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Sample records for multiple difficulties including

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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'…

  10. 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

  11. 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.

  12. 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…

  13. 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

  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. 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...

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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…

  2. 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…

  3. 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

  4. 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...

  5. 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,…

  6. 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.

  7. [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.

  8. 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.

  9. 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...

  10. 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…

  11. 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.

  12. 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.

  13. 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.

  14. 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.

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

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    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.

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

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    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.

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

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    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

  19. 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.

  20. 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 ...

  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. 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.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. 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.

  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. 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.

  12. DIFFICULTY OF AMENDMENT AND INTERPRETATIVE CHOICE

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    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.

  13. 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.

  14. 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,…

  15. 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.

  16. 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

  17. 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.

  18. 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 ...

  19. 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.

  20. 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…

  1. 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.

  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. 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.

  4. 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.

  5. Validation and analysis of the coupled multiple response Colorado upper-division electrostatics diagnostic

    Directory of Open Access Journals (Sweden)

    Bethany R. Wilcox

    2015-11-01

    Full Text Available Standardized conceptual assessment represents a widely used tool for educational researchers interested in student learning within the standard undergraduate physics curriculum. For example, these assessments are often used to measure student learning across educational contexts and instructional strategies. However, to support the large-scale implementation often required for cross-institutional testing, it is necessary for these instruments to have question formats that facilitate easy grading. Previously, we created a multiple-response version of an existing, validated, upper-division electrostatics diagnostic with the goal of increasing the instrument’s potential for large-scale implementation. Here, we report on the validity and reliability of this new version as an independent instrument. These findings establish the validity of the multiple-response version as measured by multiple test statistics including item difficulty, item discrimination, and internal consistency. Moreover, we demonstrate that the majority of student responses to the new version are internally consistent even when they are incorrect and provide an example of how the new format can be used to gain insight into student difficulties with specific content in electrostatics.

  6. 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.

  7. 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.

  8. 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.

  9. 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…

  10. 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...

  11. 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....

  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. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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...

  19. 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…

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. 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)…

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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...

  11. 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.

  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. 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.

  14. 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…

  15. 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…

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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)

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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…

  7. 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…

  8. 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.

  9. 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...

  10. 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.

  11. 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.

  12. 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.

  13. 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…

  14. Tools to support interpreting multiple regression in the face of multicollinearity.

    Science.gov (United States)

    Kraha, Amanda; Turner, Heather; Nimon, Kim; Zientek, Linda Reichwein; Henson, Robin K

    2012-01-01

    While multicollinearity may increase the difficulty of interpreting multiple regression (MR) results, it should not cause undue problems for the knowledgeable researcher. In the current paper, we argue that rather than using one technique to investigate regression results, researchers should consider multiple indices to understand the contributions that predictors make not only to a regression model, but to each other as well. Some of the techniques to interpret MR effects include, but are not limited to, correlation coefficients, beta weights, structure coefficients, all possible subsets regression, commonality coefficients, dominance weights, and relative importance weights. This article will review a set of techniques to interpret MR effects, identify the elements of the data on which the methods focus, and identify statistical software to support such analyses.

  15. 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.

  16. 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.

  17. 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...

  18. 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.

  19. 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

  20. 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

  1. 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).

  2. 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...

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. Fraction Multiplication and Division Word Problems Posed by Different Years of Pre-Service Elementary Mathematics Teachers

    Directory of Open Access Journals (Sweden)

    Tuba Aydogdu Iskenderoglu

    2018-04-01

    Full Text Available It is important for pre-service teachers to know the conceptual difficulties they have experienced regarding the concepts of multiplication and division in fractions and problem posing is a way to learn these conceptual difficulties. Problem posing is a synthetic activity that fundamentally has multiple answers. The purpose of this study is to analyze the multiplication and division of fractions problems posed by pre-service elementary mathematics teachers and to investigate how the problems posed change according to the year of study the pre-service teachers are in. The study employed developmental research methods. A total of 213 pre-service teachers enrolled in different years of the Elementary Mathematics Teaching program at a state university in Turkey took part in the study. The “Problem Posing Test” was used as the data collecting tool. In this test, there are 3 multiplication and 3 division operations. The data were analyzed using qualitative descriptive analysis. The findings suggest that, regardless of the year, pre-service teachers had more conceptual difficulties in problem posing about the division of fractions than in problem posing about the multiplication of fractions.

  8. Driving competences and neuropsychological factors associated to driving counseling in multiple sclerosis.

    Science.gov (United States)

    Badenes, Dolors; Garolera, Maite; Casas, Laura; Cejudo-Bolivar, Juan Carlos; de Francisco, Jorge; Zaragoza, Silvia; Calzado, Noemi; Aguilar, Miquel

    2014-05-01

    Multiple Sclerosis (MS) significantly impacts daily living activities, including car driving. To investigate driving difficulties experienced with MS, we compared 50 MS patients with minor or moderate disability and 50 healthy controls (HC) using computerized driving tests (the ASDE driver test and the Useful Field of View (UFOV) test) and neuropsychological tests. Inclusion criteria included being active drivers. We evaluated whether cognitive deterioration in MS is associated with the results of driving tests by comparing MS patients without cognitive deterioration with HC. The results indicated that the MS patients performed worse than the HCs in attention, information processing, working memory and visuomotor coordination tasks. Furthermore, MS patients with cognitive impairments experienced more difficulties in the driving tests than did the non-impaired MS patients. Motor dysfunction associated with MS also played an important role in this activity. The results of this study suggest that MS should be assessed carefully and that special emphasis should be placed on visuomotor coordination and executive functions because patients with minor motor disability and subtle cognitive impairments can pass measures predictive of driving safety.

  9. 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...

  10. 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…

  11. 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.

  12. 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.

  13. Analysis of Multiple Choice Tests Designed by Faculty Members of Kermanshah University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Reza Pourmirza Kalhori

    2013-12-01

    Full Text Available Dear Editor Multiple choice tests are the most common objective tests in medical education which are used to assess the ind-ividual knowledge, recall, recognition and problem solving abilities. One of the testing components is the post-test analysis. This component includes; first, qualitative analysis of the taxonomy of questions based on the Bloom’s educational objectives and percentage of the questions with no structural problems; and second, the quantitative analysis of the reliability (KR-20 and indices of difficulty and differentiation (1. This descriptive-analytical study was aimed to qualitatively and quan-titatively investigate the multiple-choice tests of the faculty members at Kermanshah University of Medical Sciences in 2009-2010. The sample size comprised of 156 tests. Data were analyzed by SPSS-16 software using t-test, chi-squared test, ANOVA and Tukey multiple comparison tests. The mean of reliability (KR-20, difficulty index, and discrimination index were 0.68 (± 0.31, 0.56 (± 0.15 and 0.21 (± 0.15, respectively, which were acceptable. The analysis of the tests at Mashad University of Medical Sciences indicated that the mean for the reliability of the tests was 0.72, and 52.2% of the tests had inappropriate difficulty index and 49.2% of the tests did not have acceptable differentiation index (2. Comparison of the tests at Kermanshah University of Medical Sciences for the fields of anatomy, physiology, biochemistry, genetics, statistics and behavioral sciences courses at Malaysia Faculty of Medicine (3 and tests at Argentina Faculty of Medicine (4 showed that while difficulty index was acceptable in all three universities, but differentiation indices in Malaysia and Argentina Medical Faculties were higher than that in Kermanshah University of Medical Sciences. The mean for the questions with no structural flaws in all tests, taxonomy I, taxonomy II, and taxonomy III were 73.88% (± 14.88, 34.65% (± 15.78, 41.34% (± 13

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Automatic Multiple-Needle Surgical Planning of Robotic-Assisted Microwave Coagulation in Large Liver Tumor Therapy.

    Directory of Open Access Journals (Sweden)

    Shaoli Liu

    Full Text Available The "robotic-assisted liver tumor coagulation therapy" (RALTCT system is a promising candidate for large liver tumor treatment in terms of accuracy and speed. A prerequisite for effective therapy is accurate surgical planning. However, it is difficult for the surgeon to perform surgical planning manually due to the difficulties associated with robot-assisted large liver tumor therapy. These main difficulties include the following aspects: (1 multiple needles are needed to destroy the entire tumor, (2 the insertion trajectories of the needles should avoid the ribs, blood vessels, and other tissues and organs in the abdominal cavity, (3 the placement of multiple needles should avoid interference with each other, (4 an inserted needle will cause some deformation of liver, which will result in changes in subsequently inserted needles' operating environment, and (5 the multiple needle-insertion trajectories should be consistent with the needle-driven robot's movement characteristics. Thus, an effective multiple-needle surgical planning procedure is needed. To overcome these problems, we present an automatic multiple-needle surgical planning of optimal insertion trajectories to the targets, based on a mathematical description of all relevant structure surfaces. The method determines the analytical expression of boundaries of every needle "collision-free reachable workspace" (CFRW, which are the feasible insertion zones based on several constraints. Then, the optimal needle insertion trajectory within the optimization criteria will be chosen in the needle CFRW automatically. Also, the results can be visualized with our navigation system. In the simulation experiment, three needle-insertion trajectories were obtained successfully. In the in vitro experiment, the robot successfully achieved insertion of multiple needles. The proposed automatic multiple-needle surgical planning can improve the efficiency and safety of robot-assisted large liver tumor

  20. Automatic Multiple-Needle Surgical Planning of Robotic-Assisted Microwave Coagulation in Large Liver Tumor Therapy.

    Science.gov (United States)

    Liu, Shaoli; Xia, Zeyang; Liu, Jianhua; Xu, Jing; Ren, He; Lu, Tong; Yang, Xiangdong

    2016-01-01

    The "robotic-assisted liver tumor coagulation therapy" (RALTCT) system is a promising candidate for large liver tumor treatment in terms of accuracy and speed. A prerequisite for effective therapy is accurate surgical planning. However, it is difficult for the surgeon to perform surgical planning manually due to the difficulties associated with robot-assisted large liver tumor therapy. These main difficulties include the following aspects: (1) multiple needles are needed to destroy the entire tumor, (2) the insertion trajectories of the needles should avoid the ribs, blood vessels, and other tissues and organs in the abdominal cavity, (3) the placement of multiple needles should avoid interference with each other, (4) an inserted needle will cause some deformation of liver, which will result in changes in subsequently inserted needles' operating environment, and (5) the multiple needle-insertion trajectories should be consistent with the needle-driven robot's movement characteristics. Thus, an effective multiple-needle surgical planning procedure is needed. To overcome these problems, we present an automatic multiple-needle surgical planning of optimal insertion trajectories to the targets, based on a mathematical description of all relevant structure surfaces. The method determines the analytical expression of boundaries of every needle "collision-free reachable workspace" (CFRW), which are the feasible insertion zones based on several constraints. Then, the optimal needle insertion trajectory within the optimization criteria will be chosen in the needle CFRW automatically. Also, the results can be visualized with our navigation system. In the simulation experiment, three needle-insertion trajectories were obtained successfully. In the in vitro experiment, the robot successfully achieved insertion of multiple needles. The proposed automatic multiple-needle surgical planning can improve the efficiency and safety of robot-assisted large liver tumor therapy

  1. 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…

  2. Modular risk analysis for assessing multiple waste sites

    International Nuclear Information System (INIS)

    Whelan, G.; Buck, J.W.; Nazarali, A.

    1994-06-01

    Human-health impacts, especially to the surrounding public, are extremely difficult to assess at installations that contain multiple waste sites and a variety of mixed-waste constituents (e.g., organic, inorganic, and radioactive). These assessments must address different constituents, multiple waste sites, multiple release patterns, different transport pathways (i.e., groundwater, surface water, air, and overland soil), different receptor types and locations, various times of interest, population distributions, land-use patterns, baseline assessments, a variety of exposure scenarios, etc. Although the process is complex, two of the most important difficulties to overcome are associated with (1) establishing an approach that allows for modifying the source term, transport, or exposure component as an individual module without having to re-evaluate the entire installation-wide assessment (i.e., all modules simultaneously), and (2) displaying and communicating the results in an understandable and useable maimer to interested parties. An integrated, physics-based, compartmentalized approach, which is coupled to a Geographical Information System (GIS), captures the regional health impacts associated with multiple waste sites (e.g., hundreds to thousands of waste sites) at locations within and surrounding the installation. Utilizing a modular/GIS-based approach overcomes difficulties in (1) analyzing a wide variety of scenarios for multiple waste sites, and (2) communicating results from a complex human-health-impact analysis by capturing the essence of the assessment in a relatively elegant manner, so the meaning of the results can be quickly conveyed to all who review them

  3. 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.

  4. 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)

  5. 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.

  6. 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.

  7. Multiple cranial neuropathies without limb involvements: guillain-barre syndrome variant?

    Science.gov (United States)

    Yu, Ju Young; Jung, Han Young; Kim, Chang Hwan; Kim, Hyo Sang; Kim, Myeong Ok

    2013-10-01

    Acute multiple cranial neuropathies are considered as variant of Guillain-Barre syndrome, which are immune-mediated diseases triggered by various cases. It is a rare disease which is related to infectious, inflammatory or systemic diseases. According to previous case reports, those affected can exhibit almost bilateral facial nerve palsy, then followed by bulbar dysfunctions (cranial nerves IX and X) accompanied by limb weakness and walking difficulties due to motor and/or sensory dysfunctions. Furthermore, reported cases of the acute multiple cranial neuropathies show electrophysiological abnormalities compatible with the typical Guillain-Barre syndromes (GBS). We recently experienced a patient with a benign infectious disease who subsequently developed symptoms of variant GBS. Here, we describe the case of a 48-year-old male patient who developed multiple symptoms of cranial neuropathy without limb weakness. His laboratory findings showed a positive result for anti-GQ1b IgG antibody. As compared with previously described variants of GBS, the patient exhibited widespread cranial neuropathy, which included neuropathies of cranial nerves III-XII, without limb involvement or ataxia.

  8. 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.

  9. 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…

  10. Sickness-related dysfunction in persons with self-reported multiple chemical sensitivity at four levels of severity.

    Science.gov (United States)

    Gibson, Pamela Reed; Vogel, Valerie M

    2009-01-01

    To examine quality of life outcome for persons who self-report chemical sensitivity, often referred to as multiple chemical sensitivity. Multiple chemical sensitivity is poorly understood with few providers specialising in its treatment. This lack of treatment and the ubiquity of chemicals engender severe life impacts such as job loss, financial loss, social isolation and even homelessness for persons who experience these sensitivities. Survey. We examined chemical incitants, symptoms and sickness-related behavioural dysfunction as measured by the Sickness Impact Profile in 254 persons self-identified with multiple chemical sensitivity. Chemicals rated as causing the most symptomatology in respondents were pesticide, formaldehyde, fresh paint, new carpet, diesel exhaust, perfume and air fresheners. The five highest rated symptoms in this sample were tiredness/lethargy, difficulty concentrating, muscle aches, memory difficulties and long-term fatigue. Overall mean Sickness Impact Profile score was 25.25%, showing serious impairment, with the most serious dysfunction in the categories of work (55.36%), alertness behaviour (53.45%) and recreation and pastimes (45.20%). Multiple chemical sensitivity is an important health care issue because it often includes serious dysfunction, is poorly understood by providers and poses extensive financial and treatment obstacles for those who experience it. Persons with multiple chemical sensitivity seek medical treatment in a variety of contexts and informed providers can both avoid iatrogenic harm due to medical exposures and provide any possible treatment for the chemical sensitivities. Understanding the impact of the health condition is crucial to communicate with and treat persons who experience the sensitivities.

  11. 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

  12. 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)

  13. 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)

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  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

    2017-12-01

    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.

  19. 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...

  20. Understanding and meeting injection device needs in multiple sclerosis: a survey of patient attitudes and practices

    Directory of Open Access Journals (Sweden)

    Russell S

    2011-03-01

    Full Text Available Elisabetta Verdun di Cantogno1, Susan Russell2, Tom Snow21Global Clinical Development Unit, Merck Serono S.A. – Geneva, Switzerland; 2Global Marketing, Merck Serono S.A. – Geneva, SwitzerlandBackground: All established disease-modifying drugs for multiple sclerosis require parenteral administration, which can cause difficulties for some patients, sometimes leading to suboptimal adherence. A new electronic autoinjection device has been designed to address these issues.Methods: Patients with relapsing multiple sclerosis currently receiving subcutaneous or intramuscular interferon beta-1a, interferon beta-1b, or glatiramer acetate completed an online questionnaire (July 4–25, 2008 that surveyed current injection practices, experiences with current injection methods, and impressions and appeal of the new device.Results: In total, 422 patients completed the survey, of whom 44% used autoinjectors, 43% prefilled syringes, and 13% syringes and vials; overall, 66% currently self-injected. Physical and psychological barriers to self-injection included difficulty with injections, needle phobia, and concerns over correct injection technique. Only 40% of respondents were “very satisfied” with their current injection method. The new electronic autoinjector was rated as “very appealing” by 65% of patients. The benefits of the new device included the ability to customize injection settings and to review dosing history.Conclusion: New technologies may help patients overcome physical and psychological barriers to self-injection. The combination of a reliable and flexible autoinjection device with dose-monitoring technology may improve communication between health care professionals and patients, and improve treatment adherence.Keywords: adherence, autoinjection, subcutaneous interferon beta-1a, multiple sclerosis 

  1. 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.

  2. 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.

  3. 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.

  4. Analysis of multiple instructional techniques on the understanding and retention of select mechanical topics

    Science.gov (United States)

    Fetsco, Sara Elizabeth

    There are several topics that introductory physics students typically have difficulty understanding. The purpose of this thesis is to investigate if multiple instructional techniques will help students to better understand and retain the material. The three units analyzed in this study are graphing motion, projectile motion, and conservation of momentum. For each unit students were taught using new or altered instructional methods including online laboratory simulations, inquiry labs, and interactive demonstrations. Additionally, traditional instructional methods such as lecture and problem sets were retained. Effectiveness was measured through pre- and post-tests and student opinion surveys. Results suggest that incorporating multiple instructional techniques into teaching will improve student understanding and retention. Students stated that they learned well from all of the instructional methods used except the online simulations.

  5. 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...

  6. 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

  7. 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.

  8. 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.

  9. 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…

  10. 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.

  11. 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.

  12. Understanding and meeting injection device needs in multiple sclerosis: a survey of patient attitudes and practices

    Science.gov (United States)

    Verdun di Cantogno, Elisabetta; Russell, Susan; Snow, Tom

    2011-01-01

    Background: All established disease-modifying drugs for multiple sclerosis require parenteral administration, which can cause difficulties for some patients, sometimes leading to suboptimal adherence. A new electronic autoinjection device has been designed to address these issues. Methods: Patients with relapsing multiple sclerosis currently receiving subcutaneous or intramuscular interferon beta-1a, interferon beta-1b, or glatiramer acetate completed an online questionnaire (July 4–25, 2008) that surveyed current injection practices, experiences with current injection methods, and impressions and appeal of the new device. Results: In total, 422 patients completed the survey, of whom 44% used autoinjectors, 43% prefilled syringes, and 13% syringes and vials; overall, 66% currently self-injected. Physical and psychological barriers to self-injection included difficulty with injections, needle phobia, and concerns over correct injection technique. Only 40% of respondents were “very satisfied” with their current injection method. The new electronic autoinjector was rated as “very appealing” by 65% of patients. The benefits of the new device included the ability to customize injection settings and to review dosing history. Conclusion: New technologies may help patients overcome physical and psychological barriers to self-injection. The combination of a reliable and flexible autoinjection device with dose-monitoring technology may improve communication between health care professionals and patients, and improve treatment adherence. PMID:21573048

  13. 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

  14. 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.

  15. 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.

  16. 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…

  17. 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.

  18. Multiple-choice test of energy and momentum concepts

    OpenAIRE

    Singh, Chandralekha; Rosengrant, David

    2016-01-01

    We investigate student understanding of energy and momentum concepts at the level of introductory physics by designing and administering a 25-item multiple choice test and conducting individual interviews. We find that most students have difficulty in qualitatively interpreting basic principles related to energy and momentum and in applying them in physical situations.

  19. 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

  20. 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...

  1. 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.

  2. 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 ...

  3. 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.

  4. 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 ...

  5. 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.

  6. 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.

  7. 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)

  8. 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.

  9. First Insights with a Vibrotactile Interface for Children with Multiple Disabilities

    DEFF Research Database (Denmark)

    Manresa-Yee, Cristina; Morrison, Ann; Jordi Muntaner, Joan

    2015-01-01

    for users with multiple disabilities. We developed V-Sense, a vibrotactile interface that encourages children with multiple disabilities to move their arms by using vibrations and exploiting the saltation perceptual illusion. In this paper we describe our initial experience evaluating the interface with 5...... children for 7 weeks and we discuss the first insights concerning the use of the interface and the difficulties encountered while conducting the evaluation sessions....

  10. 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.

  11. Workplace bullying and sleep difficulties: a 2-year follow-up study.

    Science.gov (United States)

    Hansen, Ase Marie; Hogh, Annie; Garde, Anne Helene; Persson, Roger

    2014-04-01

    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. 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. Bullied persons and witnesses reported more sleep difficulties than those who were neither bullied nor witnesses to bullying at baseline. Frequently bullied/witnesses reported more sleep difficulties than respondents who were occasionally bullied or witnessing bullying at baseline. Further, odds ratios for subsequent sleep difficulties were increased among the occasionally bullied, but not among witnesses. However, the associations weakened when adjusting for sleep difficulties at baseline. Being subjected to occasional bullying at baseline was predictive of subsequent sleep difficulties. Witnessing bullying at baseline did not predict sleep difficulties at follow-up.

  12. 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.

  13. 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.…

  14. 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.

  15. 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

  16. Evaluation of Multiple-Alternative Prompts during Tact Training

    Science.gov (United States)

    Leaf, Justin B.; Townley-Cochran, Donna; Mitchell, Erin; Milne, Christine; Alcalay, Aditt; Leaf, Jeremy; Leaf, Ron; Taubman, Mitch; McEachin, John; Oppenheim-Leaf, Misty L.

    2016-01-01

    This study compared 2 methods of fading prompts while teaching tacts to 3 individuals who had been diagnosed with autism spectrum disorder (ASD). The 1st method involved use of an echoic prompt and prompt fading. The 2nd method involved providing multiple-alternative answers and fading by increasing the difficulty of the discrimination. An adapted…

  17. 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.

  18. Self-reported everyday memory and depression in patients with multiple sclerosis.

    Science.gov (United States)

    Bruce, Jared M; Arnett, Peter A

    2004-04-01

    Depression and memory difficulties are among the most common complaints voiced by patients with multiple sclerosis (MS). Nevertheless, little is known about how depression might affect patients' perceptions of their memory difficulties. The present investigation was designed to explore this issue. Results supported a model that integrates aspects of Beck's theory of depression and the concept of depressive realism. Consistent with the depressive realism literature, nondepressed MS patients significantly overestimated their everyday memory compared with their actual performance on verbal memory and attention/concentration indices, whereas moderately depressed patients' everyday memory ratings mirrored their actual neuropsychological performance. Supporting Beck's negative cognitive schema notion, mildly depressed patients significantly overestimated their memory difficulties. Implications for the treatment of memory problems among MS patients are discussed.

  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. 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)

  1. 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.

  2. Graves′ disease allied with multiple pheochromocytoma

    Directory of Open Access Journals (Sweden)

    Brahim Housni

    2013-01-01

    Full Text Available Pheochromocytoma is an uncommon cause of high blood pressure touching adults. The combination of severe hypertension in the triad of headache, sweating, and tachycardia should suggest this diagnosis; this clinical picture is similar to that of hyperthyroidism. We report the case of a 22-year-old patient with multiple pheochromocytoma associated with Graves′ disease revealed by malignant hypertension and discussed the difficulties of the diagnosis and the treatment approach.

  3. 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.

  4. 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....

  5. 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

  6. 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.

  7. 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…

  8. 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.

  9. Coordination and resource-related difficulties encountered by Quebec's public health specialists and infectious diseases/medical microbiologists in the management of A (H1N1 - a mixed-method, exploratory survey

    Directory of Open Access Journals (Sweden)

    Nhan Charles

    2012-02-01

    Full Text Available Abstract Background In Quebec, the influenza A (H1N1 pandemic was managed using a top-down style that left many involved players with critical views and frustrations. We aimed to describe physicians' perceptions - infectious diseases specialists/medical microbiologists (IDMM and public health/preventive medicine specialists (PHPMS - in regards to issues encountered with the pandemics management at the physician level and highlight suggested improvements for future healthcare emergencies. Methods In April 2010, Quebec IDMM and PHPMS physicians were invited to anonymously complete a web-based learning needs assessment. The survey included both open-ended and multiple-choice questions. Descriptive statistics were used to report on the frequency distribution of multiple choice responses whereas thematic content analysis was used to analyse qualitative data generated from the survey and help understand respondents' experience and perceptions with the pandemics. Results Of the 102 respondents, 85.3% reported difficulties or frustrations in their practice during the pandemic. The thematic analysis revealed two core themes describing the problems experienced in the pandemic management: coordination and resource-related difficulties. Coordination issues included communication, clinical practice guidelines, decision-making, roles and responsibilities, epidemiological investigation, and public health expert advisory committees. Resources issues included laboratory resources, patient management, and vaccination process. Conclusion Together, the quantitative and qualitative data suggest a need for improved coordination, a better definition of roles and responsibilities, increased use of information technologies, merged communications, and transparency in the decisional process. Increased flexibility and less contradiction in clinical practice guidelines from different sources and increased laboratory/clinical capacity were felt critical to the proper

  10. 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...

  11. 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,…

  12. 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.

  13. Assessing College-Level Learning Difficulties and "At Riskness" for Learning Disabilities and ADHD: Development and Validation of the Learning Difficulties Assessment

    Science.gov (United States)

    Kane, Steven T.; Walker, John H.; Schmidt, George R.

    2011-01-01

    This article describes the development and validation of the "Learning Difficulties Assessment" (LDA), a normed and web-based survey that assesses perceived difficulties with reading, writing, spelling, mathematics, listening, concentration, memory, organizational skills, sense of control, and anxiety in college students. The LDA is designed to…

  14. 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

  15. 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

  16. Hopelessness, Depression and Life Satisfaction Among The Patients With Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Güler Duru Aşiret

    2014-03-01

    Full Text Available OBJECTIVE: This study was carried out to determine the level of hopelessness, depression, and life satisfaction among patients with multiple sclerosis. METHODS: 65 patients with multiple sclerosis, treated at the neurology clinic of a university hospital, were included in this study. In this descriptive study, a data collection form developed by the researchers, the Beck Depression Scale, and the Beck Hopelessness and Life Satisfaction Scale were used. RESULTS: Almost half (43.1% of the patients exhibited severe depressive symptoms. Patients’ hopelessness and life satisfaction levels were moderate. The scores on depression and life satisfaction scales were correlated negatively. While patients’ traits including female gender, low economic level, difficulties in walking, and fatigue were associated with reduced life satisfaction; variables such as having a child, low economic and education levels, experiencing incontinence, and fatigue were related to a higher level of depressive symptoms. CONCLUSION: The majority of patients were depressed; life satisfaction and hopelessness levels were moderate. Linear regression analysis revealed that education and emotional problems determined 42% of the depression score; and economic level and emotional problems identified 32% of the life satisfaction score

  17. 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

  18. 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

  19. Confidence in communicating with patients with cancer mediates the relationship between rehabilitation therapists' autistic-like traits and perceived difficulty in communication.

    Science.gov (United States)

    Hayashibara, Chinatsu; Inagaki, Masatoshi; Fujimori, Maiko; Higuchi, Yuji; Fujiwara, Masaki; Terada, Seishi; Okamura, Hitoshi; Uchitomi, Yosuke; Yamada, Norihito

    2018-01-21

    Recently, rehabilitation therapists have become involved in cancer rehabilitation; however, no communication skills training that increases the ability to provide emotional support for cancer patients has been developed for rehabilitation therapists. In addition, no study has examined associations between rehabilitation therapists' communication skills and their level of autistic-like traits (ALT), which are in-born characteristics including specific communication styles and difficulty communicating with patients. In this study, we aimed to investigate whether confidence in communicating with patients mitigates communication difficulties experienced by rehabilitation therapists who have high levels of ALT. Rehabilitation therapists who treat patients with cancer completed self-administered postal questionnaires anonymously. Scores were obtained on the Autism-Spectrum Quotient short form, confidence in communication, and communication difficulties. We used covariance structure analyses to test hypothetical models, and confirmed that confidence in communication mediates the relationship between ALT and perceived communication difficulties. Participants included 1,343 respondents (49.6%). Autism-Spectrum Quotient scores were positively correlated with communication difficulties (r = 0.16, p confidence in communication in the fit model. However, higher confidence in creating a supportive atmosphere was associated with more difficulty in communication (r = 0.16, p Communication difficulty was linked to rehabilitation therapists' ALTs. By increasing confidence in areas of communication other than creation of a supportive atmosphere, ALT-related difficulties in communication may be ameliorated. Confidence to create supportive environments correlated positively with difficulty. Communication skills training to increase confidence in communication for rehabilitation therapists should be developed with vigilance regarding ALT levels.

  20. 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

  1. Performance monitoring in obsessive-compulsive undergraduates: Effects of task difficulty.

    Science.gov (United States)

    Riesel, Anja; Richter, Anika; Kaufmann, Christian; Kathmann, Norbert; Endrass, Tanja

    2015-08-01

    Both obsessive-compulsive disorder and subclinical obsessive-compulsive (OC) symptoms seem to be associated with hyperactive error-related brain activity. The current study examined performance monitoring in subjects with subclinical OC symptoms using a new task with different levels of difficulty. Nineteen subjects with high and 18 subjects with low OC characteristics performed a random dot cinematogram (RDC) task with three levels of difficulty. The high and low OC groups did not differ in error-related negativity (ERN), correct-related negativity (CRN) and performance irrespective of task difficulty. The amplitude of the ERN decreased with increasing difficulty whereas the magnitude of CRN did not vary. ERN and CRN approached in size and topography with increasing difficulty, which suggests that errors and correct responses are processed more similarly. These results add to a growing number of studies that fail to replicate hyperactive performance monitoring in individuals with OC symptoms in task with higher difficulty or requiring learning. Together with these findings our results suggest that the relationship between OC symptoms and performance monitoring may be sensitive to type of task and task characteristics and cannot be observed in a RDC that differs from typically used tasks in difficulty and the amount of response-conflict. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. 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.

  3. The Answering Process for Multiple-Choice Questions in Collaborative Learning: A Mathematical Learning Model Analysis

    Science.gov (United States)

    Nakamura, Yasuyuki; Nishi, Shinnosuke; Muramatsu, Yuta; Yasutake, Koichi; Yamakawa, Osamu; Tagawa, Takahiro

    2014-01-01

    In this paper, we introduce a mathematical model for collaborative learning and the answering process for multiple-choice questions. The collaborative learning model is inspired by the Ising spin model and the model for answering multiple-choice questions is based on their difficulty level. An intensive simulation study predicts the possibility of…

  4. 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.

  5. Impact of Answer-Switching Behavior on Multiple-Choice Test Scores in Higher Education

    Directory of Open Access Journals (Sweden)

    Ramazan BAŞTÜRK

    2011-06-01

    Full Text Available The multiple- choice format is one of the most popular selected-response item formats used in educational testing. Researchers have shown that Multiple-choice type test is a useful vehicle for student assessment in core university subjects that usually have large student numbers. Even though the educators, test experts and different test recourses maintain the idea that the first answer should be retained, many researchers argued that this argument is not dependent with empirical findings. The main question of this study is to examine how the answer switching behavior affects the multiple-choice test score. Additionally, gender differences and relationship between number of answer switching behavior and item parameters (item difficulty and item discrimination were investigated. The participants in this study consisted of 207 upper-level College of Education students from mid-sized universities. A Midterm exam consisted of 20 multiple-choice questions was used. According to the result of this study, answer switching behavior statistically increase test scores. On the other hand, there is no significant gender difference in answer-switching behavior. Additionally, there is a significant negative relationship between answer switching behavior and item difficulties.

  6. 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

  7. 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…

  8. 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.

  9. 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.

  10. Walking and talking: an investigation of cognitive-motor dual tasking in multiple sclerosis.

    Science.gov (United States)

    Hamilton, F; Rochester, L; Paul, L; Rafferty, D; O'Leary, C P; Evans, J J

    2009-10-01

    Deficits in motor functioning, including walking, and in cognitive functions, including attention, are known to be prevalent in multiple sclerosis (MS), though little attention has been paid to how impairments in these areas of functioning interact. This study investigated the effects of performing a concurrent cognitive task when walking in people with MS. Level of task demand was manipulated to investigate whether this affected level of dual-task decrement. Eighteen participants with MS and 18 healthy controls took part. Participants completed walking and cognitive tasks under single- and dual-task conditions. Compared to healthy controls, MS participants showed greater decrements in performance under dual-task conditions in cognitive task performance, walking speed and swing time variability. In the MS group, the degree of decrement under dual-task conditions was related to levels of fatigue, a measure of general cognitive functioning and self-reported everyday cognitive errors, but not to measures of disease severity or duration. Difficulty with walking and talking in MS may be a result of a divided attention deficit or of overloading of the working memory system, and further investigation is needed. We suggest that difficulty with walking and talking in MS may lead to practical problems in everyday life, including potentially increasing the risk of falls. Clinical tools to assess cognitive-motor dual-tasking ability are needed.

  11. Multiple zone power forwards. A value at risk framework

    International Nuclear Information System (INIS)

    Demers, Jean-Guy

    2009-01-01

    Over the 1990s, deregulated power markets in New-England provided zones with fluctuating spot prices. Such prices have a notoriously high volatility, owing to the difficulty of storing electrical energy and the delays needed to adjust generation levels. In this context, forward contracts have become increasingly popular and understanding their dynamic is a problem facing many market players. This paper proposes a parsimonious parametric model, based on the price series of all n-month forward contracts (n = 1,2,3..), encompassing multiple zones. The model is then used for value at risk forecasts, which are backtested and compared with the ones in use by the risk management unit of an important electricity producer. Extensions to include natural gas and power-relevant oil-based future markets are discussed. (author)

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Relaxation height in energy landscapes : an application to multiple metastable states

    NARCIS (Netherlands)

    Cirillo, E.N.M.; Nardi, F.R.

    2012-01-01

    The study of systems with multiple (not necessarily degenerate) metastable states presents subtle difficulties from the mathematical point of view related to the variational problem that has to be solved in these cases. We introduce the notion of relaxation height in a general energy landscape and

  18. Using Multiple Intelligences To Improve Retention in Foreign Language Vocabulary Study.

    Science.gov (United States)

    Anderson, Virginia B.

    The report describes an experiment for increasing retention of foreign language vocabulary by using multiple intelligence approaches and memory enhancement tools. The targeted population was approximately 100 seventh- and eighth-grade Latin students. Student difficulty with vocabulary retention had been ascribed to the teacher's emphasis on…

  19. 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 ...

  20. 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.

  1. Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies

    Science.gov (United States)

    Clarke, David

    2017-01-01

    Objective To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Design Systematic review and thematic synthesis. Method We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Results Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Conclusions Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their

  2. 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.

  3. The Effect of an Enrichment Reading Program on the Cognitive Processes and Neural Structures of Children Having Reading Difficulties

    Directory of Open Access Journals (Sweden)

    Hayriye Gül KURUYER

    2017-06-01

    Full Text Available The main purpose of the current study is to explain the effect of an enrichment reading program on the cognitive processes and neural structures of children experiencing reading difficulties. The current study was carried out in line with a single-subject research method and the between-subjects multiple probe design belonging to this method. This research focuses on a group of eight students with reading difficulties. Within the context of the study, memory capacities, attention spans, reading-related activation and white matter pathways of the students were determined before and after the application of the enrichment reading program. This determination process was carried out in two stages. Neuro-imaging was performed in the first stage and in the second stage the students’ cognitive processes and neural structures were investigated in terms of focusing attention and memory capacities by using the following tools: Stroop Test TBAG Form, Auditory Verbal Digit Span Test-Form B, Cancellation Test and Number Order Learning Test. The results obtained show that the enrichment reading program resulted in an improvement in the reading profiles of the students having reading difficulties in terms of their cognitive processes and neural structures.

  4. 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.

  5. 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.

  6. The Influence of External User Interdependence of Financial Statements, Possibility of Clients Facing Financial Difficulties, and Auditor Evaluation of Management Integrity To Acceptable Audit Risk.

    Directory of Open Access Journals (Sweden)

    Andini Sih Afsari Utami

    2016-12-01

    Full Text Available The purpose of this research is to analyze. Analyses the influence of external users reliance on financial statements, likelihood of financial difficulties and management integrity toward acceptable audit risk were performed with 10 public accountant office who had listed from Direktorat IAPI 2013. The sample used the “Gay” theory. The analyzed method in this research uses multiple linear. The result shown that performing external users reliance on financial statements significantly influences toward acceptable audit risk, likelihood of financial difficulties significantly influences toward acceptable audit risk, and management integrity significantly influences toward acceptable audit risk.

  7. Differences in Emotion Regulation Difficulties Across Types of Eating Disorders During Adolescence.

    Science.gov (United States)

    Weinbach, Noam; Sher, Helene; Bohon, Cara

    2017-11-04

    Emotion regulation appears to play a key role in eating disorders. However, prior attempts to associate specific emotion regulation abilities with specific types of eating disorders resulted in inconsistent findings. Moreover, far less is known about emotion regulation in eating disorders during adolescence, a critical period of emotional development. The current study addresses this gap, comparing emotion regulation characteristics between adolescents with restrictive types of eating disorders and those with binge eating or purging types of eating disorders. Ninety-eight adolescents with eating disorders (49 with restrictive and 49 with binge eating/purging eating disorders) completed a set of questionnaires including the Difficulties in Emotion Regulation Scale (DERS). The results revealed that binge eating/purging types of eating disorders were associated with greater difficulties in a variety of emotion regulation dimensions including impulse control, goal-directed behavior and access to effective emotion regulation strategies. Awareness and clarity of emotions were also worse in the binge eating/purging types of eating disorders, but this difference did not remain when comorbid psychopathology measures were controlled for. Moreover, the emotion regulation profile of adolescents with anorexia nervosa-binging/purging type was more similar to that of adolescents with bulimia nervosa than to that of adolescents with anorexia nervosa-restrictive type. While both restrictive and binge eating/purging eating disorders have been associated with emotion regulation difficulties, the current study shows that the presence of binge eating or purging episodes is linked with greater severity of emotion regulation deficits among adolescents with eating disorders.

  8. Self-reported learning difficulties and dietary intake in Norwegian adolescents.

    Science.gov (United States)

    Øverby, Nina Cecilie; Lüdemann, Eva; Høigaard, Rune

    2013-11-01

    The academic performance of children impacts future educational attainment which may increase socioeconomic status which again influences their health. One of several factors that might affect academic performance is the diet. The aim of this study was to investigate the cross sectional relation between diet and self-reported reading-, writing-, and mathematical difficulties in Norwegian adolescents. In total, 475 ninth- and tenth-grade students out of 625 eligible ones from four different secondary schools in three different municipalities in Vest-Agder County, Norway, participated, giving a participation rate of 77%. The students filled in a questionnaire with food frequency questions of selected healthy and unhealthy food items, questions of meal frequency and different learning difficulties. Regular breakfast was significantly associated with decreased odds of both writing and reading difficulties (OR: 0.44 (0.2-0.8), p = 0.01) and mathematical difficulties (OR: 0.33 (0.2-0.6), p ≤ 0.001). In addition, having lunch, dinner and supper regularly were associated with decreased odds of mathematical difficulties. Further, a high intake of foods representing a poor diet (sugar-sweetened soft drinks, sweets, chocolate, savory snacks, pizza and hot dogs) was significantly associated with increased odds of mathematical difficulties. Having a less-frequent intake of unhealthy foods and not skipping meals are associated with decreased odds of self-reported learning difficulties in Norwegian adolescents in this study. The results of this study support the need for a larger study with a more representative sample.

  9. Rapid optimization of multiple-burn rocket flights.

    Science.gov (United States)

    Brown, K. R.; Harrold, E. F.; Johnson, G. W.

    1972-01-01

    Different formulations of the fuel optimization problem for multiple burn trajectories are considered. It is shown that certain customary idealizing assumptions lead to an ill-posed optimization problem for which no solution exists. Several ways are discussed for avoiding such difficulties by more realistic problem statements. An iterative solution of the boundary value problem is presented together with efficient coast arc computations, the right end conditions for various orbital missions, and some test results.

  10. 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.

  11. 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.

  12. 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

  13. 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’...

  14. 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.

  15. Emotional and Personality-Related Aspects of Persistent Career Decision-Making Difficulties

    Science.gov (United States)

    Saka, Noa; Gati, Itamar

    2007-01-01

    This study focused on examining the persistent aspects of career decision-making difficulties, using the Emotional and Personality-related Career decision-making Difficulties scale ("EPCD"; [Saka, N., Gati, I., & Kelly, K.R. (in press). Emotional and personality-related aspects of career decision-making difficulties. "Journal of Career…

  16. 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.

  17. The Difficulties Experienced by Teachers in the Process of Primary Reading and Writing Instruction and Their Solution Offers for Eliminating These Difficulties

    Science.gov (United States)

    Gündogmus, Hatice Degirmenci

    2018-01-01

    The purpose of the current research is to identify the difficulties that primary school teachers experience in the primary reading and writing instruction, and to find out their solution offers for eliminating these difficulties. The study group of the research is composed of 51 primary school teachers selected by criterion sampling as a type of…

  18. 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.

  19. 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.…

  20. [Multiple agenesis and prosthetic restoration].

    Science.gov (United States)

    Renault, P

    1990-03-01

    Cases of multiple agenesia present some difficulties in the treatment planing. Three situations may be encountered: limited agenesia, restored by a fixed, bonded or cemented prosthesis, multiple uni- or bimaxillary agenesia without remaining of deciduous teeth, restored by a fixed, bonded or cemented prosthesis or the partial adjacent prosthesis, multiple uni- or bimaxillary agenesia with remaining of deciduous teeth, restored by means of a supra-dental prosthesis. The first two situations have been described in dental literature and are relatively easy to treat. The same is not true for the third situation, where the decision to keep the temporary teeth considerably increases the difficulty of prosthetic restoration. This subject will be illustrated by the presentation of a clinical case of multiple bi-maxillary agenesia. The patient has: on the maxilla: an absence of 9 permanent teeth (18, 15, 14, 12, 22, 23, 24, 25, 28) and the presence of 4 deciduous teeth (62, 63, 64, 65), on the mandible: an absence of all permanent teeth, with the exception of 36 and 46, and the remaining of 4 deciduous teeth (75, 73, 83, 84). The remaining of deciduous teeth and the presence of a very high inter-arch space led to opting for dental coverage so as to keep the deciduous teeth and a proper vertical dimension. The patient wished to solve his "problem" in the maxilla first, and is not wanting to undergo the extraction of his deciduous teeth. The following therapeutic proposal was adapted: On the maxilla, a three-step procedure: first step: building of metal copings on 13, 16 and 26 and metal-ceramic crowns on 11 and 21, second step: building of telescop crowns on 16 and 26 and clasps on 13, 11 and 21, third step: casting of the removable partial denture framework and soldering to the telescop crowns and clasps. On the mandible, a provisional restoration using a supra-dental resin removable partial denture with ceramic occlusal surfaces was adopted. The aesthetic and functional

  1. 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...

  2. 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

  3. 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

  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. Analysis of junior high school students' difficulty in resolving rectangular conceptual problems

    Science.gov (United States)

    Utami, Aliksia Kristiana Dwi; Mardiyana, Pramudya, Ikrar

    2017-08-01

    Geometry is one part of the mathematics that must be learned in school and it has important effects on the development of creative thinking skills of learners, but in fact, there are some difficulties experienced by the students. This research focuses on analysis difficulty in resolving rectangular conceptual problems among junior high school students in every creative thinking skills level. This research used a descriptive method aimed to identify the difficulties and cause of the difficulties experienced by five students. The difficulties are associated with rectangular shapes and related problems. Data collection was done based on students' work through test, interview, and observations. The result revealed that student' difficulties in understanding the rectangular concept can be found at every creative thinking skills level. The difficulties are identifying the objects rectangular in the daily life except for a rectangle and square, analyzing the properties of rectangular shapes, and seeing the interrelationships between figures.

  6. 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.)

  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. 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…

  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. 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

  11. 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.

  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. 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.

  14. 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

  15. 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...

  16. 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…

  17. 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.

  18. 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.

  19. 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.

  20. Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies.

    Science.gov (United States)

    Wray, Faye; Clarke, David

    2017-10-06

    To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Systematic review and thematic synthesis. We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such

  1. Examination of the Relationship of Difficulties in Emotion Regulation, Behavioral Activation and Behavioral Inhibition System in the Prediction of Social Anxiety

    Directory of Open Access Journals (Sweden)

    Sohrab Amiri

    2017-07-01

    Full Text Available Background and Objectives: Anxiety has a significant impact on academic and social performance as well as quality of life. The present study was conducted to investigate the relationship between brain/behavioral systems and difficulties in emotion regulation with cognitive and physical aspects of social anxiety. Methods: In this descriptive-correlational study, 306 students were selected from the student population of the Urmia University using multistage cluster sampling. Data collection was performed using measuring scales of social anxiety dimensions, behavioral activation and inhibition system, and difficulties in emotion regulation. Data were analyzed using descriptive indicators, correlation, simultaneous multiple regression analysis, and t-test analysis. Results: In this study, there was a significant positive correlation between behavioral inhibition system and social anxiety dimensions (p<0.001, Also, examination of the relationships of difficulties in emotion regulation and social anxiety indicated a significant positive correlation between difficulties in emotion regulation and social anxiety (p<0.001. In the comparison between women and men in terms of social anxiety components, both groups were different in cognitive dimension of social anxiety, so that the women obtained higher scores than men in the cognitive dimensions. Conclusion: According to the results of this study, individual differences in using negative emotion regulation strategies and personality traits play an important role in the onset and maintenance of anxiety.

  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. Difficulties in using everyday technology after acquired brain injury: a qualitative analysis.

    Science.gov (United States)

    Engström, Ann-Louice Lövgreen; Lexell, Jan; Lund, Maria Larsson

    2010-09-01

    The aim of this study was to identify and describe the characteristics of the difficulties using everyday technology in persons with an aquired brain injury (ABI), and their experiences of how these difficulties influenced their life. Thirteen persons with an ABI were interviewed about their difficulties in using everyday technology and were observed in their use of technology. Data were analysed qualitatively with a constant comparative method. The results showed that the persons' experiences formed two categories: “A variety of combinations of difficulties in the use of everyday technology” and “Restrictions in life”. The difficulties identified were related not only to everyday technology itself but also to the interaction between the technology, the task, the person, and the environment. These difficulties influenced their experiences of restrictions in occupational performance, personal identification, and participation in society. The results emphasize that occupational therapists who design interventions for people with an ABI need to accommodate both the technology and other interacting aspects in order to overcome difficulties in using everyday technology.

  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. 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.

  6. Masculine Discrepancy Stress, Emotion-Regulation Difficulties, and Intimate Partner Violence.

    Science.gov (United States)

    Berke, Danielle S; Reidy, Dennis E; Gentile, Brittany; Zeichner, Amos

    2016-05-24

    Research suggests that masculine socialization processes contribute to the perpetration of intimate partner violence (IPV) by men. Although this research has traditionally focused on men who strongly adhere to traditional gender norms, men who negatively evaluate themselves as falling short of these norms (a construct termed masculine discrepancy stress) have proven to be at increased risk of IPV perpetration. Likewise, men experiencing problems with emotion regulation, a multidimensional construct reflecting difficulties in effectively experiencing and responding to emotional states, are also at risk of IPV perpetration. In the present research, we tested the hypothesis that the link between discrepancy stress and IPV perpetration is mediated via difficulties in emotion regulation. Three hundred fifty-seven men completed online surveys assessing their experience of discrepancy stress, emotion-regulation difficulties, and history of IPV perpetration. Results indicated that discrepancy-stressed men's use of physical IPV was fully mediated by emotion-regulation difficulties. In addition, emotion-regulation difficulties partially mediated the association between discrepancy stress and sexual IPV. Findings are discussed in terms of the potential utility of emotion-focused interventions for modifying men's experience and expression of discrepancy stress and reducing perpetration of IPV. © The Author(s) 2016.

  7. Masculine Discrepancy Stress, Emotion-Regulation Difficulties, and Intimate Partner Violence

    Science.gov (United States)

    Berke, Danielle S.; Reidy, Dennis E.; Gentile, Brittany; Zeichner, Amos

    2018-01-01

    Research suggests that masculine socialization processes contribute to the perpetration of intimate partner violence (IPV) by men. Although this research has traditionally focused on men who strongly adhere to traditional gender norms, men who negatively evaluate themselves as falling short of these norms (a construct termed masculine discrepancy stress) have proven to be at increased risk of IPV perpetration. Likewise, men experiencing problems with emotion regulation, a multidimensional construct reflecting difficulties in effectively experiencing and responding to emotional states, are also at risk of IPV perpetration. In the present research, we tested the hypothesis that the link between discrepancy stress and IPV perpetration is mediated via difficulties in emotion regulation. Three hundred fifty-seven men completed online surveys assessing their experience of discrepancy stress, emotion-regulation difficulties, and history of IPV perpetration. Results indicated that discrepancy-stressed men's use of physical IPV was fully mediated by emotion-regulation difficulties. In addition, emotion-regulation difficulties partially mediated the association between discrepancy stress and sexual IPV. Findings are discussed in terms of the potential utility of emotion-focused interventions for modifying men's experience and expression of discrepancy stress and reducing perpetration of IPV. PMID:27226013

  8. 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.

  9. 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.

  10. [Supporting parenting in families with multiple problems].

    Science.gov (United States)

    Le Foll, Julie

    2015-01-01

    Supporting parenthood in families with multiple problems is a major early prevention challenge. Indeed, the factors of vulnerability, especially if they mount up, expose the child to an increased risk of a somatic pathology, developmental delays, learning difficulties and maltreatment. In order to limit the impact of these vulnerabilities on the health of mothers and infants, it is essential to act early, to adapt the working framework and to collaborate within a network. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. A Pilot Study of Multiple Password Interference Between Text and Map-Based Passwords

    DEFF Research Database (Denmark)

    Meng, Weizhi; Li, Wenjuan; Lee, Wang

    2017-01-01

    Today’s computer users have to remember several passwords for each of their accounts. It is easily noticed that people may have difficulty in remembering multiple passwords, which result in a weak password selection. Previous studies have shown that recall success rates are not statistically...

  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. Borderline personality disorder symptoms and criminal justice system involvement: The roles of emotion-driven difficulties controlling impulsive behaviors and physical Aggression.

    Science.gov (United States)

    Moore, Kelly E; Tull, Matthew T; Gratz, Kim L

    2017-07-01

    Borderline personality disorder (BPD) is associated with elevated risk for a variety of risky behaviors, including criminal behaviors. Yet, limited research has examined the relation of BPD to criminal justice (CJ) involvement, or the mechanisms underlying this relation. This study examined the role of two mechanisms, emotion-driven difficulties controlling impulsive behaviors and physical aggression, in the relation between BPD symptom severity and CJ involvement among 118 patients in residential substance abuse treatment (76% male; 62% African-American). Participants completed measures of BPD symptom severity, CJ contact, diversity of CJ charges, emotion-driven impulse control difficulties, physical aggression, and covariates (substance use severity and antisocial personality disorder symptoms). BPD symptom severity was associated with CJ contact through emotion-driven difficulties controlling impulsive behaviors, and with diversity of CJ charges through emotion-driven difficulties controlling impulsive behaviors and physical aggression; however, the indirect relations to diversity of CJ charges became non-significant when covariates were included. Results highlight the important role of emotion-driven difficulties controlling impulsive behaviors in criminal behaviors among individuals with BPD symptoms, as well as the potential clinical utility of targeting this mechanism to prevent CJ involvement and/or recidivism. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Alone? Perceived social support and chronic interpersonal difficulties in suicidal elders.

    Science.gov (United States)

    Harrison, Katrin E; Dombrovski, Alexandre Y; Morse, Jennifer Q; Houck, Patricia; Schlernitzauer, Maryann; Reynolds, Charles F; Szanto, Katalin

    2010-05-01

    Social networks may protect depressed elders against suicidal behavior. However, conflict in important relationships may undermine the sense of social support, potentially negating the protective effects. Thus, we investigated the role of chronic interpersonal difficulties and perceived social support in depressed elders with and without suicidal thoughts and attempts. 106 individuals aged 60 years and older participated in this cross-sectional, case-control study. They were placed in three groups: suicidal depressed, non-suicidal depressed and non-depressed. Following a detailed clinical characterization, we assessed perceived social support (Interpersonal Support Evaluation List), and chronic interpersonal difficulties (Inventory of Interpersonal Problems). Using general linear models, we explored the relationship between suicidal thoughts/attempts, social support, and chronic interpersonal difficulties. We also examined whether lower perceived social support explained the relationship between chronic interpersonal difficulties and suicidal thoughts/attempts. Suicidal depressed elders reported the lowest levels of perceived social support (belonging, tangible support, and self-esteem) and higher levels of chronic interpersonal difficulties (struggle against others and interpersonal hostility), compared to both non-suicidal depressed and non-depressed elders. The relationship between chronic interpersonal difficulties and suicidal behavior was partially explained by low perceived social support. The experience of strong affects, interpersonal struggle, and hostility in relationships may undermine the sense of social support in depressed elders, possibly leading them to contemplate or attempt suicide. Depressed elders with a history of interpersonal difficulties need to be carefully monitored for suicidal behavior.

  15. Falls and Hospitalizations Among Persons With Dementia and Associated Caregiver Emotional Difficulties.

    Science.gov (United States)

    Leggett, Amanda N; Polenick, Courtney A; Maust, Donovan T; Kales, Helen C

    2018-03-19

    Falls and hospitalizations are adverse health events commonly experienced by persons with dementia (PWDs). These events often require urgent care from a family caregiver and may increase caregiver stress. We examine falls and hospitalizations among PWDs as predictors of caregivers' reported care-related emotional difficulty, in addition to care-related stressors. Cross-sectional telephone survey of 652 informal caregivers for PWDs. A multinomial logistic regression examined falls (last month) and hospitalizations (prior year) experienced by PWDs as predictors of caregivers' care-related emotional difficulty, accounting for demographic characteristics and primary and secondary caregiving stressors. Over 20% of caregivers reported high levels of care-related emotional difficulty. Controlling for demographic characteristics and primary and secondary caregiving stressors, the PWD's prior month fall was significantly associated with greater care-related emotional difficulty; the PWD's hospitalizations were not associated with care-related emotional difficulty. Approximately 30% of PWDs had experienced a past year hospitalization and prior month fall, and one in five caregivers reported high emotional difficulty related to care. Although secondary strains and resources of caregiving were strong predictors of care-related emotional difficulty, PWDs' falls represent a significant stressor that increases odds of caregiver emotional difficulty over and above other strains. Consequently, a fall experienced by a PWD may represent a key time for clinicians to assess caregiver well-being.

  16. 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.

  17. The Predictive Role of Difficulties in Emotion Regulation and Self-Control with Susceptibility to Addiction in Drug-Dependent Individuals

    Directory of Open Access Journals (Sweden)

    Mahmoud Shirazi

    2015-06-01

    Full Text Available Objective: The present study aimed to examine the predictive role of difficulties in emotion regulation and self-control in potential for addiction among drug-dependent individuals. Method: This was a correlational study which falls within the category of descriptive studies. The statistical population of the current study included all patients under treatment in outpatient health centers in Bam, among whom 315 individuals were selected through cluster sampling method as the participants of the study. Difficulties in Emotion Regulation Scale, Self-Control Scale, and Addiction Susceptibility Questionnaire were used for data collection purposes. Results: The results indicated that difficulties engaging in goal directed behavior, impulse control difficulties, lack of emotional awareness, and lack of emotional clarity (dimensions of difficulties in emotion regulation had a significant positive correlation with potential for addiction. In addition, there was a negative significant relationship between self-control and potential for addiction among drug-dependent individuals. Conclusion: In addition to common methods of abstinence from drug dependence, teaching self-control and emotional control techniques to addicted patients can help them reduce their dependence.

  18. 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.

  19. Position Affects Performance in Multiple-Object Tracking in Rugby Union Players

    Directory of Open Access Journals (Sweden)

    Andrés Martín

    2017-09-01

    Full Text Available We report an experiment that examines the performance of rugby union players and a control group composed of graduate student with no sport experience, in a multiple-object tracking task. It compares the ability of 86 high level rugby union players grouped as Backs and Forwards and the control group, to track a subset of randomly moving targets amongst the same number of distractors. Several difficulties were included in the experimental design in order to evaluate possible interactions between the relevant variables. Results show that the performance of the Backs is better than that of the other groups, but the occurrence of interactions precludes an isolated groups analysis. We interpret the results within the framework of visual attention and discuss both, the implications of our results and the practical consequences.

  20. Identification of Multiple-Mode Linear Models Based on Particle Swarm Optimizer with Cyclic Network Mechanism

    Directory of Open Access Journals (Sweden)

    Tae-Hyoung Kim

    2017-01-01

    Full Text Available This paper studies the metaheuristic optimizer-based direct identification of a multiple-mode system consisting of a finite set of linear regression representations of subsystems. To this end, the concept of a multiple-mode linear regression model is first introduced, and its identification issues are established. A method for reducing the identification problem for multiple-mode models to an optimization problem is also described in detail. Then, to overcome the difficulties that arise because the formulated optimization problem is inherently ill-conditioned and nonconvex, the cyclic-network-topology-based constrained particle swarm optimizer (CNT-CPSO is introduced, and a concrete procedure for the CNT-CPSO-based identification methodology is developed. This scheme requires no prior knowledge of the mode transitions between subsystems and, unlike some conventional methods, can handle a large amount of data without difficulty during the identification process. This is one of the distinguishing features of the proposed method. The paper also considers an extension of the CNT-CPSO-based identification scheme that makes it possible to simultaneously obtain both the optimal parameters of the multiple submodels and a certain decision parameter involved in the mode transition criteria. Finally, an experimental setup using a DC motor system is established to demonstrate the practical usability of the proposed metaheuristic optimizer-based identification scheme for developing a multiple-mode linear regression model.

  1. 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

  2. STRATEGIES OF COPING WITH DIFFICULTIES DURING RESEARCH PERFORMED BY YOUNG SCIENTISTS

    Directory of Open Access Journals (Sweden)

    Tatiana G. Bokhan

    2017-03-01

    Full Text Available Introduction: young scientists engaged in creative activities face difficulties during scientific research, implementation and commercialisation of the results. The impossibility of coping with obstacles leads to the impairment of motivational and creative activity. The problem of studying the main semantic contents of difficult situations and strategies to cope with them becomes relevant as it is conducive to the process of personal development of young scientists. Materials and Methods: the authors used a questionnaire with open-ended questions for revealing the main difficulties and coping strategies in the process of research activity; COPE questionnaire adapted by E. Rasskazova, T. Gordeyeva, E. Osin; Style of Self-Regulation of Behaviour technique by V. I. Morosanova. Statistical data processing was carried out with descriptive statistics methods, analysis of frequencies, factor analysis (Varimax rotation with Kaiser normalisation, cluster analysis (furthest neighbour method and Ward’s method. Results: eight main semantic categories related to difficulties experienced in the process of performing the research work have been detected. The main ways of coping with arising difficulties have been identified. Types of respondents different in terms of coping strategies and regulatory-behavioural characteristics have been distinguished. Discussion and Conclusions: difficulties of self-organisation in time for realisation of new meanings, difficulties in structuring the research work and search for information act as psychological barriers provoking mental stress. The most efficient coping strategies in respondents are strategies Active coping and search for positive meaning and personal development. The inefficient coping strategy with difficulties complicating the process of self-development is Avoiding problems strategies.

  3. 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.

  4. 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.

  5. Observations on Student Difficulties with Mathematics in Upper-Division Electricity and Magnetism

    Science.gov (United States)

    Pepper, Rachel E.; Chasteen, Stephanie V.; Pollock, Steven J.; Perkins, Katherine K.

    2012-01-01

    We discuss common difficulties in upper-division electricity and magnetism (E&M) in the areas of Gauss's law, vector calculus, and electric potential using both quantitative and qualitative evidence. We also show that many of these topical difficulties may be tied to student difficulties with mathematics. At the junior level, some students…

  6. 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.

  7. 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

  8. Emotional and Personality-Related Aspects of Career-Decision-Making Difficulties

    Science.gov (United States)

    Saka, Noa; Gati, Itamar; Kelly, Kevin R.

    2008-01-01

    This research focuses on developing a theoretical framework for analyzing the emotional and personality-related aspects of career-decision-making difficulties. The proposed model is comprised of three major clusters: pessimistic views, anxiety, and self-concept and identity. In Study 1, the Emotional and Personality Career Difficulties Scale…

  9. 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...

  10. An examination of the relationship between childhood emotional abuse and borderline personality disorder features: the role of difficulties with emotion regulation.

    Science.gov (United States)

    Kuo, Janice R; Khoury, Jennifer E; Metcalfe, Rebecca; Fitzpatrick, Skye; Goodwill, Alasdair

    2015-01-01

    Childhood abuse has been consistently linked with borderline personality disorder (BPD) and recent studies suggest that some forms of childhood abuse might be uniquely related to both BPD and BPD features. In addition, difficulties with emotion regulation have been found to be associated with childhood abuse, BPD, as well as BPD features. The present study examined (1) whether frequency of childhood emotional abuse is uniquely associated with BPD feature severity when controlling for other forms of childhood abuse and (2) whether difficulties with emotion regulation accounts for the relationship between childhood emotional abuse and BPD feature severity. A sample of undergraduates (n=243) completed the Childhood Trauma Questionnaire - Short Form, Difficulties in Emotion Regulation Scale, and Borderline Symptom List-23. Multiple regression analyses and Structural Equation Modeling were conducted. Results indicated that frequency of childhood emotional abuse (and not sexual or physical abuse) was uniquely associated with BPD feature severity. In addition, while there was no direct path between childhood emotional abuse, childhood physical abuse, or childhood sexual abuse and BPD features, there was an indirect relationship between childhood emotional abuse and BPD features through difficulties with emotion regulation. These findings suggest that, of the different forms of childhood abuse, emotional abuse specifically, may have a developmental role in BPD pathology. Prevention and treatment of BPD pathology might benefit from the provision of emotion regulation strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Emission Constrained Multiple-Pulse Fuel Injection Optimisation and Control for Fuel-Efficient Diesel Engines

    NARCIS (Netherlands)

    Luo, X.; Jager, B. de; Willems, F.P.T.

    2015-01-01

    With the application of multiple-pulse fuel injection profiles, the performance of diesel engines is enhanced in terms of low fuel consumption and low engine-out emission levels. However, the calibration effort increases due to a larger number of injection timing parameters. The difficulty of

  12. 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…

  13. Difficulties in emotion regulation mediate negative and positive affects and craving in alcoholic patients.

    Science.gov (United States)

    Khosravani, Vahid; Sharifi Bastan, Farangis; Ghorbani, Fatemeh; Kamali, Zoleikha

    2017-08-01

    The aim of this study was to assess the mediating effects of difficulties in emotion regulation (DER) on the relations of negative and positive affects to craving in alcoholic patients. 205 treatment-seeking alcoholic outpatients were included. DER, positive and negative affects as well as craving were evaluated by the Difficulties in Emotion Regulation Scale (DERS), the Positive/Negative Affect Scales, and the Obsessive Compulsive Drinking Scale (OCDS) respectively. Clinical factors including depression and severity of alcohol dependence were investigated by the Alcohol Use Disorders Identification Test (AUDIT) and the Beck Depression Inventory-II (BDI-II) respectively. Results revealed that both increased negative affect and decreased positive affect indirectly influenced craving through limited access to emotion regulation strategies. It was concluded that limited access to emotion regulation strategies may be important in predicting craving for alcoholics who experience both increased negative affect and decreased positive affect. This suggests that treatment and prevention efforts focused on increasing positive affect, decreasing negative affect and teaching effective regulation strategies may be critical in reducing craving in alcoholic patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. 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)

  15. 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

  16. 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…

  17. Environmental issues and work: women with multiple chemical sensitivities.

    Science.gov (United States)

    Lipson, Juliene G; Doiron, Nathalie

    2006-08-01

    Multiple chemical sensitivities (MCS) is an acquired condition in which exposure to low levels of chemicals causes symptoms in multiple organ systems. Some 12%-16% of the U.S. population has some level of chemical sensitivity, 80% of whom are women. Attempts to reduce chemical exposures leads to enormous life difficulties at home, school, and workplace. We base our article on an ethnographic study of MCS in the United States and Canada. We describe here themes related to work issues in terms of a general trajectory of becoming sick from work exposures, coping with toxic physical environments and dealing with coworkers and, when unable to continue working, applying for workers' compensation, or disability status, or both.

  18. Applying a Systemic Procedure to Locate Career Decision-Making Difficulties

    Science.gov (United States)

    Gati, Itamar; Amir, Tamar

    2010-01-01

    Locating clients' career decision-making difficulties is one of the first steps in career counseling. The authors demonstrate the feasibility and utility of a systematic 4-stage procedure for locating and interpreting career decision-making difficulties by analyzing responses of 626 college students (collected by Tai, 2007) to the Career…

  19. FEEDING DIFFICULTIES IN PRESCHOOL CHILDREN, PREVIOUS FEEDING PRACTICES, AND NUTRITIONAL STATUS.

    Science.gov (United States)

    Maranhão, Hélcio de Sousa; Aguiar, Renata Cunha de; Lira, Débora Teixeira Jales de; Sales, Mônica Úrsula Figuerêdo; Nóbrega, Nathalia Ávila do Nascimento

    2018-01-01

    To identify the prevalence of feeding difficulties in preschoolers, its association with epidemiological factors and previous eating habits, and repercussion on nutritional status. Cross-sectional study with a questionnaire given to the mothers of 301 children aged 2-6 years enrolled in public and private kindergartens in Natal, Northeast Brazil, conducted in 2014-2015. Feeding difficulty was assessed according to Kerzner's criteria, resulting in the profiles "highly selective intake", "active child with small appetite", "fear of feeding", and "child with psychological disorder or neglected". Association with the following independent variables was analyzed by logistic regression: breastfeeding time, age of cows' milk and complementary feeding introduction, age range, family income, type of school, mothers' profile (responsive or nonresponsive), and body mass index (BMI). Feeding difficulty was found in 37.2% of cases, with predominance of "highly selective intake" (25.4%). It was not associated with infancy feeding practices, family income or type of school. There were no differences between the BMI Z score means for the groups with and without feeding difficulty (1.0±1.5 SD and 1.1±1.4 SD, respectively). The five-to-six age range had more occurrences (OR 1.8; 95%CI 1.1-2.9). Children of responsive mothers were less likely to have feeding difficulties (OR 0.4; 95%CI 0.2-0.8). Feeding difficulties were very frequent. Nutritional status was not impacted by it, and infancy eating habits were not associated with it. Responsive mothers' profile is a protective factor against eating difficulties and reinforces the importance of behavioral factors and mother-child interaction.

  20. Performance analysis of quantum access network using code division multiple access model

    International Nuclear Information System (INIS)

    Hu Linxi; Yang Can; He Guangqiang

    2017-01-01

    A quantum access network has been implemented by frequency division multiple access and time division multiple access, while code division multiple access is limited for its difficulty to realize the orthogonality of the code. Recently, the chaotic phase shifters were proposed to guarantee the orthogonality by different chaotic signals and spread the spectral content of the quantum states. In this letter, we propose to implement the code division multiple access quantum network by using chaotic phase shifters and synchronization. Due to the orthogonality of the different chaotic phase shifter, every pair of users can faithfully transmit quantum information through a common channel and have little crosstalk between different users. Meanwhile, the broadband spectra of chaotic signals efficiently help the quantum states to defend against channel loss and noise. (paper)

  1. Prevalence of functioning difficulties and disability in Mexican adolescent women and their populational characteristics

    Directory of Open Access Journals (Sweden)

    Betania Allen-Leigh

    2017-07-01

    Full Text Available Objective. Report prevalence of functioning difficulties and disabilities among Mexican adolescent women 15-17 years old and identify differences in characteristics of those with and without a functioning difficulty or disability Materials and methods. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used chi square tests for independence and logistic regression to explore associations between this condition and various characteristics. Results. Of Mexican adolescent women 15-17 years old, 11.1% had a functioning difficulty or disability. The group of domains of functioning difficulty and disability with by far the highest prevalence was socio-emotional and behavioral functioning difficulties or disability with 8.6%. Being employed, rural residence and self-reported depression symptoms were associated with having functioning difficulties or disability. Conclusions. This survey constitutes an important initial step in collecting data on functioning difficulty and disability in Mexico although larger samples should be studied.

  2. [The comorbidity of learning difficulties and ADHD symptoms in primary-school-age children].

    Science.gov (United States)

    Schuchardt, Kirsten; Fischbach, Anne; Balke-Melcher, Christina; Mähler, Claudia

    2015-05-01

    Children having difficulties in acquiring early literacy and mathematical skills often show an increased rate of inattention, hyperactivity, and impulsivity. This study provides data on the comorbidity rates of specific learning difficulties and ADHD symptoms. We analyzed the data of 273 children with learning difficulties despite an at least average IQ, 57 children with low IQ, and 270 children without learning difficulties and average IQ (comparison group). We assessed children’s IQ and school achievement using standardized achievement tests. ADHD symptoms were assessed via parents’ ratings. Our results showed that only 5 % of both the control group and the group with solely mathematical difficulties fulfilled the criteria of an ADHD subtype according to the DSM-IV based on parents’ ratings. In contrast, this was the case in even 20 % of the children with difficulties in reading/writing and of those with low IQ. Compared to girls, boys in the control group had a 150% higher risk for matching the criteria of one of the ADHD subtypes in parents’ ratings, whereas boys with learning difficulties and those with low IQ had an even 200% to 600% higher risk for it. The relationship between learning difficulties and ADHD symptoms can be found predominantly in the inattentive type. Possible reasons for the results are discussed.

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Coupled Multiple-Response versus Free-Response Conceptual Assessment: An Example from Upper-Division Physics

    Science.gov (United States)

    Wilcox, Bethany R.; Pollock, Steven J.

    2014-01-01

    Free-response research-based assessments, like the Colorado Upper-division Electrostatics Diagnostic (CUE), provide rich, fine-grained information about students' reasoning. However, because of the difficulties inherent in scoring these assessments, the majority of the large-scale conceptual assessments in physics are multiple choice. To increase…

  8. Emission constrained multiple-pulse fuel injection optimisation and control for fuel-efficient diesel engines

    NARCIS (Netherlands)

    Luo, X.; Jager, de A.G.; Willems, F.P.T.

    2015-01-01

    With the application of multiple-pulse fuel injec- tion profiles, the performance of diesel engines is enhanced in terms of low fuel consumption and low engine-out emission levels. However, the calibration effort increases due to a larger number of injection timing parameters. The difficulty of

  9. Learning difficulties of senior high school students based on probability understanding levels

    Science.gov (United States)

    Anggara, B.; Priatna, N.; Juandi, D.

    2018-05-01

    Identifying students' difficulties in learning concept of probability is important for teachers to prepare the appropriate learning processes and can overcome obstacles that may arise in the next learning processes. This study revealed the level of students' understanding of the concept of probability and identified their difficulties as a part of the epistemological obstacles identification of the concept of probability. This study employed a qualitative approach that tends to be the character of descriptive research involving 55 students of class XII. In this case, the writer used the diagnostic test of probability concept learning difficulty, observation, and interview as the techniques to collect the data needed. The data was used to determine levels of understanding and the learning difficulties experienced by the students. From the result of students' test result and learning observation, it was found that the mean cognitive level was at level 2. The findings indicated that students had appropriate quantitative information of probability concept but it might be incomplete or incorrectly used. The difficulties found are the ones in arranging sample space, events, and mathematical models related to probability problems. Besides, students had difficulties in understanding the principles of events and prerequisite concept.

  10. 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.

  11. Understanding handwriting difficulties: A comparison of children with and without motor impairment.

    Science.gov (United States)

    Prunty, Mellissa; Barnett, Anna L

    The nature of handwriting difficulties have been explored in children with specific developmental disorders. The aim of this study was to investigate the nature of handwriting difficulties in children with dysgraphia, a less studied group who have significant handwriting difficulties in the absence of motor control or cognitive difficulties. The performance of a dysgraphia group aged 8-14 years was compared to a group with Developmental Coordination Disorder and to typically developing (TD) controls. Participants completed two handwriting tasks on a digitizing writing tablet. The amount and accuracy of the handwriting product was measured, plus various temporal and spatial features of the writing process. There were no significant differences in performance between the two groups with handwriting difficulties but both performed more poorly than the TD group. Individual differences in the type and severity of handwriting impairments suggest the need for a range of classroom assessments to tailor intervention appropriately.

  12. 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

  13. Malnutrition, eating difficulties and feeding dependence in a stroke rehabilitation centre

    NARCIS (Netherlands)

    Poels, Bas; Brinkman-Zijlker, HG; Dijkstra, PU; Postema, K

    Purpose. To analyse prevalence of malnutrition, eating difficulties and feeding dependence in stroke rehabilitation patients because little is known about these prevalence's. Stroke patients have an increased risk for developing eating difficulties, feeding dependence and malnutrition because of

  14. Characterization of the first symptoms of multiple sclerosis in a Brazilian center: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Vitor Breseghello Cavenaghi

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Multiple sclerosis (MS is a chronic, immune-mediated and degenerative central nervous system (CNS disease with well-established diagnostic criteria. Treatment can modify the course of the disease. The objective of this study was to describe the initial symptoms of multiple sclerosis in a Brazilian medical center. DESIGN AND SETTING: Descriptive study, conducted in a Brazilian reference center for multiple sclerosis treatment. METHODS: Data on 299 patients with confirmed diagnoses of MS were included in the study. Their medical files were evaluated and the data were analyzed. RESULTS: The most common symptom involved the cranial nerves (50.83% and unifocal manifestation was presented by the majority of this population (73.91%. The mean time between the first symptom and the diagnosis was 2.84 years. Unifocal symptoms correlated with longer time taken to establish the diagnosis, with an average of 3.20 years, while for multifocal symptoms the average time taken for the diagnosis was 1.85 years. Unifocal onset was related to greater diagnostic difficulty. CONCLUSIONS: MS is a heterogeneous disease and its initial clinical manifestation is very variable.

  15. 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…

  16. Metacognition Difficulty of Students with Visual-Spatial Intelligence during Solving Open-Ended Problem

    Science.gov (United States)

    Rimbatmojo, S.; Kusmayadi, T. A.; Riyadi, R.

    2017-09-01

    This study aims to find out students metacognition difficulty during solving open-ended problem in mathematics. It focuses on analysing the metacognition difficulty of students with visual-spatial intelligence in solving open-ended problem. A qualitative research with case study strategy is used in this study. Data in the form of visual-spatial intelligence test result and recorded interview during solving open-ended problems were analysed qualitatively. The results show that: (1) students with high visual-spatial intelligence have no difficulty on each metacognition aspects, (2) students with medium visual-spatial intelligence have difficulty on knowledge aspect on strategy and cognitive tasks, (3) students with low visual-spatial intelligence have difficulty on three metacognition aspects, namely knowledge on strategy, cognitive tasks and self-knowledge. Even though, several researches about metacognition process and metacognition literature recommended the steps to know the characteristics. It is still important to discuss that the difficulties of metacognitive is happened because of several factors, one of which on the characteristics of student’ visual-spatial intelligence. Therefore, it is really important for mathematics educators to consider and pay more attention toward students’ visual-spatial intelligence and metacognition difficulty in designing better mathematics learning.

  17. 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 ...

  18. A Particle Swarm Optimization Approach to Composing Serial Test Sheets for Multiple Assessment Criteria

    Science.gov (United States)

    Yin, Peng-Yeng; Chang, Kuang-Cheng; Hwang, Gwo-Jen; Hwang, Gwo-Haur; Chan, Ying

    2006-01-01

    To accurately analyze the problems of students in learning, the composed test sheets must meet multiple assessment criteria, such as the ratio of relevant concepts to be evaluated, the average discrimination degree, difficulty degree and estimated testing time. Furthermore, to precisely evaluate the improvement of student's learning performance…

  19. The Bears Family Projective Test: evaluating stories of children with emotional difficulties.

    Science.gov (United States)

    Iandolo, Giuseppe; Esposito, Gianluca; Venuti, Paola

    2012-06-01

    The aim of this study was to describe and analyze the storytelling of children with emotional difficulties. Forty children with emotional and relational difficulties (inhibited and impulsive), ages between 5.5 and 9.4 years old, were assessed by a multiaxial procedure and the bears family projective test. The bears family test is a constructive-thematic-projective method based on an anthropomorphic family of bears that children can manipulate to tell a story. The stories of 40 children without emotional difficulties (matched by IQ, socio-economic status, and gender) and 322 typically developing children, aged between four and 10 years old, were used as a reference for comparisons. Results indicated that the stories of children with emotional difficulties showed many unsolved problematic events, unclear characters, negative relationships, and negative behaviors. Unlike the stories of children without emotional difficulties, positive contents didn't prevail over negative, and there wasn't a positive compensation for negative elements.

  20. 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.

  1. 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.

  2. 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.

  3. Difficulties encountered by hospitalized Syrian refugees and their expectations from nurses.

    Science.gov (United States)

    Sevinç, S; Kılıç, S P; Ajghif, M; Öztürk, M H; Karadağ, E

    2016-09-01

    Treating patients with care and respecting their cultural values are key factors necessary to enhance the quality of nursing care. The objective of this study was to explore and describe the difficulties experienced by hospitalized Syrian refugees and their expectations from nurses and hospital administration. We used a descriptive qualitative research approach to engage 30 Syrian refugees undergoing treatment in internal medicine who met the study criteria. Data were collected using a descriptive questionnaire and a semi-structured interview with open-ended interview questions. Interview transcripts were analysed using an inductive coding approach. Descriptive questions were analysed and presented via number and percentage. Other data were assessed using content analysis methods. Three major themes were developed following the analysis of the interviews. We determined that the refugees who participated in the study experienced difficulties in communicating, meeting their personal needs and correctly following treatment instructions. They also had certain expectations from the hospital administration and nurses, and they felt gratitude for both nurses and the nation of Turkey. The results of this study, shared with the executive administration of the hospital, may result in new policies which will help new Syrian refugee patients and patients with similar needs to have better experience related to patient care, communications and meeting personal needs. It is important that nurses and other healthcare provider consider the difficulties and expectations of refugees regarding healthcare services and include same in the development of provider training programmes. Development of public health welfare and employment law and policies help to lay the groundwork for successful integration of refugees in new cultures and countries. © 2016 International Council of Nurses.

  4. College Adjustment Difficulties and the Overt and Covert Forms of Narcissism

    Science.gov (United States)

    Weikel, Kim A.; Avara, Renee Mowery; Hanson, Chad A.; Kater, Hope

    2010-01-01

    Overt narcissism correlated negatively with emotional distress and interpersonal difficulties among female, but not male, students. After controlling for self-esteem, overt narcissism correlated positively with depression among female students and with emotional distress and interpersonal difficulties among male students. Covert narcissism…

  5. Difficulties to implement interdisciplinary practices in state schools, appointed by Science teachers

    Directory of Open Access Journals (Sweden)

    Thaís Gimenez da Silva Augusto

    2007-03-01

    Full Text Available Teachers who try to introduce interdisciplinarys practices at São Paulo public schools, still find many difficulties. On present research, teachers from area of Sciences from Nature, participants by formation in service indicated which the difficulties for introduce of that practices into the High School. The analysis from the answers of this teachers shows that the main difficulties are: there is not time enough to be together with others teachers, research and dedicate the reading; the lack of knowledge in relation to contents of another disciplines; the difficulties of relationship with the school administration and absence of pedagogical coordination among the teachers´actions, beyond of the disinterest and undisciplined from the students.

  6. 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.

  7. Male professional footballers' experiences of mental health difficulties and help-seeking.

    Science.gov (United States)

    Wood, Susan; Harrison, Lesley K; Kucharska, Jo

    2017-05-01

    Male professional footballers (soccer) represent an at-risk population of developing mental health difficulties and not accessing professional support. One in four current footballers report mental health difficulties. Higher prevalence is reported after retirement. This qualitative study aimed to provide in-depth insight into male professional footballers' lived experiences of mental health difficulties and help-seeking. Seven participants were interviewed. Data were analysed using interpretative phenomenological analysis. One superordinate theme emerged; 'Survival'. This related to survival in the professional football world, of mental health difficulties and after transition into the 'real world'. Six subordinate themes are explored alongside literature pertaining to male mental health, identity, injury, transition, and emotional development. Shame, stigma, fear and level of mental health literacy (knowledge of mental health and support) were barriers to help-seeking. Support for professional footballers' mental wellbeing requires improvement. Recommendations are made for future research, mental health education and support.

  8. Multiple player tracking in sports video: a dual-mode two-way bayesian inference approach with progressive observation modeling.

    Science.gov (United States)

    Xing, Junliang; Ai, Haizhou; Liu, Liwei; Lao, Shihong

    2011-06-01

    Multiple object tracking (MOT) is a very challenging task yet of fundamental importance for many practical applications. In this paper, we focus on the problem of tracking multiple players in sports video which is even more difficult due to the abrupt movements of players and their complex interactions. To handle the difficulties in this problem, we present a new MOT algorithm which contributes both in the observation modeling level and in the tracking strategy level. For the observation modeling, we develop a progressive observation modeling process that is able to provide strong tracking observations and greatly facilitate the tracking task. For the tracking strategy, we propose a dual-mode two-way Bayesian inference approach which dynamically switches between an offline general model and an online dedicated model to deal with single isolated object tracking and multiple occluded object tracking integrally by forward filtering and backward smoothing. Extensive experiments on different kinds of sports videos, including football, basketball, as well as hockey, demonstrate the effectiveness and efficiency of the proposed method.

  9. 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.

  10. 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)

  11. Diagnosing companies in financial difficulty based on the auditor’s report

    Directory of Open Access Journals (Sweden)

    Robert Zenzerović

    2016-04-01

    Full Text Available The approach used in this paper expands on existing research that focuses on devising prediction models for companies experiencing financial difficulties and which in turn serves as a criteria-based diagnosis tool for distinguishing healthy companies from those facing seriously financial difficulties. It draws on auditors’ reports on company financial statements that emphasize a company’s ability to continue as a going concern as the main criterion used to distinguish companies experiencing financial difficulties from companies that are not. Two closely-related hypotheses were tested in this paper. First, the authors tested the hypothesis that an auditor’s report accompanied by an explanatory paragraph pointing out issues associated with the going concern assumption is the proper criterion for differentiating companies experiencing financial difficulties from those that are not. Second, the central assumption that is tested relates to a combination of financial ratios whereby authors presume that an appropriate combination of financial ratios is a good analytical tool for distinguishing companies experiencing serious financial difficulties from those that are not. Research results conducted among 191 companies listed on the Zagreb Stock Exchange confirm both hypotheses. The LRA model – a diagnosis tool for identifying companies with financial problems, was also derived using logistic regression analysis. The statistical adequacy and quality of the model was tested using measures like Nagelkerke R2, type 1 and type 2 errors that appear when calculating the classification ability of the model. All measures indicated that model was statistically sufficient and validated its use as a diagnosis tool in recognizing the companies facing financial difficulties.

  12. Difficulties reported by hiv-infected patients using antiretroviral therapy in brazil

    Directory of Open Access Journals (Sweden)

    Mark Drew Crosland Guimarães

    2008-01-01

    Full Text Available OBJECTIVE: To describe the degree of difficulty that HIV-infected patients have with therapy treatment. INTRODUCTION: Patients’ perceptions about their treatment are a determinant factor for improved adherence and a better quality of life. METHODS: Two cross-sectional analyses were conducted in public AIDS referral centers in Brazil among patients initiating treatment. Patients interviewed at baseline, after one month, and after seven months following the beginning of treatment were asked to classify and justify the degree of difficulty with treatment. Logistic regression was used for analysis. RESULTS: Among 406 patients initiating treatment, 350 (86.2% and 209 (51.5% returned for their first and third visits, respectively. Treatment perceptions ranged from medium to very difficult for 51.4% and 37.3% on the first and third visits, respectively. The main difficulties reported were adverse reactions to the medication and scheduling. A separate logistic regression indicated that the HIV-seropositive status disclosure, symptoms of anxiety, absence of psychotherapy, higher CD4+ cell count (> 200/mm³ and high (> 4 adverse reaction count reported were independently associated with the degree of difficulty in the first visit, while CDC clinical category A, pill burden (> 7 pills, use of other medications, high (> 4 adverse reaction count reported and low understanding of medical orientation showed independent association for the third visit. CONCLUSIONS: A significant level of difficulty was observed with treatment. Our analyses suggest the need for early assessment of difficulties with treatment, highlighting the importance of modifiable factors that may contribute to better adherence to the treatment protocol.

  13. Associations between narcissism and emotion regulation difficulties: Respiratory sinus arrhythmia reactivity as a moderator.

    Science.gov (United States)

    Zhang, Hui; Wang, Zhenhong; You, Xuqun; Lü, Wei; Luo, Yun

    2015-09-01

    The aim of the current study was to examine the direct and interactive effects of two types of narcissism (overt and covert) and respiratory sinus arrhythmia (RSA) reactivity on emotion regulation difficulties in 227 undergraduate students. Overt and covert narcissism and emotion regulation difficulties were assessed with self-report measures (narcissistic personality inventory (NPI)-16, hypersensitive narcissism scale (HSNS), and difficulties in emotion regulation scale (DERS)), and physiological data were measured during the baseline, stress (a public-speaking task), and recovery periods in the laboratory. Results indicated that overt narcissism was negatively related to a lack of emotional awareness and emotional clarity, whereas covert narcissism was positively related to overall emotion regulation difficulties, nonacceptance of emotional responses, impulse control difficulties, limited access to emotion regulation strategies, and a lack of emotional clarity. RSA reactivity in response to a mock job interview moderated the associations between covert narcissism (as a predictor) and overall emotion regulation difficulties and impulse control difficulties (as outcomes). This finding showed that a greater stress-induced RSA decrease may serve as a protective factor and ameliorate the effect of covert narcissism on individuals' emotion regulation difficulties. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. 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.

  15. 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.

  16. Multimodal examination of emotion regulation difficulties as a function of co-occurring avoidant personality disorder among women with borderline personality disorder.

    Science.gov (United States)

    Gratz, Kim L; Tull, Matthew T; Matusiewicz, Alexis M; Breetz, Alisa A; Lejuez, C W

    2013-10-01

    Despite a robust association between borderline personality disorder (BPD) and emotion dysregulation, evidence of within-BPD group differences in emotion regulation (ER) difficulties highlights the need to examine factors that increase the risk for ER difficulties within BPD. One factor that warrants consideration is co-occurring avoidant personality disorder (AVPD), the presence of which is associated with worse outcomes in and outside of BPD and theorized to interfere with adaptive ER. Thus, this study examined if co-occurring AVPD among women with BPD is associated with heightened ER difficulties (assessed across self-report, behavioral, and physiological domains). Participants included 39 women with BPD (13 with co-occurring AVPD) and 18 women without BPD. Although results revealed no significant differences in overall self-reported ER difficulties (or the specific dimensions involving emotional clarity and the control of behaviors when distressed) between BPD participants with and without AVPD (with both groups reporting greater ER difficulties than non-BPD participants), other ER difficulties were found to be heightened among BPD participants with AVPD. Specifically, BPD participants with (vs. without) AVPD reported greater difficulties accessing effective ER strategies, evidenced less willingness to experience distress on a laboratory stressor, and exhibited a greater decrease in high frequency heart rate variability in response to this stressor (indicative of poor ER capacity). Findings add to the literature on ER difficulties in BPD, suggesting that co-occurring AVPD within BPD may be associated with a lower capacity for regulating distress and greater difficulties accessing effective ER strategies, potentially leading to greater efforts to avoid emotional distress. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  17. Effectiveness of a self-regulated remedial program for handwriting difficulties.

    Science.gov (United States)

    Van Waelvelde, Hilde; De Roubaix, Amy; Steppe, Lien; Troubleyn, Evy; De Mey, Barbara; Dewitte, Griet; Debrabant, Julie; Van de Velde, Dominique

    2017-09-01

    Handwriting difficulties may have pervasive effects on a child's school performance. I Can! is a remedial handwriting program with a focus on self-regulated learning and applying motor learning principles combined with a behavioural approach. It is developed for typically developing children with handwriting problems. The study aim was to evaluate the program's effectiveness. Thirty-one children aged 7-8 year participated in a cross-over study. Handwriting quality and speed were repeatedly assessed by means of the Systematic Screening of Handwriting Difficulties test. Difficulties addressed were fluency in letter formation, fluency in letter connections, letter height, regularity of letter height, space between words, and line path. Mixed model analysis revealed improved quality of writing and speed for all children but significantly more improvement in handwriting quality for the children participating in the program. Although writing speed improved over time, no additional effects of the program occurred. 'I Can!' is found to be an effective instructive program to ameliorate handwriting quality in typically developing children with handwriting difficulties. The program's success was by a therapy burst of only 7 weeks focusing on the child's self-regulated learning capacities, within an individualized education plan according to their needs and goals.

  18. Young people with features of gender dysphoria: Demographics and associated difficulties.

    Science.gov (United States)

    Holt, Vicky; Skagerberg, Elin; Dunsford, Michael

    2016-01-01

    This article presents the findings from a cross-sectional study on demographic variables and associated difficulties in 218 children and adolescents (Mean age = 14 years, SD = 3.08, range = 5-17 years), with features of gender dysphoria, referred to the Gender Identity Development Service (GIDS) in London during a 1-year period (1 January 2012-31 December 2012). Data were extracted from patient files (i.e. referral letters, clinical notes and clinician reports). The most commonly reported associated difficulties were bullying, low mood/depression and self-harming. There was a gender difference on some of the associated difficulties with reports of self-harm being significantly more common in the natal females and autism spectrum conditions being significantly more common in the natal males. The findings also showed that many of the difficulties increased with age. Findings regarding demographic variables, gender dysphoria, sexual orientation and family features are reported, and limitations and implications of the cross-sectional study are discussed. In conclusion, young people with gender dysphoria often present with a wide range of associated difficulties which clinicians need to take into account, and our article highlights the often complex presentations of these young people. © The Author(s) 2014.

  19. Effects of Gait and Cognitive Task Difficulty on Cognitive-Motor Interference in Aging

    Directory of Open Access Journals (Sweden)

    Prudence Plummer-D'Amato

    2012-01-01

    Full Text Available Although gait-related dual-task interference in aging is well established, the effect of gait and cognitive task difficulty on dual-task interference is poorly understood. The purpose of this study was to examine the effect of gait and cognitive task difficulty on cognitive-motor interference in aging. Fifteen older adults (72.1 years, SD 5.2 and 20 young adults (21.7 years, SD 1.6 performed three walking tasks of varying difficulty (self-selected speed, fast speed, and fast speed with obstacle crossing under single- and dual-task conditions. The cognitive tasks were the auditory Stroop task and the clock task. There was a significant Group × Gait Task × Cognitive Task interaction for the dual-task effect on gait speed. After adjusting for education, there were no significant effects of gait or cognitive task difficulty on the dual-task effects on cognitive task performance. The results of this study provide evidence that gait task difficulty influences dual-task effects on gait speed, especially in older adults. Moreover, the effects of gait task difficulty on dual-task interference appear to be influenced by the difficulty of the cognitive task. Education is an important factor influencing cognitive-motor interference effects on cognition, but not gait.

  20. [Difficulties in emotion regulation and personal distress in young adults with social anxiety].

    Science.gov (United States)

    Contardi, Anna; Farina, Benedetto; Fabbricatore, Mariantonietta; Tamburello, Stella; Scapellato, Paolo; Penzo, Ilaria; Tamburello, Antonino; Innamorati, Marco

    2013-01-01

    The aim of this study was to assess the association between social anxiety and difficulties in emotion regulation in a sample of Italian young adults. Our convenience sample was composed of 298 Italian young adults (184 women and 114 men) aged 18-34 years. Participants were administered the Interaction Anxiousness Scale (IAS), the Audience Anxiousness Scale (AAS), the Difficulties in Emotion Regulation Scale (DERS), and the Interpersonal Reactivity Index (IRI). A Two Step cluster analysis was used to group subjects according to their level of social anxiety. The cluster analysis indicated a two-cluster solution. The first cluster included 163 young adults with higher scores on the AAS and the IAS than those included in cluster 2 (n=135). A generalized linear model with groups as dependent variable indicated that people with higher social anxiety (compared to those with lower social anxiety) have higher scores on the dimension personal distress of the IRI (p<0.01), and on the DERS non acceptance of negative emotions (p<0.001) and lack of emotional clarity (p<0.05). The results are consistent with models of psychopathology, which hypothesize that people who cannot deal effectively with their emotions may develop depressive and anxious disorders.

  1. 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

  2. Student Strategies Suggesting Emergence of Mental Structures Supporting Logical and Abstract Thinking: Multiplicative Reasoning

    Science.gov (United States)

    Carrier, Jim

    2014-01-01

    For many students, developing mathematical reasoning can prove to be challenging. Such difficulty may be explained by a deficit in the core understanding of many arithmetical concepts taught in early school years. Multiplicative reasoning is one such concept that produces an essential foundation upon which higher-level mathematical thinking skills…

  3. 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…

  4. 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.

  5. Quantifying siting difficulty: a case study of US transmission line siting

    Energy Technology Data Exchange (ETDEWEB)

    Vajjhala, S.P. [Resources for the Future, Washington DC (United States); Fischbeck, P.S. [Carnegie Mellon University, Pittsburgh, PA (United States). Departments of Social and Decision Sciences and Engineering and Public Policy

    2007-01-15

    The worldwide demand for new energy infrastructures has been paralleled in recent years by the increasing difficulty of siting major facilities. Siting difficulty is the subject of widespread discussion, but because of the complexity of the problem, potential solutions are not obvious or well understood. This paper presents a two-step policy-level framework that first develops an empirical measure of siting difficulty and then qualitatively assesses its major causes. The approach is based on the creation and aggregation of four siting indicators that are independent of the common causes and localized effects of siting problems. The proposed framework is demonstrated for the case of US transmission line siting. Results of the analyses reveal significant variations in state siting difficulty and industry experts' perceptions of its dominant causes, with implications for the long-term success of Regional Transmission Organizations (RTOs) and knowledge transfer among siting professionals in the deregulated industry. (author)

  6. 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

  7. [I want to breastfeed my baby: Unvealing the experiences of women who lived process difficulties in their breastfeeding].

    Science.gov (United States)

    Lucchini Raies, Camila; Márquez Doren, Francisca; Rivera Martínez, María Soledad

    2017-01-01

    Breastfeeding is the most beneficial feeding practice for infants. However, it is not always the first choice for mothers and their encouragement and support from health professionals is variable. To understand the experience of mothers who had difficulties with their breastfeeding process. A phenomenological study was conducted in a University Health center. Twelve breastfeeding women were included. Data collection technique was in depth interviews, taped recorded with participants’ consent. Phenomenological analysis of data followed Streubert´s method. The rigor of the study was guarded by criteria for qualitative research and the research process. Ethical aspects were sheltered through the informed consent process, confidentiality and methodological rigor. The experience of living difficulties in the breastfeeding process is revealed in five comprehensive categories: recognizing the difficulties with breastfeeding; emotional impact when unable to breastfeed; motivation to overcome the difficulty and ask for help; support for breastfeeding recovery; and transition process from stress and anxiety to peace, gratification and empowerment. The understanding of this experience is qualitative evidence that contributes to a comprehensive understanding of the situation of each mother and child, allowing to improve support care interventions in health.

  8. 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.

  9. Multiple Cranial Neuropathies Without Limb Involvements: Guillain-Barre Syndrome Variant?

    OpenAIRE

    Yu, Ju Young; Jung, Han Young; Kim, Chang Hwan; Kim, Hyo Sang; Kim, Myeong Ok

    2013-01-01

    Acute multiple cranial neuropathies are considered as variant of Guillain-Barre syndrome, which are immune-mediated diseases triggered by various cases. It is a rare disease which is related to infectious, inflammatory or systemic diseases. According to previous case reports, those affected can exhibit almost bilateral facial nerve palsy, then followed by bulbar dysfunctions (cranial nerves IX and X) accompanied by limb weakness and walking difficulties due to motor and/or sensory dysfunction...

  10. 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…

  11. Perceived difficulties using everyday technology after acquired brain injury: influence on activity and participation.

    Science.gov (United States)

    Lindén, Anita; Lexell, Jan; Lund, Maria Larsson

    2010-12-01

    Using everyday technology (ET) is a prerequisite for activities and participation at home and in the community. It is well known that persons with an acquired brain injury (ABI) can have limitations in activities of daily living but our knowledge of their difficulties using ET is not known. Thirty-six persons (27 men and 9 women, mean age 44 years, age range 26-60) with an ABI (2-10 years post injury) were interviewed, using the Everyday Technology Use Questionnaire (ETUQ), about their perceived difficulties using ET and how these difficulties influenced their everyday activities and their possibilities to participate at home and in the community. A majority (78%) of the persons reported difficulties using ET. The most common difficulties were related to the use of telecommunication and computers. Despite these difficulties, a majority still used most objects and services independently. Twenty-six participants (72%) perceived that their difficulties using ET influenced their everyday activities and their possibility to participate at home and in the community. The results indicate that rehabilitation following an ABI should consider whether clients' use of ET influences their activity and participation and adopt interventions accordingly. The results also indicate that difficulties using ET need to be considered in the design of community services to prevent societal barriers.

  12. Does spinal excitability scale to the difficulty of the dual-task?

    Science.gov (United States)

    Day, Devon M; Boivin, Mario T; Adkin, Allan L; Tokuno, Craig D

    2017-08-01

    This study examined whether spinal excitability, as measured by the soleus Hoffmann reflex (H-reflex), is scaled to the difficulty level of the dual-task being performed. Twenty-two participants completed a combination of three balance task and three secondary cognitive (visuo-motor) task difficulty levels for a total of nine dual-task conditions. An additional eight participants were tested while performing the same three balance task difficulty levels on its own (i.e., single-tasking). The balance task required participants to maintain their balance on a fixed or rotating stabilometer while the visuo-motor task required participants to respond to moving targets presented on a monitor. Throughout each single- and dual-task trial, H-reflexes were elicited from the soleus. Although dual-task performance, as quantified by visuo-motor task accuracy as well as the root mean square of the stabilometer position and velocity, decreased by 10-34% with increasing dual-task difficulty (p dual-task conditions (p = 0.483-0.758). This contrasts to when participants performed the balance task as a single-task, where the H-reflex amplitude decreased by ~25% from the easy to the hard balance task difficulty level (p = 0.037). In contrast to the commonly reported finding of a reduced soleus H-reflex amplitude when individuals perform a less posturally stable task by itself, the results indicate that spinal excitability is not modulated as a function of dual-task difficulty. It is possible that when an individual's attentional resource capacity is exceeded during dual-tasking, they become ineffective in regulating spinal excitability for balance control.

  13. 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)

  14. Does Early Algebraic Reasoning Differ as a Function of Students' Difficulty with Calculations versus Word Problems?

    Science.gov (United States)

    Powell, Sarah R; Fuchs, Lynn S

    2014-08-01

    According to national mathematics standards, algebra instruction should begin at kindergarten and continue through elementary school. Most often, teachers address algebra in the elementary grades with problems related to solving equations or understanding functions. With 789 2 nd - grade students, we administered (a) measures of calculations and word problems in the fall and (b) an assessment of pre-algebraic reasoning, with items that assessed solving equations and functions, in the spring. Based on the calculation and word-problem measures, we placed 148 students into 1 of 4 difficulty status categories: typically performing, calculation difficulty, word-problem difficulty, or difficulty with calculations and word problems. Analyses of variance were conducted on the 148 students; path analytic mediation analyses were conducted on the larger sample of 789 students. Across analyses, results corroborated the finding that word-problem difficulty is more strongly associated with difficulty with pre-algebraic reasoning. As an indicator of later algebra difficulty, word-problem difficulty may be a more useful predictor than calculation difficulty, and students with word-problem difficulty may require a different level of algebraic reasoning intervention than students with calculation difficulty.

  15. Does Early Algebraic Reasoning Differ as a Function of Students’ Difficulty with Calculations versus Word Problems?

    Science.gov (United States)

    Powell, Sarah R.; Fuchs, Lynn S.

    2014-01-01

    According to national mathematics standards, algebra instruction should begin at kindergarten and continue through elementary school. Most often, teachers address algebra in the elementary grades with problems related to solving equations or understanding functions. With 789 2nd- grade students, we administered (a) measures of calculations and word problems in the fall and (b) an assessment of pre-algebraic reasoning, with items that assessed solving equations and functions, in the spring. Based on the calculation and word-problem measures, we placed 148 students into 1 of 4 difficulty status categories: typically performing, calculation difficulty, word-problem difficulty, or difficulty with calculations and word problems. Analyses of variance were conducted on the 148 students; path analytic mediation analyses were conducted on the larger sample of 789 students. Across analyses, results corroborated the finding that word-problem difficulty is more strongly associated with difficulty with pre-algebraic reasoning. As an indicator of later algebra difficulty, word-problem difficulty may be a more useful predictor than calculation difficulty, and students with word-problem difficulty may require a different level of algebraic reasoning intervention than students with calculation difficulty. PMID:25309044

  16. 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

  17. 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)

  18. Glucose uptake heterogeneity of the leg muscles is similar between patients with multiple sclerosis and healthy controls during walking.

    Science.gov (United States)

    Kindred, John H; Ketelhut, Nathaniel B; Rudroff, Thorsten

    2015-02-01

    Difficulties in ambulation are one of the main problems reported by patients with multiple sclerosis. A previous study by our research group showed increased recruitment of muscle groups during walking, but the influence of skeletal muscle properties, such as muscle fiber activity, has not been fully elucidated. The purpose of this investigation was to use the novel method of calculating glucose uptake heterogeneity in the leg muscles of patients with multiple sclerosis and compare these results to healthy controls. Eight patients with multiple sclerosis (4 men) and 8 healthy controls (4 men) performed 15 min of treadmill walking at a comfortable self-selected speed following muscle strength tests. Participants were injected with ≈ 8 mCi of [(18)F]-fluorodeoxyglucose during walking after which positron emission tomography/computed tomography imaging was performed. No differences in muscle strength were detected between multiple sclerosis and control groups (P>0.27). Within the multiple sclerosis, group differences in muscle volume existed between the stronger and weaker legs in the vastus lateralis, semitendinosus, and semimembranosus (Pmuscle group or individual muscle of the legs (P>0.16, P≥0.05). Patients with multiple sclerosis and healthy controls showed similar muscle fiber activity during walking. Interpretations of these results, with respect to our previous study, suggest that walking difficulties in patients with multiple sclerosis may be more associated with altered central nervous system motor patterns rather than alterations in skeletal muscle properties. Published by Elsevier Ltd.

  19. Learners' Listening Comprehension Difficulties in English Language Learning: A Literature Review

    Science.gov (United States)

    Gilakjani, Abbas Pourhosein; Sabouri, Narjes Banou

    2016-01-01

    Listening is one of the most important skills in English language learning. When students listen to English language, they face a lot of listening difficulties. Students have critical difficulties in listening comprehension because universities and schools pay more attention to writing, reading, and vocabulary. Listening is not an important part…

  20. 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.

  1. The effect of question format and task difficulty on reasoning strategies and diagnostic performance in Internal Medicine residents.

    Science.gov (United States)

    Heemskerk, Laura; Norman, Geoff; Chou, Sophia; Mintz, Marcy; Mandin, Henry; McLaughlin, Kevin

    2008-11-01

    Previous studies have suggested an association between reasoning strategies and diagnostic success, but the influence on this relationship of variables such as question format and task difficulty, has not been studied. Our objective was to study the association between question format, task difficulty, reasoning strategies and diagnostic success. Study participants were 13 Internal Medicine residents at the University of Calgary. Each was given eight problem-solving questions in four clinical presentations and were randomized to groups that differed only in the question format, such that a question presented as short answer (SA) to the first group was presented as extended matching (EM) to the second group. There were equal numbers of SA/EM questions and straightforward/difficult tasks. Participants performed think-aloud during diagnostic reasoning. Data were analyzed using multiple logistic regression. Question format was associated with reasoning strategies; hypothetico-deductive reasoning being used more frequently on EM questions and scheme-inductive reasoning on SA questions. For SA question, non-analytic reasoning alone was used more frequently to answer straightforward cases than difficult cases, whereas for EM questions no such association was observed. EM format and straightforward task increased the odds of diagnostic success, whereas hypothetico-deductive reasoning was associated with reduced odds of success. Question format and task difficulty both influence diagnostic reasoning strategies and studies that examine the effect of reasoning strategies on diagnostic success should control for these effects. Further studies are needed to investigate the effect of reasoning strategies on performance of different groups of learners.

  2. [The portrayal of multiple sclerosis in television series].

    Science.gov (United States)

    Karenberg, A

    2009-04-01

    An increasing number of television series deal with neurological disorders, including fictional portrayals of multiple sclerosis (MS). The aim of this paper was to analyze every available TV episode with an MS character. Productions were identified by film databases and by hand search. Each episode was evaluated along neurologic and cinematic lines. Between 1985 and 2006, portrayals of MS appeared in 17 episodes produced in Germany, the US, and the UK. The frequency of symptoms shown onscreen strongly differed from epidemiological data. In particular sensory, cognitive, and bladder symptoms as well as difficulties with sexual function were under-represented. The authenticity of the disease depiction was strongly dependent upon the genre. Coping stories could be identified as the most prominent genre. Television patients were often portrayed as "brave fighters", "refined characters", and "afflicted without symptoms". Television series attract millions of viewers and thus shape the public image of a disease. Sound knowledge of how symptoms, diagnosis, and therapeutic options are presented in mass media is therefore indispensable for all who deal with MS patients, relatives, and caregivers.

  3. How general practitioners perceive and assess self-care in patients with multiple chronic conditions

    DEFF Research Database (Denmark)

    Kristensen, Mads Aage Toft; Hølge-Hazelton, Bibi; Waldorff, Frans Boch

    2017-01-01

    Background: It is not known how general practitioners (GPs) perceive the concept of self-care and how they assess self-care ability in patients with multiple chronic conditions. As a part of the strategy to improve the care of people living with chronic conditions, disease management programs...... in Denmark require GPs and other health care workers to assess and support patients' self-care ability. The aim of the present study was to explore GPs' perceptions and assessment of self-care ability in patients with multiple chronic conditions who have difficulty following a given treatment. Methods...

  4. 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…

  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. Difficulty Systematized Evaluation of Vocal Folds Exposure in Microsurgery of the Larynx

    Directory of Open Access Journals (Sweden)

    Ballin, Annelyse Cristine

    2010-09-01

    Full Text Available Introduction: Several studies addressing preoperative factors that predict difficulty of endotracheal intubation graduated by anesthesiologists, for the scale of the Cormack-Lehane. These parameters were evaluated for the difficulty of location of the laryngoscope in microsurgery of the larynx. There is not a standard scale of difficulty targeted to surgeons of the larynx. Objective: Create a standard scale of difficulty leasing the laryngoscope during microsurgery of the larynx, with a focus on exposure of the vocal folds (vocal cords to evaluate which clinical parameters predict difficulty of exposure of their vocal folds and verify the improvement of laryngeal exposure with the hanger of the laryngoscope. Method: A prospective randomized study, 57 patients undergoing laryngeal microsurgery. The preoperative parameters were evaluated: three epidemiological data, two of history and 13 physical examination. Intraoperatively: the anesthesiologist evaluated the Cormack-Lehane score and the surgeon evaluated according to the proposed scale, before and after placement of the hanger. Results and Conclusion: Several parameters showed sensitivity, specificity, positive predictive value for high inadequate exposure of the larynx. But only distance hiomentual <6.05 cm (p = 0.003 and 2 classes of Cormack-Lehane (p = 0.04 with statistical significance and high sensitivity of 100% and 81% respectively. The use of the hanger of laryngoscope laryngeal exposure improved significantly (p = 0.04. The proposed scale standardizes the visualization and grades the difficulty of exposure of their vocal folds, facilitating comparisons between studies and communication between otolaryngologists.

  7. Reflections on providing sport science support for athletes with learning difficulties.

    Science.gov (United States)

    Hills, Laura; Utley, Andrea

    2010-01-01

    To highlight the benefits and the need for sport science support for athletes with learning difficulties, and to reflect on our experience of working with the GB squad for athletes with learning difficulties. A review of key and relevant literature is presented, followed by a discussion of the sport science support provision and the issues that emerged in working with athletes with learning difficulties. Pre- and post- physiological tests along with evaluations of athletes' potential to benefit from sport psychology support were conducted. The aim of these tests was to provide information for the athletes and the coaches on fitness levels, to use this information to plan future training, and to identify how well the performance could be enhanced. A case study is presented for one athlete, who had competed in distance events. The focus is the psychological support that was provided. It is clear that athletes with learning difficulties require the same type of sports science support as their mainstream peers. However, sport scientists will need to consider ways to extend their practice in order to provide the appropriate level of support.

  8. Do age-related word retrieval difficulties appear (or disappear) in connected speech?

    Science.gov (United States)

    Kavé, Gitit; Goral, Mira

    2017-09-01

    We conducted a comprehensive literature review of studies of word retrieval in connected speech in healthy aging and reviewed relevant aphasia research that could shed light on the aging literature. Four main hypotheses guided the review: (1) Significant retrieval difficulties would lead to reduced output in connected speech. (2) Significant retrieval difficulties would lead to a more limited lexical variety in connected speech. (3) Significant retrieval difficulties would lead to an increase in word substitution errors and in pronoun use as well as to greater dysfluency and hesitation in connected speech. (4) Retrieval difficulties on tests of single-word production would be associated with measures of word retrieval in connected speech. Studies on aging did not confirm these four hypotheses, unlike studies on aphasia that generally did. The review suggests that future research should investigate how context facilitates word production in old age.

  9. Military children's difficulty with reintegration after deployment: A relational turbulence model perspective.

    Science.gov (United States)

    Knobloch, Leanne K; Knobloch-Fedders, Lynne M; Yorgason, Jeremy B; Ebata, Aaron T; McGlaughlin, Patricia C

    2017-08-01

    This study drew on the relational turbulence model to investigate how the interpersonal dynamics of military couples predict parents' reports of the reintegration difficulty of military children upon homecoming after deployment. Longitudinal data were collected from 118 military couples once per month for 3 consecutive months after reunion. Military couples reported on their depressive symptoms, characteristics of their romantic relationship, and the reintegration difficulty of their oldest child. Results of dyadic growth curve models indicated that the mean levels of parents' depressive symptoms (H1), relationship uncertainty (H2), and interference from a partner (H3) were positively associated with parents' reports of military children's reintegration difficulty. These findings suggest that the relational turbulence model has utility for illuminating the reintegration difficulty of military children during the postdeployment transition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Language delays, reading delays, and learning difficulties: interactive elements requiring multidimensional programming.

    Science.gov (United States)

    Hay, Ian; Elias, Gordon; Fielding-Barnsley, Ruth; Homel, Ross; Freiberg, Kate

    2007-01-01

    Researchers have hypothesized four levels of instructional dialogue and claimed that teachers can improve children's language development by incorporating these dialogue levels in their classrooms. It has also been hypothesized that enhancing children's early language development enhances children's later reading development. This quasi-experimental research study investigated both of these hypotheses using a collaborative service delivery model for Grade 1 children with language difficulties from a socially and economically disadvantaged urban community in Australia. Comparing the end-of-year reading achievement scores for the 57 children who received the language intervention with those of the 59 children in the comparison group, the findings from this research are supportive of both hypotheses. The interrelationships between learning difficulties, reading difficulties, and language difficulties are discussed along with children's development in vocabulary, use of memory strategies and verbal reasoning, and the need for multidimensional programming.

  11. Severe plastic deformation of copper and Al-Cu alloy using multiple channel-die compression

    International Nuclear Information System (INIS)

    Parimi, A.K.; Robi, P.S.; Dwivedy, S.K.

    2011-01-01

    Research highlights: → SPD of copper and Al-Cu alloy by multiple channel-die compression tests.→ Extensive grain refinement resulting in nano-sized grains after SPD. → Investigation of micro-structure using optical microscope and SEM. → Shear band formation as the failure mechanism in the two phase Al-Cu alloy. → Difficulty in obtaining SPD for Al-Cu alloy in this method. -- Abstract: Severe plastic deformation studies of copper and Al-Cu alloy by multiple channel-die compression tests were investigated. The materials were tested under plane strain condition by maintaining a constant strain rate of 0.001/s. Extensive grain refinement was observed resulting in nano-sized grains after severe plastic deformation with concomitant increase in flow stress and hardness. The microstructural investigation of the severely deformed materials was investigated using optical microscope and scanning electron microscope. Shear band formation was identified as the failure mechanism in the two phase Al-Cu alloy. The results indicate difficulty in obtaining severe plastic deformation for alloys having two phase micro-structure.

  12. 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…

  13. 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)

  14. Visualization-based analysis of multiple response survey data

    Science.gov (United States)

    Timofeeva, Anastasiia

    2017-11-01

    During the survey, the respondents are often allowed to tick more than one answer option for a question. Analysis and visualization of such data have difficulties because of the need for processing multiple response variables. With standard representation such as pie and bar charts, information about the association between different answer options is lost. The author proposes a visualization approach for multiple response variables based on Venn diagrams. For a more informative representation with a large number of overlapping groups it is suggested to use similarity and association matrices. Some aggregate indicators of dissimilarity (similarity) are proposed based on the determinant of the similarity matrix and the maximum eigenvalue of association matrix. The application of the proposed approaches is well illustrated by the example of the analysis of advertising sources. Intersection of sets indicates that the same consumer audience is covered by several advertising sources. This information is very important for the allocation of the advertising budget. The differences between target groups in advertising sources are of interest. To identify such differences the hypothesis of homogeneity and independence are tested. Recent approach to the problem are briefly reviewed and compared. An alternative procedure is suggested. It is based on partition of a consumer audience into pairwise disjoint subsets and includes hypothesis testing of the difference between the population proportions. It turned out to be more suitable for the real problem being solved.

  15. New approaches in the management of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Laurie J Barten

    2010-11-01

    Full Text Available Laurie J Barten1, Douglas R Allington1, Kendra A Procacci2, Michael P Rivey11The University of Montana and Community Medical Center, Missoula, MT, USA; 2The University of Montana School of Pharmacy, Missoula, MT, USAAbstract: Multiple sclerosis (MS is a central nervous system chronic inflammatory disease that is characterized by an extensive and complex immune response. Scientific advances have occurred in immunology, pathophysiology, and diagnostic and clinical assessment tools, and recent discovery of unique therapeutic targets has spurred numerous Phase II and Phase III clinical trials. Reductions in MS relapse rates and improvements in T2 or gadolinium-enhancing lesion burdens have been reported from Phase III trials that include fingolimod, alemtuzumab, cladribine, and rituximab. Promising Phase II trial data exist for teriflunomide, daclizumab, laquinimod, and fumarate. The optimism created by these favorable findings must be tempered with evaluation of the adverse effect profile produced by these new agents. Given the discovery of progressive multifocal leukoencephalopathy with the use of natalizumab, ongoing vigilance for rare and life-threatening reactions due to new agents should be paramount. Patients with MS often experience difficulty with ambulation, spasticity, and cognition. Recent clinical trial data from two Phase III dalfampridine-SR trials indicate certain patients receive benefits in ambulation. This article provides an overview of data from clinical trials of newer agents of potential benefit in MS.Keywords: multiple sclerosis, Phase II trials, Phase III trials, progressive multifocal leukoencephalopathy, monoclonal antibody

  16. 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.

  17. 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.

  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. 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.

  20. 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.

  1. Working memory: its role in dyslexia and other specific learning difficulties.

    Science.gov (United States)

    Jeffries, Sharman; Everatt, John

    2004-08-01

    This paper reports a study contrasting dyslexic children against a control group of children without special educational needs (SEN) and a group with varied SENs. Children's abilities were compared on tasks assessing phonological processing, visuo-spatial/motor coordination and executive/inhibitory functioning; being targeted for assessment based on theoretical proposals related to the working memory model. Primary and secondary school level children were tested: 21 assessed as dyslexic with no comorbid difficulties, 26 children assessed with difficulties including dyspraxia, emotional/behavioural problems and attention deficits, 40 children with no known education-related deficits were controls. Results indicated both SEN groups performed worse than controls on working memory phonological loop measures. However, SEN groups could only be differentiated on phonological awareness measures: the dyslexics showing lower scores. Dyslexics performed as well as controls on working memory visuo-spatial scratch pad measures and one of two additional visual-motor coordination tasks, whereas the performance of the other SEN children was lowest on the majority of these measures. Central executive and interference measures engendered mixed performances, both SEN groups showing evidence of deficits in one or more of these areas of functioning, although, of the two SEN groups, the dyslexics seem to have performed the worse when digit name processing was required.

  2. Multiple Object Tracking Using the Shortest Path Faster Association Algorithm

    Directory of Open Access Journals (Sweden)

    Zhenghao Xi

    2014-01-01

    Full Text Available To solve the persistently multiple object tracking in cluttered environments, this paper presents a novel tracking association approach based on the shortest path faster algorithm. First, the multiple object tracking is formulated as an integer programming problem of the flow network. Then we relax the integer programming to a standard linear programming problem. Therefore, the global optimum can be quickly obtained using the shortest path faster algorithm. The proposed method avoids the difficulties of integer programming, and it has a lower worst-case complexity than competing methods but better robustness and tracking accuracy in complex environments. Simulation results show that the proposed algorithm takes less time than other state-of-the-art methods and can operate in real time.

  3. The contribution of emotion regulation difficulties to risky sexual behavior within a sample of patients in residential substance abuse treatment.

    Science.gov (United States)

    Tull, Matthew T; Weiss, Nicole H; Adams, Claire E; Gratz, Kim L

    2012-10-01

    The present study examined the unique contribution of emotion regulation difficulties to past-year risky sexual behavior (RSB) among substance use disorder (SUD) patients (above and beyond other known RSB risk factors). A sample of 177 SUD patients completed a series of questionnaires. At the zero-order level, emotion regulation difficulties, were significantly positively associated with the number of commercial sexual (i.e., the exchange of sex for drugs or money) partners with which penetrative sex occurred and significantly negatively associated with the likelihood of using a condom when having sex with a commercial partner under the influence of drugs. Emotion regulation difficulties also significantly predicted these RSB indices above and beyond other RSB risk factors, including demographics, depression, sensation seeking, traumatic exposure, and substance use severity. The specific emotion regulation difficulty of lack of emotional clarity emerged as a unique predictor of RSB. The implications of these findings for understanding motivations for RSB and developing targeted interventions for RSB among SUD patients are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. 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.

  5. 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.

  6. Multidrug-resistant Nocardia pseudobrasiliensis presenting as multiple muscle abscesses.

    Science.gov (United States)

    Veerappan Kandasamy, Vimalkumar; Nagabandi, Arun; Horowitz, Edward A; Vivekanandan, Renuga

    2015-05-06

    A 79-year-old Caucasian man presented with multiple leg abscesses due to Nocardia pseudobrasiliensis. He was on chronic steroid therapy for myasthenia gravis. We present the difficulties in diagnosis and treatment of this rare organism. N. pseudobrasiliensis is a new emerging species that was previously thought to belong to the N. brasiliensis species. The distinction between the two species is extremely important given the different antibiotic susceptibility pattern and association of N. pseudobrasiliensis with more invasive and disseminated disease. 2015 BMJ Publishing Group Ltd.

  7. 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.

  8. 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....

  9. 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…

  10. 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…

  11. 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…

  12. 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)

  13. Improving quality of life in multiple sclerosis: an unmet need.

    Science.gov (United States)

    Zwibel, Howard L; Smrtka, Jennifer

    2011-05-01

    Multiple sclerosis (MS) affects approximately 400,000 people in the United States and 2.1 million people worldwide. It is the most common chronic, non-traumatic neurological disorder afflicting young people during their peak productive ages. MS can diminish quality of life (QOL) by interfering with the ability to work, pursue leisure activities, and carry on usual life roles. Symptoms that affect QOL may include impaired mobility, fatigue, depression, pain, spasticity, cognitive impairment, sexual dysfunction, bowel and bladder dysfunction, vision and hearing problems, seizures, and sDwallowing and breathing difficulties. Direct medical costs of MS in the United States are estimated in excess of $10 billion per year. Indirect costs of MS include costs of reduced employment or unemployment, assistive equipment, disability related home modifications, and paid and unpaid personal care. Although direct medical costs predominate in the earlier stages of MS, indirect costs of productivity loss are responsible for higher costs later. Disease-modifying therapies (DMTs) lessen symptoms, reduce relapses, and delay disability progression. Unfortunately, many DMTs might produce only modest improvements in QOL. Although symptom-specific therapies do not delay disease progression, they may delay unemployment and dependency, thereby reducing indirect costs.

  14. 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-…

  15. 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.…

  16. 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.

  17. 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

  18. IMPAIRED FERTILITY AND PERCEIVED DIFFICULTIES CONCEIVING IN GHANA: MEASUREMENT PROBLEMS AND PROSPECTS.

    Science.gov (United States)

    Fledderjohann, Jasmine; Johnson, David R

    2016-08-01

    What is the most appropriate measure of impaired fertility for understanding its social consequences in sub-Saharan Africa? The dearth of subjective measures in surveys in the region has prevented comparisons of subjective and objective measures. Perceived difficulties conceiving may have a greater impact than objective measures for social outcomes such as divorce, stigmatization and distress. This study compares 12- (clinical) and 24- (epidemiological) month measures from biomedicine and 5- and 7-year measures from demography with a subjective measure of impaired fertility using correlations, random effects models and test-retest models to assess relationships between measures, their association with sociodemographic characteristics and the stability of measures across time. Secondary panel data (1998-2004) from 1350 Ghanaian women aged 15-49 of all marital statuses are used. Longer waiting times to identification of impaired fertility required by demographic measures result in more stable measures, but perceived difficulties conceiving are most closely aligned with clinical infertility (r=0.61; pconceiving and self-identified infertility to assess which is most valid; in order to accomplish this, it is imperative that subjective measures of infertility be included in social surveys in sub-Saharan Africa.

  19. 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

  20. 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.

  1. Are Faculty Predictions or Item Taxonomies Useful for Estimating the Outcome of Multiple-Choice Examinations?

    Science.gov (United States)

    Kibble, Jonathan D.; Johnson, Teresa

    2011-01-01

    The purpose of this study was to evaluate whether multiple-choice item difficulty could be predicted either by a subjective judgment by the question author or by applying a learning taxonomy to the items. Eight physiology faculty members teaching an upper-level undergraduate human physiology course consented to participate in the study. The…

  2. 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.

  3. Development of the Multiple Use Plug Hybrid for Nanosats (MUPHyN) miniature thruster

    Science.gov (United States)

    Eilers, Shannon

    The Multiple Use Plug Hybrid for Nanosats (MUPHyN) prototype thruster incorporates solutions to several major challenges that have traditionally limited the deployment of chemical propulsion systems on small spacecraft. The MUPHyN thruster offers several features that are uniquely suited for small satellite applications. These features include 1) a non-explosive ignition system, 2) non-mechanical thrust vectoring using secondary fluid injection on an aerospike nozzle cooled with the oxidizer flow, 3) a non-toxic, chemically-stable combination of liquid and inert solid propellants, 4) a compact form factor enabled by the direct digital manufacture of the inert solid fuel grain. Hybrid rocket motors provide significant safety and reliability advantages over both solid composite and liquid propulsion systems; however, hybrid motors have found only limited use on operational vehicles due to 1) difficulty in modeling the fuel flow rate 2) poor volumetric efficiency and/or form factor 3) significantly lower fuel flow rates than solid rocket motors 4) difficulty in obtaining high combustion efficiencies. The features of the MUPHyN thruster are designed to offset and/or overcome these shortcomings. The MUPHyN motor design represents a convergence of technologies, including hybrid rocket regression rate modeling, aerospike secondary injection thrust vectoring, multiphase injector modeling, non-pyrotechnic ignition, and nitrous oxide regenerative cooling that address the traditional challenges that limit the use of hybrid rocket motors and aerospike nozzles. This synthesis of technologies is unique to the MUPHyN thruster design and no comparable work has been published in the open literature.

  4. Special needs children with speech and hearing difficulties: prevalence and unmet needs.

    Science.gov (United States)

    Kenney, Mary Kay; Kogan, Michael D

    2011-01-01

    The purpose of this study was to establish prevalences and sociodemographic characteristics associated with parent-reported speech and hearing difficulties among children with special health care needs (CSHCN); determine unmet needs for therapy, hearing aids, and communication devices; and examine the association between unmet needs and resources such as health insurance, early intervention/special education, and a medical home. Data were analyzed for 300,910 children without special health care needs and 40,723 CSHCN from the 2005-2006 National Survey of Children with Special Health Care Needs. Prevalence, sociodemographic characteristics, and unmet needs for 7132 CSHCN with speech difficulties and 1982 CSHCN with hearing difficulties were assessed. Logistic regression was used to determine the associations between unmet needs for therapy or hearing/communication devices and resources for addressing needs for therapy, hearing, and communication aids. The parent-reported prevalence of speech difficulty among CSHCN in the general population was 2.9% and approximately 20% among all CSHCN, in contrast to the lower prevalence of hearing difficulty (0.7% and 5%, respectively). Relative unmet need was greatest for communication devices and least for hearing aids. The strongest association with reducing unmet needs was having a medical home, and the most significant aspect of medical home was having effective care coordination. Having a medical home is significantly associated with fewer unmet needs for therapy and hearing/communication devices among CSHCN with speech and hearing difficulties. Care coordination may constitute an important factor that allows the primary care provider to link with services that CSHCN with communication problems require. Published by Elsevier Inc.

  5. 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…

  6. Response actions to difficulties in using everyday technology after acquired brain injury.

    Science.gov (United States)

    Larsson Lund, Maria; Lövgren Engström, Ann-Louice; Lexell, Jan

    2012-03-01

    People with acquired brain injury (ABI) have difficulties using everyday technology (ET) in daily tasks at home and in society. To support them in managing the demands imposed by using ET, knowledge is needed concerning their response actions to the difficulties. The aim of this study was to explore and describe what characterizes response actions to difficulties using ET, their conditions, and how they influence the experiences of tasks in daily life among people with ABI. Interviews and observations were undertaken with 13 persons with an ABI. Data were analysed qualitatively using the constant comparative method. The participants' response actions were categorized as (i) deliberate and organized planning, (ii) random and inflexible repeating (iii), re-evaluating tasks, (iv) explaining difficulties related to others, and (iv) proving and protecting capability. Certain conditions were decisive for the different response actions to be applied and also for their effectiveness in enabling engagement in tasks in daily life. Each participant used several types of response actions and the same action could be applied in several situations. To support people with an ABI to manage the demands imposed by using ET, it is important to identify the uniqueness of each client and his or her response actions to difficulties using ET and thereafter adjust the interventions accordingly.

  7. Operational tools to build a multicriteria territorial risk scale with multiple stakeholders

    International Nuclear Information System (INIS)

    Cailloux, Olivier; Mayag, Brice; Meyer, Patrick; Mousseau, Vincent

    2013-01-01

    Evaluating and comparing the threats and vulnerabilities associated with territorial zones according to multiple criteria (industrial activity, population, etc.) can be a time-consuming task and often requires the participation of several stakeholders. Rather than a direct evaluation of these zones, building a risk assessment scale and using it in a formal procedure permits to automate the assessment and therefore to apply it in a repeated way and in large-scale contexts and, provided the chosen procedure and scale are accepted, to make it objective. One of the main difficulties of building such a formal evaluation procedure is to account for the multiple decision makers' preferences. The procedure used in this article, ELECTRE TRI, uses the performances of each territorial zone on multiple criteria, together with preferential parameters from multiple decision makers, to qualitatively assess their associated risk level. We also present operational tools in order to implement such a procedure in practice, and show their use on a detailed example

  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. 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.

  10. Differences in perceived difficulty in print and online patient education materials.

    Science.gov (United States)

    Farnsworth, Michael

    2014-01-01

    Written patient education materials frequently exceed the reading ability of the general public. Patients are often intimidated by the task of reading patient education materials, perceiving the materials’ difficulty levels as prohibitive, even when they do not exceed the patients’ reading abilities. It is unclear how the delivery mechanism--print or a computer screen--affects a patient’s reading experience through his/her perception of its difficulty. To determine whether first-year college students perceived online or print-based patient education materials as more difficult to read. Convenience sampling of first-year college students. Some first-year college students perceived online patient education materials to be more difficult to read than print-based ones--even when the reading level of the patient education materials was similar. Demographic information about this sample’s high levels of digital literacy suggests that other populations might also perceive online patient education materials as more difficult to read than print-based equivalents. Patients’ perceptions of the difficulty of patient education materials influenced their ability to effectively learn from those materials. This article concludes with a call for more research into patients’ perceptions of difficulty of patient education materials in print vs on a screen.

  11. 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.

  12. Perceptual discrimination difficulty and familiarity in the Uncanny Valley: more like a "Happy Valley".

    Science.gov (United States)

    Cheetham, Marcus; Suter, Pascal; Jancke, Lutz

    2014-01-01

    The Uncanny Valley Hypothesis (UVH) predicts that greater difficulty perceptually discriminating between categorically ambiguous human and humanlike characters (e.g., highly realistic robot) evokes negatively valenced (i.e., uncanny) affect. An ABX perceptual discrimination task and signal detection analysis was used to examine the profile of perceptual discrimination (PD) difficulty along the UVH' dimension of human likeness (DHL). This was represented using avatar-to-human morph continua. Rejecting the implicitly assumed profile of PD difficulty underlying the UVH' prediction, Experiment 1 showed that PD difficulty was reduced for categorically ambiguous faces but, notably, enhanced for human faces. Rejecting the UVH' predicted relationship between PD difficulty and negative affect (assessed in terms of the UVH' familiarity dimension), Experiment 2 demonstrated that greater PD difficulty correlates with more positively valenced affect. Critically, this effect was strongest for the ambiguous faces, suggesting a correlative relationship between PD difficulty and feelings of familiarity more consistent with the metaphor happy valley. This relationship is also consistent with a fluency amplification instead of the hitherto proposed hedonic fluency account of affect along the DHL. Experiment 3 found no evidence that the asymmetry in the profile of PD along the DHL is attributable to a differential processing bias (cf. other-race effect), i.e., processing avatars at a category level but human faces at an individual level. In conclusion, the present data for static faces show clear effects that, however, strongly challenge the UVH' implicitly assumed profile of PD difficulty along the DHL and the predicted relationship between this and feelings of familiarity.

  13. Associations between sports participation and psychological difficulties during childhood: a two-year follow up.

    Science.gov (United States)

    Vella, Stewart A; Cliff, Dylan P; Magee, Christopher A; Okely, Anthony D

    2015-05-01

    This paper assessed the associations between sports participation and the development of psychological strengths and difficulties during childhood. Two-year follow up study of a sample of 4042 Australian children who were followed from age 8 years to 10 years. Parents reported children's participation in organised sports, and completed the Strengths and Difficulties Questionnaire. Univariate general linear models were used to examine the association between changes in sports participation and psychological strengths and difficulties at 10 years, adjusting for psychological strengths and difficulties at age 8. Children who maintained participation in sport had lower rates of parent-reported psychological difficulties at 10 years compared with children who dropped out of sport. Less internalising problems were also reported for children who participated in organised sports compared to children who dropped out of sports and children who did not participate in sports. These relationships did not differ by BMI, socioeconomic status, or parental education. Greater psychological difficulties are experienced by children who drop out of sports, and greater social and emotional problems are experienced by children who drop out of sports and who do not participate in organised sports. Due consideration should be given to the quality and implementation of sporting programs to ensure that they provide benefits to mental health. Due consideration should also be given to the potential psychological difficulties being experienced by children who drop out of organised sports as a higher level of psychological difficulties may be experienced prior to or subsequent to dropout. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. Persistent Handwriting Difficulties in Children With ADHD After Treatment With Stimulant Medication.

    Science.gov (United States)

    Brossard-Racine, Marie; Shevell, Michael; Snider, Laurie; Bélanger, Stacey Ageranioti; Julien, Marilyse; Majnemer, Annette

    2015-07-01

    Children with ADHD often present with handwriting difficulties. However, the extent to which motor and attention skills influence performance in this group has not yet been explored. The objective of this study was to examine the factors associated with change in handwriting performance. This study examines the factors associated with change in handwriting performance of 49 children newly diagnosed with ADHD (mean age = 8.4 [SD=1.3] years) prior to and 3 months following use of a stimulant medication. Handwriting legibility and speed improved significantly at follow-up evaluation. However, most of the children with legibility difficulties at baseline continued to demonstrate difficulties when evaluated 3 months after initiation of medication. Change in handwriting legibility was best determined by improvements in visual-motor integration skills (β = 0.07-0.10; p Handwriting difficulties are common in children with ADHD, and medication alone is not sufficient to resolve these challenges. © 2012 SAGE Publications.

  15. [Correlation between adolescents psychical disorders and their difficulties of psychosocial adaptation].

    Science.gov (United States)

    Markeviciūte, Aurelija; Kalkyte, Rūta; Adomaitiene, Virginija; Gudiene, Devika; Velaviciene, Dalia

    2007-01-01

    To study the correlation between adolescents' psychical disorders and their difficulties of psychosocial adaptation. There were 63 adolescent participants in our study (47 girls and 16 boys) who were hospitalized in Department of Children and Adolescent Psychiatry, Kaunas University of Medicine Hospital (Lithuania) during the period from September to December, 2005. Twenty-seven adolescents (19 girls and 8 boys) had suicidal and self-harming behavior. Psychical disorders were diagnosed according to ICD-10 diagnostic criterions. We used Strengths and Difficulties Questionnaire SDQ-lit adapted for Lithuania. While comparing the mean scores in both sexes of adolescents with diagnoses of depressive, behavioral and adaptation disturbances, we found a statistically significant difference only in emotionally disturbance scale results (p=0.016). Analyzing groups of girls and boys separately, girls showed to be worse psychosocially adapted and had more emotional problems. Girls who tried to commit suicide had more emotional (p=0.006) and psychosocial problems (padaptation (p=0.031) difficulties. Parents noted that those who committed a suicide and had behavior disturbances had more expressed emotional (p=0.007) and general adaptation (p=0.053) problems. 1. Adolescent girls who were diagnosed depressive illnesses had more emotional and general adaptation problems than girls who were diagnosed behavior or adaptation disorders. 2. Adolescent girls who tried to commit suicide had more expressed behavior problems and difficulties of emotional, general adaptation. 3. Most expressed difficulties of emotional and general adaptation were typical to girls who were diagnosed with depression and who tried to commit a suicide.

  16. Motor performance and learning difficulties in schoolchildren aged 7 to 10 years old

    Directory of Open Access Journals (Sweden)

    J. Silva

    2011-01-01

    Full Text Available The general objective of this study was to evaluate the motor performance of children with and without learning difficulty indicatives. Took part in the study 406 students aged 7 to 10 years old, being 231 girls (56.9% and 175 (43.1% boys enrolled in a municipal public school in São José, Santa Catarina, Brazil. The indicative of learning difficulties was verified through the TDE, while motor performance was evaluated with the MABC. Boys without learning difficulties had better performance in the majority of the abilities evaluated, beyond an association between the indicative of motor problems with learning difficulties towards writing, arithmetic, reading, and in general. On the other hand, female students of the sample with and without any indicative of learning difficulties did not differentiate themselves as to motor abilities evaluated, with an association merely between the indicative of motor problems and reading problems. Based on the differences identified between girls and boys, results call attention to the need for future research in this area, considering gender as a differential variable in this relationship.

  17. 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…

  18. Sleep difficulties and alcohol use motives in female rape victims with posttraumatic stress disorder.

    Science.gov (United States)

    Nishith, P; Resick, P A; Mueser, K T

    2001-07-01

    The purpose of this study was to assess the relationship between sleep difficulties and drinking motives in female rape victims with posttraumatic stress disorder (PTSD). Seventy-four participants were assessed for PTSD symptoms, depression, sleep difficulties, and drinking motives. Results demonstrated that neither PTSD symptoms nor depression were related to any motives for using alcohol. On the other hand, after controlling for education, sleep difficulties were significantly related to drinking motives for coping with negative affect, but not pleasure enhancement or socialization. The findings suggest that sleep difficulties may be an important factor contributing to alcohol use in rape victims with PTSD.

  19. Beyond Epistemological Deficits: Dynamic explanations of engineering students' difficulties with mathematical sense-making

    Science.gov (United States)

    Gupta, Ayush; Elby, Andrew

    2011-12-01

    Researchers have argued against deficit-based explanations of students' difficulties with mathematical sense-making, pointing instead to factors such as epistemology. Students' beliefs about knowledge and learning can hinder the activation and integration of productive knowledge they have. Such explanations, however, risk falling into a 'deficit trap'-substituting a concepts/skills deficit with an epistemological one. Our interview-based case study of a freshman engineering major, 'Jim,' explains his difficulty solving a physics problem (on hydrostatic pressure) in terms of his epistemology, but avoids a deficit trap by modeling the dynamics of his epistemological stabilities and shifts in terms of fine-grained cognitive elements that include the seeds of epistemological expertise. Specifically, during a problem-solving episode in the interview, Jim reaches and sticks with an incorrect answer that violates common sense. We show that Jim has all the mathematical skills and physics knowledge he would need to resolve the contradiction. We argue that his difficulty doing so stems in part from his epistemological views that (i) physics equations are much more trustworthy than everyday reasoning, and (ii) physics equations do not express meaning that tractably connects to common sense. For these reasons, he does not view reconciling between common sense and formalism as either necessary or plausible to accomplish. But Jim's in-the-moment shift to a more sophisticated epistemological stance highlights the seeds of epistemological expertise that were present all along: he does see common sense as connected to formalism (though not always tractably so), and in some circumstances, this connection is both salient and valued.

  20. The Multiple-Choice Model: Some Solutions for Estimation of Parameters in the Presence of Omitted Responses

    Science.gov (United States)

    Abad, Francisco J.; Olea, Julio; Ponsoda, Vicente

    2009-01-01

    This article deals with some of the problems that have hindered the application of Samejima's and Thissen and Steinberg's multiple-choice models: (a) parameter estimation difficulties owing to the large number of parameters involved, (b) parameter identifiability problems in the Thissen and Steinberg model, and (c) their treatment of omitted…

  1. Can Readability Formulas Be Used to Successfully Gauge Difficulty of Reading Materials?

    Science.gov (United States)

    Begeny, John C.; Greene, Diana J.

    2014-01-01

    A grade level of reading material is commonly estimated using one or more readability formulas, which purport to measure text difficulty based on specified text characteristics. However, there is limited direction for teachers and publishers regarding which readability formulas (if any) are appropriate indicators of actual text difficulty. Because…

  2. Dual processing theory and experts' reasoning: exploring thinking on national multiple-choice questions.

    Science.gov (United States)

    Durning, Steven J; Dong, Ting; Artino, Anthony R; van der Vleuten, Cees; Holmboe, Eric; Schuwirth, Lambert

    2015-08-01

    An ongoing debate exists in the medical education literature regarding the potential benefits of pattern recognition (non-analytic reasoning), actively comparing and contrasting diagnostic options (analytic reasoning) or using a combination approach. Studies have not, however, explicitly explored faculty's thought processes while tackling clinical problems through the lens of dual process theory to inform this debate. Further, these thought processes have not been studied in relation to the difficulty of the task or other potential mediating influences such as personal factors and fatigue, which could also be influenced by personal factors such as sleep deprivation. We therefore sought to determine which reasoning process(es) were used with answering clinically oriented multiple-choice questions (MCQs) and if these processes differed based on the dual process theory characteristics: accuracy, reading time and answering time as well as psychometrically determined item difficulty and sleep deprivation. We performed a think-aloud procedure to explore faculty's thought processes while taking these MCQs, coding think-aloud data based on reasoning process (analytic, nonanalytic, guessing or combination of processes) as well as word count, number of stated concepts, reading time, answering time, and accuracy. We also included questions regarding amount of work in the recent past. We then conducted statistical analyses to examine the associations between these measures such as correlations between frequencies of reasoning processes and item accuracy and difficulty. We also observed the total frequencies of different reasoning processes in the situations of getting answers correctly and incorrectly. Regardless of whether the questions were classified as 'hard' or 'easy', non-analytical reasoning led to the correct answer more often than to an incorrect answer. Significant correlations were found between self-reported recent number of hours worked with think-aloud word count

  3. Children with Speech Difficulties: A survey of clinical practice in the Western Cape

    Directory of Open Access Journals (Sweden)

    Michelle Pascoe

    2010-12-01

    Full Text Available This paper is based on a study by Joffe and Pring (2008 which investigated assessment and therapy methods used by Speech Language Therapists (SLTs in the United Kingdom for children with phonological difficulties. Joffe and Pring reported SLTs’ most favoured assessments and therapy approaches in that context. Children with speech difficulties are likely to form a considerable part of SLT caseloads in South Africa, but the choice of assessments may not be so clearcut given the linguistic diversity of the region and the fact that few assessments have been developed specifically for the SA population. Linked to difficulties with assessment, selection of intervention approaches may also pose challenges. This study aimed to investigate the methods of assessment and intervention used by SLTs in the Western Cape when working with children with speech difficulties. A questionnaire was sent to SLTs working with pre and/ or primary school- aged children. Twenty-nine clinicians of varying experience responded. The majority of SLTs (89% use informal assessment tools in combination with formal assessment. When using formal assessments, more than 50% of SLTs make modifications to better suit the population. Participants use a variety of intervention approaches, often in combination, and based on a child’s individual profile of difficulties and available resources. Forty-six percent of SLTs felt unsure about the selection of assessments and intervention for bi/multilingual children with speech difficulties. SLTs suggested that guidelines about accepted / typical speech development in the region would be helpful for their clinical practice. Clinical implications of the findings are discussed together with some suggestions for developing knowledge of children’s speech difficulties in the South African context.

  4. Multiple Sclerosis and autoimmune diseases: clinical cases and review of the literature

    Directory of Open Access Journals (Sweden)

    A. Protti

    2011-09-01

    Full Text Available Multiple sclerosis (MS, the most frequent demyelinating disease in adults, is thought to be an autoimmune disease. Symptoms and signs observed in MS reflect lesions present mainly in the white matter of the central nervous system (CNS. The diagnosis remains difficult, at least concerning presenting symptoms, because of their low specificity. Diagnosis criteria are usually based on dissemination of signs in time and space, evoked potentials, findings of magnetic resonance imaging, results of cerebrospinal fluid examination, and the exclusion of other diagnosis possibly explaining the clinical signs. However, no clinical and paraclinical investigation can distinguish with certainity MS from other conditions such as autoimmune or inflammatory diseases predominantly affecting the central nervous system. These other disorders include systemic lupus erythematosus, antiphospholipid syndrome, Behcet disease, Sjogren syndrome, sarcoidosis and vasculitides. We present four clinical cases showing the difficulty in reaching a proper diagnosis...

  5. The Effects of Locus of Control and Task Difficulty on Procrastination.

    Science.gov (United States)

    Janssen, Tracy; Carton, John S

    1999-12-01

    The authors investigated the effects of locus of control expectancies and task difficulty on procrastination. Forty-two college students were administered an academic locus of control scale and a task that was similar to a typical college homework assignment. The students were randomly assigned to 1 of 2 task difficulty levels. Although none of the results involving task difficulty was significant, several results involving locus of control were significant. Specifically, analyses revealed that students with internal locus of control expectancies tended to begin working on the assignment sooner than students with external locus of control expectancies. In addition, students with internal locus of control completed and returned the assignment sooner than students with external locus of control. The results are discussed within the context of J. B. Rotter's (1966, 1975, 1982) social learning theory.

  6. CAN INFOGRAPHICS FACILITATE THE LEARNING OF INDIVIDUALS WITH MATHEMATICAL LEARNING DIFFICULTIES?

    Directory of Open Access Journals (Sweden)

    Basak Baglama

    2017-12-01

    Full Text Available Visualization of data has recently gained great importance in education and use of infographics is regarded as an important tool in teaching mathematics since it presents information in a clear and abstract way. Therefore, use of infographics for helping individuals with mathematical learning difficulties has become an important research question. This study aims to provide an overview on the use of infographics in teaching mathematics to individuals with mathematical learning difficulties. This is a qualitative study in which document analysis was used the collect the data. Results provided information about the definition of infographics, effectiveness of using infographics in education and facilitative role of infographics in enhancing learning of individuals with mathematical learning difficulties, namely dyscalculia. Results were discussed with relevant literature and recommendations for further research and practices were also presented.

  7. Readability Formulas and User Perceptions of Electronic Health Records Difficulty: A Corpus Study.

    Science.gov (United States)

    Zheng, Jiaping; Yu, Hong

    2017-03-02

    Electronic health records (EHRs) are a rich resource for developing applications to engage patients and foster patient activation, thus holding a strong potential to enhance patient-centered care. Studies have shown that providing patients with access to their own EHR notes may improve the understanding of their own clinical conditions and treatments, leading to improved health care outcomes. However, the highly technical language in EHR notes impedes patients' comprehension. Numerous studies have evaluated the difficulty of health-related text using readability formulas such as Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning-Fog Index (GFI). They conclude that the materials are often written at a grade level higher than common recommendations. The objective of our study was to explore the relationship between the aforementioned readability formulas and the laypeople's perceived difficulty on 2 genres of text: general health information and EHR notes. We also validated the formulas' appropriateness and generalizability on predicting difficulty levels of highly complex technical documents. We collected 140 Wikipedia articles on diabetes and 242 EHR notes with diabetes International Classification of Diseases, Ninth Revision code. We recruited 15 Amazon Mechanical Turk (AMT) users to rate difficulty levels of the documents. Correlations between laypeople's perceived difficulty levels and readability formula scores were measured, and their difference was tested. We also compared word usage and the impact of medical concepts of the 2 genres of text. The distributions of both readability formulas' scores (Preadability predictions and laypeople's perceptions were weak. Furthermore, despite being graded at similar levels, documents of different genres were still perceived with different difficulty (Preadability formulas' predictions did not align with perceived difficulty in either text genre. The widely used readability formulas were

  8. Factors associated with the difficulty in hospital acceptance among elderly emergency patients: A population-based study in Osaka City, Japan.

    Science.gov (United States)

    Matsuyama, Tasuku; Kitamura, Tetsuhisa; Katayama, Yusuke; Kiyohara, Kosuke; Hayashida, Sumito; Kawamura, Takashi; Iwami, Taku; Ohta, Bon

    2017-12-01

    We aimed to investigate prehospital factors associated with difficulty in hospital acceptance among elderly emergency patients. We reviewed ambulance records in Osaka City from January 2013 through December 2014, and enrolled all elderly emergency patients aged ≥65 years who were transported by on-scene emergency medical service personnel to a hospital that the personnel had selected. The definition of difficulty in hospital acceptance was to the requirement for ≥4 phone calls to hospitals by emergency medical service personnel before receiving a decision from the destination hospitals. Prehospital factors associated with difficulty in hospital acceptance were examined through logistic regression analysis. During the study period, 72 105 elderly patients were included, and 13 332 patients (18.5%) experienced difficulty in hospital acceptance. In the simple linear regression model, hospital selection time increased significantly with an increasing number of phone calls (R 2  = 0.774). In the multivariable analysis, older age (P for trend emergency-related symptoms and difficulty in hospital acceptance among elderly patients with symptoms of internal disease (AOR 1.71, 95% CI 1.53-1.91). In Japan, which has a rapidly aging population, a comprehensive strategy for elderly emergency patients, especially for advanced age groups or nursing home residents, is required. Geriatr Gerontol Int 2017; 17: 2441-2448. © 2017 Japan Geriatrics Society.

  9. On relating multiple M2 and D2-branes

    International Nuclear Information System (INIS)

    Gran, U.; Nilsson, B.E.W; Petersson, C.

    2008-01-01

    Due to the difficulties of finding superconformal Lagrangian theories for multiple M2-branes, we will in this paper instead focus on the field equations. By relaxing the requirement of a Lagrangian formulation we can explore the possibility of having structure constants f ABC D satisfying the fundamental identity but which are not totally antisymmetric. We exemplify this discussion by making use of an explicit choice of a non-antisymmetric f ABC D constructed from the Lie algebra structure constants f ab c of an arbitrary gauge group. Although this choice of f ABC D does not admit an obvious Lagrangian description, it does reproduce the correct SYM theory for a stack of N D2-branes to leading order in g YM -1 upon reduction and, moreover, it sheds new light on the centre of mass coordinates for multiple M2-branes.

  10. 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.

  11. 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…

  12. The Deficit Profile of Working Memory, Inhibition, and Updating in Chinese Children with Reading Difficulties

    Science.gov (United States)

    Peng, Peng; Sha, Tao; Li, Beilei

    2013-01-01

    This study investigated executive function deficits among Chinese children with reading difficulties. Verbal and numerical measures of working memory, inhibition, updating, and processing speed were examined among children with only reading difficulties (RD), children with reading and mathematics difficulties (RDMD), and typically developing peers…

  13. 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...

  14. 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.

  15. The difficulties encountered in conversion from classic pancreaticoduodenectomy to total laparoscopic pancreaticoduodenectomy

    Directory of Open Access Journals (Sweden)

    Muharrem Battal

    2016-01-01

    Full Text Available Background: Recently, total laparoscopic pancreatectomy has been performed at many centres as an alternative to open surgery. In this study, we aimed to present the difficulties that we have encountered in converting from classic open pancreaticoduodenectomy to total laparoscopic pancreatectomy. Materials and Methods: Between December 2012 and January 2014, we had 100 open pancreaticoduodenectomies. Subsequently, we tried to perform total laparoscopic pancreaticoduodenectomy (TLPD in 22 patients. In 17 of these 22 patients, we carried out the total laparoscopic procedure. We analysed the difficulties that we encountered converting to TLPD in three parts: Preoperative, operative and postoperative. Preoperative difficulties involved patient selection, preparation of operative instruments, and planning the operation. Operative difficulties involved the position of the trocars, dissection, and reconstruction problems. The postoperative difficulty involved follow-up of the patient. Results: According to our experiences, the most important problem is the proper selection of patients. Contrary to our previous thoughts, older patients who were in better condition were comparatively more appropriate candidates than younger patients. This is because the younger patients have generally soft pancreatic texture, which complicates the reconstruction. The main operative problems are trocar positions and maintaining the appropriate position of the camera, which requires continuous changes in its angles during the operation. However, postoperative follow-up is not very different from the classic procedure. Conclusion: TLPD is a suitable procedure under appropriate conditions.

  16. 3D velocity measurements in fluid flows using multiple exposure holography

    International Nuclear Information System (INIS)

    Stanislas, M.; Rodriguez, O.; Dadi, M.; Beluche, F.

    1987-01-01

    An account is given of multiple exposure holography's application to the measurement of velocity in fluid flows. The method is nonintrusive, and yields access to the three components of the instantaneous velocity in three-dimensional domains. These characteristics render such holographic data complementary to classical LDV. Attention is given to solutions proposed for such limitations inherent in the method as the rather lengthy acquisition time; this difficulty is presently addressed by means of an automated evaluation methodology. 12 references

  17. Guiding People to Interpret Their Experienced Difficulty as Importance Highlights Their Academic Possibilities and Improves Their Academic Performance

    Science.gov (United States)

    Oyserman, Daphna; Elmore, Kristen; Novin, Sheida; Fisher, Oliver; Smith, George C.

    2018-01-01

    Does experiencing difficulty bolster or undermine future self-images, strategies to get there and actual performance? We build on four insights from prior research to predict that accessible interpretation-of-experienced-difficulty mindset shapes identity and performance. First, people have two different interpretation-of-experienced-difficulty mindsets available in memory; their difficulty-as-impossibility mindset focuses attention on difficulty as implying low odds and their difficulty-as-importance mindset focuses attention on difficulty as implying high value. Second, people are sensitive to contextual cues as to which mindset to apply to understand their experienced difficulty. Third, people apply the mindset that comes to mind unless they have reason to question why it is “on-the-mind.” Fourth, social class can be thought of as a chronic context influencing how much people endorse each interpretation-of-experienced-difficulty mindset. We used subtle primes to guide participants’ attention toward either a difficulty-as-importance or a difficulty-as-impossibility mindset (N = 591). Participants guided toward a difficulty-as-importance mindset performed better on difficult academic tasks (Studies 1, 2) than participants guided toward a difficulty-as-impossibility mindset; whether they had more school-focused possible identities and linked strategies depended on sample (Studies 3, 4). For college students, the effect of guided interpretation-of-experienced-difficulty mindset was not moderated by how much participants agreed with that mindset (Studies 1, 3, 4). College students mostly disagreed with a difficulty-as-impossibility mindset, but making that mindset accessible undermined their performance and sometimes their possible identities anyway. In contrast, middle school students (a younger and lower social class sample) were more likely to agree with a difficulty-as-impossibility mindset. In this sample (Study 2), we found an effect of mindset

  18. Differential Identification of Females and Males with Reading Difficulties: A Meta-Analysis

    Science.gov (United States)

    Quinn, Jamie M.

    2018-01-01

    Males are more likely than females to be identified as having reading difficulties, but it is unclear if this is a result of sample ascertainment or identification bias. The purpose of this meta-analysis was to determine the magnitude of gender differences in reading difficulties using available studies in which researchers investigated this…

  19. Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization

    Directory of Open Access Journals (Sweden)

    Classi Peter

    2012-10-01

    Full Text Available Abstract Background The objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD. Methods Data were from the 2007 U.S. National Health Interview Survey (NHIS and were based on parental proxy responses to questions in the Sample Child Core, which includes questions on demographics, health, healthcare treatment, and social and emotional status as measured by questions about depression, anxiety, and phobias, as well as items from the brief version of the Strength and Difficulties Questionnaire (SDQ. Logistic regression was used to assess the association between co-occurring social and emotional difficulties with missed school days and healthcare utilization, adjusting for demographics. Results Of the 5896 children aged 6–17 years in the 2007 NHIS, 432 (7.3% had ADHD, based on parental report. Children with ADHD and comorbid depression, anxiety, or phobias had significantly greater odds of experiencing > 2 weeks of missed school days, ≥ 6 visits to a healthcare provider (HCP, and ≥ 2 visits to the ER, compared with ADHD children without those comorbidities (OR range: 2.1 to 10.4. Significantly greater odds of missed school days, HCP visits, and ER visits were also experienced by children with ADHD who were worried, unhappy/depressed, or having emotional difficulties as assessed by the SDQ, compared with ADHD children without those difficulties (OR range: 2.2 to 4.4. Conclusions In children with ADHD, the presence of social and emotional problems resulted in greater odds of missed school days and healthcare utilization. These findings should be viewed in light of the limited nature of the parent-report measures used to assess social and emotional problems.

  20. 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)

  1. Mixed methods research in pedagogy: Characteristics, advantages and difficulties in application

    Directory of Open Access Journals (Sweden)

    Matović Nataša

    2015-01-01

    Full Text Available The mixed methods research, as a new type of research, is discussed in the context of re-examining the relation between the two approaches, i.e. the possibility of not opposing, but connecting, combining and integrating them within research. The possibility to use such grounding in research as well could be quite important for pedagogy since the nature of the examined phenomena in this field is such that the majority has both quantitative and qualitative aspects. In order to explain the essence of a mixed methods research, the paper analyses its characteristics, first of all, what elements are combined, what is the nature of the relation between the combined elements and why they are combined, as well as its advantages and difficulties in application. The essential thing in a mixed methods research is the fact that combining refers to the research process as a whole, including the ontological and epistemological assumptions it is based on, which implies that the elements that are combined are understood rather broadly. The advantages and difficulties in application are considered in the context of the discussion of the possibility to combine all research elements, neutralise the limitations of quantitative and qualitative research methodology, implement the complex combining procedures etc. [Projekat Ministarstva nauke Republike Srbije, br. 179060: Modeli procenjivanja i strategije unapređivanja kvaliteta obrazovanja

  2. Amyloid PET in pseudotumoral multiple sclerosis.

    Science.gov (United States)

    Matías-Guiu, Jordi A; Cabrera-Martín, María Nieves; Cortés-Martínez, Ana; Pytel, Vanesa; Moreno-Ramos, Teresa; Oreja-Guevara, Celia; Carreras, José Luis; Matías-Guiu, Jorge

    2017-07-01

    Pseudotumoral multiple sclerosis is a rare form of demyelinating disease of the central nervous system. Positron emission tomography (PET) using amyloid-tracers has also been suggested as a marker of damage in white matter lesions in multiple sclerosis due to the nonspecific uptake of these tracers in white matter. We present the case of a 59 year-old woman with a pathological-confirmed pseudotumoral multiple sclerosis, who was studied with the amyloid tracer 18 F-florbetaben. The patient had developed word-finding difficulties and right hemianopia twelve years ago. In that time, MRI showed a lesion on the left hemisphere with an infiltrating aspect in frontotemporal lobes. Brain biopsy showed demyelinating areas and inflammation. During the following years, two new clinical relapses occurred. 18 F-florbetaben PET showed lower uptake in the white matter lesion visualized in the CT and MRI images. Decreased tracer uptake was also observed in a larger area of the left hemisphere beyond the lesions observed on MRI or CT. White matter lesion volume on FLAIR was 44.2mL, and tracer uptake change between damaged white matter and normal appearing white matter was - 40.5%. Standardized uptake value was inferior in the pseudotumoral lesion than in the other white matter lesions. We report the findings of amyloid PET in a patient with pseudotumoral multiple sclerosis. This case provides further evidence on the role of amyloid PET in the assessment of white matter and demyelinating diseases. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Hearing acuity as a predictor of walking difficulties in older women.

    Science.gov (United States)

    Viljanen, Anne; Kaprio, Jaakko; Pyykkö, Ilmari; Sorri, Martti; Koskenvuo, Markku; Rantanen, Taina

    2009-12-01

    To examine whether hearing acuity correlates with walking ability and whether impaired hearing at baseline predicts new self-reported walking difficulties after 3 years. Prospective follow-up. Research laboratory and community. Four hundred thirty-four women aged 63 to 76. Hearing was measured using clinical audiometry. A person was defined as having a hearing impairment if a pure-tone average of thresholds at 0.5 to 4 kHz in the better ear was 21 dB or greater. Maximal walking speed was measured over 10 m (m/s), walking endurance as the distance (m), covered in 6 minutes and difficulties in walking 2 km according to self-report. At baseline, women with hearing impairment (n=179) had slower maximal walking speed (1.7 +/- 0.3 m/s vs 1.8 +/- 0.3 m/s, P=.007), lower walking endurance (520 +/- 75 m vs 536 +/- 75 m, P=.08), and more selfreported major difficulties in walking 2 km (12.8% vs 5.5%, P=.02) than those without hearing impairment. During follow-up, major walking difficulties developed for 33 participants. Women with hearing impairment at baseline had a twice the age-adjusted risk for new walking difficulties as those without hearing impairment (odds ratio=2.04, 95% confidence interval=0.96-4.33). Hearing acuity correlated with mobility, which may be explained by the association between impaired hearing and poor balance and greater risk for falls, both of which underlie decline in mobility. Prevention of hearing loss is not only important for the ability to communicate, but may also have more wide-ranging influences on functional ability.

  4. Comments on the Bagger-Lambert theory and multiple M2-branes

    International Nuclear Information System (INIS)

    Raamsdonk, Mark Van

    2008-01-01

    We study the SO(8) superconformal theory proposed recently by Bagger and Lambert as a possible worldvolume theory for multiple M2-branes. For their explicit example with gauge group SO(4), we rewrite the theory (originally formulated in terms of a three-algebra) as an ordinary SU(2) x SU(2) gauge theory with bifundamental matter. In this description, the parity invariance of the theory, required for a proper description of M2-branes, is clarified. We describe the subspace of scalar field configurations on which the potential vanishes, correcting an earlier claim. Finally, we point out, for general three-algebras, a difficulty in constructing the required set of superconformal primary operators which should be present in the correct theory describing multiple M2-branes.

  5. Learning Multiplication Using Indonesian Traditional game in Third Grade

    Directory of Open Access Journals (Sweden)

    Rully Charitas Indra Prahmana

    2012-07-01

    Full Text Available Several previous researches showed that students had difficulty inunderstanding the basic concept of multiplication. Students are morelikely to be introduced by using formula without involving the conceptitself. This underlies the researcher to design a learning trajectory oflearning multiplication using Permainan Tradisional Tepuk Bergambar(PT2B as a context based on the student experience. The purpose ofthis research is to look at the role of PT2B in helping students'understanding in learning multiplication, which evolved from theinformal to formal level in third grade with Pendidikan MatematikaRealistik Indonesia (PMRI approach. The method used is designresearch starting from preliminary design, teaching experiments, andretrospective analysis. This research describes how PT2B make a realcontribution to the third grade students of SDN 179 Palembang tounderstand the concept of multiplication. The results showed PT2Bcontext can stimulate students to understand their knowledge of themultiplication concept. The whole strategy and model that studentsdiscover, describe, and discuss shows how the students construction orcontribution can uses to help their initial understanding of that concept.The stages in the learning trajectory of student have an important rolein understanding the concept of the operation number from informal tothe formal level.Keyword: Design Research, PMRI, Multiplication, Permainan TradisionalTepuk Bergambar DOI: http://dx.doi.org/10.22342/jme.3.2.1931.115-132

  6. Differences in Perceived Difficulty in Print and Online Patient Education Materials

    Science.gov (United States)

    Farnsworth, Michael

    2014-01-01

    Context: Written patient education materials frequently exceed the reading ability of the general public. Patients are often intimidated by the task of reading patient education materials, perceiving the materials’ difficulty levels as prohibitive, even when they do not exceed the patients’ reading abilities. It is unclear how the delivery mechanism—print or a computer screen—affects a patient’s reading experience through his/her perception of its difficulty. Objective: To determine whether first-year college students perceived online or print-based patient education materials as more difficult to read. Design: Convenience sampling of first-year college students. Results: Some first-year college students perceived online patient education materials to be more difficult to read than print-based ones—even when the reading level of the patient education materials was similar. Demographic information about this sample’s high levels of digital literacy suggests that other populations might also perceive online patient education materials as more difficult to read than print-based equivalents. Patients’ perceptions of the difficulty of patient education materials influenced their ability to effectively learn from those materials. Conclusion: This article concludes with a call for more research into patients’ perceptions of difficulty of patient education materials in print vs on a screen. PMID:25662526

  7. 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.

  8. Sexual dysfunctions and difficulties in denmark: prevalence and associated sociodemographic factors

    DEFF Research Database (Denmark)

    Christensen, Birgitte S; Grønbaek, Morten; Osler, Merete

    2011-01-01

    Sexual dysfunctions and difficulties are common experiences that may impact importantly on the perceived quality of life, but prevalence estimates are highly sensitive to the definitions used. We used questionnaire data for 4415 sexually active Danes aged 16-95 years who participated in a national......%), and dyspareunia (0.1%); among women: lubrication insufficiency (7%), anorgasmia (6%), dyspareunia (3%), and vaginismus (0.4%). Highest frequencies of sexual dysfunction were seen in men above age 60 years and women below age 30 years or above age 50 years. In logistic regression analysis, indicators of economic...... health and morbidity survey in 2005 to estimate the prevalence of sexual dysfunctions and difficulties and to identify associated sociodemographic factors. Overall, 11% (95% CI, 10-13%) of men and 11% (10-13%) of women reported at least one sexual dysfunction (i.e., a frequent sexual difficulty...

  9. Posttraumatic stress, difficulties in emotion regulation, and coping-oriented marijuana use.

    Science.gov (United States)

    Bonn-Miller, Marcel O; Vujanovic, Anka A; Boden, Matthew Tyler; Gross, James J

    2011-01-01

    In an effort to better understand factors that may explain prior findings of a positive relation between posttraumatic stress symptom severity and coping-oriented marijuana use motivation, the present study tested whether the association between posttraumatic stress symptom severity and marijuana use coping motives is mediated by difficulties in emotion regulation. Participants were 79 (39 women; M(age) = 22.29 years, SD = 6.99) community-recruited adults who reported (1) lifetime exposure to at least one posttraumatic stress disorder Criterion A traumatic event and (2) marijuana use in the past 30 days. Results indicated that difficulties in emotion regulation, as indexed by the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), fully mediated the association between posttraumatic stress symptom severity and marijuana use coping motives. Implications for the treatment of co-occurring posttraumatic stress and marijuana use are discussed.

  10. Validity of a Protocol for Adult Self-Report of Dyslexia and Related Difficulties

    Science.gov (United States)

    Snowling, Margaret; Dawes, Piers; Nash, Hannah; Hulme, Charles

    2012-01-01

    Background There is an increased prevalence of reading and related difficulties in children of dyslexic parents. In order to understand the causes of these difficulties, it is important to quantify the risk factors passed from parents to their offspring. Method 417 adults completed a protocol comprising a 15-item questionnaire rating reading and related skills and a scale assessing ADHD symptoms; 344 completed reading, nonword reading and spelling tests. Results A confirmatory factor analysis with four factors (Reading, Word Finding, Attention and Hyperactivity) provided a reasonable fit to the data. The Reading Factor showed robust correlations with measured literacy skills. Adults who reported as dyslexic, or rated their reading difficulties as more severe, gained lower scores on objective measures of literacy skills. Although the sensitivity of the new scale was acceptable, it tended to miss some cases of low literacy. Conclusions Self-report scales of reading and of attention difficulties are useful for identifying adults with reading and attention difficulties which may confer risks on their children of related problems. It is important for research following children at family risk of dyslexia to be aware of these effects. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22271419

  11. Mapping area variability in social and behavioural difficulties among Glasgow pre-schoolers: linkage of a survey of pre-school staff with routine monitoring data.

    Science.gov (United States)

    Barry, S J E; Marryat, L; Thompson, L; Ellaway, A; White, J; McClung, M; Wilson, P

    2015-11-01

    Social, emotional and behavioural development in early to middle childhood impact upon many outcomes in future life and are influenced by home, neighbourhood and school environments. We used linked data to investigate differences between areas in Glasgow City in level of difficulties in pre-school age children, after consideration of demographics, including area-level deprivation. Pre-school education staff completed Strengths and Difficulties Questionnaires (SDQ) on all children progressing to school from a local authority or partnership (local authority-funded private) pre-school in Glasgow City between 2010 and 2012. These data were linked to individual (age, gender) and area-level (deprivation) demographics from the City Council Education Services Department. Statistical models were fitted to the SDQ scores, adjusting for age, gender, area deprivation, year of school entry, pre-school establishment attended and electoral ward of residence. Correlation between neighbouring wards was incorporated to allow for clustering of scores. Boys and those living in more deprived areas had higher levels of difficulties. Children aged 5.0-5.5 years had fewest difficulties, while the oldest and youngest children had similar levels of difficulties. There were no significant secular trends by year of school entry. There remained differences among areas after adjusting for these variables, with children living in some areas having fewer difficulties than would be expected based on their socio-demographic characteristics. There remained differences in children's levels of difficulties between areas after adjusting for age, gender, area deprivation and year of school entry. Children in some very deprived areas had fewer difficulties than might be expected, while those in relatively affluent areas had more difficulties than expected based on their deprivation level. There may be other, unmeasured, individual- and area-level reasons for children's level of difficulties, and these

  12. Perceived Sexual Difficulties and Sexual Counseling in Men and Women Across Heart Diagnoses

    DEFF Research Database (Denmark)

    Rundblad, Lucas; Zwisler, Ann Dorthe; Johansen, Pernille Palm

    2017-01-01

    -reported using single-item questions, and factors associated with sexual difficulties were collected from the survey and national registers. RESULTS: The study population consisted of 1,549 men and 807 women (35-98 years old) with heart failure (n = 243), ischemic heart disease (n = 1,036), heart valve surgery...... for improved information and counseling about sex and relationships for patients. STRENGTHS AND LIMITATIONS: This large nationwide survey of men and women combined a survey with administrative data from national registries. However, this study used non-validated single-item questions to assess sexual......BACKGROUND: Ischemic heart disease and heart failure often lead to sexual difficulties in men, but little is known about the sexual difficulties in women and patients with other heart diagnoses or the level of information patients receive about the risk of sexual difficulties. AIM: To investigate...

  13. Disconnection Mechanism and Regional Cortical Atrophy Contribute to Impaired Processing of Facial Expressions and Theory of Mind in Multiple Sclerosis: A Structural MRI Study

    OpenAIRE

    Mike, Andrea; Strammer, Erzsebet; Aradi, Mihaly; Orsi, Gergely; Perlaki, Gabor; Hajnal, Andras; Sandor, Janos; Banati, Miklos; Illes, Eniko; Zaitsev, Alexander; Herold, Robert; Guttmann, Charles R. G.; Illes, Zsolt

    2013-01-01

    Successful socialization requires the ability of understanding of others' mental states. This ability called as mentalization (Theory of Mind) may become deficient and contribute to everyday life difficulties in multiple sclerosis. We aimed to explore the impact of brain pathology on mentalization performance in multiple sclerosis. Mentalization performance of 49 patients with multiple sclerosis was compared to 24 age- and gender matched healthy controls. T1- and T2-weighted three-dimensional...

  14. Differences in Perceived Difficulty in Print and Online Patient Education Materials

    OpenAIRE

    Farnsworth, Michael

    2014-01-01

    Patients are often intimidated by the task of reading patient education materials, perceiving the materials’ difficulty levels as prohibitive, even when they do not exceed the patients’ reading abilities. Some first-year college students perceived online patient education materials to be more difficult to read than print-based ones—even when the reading level of the patient education materials was similar. Patients’ perceptions of the difficulty of patient education materials influenced their...

  15. Natural science textbooks for the fourth grade and their text difficulty

    Directory of Open Access Journals (Sweden)

    Libuše Hrabí

    2012-09-01

    Full Text Available This paper presents findings regarding an assessment of the difficulty of text in six current Czech natural science textbooks for the fourth grade. The textual analysis was carried out according to a modified Průcha method. The results indicate that textual difficulty varies in the textbooks examined (19 - 31 points. Textbooks published by the Alter, Fortuna and SPN publishing companies are suitable for teaching in the fourth grade.

  16. Awareness of single and multiple emotions in high-functioning childeren with autism

    OpenAIRE

    Rieffe, C.J.; Meerum Terwogt, M.; Kotronopoulo, K.

    2007-01-01

    This study examined emotional awareness in children with autism. Twenty-two high functioning children with autism (mean age 10 years and 2 months) and 22 typically developing children, matched for age and gender, were presented with the four basic emotions (happiness, anger, sadness and fear) in single and multiple emotion tasks. Findings suggest that children with autism have difficulties identifying their own emotions and less developed emotion concepts (which causes an impaired capacity to...

  17. Sleep Difficulties and Alcohol Use Motives in Female Rape Victims With Posttraumatic Stress Disorder

    OpenAIRE

    Nishith, Pallavi; Resick, Patricia A.; Mueser, Kim T.

    2001-01-01

    The purpose of this study was to assess the relationship between sleep difficulties and drinking motives in female rape victims with posttraumatic stress disorder (PTSD). Seventy-four participants were assessed for PTSD symptoms, depression, sleep difficulties, and drinking motives. Results demonstrated that neither PTSD symptoms nor depression were related to any motives for using alcohol. On the other hand, after controlling for education, sleep difficulties were significantly related to dr...

  18. Anaesthetic Management of A Child with Multiple Congenital Anomalies Scheduled for Cataract Extraction

    Directory of Open Access Journals (Sweden)

    Kalpana Kulkarni

    2009-01-01

    Full Text Available In infants& children variety of conditions and syndromes are associated with difficult Airway. Anaesthetic management becomes a challenge if it remains unrecognized until induction and sometimes results in disaster, leading to oropharyngeal trauma, laryngeal oedema, cardiovascular& neurological complications. A 4-month-old child with multiple congenital anomalies was posted for cataract extraction for early and better development of vision. He had history of post birth respiratory distress, difficulty in feeding, breath holding with delayed mile stones. He was treated as for Juvenile asthma. This child was induced with inhalation anaesthesia. There was difficulty in laryngoscopic intubation and could pass much smaller size of the tube than predicted. He developed post operative stridor and desaturation. The problems which we faced during the anaesthetic management and during postoperative period are discussed with this case.

  19. A Prospective Observational Study of Technical Difficulty With GlideScope-Guided Tracheal Intubation in Children.

    Science.gov (United States)

    Zhang, Bin; Gurnaney, Harshad G; Stricker, Paul A; Galvez, Jorge A; Isserman, Rebecca S; Fiadjoe, John E

    2018-05-09

    The GlideScope Cobalt is one of the most commonly used videolaryngoscopes in pediatric anesthesia. Although visualization of the airway may be superior to direct laryngoscopy, users need to learn a new indirect way to insert the tracheal tube. Learning this indirect approach requires focused practice and instruction. Identifying the specific points during tube placement, during which clinicians struggle, would help with targeted education. We conducted this prospective observational study to determine the incidence and location of technical difficulties using the GlideScope, the success rates of various corrective maneuvers used, and the impact of technical difficulty on success rate. We conducted this observational study at our quaternary pediatric hospital between February 2014 and August 2014. We observed 200 GlideScope-guided intubations and documented key intubation-related outcomes. Inclusion criteria for patients were the number of advancement maneuvers required to intubate the trachea, the location where technical difficulty occurred, the types of maneuvers used to address difficulties, and the tracheal intubation success rate. We used a bias-corrected bootstrapping method with 300 replicates to determine the 95% confidence interval (CI) around the rate of difficulty with an intubation attempt. After excluding attempts by inexperienced clinicians, there were 225 attempts in 187 patients, 58% (131 of 225; bootstrap CI, 51.6%-64.6%]) of the attempts had technical difficulties. Technical difficulty was most likely to occur when inserting the tracheal tube between the plane of the arytenoid cartilages to just beyond the vocal cords: "zone 3." Clockwise rotation of the tube was the most common successful corrective maneuver in zone 3. The overall tracheal intubation success rate was 98% (CI, 95%-99%); however, the first attempt success rate was only 80% (CI, 74%-86%). Patients with technical difficulty had more attempts (median [interquartile range], 2 [1

  20. Difficulties implementing a mental health guideline: an exploratory investigation using psychological theory

    Directory of Open Access Journals (Sweden)

    Eccles Martin P

    2007-03-01

    Full Text Available Abstract Background Evaluations of interventions to improve implementation of guidelines have failed to produce a clear pattern of results favouring a particular method. While implementation depends on clinicians and managers changing a variety of behaviours, psychological theories of behaviour and behaviour change are seldom used to try to understand difficulties in implementation or to develop interventions to overcome them. Objectives This study applied psychological theory to examine explanations for difficulties in implementation. It used a theoretical framework derived from an interdisciplinary consensus exercise to code interviews across 11 theoretical domains. The focus of the study was a National Institute for Health and Clinical Excellence's Schizophrenia guideline recommendation that family intervention should be offered to the families of people with schizophrenia. Methods Participants were recruited from community mental health teams from three United Kingdom National Health Service (NHS Trusts; 20 members (social workers, nurses, team managers, psychologists, and psychiatrists participated. Semi-structured interviews were audio-taped and transcribed. Interview questions were based on the theoretical domains and addressed respondents' knowledge, attitudes and opinions regarding the guideline. Two researchers independently coded the transcript segments from each interview that were related to each theoretical domain. A score of 1 indicated that the transcript segments relating to the domain did not appear to contain description of difficulties in implementation of the family therapy guidelines; similarly a score of 0.5 indicated possible difficulties and a score of 0 indicated definite difficulties. Results Coding respondents' answers to questions related to the three domains 'beliefs about consequences,' 'social/professional role and identity,' and 'motivation' produced the three highest total scores indicating that factors relating

  1. How general practitioners perceive and assess self-care in patients with multiple chronic conditions

    DEFF Research Database (Denmark)

    Kristensen, Mads Aage Toft; Hølge-Hazelton, Bibi; Waldorff, Frans Boch

    2017-01-01

    in Denmark require GPs and other health care workers to assess and support patients' self-care ability. The aim of the present study was to explore GPs' perceptions and assessment of self-care ability in patients with multiple chronic conditions who have difficulty following a given treatment. METHODS...... text condensation. RESULTS: Most GPs in our study had a health-related perception of self-care, but some had a broader perception encompassing the situational context of the patient's life. The GPs' assessments of patients' self-care ability were based on information from the ongoing and often long...... and do not consider whether a relationship with the patient is established. If GPs' perceptions and assessments of self-care ability are not included in chronic disease management models, there is a risk that they vill be insufficiently implemented in general practice....

  2. Coordination difficulties and self-esteem: a review and findings from a New Zealand survey.

    Science.gov (United States)

    Eggleston, Matthew; Hanger, Nicola; Frampton, Christopher; Watkins, William

    2012-12-01

    Children and adolescents with significant coordination difficulties have consistently been found to have lower self-esteem in relation to athletic competence and physical ability. However, findings in relation to global self-esteem have been mixed. This study aimed to investigate the self-esteem of children and adolescents with a diagnosis of dyspraxia in a large New Zealand sample. A confidential postal questionnaire was sent to all members of the Dyspraxia Support Group of New Zealand. Children and adolescents aged seven to 18 years with a diagnosis of dyspraxia were asked to complete the Piers-Harris Children's Self-Concept Scale 2nd edition (PHCSCS-2), while parents were asked about a range of factors which might affect self-esteem including possible coexisting conditions. There was a response rate of 20% with 75 valid responses. Coexisting conditions were common including 50.7% with a diagnosis of dyslexia or another learning disorder. Children and adolescents with dyspraxia scored significantly lower than PHCSCS-2 norms on the physical appearance and attributes, intellectual and school status and popularity subscales and also the PHCSCS-2 total score, indicating lower global self-esteem. This study strengthens the evidence that an association exists in children and adolescents between having significant coordination difficulties and lower global self-esteem. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

  3. 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.

  4. ACCOUNTABILITY INFLUENCE, TECHNICAL DIFFICULTY AND MEASUREMENT DIFFICULTY TOWARDS THE IMPLEMENTATION OF INDONESIAN STANDARD STATEMENT OF FINANCIAL ACCOUNTING (PSAK) NO. 27 (REVISED 1998) ABOUT COOPERATIVES ACCOUNTING IN EAST JAVA

    OpenAIRE

    ., Sutarto; ., Isnalita; ., Habiburrochman

    2008-01-01

    Financial report is a tool for business entity to deliver information to stakeholders. Thedifference of user’s interests causes that the financial report needs to be audited by theindependent auditor, to make sure fairness and conform with accounting standard. Thecooperatives managers must conduct the rule stated in accounting standard. Thus, thatthe Accountability, Technical Difficulty, Measurement Difficulty are the basic to realizethe implementation of cooperative accounting standard. The ...

  5. Accountability Influence, Technical Difficulty and Measurement Difficulty Towards the Implementation of Indonesian Standard Statement of Financial Accounting (PSAK) No. 27 (Revised 1998) About Cooperatives Accounting in East Java

    OpenAIRE

    Habiburrahman, Sutarto Isnalita

    2008-01-01

    Financial report is a tool for business entity to deliver information to stakeholders. Thedifference of user's interests causes that the financial report needs to be audited by theindependent auditor, to make sure fairness and conform with accounting standard. Thecooperatives managers must conduct the rule stated in accounting standard. Thus, thatthe Accountability, Technical Difficulty, Measurement Difficulty are the basic to realizethe implementation of cooperative accounting standard. The...

  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. Difficulties of diabetic patients in the illness control: feelings and behaviors

    OpenAIRE

    Péres, Denise Siqueira; Santos, Manoel Antônio dos; Zanetti, Maria Lúcia; Ferronato, Antônio Augusto

    2007-01-01

    This study aimed to identify difficulties diabetic patients face during treatment in controlling the disease. A total of 24 diabetic patients, attended in the Nurse Educational Center for Adults and Elders in 2003, participated in the study. The data was collected individually, through a written report guided by a question previously elaborated, on a pre-scheduled date. The Content Analysis technique was used in the data analysis. The results showed several difficulties related to the treatme...

  8. Using the Nudge and Shove Methods to Adjust Item Difficulty Values.

    Science.gov (United States)

    Royal, Kenneth D

    2015-01-01

    In any examination, it is important that a sufficient mix of items with varying degrees of difficulty be present to produce desirable psychometric properties and increase instructors' ability to make appropriate and accurate inferences about what a student knows and/or can do. The purpose of this "teaching tip" is to demonstrate how examination items can be affected by the quality of distractors, and to present a simple method for adjusting items to meet difficulty specifications.

  9. Aggression in children with behavioural/emotional difficulties: seeing aggression on television and video games.

    Science.gov (United States)

    Mitrofan, Oana; Paul, Moli; Weich, Scott; Spencer, Nicholas

    2014-11-18

    Mental health professionals are often asked to give advice about managing children's aggression. Good quality evidence on contributory environmental factors such as seeing aggression on television and in video games is relatively lacking, although societal and professional concerns are high. This study investigated possible associations between seeing aggression in such media and the aggressive behaviour of children attending specialist outpatient child and adolescent mental health services (CAMHS). In this mixed methods study, forty-seven British children aged 7-11 years with behavioural/emotional difficulties attending CAMHS and their carers participated in a survey; twenty purposively-selected children and a parent/carer of theirs participated in a qualitative study, involving semi-structured interviews, analysed using the Framework Analysis Approach; findings were integrated. Children attending CAMHS exhibit clinically significant aggression, of varying types and frequency. They see aggression in multiple real and virtual settings. Verbal aggression was often seen, frequently exhibited and strongly associated with poor peer relationships and low prosocial behaviour. Children did not think seeing aggression influences their own behaviour but believed it influences others. Carers regarded aggression as resulting from a combination of inner and environmental factors and seeing aggression in real-life as having more impact than television/video games. There is yet no definitive evidence for or against a direct relationship between aggression seen in the media and aggression in children with behavioural/emotional difficulties. Future research should take an ecological perspective, investigating individual, developmental and environmental factors. Carers, professional organisations and policy makers should address aggression seen in all relevant area of children's lives, primarily real-life and secondly virtual environments.

  10. 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…

  11. Brain Interaction during Cooperation: Evaluating Local Properties of Multiple-Brain Network.

    Science.gov (United States)

    Sciaraffa, Nicolina; Borghini, Gianluca; Aricò, Pietro; Di Flumeri, Gianluca; Colosimo, Alfredo; Bezerianos, Anastasios; Thakor, Nitish V; Babiloni, Fabio

    2017-07-21

    Subjects' interaction is the core of most human activities. This is the reason why a lack of coordination is often the cause of missing goals, more than individual failure. While there are different subjective and objective measures to assess the level of mental effort required by subjects while facing a situation that is getting harder, that is, mental workload, to define an objective measure based on how and if team members are interacting is not so straightforward. In this study, behavioral, subjective and synchronized electroencephalographic data were collected from couples involved in a cooperative task to describe the relationship between task difficulty and team coordination, in the sense of interaction aimed at cooperatively performing the assignment. Multiple-brain connectivity analysis provided information about the whole interacting system. The results showed that averaged local properties of a brain network were affected by task difficulty. In particular, strength changed significantly with task difficulty and clustering coefficients strongly correlated with the workload itself. In particular, a higher workload corresponded to lower clustering values over the central and parietal brain areas. Such results has been interpreted as less efficient organization of the network when the subjects' activities, due to high workload tendencies, were less coordinated.

  12. 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.

  13. Alcohol and Difficulty Conceiving in the SUN Cohort: A Nested Case-Control Study.

    Science.gov (United States)

    Lopez-del Burgo, Cristina; Gea, Alfredo; de Irala, Jokin; Martínez-González, Miguel A; Chavarro, Jorge E; Toledo, Estefania

    2015-07-27

    The role of alcohol on fertility remains unclear. We aimed to investigate the association between alcohol and specific alcoholic beverages consumption and the risk of difficulty getting pregnant. We used a case-control study nested within the Seguimiento Universidad de Navarra (SUN) cohort, a prospective, dynamic and multipurpose cohort of 21,705 Spanish university graduates, followed biennially with mailed questionnaires. We identified 686 case-control pairs, matched for age and time in the cohort. Cases were women reporting difficulty getting pregnant. Controls did not consult due to difficulty conceiving and had at least one child during follow-up. After adjustment for potential confounders, we found no association between self-reported difficulty getting pregnant and the number of alcoholic beverages consumed per week, (Odds Ratio [OR] > 5 drinks/week vs. none = 1.04, 95% Confidence Interval [CI] = 0.72-1.51). No association between types of alcoholic beverage and difficulty conceiving (OR > 5 drinks of wine/week vs. none = 1.16, 95% CI = 0.72-1.88; OR > 5 drinks of beer/week vs. none = 1.06, 95% CI = 0.82-1.37; OR > 5 drinks of spirits/week vs. none = 1.24, 95% CI = 0.84-1.64) was observed. In conclusion, we found no association between alcohol intake and risk of consulting a physician due to difficulty conceiving. More studies are needed to clearly elucidate the effects of alcohol intake on women's fertility. In the meantime, recommendations about alcohol intake to couples trying to conceive have to be given cautiously.

  14. Alcohol and Difficulty Conceiving in the SUN Cohort: A Nested Case-Control Study

    Directory of Open Access Journals (Sweden)

    Cristina Lopez-del Burgo

    2015-07-01

    Full Text Available The role of alcohol on fertility remains unclear. We aimed to investigate the association between alcohol and specific alcoholic beverages consumption and the risk of difficulty getting pregnant. We used a case-control study nested within the Seguimiento Universidad de Navarra (SUN cohort, a prospective, dynamic and multipurpose cohort of 21,705 Spanish university graduates, followed biennially with mailed questionnaires. We identified 686 case-control pairs, matched for age and time in the cohort. Cases were women reporting difficulty getting pregnant. Controls did not consult due to difficulty conceiving and had at least one child during follow-up. After adjustment for potential confounders, we found no association between self-reported difficulty getting pregnant and the number of alcoholic beverages consumed per week, (Odds Ratio [OR] > 5 drinks/week vs. none = 1.04, 95% Confidence Interval [CI] = 0.72–1.51. No association between types of alcoholic beverage and difficulty conceiving (OR > 5 drinks of wine/week vs. none = 1.16, 95% CI = 0.72–1.88; OR > 5 drinks of beer/week vs. none = 1.06, 95% CI = 0.82–1.37; OR > 5 drinks of spirits/week vs. none = 1.24, 95% CI = 0.84–1.64 was observed. In conclusion, we found no association between alcohol intake and risk of consulting a physician due to difficulty conceiving. More studies are needed to clearly elucidate the effects of alcohol intake on women’s fertility. In the meantime, recommendations about alcohol intake to couples trying to conceive have to be given cautiously.

  15. Are externalizing and internalizing difficulties of young children with spelling impairment related to their ADHD symptoms?

    Science.gov (United States)

    Rietz, Chantal Sabrina; Hasselhorn, Marcus; Labuhn, Andju Sara

    2012-08-01

    Children with literacy difficulties often suffer from a variety of co-occurring externalizing and internalizing difficulties, as well as comorbid ADHD. Therefore, these externalizing and internalizing problems might be more related to comorbid ADHD, rather than being a correlate of literacy difficulties per se. In the present study, we investigated the occurrence of externalizing and internalizing difficulties in elementary school children (third grade) with and without spelling impairment. Taking the high rate of comorbidity between literacy difficulties and ADHD into account, we investigated whether co-occurring difficulties are associated with spelling impairment per se or with comorbid ADHD symptoms. Results indicated that these young children with spelling impairment showed more co-occurring difficulties compared with children without spelling impairment. Hierarchical regression analysis indicated that occurrence of externalizing symptoms is more strongly related to comorbid ADHD symptoms than to spelling impairment per se. The pattern of results concerning internalizing problems was not as distinct but showed a similar trend. Preferably, carers and educators should be aware of co-occurring socio-emotional and behavioural problems in children with spelling impairment. Particularly children with spelling impairment and comorbid ADHD symptoms seem to have an increased risk of encountering further co-occurring difficulties. Copyright © 2012 John Wiley & Sons, Ltd.

  16. 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 ...

  17. Utilizing the Zero-One Linear Programming Constraints to Draw Multiple Sets of Matched Samples from a Non-Treatment Population as Control Groups for the Quasi-Experimental Design

    Science.gov (United States)

    Li, Yuan H.; Yang, Yu N.; Tompkins, Leroy J.; Modarresi, Shahpar

    2005-01-01

    The statistical technique, "Zero-One Linear Programming," that has successfully been used to create multiple tests with similar characteristics (e.g., item difficulties, test information and test specifications) in the area of educational measurement, was deemed to be a suitable method for creating multiple sets of matched samples to be…

  18. The Role of Materialism on Social, Emotional and Behavioural Difficulties for British Adolescents

    Science.gov (United States)

    Maras, Pam; Moon, Amy; Gupta, Taveeshi; Gridley, Nicole

    2015-01-01

    The relationship between materialism and social-emotional behavioural difficulties (SEBDs) was assessed by comparing a sample of adolescents receiving in-school behavioural support with adolescents not receiving any support. All participants completed the Youth Materialism Scale and the Strengths and Difficulties Questionnaire. Binary logistic…

  19. Psychological difficulties among children and adolescents with ethnic Danish, immigrant or refugee background

    DEFF Research Database (Denmark)

    Leth, Ingrid; Niclasen, Janni; Ryding, Else

    2014-01-01

    Objective: This study investigated and compared the prevalence of psychological difficulties among Danish, immigrant, and refugee children. Methods: We enrolled 332 children between the ages of 8 and 18 years (148 Danish children, 81 immigrant children, and 67 children with refugee backgrounds....... No significant differences with regard to age or gender were found among the groups. Conclusions: Our data suggest that, although immigrant children had higher levels of conduct problems than ethnic Danish children, they did not suffer from higher levels of internalizing psychological difficulties. However......, refugee children were at higher risk for psychological difficulties associated with both externalizing and internalizing....

  20. DIFFICULTIES ENCOUNTERED IN ISO 9001:2008 IMPLEMENTATION PROJECTS IN INCUBATED TECHNOLOGY-BASED COMPANIES

    Directory of Open Access Journals (Sweden)

    Eduardo Gome Salgado

    2014-09-01

    Full Text Available Quality Management Systems (QMS are designed to continuously improve the performance of organizations aiming to constantly improve their services seeking to overcome their results. Thus, for the services and/or products offered to transmit confidence and credibility, they should be designed within appropriate norms and standards. This research aims to assess the difficulties encountered by the incubated companies participating in the PRIME-FINEP project and developing projects for certification of their QMS in accordance with ISO 9001:2008. An exploratory survey was performed in nine incubated technology-based companies (TBC, through a questionnaire with 21 questions totaling the opinion of 20 respondents. After analyzing the data it is concluded, with statistical meaning, that the TBC's with little incubation time present difficulties in implementing the quality policy (5.3, difficulty not identified in other studies conducted in large companies. However difficulties similar to those of the large companies are present in the incubated TBC, and are the following: documentation requirements (4.2 present in all incubated companies (regardless of incubation time, and design and development (7.3 present in companies with little incubation time. The difficulty in implementing the quality policy (5.3 is reflected in the achievement of the QMS certification project in accordance with ISO 9001:2008.