an adaptive manner. Therefore, we hypothesized that women with PMDD would exhibit increased difficulty with emotional regulation. A total of 648 female Israeli college students were assessed by the Premenstrual Symptoms Screening Tool (PSST) and the Difficulties in Emotion Regulation Scale (DERS). Of these women, 166 (25.6 %) met the criteria for PMS. Sixty-four (9.9 %) suffered from PMDD. More emotion regulation deficits were observed in the PMDD and PMS groups compared to the control group. Furthermore, there were more emotional regulation deficits among the predominantly psychological and mixed symptom subtype compared to the predominantly physical symptom subtype group. This is the first study to report an association between emotional dysregulation and PMDD. These findings may lead to development of more individually tailored treatment protocols focused on improving emotional regulation techniques.

  10. Improving readability through extractive summarization for learners with reading difficulties

    Directory of Open Access Journals (Sweden)

    K. Nandhini

    2013-11-01

    Full Text Available In this paper, we describe the design and evaluation of extractive summarization approach to assist the learners with reading difficulties. As existing summarization approaches inherently assign more weights to the important sentences, our approach predicts the summary sentences that are important as well as readable to the target audience with good accuracy. We used supervised machine learning technique for summary extraction of science and social subjects in the educational text. Various independent features from the existing literature for predicting important sentences and proposed learner dependent features for predicting readable sentences are extracted from texts and are used for automatic classification. We performed both extrinsic and intrinsic evaluation on this approach and the intrinsic evaluation is carried out using F-measure and readability analysis. The extrinsic evaluation comprises of learner feedback using likert scale and the effect of assistive summary on improving readability for learners’ with reading difficulty using ANOVA. The results show significant improvement in readability for the target audience using assistive summary.

  11. Student Difficulties in Learning Density: A Distributed Cognition Perspective

    Science.gov (United States)

    Xu, Lihua; Clarke, David

    2012-08-01

    Density has been reported as one of the most difficult concepts for secondary school students (e.g. Smith et al. 1997). Discussion about the difficulties of learning this concept has been largely focused on the complexity of the concept itself or student misconceptions. Few, if any, have investigated how the concept of density was constituted in classroom interactions, and what consequences these interactions have for individual students' conceptual understanding. This paper reports a detailed analysis of two lessons on density in a 7th Grade Australian science classroom, employing the theory of Distributed Cognition (Hollan et al. 1999; Hutchins 1995). The analysis demonstrated that student understanding of density was shaped strongly by the public classroom discussion on the density of two metal blocks. It also revealed the ambiguities associated with the teacher demonstration and the student practical work. These ambiguities contributed to student difficulties with the concept of density identified in this classroom. The results of this study suggest that deliberate effort is needed to establish shared understanding not only about the purpose of the activities, but also about the meaning of scientific language and the utility of tools. It also suggests the importance of appropriate employment of instructional resources in order to facilitate student scientific understanding.

  12. Social communication difficulties and autism in previously institutionalized children.

    Science.gov (United States)

    Levin, April R; Fox, Nathan A; Zeanah, Charles H; Nelson, Charles A

    2015-02-01

    To determine the risk of difficulties with social communication and restricted/repetitive behaviors as well as the rate of autism in children institutionalized in early infancy and to assess the impact of a foster care intervention on ameliorating this risk. Children abandoned at birth and raised in institutions in Bucharest, Romania were randomly assigned to a care-as-usual group (institutional care, CAUG), or placed in family-centered foster care (FCG) as part of the Bucharest Early Intervention Project (BEIP). At approximately 10 years of age, the Social Communication Questionnaire (SCQ) was administered to caregivers of children in both groups as well as to parents of a typically developing community sample (Never-Institutionalized group [NIG]) residing in Bucharest, Romania. Children scoring ≥12 on the SCQ underwent clinical evaluation for autism spectrum disorder (ASD). Caregivers of children with a history of institutionalization reported that these children had significantly more deviant behavior than never-institutionalized children on all subdomains of the SCQ (all p communication. Three of 60 CAUG children, 2 of 57 FCG children, and none of the NIG children received a formal ASD diagnosis. Early institutional rearing was associated with an increased risk of social communication difficulties and ASD. A family-centered foster care intervention improved social communication skills. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. Merits and difficulties in adopting codes, standards and nuclear regulations

    International Nuclear Information System (INIS)

    El-Saiedi, A.F.; Morsy, S.; Mariy, A.

    1978-01-01

    Developing countries planning for introducing nuclear power plants as a source of energy have to develop or adopt sound regulatory practices. These are necessary to help governmental authorities to assess the safety of nuclear power plants and to perform inspections needed to confirm the established safe and sound limits. The first requirement is to form an independent regulatory body capable of setting up and enforcing proper safety regulations. The formation of this body is governed by several considerations related to local conditions in the developing countries, which may not always be favourable. It is quite impractical for countries with limited experience in the nuclear power field to develop their own codes, standards and regulations required for the nuclear regulatory body to perform its tasks. A practical way is to adopt codes, standards and regulations of a well-developed country. This has merits as well as drawbacks. The latter are related to problems of personnel, software, equipment and facilities. The difficulties involved in forming a nuclear regulatory body, and the merits and difficulties in adopting foreign codes, standards and regulations required for such body to perform its tasks, are discussed in this paper. Discussions are applicable to many developing countries and particular emphasis is given to the conditions and practices in Egypt. (author)

  14. Undergraduate Students' Experiences in Programming: Difficulties and Obstacles

    Directory of Open Access Journals (Sweden)

    Büşra Özmen

    2014-03-01

    Full Text Available Programming courses become prominent as one of the courses in which undergraduate students are unsuccessful especially in departments which offer computer education. Students often state that these courses are quite difficult compared to other courses. Therefore, a qualitative phenomenological approach was used to reveal the reasons of the failures of the undergraduate students in programming courses and to examine the difficulties they confronted with programming. In this scope, the laboratory practices of the Internet Programming course were observed in fall term of the 2013-2014 academic year in a university at central Anatolia. Interviews were made with 12 undergraduate students taking this course. Finally, the difficulties students experienced in the programming were determined as programming knowledge, programming skills, understanding semantics of the program, and debugging. Students emphasized that the biggest causes of failure in programming languages are lack of practice, not using algorithms and lack of knowledge. In addition, it was seen that the students who had high programming experience possess higher programming success and self-efficacy related to programming

  15. Device including a contact detector

    DEFF Research Database (Denmark)

    2011-01-01

    arms (12) may extend from the supporting body in co-planar relationship with the first surface. The plurality of cantilever arms (12) may extend substantially parallel to each other and each of the plurality of cantilever arms (12) may include an electrical conductive tip for contacting the area......The present invention relates to a probe for determining an electrical property of an area of a surface of a test sample, the probe is intended to be in a specific orientation relative to the test sample. The probe may comprise a supporting body defining a first surface. A plurality of cantilever...... of the test sample by movement of the probe relative to the surface of the test sample into the specific orientation.; The probe may further comprise a contact detector (14) extending from the supporting body arranged so as to contact the surface of the test sample prior to any one of the plurality...

  16. Neoclassical transport including collisional nonlinearity.

    Science.gov (United States)

    Candy, J; Belli, E A

    2011-06-10

    In the standard δf theory of neoclassical transport, the zeroth-order (Maxwellian) solution is obtained analytically via the solution of a nonlinear equation. The first-order correction δf is subsequently computed as the solution of a linear, inhomogeneous equation that includes the linearized Fokker-Planck collision operator. This equation admits analytic solutions only in extreme asymptotic limits (banana, plateau, Pfirsch-Schlüter), and so must be solved numerically for realistic plasma parameters. Recently, numerical codes have appeared which attempt to compute the total distribution f more accurately than in the standard ordering by retaining some nonlinear terms related to finite-orbit width, while simultaneously reusing some form of the linearized collision operator. In this work we show that higher-order corrections to the distribution function may be unphysical if collisional nonlinearities are ignored.

  17. Sit less and move more: perspectives of adults with multiple sclerosis.

    Science.gov (United States)

    Aminian, Saeideh; Ezeugwu, Victor E; Motl, Robert W; Manns, Patricia J

    2017-12-20

    Multiple sclerosis is a chronic neurological disease with the highest prevalence in Canada. Replacing sedentary behavior with light activities may be a feasible approach to manage multiple sclerosis symptoms. This study explored the perspectives of adults with multiple sclerosis about sedentary behavior, physical activity and ways to change behavior. Fifteen adults with multiple sclerosis (age 43 ± 13 years; mean ± standard deviation), recruited through the multiple sclerosis Clinic at the University of Alberta, Edmonton, Canada, participated in semi-structured interviews. Interview audios were transcribed verbatim and coded. NVivo software was used to facilitate the inductive process of thematic analysis. Balancing competing priorities between sitting and moving was the primary theme. Participants were aware of the benefits of physical activity to their overall health, and in the management of fatigue and muscle stiffness. Due to fatigue, they often chose sitting to get their energy back. Further, some barriers included perceived fear of losing balance or embarrassment while walking. Activity monitoring, accountability, educational and individualized programs were suggested strategies to motivate more movement. Adults with multiple sclerosis were open to the idea of replacing sitting with light activities. Motivational and educational programs are required to help them to change sedentary behavior to moving more. IMPLICATIONS FOR REHABILITATION One of the most challenging and common difficulties of multiple sclerosis is walking impairment that worsens because of multiple sclerosis progression, and is a common goal in the rehabilitation of people with multiple sclerosis. The deterioration in walking abilities is related to lower levels of physical activity and more sedentary behavior, such that adults with multiple sclerosis spend 8 to 10.5 h per day sitting. Replacing prolonged sedentary behavior with light physical activities, and incorporating education

  18. Multiplicity in Early Stellar Evolution

    Science.gov (United States)

    Reipurth, B.; Clarke, C. J.; Boss, A. P.; Goodwin, S. P.; Rodríguez, L. F.; Stassun, K. G.; Tokovinin, A.; Zinnecker, H.

    Observations from optical to centimeter wavelengths have demonstrated that multiple systems of two or more bodies is the norm at all stellar evolutionary stages. Multiple systems are widely agreed to result from the collapse and fragmentation of cloud cores, despite the inhibiting influence of magnetic fields. Surveys of class 0 protostars with millimeter interferometers have revealed a very high multiplicity frequency of about 2/3, even though there are observational difficulties in resolving close protobinaries, thus supporting the possibility that all stars could be born in multiple systems. Near-infrared adaptive optics observations of class I protostars show a lower binary frequency relative to the class 0 phase, a declining trend that continues through the class II/III stages to the field population. This loss of companions is a natural consequence of dynamical interplay in small multiple systems, leading to ejection of members. We discuss observational consequences of this dynamical evolution, and its influence on circumstellar disks, and we review the evolution of circumbinary disks and their role in defining binary mass ratios. Special attention is paid to eclipsing PMS binaries, which allow for observational tests of evolutionary models of early stellar evolution. Many stars are born in clusters and small groups, and we discuss how interactions in dense stellar environments can significantly alter the distribution of binary separations through dissolution of wider binaries. The binaries and multiples we find in the field are the survivors of these internal and external destructive processes, and we provide a detailed overview of the multiplicity statistics of the field, which form a boundary condition for all models of binary evolution. Finally, we discuss various formation mechanisms for massive binaries, and the properties of massive trapezia.

  19. Adjustment Difficulties and Caregiving Burdens Faced by College Students with a Parent with Bipolar or Depressive Disorders

    Science.gov (United States)

    Crandall, Erin K.; Ruggero, Camilo J.; Bain, Kathleen; Kilmer, Jared

    2014-01-01

    College campuses often host students who come from families where one or more parent has been affected by a bipolar or depressive disorder. The present study sought to determine whether these students face unique challenges in college, including increased adjustment difficulties as well as greater caregiving burden associated with their…

  20. Identifying Student and Teacher Difficulties in Interpreting Atomic Spectra Using a Quantum Model of Emission and Absorption of Radiation

    Science.gov (United States)

    Savall-Alemany, Francisco; Domènech-Blanco, Josep Lluís; Guisasola, Jenaro; Martínez-Torregrosa, Joaquín

    2016-01-01

    Our study sets out to identify the difficulties that high school students, teachers, and university students encounter when trying to explain atomic spectra. To do so, we identify the key concepts that any quantum model for the emission and absorption of electromagnetic radiation must include to account for the gas spectra and we then design two…

  1. A Case Study: The Implementation of a Problem-Solving Model with a Student with Reading Difficulties in Turkey

    Science.gov (United States)

    Ozmen, E. Ruya; Doganay-Bilgi, Arzu

    2016-01-01

    The purpose of this case study was to improve the reading accuracy and reading comprehension of a 10-year-old fourth-grade female student with reading difficulties. For that purpose, the problem- solving model was implemented in four stages. These stages included problem identification, problem analysis, intervention, and evaluation. During the…

  2. Emotion dysregulation mediates the relationship between trauma exposure, post-migration living difficulties and psychological outcomes in traumatized refugees.

    Science.gov (United States)

    Nickerson, Angela; Bryant, Richard A; Schnyder, Ulrich; Schick, Matthis; Mueller, Julia; Morina, Naser

    2015-03-01

    While emotion dysregulation represents an important mechanism underpinning psychological responses to trauma, little research has investigated this in refugees. In the current study, we examined the mediating role of emotion dysregulation in the relationship between refugee experiences (trauma and living difficulties) and psychological outcomes. Participants were 134 traumatized treatment-seeking refugees who completed measures indexing trauma exposure, post-migration living difficulties, difficulties in emotion regulation, posttraumatic stress disorder, depression, and explosive anger. Findings revealed distinctive patterns of emotion dysregulation associated with each of these psychological disorders. Results also indicated that emotion regulation difficulties mediated the association between both trauma and psychological symptoms, and living difficulties and psychological symptoms. Limitations include a cross-sectional design and the use of measures that had not been validated across all cultural groups in this study. These findings underscore the key role of emotion dysregulation in psychological responses of refugees, and highlight potential directions for treatment interventions for traumatized refugees. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Trajectories of older adults' hearing difficulties: examining the influence of health behaviors and social activity over 10 years.

    Science.gov (United States)

    Heine, Chyrisse; Browning, Colette; Cowlishaw, Sean; Kendig, Hal

    2013-10-01

    The aims of the present study were to describe the trajectories of self-reported hearing difficulties over time, and evaluate the impacts of age, sex, lifestyle factors and social activity, in explaining individual differences in patterns of change over time. As part of the Melbourne Longitudinal Studies on Healthy Aging (MELSHA) Program, the hearing status of 947 adults aged 65 years and older, across five measurement periods (over 10 years), were analyzed using Latent Growth Curve Modeling analysis. A multidimensional survey was also administered, which included questions relating to sociodemographic variables, self-reported hearing difficulties, nutrition, smoking habits and level of social activity. Although there was a general increase in hearing difficulties over time, older age, poor nutrition, a lifetime of smoking and increased social activity predicted more rapid increases in hearing difficulty over time. Findings support the importance of lifestyle factors in reducing the rate of perceived hearing difficulties in older people, and provide further evidence of the links between lifestyle and sensory loss in older people. Poor nutrition and smoking are areas that both clinicians and public health professionals should address in their work with older people. © 2013 Japan Geriatrics Society.

  4. Who walks? Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty.

    Science.gov (United States)

    Simonsick, E M; Guralnik, J M; Fried, L P

    1999-06-01

    To determine how severity of walking difficulty and sociodemographic, psychosocial, and health-related factors influence walking behavior in disabled older women. Cross-sectional analyses of baseline data from the Women's Health and Aging Study (WHAS). An urban community encompassing 12 contiguous zip code areas in the eastern portion of Baltimore City and part of Baltimore County, Maryland. A total of 920 moderately to severely disabled community-resident women, aged 65 years and older, identified from an age-stratified random sample of Medicare beneficiaries. Walking behavior was defined as minutes walked for exercise and total blocks walked per week. Independent variables included self-reported walking difficulty, sociodemographic factors, psychological status (depression, mastery, anxiety, and cognition), and health-related factors (falls and fear of falling, fatigue, vision and balance problems, weight, smoking, and cane use). Walking at least 8 blocks per week was strongly negatively related to severity of walking difficulty. Independent of difficulty level, older age, black race, fatigue, obesity, and cane use were also negatively associated with walking; living alone and high mastery had a positive association with walking. Even among functionally limited women, sociocultural, psychological, and health-related factors were independently associated with walking behavior. Thus, programs aimed at improving walking ability need to address these factors in addition to walking difficulties to maximize participation and compliance.

  5. Premorbid and illness-related social difficulties in eating disorders: an overview of the literature and treatment developments.

    Science.gov (United States)

    Cardi, Valentina; Tchanturia, Kate; Treasure, Janet

    2018-01-17

    Social difficulties in eating disorders can manifest as predisposing traits and premorbid difficulties, and/or as consequences of the illness. Objective The aim of this paper is to briefly review the evidence for social problems in people with eating disorders and to consider the literature on treatments that target these features. Method A narrative review of the literature was conducted. Results People with eating disorders often manifest traits, such as shyness, increased tendency to submissiveness and social comparison, and problems with peer relationships before illness onset. Further social difficulties occur as the illness develops, including impaired social cognition and increased threat sensitivity. All relationships with family, peers and therapists are compromised by these effects. Thus, social difficulties are both risk and maintaining factors of eating disorders and are suitable targets for interventions. Several forms of generic treatments (e.g. interpersonal psychotherapy, cognitive analytic therapy, focal psychodynamic therapy) have an interpersonal focus and show some efficacy. Guided self-management based on the cognitive interpersonal model of the illness and directed to both individuals and support persons have been found to improve outcomes for all parties. Adjunctive treatments that focus on specific social difficulties, such as Cognitive Remediation and Emotion Skills Training and Cognitive Bias Modification have been shown to have promise. Conclusion More work is needed to establish whether these approaches can improve on the rather disappointing outcomes that are attained by currently used treatments for eating disorders. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. The Interlanguage Interference on the Difficulties of Building Question Sentences by the Second Year Students of MA As Soorkaty Salatiga

    Directory of Open Access Journals (Sweden)

    Sari Famularsih

    2014-06-01

    Full Text Available This study is aimed to elaborate the interlanguage interference of the difficulties which are faced by 40 second year students of MA As Soorkaty Salatiga in academic year of 2004-2005 in building question sentences and the sources of difficulties. The research is conducted by such kind of test. The total number of test are 20 items, consist of 5 yes-no questions, 5 W-H questions, and 10 tag questions which is done in a written essay form. Based on the analysis, the result shows some conclusions. Firstly, the researcher finds the types of difficulties problems are faced by the students in building question mastery, such as: (1 building yes-no question sentences in translation the word “apakah”, that is related with the use of to be. (2 Building interrogative word question sentences in translation the words “apa”, “kapan”, “milik siapa”, etc. That are related with the use of “what”, “when”, “whose”, etc. (3 Completing the tag question sentences with the proper auxiliary based on tense of the sentences. The most difficulties in building question sentences are especially in yes-no question form by using the word “apakah”. In the term of interlanguage, the students’ errors are mostly included in expressing meaning by the words and grammar of the first language. The source of difficulties which have been analyzed are mostly caused by inter lingual and intra lingual transfer.

  7. Multiple purpose electrical profit; Emprendimiento electrico de prestacion multiple

    Energy Technology Data Exchange (ETDEWEB)

    Assennato, H. [Electrica de Azul Ltda., Buenos Aires (Argentina)

    1986-12-31

    This paper shows the multiple purpose aspects of electrification projects in rural and isolated areas. The multiple aspects involved in the electrification process may include, over electric power supply: improvement of life quality, irrigation and rural mechanization. 4 figs., 6 tabs., 4 refs.

  8. Ecological, psychological, and cognitive components of reading difficulties: testing the component model of reading in fourth graders across 38 countries.

    Science.gov (United States)

    Chiu, Ming Ming; McBride-Chang, Catherine; Lin, Dan

    2012-01-01

    The authors tested the component model of reading (CMR) among 186,725 fourth grade students from 38 countries (45 regions) on five continents by analyzing the 2006 Progress in International Reading Literacy Study data using measures of ecological (country, family, school, teacher), psychological, and cognitive components. More than 91% of the differences in student difficulty occurred at the country (61%) and classroom (30%) levels (ecological), with less than 9% at the student level (cognitive and psychological). All three components were negatively associated with reading difficulties: cognitive (student's early literacy skills), ecological (family characteristics [socioeconomic status, number of books at home, and attitudes about reading], school characteristics [school climate and resources]), and psychological (students' attitudes about reading, reading self-concept, and being a girl). These results extend the CMR by demonstrating the importance of multiple levels of factors for reading deficits across diverse cultures.

  9. The planning of Mechanics and Modern Physics teaching activities for blind students: difficulties and alternatives.

    Directory of Open Access Journals (Sweden)

    Eder Pires de Camargo

    2006-12-01

    Full Text Available We report here partial outcomes of a study aimed to verify future High School teachers performance when, during the development of a called “TeachingPractice” undergraduate course, were asked to plan Mechanics and Modern Physics topics to a students class which included visual handicapped pupils. Data analyzed show that the main difficulties presented by the future Physics High School teachers are related to the approach to know physics phenomena as dependent of vision. By other hand, as alternatives, future teachers showed creativity in order to surpass passive aptitudes related to this educational problem and working out methodological strategies deprived of the relation knowing/seeing.

  10. Applications of Fast Truncated Multiplication in Cryptography

    Directory of Open Access Journals (Sweden)

    Laszlo Hars

    2006-12-01

    Full Text Available Truncated multiplications compute truncated products, contiguous subsequences of the digits of integer products. For an n-digit multiplication algorithm of time complexity O(nα, with 1<α≤2, there is a truncated multiplication algorithm, which is constant times faster when computing a short enough truncated product. Applying these fast truncated multiplications, several cryptographic long integer arithmetic algorithms are improved, including integer reciprocals, divisions, Barrett and Montgomery multiplications, 2n-digit modular multiplication on hardware for n-digit half products. For example, Montgomery multiplication is performed in 2.6 Karatsuba multiplication time.

  11. Addressing pre-service teachers' understandings and difficulties with some core concepts in the special theory of relativity

    International Nuclear Information System (INIS)

    Selcuk, Gamze Sezgin

    2011-01-01

    The aim of this study is to investigate pre-service teachers' understanding of and difficulties with some core concepts in the special theory of relativity. The pre-service teachers (n = 185) from the Departments of Physics Education and Elementary Science Education at Dokuz Eylul University (in Turkey) participated. Both quantitative and qualitative research methods were used in this study. Students' understanding of and difficulties with core elements (time, length, mass and density) were tested using a paper-and-pencil questionnaire (including four questions) and in-depth interviews after the instruction of related modern physics topics. The analyses of the collected data were based on quantitative and qualitative techniques. The results indicate that pre-service teachers at different academic levels have specific and considerable difficulties with proper time, time dilation, proper length, mass and relativistic density concepts. In this paper, the conclusions of the study and implications for physics teaching are discussed.

  12. Management of the multiple limb amputee.

    Science.gov (United States)

    Davidson, J H; Jones, L E; Cornet, J; Cittarelli, T

    2002-09-10

    Multiple limb amputations involving at least one upper extremity are very uncommon. The amputation of both an upper and lower limb is even more uncommon. Due to the rarity of these amputations therapists are uncertain regarding the most appropriate treatment methods. While the majority of the protocols used for single limb amputations are appropriate for these multiple limb amputees, there are differences. Loss of multiple limbs creates a problem of overheating for the individual. Loss of an arm and leg results in difficulty donning the prostheses and difficulty using crutches and parallel bars during mobilization. A review is given of 16 multiple limb amputees seen in our rehabilitation centre in the last 15 years. Return to work was seen in one third and was not related to the number of the amputations. A higher proportion of these multiple limb amputations occur through alcoholism or attempted suicide behaviour than occurs with either single upper limb amputations or lower limb amputations. This existing behaviour can create a management problem for the rehabilitation team during rehabilitation. Guidelines as to appropriate prosthetic and preprosthetic care are provided to assist the practitioner who has the acute and long term care of these patients. All multiple limb amputees should be referred to a specialized rehabilitation centre to discuss prosthetic options and long term rehabilitation requirements. This paper does not discuss bilateral lower limb amputations when not combined with an upper limb amputation.

  13. Contributions of physical and cognitive impairments to self-reported driving difficulty in chronic whiplash-associated disorders.

    Science.gov (United States)

    Takasaki, Hiroshi; Treleaven, Julia; Johnston, Venerina; Jull, Gwendolen

    2013-08-15

    Cross-sectional. To conduct a preliminary analysis of the physical, cognitive, and psychological domains contributing to self-reported driving difficulty after adjusting for neck pain, dizziness, and relevant demographics in chronic whiplash-associated disorders (WAD) using hierarchical regression modeling. Pain is a risk factor for car crashes, and dizziness may affect fitness to drive. Both symptoms are common in chronic WAD and difficulty driving is a common complaint in this group. Chronic WAD is often accompanied by physical, cognitive, and psychological impairments. These impairments may contribute to self-reported driving difficulty beyond neck pain, dizziness, and relevant demographics. Forty individuals with chronic WAD participated. Dependent variables were the magnitude of self-reported driving difficulty assessed in the strategic, tactical, and operational levels of the Neck Pain Driving Index. Three models were developed to assess the contributions of independent variables (physical, cognitive, and psychological domains) to each of the 3 dependent variables after adjusting for neck pain intensity, dizziness, and driving demographics. The measures included were: physical domain-range and maximum speed of head rotation, performances during gaze stability, eye-head coordination, and visual dependency tests; cognitive domain-self-reported cognitive symptoms including fatigue and the trail making tests; and psychological domain-general stress, traumatic stress, depression, and fear of neck movements and driving. Symptom duration was relevant to driving difficulty in the strategic and tactical levels. The cognitive domain increased statistical power to estimate the strategic and operational levels (P < 0.1) beyond other contributors. The physical domain increased statistical power to estimate the tactical level (P < 0.1) beyond other contributors. Physical and cognitive impairments independently contributed to self-reported driving difficulty in chronic WAD

  14. The effects of task difficulty, novelty and the size of the search space on intrinsically motivated exploration.

    Science.gov (United States)

    Baranes, Adrien F; Oudeyer, Pierre-Yves; Gottlieb, Jacqueline

    2014-01-01

    Devising efficient strategies for exploration in large open-ended spaces is one of the most difficult computational problems of intelligent organisms. Because the available rewards are ambiguous or unknown during the exploratory phase, subjects must act in intrinsically motivated fashion. However, a vast majority of behavioral and neural studies to date have focused on decision making in reward-based tasks, and the rules guiding intrinsically motivated exploration remain largely unknown. To examine this question we developed a paradigm for systematically testing the choices of human observers in a free play context. Adult subjects played a series of short computer games of variable difficulty, and freely choose which game they wished to sample without external guidance or physical rewards. Subjects performed the task in three distinct conditions where they sampled from a small or a large choice set (7 vs. 64 possible levels of difficulty), and where they did or did not have the possibility to sample new games at a constant level of difficulty. We show that despite the absence of external constraints, the subjects spontaneously adopted a structured exploration strategy whereby they (1) started with easier games and progressed to more difficult games, (2) sampled the entire choice set including extremely difficult games that could not be learnt, (3) repeated moderately and high difficulty games much more frequently than was predicted by chance, and (4) had higher repetition rates and chose higher speeds if they could generate new sequences at a constant level of difficulty. The results suggest that intrinsically motivated exploration is shaped by several factors including task difficulty, novelty and the size of the choice set, and these come into play to serve two internal goals-maximize the subjects' knowledge of the available tasks (exploring the limits of the task set), and maximize their competence (performance and skills) across the task set.

  15. The effects of task difficulty, novelty and the size of the search space on intrinsically motivated exploration

    Directory of Open Access Journals (Sweden)

    Adrien Fredj Baranes

    2014-10-01

    Full Text Available Devising efficient strategies for exploration in large open-ended spaces is one of the most difficult computational problems of intelligent organisms. Because the available rewards are ambiguous or unknown during the exploratory phase, subjects must act in intrinsically motivated fashion. However, a vast majority of behavioral and neural studies to date have focused on decision making in reward-based tasks, and the rules guiding intrinsically motivated exploration remain largely unknown. To examine this question we developed a paradigm for systematically testing the choices of human observers in a free play context. Adult subjects played a series of short computer games of variable difficulty, and freely choose which game they wished to sample without external guidance or physical rewards. Subjects performed the task in three distinct conditions where they sampled from a small or a large choice set (7 vs 64 possible levels of difficulty, and where they did or did not have the possibility to sample new games at a constant level of difficulty. We show that despite the absence of external constraints, the subjects spontaneously adopted a structured exploration strategy whereby they (1 started with easier games and progressed to more difficult games, (2 sampled the entire choice set including extremely difficult games that could not be learnt, (3 repeated moderately and high difficulty games much more frequently than was predicted by chance, and (4 had higher repetition rates and chose higher speeds if they could generate new sequences at a constant level of difficulty. The results suggest that intrinsically motivated exploration is shaped by several factors including task difficulty, novelty and the size of the choice set, and these come into play to serve two internal goals - maximize the subjects’ knowledge of the available tasks (exploring the limits of the task set, and maximize their competence (performance and skills across the task set.

  16. Musculoskeletal ultrasound including definitions for ultrasonographic pathology

    DEFF Research Database (Denmark)

    Wakefield, RJ; Balint, PV; Szkudlarek, Marcin

    2005-01-01

    Ultrasound (US) has great potential as an outcome in rheumatoid arthritis trials for detecting bone erosions, synovitis, tendon disease, and enthesopathy. It has a number of distinct advantages over magnetic resonance imaging, including good patient tolerability and ability to scan multiple joints...... in a short period of time. However, there are scarce data regarding its validity, reproducibility, and responsiveness to change, making interpretation and comparison of studies difficult. In particular, there are limited data describing standardized scanning methodology and standardized definitions of US...... pathologies. This article presents the first report from the OMERACT ultrasound special interest group, which has compared US against the criteria of the OMERACT filter. Also proposed for the first time are consensus US definitions for common pathological lesions seen in patients with inflammatory arthritis....

  17. Difficulties in the evaluation and measuring of soil water infiltration

    Science.gov (United States)

    Pla-Sentís, Ildefonso

    2013-04-01

    Soil water infiltration is the most important hydrological parameter for the evaluation and diagnosis of the soil water balance and soil moisture regime. Those balances and regimes are the main regulating factors of the on site water supply to plants and other soil organisms and of other important processes like runoff, surface and mass erosion, drainage, etc, affecting sedimentation, flooding, soil and water pollution, water supply for different purposes (population, agriculture, industries, hydroelectricity), etc. Therefore the evaluation and measurement of water infiltration rates has become indispensable for the evaluation and modeling of the previously mentioned processes. Infiltration is one of the most difficult hydrological parameters to evaluate or measure accurately. Although the theoretical aspects of the process of soil water infiltration are well known since the middle of the past century, when several methods and models were already proposed for the evaluation of infiltration, still nowadays such evaluation is not frequently enough accurate for the purposes being used. This is partially due to deficiencies in the methodology being used for measuring infiltration, including some newly proposed methods and equipments, and in the use of non appropriate empirical models and approaches. In this contribution we present an analysis and discussion about the main difficulties found in the evaluation and measurement of soil water infiltration rates, and the more commonly committed errors, based on the past experiences of the author in the evaluation of soil water infiltration in many different soils and land conditions, and in their use for deducing soil water balances under variable and changing climates. It is concluded that there are not models or methods universally applicable to any soil and land condition, and that in many cases the results are significantly influenced by the way we use a particular method or instrument, and by the alterations in the soil

  18. Achievements, difficulties and future challenges for the FARMING network

    International Nuclear Information System (INIS)

    Nisbet, A.F.; Mercer, J.A.; Rantavaara, A.; Hanninen, R.; Vandecasteele, C.; Carle, B.; Hardeman, F.; Ioannides, K.G.; Papachristodoulou, C.; Tzialla, C.; Ollagnon, H.; Jullien, T.; Pupin, V.

    2005-01-01

    The EC FARMING network (Food and Agriculture Restoration Management Involving Networked Groups) was set up to bring together the many and diverse stakeholders who would be involved in intervention following wide scale radioactive contamination of the food chain, so that acceptable strategies can be developed for maintaining agricultural production and safe food supply. The network comprises stakeholder panels in the UK, Finland, Belgium, France and Greece that have met regularly since 2001 to debate, discuss and exchange opinion on the acceptability, constraints and impact of various countermeasure options and strategies. The objectives of this paper are to consolidate the main achievements of the FARMING project over the period 2000-2004, to highlight the various difficulties that were encountered and to discuss the challenges for engaging stakeholders in off-site emergency management and long-term rehabilitation in the future

  19. Behavioral Executive Functions Among Adolescents With Mathematics Difficulties.

    Science.gov (United States)

    Holm, Marja E; Aunio, Pirjo; Björn, Piia M; Klenberg, Liisa; Korhonen, Johan; Hannula, Markku S

    2017-07-01

    This study investigates behavioral executive functions (EFs) in the mathematics classroom context among adolescents with different mathematics performance levels. The EF problems were assessed by teachers using a behavioral rating inventory. Using cutoff scores on a standardized mathematics assessment, groups with mathematics difficulties (MD; n = 124), low mathematics performance (LA; n = 140), and average or higher scores (AC; n = 355) were identified. Results showed that the MD group had more problems with distractibility, directing attention, shifting attention, initiative, execution of action, planning, and evaluation than the LA group, whereas the differences in hyperactivity, impulsivity, and sustaining attention were not significant. Compared to the AC group, the MD group showed more problems with all behavioral EFs except hyperactivity and impulsivity, while the LA group showed more problems only with shifting attention. Male adolescents showed more behavioral EF problems than female adolescents, but this gender difference was negligible within the MD group. The practical implications of the results are discussed.

  20. Uncertainty and the difficulty of thinking through disjunctions.

    Science.gov (United States)

    Shafir, E

    1994-01-01

    This paper considers the relationship between decision under uncertainty and thinking through disjunctions. Decision situations that lead to violations of Savage's sure-thing principle are examined, and a variety of simple reasoning problems that often generate confusion and error are reviewed. The common difficulty is attributed to people's reluctance to think through disjunctions. Instead of hypothetically traveling through the branches of a decision tree, it is suggested, people suspend judgement and remain at the node. This interpretation is applied to instances of decision making, information search, deductive and inductive reasoning, probabilistic judgement, games, puzzles and paradoxes. Some implications of the reluctance to think through disjunctions, as well as potential corrective procedures, are discussed.