Preliminary Results of the Louisiana Sex Offender Treatment Program

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Lee A. Underwood

2015-12-01

Full Text Available The purpose of this study was to offer preliminary support for the Louisiana Sex Offender Treatment Program (LSOTP in addressing the needs of juvenile sex offenders. Research objectives were (1 to offer statistical evidence for reductions in anxiety, depression, cognitive distortion and negative attitudes towards women comparing a group of 21 adolescents, 12 of whom received services as usual and nine of whom participated in the LSOTP. A controlled experimental evaluation design was utilized. The juvenile sex offenders were randomly assigned to the experimental group for 12 weeks receiving treatment services and a control group receiving care “as usual” in a residential group care program. Participants in the experimental group experienced statistically significant decreases in cognitive distortions related specifically to rape and molestation.The results of this study offer preliminary support of the LSOTP as a best practices alternative to other treatment modalities.

Causal role for inverse reasoning on obsessive-compulsive symptoms: Preliminary evidence from a cognitive bias modification for interpretation bias study.

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Wong, Shiu F; Grisham, Jessica R

2017-12-01

The inference-based approach (IBA) is a cognitive account of the genesis and maintenance of obsessive-compulsive disorder (OCD). According to the IBA, individuals with OCD are prone to using inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Several studies have provided preliminary support for an association between features of the IBA and OCD symptoms. However, there are currently no studies that have investigated the proposed causal relationship of inverse reasoning in OCD. In a non-clinical sample (N = 187), we used an interpretive cognitive bias procedure to train a bias towards using inverse reasoning (n = 64), healthy sensory-based reasoning (n = 65), or a control condition (n = 58). Participants were randomly allocated to these training conditions. This manipulation allowed us to assess whether, consistent with the IBA, inverse reasoning training increased compulsive-like behaviours and self-reported OCD symptoms. Results indicated that compared to a control condition, participants trained in inverse reasoning reported more OCD symptoms and were more avoidant of potentially contaminated objects. Moreover, change in inverse reasoning bias was a small but significant mediator of the relationship between training condition and behavioural avoidance. Conversely, training in a healthy (non-inverse) reasoning style did not have any effect on symptoms or behaviour relative to the control condition. As this study was conducted in a non-clinical sample, we were unable to generalise our findings to a clinical population. Findings generally support the IBA model by providing preliminary evidence of a causal role for inverse reasoning in OCD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Social support and nocturnal blood pressure dipping: a systematic review.

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Fortmann, Addie L; Gallo, Linda C

2013-03-01

Attenuated nocturnal blood pressure (BP) dipping is a better predictor of cardiovascular disease (CVD) morbidity and mortality than resting BP measurements. Studies have reported associations between social support, variously defined, and BP dipping. A systematic review of the literature was conducted to investigate associations of functional and structural social support with nocturnal BP dipping assessed over a minimum of 24 hours. A total of 297 articles were identified. Of these, 11 met criteria for inclusion; all studies were cross-sectional in design and included adult participants only (mean age = 19 to 72 years). Evidence was most consistent for an association between functional support and BP dipping, such that 5 of 7 studies reported statistically (or marginally) significant positive associations with BP dipping. Statistically significant functional support-BP dipping associations were moderate (standardized effect size (d) = 0.41) to large (d = 2.01) in magnitude. Studies examining structural support were fewer and relatively less consistent; however, preliminary evidence was observed for associations of marital status and social contact frequency with BP dipping. Statistically significant structural support findings were medium (d = 0.53) to large (d = 1.13) in magnitude. Overall, findings suggest a link between higher levels of functional support and greater nocturnal BP dipping; preliminary evidence was also observed for the protective effects of marriage and social contact frequency. Nonetheless, the relatively small number of studies conducted to date and the heterogeneity of findings across meaningful subgroups suggest that additional research is needed to substantiate these conclusions.

Scientific Evidence on the Supportive Cancer Care with Chinese Medicine

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William CS CHO

2010-03-01

Full Text Available Complementary and alternative medicine has been increasingly utilized by cancer patients in developed countries. Among the various forms of complementary and alternative medicine, Traditional Chinese Medicine is one of the few that has a well constructed theoretical framework and established treatment approaches for diseases including cancer. Recent research has revealed growing evidence suggesting that Traditional Chinese Medicine is effective in the supportive care of cancer patients during and after major conventional cancer treatments. This paper succinctly summarizes some published clinical evidence and meta-analyses which support the usage of various Traditional Chinese Medicine treatment strategies including Chinese herbal medicine, acupuncture and Qigong in supportive cancer care.

Preliminary Lessons about Supporting Participation and Learning in Inclusive Classrooms

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Morningstar, Mary E.; Shogren, Karrie A.; Lee, Hyunjoo; Born, Kiara

2015-01-01

This descriptive study examined observational data collected in inclusive classrooms from six schools that were operating schoolwide inclusive policies and practices. Illustrative evidence of classroom practices supporting learning and participation of all students, including students with significant disabilities, adds to an understanding of…

Proposal of a Holistic Model to Support Local-Level Evidence-Based Practice

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Said Shahtahmasebi

2010-01-01

Full Text Available In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com.

Preliminary Results of the Louisiana Sex Offender Treatment Program

OpenAIRE

Lee A. Underwood; Frances L.L. Dailey; Carrie Merino; Yolanda Crump

2015-01-01

The purpose of this study was to offer preliminary support for the Louisiana Sex Offender Treatment Program (LSOTP) in addressing the needs of juvenile sex offenders. Research objectives were (1) to offer statistical evidence for reductions in anxiety, depression, cognitive distortion and negative attitudes towards women comparing a group of 21 adolescents, 12 of whom received services as usual and nine of whom participated in the LSOTP. A controlled experimental evaluation design was utilize...

Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

Science.gov (United States)

Snyder, Patricia A.; Hemmeter, Mary Louise; Fox, Lise

2015-01-01

In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

Preliminary Evidence for Cognitive Mediation During Cognitive–Behavioral Therapy of Panic Disorder

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Hofmann, Stefan G.; Suvak, Michael K.; Barlow, David H.; Shear, M. Katherine; Meuret, Alicia E.; Rosenfield, David; Gorman, Jack M.; Woods, Scott W.

2007-01-01

Cognitive–behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus imipramine, and CBT plus placebo. Ninety-one individuals who received 1 of these interventions were assessed before and after acute treatment, and after a 6-month maintenance period. Multilevel moderated mediation analyses provided preliminary support for the notion that changes in panic-related cognitions mediate changes in panic severity only in treatments that include CBT. PMID:17563154

When Is Statistical Evidence Superior to Anecdotal Evidence in Supporting Probability Claims? The Role of Argument Type

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Hoeken, Hans; Hustinx, Lettica

2009-01-01

Under certain conditions, statistical evidence is more persuasive than anecdotal evidence in supporting a claim about the probability that a certain event will occur. In three experiments, it is shown that the type of argument is an important condition in this respect. If the evidence is part of an argument by generalization, statistical evidence…

What is driving rates of social policy preliminary references to the CJEU? Evidence from the United Kingdom and France

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Sigafoos, Jennifer

2013-01-01

Preliminary references to the Court of Justice for the European Union are unevenly distributed across the EU, creating differing access to justice for European citizens. This study presents case studies of the UK and France, exploring factors affecting rates of social policy preliminary references from 1996–2009. The UK had a rate twice that of France. What accounts for this difference? Analysis of documentary evidence and 25 expert interviews help to explain the differing rates. Themes were related to policy, structural factors and the agency of actors. In the UK, policy themes are the free movement of persons and the ‘Right to Reside’ test. Legal aid and legal NGOs help individuals access the Court and drive test case strategies. In France, a high degree of dualisation in the welfare state creates an insider/outsider dynamic. Coupled with the resistance of courts and a lack of comparable actors to drive preliminary references, this contributes to a lower rate of references. PMID:23565042

Evidence-informed health policy 2 - survey of organizations that support the use of research evidence.

Science.gov (United States)

Lavis, John N; Paulsen, Elizabeth J; Oxman, Andrew D; Moynihan, Ray

2008-12-17

Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs) or undertake health technology assessments (HTAs). Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs) that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs). We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE) collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone. We received completed questionnaires from 152 (86%) organizations. More than one-half of the organizations (and particularly HTA agencies) reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer) full-time equivalent (FTE) staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations do not collect data systematically about

Are advertisements in dental journals supported by an appropriate evidence-base?

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Chestnutt, Ivor G; Hardy, Robert

2013-09-01

Dental professionals are constantly exposed to advertisements in the dental literature. These promote products, either for use in the operatory or to recommend to patients. In an era of evidence-based practice, what references are provided to support claims made by the advertisers? This study aimed to determine if advertisements in four major dental journals, whose target audience is general dental practitioners, were supported by an appropriate evidence-base, readily accessible to readers. The 2010 printed volumes of the Australian Dental Journal, British Dental Journal, Dental Update and the Journal of the American Dental Association were hand searched to identify advertisements which made a claim of clinical benefit or superiority to competing products. Advertisements were categorized according to type of product being promoted and the availability, nature and number of any supporting references was recorded. Repeated advertisements were analyzed only once. A total of 390 advertisements were identified and 369 made a claim of benefit or superiority. When the 222 duplicates of the same advertisement were removed, 147 unique advertisements remained. Of these: 54 (37%) were advertisements related to dental devices for in-surgery use; 44 (30%) for dental materials, and 27 (18%) for dentifrices/medicaments. 113 (76.9%) advertisements offered no evidential support for claims made. Of the 34 advertisements that provided evidential support, only 20 provided a complete reference that could readily be sourced by an interested reader: 15 articles in refereed journals; 5 data on file; 3 in-house studies and combinations thereof. Four references were not accessible due to incomplete referencing. Two advertisements provided evidence that was not relevant to the product being advertised. The majority of advertisements in the dental literature do not provide an adequate evidence-base, readily available to readers, to support the claims being made. If evidence-based practice is

Size, Diversification and Risk: Preliminary Evidence from Commercial Banks in Pakistan

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Ayesha Afzal

2012-12-01

Full Text Available The aim of this paper is to provide some preliminary evidence on relation between size, diversification and risk in commercial banks of Pakistan. Using a panel of Pakistani banks, we investigated whether bigger banks are better diversified than smaller banks.The results suggested that larger banks were more diversified than their smaller counterparts mainly on account of their outreach and size of credit portfolio. On the risk side, based on accounting and market based risk measures, we explored if there is any impact of diversification on risk. We could not deduce significant result in favor of accounting risk measure of impaired lending signaling that banks find no incentive in diversification of credit books. The market based measures of VaR and Default indicator were significantly related to diversification signifying that market participants consider diversification as a relevant tool for risk mitigation. These findings have policy implications for regulators and risk management to ensure stability in financial system.

Organizational Supports for Research Evidence Use in State Public Health Agencies: A Latent Class Analysis.

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Hu, Hengrui; Allen, Peg; Yan, Yan; Reis, Rodrigo S; Jacob, Rebekah R; Brownson, Ross C

2018-05-30

Use of research evidence in public health decision making can be affected by organizational supports. Study objectives are to identify patterns of organizational supports and explore associations with research evidence use for job tasks among public health practitioners. In this longitudinal study, we used latent class analysis to identify organizational support patterns, followed by mixed logistic regression analysis to quantify associations with research evidence use. The setting included 12 state public health department chronic disease prevention units and their external partnering organizations involved in chronic disease prevention. Chronic disease prevention staff from 12 US state public health departments and partnering organizations completed self-report surveys at 2 time points, in 2014 and 2016 (N = 872). Latent class analysis was employed to identify subgroups of survey participants with distinct patterns of perceived organizational supports. Two classify-analyze approaches (maximum probability assignment and multiple pseudo-class draws) were used in 2017 to investigate the association between latent class membership and research evidence use. The optimal model identified 4 latent classes, labeled as "unsupportive workplace," "low agency leadership support," "high agency leadership support," and "supportive workplace." With maximum probability assignment, participants in "high agency leadership support" (odds ratio = 2.08; 95% CI, 1.35-3.23) and "supportive workplace" (odds ratio = 1.74; 95% CI, 1.10-2.74) were more likely to use research evidence in job tasks than "unsupportive workplace." The multiple pseudo-class draws produced comparable results with odds ratio = 2.09 (95% CI, 1.31-3.30) for "high agency leadership support" and odds ratio = 1.74 (95% CI, 1.07-2.82) for "supportive workplace." Findings suggest that leadership support may be a crucial element of organizational supports to encourage research evidence use. Organizational supports such

Are claims made in orthodontic journal advertisements evidence-supported?

NARCIS (Netherlands)

Livas, Christos; Kouskoura, Thaleia; Ren, Yijin; Katsaros, Christos; Pandis, Nikolaos

Objective: To examine the supporting evidence of advertisements published in six leading orthodontic journals. Materials and Methods: The 2012-2013 printed issues of American Journal of Orthodontics and Dentofacial Orthopedics, Australian Orthodontic Journal, Journal of Orthodontics, European

Evidence-informed health policy 2 – Survey of organizations that support the use of research evidence

Directory of Open Access Journals (Sweden)

Oxman Andrew D

2008-12-01

Full Text Available Abstract Background Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs or undertake health technology assessments (HTAs. Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs. Methods We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone. Results We received completed questionnaires from 152 (86% organizations. More than one-half of the organizations (and particularly HTA agencies reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer full-time equivalent (FTE staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations

What evidence and support do state-level public health practitioners need to address obesity prevention.

Science.gov (United States)

Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

2014-01-01

Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

ADDIS: A decision support system for evidence-based medicine

NARCIS (Netherlands)

G. van Valkenhoef (Gert); T. Tervonen (Tommi); T. Zwinkels (Tijs); B. de Brock (Bert); H.L. Hillege (Hans)

2013-01-01

textabstractClinical trials are the main source of information for the efficacy and safety evaluation of medical treatments. Although they are of pivotal importance in evidence-based medicine, there is a lack of usable information systems providing data-analysis and decision support capabilities for

The Portuguese formal social support for autonomy and dependence in pain inventory (FSSADI_PAIN): a preliminary validation study.

Science.gov (United States)

Matos, Marta; Bernardes, Sónia F

2013-09-01

Development and preliminary validation of a Portuguese measure of perceived Formal Social Support for Autonomy and Dependence in Pain (FSSADI_PAIN). One hundred and fifty-one older adults (88.1% women), between 56 and 94 years of age (M = 75.41; SD = 9.11), who attended one of the following institutions--day care centre (33.1%), nursing home (36.4%) and senior university (30.5%)--were recruited for this study. Along with the FSSADI_PAIN, participants filled out the Portuguese versions of the Brief Pain Inventory (Azevedo et al., 2007, Dor, 15, 6) and the Social Support Scale of Medical Outcomes Survey (Pais-Ribeiro & Ponte, 2009, Psicologia, Saúde & Doença, 10, 163). The factorial structure reflected the functions of perceived promotion of (1) dependence and (2) autonomy, showing good internal consistency (α > .70) and sensitivity indices. The FSSADI_PAIN showed good content, discriminant and criterion validity; it differentiated the perceptions of promotion of dependence/autonomy according to individual's pain severity and disability, as well as the type of institution. These preliminary findings suggest that the FSSADI_PAIN is an innovative and promising measure of perceived formal social support adapted to pain-related contexts. © 2012 The British Psychological Society.

Development and preliminary validation of the physician support of skin self-examination scale.

Science.gov (United States)

Coroiu, Adina; Moran, Chelsea; Garland, Rosalind; Körner, Annett

2018-05-01

Skin self-examination (SSE) is a crucial preventive health behaviour in melanoma survivors, as it facilitates early detection. Physician endorsement of SSE is important for the initiation and maintenance of this behaviour. This study focussed on the preliminary validation of a new nine-item measure assessing physician support of SSE in melanoma patients. English and French versions of this measure were administered to 188 patients diagnosed with melanoma in the context of a longitudinal study investigating predictors and facilitators of SSE. Structural validity was investigated using exploratory factor analysis conducted in Mplus and convergent and divergent validity was assessed using bivariate correlations conducted in spss. Results suggest that the scale is a unidimensional and reliable measure of physician support for SSE. Given the uncertainty regarding the optimal frequency of SSE for at-risk individuals, we recommend that future psychometric evaluations of this scale consider tailoring items according to the most up-to-date research on SSE effectiveness.

Preliminary assessment report for Virginia Army National Guard Army Aviation Support Facility, Richmond International Airport, Installation 51230, Sandston, Virginia

International Nuclear Information System (INIS)

Dennis, C.B.

1993-09-01

This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Virginia Army National Guard (VaARNG) property in Sandston, Virginia. The Army Aviation Support Facility (AASF) is contiguous with the Richmond International Airport. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The PA is designed to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. The AASF, originally constructed as an active Air Force interceptor base, provides maintenance support for VaARNG aircraft. Hazardous materials used and stored at the facility include JP-4 jet fuel, diesel fuel, gasoline, liquid propane gas, heating oil, and motor oil

Preliminary structural evaluations of the STAR-LM reactor vessel and the support design

International Nuclear Information System (INIS)

Koo, Gyeong-Hoi; Sienicki, James J.; Moisseytsev, Anton

2007-01-01

In this paper, preliminary structural evaluations of the reactor vessel and support design of the STAR-LM (The Secure, Transportable, Autonomous Reactor - Liquid Metal variant), which is a lead-cooled reactor, are carried out with respect to an elevated temperature design and seismic design. For an elevated temperature design, the structural integrity of a direct coolant contact to the reactor vessel is investigated by using a detail structural analysis and the ASME-NH code rules. From the results of the structural analyses and the integrity evaluations, it was found that the design concept of a direct coolant contact to the reactor vessel cannot satisfy the ASME-NH rules for a given design condition. Therefore, a design modification with regards to the thermal barrier is introduced in the STAR-LM design. For a seismic design, detailed seismic time history response analyses for a reactor vessel with a consideration of a fluid-structure interaction are carried out for both a top support type and a bottom support type. And from the results of the hydrodynamic pressure responses, an investigation of the minimum thickness design of the reactor vessel is tentatively carried out by using the ASME design rules

NICU nurse educators: what evidence supports your teaching strategies?

Science.gov (United States)

Pilcher, Jobeth

2013-01-01

One of our roles as nurse educators is to teach best practices related to patient care. However, have you ever stopped to think about what evidence supports your teaching strategies? Just as our patients deserve care that is based on the best available evidence, our learners also deserve education that is based on evidence.1-3 With so many advances in knowledge, technology, and even life itself, it is interesting that education has changed very little over the past 100 years. A study among 946 nurse educators documented that most teach the way they were taught.4 In addition, even after learning new strategies, educators often continue teaching in the manner they are most comfortable. However, this trend is beginning to change. Nurse educators are becoming increasingly aware of and willing to try new and innovative teaching strategies. Educators are also seeking out evidence-based teaching strategies and are becoming more involved in nursing education research.

Comparison between two different modes of non-invasive ventilatory support in preterm newborn infants with respiratory distress syndrome mild to moderate: preliminary data.

Science.gov (United States)

Ciuffini, F; Pietrasanta, C; Lavizzari, A; Musumeci, S; Gualdi, C; Sortino, S; Colnaghi, M; Mosca, F

2014-08-31

Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV) is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP) is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC) is emerging as a better tolerated form of NIV, allowing better access to the baby's face, which may improve nursing, feeding and bonding. HFNC may be effective in the treatment of some neonatal respiratory conditions while being more user-friendly for care-givers than conventional NCPAP. Limited evidence is available to support the specific role, efficacy and safety of HFNC in newborns and to demonstrate efficacy compared with NCPAP; some studies suggest a potential role for HFNC in respiratory care of the neonate as a distinct non invasive ventilatory support. We present the preliminary data of a randomized clinical trial; the aim of this study was to assess efficacy and safety of HFNC compared to NCPAP in preterm newborns with mild to moderate respiratory distress syndrome (RDS).

Comparison between two different modes of non-invasive ventilatory support in preterm newborn infants with respiratory distress syndrome mild to moderate: preliminary data

Directory of Open Access Journals (Sweden)

F. Ciuffini

2014-08-01

Full Text Available Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC is emerging as a better tolerated form of NIV, allowing better access to the baby’s face, which may improve nursing, feeding and bonding. HFNC may be effective in the treatment of some neonatal respiratory conditions while being more user-friendly for care-givers than conventional NCPAP. Limited evidence is available to support the specific role, efficacy and safety of HFNC in newborns and to demonstrate efficacy compared with NCPAP; some studies suggest a potential role for HFNC in respiratory care of the neonate as a distinct non invasive ventilatory support. We present the preliminary data of a randomized clinical trial; the aim of this study was to assess efficacy and safety of HFNC compared to NCPAP in preterm newborns with mild to moderate respiratory distress syndrome (RDS.

A Systematic Review of the Economic Evidence for Home Support Interventions in Dementia.

Science.gov (United States)

Clarkson, Paul; Davies, Linda; Jasper, Rowan; Loynes, Niklas; Challis, David

2017-09-01

Recent evidence signals the need for effective forms of home support to people with dementia and their carers. The cost-effectiveness evidence of different approaches to support is scant. To appraise economic evidence on the cost-effectiveness of home support interventions for dementia to inform future evaluation. A systematic literature review of full and partial economic evaluations was performed using the British National Health Service Economic Evaluation Database supplemented by additional references. Study characteristics and findings, including incremental cost-effectiveness ratios, when available, were summarized narratively. Study quality was appraised using the National Health Service Economic Evaluation Database critical appraisal criteria and independent ratings, agreed by two reviewers. Studies were located on a permutation matrix describing their mix of incremental costs/effects to aid decision making. Of the 151 articles retrieved, 14 studies met the inclusion criteria: 8 concerning support to people with dementia and 6 to carers. Five studies were incremental cost-utility analyses, seven were cost-effectiveness analyses, and two were cost consequences analyses. Five studies expressed incremental cost-effectiveness ratios as cost per quality-adjusted life-year (£6,696-£207,942 per quality-adjusted life-year). In four studies, interventions were dominant over usual care. Two interventions were more costly but more beneficial and were favorable against current acceptability thresholds. Occupational therapy, home-based exercise, and a carers' coping intervention emerged as cost-effective approaches for which there was better evidence. These interventions used environmental modifications, behavior management, physical activity, and emotional support as active components. More robust evidence is needed to judge the value of these and other interventions across the dementia care pathway. Copyright © 2017 International Society for Pharmacoeconomics and

Preliminary evidence of hippocampal damage in chronic users of ecstasy.

Science.gov (United States)

den Hollander, Bjørnar; Schouw, Marieke; Groot, Paul; Huisman, Henk; Caan, Matthan; Barkhof, Frederik; Reneman, Liesbeth

2012-01-01

Various studies have shown that ecstasy (3,4-methylenedioxymethamphetamine) users display significant memory impairments, whereas their performance on other cognitive tests is generally normal. The hippocampus plays an essential role in short-term memory. There are, however, no structural human data on the effects of ecstasy on the hippocampus. The objective of this study was to investigate whether the hippocampal volume of chronic ecstasy users is reduced when compared with healthy polydrug-using controls, as an indicator of hippocampal damage. The hippocampus was manually outlined in volumetric MRI scans in 10 male ecstasy users (mean age 25.4 years) and seven healthy age- and gender-matched control subjects (21.3 years). Other than the use of ecstasy, there were no statistically significant differences between both groups in exposure to other drugs of abuse and alcohol. The ecstasy users were on average drug-free for more than 2 months and had used on average 281 tablets over the past six and a half years. The hippocampal volume in the ecstasy using group was on average 10.5% smaller than the hippocampal volume in the control group (p=0.032). These data provide preliminary evidence that ecstasy users may be prone to incurring hippocampal damage, in line with previous reports of acute hippocampal sclerosis and subsequent atrophy in chronic users of this drug.

Assessing Confidence in Performance Assessments Using an Evidence Support Logic Methodology: An Application of Tesla

International Nuclear Information System (INIS)

Egan, M.; Paulley, A.; Lehman, L.; Lowe, J.; Rochette, E.; Baker, St.

2009-01-01

The assessment of uncertainties and their implications is a key requirement when undertaking performance assessment (PA) of radioactive waste facilities. Decisions based on the outcome of such assessments become translated into judgments about confidence in the information they provide. This confidence, in turn, depends on uncertainties in the underlying evidence. Even if there is a large amount of information supporting an assessment, it may be only partially relevant, incomplete or less than completely reliable. In order to develop a measure of confidence in the outcome, sources of uncertainty need to be identified and adequately addressed in the development of the PA, or in any overarching strategic decision-making processes. This paper describes a trial application of the technique of Evidence Support Logic (ESL), which has been designed for application in support of 'high stakes' decisions, where important aspects of system performance are subject to uncertainty. The aims of ESL are to identify the amount of uncertainty or conflict associated with evidence relating to a particular decision, and to guide understanding of how evidence combines to support confidence in judgments. Elicitation techniques are used to enable participants in the process to develop a logical hypothesis model that best represents the relationships between different sources of evidence to the proposition under examination. The aim is to identify key areas of subjectivity and other sources of potential bias in the use of evidence (whether for or against the proposition) to support judgments of confidence. Propagation algorithms are used to investigate the overall implications of the logic according to the strength of the underlying evidence and associated uncertainties. (authors)

Automated respiratory support in newborn infants.

Science.gov (United States)

Claure, Nelson; Bancalari, Eduardo

2009-02-01

A considerable proportion of premature infants requires mechanical ventilatory support and supplemental oxygen. Due to their immaturity, exposure to these forms of respiratory support contributes to the development of lung injury, oxidative stress and abnormal retinal development. These conditions are associated with poor long-term respiratory and neurological outcome. Mechanically ventilated preterm infants present with frequent fluctuations in ventilation and gas exchange. Currently available ventilatory modes and manual adjustment to the ventilator or supplemental oxygen cannot effectively adapt to these recurrent fluctuations. Moreover, the respiratory support often exceeds the infant's real needs. Techniques that adapt the mechanical ventilatory support and supplemental oxygen to the changing needs of preterm infants are being developed in order to improve stability of gas exchange, to minimise respiratory support and to reduce personnel workload. This article describes the preliminary evidence on the application of these new techniques in preterm infants and animal models.

Posterior perineal support as treatment for anal fissures--preliminary results with a new toilet seat device.

Science.gov (United States)

Tan, Kok-Yang; Seow-Choen, Francis; Hai, Chew Heng; Thye, Gan Kok

2009-03-01

Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure exerted by the faeces on the anal wall, thus improving evacuation and reducing the trauma associated with it, and reducing symptoms of anal fissures. Symptoms of constipation may also be reduced secondarily. We report the preliminary results with a novel, simple and noninvasive method of treatment provided by a toilet seat device. A prospective study was performed in 32 patients. The study was designed mainly to investigate the patients' subjective perceptions of their symptoms related to anal fissures and constipation. Questionnaires were provided to patients before, during and after treatment. The study revealed statistically significant improvement in pain, bleeding, symptoms of constipation and abdominal discomfort after 3 months usage of the device. The odds of patients perceiving an improvement in symptoms were also significantly increased after 3 months of treatment compared to 2 weeks of treatment. This preliminary study revealed that a posterior perineal support device can bring about significant improvement in the symptoms of patients with anal fissures. There may also be secondary benefits of a reduction in the symptoms of constipation. Although not conclusive, these results should serve as a springboard for further research into this area.

Preliminary study of the space adaptation of the MELiSSA life support system

Science.gov (United States)

Mas-Albaigès, Joan L.; Duatis, Jordi; Podhajsky, Sandra; Guirado, Víctor; Poughon, Laurent

MELiSSA (Micro-Ecological Life Support System Alternative) is an European Space Agency (ESA) project focused on the development of a closed regenerative life support system to aid the development of technologies for future life support systems for long term manned planetary missions, e.g. a lunar base or missions to Mars. In order to understand the potential evolution of the MELiSSA concept towards its future use in the referred manned planetary mission context the MELiSSA Space Adaptation (MSA) activity has been undertaken. MSA's main objective is to model the different MELiSSA compartments using EcosimPro R , a specialized simulation tool for life support applications, in order to define a preliminary MELiSSA implementation for service in a man-tended lunar base scenario, with a four-member crew rotating in six-month increments, and performing the basic LSS functions of air revitalization, food production, and waste and water recycling. The MELiSSA EcosimPro R Model features a dedicated library for the different MELiSSA elements (bioreactors, greenhouse, crew, interconnecting elements, etc.). It is used to dimension the MELiSSA system in terms of major parameters like mass, volume and energy needs, evaluate the accuracy of the results and define the strategy for a progressive loop closure from the initial required performance (approx.100 The MELiSSA configuration(s) obtained through the EcosimPro R simulation are further analysed using the Advanced Life Support System Evaluation (ALISSE) metric, relying on mass, energy, efficiency, human risk, system reliability and crew time, for trade-off and optimization of results. The outcome of the MSA activity is, thus, a potential Life Support System architecture description, based on combined MELiSSA and other physico-chemical technologies, defining its expected performance, associated operational conditions and logistic needs.

Are claims made in orthodontic journal advertisements evidence-supported?

Science.gov (United States)

Livas, Christos; Kouskoura, Thaleia; Ren, Yijin; Katsaros, Christos; Pandis, Nikolaos

2015-03-01

To examine the supporting evidence of advertisements published in six leading orthodontic journals. The 2012-2013 printed issues of American Journal of Orthodontics and Dentofacial Orthopedics, Australian Orthodontic Journal, Journal of Orthodontics, European Journal of Orthodontics, Journal of Clinical Orthodontics, and Journal of Orofacial Orthopedics were screened for advertisements implying superior performance compared with competitor products. Advertisements were classified according to type of product, availability, and currency of supporting references. A total of 99 unique advertisements claiming clinical benefit or superiority were identified. The overwhelming majority of the identified advertisements promoted appliance products (62.6%), orthodontic materials (14.1%), and dental operatory equipment, including imaging systems (12.1%). Advertisements were found to provide references or not regardless of the product type. Half of the advertisements referred to at least one peer-reviewed publication, whereas unpublished studies were cited by 25% of the advertisements. Most of the referenced articles were published within the past 5 years. The scientific background of advertisements in the orthodontic literature appears limited. While surveillance of journal advertising needs to be regulated, clinicians are urged to critically appraise the claims being made in orthodontic print advertisements by consulting the associated existing evidence.

Is the evidence supporting dental procedures strong? A survey of Cochrane systematic reviews in oral health.

Science.gov (United States)

Faggion, Clovis Mariano

2012-09-01

Every day a large number and variety of dental procedures are performed in clinical dental practice. There is, however, no information on the overall quality of evidence supporting these procedures. The objective of this study was to assess whether several common dental procedures are based on sound evidence. All Cochrane systematic reviews (CSR) published in dentistry were surveyed. The authors' conclusions about the quality of evidence supporting a specific clinical treatment were used as the measure of outcome. The evidence was considered adequate if the authors did not clearly state the evidence was weak in the conclusions while also suggesting some evidence of the effectiveness of the therapy. Of 120 CSRs assessed, in only 26 (22.0% of the reviews) was the quality of evidence regarded as adequate for supporting clinical decisions, although some methodological limitations were identified in the full text of these reviews. Moreover, the authors of most reviews reported weak or unavailable evidence. On the basis of CSRs, the overall quality of evidence can be regarded as low or nonexistent for most of the dental procedures assessed. The information reported may guide future research. Copyright © 2012 Elsevier Inc. All rights reserved.

Evidence-Based Literacy Support: The "Literacy Octopus" Trial. Evaluation Report and Executive Summary

Science.gov (United States)

Lord, Pippa; Rabiasz, Adam; Roy, Palak; Harland, Jennie; Styles, Ben; Fowler, Katherine

2017-01-01

The Evidence-based Literacy Support-"Literacy Octopus" Trial tested a range of dissemination interventions and resources, all of which aimed to engage schools in using evidence-based materials to improve teaching and learning in Key Stage 2 literacy. Four delivery partners provided interventions. These included light-touch,…

Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): protocol and preliminary results

NARCIS (Netherlands)

Treweek, Shaun; Oxman, Andrew D.; Alderson, Philip; Bossuyt, Patrick M.; Brandt, Linn; Brożek, Jan; Davoli, Marina; Flottorp, Signe; Harbour, Robin; Hill, Suzanne; Liberati, Alessandro; Liira, Helena; Schünemann, Holger J.; Rosenbaum, Sarah; Thornton, Judith; Vandvik, Per Olav; Alonso-Coello, Pablo; Hartley, Claire; Loudon, Kirsty; Slater, William; Stewart, Neil; Glenton, Claire; Kristiansen, Annette; Lewin, Simon; Moberg, Jenny; Morelli, Angela; Oxman, Andy; Ødgaard-Jensen, Jan; Martinez-García, Laura; Rigau, David; Solà, Ivan; Sanabria, Andrea Juliana; Amato, Laura; Brunetti, Massimo; Magrini, Nicola; Parmelli, Elena; Nonino, Francesco; de Palma, Rossana; Papini, Donato; Pregno, Silvia; Saitto, Carlo; Gopalakrishna, Gowri; Langendam, Miranda; Leeflang, Mariska; Scholten, Rob; Gülmezoglu, Metin; Permanand, Govin; Weerasuriyak, Krisantha; Antes, Gerd; Meerpohl, Jörg

2013-01-01

Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. GRADE is a systematic approach towards assessing the quality of evidence and the

PUBLIC SUPPORT FOR THE EUROPEAN UNION IN THE CURRENT CONTEXT: PRELIMINARY REMARKS

Directory of Open Access Journals (Sweden)

Iuliana-Lacramioara TINCU

2017-12-01

Full Text Available The European Union appears, in the context of a conceptual and transformational change, in the shape of a fluid structure that is continuously shaped by a wide variety of factors. Under the current redefining process, the present article pursues the amplitude of the social force in the Union’s configuration. The EU can be currently viewed as a reality found at crossroads, due to a growing fragility of public support for integration and the increasing contestation of the EU through the amplification of Eurosceptic attitudes and the rising popularity of the populist-nationalist parties. In the conditions of a populism-terrorism-migration triad that is threatening the European integration project, this article represents an attempt to provide a preliminary insight on the forces that shape the configuration of this supranational structure, with regard to the factors that are accountable for the growing scepticism among the European citizens and have shifted the citizens’ approach on the EU from a permissive consensus to a constraining dissensus.

Exploring Nurse Manager Support of Evidence-Based Practice: Clinical Nurse Perceptions.

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Caramanica, Laura; Spiva, LeeAnna

2018-05-01

The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.

Preliminary designs: passive solar manufactured housing. Technical status report

Energy Technology Data Exchange (ETDEWEB)

1980-05-12

The criteria established to guide the development of the preliminary designs are listed. Three preliminary designs incorporating direct gain and/or sunspace are presented. Costs, drawings, and supporting calculations are included. (MHR)

New evidence: data documenting parental support for earlier sexuality education.

Science.gov (United States)

Barr, Elissa M; Moore, Michele J; Johnson, Tammie; Forrest, Jamie; Jordan, Melissa

2014-01-01

Numerous studies document support for sexuality education to be taught in high school, and often, in middle school. However, little research has been conducted addressing support for sexuality education in elementary schools. As part of the state Behavioral Risk Factor Surveillance System (BRFSS) Survey administration, the Florida Department of Health conducted the Florida Child Health Survey (FCHS) by calling back parents who had children in their home and who agreed to participate (N = 1715). Most parents supported the following sexuality education topics being taught specifically in elementary school: communication skills (89%), human anatomy/reproductive information (65%), abstinence (61%), human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) (53%), and gender/sexual orientation issues (52%). Support was even greater in middle school (62-91%) and high school (72-91%) for these topics and for birth control and condom education. Most parents supported comprehensive sexuality education (40.4%), followed by abstinence-plus (36.4%) and abstinence-only (23.2%). Chi-square results showed significant differences in the type of sexuality education supported by almost all parent demographic variables analyzed including sex, race, marital status, and education. Results add substantial support for age-appropriate school-based sexuality education starting at the elementary school level, the new National Sexuality Education Standards, and funding to support evidence-based abstinence-plus or comprehensive sexuality education. © 2013, American School Health Association.

Evidence-informed health policy 1 - synthesis of findings from a multi-method study of organizations that support the use of research evidence.

Science.gov (United States)

Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J

2008-12-17

Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs). We undertook a multi-method study in three phases - a survey, interviews, and case descriptions that drew on site visits - and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1) collaborate with other organizations; 2) establish strong links with policymakers and involve stakeholders in the work; 3) be independent and manage conflicts of interest among those involved in the work; 4) build capacity among those working in the organization; 5) use good methods and be transparent in the work; 6) start small, have a clear audience and scope, and address important questions; and 7) be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO) and other international organizations and networks: 1) support collaborations among organizations; 2) support local adaptation efforts; 3) mobilize support; and 4) create global public goods. This synthesis of

Organizational supports used by private child and family serving agencies to facilitate evidence use: a mixed methods study protocol.

Science.gov (United States)

Chuang, Emmeline; Collins-Camargo, Crystal; McBeath, Bowen

2017-04-08

Challenges to evidence use are well documented. Less well understood are the formal supports-e.g., technical infrastructure, inter-organizational relationships-organizations may put in place to help overcome these challenges. This study will identify supports for evidence use currently used by private child and family serving agencies delivering publicly funded behavioral health and/or human services; examine contextual, organizational, and managerial factors associated with use of such supports; and determine how identified supports affect evidence use by staff at multiple levels of the organization. We will use a sequential explanatory mixed methods design, with study activities occurring in two sequential phases: In phase 1, quantitative survey data collected from managers of private child and family serving agencies in six states (CA, IN, KY, MO, PA, and WI) and analyzed using both regression and qualitative comparative analysis (QCA) will identify organizational supports currently being used to facilitate evidence use and examine the contextual, organizational, and managerial factors associated with the use of such supports. In phase 2, data from phase 1 will be used to select a purposive sample of 12 agencies for in-depth case studies. In those 12 agencies, semi-structured interviews with key informants and managers, focus groups with frontline staff, and document analysis will provide further insight into agencies' motivation for investing in organizational supports for evidence use and the facilitators and barriers encountered in doing so. Semi-structured interviews with managers and focus groups with frontline staff will also assess whether and how identified supports affect evidence use at different levels of the organization (senior executives, middle managers, frontline supervisors, and frontline staff). Within- and between-case analyses supplemented by QCA will identify combinations of factors associated with the highest and lowest levels of staff

Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support.

Science.gov (United States)

Proctor, Enola; Luke, Douglas; Calhoun, Annaliese; McMillen, Curtis; Brownson, Ross; McCrary, Stacey; Padek, Margaret

2015-06-11

Little is known about how well or under what conditions health innovations are sustained and their gains maintained once they are put into practice. Implementation science typically focuses on uptake by early adopters of one healthcare innovation at a time. The later-stage challenges of scaling up and sustaining evidence-supported interventions receive too little attention. This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work. A multi-method, multi-stage approach, was used: (1) identifying and recruiting experts in sustainability as participants, (2) conducting research on sustainability using concept mapping, (3) action planning during an intensive working conference of sustainability experts to expand the concept mapping quantitative results, and (4) consolidating results into a set of recommendations for research, methodological advances, and infrastructure building to advance understanding of sustainability. Participants comprised researchers, funders, and leaders in health, mental health, and public health with shared interest in the sustainability of evidence-based health care. Prompted to identify important issues for sustainability research, participants generated 91 distinct statements, for which a concept mapping process produced 11 conceptually distinct clusters. During the conference, participants built upon the concept mapping clusters to generate recommendations for sustainability research. The recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research. Implementation science needs to pursue later-stage translation research questions required for population impact. Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence

The information infrastructure that supports evidence-based veterinary medicine: a comparison with human medicine.

Science.gov (United States)

Toews, Lorraine

2011-01-01

In human medicine, the information infrastructure that supports the knowledge translation processes of exchange, synthesis, dissemination, and application of the best clinical intervention research has developed significantly in the past 15 years, facilitating the uptake of research evidence by clinicians as well as the practice of evidence-based medicine. Seven of the key elements of this improved information infrastructure are clinical trial registries, research reporting standards, systematic reviews, organizations that support the production of systematic reviews, the indexing of clinical intervention research in MEDLINE, clinical search filters for MEDLINE, and point-of-care decision support information resources. The objective of this paper is to describe why these elements are important for evidence-based medicine, the key developments and issues related to these seven information infrastructure elements in human medicine, how these 7 elements compare with the corresponding infrastructure elements in veterinary medicine, and how all of these factors affect the translation of clinical intervention research into clinical practice. A focused search of the Ovid MEDLINE database was conducted for English language journal literature published between 2000 and 2010. Two bibliographies were consulted and selected national and international Web sites were searched using Google. The literature reviewed indicates that the information infrastructure supporting evidence-based veterinary medicine practice in all of the 7 elements reviewed is significantly underdeveloped in relation to the corresponding information infrastructure in human medicine. This lack of development creates barriers to the timely translation of veterinary medicine research into clinical practice and also to the conduct of both primary clinical intervention research and synthesis research.

Coherence of evidence from systematic reviews as a basis for evidence strength - a case study in support of an epistemological proposition

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Mickenautsch Steffen

2012-01-01

Full Text Available Abstract Background This article aims to offer, on the basis of Coherence theory, the epistemological proposition that mutually supportive evidence from multiple systematic reviews may successfully refute radical, philosophical scepticism. Methods A case study including seven systematic reviews is presented with the objective of refuting radical philosophical scepticism towards the belief that glass-ionomer cements (GIC are beneficial in tooth caries therapy. The case study illustrates how principles of logical and empirical coherence may be applied as evidence in support of specific beliefs in healthcare. Results The results show that radical scepticism may epistemologically be refuted on the basis of logical and empirical coherence. For success, several systematic reviews covering interconnected beliefs are needed. In praxis, these systematic reviews would also need to be of high quality and its conclusions based on reviewed high quality trials. Conclusions A refutation of radical philosophical scepticism to clinical evidence may be achieved, if and only if such evidence is based on the logical and empirical coherence of multiple systematic review results. Practical application also requires focus on the quality of the systematic reviews and reviewed trials.

Supporting Evidence-Informed Teaching in Biomedical and Health Professions Education Through Knowledge Translation: An Interdisciplinary Literature Review.

Science.gov (United States)

Tractenberg, Rochelle E; Gordon, Morris

2017-01-01

Phenomenon: The purpose of "systematic" reviews/reviewers of medical and health professions educational research is to identify best practices. This qualitative article explores the question of whether systematic reviews can support "evidence informed" teaching and contrasts traditional systematic reviewing with a knowledge translation (KT) approach to this objective. Degrees of freedom analysis (DOFA) is used to examine the alignment of systematic review methods with educational research and the pedagogical strategies and approaches that might be considered with a decision-making framework developed to support valid assessment. This method is also used to explore how KT can be used to inform teaching and learning. The nature of educational research is not compatible with most (11/14) methods for systematic review. The inconsistency of systematic reviewing with the nature of educational research impedes both the identification and implementation of "best-evidence" pedagogy and teaching. This is primarily because research questions that do support the purposes of review do not support educational decision making. By contrast to systematic reviews of the literature, both a DOFA and KT are fully compatible with informing teaching using evidence. A DOFA supports the translation of theory to a specific teaching or learning case, so could be considered a type of KT. The DOFA results in a test of alignment of decision options with relevant educational theory, and KT leads to interventions in teaching or learning that can be evaluated. Examples of how to structure evaluable interventions are derived from a KT approach that are simply not available from a systematic review. Insights: Systematic reviewing of current empirical educational research is not suitable for deriving or supporting best practices in education. However, both "evidence-informed" and scholarly approaches to teaching can be supported as KT projects, which are inherently evaluable and can generate

78 FR 13563 - Energy Conservation Program: Availability of the Preliminary Technical Support Document for...

Science.gov (United States)

2013-02-28

... identify and resolve issues involved in the preliminary analyses. Chapter 2 of the preliminary technical... DOE conducted in-depth technical analyses in the following areas for GSFLs and IRLs currently under... also begun work on the manufacturer impact analysis and identified the methods to be used for the LCC...

Trichloroethylene: Mechanistic, epidemiologic and other supporting evidence of carcinogenic hazard.

Science.gov (United States)

Rusyn, Ivan; Chiu, Weihsueh A; Lash, Lawrence H; Kromhout, Hans; Hansen, Johnni; Guyton, Kathryn Z

2014-01-01

The chlorinated solvent trichloroethylene (TCE) is a ubiquitous environmental pollutant. The carcinogenic hazard of TCE was the subject of a 2012 evaluation by a Working Group of the International Agency for Research on Cancer (IARC). Information on exposures, relevant data from epidemiologic studies, bioassays in experimental animals, and toxicity and mechanism of action studies was used to conclude that TCE is carcinogenic to humans (Group 1). This article summarizes the key evidence forming the scientific bases for the IARC classification. Exposure to TCE from environmental sources (including hazardous waste sites and contaminated water) is common throughout the world. While workplace use of TCE has been declining, occupational exposures remain of concern, especially in developing countries. The strongest human evidence is from studies of occupational TCE exposure and kidney cancer. Positive, although less consistent, associations were reported for liver cancer and non-Hodgkin lymphoma. TCE is carcinogenic at multiple sites in multiple species and strains of experimental animals. The mechanistic evidence includes extensive data on the toxicokinetics and genotoxicity of TCE and its metabolites. Together, available evidence provided a cohesive database supporting the human cancer hazard of TCE, particularly in the kidney. For other target sites of carcinogenicity, mechanistic and other data were found to be more limited. Important sources of susceptibility to TCE toxicity and carcinogenicity were also reviewed by the Working Group. In all, consideration of the multiple evidence streams presented herein informed the IARC conclusions regarding the carcinogenicity of TCE. © 2013.

Perceived autonomy support, motivation regulations and the self-evaluative tendencies of student dancers.

Science.gov (United States)

Quested, Eleanor; Duda, Joan L

2011-03-01

Limited research has considered the social-environmental and motivational processes predictive of self evaluations and body-related concerns. Evidence suggests that low self-esteem, poor body evaluations, and associated anxieties are particularly prevalent among the student dance population. Grounded in self-determination theory (SDT), this study examined the relationships among perceptions of autonomy support, motivation regulations, and self-evaluations of body-related concerns in the context of vocational dance. Three hundred and ninety-two dancers completed questionnaires regarding their perceptions of autonomy support in their dance school, reasons for engaging in dance, self-esteem, social physique anxiety (SPA), and body dissatisfaction. Structural equation modeling analyses revealed that perceived autonomy support predicted intrinsic motivation (+) and amotivation (-). Extrinsic regulation positively predicted SPA. Amotivation mediated the associations between perceptions of autonomy support and dancers' self-esteem, SPA, and body dissatisfaction. The utility of SDT in understanding predictors of self-worth, physical evaluations, and associated concerns was supported. Moreover, this study provides preliminary evidence supporting the applicability of SDT in dance contexts.

Corporate Health and Wellness and the Financial Bottom Line: Evidence From South Africa.

Science.gov (United States)

Conradie, Christina Susanna; van der Merwe Smit, Eon; Malan, Daniel Pieter

2016-02-01

The research objective was to test the hypothesis that corporate health and wellness contributed positively to South African companies' financial results. The past share market performance of eligible healthy companies, based on Discovery's Healthy Company Index, was tracked under three investment scenarios and compared with the market performance on the basis of the JSE FTSE All Share Index. The evidence supports the hypothesis that a culture of health and wellness provides a financial advantage, in so far as the portfolio of healthy companies consistently outperformed the market over the selected simulations. Given the limitations of the investigation, namely small sample size, the brevity of the period of investigation, and the reliance on accessibility sampling, the research provides the first and preliminary evidence supportive of the direct financial benefits of companies' wellness programs.

Building organizational supports for research-minded practitioners.

Science.gov (United States)

Austin, Michael J; Dal Santo, Teresa S; Lee, Chris

2012-01-01

One of the biggest challenges facing human service organizations is the proliferation of information from inside and outside the agency that needs to be managed if it is to be of use. The concepts of tacit and explicit knowledge can inform an approach to this challenge. Tacit knowledge is stored in the minds of practitioners (often called practice wisdom) and the explicit knowledge is often found in organizational procedure manuals and educational and training materials. Building on this perspective, this analysis provides a preliminary definition of research-minded practitioners by explicating the elements of curiosity, critical reflection, and critical thinking. The organizational implications of developing a cadre of research-minded practitioners include the commitment of top management to support "link officers", evidence request services, research and development units, and service standards. The challenges include the capacity to identify/support research-minded practitioners, promote an organizational culture of evidence-informed practice, redefine staff development and training, redefine job descriptions, and specify the nature of managerial leadership. Copyright © Taylor & Francis Group, LLC

Complementary Medicine, Exercise, Meditation, Diet, and Lifestyle Modification for Anxiety Disorders: A Review of Current Evidence

Directory of Open Access Journals (Sweden)

J. Sarris

2012-01-01

Full Text Available Use of complementary medicines and therapies (CAM and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders.

The implementation of mindfulness-based interventions and educational interventions to support family caregivers of patients with cancer: A systematic review.

Science.gov (United States)

Al Daken, Laila I; Ahmad, Muayyad M

2018-05-10

This review aims to determine the effectiveness of mindfulness-based interventions (MBIs) and educational interventions (EIs) as supportive care for family caregivers (FCs) of patients with cancer. Review was conducted following PRISMA guidelines. The search protocol was performed using EBSCO, Google Scholar, and Science Direct for the studies published between 2007 and 2017. Little evidence is available on the usefulness of MBIs among FCs of patients with cancer. However, the available evidence supports that MBIs have the potential to enhance overall well-being and reduce the burden for FCs. EIs have shown positive outcomes on some aspects of well-being and reducing the burden. The findings provide preliminary support for effectiveness of MBIs and EIs as a supportive care for FCs. © 2018 Wiley Periodicals, Inc.

A Preliminary Review of Fatigue Among Rail Staff

OpenAIRE

Jialin Fan; Andrew P. Smith

2018-01-01

Background: Fatigue is a severe problem in the rail industry, which may jeopardize train crew's health and safety. Nonetheless, a preliminary review of all empirical evidence for train crew fatigue is still lacking. The aim of the present paper is, therefore, to provide a preliminary description of occupational fatigue in the rail industry. This paper reviews the literature with the research question examining the risk factors associated with train crew fatigue, covering both papers published...

Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review.

Science.gov (United States)

Wang, Jingyi; Mann, Farhana; Lloyd-Evans, Brynmor; Ma, Ruimin; Johnson, Sonia

2018-05-29

The adverse effects of loneliness and of poor perceived social support on physical health and mortality are established, but no systematic synthesis is available of their relationship with the outcomes of mental health problems over time. In this systematic review, we aim to examine the evidence on whether loneliness and closely related concepts predict poor outcomes among adults with mental health problems. We searched six databases and reference lists for longitudinal quantitative studies that examined the relationship between baseline measures of loneliness and poor perceived social support and outcomes at follow up. Thirty-four eligible papers were retrieved. Due to heterogeneity among included studies in clinical populations, predictor measures and outcomes, a narrative synthesis was conducted. We found substantial evidence from prospective studies that people with depression who perceive their social support as poorer have worse outcomes in terms of symptoms, recovery and social functioning. Loneliness has been investigated much less than perceived social support, but there is some evidence that greater loneliness predicts poorer depression outcome. There is also some preliminary evidence of associations between perceived social support and outcomes in schizophrenia, bipolar disorder and anxiety disorders. Loneliness and quality of social support in depression are potential targets for development and testing of interventions, while for other conditions further evidence is needed regarding relationships with outcomes.

Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice.

Science.gov (United States)

Cortez, Susan; Dietrich, Mary S; Wells, Nancy

2016-07-01

To measure the effect of clinical decision support (CDS) on oncology nurse evidence-based practice (EBP).
. Longitudinal cluster-randomized design.
. Four distinctly separate oncology clinics associated with an academic medical center.
. The study sample was comprised of randomly selected data elements from the nursing documentation software. The data elements were patient-reported symptoms and the associated nurse interventions. The total sample observations were 600, derived from a baseline, posteducation, and postintervention sample of 200 each (100 in the intervention group and 100 in the control group for each sample).
. The cluster design was used to support randomization of the study intervention at the clinic level rather than the individual participant level to reduce possible diffusion of the study intervention. An elongated data collection cycle (11 weeks) controlled for temporary increases in nurse EBP related to the education or CDS intervention.
. The dependent variable was the nurse evidence-based documentation rate, calculated from the nurse-documented interventions. The independent variable was the CDS added to the nursing documentation software.
. The average EBP rate at baseline for the control and intervention groups was 27%. After education, the average EBP rate increased to 37%, and then decreased to 26% in the postintervention sample. Mixed-model linear statistical analysis revealed no significant interaction of group by sample. The CDS intervention did not result in an increase in nurse EBP.
. EBP education increased nurse EBP documentation rates significantly but only temporarily. Nurses may have used evidence in practice but may not have documented their interventions.
. More research is needed to understand the complex relationship between CDS, nursing practice, and nursing EBP intervention documentation. CDS may have a different effect on nurse EBP, physician EBP, and other medical professional EBP.

Preliminary Analysis of Helicopter Options to Support Tunisian Counterterrorism Operations

Science.gov (United States)

2016-04-27

helicopters from Sikorsky to fulfill a number of roles in counterterrorism operations. Rising costs and delays in delivery raised the question of...whether other cost-effective options exist to meet Tunisia’s helicopter requirement. Approach Our team conducted a preliminary assessment of...alternative helicopters for counterterrorism air assault missions. Any decision to acquire an aircraft must consider many factors, including technical

Evidence-informed health policy 1 – Synthesis of findings from a multi-method study of organizations that support the use of research evidence

Directory of Open Access Journals (Sweden)

Moynihan Ray

2008-12-01

Full Text Available Abstract Background Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs. Methods We undertook a multi-method study in three phases – a survey, interviews, and case descriptions that drew on site visits – and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Results Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1 collaborate with other organizations; 2 establish strong links with policymakers and involve stakeholders in the work; 3 be independent and manage conflicts of interest among those involved in the work; 4 build capacity among those working in the organization; 5 use good methods and be transparent in the work; 6 start small, have a clear audience and scope, and address important questions; and 7 be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO and other international organizations and networks: 1 support collaborations among organizations; 2 support local adaptation efforts; 3 mobilize support; and 4 create

Fort Hood Solar Total Energy Project. Volume II. Preliminary design. Part 2. System performance and supporting studies. Final report

Energy Technology Data Exchange (ETDEWEB)

None,

1979-01-01

The preliminary design developed for the Solar Total Energy System to be installed at Fort Hood, Texas, is presented. System performance analysis and evaluation are described. Feedback of completed performance analyses on current system design and operating philosophy is discussed. The basic computer simulation techniques and assumptions are described and the resulting energy displacement analysis is presented. Supporting technical studies are presented. These include health and safety and reliability assessments; solar collector component evaluation; weather analysis; and a review of selected trade studies which address significant design alternatives. Additional supporting studies which are generally specific to the installation site are reported. These include solar availability analysis; energy load measurements; environmental impact assessment; life cycle cost and economic analysis; heat transfer fluid testing; meteorological/solar station planning; and information dissemination. (WHK)

What supports do health system organizations have in place to facilitate evidence-informed decision-making? A qualitative study.

Science.gov (United States)

Ellen, Moriah E; Léon, Gregory; Bouchard, Gisèle; Lavis, John N; Ouimet, Mathieu; Grimshaw, Jeremy M

2013-08-06

Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making. The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making. In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a 'knowledge broker') in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff's capacity building. This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision-making. Some of the identified supports may increase the use of

Democratic Values and Support for Militancy: Evidence from a National Survey of Pakistan

Science.gov (United States)

2011-06-14

our survey provides prima facie evidence that this technique reduced respondents’ concerns about reporting sensitive information.18 That the...the empirical underpinnings of popular support for militancy, researchers have a duty to minimize risk to all survey participants and enumerators

The Influence of Sleep on the Consolidation of Positive Emotional Memories: Preliminary Evidence

Directory of Open Access Journals (Sweden)

Alexis M. Chambers

2014-05-01

Full Text Available Studies have not only shown that a period of sleep following learning offers greater benefits to later memory than a period of wakefulness, but also that sleep actively promotes those components of memories that are emotionally salient. However, sleep's role in emotional memory consolidation has largely been investigated with memories that are specifically negative in content, such as memory for negative images or texts, leaving open the question of whether sleep influences positive memories in a similar manner. The current study investigated the emotional memory trade-off effect for positive versus neutral information. Scenes in which a positive or neutral object was placed on a neutral background were encoded prior to a period of polysomnographically-monitored nocturnal sleep or daytime wakefulness. Recognition memory was tested for the objects and backgrounds separately following the delay using the Remember/Know paradigm. Compared to wake participants, those who slept during the delay had increased recollection memory performance for positive objects, but not the neutral components of the studied scenes. Further, familiarity of positive objects was negatively correlated with REM latency. These results provide preliminary evidence that sleep contributes to the selective processing of positive memories, and point toward a role for REM sleep in positive memory formation.

Automatic evidence quality prediction to support evidence-based decision making.

Science.gov (United States)

Sarker, Abeed; Mollá, Diego; Paris, Cécile

2015-06-01

Evidence-based medicine practice requires practitioners to obtain the best available medical evidence, and appraise the quality of the evidence when making clinical decisions. Primarily due to the plethora of electronically available data from the medical literature, the manual appraisal of the quality of evidence is a time-consuming process. We present a fully automatic approach for predicting the quality of medical evidence in order to aid practitioners at point-of-care. Our approach extracts relevant information from medical article abstracts and utilises data from a specialised corpus to apply supervised machine learning for the prediction of the quality grades. Following an in-depth analysis of the usefulness of features (e.g., publication types of articles), they are extracted from the text via rule-based approaches and from the meta-data associated with the articles, and then applied in the supervised classification model. We propose the use of a highly scalable and portable approach using a sequence of high precision classifiers, and introduce a simple evaluation metric called average error distance (AED) that simplifies the comparison of systems. We also perform elaborate human evaluations to compare the performance of our system against human judgments. We test and evaluate our approaches on a publicly available, specialised, annotated corpus containing 1132 evidence-based recommendations. Our rule-based approach performs exceptionally well at the automatic extraction of publication types of articles, with F-scores of up to 0.99 for high-quality publication types. For evidence quality classification, our approach obtains an accuracy of 63.84% and an AED of 0.271. The human evaluations show that the performance of our system, in terms of AED and accuracy, is comparable to the performance of humans on the same data. The experiments suggest that our structured text classification framework achieves evaluation results comparable to those of human performance

Supporting Better Evidence Generation and Use within Social Innovation in Health in Low- and Middle-Income Countries: A Qualitative Study.

Science.gov (United States)

Ballard, Madeleine; Tran, Jenny; Hersch, Fred; Lockwood, Amy; Hartigan, Pamela; Montgomery, Paul

2017-01-01

While several papers have highlighted a lack of evidence to scale social innovations in health, fewer have explored decision-maker understandings of the relative merit of different types of evidence, how such data are interpreted and applied, and what practical support is required to improve evidence generation. The objectives of this paper are to understand (1) beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (2) approaches to evidence generation and evaluation used in systems and policy change, and (3) how better evidence-generation can be undertaken and supported within social innovation in health. Thirty-two one-on-one interviews were conducted between July and November 2015 with purposively selected practitioners, policymakers, and funders from low- and middle- income countries (LMICs). Data were analysed using a Framework Analysis Approach. While practitioners, funders, and policymakers said they held outcome evidence in high regard, their practices only bear out this assertion to varying degrees. Few have given systematic consideration to potential unintended consequences, in particular harm, of the programs they implement, fund, or adopt. Stakeholders suggest that better evidence-generation can be undertaken and supported within social innovation in health by supporting the research efforts of emerging community organizations; creating links between practitioners and academia; altering the funding landscape for evidence-generation; providing responsive technical education; and creating accountability for funders, practitioners, and policymakers. How better evidence-generation can be undertaken and supported within social innovation in health is a previously under-operationalised aspect of the policy-making process that remains essential in order to refrain from causing harm, enable the optimization of existing interventions, and ultimately, to scale and fund what works.

Evidence-informed health policy 4 – Case descriptions of organizations that support the use of research evidence

Directory of Open Access Journals (Sweden)

Oxman Andrew D

2008-12-01

Full Text Available Abstract Background Previous efforts to produce case descriptions have typically not focused on the organizations that produce research evidence and support its use. External evaluations of such organizations have typically not been analyzed as a group to identify the lessons that have emerged across multiple evaluations. Case descriptions offer the potential for capturing the views and experiences of many individuals who are familiar with an organization, including staff, advocates, and critics. Methods We purposively sampled a subgroup of organizations from among those that participated in the second (interview phase of the study and (once from among other organizations with which we were familiar. We developed and pilot-tested a case description data collection protocol, and conducted site visits that included both interviews and documentary analyses. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. We produced both a brief (one to two pages written description and a video documentary for each case. Results We conducted 51 interviews as part of the eight site visits. Two organizational strengths were repeatedly cited by individuals participating in the site visits: use of an evidence-based approach (which was identified as being very time-consuming and existence of a strong relationship between researchers and policymakers (which can be challenged by conflicts of interest. Two organizational weaknesses – a lack of resources and the presence of conflicts of interest – were repeatedly cited by individuals participating in the site visits. Participants offered two main suggestions for the World Health Organization (and other international organizations and networks: 1 mobilize one or more of government support, financial resources, and the participation of both policymakers and researchers; and 2 create knowledge-related global public goods. Conclusion The findings from

Clinical utility of color-form naming in Alzheimer's disease: preliminary evidence

DEFF Research Database (Denmark)

Nielsen, Niels Peter; Wiig, Elisabeth H; Warkentin, Siegbert

2004-01-01

Performances on Alzheimer's Quick Test color-form naming and Mini-Mental State Examination were compared for 38 adults with Alzheimer's disease and 38 age- and sex-matched normal controls. Group means differed significantly and indicated longer naming times by adults with Alzheimer's disease...... associated with Alzheimer's disease, are preliminary given the relatively small sample....

Preliminary Results of Ancillary Safety Analyses Supporting TREAT LEU Conversion Activities

Energy Technology Data Exchange (ETDEWEB)

Brunett, A. J. [Argonne National Lab. (ANL), Argonne, IL (United States); Fei, T. [Argonne National Lab. (ANL), Argonne, IL (United States); Strons, P. S. [Argonne National Lab. (ANL), Argonne, IL (United States); Papadias, D. D. [Argonne National Lab. (ANL), Argonne, IL (United States); Hoffman, E. A. [Argonne National Lab. (ANL), Argonne, IL (United States); Kontogeorgakos, D. C. [Argonne National Lab. (ANL), Argonne, IL (United States); Connaway, H. M. [Argonne National Lab. (ANL), Argonne, IL (United States); Wright, A. E. [Argonne National Lab. (ANL), Argonne, IL (United States)

2015-10-01

Report (FSAR) [3]. Depending on the availability of historical data derived from HEU TREAT operation, results calculated for the LEU core are compared to measurements obtained from HEU TREAT operation. While all analyses in this report are largely considered complete and have been reviewed for technical content, it is important to note that all topics will be revisited once the LEU design approaches its final stages of maturity. For most safety significant issues, it is expected that the analyses presented here will be bounding, but additional calculations will be performed as necessary to support safety analyses and safety documentation. It should also be noted that these analyses were completed as the LEU design evolved, and therefore utilized different LEU reference designs. Preliminary shielding, neutronic, and thermal hydraulic analyses have been completed and have generally demonstrated that the various LEU core designs will satisfy existing safety limits and standards also satisfied by the existing HEU core. These analyses include the assessment of the dose rate in the hodoscope room, near a loaded fuel transfer cask, above the fuel storage area, and near the HEPA filters. The potential change in the concentration of tramp uranium and change in neutron flux reaching instrumentation has also been assessed. Safety-significant thermal hydraulic items addressed in this report include thermally-induced mechanical distortion of the grid plate, and heating in the radial reflector.

Supporting Better Evidence Generation and Use within Social Innovation in Health in Low- and Middle-Income Countries: A Qualitative Study.

Directory of Open Access Journals (Sweden)

Madeleine Ballard

Full Text Available While several papers have highlighted a lack of evidence to scale social innovations in health, fewer have explored decision-maker understandings of the relative merit of different types of evidence, how such data are interpreted and applied, and what practical support is required to improve evidence generation. The objectives of this paper are to understand (1 beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (2 approaches to evidence generation and evaluation used in systems and policy change, and (3 how better evidence-generation can be undertaken and supported within social innovation in health.Thirty-two one-on-one interviews were conducted between July and November 2015 with purposively selected practitioners, policymakers, and funders from low- and middle- income countries (LMICs. Data were analysed using a Framework Analysis Approach.While practitioners, funders, and policymakers said they held outcome evidence in high regard, their practices only bear out this assertion to varying degrees. Few have given systematic consideration to potential unintended consequences, in particular harm, of the programs they implement, fund, or adopt. Stakeholders suggest that better evidence-generation can be undertaken and supported within social innovation in health by supporting the research efforts of emerging community organizations; creating links between practitioners and academia; altering the funding landscape for evidence-generation; providing responsive technical education; and creating accountability for funders, practitioners, and policymakers.How better evidence-generation can be undertaken and supported within social innovation in health is a previously under-operationalised aspect of the policy-making process that remains essential in order to refrain from causing harm, enable the optimization of existing interventions, and ultimately, to scale and fund what works.

Is There Evidence to Support a Forefoot Strike Pattern in Barefoot Runners? A Review

OpenAIRE

Lorenz, Daniel S.; Pontillo, Marisa

2012-01-01

Context: Barefoot running is a trend among running enthusiasts that is the subject of much controversy. At this time, benefits appear to be more speculative and anecdotal than evidence based. Additionally, the risk of injuries is not well established. Evidence acquisition: A PubMed search was undertaken for articles published in English from 1980 to 2011. Additional references were accrued from reference lists of research articles. Results: While minimal data exist that definitively support b...

Cooptation of Peer Support Staff: Quantitative Evidence

Directory of Open Access Journals (Sweden)

Anthony J. Alberta

2014-03-01

Full Text Available Objective In 2007, the Centers for Medicare and Medicaid Services (CMS sent a letter to state Medicaid directors outlining requirements for implementing peer-based recovery support services (P-BRSS as a Medicaid-funded service. Since then, 30 states have implemented these services. Although the literature describing implementation of P-BRSS has identified the cooptation of peer support staff (PSS as a barrier to the effective provision of P-BRSS, the evidence for it remains anecdotal. This study attempts to determine if the context of employment in either a treatment organization or peer organization affected cooptation. Methods We conducted a survey of PSS in the fall of 2013. In all, 92 of the 181 respondents were working as PSS at the time, 53 in treatment organizations. Chi-square analysis was used to determine if the context of employment had an effect on the cooptation of peer staff. Results Peer staff working in treatment organizations reported that they were supervised by treatment staff and participated in employment-related training to improve their skills at providing treatment services more frequently than their counterparts in peer organizations. Peer staff working in treatment organizations also participated in training and education to prepare for employment as treatment professionals more frequently than peer staff working in peer organizations. Conclusions and Implications for Practice Peer staff members working in treatment organizations are subject to processes of acculturation into professional cultures that peer staff working in peer organizations are not. Effective implementation of P-BRSS should include specific efforts to minimize the cooptation of peer staff.

Norms for environmentally responsible behaviour: An extended taxonomy and a preliminary assessment

DEFF Research Database (Denmark)

Thøgersen, John

The currently used concept of personal or moral norms is ambiguous with regard to its motivational content. Therefore, a revision of the norm taxonomy is suggested, implying a distinction between three types of personal norms, called introjected, identified, and integrated norms. A preliminary as...... is also supported, with the reservation that the different behavioural references are more than just different methods of measuring the same latent construct(s). People evidently hold different norms for different environmentally responsible behaviours.......The currently used concept of personal or moral norms is ambiguous with regard to its motivational content. Therefore, a revision of the norm taxonomy is suggested, implying a distinction between three types of personal norms, called introjected, identified, and integrated norms. A preliminary...... assessment of the taxonomy is carried out based of a survey of a random sample of Danish residents 18 years or older. A range of norm constructs were measured with regard to four environmentally relevant behaviours: buying organic milk, buying energy saving light bulbs, source-separating compostable kitchen...

A framework for production of systematic review based briefings to support evidence-informed decision-making.

Science.gov (United States)

Chambers, Duncan; Wilson, Paul

2012-07-09

We have developed a framework for translating existing sources of synthesized and quality-assessed evidence, primarily systematic reviews, into actionable messages in the form of short accessible briefings. The service aims to address real-life problems in response to requests from decision-makers.Development of the framework was based on a scoping review of existing resources and our initial experience with two briefing topics, including models of service provision for young people with eating disorders. We also drew on previous experience in dissemination research and practice. Where appropriate, we made use of the SUPporting POlicy relevant Reviews and Trials (SUPPORT) tools for evidence-informed policymaking. To produce a product that it is fit for this purpose it has been necessary to go beyond a traditional summary of the available evidence relating to effectiveness. Briefings have, therefore, included consideration of cost effectiveness, local applicability, implications relating to local service delivery, budgets, implementation and equity. Our first evidence briefings produced under this framework cover diagnostic endoscopy by specialist nurses and integrated care pathways in mental healthcare settings. The framework will enable researchers to present and contextualize evidence from systematic reviews and other sources of synthesized and quality-assessed evidence. The approach is designed to address the wide range of questions of interest to decision-makers, especially those commissioning services or managing service delivery and organization in primary or secondary care. Evaluation of the use and usefulness of the evidence briefings we produce is an integral part of the framework and will help to fill a gap in the literature.

Preliminary assessment report for Army Aviation Support Facility No. 3, Installation 13307, Hunter Army Airfield, Savannah, Georgia

International Nuclear Information System (INIS)

Kolpa, R.; Smith, K.

1993-07-01

This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Georgia Army National Guard property located on Hunter Army Airfield (HAA) near Savannah, Georgia, known as Army Aviation Support Facility (AASF) No. 3. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, types and quantities of hazardous substances utilized, the nature and amounts of wastes generated or stored at the facility, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the AASF No. 3 property, requirements of the Department of Defense Installation Restoration Program (IRP). The scope of this assessment is limited to the facilities and past activities contained within the area now occupied by AASF No. 3. However, this assessment report is intended to be read in conjunction with a previous IRP assessment of HAA completed in 1992 (USATHAMA 1992) and to provide comprehensive information on AASF No. 3 for incorporation with information contained in that previous assessment for the entirety of HAA

Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study.

Science.gov (United States)

Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

2014-11-29

There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government

Evidence-based emergency medicine. Creating a system to facilitate translation of evidence into standardized clinical practice: a preliminary report.

Science.gov (United States)

Wright, Stewart W; Trott, Alexander; Lindsell, Christopher J; Smith, Carol; Gibler, W Brian

2008-01-01

The Institute of Medicine, through its landmark report concerning errors in medicine, suggests that standardization of practice through systematic development and implementation of evidence-based clinical pathways is an effective way of reducing errors in emergency systems. The specialty of emergency medicine is well positioned to develop a complete system of innovative quality improvement, incorporating best practice guidelines with performance measures and practitioner feedback mechanisms to reduce errors and therefore improve quality of care. This article reviews the construction, ongoing development, and initial impact of such a system at a large, urban, university teaching hospital and at 2 affiliated community hospitals. The Committee for Procedural Quality and Evidence-Based Practice was formed within the Department of Emergency Medicine to establish evidence-based guidelines for nursing and provider care. The committee measures the effect of such guidelines, along with other quality measures, through pre- and postguideline patient care medical record audits. These measures are fed back to the providers in a provider-specific, peer-matched "scorecard." The Committee for Procedural Quality and Evidence-Based Practice affects practice and performance within our department. Multiple physician and nursing guidelines have been developed and put into use. Using asthma as an example, time to first nebulizer treatment and time to disposition from the emergency department decreased. Initial therapeutic agent changed and documentation improved. A comprehensive, guideline-driven, evidence-based approach to clinical practice is feasible within the structure of a department of emergency medicine. High-level departmental support with dedicated personnel is necessary for the success of such a system. Internet site development (available at http://www.CPQE.com) for product storage has proven valuable. Patient care has been improved in several ways; however, consistent and

Preliminary evidence for a unique role of disgust-based conditioning in posttraumatic stress.

Science.gov (United States)

Badour, Christal L; Feldner, Matthew T; Blumenthal, Heidemarie; Knapp, Ashley

2013-04-01

Independent lines of evidence have linked posttraumatic stress symptomatology to both peritraumatic disgust (i.e., disgust experienced during a traumatic event) and posttraumatic disgust reactivity in response to traumatic event cues among individuals exposed to traumatic events. Much of this work suggests disgust, defined as a rejection/revulsion response aimed at distancing oneself from a potential source of contamination, may be important in understanding the nature of posttraumatic stress reactions even after accounting for the more frequently studied affective states of fear and anxiety. The current investigation provided a preliminary test of a model of disgust in posttraumatic stress among a sample of 54 community-recruited women with a history sexual victimization. Both peritraumatic disgust (r = .31) and posttraumatic disgust reactivity (r = .42) in response to an idiographic traumatic event script were significantly associated with posttraumatic stress symptom severity. After accounting for variability-associated peritraumatic fear and posttraumatic anxious reactivity, an indirect effect of peritraumatic disgust through posttraumatic disgust reactivity also was found, suggesting that one mechanism through which peritraumatic disgust relates to posttraumatic stress is through its relation with increased posttraumatic disgust reactivity. These findings highlight the importance of further elucidating the nature of disgust in relation to traumatic events and subsequent posttraumatic stress reactions. Copyright © 2013 International Society for Traumatic Stress Studies.

Financial decision-making abilities and financial exploitation in older African Americans: Preliminary validity evidence for the Lichtenberg Financial Decision Rating Scale (LFDRS).

Science.gov (United States)

Lichtenberg, Peter A; Ficker, Lisa J; Rahman-Filipiak, Annalise

2016-01-01

This study examines preliminary evidence for the Lichtenberg Financial Decision Rating Scale (LFDRS), a new person-centered approach to assessing capacity to make financial decisions, and its relationship to self-reported cases of financial exploitation in 69 older African Americans. More than one third of individuals reporting financial exploitation also had questionable decisional abilities. Overall, decisional ability score and current decision total were significantly associated with cognitive screening test and financial ability scores, demonstrating good criterion validity. Study findings suggest that impaired decisional abilities may render older adults more vulnerable to financial exploitation, and that the LFDRS is a valid tool.

A framework for production of systematic review based briefings to support evidence-informed decision-making

Directory of Open Access Journals (Sweden)

Chambers Duncan

2012-07-01

Full Text Available Abstract Background We have developed a framework for translating existing sources of synthesized and quality-assessed evidence, primarily systematic reviews, into actionable messages in the form of short accessible briefings. The service aims to address real-life problems in response to requests from decision-makers. Development of the framework was based on a scoping review of existing resources and our initial experience with two briefing topics, including models of service provision for young people with eating disorders. We also drew on previous experience in dissemination research and practice. Where appropriate, we made use of the SUPporting POlicy relevant Reviews and Trials (SUPPORT tools for evidence-informed policymaking. Findings To produce a product that it is fit for this purpose it has been necessary to go beyond a traditional summary of the available evidence relating to effectiveness. Briefings have, therefore, included consideration of cost effectiveness, local applicability, implications relating to local service delivery, budgets, implementation and equity. Our first evidence briefings produced under this framework cover diagnostic endoscopy by specialist nurses and integrated care pathways in mental healthcare settings. Conclusions The framework will enable researchers to present and contextualize evidence from systematic reviews and other sources of synthesized and quality-assessed evidence. The approach is designed to address the wide range of questions of interest to decision-makers, especially those commissioning services or managing service delivery and organization in primary or secondary care. Evaluation of the use and usefulness of the evidence briefings we produce is an integral part of the framework and will help to fill a gap in the literature.

Integrated Bio-ISRU and Life Support Systems at the Lunar Outpost: Concept and Preliminary Results

Science.gov (United States)

Brown, I. I.; Garrison, D. H.; Allen, C. C.; Pickering, K.; Sarkisova, S. A.; Galindo, C., Jr.; Pan, D.; Foraker, E.; Mckay, D. S.

2009-01-01

We continue the development of our concept of a biotechnological loop for in-situ resource extraction along with propellant and food production at a future lunar outpost, based on the cultivation of litholytic cyanobacteria (LCB) with lunar regolith (LR) in a geobioreactor energized by sunlight. Our preliminary studies have shown that phototropic cultivation of LCB with simulants of LR in a low-mineralized medium supplemented with CO2 leads to rock dissolution (bioweathering) with the resulting accumulation of Fe, Mg and Al in cyanobacterial cells and in the medium. LCB cultivated with LR simulants produces more O2 than the same organisms cultivated in a high-mineralized medium. The loss of rock mass after bioweathering with LCB suggests the release of O from regolith. Further studies of chemical pathways of released O are required. The bioweathering process is limited by the availability of CO2, N, and P. Since lunar regolith is mainly composed of O, Si, Ca, Al and Mg, we propose to use organic waste to supply a geobioreactor with C, N and P. The recycling of organic waste, including urine, through a geobioreactor will allow for efficient element extraction as well as oxygen and biomass production. The most critical conclusion is that a biological life support system tied to a geobioreactor might be more efficient for supporting an extraterrestrial outpost than a closed environmental system.

Physical Feature Encoding and Word Recognition Abilities Are Altered in Children with Intractable Epilepsy: Preliminary Neuromagnetic Evidence

Science.gov (United States)

Pardos, Maria; Korostenskaja, Milena; Xiang, Jing; Fujiwara, Hisako; Lee, Ki H.; Horn, Paul S.; Byars, Anna; Vannest, Jennifer; Wang, Yingying; Hemasilpin, Nat; Rose, Douglas F.

2015-01-01

Objective evaluation of language function is critical for children with intractable epilepsy under consideration for epilepsy surgery. The purpose of this preliminary study was to evaluate word recognition in children with intractable epilepsy by using magnetoencephalography (MEG). Ten children with intractable epilepsy (M/F 6/4, mean ± SD 13.4 ± 2.2 years) were matched on age and sex to healthy controls. Common nouns were presented simultaneously from visual and auditory sensory inputs in “match” and “mismatch” conditions. Neuromagnetic responses M1, M2, M3, M4, and M5 with latencies of ~100 ms, ~150 ms, ~250 ms, ~350 ms, and ~450 ms, respectively, elicited during the “match” condition were identified. Compared to healthy children, epilepsy patients had both significantly delayed latency of the M1 and reduced amplitudes of M3 and M5 responses. These results provide neurophysiologic evidence of altered word recognition in children with intractable epilepsy. PMID:26146459

Arthroplasty knee registry of Catalonia: What scientific evidence supports the implantation of our prosthesis?

Science.gov (United States)

Samaniego Alonso, R; Gaviria Parada, E; Pons Cabrafiga, M; Espallargues Carreras, M; Martinez Cruz, O

2018-02-28

In our environment, it is increasingly necessary to perform an activity based on scientific evidence and the field of prosthetic surgery should be governed by the same principles. The national arthroplasty registries allow us to obtain a large amount of data in order to evaluate this technique. The aim of our study is to analyse the scientific evidence that supports the primary total knee arthroplasties implanted in Catalonian public hospitals, based on the Arthoplasty Registry of Catalonia (RACat) MATERIAL AND METHODS: A review of the literature was carried out on knee prostheses (cruciate retaining, posterior stabilized, constricted and rotational) recorded in RACat between the period 2005-2013 in the following databases: Orthopedic Data Evaluation Panel, PubMed, TripDatabase and Google Scholar. The prostheses implanted in fewer than 10 units (1,358 prostheses corresponding to 62 models) were excluded. 41,947 prostheses (96.86%) were analysed out of 43,305 implanted, corresponding to 74 different models. In 13 models (n = 4,715) (11.24%) no clinical evidence to support their use was found. In the remaining 36 models (n = 13,609) (32.45%), level iv studies were the most predominant evidence. There was a significant number of implanted prostheses (11.24%) for which no clinical evidence was found. The number of models should be noted, 36 out of 110, with fewer than 10 units implanted. The use of arthroplasty registries has proved an extremely useful tool that allows us to analyse and draw conclusions in order to improve the efficiency of this surgical technique. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Evidence-informed health policy 3 - interviews with the directors of organizations that support the use of research evidence.

Science.gov (United States)

Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J

2008-12-17

Only a small number of previous efforts to describe the experiences of organizations that produce clinical practice guidelines (CPGs), undertake health technology assessments (HTAs), or directly support the use of research evidence in developing health policy (i.e., government support units, or GSUs) have relied on interviews and then only with HTA agencies. Interviews offer the potential for capturing experiences in great depth, particularly the experiences of organizations that may be under-represented in surveys. We purposively sampled organizations from among those who completed a questionnaire in the first phase of our three-phase study, developed and piloted a semi-structured interview guide, and conducted the interviews by telephone, audio-taped them, and took notes simultaneously. Binary or categorical responses to more structured questions were counted when possible. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. Illustrative quotations were identified to supplement the narrative description of the themes. We interviewed the director (or his or her nominee) in 25 organizations, of which 12 were GSUs. Using rigorous methods that are systematic and transparent (sometimes shortened to 'being evidence-based') was the most commonly cited strength among all organizations. GSUs more consistently described their close links with policymakers as a strength, whereas organizations producing CPGs, HTAs, or both had conflicting viewpoints about such close links. With few exceptions, all types of organizations tended to focus largely on weaknesses in implementation, rather than strengths. The advice offered to those trying to establish similar organizations include: 1) collaborate with other organizations; 2) establish strong links with policymakers and stakeholders; 3) be independent and manage conflicts of interest; 4) build capacity; 5) use good methods and be transparent; 6) start small and

Working group reports: Evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project

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The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm an...

Equity and Blindness: Closing Evidence Gaps to Support Universal Eye Health.

Science.gov (United States)

Ramke, Jacqueline; Zwi, Anthony B; Palagyi, Anna; Blignault, Ilse; Gilbert, Clare E

2015-01-01

The World Health Organization Program for the Prevention of Blindness adopted the principles of universal health coverage (UHC) in its latest plan, Universal Eye Health: A Global Action Plan, 2014-2019. This plan builds on the achievements of Vision 2020, which aimed to reduce the global prevalence of avoidable blindness, and its unequal distribution, by the year 2020. We reviewed the literature on health equity and the generation and use of evidence to promote equity, particularly in eye health. We describe the nature and extent of the equity-focused evidence to support and inform eye health programs on the path to universal eye health, and propose ways to improve the collection and reporting of this evidence. Blindness prevalence decreased in all regions of the world between 1990 and 2010, albeit not at the same rate or to the same extent. In 2010, the prevalence of blindness in West Africa (6.0%) remained 15 times higher than in high-income regions (0.4%); within all regions, women had a higher prevalence of blindness than men. Beyond inter-regional and sex differences, there is little comparable data on the distribution of blindness across social groups within regions and countries, or on whether this distribution has changed over time. Similarly, interventions known to address inequity in blindness are few, and equity-relevant goals, targets and indicators for eye health programs are scarce. Equity aims of eye health programs can benefit from the global momentum towards achieving UHC, and the progress being made on collecting, communicating and using equity-focused evidence.

Analysis of Evidence Supporting the Educational Leadership Constituent Council 2011 Educational Leadership Program Standards

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Tucker, Pamela D.; Anderson, Erin; Reynolds, Amy L.; Mawhinney, Hanne

2016-01-01

This document analysis provides a summary of the research from high-impact journals published between 2008 and 2013 with the explicit purpose of determining the extent to which the current empirical evidence supports the individual 2011 Educational Leadership Constituent Council Program Standards and their elements. We found that the standards are…

TITAN Legal Weight Truck cask preliminary design report

International Nuclear Information System (INIS)

1990-04-01

The Preliminary Design of the TITAN Legal Weight Truck (LWT) Cask System and Ancillary Equipment is presented in this document. The scope of this document includes the LWT cask with fuel baskets, impact limiters, and lifting and tiedown features; the cask support system for transportation; intermodal transfer skid; personnel barrier; and cask lifting yoke assembly. The results of the tradeoff studies and evaluations that were performed during the preliminary design are presented in Appendix A to this report. 51 figs., 17 tabs

Integration of evidence-based practice in bedside teaching paediatrics supported by e-learning.

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Potomkova, Jarmila; Mihal, Vladimir; Zapletalova, Jirina; Subova, Dana

2010-03-01

Bedside teaching with evidence-based practice elements, supported by e-learning activities, can play an important role in modern medical education. Teachers have to incorporate evidence from the medical literature to increase student motivation and interactivity. An integral part of the medical curricula at Palacky University Olomouc (Czech Republic) are real paediatric scenarios supplemented with a review of current literature to enhance evidence-based bedside teaching & learning. Searching for evidence is taught through librarian-guided interactive hands-on sessions and/or web-based tutorials followed by clinical case presentations and feedback. Innovated EBM paediatric clerkship demonstrated students' preferences towards web-based interactive bedside teaching & learning. In two academic years (2007/2008, 2008/2009), learning-focused feedback from 106 and 131 students, resp. was obtained about their attitudes towards evidence-based bedside teaching. The assessment included among others the overall level of instruction, quality of practical evidence-based training, teacher willingness and impact of instruction on increased interest in the specialty. There was some criticism about excessive workload. A parallel survey was carried out on the perceived values of different forms of information skills training (i.e. demonstration, online tutorials, and librarian-guided interactive search sessions) and post-training self-reported level of search skills. The new teaching/learning paediatric portfolio is a challenge for further activities, including effective knowledge translation, continuing medical & professional development of teachers, and didactic, clinically integrated teaching approaches.

Evidence Supporting an Early as Well as Late Heavy Bombardment on the Moon

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Frey, Herbert

2015-01-01

Evidence supporting an intense early bombardment on the Moon in addition to the traditional Late Heavy Bombardment at approx. 4 BY ago include the distribution of N(50) Crater Retention Ages (CRAs) for candidate basins, a variety of absolute age scenarios for both a "young" and an "old" Nectaris age, and the decreasing contrasts in both topographic relief and Bouguer gravity with increasing CRA.

Factors influencing law enforcement decisions to adopt an evidence-based robbery prevention program.

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Cabell, A; Casteel, C; Chronister, T; Nocera, M; Vladutiu, C J; Peek-Asa, C

2013-12-01

Homicide is the leading cause of workplace death among small retail and service businesses in the United States. Evidence-based programs have been shown to reduce robbery and robbery-related crimes in small retail businesses; however, reaching small businesses with programs has been difficult. As small businesses typically have no corporate backing or trade affiliation, police departments have been identified as potential vehicles for program dissemination. A national sample of 300 law enforcement agencies was surveyed to identify facilitators and barriers to adoption and sustainability of an evidence-based program. The questionnaire was developed using behavioral theory concepts and administered via telephone. Preliminary findings suggest the primary facilitators to program adoption included organizational capacity factors such as staff buy-in, dedicated personnel and financial support. Competing responsibilities was the primary barrier identified by agencies. Agency size and program complexity were identified as potential predictors of program adoption. Identifying agency and program-specific characteristics that influence program adoption by law enforcement agencies will be valuable for marketing programs to agencies that have the infrastructure to support and sustain program dissemination. Understanding these factors will optimize the reach of evidence-based strategies to small businesses.

Experimental support for an immunological approach to the search for life on other planets.

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Schweitzer, Mary Higby; Wittmeyer, Jennifer; Avci, Recep; Pincus, Seth

2005-02-01

We propose a three-phase approach to test for evidence of life in extraterrestrial samples. The approach capitalizes on the flexibility, sensitivity, and specificity of antibody-antigen interactions. Data are presented to support the first phase, in which various extraction protocols are compared for efficiency, and in which a preliminary suite of antibodies are tested against various antigens. The antigens and antibodies were chosen on the basis of criteria designed to optimize the detection of extraterrestrial biomarkers unique to living or once-living organisms.

Hippocampal declarative memory supports gesture production: Evidence from amnesia.

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Hilverman, Caitlin; Cook, Susan Wagner; Duff, Melissa C

2016-12-01

Spontaneous co-speech hand gestures provide a visuospatial representation of what is being communicated in spoken language. Although it is clear that gestures emerge from representations in memory for what is being communicated (De Ruiter, 1998; Wesp, Hesse, Keutmann, & Wheaton, 2001), the mechanism supporting the relationship between gesture and memory is unknown. Current theories of gesture production posit that action - supported by motor areas of the brain - is key in determining whether gestures are produced. We propose that when and how gestures are produced is determined in part by hippocampally-mediated declarative memory. We examined the speech and gesture of healthy older adults and of memory-impaired patients with hippocampal amnesia during four discourse tasks that required accessing episodes and information from the remote past. Consistent with previous reports of impoverished spoken language in patients with hippocampal amnesia, we predicted that these patients, who have difficulty generating multifaceted declarative memory representations, may in turn have impoverished gesture production. We found that patients gestured less overall relative to healthy comparison participants, and that this was particularly evident in tasks that may rely more heavily on declarative memory. Thus, gestures do not just emerge from the motor representation activated for speaking, but are also sensitive to the representation available in hippocampal declarative memory, suggesting a direct link between memory and gesture production. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prospective Links between Friendship and Early Physical Aggression: Preliminary Evidence Supporting the Role of Friendship Quality through a Dyadic Intervention

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Salvas, Marie-Claude; Vitaro, Frank; Brendgen, Mara; Cantin, Ste´phane

2016-01-01

Positive friendships have been related to decreasing levels of children's physical aggression over time. While this evidence calls for interventions aimed at helping children build good-quality friendships, tests of causality through experimental manipulations are still needed. The goal of this study was to examine whether an intervention aimed to…

Evidence supporting the use of cone-beam computed tomography in orthodontics.

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van Vlijmen, Olivier J C; Kuijpers, Mette A R; Bergé, Stefaan J; Schols, Jan G J H; Maal, Thomas J J; Breuning, Hero; Kuijpers-Jagtman, Anne Marie

2012-03-01

The authors conducted a systematic review of cone-beam computed tomography (CBCT) applications in orthodontics and evaluated the level of evidence to determine whether the use of CBCT is justified in orthodontics. The authors identified articles by searching the Cochrane Library, PubMed, MEDLINE, Embase, Scopus and Cumulative Index to Nursing and Allied Health Literature databases. They searched the articles' reference lists manually for additional articles and had no language limitations. They did not search the gray literature. Inclusion criteria were CBCT use in orthodontics and that the participants be human. The lowest level of evidence accepted for inclusion was a case series with five or more participants. The authors evaluated the studies' methodological quality according to 13 criteria related to study design, measurements and statistical analysis. The authors identified 550 articles, and 50 met the inclusion criteria. Study topics included temporary anchorage devices, cephalometry, combined orthodontic and surgical treatment, airway measurements, root resorption and tooth impactions, and cleft lip and palate. The methodological quality averaged 53 percent (range, 15-77 percent) of the maximum score. The authors found no high-quality evidence regarding the benefits of CBCT use in orthodontics. Limited evidence shows that CBCT offers better diagnostic potential, leads to better treatment planning or results in better treatment outcome than do conventional imaging modalities. Only the results of studies on airway diagnostics provided sound scientific data suggesting that CBCT use has added value. The additional radiation exposure should be weighed against possible benefits of CBCT, which have not been supported in the literature. In future studies, investigators should evaluate the effects of CBCT on treatment procedures, progression and outcome quantitatively.

Preliminary study of mechanism of action of SN38 derivatives. Physicochemical data, evidence of interaction and alkylation of DNA octamer d(GCGATCGC)2.

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Naumczuk, Beata; Kawęcki, Robert; Bocian, Wojciech; Bednarek, Elżbieta; Sitkowski, Jerzy; Kozerski, Lech

2017-02-01

The synthesis of water-soluble SN38 derivatives is presented, and their stability in solutions used during drug development studies has been investigated. A preliminary study of mechanism of action of 9-aminomethyl SN38 is presented. Using NMR techniques, the interaction of the oligomer d(GCGATCGC) 2 is studied, showing that the terminal GC base pairs are the main site of interaction. Using pulsed field gradient spin echo and mass spectroscopy, evidence of a spontaneous alkylation reaction of the DNA oligomer with SN38 derivatives is presented. A proposed mechanism of reaction is suggested. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A multi-site randomised controlled trial of evidence-based supported employment for adults with severe and persistent mental illness.

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Waghorn, Geoffrey; Dias, Shannon; Gladman, Beverley; Harris, Meredith; Saha, Sukanta

2014-12-01

The Individual Placement and Support (IPS) approach is an evidence-based form of supported employment for people with severe and persistent mental illness. This approach is not yet widely available in Australia even though there is mounting evidence of its generalisability outside the USA. One previous Australian randomised controlled trial found that IPS is effective for young people with first episode psychosis. The aim of the current trial was to assess the effectiveness of evidence-based supported employment when implemented for Australian adult consumers of public mental health services by utilising existing service systems. A four-site randomised control trial design (n = 208) was conducted in Brisbane (two sites), Townsville and Cairns. The intervention consisted of an IPS supported employment service hosted by a community mental health team. The control condition was delivered at each site by mental health teams referring consumers to other disability employment services in the local area. At 12 months, those in the IPS condition had 2.4 times greater odds of commencing employment than those in the control condition (42.5% vs. 23.5%). The conditions did not differ on secondary employment outcomes including job duration, hours worked, or job diversity. Attrition was higher than expected in both conditions with 28.4% completing the baseline interview but taking no further part in the study. The results support previous international findings that IPS-supported employment is more effective than non-integrated supported employment. IPS can be successfully implemented this way in Australia, but with a loss of effect strength compared to previous USA trials. © 2014 Occupational Therapy Australia.

Reliability and preliminary evidence of validity of a Farsi version of the depression anxiety stress scales.

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Bayani, Ali Asghar

2010-08-01

The internal consistency, test-retest reliability, and construct validity of the Farsi version of the Depression Anxiety Stress Scales were examined, with a sample of 306 undergraduate students (123 men, 183 women) ranging from 18 to 51 years of age (M age = 25.4, SD = 6.1). Participants completed the Satisfaction with Life Scale, Rosenberg Self-esteem Scale, and the Depression Anxiety Stress Scales. The findings confirmed the preliminary reliabilities and preliminary construct validity of the Farsi translation of the Depression Anxiety Stress Scales.

Neonatal non-invasive respiratory support: synchronised NIPPV, non-synchronised NIPPV or bi-level CPAP: what is the evidence in 2013?

Science.gov (United States)

Roberts, C T; Davis, P G; Owen, L S

2013-01-01

Nasal continuous positive airway pressure (NCPAP) has proven to be an effective mode of non-invasive respiratory support in preterm infants; however, many infants still require endotracheal ventilation, placing them at an increased risk of morbidities such as bronchopulmonary dysplasia. Several other modes of non-invasive respiratory support beyond NCPAP, including synchronised and non-synchronised nasal intermittent positive pressure ventilation (SNIPPV and nsNIPPV) and bi-level positive airway pressure (BiPAP) are now also available. These techniques require different approaches, and the exact mechanisms by which they act remain unclear. SNIPPV has been shown to reduce the rate of reintubation in comparison to NCPAP when used as post-extubation support, but the evidence for nsNIPPV and BiPAP in this context is less convincing. There is some evidence that NIPPV (whether synchronised or non-synchronised) used as primary respiratory support is beneficial, but the variation in study methodology makes this hard to translate confidently into clinical practice. There is currently no evidence to suggest a reduction in mortality or important morbidities such as bronchopulmonary dysplasia, with NIPPV or BiPAP in comparison to NCPAP, and there is a lack of appropriately designed studies in this area. This review discusses the different approaches and proposed mechanisms of action of SNIPPV, nsNIPPV and BiPAP, the challenges of applying the available evidence for these distinct modalities of non-invasive respiratory support to clinical practice, and possible areas of future research. © 2013 S. Karger AG, Basel.

Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes

Directory of Open Access Journals (Sweden)

SL Wagner

2015-10-01

Full Text Available Background: There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. Objective: To determine the value of social support interventions for work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. Results: The search resulted in 3363 titles of which 3248 were excluded following title/abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. Conclusion: There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.

Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes.

Science.gov (United States)

Wagner, S L; White, M I; Schultz, I Z; Williams-Whitt, K; Koehn, C; Dionne, C E; Koehoorn, M; Harder, H G; Pasca, R; Wärje, O; Hsu, V; McGuire, L; Lama, I; Schulz, W; Kube, D; Wright, M D

2015-10-01

There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. To determine the value of social support interventions for work outcomes. Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. The search resulted in 3363 titles of which 3248 were excluded following title/abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.

Investigation assessing the publicly available evidence supporting postmarketing withdrawals, revocations and suspensions of marketing authorisations in the EU since 2012

Science.gov (United States)

Lynn, Elizabeth; Shakir, Saad

2018-01-01

Objectives To assess the sources of publicly available evidence supporting withdrawal, revocation or suspension of marketing authorisations (‘regulatory actions’) due to safety reasons in the EU since 2012 and to investigate the time taken since initial marketing authorisation to reach these regulatory decisions. Setting This investigation examined the sources of evidence supporting 18 identified prescription medicinal products which underwent regulatory action due to safety reasons within the EU in the period 1 July 2012 to 31 December 2016. Results Eighteen single or combined active substances (‘medicinal products’) withdrawn, revoked or suspended within the EU for safety reasons between 2012 and 2016 met the inclusion criteria. Case reports were most commonly cited, supporting 94.4% of regulatory actions (n=17), followed by randomised controlled trial, meta-analyses, animal and in vitro, ex vivo or in silico study designs, each cited in 72.2% of regulatory actions (n=13). Epidemiological study designs were least commonly cited (n=8, 44.4%). Multiple sources of evidence contributed to 94.4% of regulatory decisions (n=17). Death was the most common adverse drug reaction leading to regulatory action (n=5; 27.8%), with four of these related to medication error or overdose. Median (IQR) time taken to reach a decision from the start of regulatory review was found to be 204.5 days (143, 535 days) and decreased across the study period. Duration of marketing prior to regulatory action, from the medicinal product’s authorisation date, increased across the period 2012–2016. Conclusions The sources of evidence supporting pharmacovigilance regulatory activities appear to have changed since implementation of Directive 2010/84/EU and Regulation (EU) No. 1235/2010. This, together with a small improvement in regulatory efficiency, suggests progress towards more rapid regulatory decisions based on more robust evidence. Future research should continue to monitor

Conversational evidence in therapeutic dialogue.

Science.gov (United States)

Strong, Tom; Busch, Robbie; Couture, Shari

2008-07-01

Family therapists' participation in therapeutic dialogue with clients is typically informed by evidence of how such dialogue is developing. In this article, we propose that conversational evidence, the kind that can be empirically analyzed using discourse analyses, be considered a contribution to widening psychotherapy's evidence base. After some preliminaries about what we mean by conversational evidence, we provide a genealogy of evaluative practice in psychotherapy, and examine qualitative evaluation methods for their theoretical compatibilities with social constructionist approaches to family therapy. We then move on to examine the notion of accomplishment in therapeutic dialogue given how such accomplishments can be evaluated using conversation analysis. We conclude by considering a number of research and pedagogical implications we associate with conversational evidence.

Using mobile health technology to improve behavioral skill implementation through homework in evidence-based parenting intervention for disruptive behavior disorders in youth: study protocol for intervention development and evaluation.

Science.gov (United States)

Chacko, Anil; Isham, Andrew; Cleek, Andrew F; McKay, Mary M

2016-01-01

Disruptive behavior disorders (DBDs) (oppositional defiant disorder (ODD) and conduct disorder (CD)) are prevalent, costly, and oftentimes chronic psychiatric disorders of childhood. Evidence-based interventions that focus on assisting parents to utilize effective skills to modify children's problematic behaviors are first-line interventions for the treatment of DBDs. Although efficacious, the effects of these interventions are often attenuated by poor implementation of the skills learned during treatment by parents, often referred to as between-session homework. The multiple family group (MFG) model is an evidence-based, skills-based intervention model for the treatment of DBDs in school-age youth residing in urban, socio-economically disadvantaged communities. While data suggest benefits of MFG on DBD behaviors, similar to other skill-based interventions, the effects of MFG are mitigated by the poor homework implementation, despite considerable efforts to support parents in homework implementation. This paper focuses on the study protocol for the development and preliminary evaluation of a theory-based, smartphone mobile health (mHealth) application (My MFG) to support homework implementation by parents participating in MFG. This paper describes a study design proposal that begins with a theoretical model, uses iterative design processes to develop My MFG to support homework implementation in MFG through a series of pilot studies, and a small-scale pilot randomised controlled trial to determine if the intervention can demonstrate change (preliminary efficacy) of My MFG in outpatient mental health settings in socioeconomically disadvantaged communities. This preliminary study aims to understand the implementation of mHealth methods to improve the effectiveness of evidence-based interventions in routine outpatient mental health care settings for youth with disruptive behavior and their families. Developing methods to augment the benefits of evidence

Biomarkers of Eating Disorders Using Support Vector Machine Analysis of Structural Neuroimaging Data: Preliminary Results

Directory of Open Access Journals (Sweden)

Antonio Cerasa

2015-01-01

Full Text Available Presently, there are no valid biomarkers to identify individuals with eating disorders (ED. The aim of this work was to assess the feasibility of a machine learning method for extracting reliable neuroimaging features allowing individual categorization of patients with ED. Support Vector Machine (SVM technique, combined with a pattern recognition method, was employed utilizing structural magnetic resonance images. Seventeen females with ED (six with diagnosis of anorexia nervosa and 11 with bulimia nervosa were compared against 17 body mass index-matched healthy controls (HC. Machine learning allowed individual diagnosis of ED versus HC with an Accuracy ≥ 0.80. Voxel-based pattern recognition analysis demonstrated that voxels influencing the classification Accuracy involved the occipital cortex, the posterior cerebellar lobule, precuneus, sensorimotor/premotor cortices, and the medial prefrontal cortex, all critical regions known to be strongly involved in the pathophysiological mechanisms of ED. Although these findings should be considered preliminary given the small size investigated, SVM analysis highlights the role of well-known brain regions as possible biomarkers to distinguish ED from HC at an individual level, thus encouraging the translational implementation of this new multivariate approach in the clinical practice.

Biomarkers of Eating Disorders Using Support Vector Machine Analysis of Structural Neuroimaging Data: Preliminary Results

Science.gov (United States)

Cerasa, Antonio; Castiglioni, Isabella; Salvatore, Christian; Funaro, Angela; Martino, Iolanda; Alfano, Stefania; Donzuso, Giulia; Perrotta, Paolo; Gioia, Maria Cecilia; Gilardi, Maria Carla; Quattrone, Aldo

2015-01-01

Presently, there are no valid biomarkers to identify individuals with eating disorders (ED). The aim of this work was to assess the feasibility of a machine learning method for extracting reliable neuroimaging features allowing individual categorization of patients with ED. Support Vector Machine (SVM) technique, combined with a pattern recognition method, was employed utilizing structural magnetic resonance images. Seventeen females with ED (six with diagnosis of anorexia nervosa and 11 with bulimia nervosa) were compared against 17 body mass index-matched healthy controls (HC). Machine learning allowed individual diagnosis of ED versus HC with an Accuracy ≥ 0.80. Voxel-based pattern recognition analysis demonstrated that voxels influencing the classification Accuracy involved the occipital cortex, the posterior cerebellar lobule, precuneus, sensorimotor/premotor cortices, and the medial prefrontal cortex, all critical regions known to be strongly involved in the pathophysiological mechanisms of ED. Although these findings should be considered preliminary given the small size investigated, SVM analysis highlights the role of well-known brain regions as possible biomarkers to distinguish ED from HC at an individual level, thus encouraging the translational implementation of this new multivariate approach in the clinical practice. PMID:26648660

ProVac Global Initiative: a vision shaped by ten years of supporting evidence-based policy decisions.

Science.gov (United States)

Jauregui, Barbara; Janusz, Cara Bess; Clark, Andrew D; Sinha, Anushua; Garcia, Ana Gabriela Felix; Resch, Stephen; Toscano, Cristiana M; Sanderson, Colin; Andrus, Jon Kim

2015-05-07

The Pan American Health Organization (PAHO) created the ProVac Initiative in 2004 with the goal of strengthening national technical capacity to make evidence-based decisions on new vaccine introduction, focusing on economic evaluations. In view of the 10th anniversary of the ProVac Initiative, this article describes its progress and reflects on lessons learned to guide the next phase. We quantified the output of the Initiative's capacity-building efforts and critically assess its progress toward achieving the milestones originally proposed in 2004. Additionally, we reviewed how country studies supported by ProVac have directly informed and strengthened the deliberations around new vaccine introduction. Since 2004, ProVac has conducted four regional workshops and supported 24 health economic analyses in 15 Latin American and Caribbean countries. Five Regional Centers of Excellence were funded, resulting in six operational research projects and nine publications. Twenty four decisions on new vaccine introductions were supported with ProVac studies. Enduring products include the TRIVAC and CERVIVAC cost-effectiveness models, the COSTVAC program costing model, methodological guides, workshop training materials and the OLIVES on-line data repository. Ten NITAGs were strengthened through ProVac activities. The evidence accumulated suggests that initiatives with emphasis on sustainable training and direct support for countries to generate evidence themselves, can help accelerate the introduction of the most valuable new vaccines. International and Regional Networks of Collaborators are necessary to provide technical support and tools to national teams conducting analyses. Timeliness, integration, quality and country ownership of the process are four necessary guiding principles for national economic evaluations to have an impact on policymaking. It would be an asset to have a model that offers different levels of complexity to choose from depending on the vaccine being

A Scaffolding Framework to Support the Construction of Evidence-Based Arguments among Middle School Students

Science.gov (United States)

Belland, Brian R.; Glazewski, Krista D.; Richardson, Jennifer C.

2008-01-01

Problem-based learning (PBL) is an instructional approach in which students in small groups engage in an authentic, ill-structured problem, and must (1) define, generate and pursue learning issues to understand the problem, (2) develop a possible solution, (3) provide evidence to support their solution, and (4) present their solution and the…

What is the evidence to support the use of therapeutic gardens for the elderly?

Science.gov (United States)

Detweiler, Mark B; Sharma, Taral; Detweiler, Jonna G; Murphy, Pamela F; Lane, Sandra; Carman, Jack; Chudhary, Amara S; Halling, Mary H; Kim, Kye Y

2012-06-01

Horticulture therapy employs plants and gardening activities in therapeutic and rehabilitation activities and could be utilized to improve the quality of life of the worldwide aging population, possibly reducing costs for long-term, assisted living and dementia unit residents. Preliminary studies have reported the benefits of horticultural therapy and garden settings in reduction of pain, improvement in attention, lessening of stress, modulation of agitation, lowering of as needed medications, antipsychotics and reduction of falls. This is especially relevant for both the United States and the Republic of Korea since aging is occurring at an unprecedented rate, with Korea experiencing some of the world's greatest increases in elderly populations. In support of the role of nature as a therapeutic modality in geriatrics, most of the existing studies of garden settings have utilized views of nature or indoor plants with sparse studies employing therapeutic gardens and rehabilitation greenhouses. With few controlled clinical trials demonstrating the positive or negative effects of the use of garden settings for the rehabilitation of the aging populations, a more vigorous quantitative analysis of the benefits is long overdue. This literature review presents the data supporting future studies of the effects of natural settings for the long term care and rehabilitation of the elderly having the medical and mental health problems frequently occurring with aging.

Preliminary assessment report for Army Aviation Support Facility No. 3, Installation 13307, Hunter Army Airfield, Savannah, Georgia. Installation Restoration Program

Energy Technology Data Exchange (ETDEWEB)

Kolpa, R.; Smith, K.

1993-07-01

This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Georgia Army National Guard property located on Hunter Army Airfield (HAA) near Savannah, Georgia, known as Army Aviation Support Facility (AASF) No. 3. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, types and quantities of hazardous substances utilized, the nature and amounts of wastes generated or stored at the facility, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the AASF No. 3 property, requirements of the Department of Defense Installation Restoration Program (IRP). The scope of this assessment is limited to the facilities and past activities contained within the area now occupied by AASF No. 3. However, this assessment report is intended to be read in conjunction with a previous IRP assessment of HAA completed in 1992 (USATHAMA 1992) and to provide comprehensive information on AASF No. 3 for incorporation with information contained in that previous assessment for the entirety of HAA.

An evidence-based approach to perioperative nutrition support in the elective surgery patient.

Science.gov (United States)

Miller, Keith R; Wischmeyer, Paul E; Taylor, Beth; McClave, Stephen A

2013-09-01

In surgical practice, great attention is given to the perioperative management of the elective surgical patient with regard to surgical planning, stratification of cardiopulmonary risk, and postoperative assessment for complication. However, growing evidence supports the beneficial role for implementation of a consistent and literature-based approach to perioperative nutrition therapy. Determining nutrition risk should be a routine component of the preoperative evaluation. As with the above issues, this concept begins with the clinician's first visit with the patient as risk is assessed and the severity of the surgical insult considered. If the patient is an appropriate candidate for benefit from preoperative support, a plan for initiation and reassessment should be implemented. Once appropriate nutrition end points have been achieved, special consideration should be given to beneficial practices the immediate day preceding surgery that may better prepare the patient for the intervention from a metabolic standpoint. In the operating room, consideration should be given to the potential placement of enteral access during the index operation as well as judicious and targeted intraoperative resuscitation. Immediately following the intervention, adequate resuscitation and glycemic control are key concepts, as is an evidence-based approach to the early advancement of an enteral/oral diet in the postoperative patient. Through the implementation of perioperative nutrition therapy plans in the elective surgery setting, outcomes can be improved.

Additional Interventions to Enhance the Effectiveness of Individual Placement and Support: A Rapid Evidence Assessment

Directory of Open Access Journals (Sweden)

Naomi Boycott

2012-01-01

Full Text Available Topic. Additional interventions used to enhance the effectiveness of individual placement and support (IPS. Aim. To establish whether additional interventions improve the vocational outcomes of IPS alone for people with severe mental illness. Method. A rapid evidence assessment of the literature was conducted for studies where behavioural or psychological interventions have been used to supplement standard IPS. Published and unpublished empirical studies of IPS with additional interventions were considered for inclusion. Conclusions. Six published studies were found which compared IPS alone to IPS plus a supplementary intervention. Of these, three used skills training and three used cognitive remediation. The contribution of each discrete intervention is difficult to establish. Some evidence suggests that work-related social skills and cognitive training are effective adjuncts, but this is an area where large RCTs are required to yield conclusive evidence.

Shifting mindsets: a realist synthesis of evidence from self-management support training.

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Davies, Freya; Wood, Fiona; Bullock, Alison; Wallace, Carolyn; Edwards, Adrian

2018-03-01

Accompanying the growing expectation of patient self-management is the need to ensure health care professionals (HCPs) have the required attitudes and skills to provide effective self-management support (SMS). Results from existing training interventions for HCPs in SMS have been mixed and the evidence base is weaker for certain settings, including supporting people with progressive neurological conditions (PNCs). We set out to understand how training operates, and to identify barriers and facilitators to training designed to support shifts in attitudes amongst HCPs. We undertook a realist literature synthesis focused on: (i) the influence of how HCPs, teams and organisations view and adopt self-management; and (ii) how SMS needs to be tailored for people with PNCs. A traditional database search strategy was used alongside citation tracking, grey literature searching and stakeholder recommendations. We supplemented PNC-specific literature with data from other long-term conditions. Key informant interviews and stakeholder advisory group meetings informed the synthesis process. Realist context-mechanism-outcome configurations were generated and mapped onto the stages described in Mezirow's Transformative Learning Theory. Forty-four original articles were included (19 relating to PNCs), from which seven refined theories were developed. The theories identified important training elements (evidence provision, building skills and confidence, facilitating reflection and generating empathy). The significant influence of workplace factors as possible barriers or facilitators was highlighted. Embracing SMS often required challenging traditional professional role boundaries. The integration of SMS into routine care is not an automatic outcome from training. A transformative learning process is often required to trigger the necessary mindset shift. Training should focus on how individual HCPs define and value SMS and how their work context (patient group and organisational

Altering micro-environments to change population health behaviour: towards an evidence base for choice architecture interventions

Science.gov (United States)

2013-01-01

Background The idea that behaviour can be influenced at population level by altering the environments within which people make choices (choice architecture) has gained traction in policy circles. However, empirical evidence to support this idea is limited, especially its application to changing health behaviour. We propose an evidence-based definition and typology of choice architecture interventions that have been implemented within small-scale micro-environments and evaluated for their effects on four key sets of health behaviours: diet, physical activity, alcohol and tobacco use. Discussion We argue that the limitations of the evidence base are due not simply to an absence of evidence, but also to a prior lack of definitional and conceptual clarity concerning applications of choice architecture to public health intervention. This has hampered the potential for systematic assessment of existing evidence. By seeking to address this issue, we demonstrate how our definition and typology have enabled systematic identification and preliminary mapping of a large body of available evidence for the effects of choice architecture interventions. We discuss key implications for further primary research, evidence synthesis and conceptual development to support the design and evaluation of such interventions. Summary This conceptual groundwork provides a foundation for future research to investigate the effectiveness of choice architecture interventions within micro-environments for changing health behaviour. The approach we used may also serve as a template for mapping other under-explored fields of enquiry. PMID:24359583

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

Science.gov (United States)

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

2009-02-01

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

Preliminary assessment of the possibility of supporting the decomposition of biodegradable packaging

OpenAIRE

Niekraś Lidia; Moliszewska Ewa

2017-01-01

This article presents a preliminary evaluation of the possibility of using grass biomass from a sports field as a compost ingredient which positively affects the degree of decomposition of the biodegradable wrappings. For 5 months the biodegradable bags were stored, both empty and filled with organic waste in the heap of grass clippings. After that period, fragments of the bags were observed under the microscope and then assessed the state of their decomposition. The results indicate that the...

The Evidence Base for How We Learn: Supporting Students' Social, Emotional, and Academic Development. Consensus Statements of Evidence from the Council of Distinguished Scientists

Science.gov (United States)

Jones, Stephanie M.; Kahn, Jennifer

2017-01-01

"The Evidence Base for How We Learn: Supporting Students' Social, Emotional, and Academic Development" articulates the scientific consensus regarding how people learn. The research brief presents a set of consensus statements--developed and unanimously signed onto by the Commission's Council of Distinguished Scientists--that affirm the…

Cable Supported Bridges

DEFF Research Database (Denmark)

Gimsing, Niels Jørgen

Cable supported bridges in the form of suspension bridges and cable-stayed bridges are distinguished by their ability to overcome large spans.The book concentrates on the synthesis of cable supported bridges, covering both design and construction aspects. The analytical part covers simple methods...... to quantify the different structural configurations and allows a preliminary optimization of the main structure.Included are the most recent advances in structural design, corrosion protection of cables, aerodynamic safety, and erection procedures....

Evidence Support and Guidelines for Using Heated, Humidified, High-Flow Nasal Cannulae in Neonatology: Oxford Nasal High-Flow Therapy Meeting, 2015.

Science.gov (United States)

Roehr, Charles C; Yoder, Bradley A; Davis, Peter G; Ives, Kevin

2016-12-01

Nasal high-flow therapy (nHFT) has become a popular form of noninvasive respiratory support in neonatal intensive care units. A meeting held in Oxford, UK, in June 2015 examined the evidence base and proposed a consensus statement. In summary, nHFT is effective for support of preterm infants following extubation. There is growing evidence evaluating its use in the primary treatment of respiratory distress. Further study is needed to assess which clinical conditions are most amenable to nHFT support, the most effective flow rates, and escalation and weaning strategies. Its suitability as first-line treatment needs to be further evaluated. Copyright © 2016 Elsevier Inc. All rights reserved.

Hydrogen Gas Retention and Release from WTP Vessels: Summary of Preliminary Studies

Energy Technology Data Exchange (ETDEWEB)

Gauglitz, Phillip A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bontha, Jagannadha R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Daniel, Richard C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mahoney, Lenna A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rassat, Scot D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wells, Beric E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bao, Jie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Boeringa, Gregory K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Buchmiller, William C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Burns, Carolyn A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chun, Jaehun [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Karri, Naveen K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Li, Huidong [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tran, Diana N. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2015-07-01

The Hanford Waste Treatment and Immobilization Plant (WTP) is currently being designed and constructed to pretreat and vitrify a large portion of the waste in the 177 underground waste storage tanks at the Hanford Site. A number of technical issues related to the design of the pretreatment facility (PTF) of the WTP have been identified. These issues must be resolved prior to the U.S. Department of Energy (DOE) Office of River Protection (ORP) reaching a decision to proceed with engineering, procurement, and construction activities for the PTF. One of the issues is Technical Issue T1 - Hydrogen Gas Release from Vessels (hereafter referred to as T1). The focus of T1 is identifying controls for hydrogen release and completing any testing required to close the technical issue. In advance of selecting specific controls for hydrogen gas safety, a number of preliminary technical studies were initiated to support anticipated future testing and to improve the understanding of hydrogen gas generation, retention, and release within PTF vessels. These activities supported the development of a plan defining an overall strategy and approach for addressing T1 and achieving technical endpoints identified for T1. Preliminary studies also supported the development of a test plan for conducting testing and analysis to support closing T1. Both of these plans were developed in advance of selecting specific controls, and in the course of working on T1 it was decided that the testing and analysis identified in the test plan were not immediately needed. However, planning activities and preliminary studies led to significant technical progress in a number of areas. This report summarizes the progress to date from the preliminary technical studies. The technical results in this report should not be used for WTP design or safety and hazards analyses and technical results are marked with the following statement: “Preliminary Technical Results for Planning – Not to be used for WTP Design

Danish evidence-based clinical guideline for use of nutritional support in pulmonary rehabilitation of undernourished patients with stable COPD

DEFF Research Database (Denmark)

Beck, Anne Marie; Iepsen, Ulrik Winning; Topperup, Randi

2015-01-01

Background and aims Disease-related under-nutrition is a common problem in individuals with COPD. The rationale for nutritional support in pulmonary rehabilitation therefore seems obvious. However there is limited evidence regarding the patient-relevant outcomes i.e. activities of daily living (ADL......) or quality of life. Therefore the topic was included in The Danish Health and Medicines Authority's development of an evidence-based clinical guideline for rehabilitation of patients with stable COPD. Methods The methods were specified by The Danish Health and Medicines Authority as part of a standardized...... studies had been published. There were evidence of moderate quality that nutritional support for undernourished patients with COPD lead to a weight gain of 1.7 kg (95% confidence interval: 1.3 to 2.2 kg), but the effect was quantified as a mean change from baseline, which is less reliable. There were...

Epidemiological evidence of carcinogenicity of chlorinated organics in drinking water.

Science.gov (United States)

Cantor, K P

1982-12-01

Concern has recently been voiced over possible chronic toxicity associated with chlorination of public drinking water supplies in the United States. This paper reviews the available evidence and the studies underway to further evaluate hypothesized associations between cancer risk and byproducts of chlorination. Preliminary data from measures of halogenated volatiles and personal exposure histories from respondents in a large epidemiologic study of bladder cancer are presented. These data support the use in epidemiologic studies of categorical measures of exposure and suggest that results from completed case-control studies, based on death certificates, may have underestimated the true risk of exposure to chlorination by-products. The current generation of studies which use a case-control interview design offer many advantages over earlier efforts to evaluate this issue.

Evidence supporting the use of recombinant activated factor VII in congenital bleeding disorders

Directory of Open Access Journals (Sweden)

Pär I Johansson

2010-06-01

Full Text Available Pär I Johansson, Sisse R OstrowskiCapital Region Blood Bank, Section for Transfusion Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkBackground: Recombinant activated factor VII (rFVIIa, NovoSeven® was introduced in 1996 for the treatment of hemophilic patients with antibodies against coagulation factor VIII or IX.Objective: To review the evidence supporting the use of rFVIIa for the treatment of patients with congenital bleeding disorders.Patients and methods: English-language databases were searched in September 2009 for reports of randomized controlled trials (RCTs evaluating the ability of rFVIIa to restore hemostasis in patients with congenital bleeding disorders.Results: Eight RCTs involving 256 hemophilic patients with antibodies against coagulation factors, also known as inhibitors, were identified. The evidence supporting the use of rFVIIa in these patients was weak with regard to dose, clinical setting, mode of administration, efficacy, and adverse events, given the limited sample size of each RCT and the heterogeneity of the studies.Conclusion: The authors suggest that rFVIIa therapy in hemophilic patients with inhibitors should be based on the individual’s ability to generate thrombin and form a clot, and not on the patient’s weight alone. Therefore, assays for thrombin generation, such as whole-blood thromboelastography, have the potential to significantly improve the treatment of these patients.Keywords: hemophilia, inhibitors, coagulation factor VIII, coagulation factor IX, rFVIIa, NovoSeven, FEIBA, hemostasis, RCT

Facilitating the implementation of evidence-based practice through contextual support and nursing leadership

Directory of Open Access Journals (Sweden)

Kueny A

2015-06-01

Full Text Available Angela Kueny,1 Leah L Shever,2 Melissa Lehan Mackin,3 Marita G Titler4 1Luther College, Decorah, IA, 2The University of Michigan Hospital and Health Center, Ann Arbor, MI, 3University of Iowa College of Nursing, Iowa City, IA, 4University of Michigan School of Nursing, Ann Arbor, MI, USA Background/purpose: Nurse managers (NMs play an important role promoting evidence-based practice (EBP on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. Methods: This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. Results: NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality

Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study.

Science.gov (United States)

Ellen, Moriah E; Léon, Grégory; Bouchard, Gisèle; Ouimet, Mathieu; Grimshaw, Jeremy M; Lavis, John N

2014-12-05

Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitate the use of research evidence in health system decision-making. Factors influencing the implementation of such supports remain poorly described in the literature. Identifying the barriers to and facilitators of different interventions is essential for implementation of effective, context-specific, supports for evidence-informed decision-making (EIDM) in health systems. The purpose of this study was to identify (a) barriers and facilitators to implementing supports for EIDM in Canadian health-care organizations, (b) views about emerging development of supports for EIDM, and (c) views about the priorities to bridge the gaps in the current mix of supports that these organizations have in place. This qualitative study was conducted in three types of health-care organizations (regional health authorities, hospitals, and primary care practices) in two Canadian provinces (Ontario and Quebec). Fifty-seven in-depth semi-structured telephone interviews were conducted with senior managers, library managers, and knowledge brokers from health-care organizations that have already undertaken strategic initiatives in knowledge translation. The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. Limited resources (i.e., money or staff), time constraints, and negative attitudes (or resistance) toward change were the most frequently identified barriers to implementing supports for EIDM. Genuine interest from health system decision-makers, notably their willingness to invest money and resources and to create a knowledge translation culture over time in health-care organizations, was the most frequently identified facilitator to

Preliminary structural assessment of DEMO vacuum vessel against a vertical displacement event

International Nuclear Information System (INIS)

Mozzillo, Rocco; Tarallo, Andrea; Marzullo, Domenico; Bachmann, Christian; Di Gironimo, Giuseppe; Mazzone, Giuseppe

2016-01-01

Highlights: • The paper focuses on a preliminary structural analysis of the current concept design of DEMO vacuum vessel. • The Vacuum Vessel was checked against the VDE in combinations with the weight force of all components that the vessel shall bear. • Different configurations for the vacuum vessel supports are considered, showing that the best solution is VV supported at the lower port. • The analyses evaluated the “P damage” according to RCC-MRx code. - Abstract: This paper focuses on a preliminary structural analysis of the current concept design of DEMO vacuum vessel (VV). The VV structure is checked against a vertical load due to a Vertical Displacement Event in combination with the weight force of all components that the main vessel shall bear. Different configurations for the supports are considered. Results show that the greatest safety margins are reached when the tokamak is supported through the lower ports rather than the equatorial ports, though all analyzed configurations are compliant with RCC-MRx design rules.

Preliminary structural assessment of DEMO vacuum vessel against a vertical displacement event

Energy Technology Data Exchange (ETDEWEB)

Mozzillo, Rocco, E-mail: rocco.mozzillo@unina.it [CREATE, University of Naples Federico II, DII, P.le Tecchio 80, 80125, Naples (Italy); Tarallo, Andrea; Marzullo, Domenico [CREATE, University of Naples Federico II, DII, P.le Tecchio 80, 80125, Naples (Italy); Bachmann, Christian [EUROfusion PMU, Boltzmannstraße 2, 85748 Garching (Germany); Di Gironimo, Giuseppe [CREATE, University of Naples Federico II, DII, P.le Tecchio 80, 80125, Naples (Italy); Mazzone, Giuseppe [Unità Tecnica Fusione - ENEA C.R. Frascati, Via E. Fermi 45, 00044 Frascati (Italy)

2016-11-15

Highlights: • The paper focuses on a preliminary structural analysis of the current concept design of DEMO vacuum vessel. • The Vacuum Vessel was checked against the VDE in combinations with the weight force of all components that the vessel shall bear. • Different configurations for the vacuum vessel supports are considered, showing that the best solution is VV supported at the lower port. • The analyses evaluated the “P damage” according to RCC-MRx code. - Abstract: This paper focuses on a preliminary structural analysis of the current concept design of DEMO vacuum vessel (VV). The VV structure is checked against a vertical load due to a Vertical Displacement Event in combination with the weight force of all components that the main vessel shall bear. Different configurations for the supports are considered. Results show that the greatest safety margins are reached when the tokamak is supported through the lower ports rather than the equatorial ports, though all analyzed configurations are compliant with RCC-MRx design rules.

Ramadan fasting: Evidence or expert opinion? Results of preliminary studies

Directory of Open Access Journals (Sweden)

1Maryam Kazemi

2013-11-01

Full Text Available Each year, over a billion Muslims fast worldwide during the month of Ramadan. Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations.

Ramadan fasting: Evidence or expert opinion? Results of preliminary studies

Directory of Open Access Journals (Sweden)

Maryam Kazemi

2013-12-01

Full Text Available Each year, over a billion Muslims fast worldwide during the month of Ramadan.  Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations.

How task characteristics and social support relate to managerial learning: empirical evidence from Dutch home care.

Science.gov (United States)

Ouweneel, A P Else; Taris, Toon W; Van Zolingen, Simone J; Schreurs, Paul J G

2009-01-01

Researchers have revealed that managers profit most from informal and on-the-job learning. Moreover, research has shown that task characteristics and social support affect informal learning. On the basis of these insights, the authors examined the effects of task characteristics (psychological job demands, job control) and social support from the supervisor and colleagues on informal on-the-job learning among 1588 managers in the Dutch home-care sector. A regression analysis revealed that high demands, high control, and high colleague and supervisor support were each associated with high levels of informal learning. The authors found no evidence for statistical interactions among the effects of these concepts. They concluded that to promote managers' informal workplace learning, employers should especially increase job control.

Memory-Focused Cognitive Therapy for Cocaine Use Disorder: Theory, Procedures and Preliminary Evidence From an External Pilot Randomised Controlled Trial

Directory of Open Access Journals (Sweden)

John Marsden

2018-03-01

of regular cocaine use, baseline outcome score, and group estimated the effectiveness of the intervention. The trial is registered with the ISCRTN (ISRCTN16462783. Findings: Between July 15, 2015, and November 27, 2016, 58 patients were assessed for eligibility and 30 participants were randomised (14 to the control group and 16 to the intervention. With outcome data collected for all participants at the endpoint, the intervention group mean CEQ-F score (14·77; SD 21·47 was lower than the control group mean (51·75; SD 22·72; ES -1·62; 95% CI -2·45 to −0·80.MFCT was associated with more cocaine abstinence in the intervention group (PDA 85·94; SD 18·96 than the control group (PDA 54·59; SD 30·29; ES 1·19; 90% CI 0·54 to 1·84. There was also greater maximum abstinence in the intervention group (LPA 15·69; SD 10·10 than the control group (6·00; SD 7·36; ES 1·06; 90% CI 0·41 to 1·70. Exploratory, confounder-adjusted regression models for this preliminary effect supported the treatment association for reduced craving experiences (CEQ-F Coef. -28·25; 95% CI -45·15 to −11·35; more abstinence (PDA Incidence Rate Ratio [IRR] 1·56; 95% CI 1·31 to 1·88; and greater maximum abstinence (LPA IRR 2·56; 95% CI 1·96 to 3·35, although relative weak unmeasured confounding could overturn these model-adjusted exposure-outcome associations.There were four serious adverse events (among three participants. None were judged related to study procedures or interventions. Interpretation: In this first external pilot randomised controlled trial of MFCT for CUD, we have shown that the intervention and control procedures and acceptable feasible and safe, and report preliminary evidence that MFCT is associated with reduced craving and increased abstinence. These findings support progression to a substantive trial. Funding Source: UK National Institute for Health Research, Biomedical Research Centre. Keywords: Cocaine, Craving, Memory, Reconsolidation, Cognitive

Effectiveness of Service Dogs for Veterans with PTSD: Preliminary Outcomes.

Science.gov (United States)

Vincent, Claude; Belleville, Geneviève; Gagnon, Dany H; Dumont, Frédéric; Auger, Edouard; Lavoie, Vicky; Besemann, Markus; Champagne, Noël; Lessart, Geneviève

2017-01-01

Limited scientific evidence on the effectiveness of psychiatric service dogs used by Veterans with post-traumatic stress disorder (PTSD) is available. This study investigated their short-term effectiveness among 15 Canadian veterans who received a first psychiatric service dog. Preliminary results suggest potential beneficial effects at 3 months on the psychiatric symptoms.

Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care.

Science.gov (United States)

Sinn, Chi-Ling Joanna; Jones, Aaron; McMullan, Janet Legge; Ackerman, Nancy; Curtin-Telegdi, Nancy; Eckel, Leslie; Hirdes, John P

2017-11-25

Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care

Directory of Open Access Journals (Sweden)

Chi-Ling Joanna Sinn

2017-11-01

Full Text Available Abstract Background Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. Methods The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. Results The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. Conclusions The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

Transport processes for Chernobyl-labelled sediments: preliminary evidence from upland mid-Wales

International Nuclear Information System (INIS)

Bonnett, P.J.P.; Leeks, G.J.L.; Cambray, R.S.

1989-01-01

The nuclear accident at Chernobyl in April 1986 resulted in a significant increase in the inventory of radiocaesium retained in the soil in many regions of the United Kingdom. The deposition of 134 Cs provides a convenient tool for the examination of erosional processes in upland systems. Detailed soil sampling has been undertaken within the Plynlimon experimental catchments to establish the pattern of deposition of Chernobyl-derived radionuclides. The preliminary results of a combined radiometric and mineral magnetic approach to the study of the transport of Chernobyl-labelled sediments and their source areas on these upland catchments in mid-Wales are described. (author)

Brief Report: An Independent Replication and Extension of Psychometric Evidence Supporting the Theory of Mind Inventory

Science.gov (United States)

Greenslade, Kathryn J.; Coggins, Truman E.

2016-01-01

This study presents an independent replication and extension of psychometric evidence supporting the "Theory of Mind Inventory" ("ToMI"). Parents of 20 children with ASD (4; 1-6; 7 years; months) and 20 with typical development (3; 1-6; 5), rated their child's theory of mind abilities in everyday situations. Other parent report…

Is there evidence to support a forefoot strike pattern in barefoot runners? A review.

Science.gov (United States)

Lorenz, Daniel S; Pontillo, Marisa

2012-11-01

Barefoot running is a trend among running enthusiasts that is the subject of much controversy. At this time, benefits appear to be more speculative and anecdotal than evidence based. Additionally, the risk of injuries is not well established. A PubMed search was undertaken for articles published in English from 1980 to 2011. Additional references were accrued from reference lists of research articles. While minimal data exist that definitively support barefoot running, there are data lending support to the argument that runners should use a forefoot strike pattern in lieu of a heel strike pattern to reduce ground reaction forces, ground contact time, and step length. Whether there is a positive or negative effect on injury has yet to be determined. Unquestionably, more research is needed before definitive conclusions can be drawn.

Development and preliminary evaluation of the Child Feeding Guide website and app: A tool to support caregivers with promoting healthy eating in children

Directory of Open Access Journals (Sweden)

Emma Haycraft

2015-10-01

Full Text Available Background: Fussy eating in young children is very common, with at least 50% of parents reporting having a fussy child. Eating behaviours established early in life tend to remain throughout childhood and into adulthood, so ensuring that children develop healthy eating behaviours from their earliest years is vital. Fussy children often refuse to eat healthy foods, like fruit and vegetables, but favour high-calorie foods instead. Diets low in fruit and vegetables have been linked to a number of preventable health conditions, such as diabetes and cancers, as well as to overweight and obesity. Fussy child eating behaviours can also cause anxiety and stress in caregivers, which can perpetuate the problem. Despite an abundance of available support for introducing complementary foods, practical advice about child feeding once weaning has occurred is lacking. Moreover, caregivers find available resources about feeding young children and promoting healthy eating to be “too basic” and have called for evidence-based, credible resources to help them manage children’s difficult or fussy eating behaviours. Empowering caregivers to effectively manage fussy eating behaviours and improve health in their children will likely prevent these eating behaviours from becoming engrained and reduce the number of children eating unhealthy or limited diets. Aim: To address the lack of child feeding support for caregivers by developing an evidence-based, credible and accessible support resource to promote healthy eating habits in young children and healthy feeding practices in caregivers. Method: Following a review of the literature and consultation with caregivers, the Child Feeding Guide was developed. The Child Feeding Guide is a website and free mobile app which offers information, advice and tools to help caregivers manage fussy eating behaviours. An online format was used to ensure the Child Feeding Guide is accessible and that a diverse range of caregivers can

Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain

Directory of Open Access Journals (Sweden)

Clarke S

2011-11-01

Full Text Available Angela Dunsford1, Saravana Kumar1,2, Sarah Clarke1 1International Centre for Allied Health Evidence, 2School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia Abstract: Low back pain (LBP is a major health issue with significant socioeconomic implications in most Western countries. Many forms of treatment have been proposed and investigated in the past, with exercise being a commonly prescribed intervention. Within allied health, in particular physiotherapy, there has been a growing movement that recognizes the role of the McKenzie method in treating LBP. Within the McKenzie framework, directional preference (DP exercises are one such intervention, with preliminary data demonstrating its effectiveness in the management of LBP. In this paper, we aim to integrate the evidence from current research, identified using a systematic review, and utilize a practical real-life case scenario to outline how evidence from the literature can be implemented in clinical practice. The findings from the systematic review indicate that DP exercises may have positive effects in the management of LBP. While the body of evidence to support this is limited (only four studies and therefore modest at best, it does provide some emerging evidence to support the use of DP exercises in clinical practice. Despite this, gaps also persist in the literature on DP exercises, and this relates to the exercise parameters and the compliance rates. Recognizing this dichotomy (modest evidence in some areas and evidence gaps in other areas, which is likely to confront health practitioners, using a practical approach with a real-life clinical scenario, we outline how the evidence from the systematic review can be implemented in clinical practice. This approach builds on the philosophy of evidence-based practice of integrating research evidence with clinical expertise and patient values. Keywords: low back pain, McKenzie method, directional

Modelled and Observed Diurnal SST Signals: "SSTDV:R.EX.-IM.A.M." Project Preliminary Results

DEFF Research Database (Denmark)

Karagali, Ioanna; Høyer, Jacob; LeBorgne, Pierre

2013-01-01

This study presents some of the preliminary results from the ESA Support To Science Element (STSE) funded project on the Diurnal Variability of the Sea Surface Temperature, regarding its Regional Extend and Implications in Atmospheric Modelling (SSTDV:R.EX.–IM.A.M.). During this phase of the proj......This study presents some of the preliminary results from the ESA Support To Science Element (STSE) funded project on the Diurnal Variability of the Sea Surface Temperature, regarding its Regional Extend and Implications in Atmospheric Modelling (SSTDV:R.EX.–IM.A.M.). During this phase...

Controlled rehabilitative and supportive care intervention trials in patients with high-grade gliomas and their caregivers

DEFF Research Database (Denmark)

Piil, K; Juhler, M; Jakobsen, J

2016-01-01

and Embase were searched for literature published from 1995 to May 2013. Data from eight studies were reviewed for substantive methods and results. Methodological quality was described and assessed using the scoring system for appraising mixed methods research and concomitantly appraising qualitative......, quantitative and mixed methods primary studies in mixed study reviews. RESULTS: The search yielded 914 unique publications, of which 9 were classified eligible for this review. There is preliminary evidence that cognitive group therapy improves memory skills in patients with high-grade gliomas, early physical....... CONCLUSIONS: As evidence is beginning to emerge, there is a need for well-designed longitudinal and randomised controlled trials of non-pharmacological interventions in high-grade glioma patients and their caregivers in order to develop clinical guidelines for supportive and rehabilitative approaches...

Life support decision making in critical care: Identifying and appraising the qualitative research evidence.

Science.gov (United States)

Giacomini, Mita; Cook, Deborah; DeJean, Deirdre

2009-04-01

The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings. Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings. Qualitative evidence often appears outside of clinical journals, with most research from the United States. Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and

Supporting Formulary Decisions: The Discovery of New Facts or Constructed Evidence?

Directory of Open Access Journals (Sweden)

Paul C Langley

2016-07-01

Full Text Available A critical question, given the growing importance of more targeted therapies to support personalized and precision medicine, is the credibility of the evidence base to support formulary decisions and pricing. On the one hand, for those who subscribe to the reference case model of the National Institute of Health and Care Excellence (NICE in the UK, the decision rests upon the creation of modeled or simulated imaginary worlds and the application of threshold willingness-to-pay cost-per-QALY thresholds. On the other hand, for those who subscribe to the standards of normal science, the decision rests upon the ability to evaluate competing claims, both clinical and cost-effective, in a timeframe that is meaningful to a formulary committee. If we subscribe to the scientific method where the focus is on the discovery of new facts, untestable claims for clinical benefit and cost-effectiveness, such as created claims for lifetime cost per-quality-adjusted discounted life years (QALYs, are properly relegated to the category of pseudoscience. We have no idea, and will never know, whether the claims are right or even if they are wrong. If formulary decisions are to respect the standards of normal science then there has to be a commitment to claims evaluation. A willingness to accept new products provisionally, subject to an agreed protocol to support the evaluation of clinical and cost-effectiveness claims. This dichotomy between the standards of normal science and pseudoscience is explored in the context of published claims for cost-effectiveness and recommendations for product pricing in the US.   Type: Commentary

Ocean Acidification and the End-Permian Mass Extinction: To What Extent does Evidence Support Hypothesis?

Directory of Open Access Journals (Sweden)

Marie-Béatrice Forel

2012-09-01

Full Text Available Ocean acidification in modern oceans is linked to rapid increase in atmospheric CO2, raising concern about marine diversity, food security and ecosystem services. Proxy evidence for acidification during past crises may help predict future change, but three issues limit confidence of comparisons between modern and ancient ocean acidification, illustrated from the end-Permian extinction, 252 million years ago: (1 problems with evidence for ocean acidification preserved in sedimentary rocks, where proposed marine dissolution surfaces may be subaerial. Sedimentary evidence that the extinction was partly due to ocean acidification is therefore inconclusive; (2 Fossils of marine animals potentially affected by ocean acidification are imperfect records of past conditions; selective extinction of hypercalcifying organisms is uncertain evidence for acidification; (3 The current high rates of acidification may not reflect past rates, which cannot be measured directly, and whose temporal resolution decreases in older rocks. Thus large increases in CO2 in the past may have occurred over a long enough time to have allowed assimilation into the oceans, and acidification may not have stressed ocean biota to the present extent. Although we acknowledge the very likely occurrence of past ocean acidification, obtaining support presents a continuing challenge for the Earth science community.

Proposed preliminary definition of the disturbed-zone boundary appropriate for a repository at Yucca Mountain

International Nuclear Information System (INIS)

Langkopf, B.S.

1987-12-01

Some of the calculations that support the licensing of a repository for high-level radioactive waste will use the regulatory concept of a disturbed zone. The Nevada Nuclear Waste Storage Investigations (NNWSI) project must determine the location of the boundary of the disturbed zone for use in these calculations. This paper summarizes results of computer analyses and laboratory experiments and suggests a preliminary definition for the boundary of the disturbed zone for the unsaturated environment at Yucca Mountain. Although the intent of this paper is to define the boundary of the disturbed zone at the edge of significant changes in intrinsic hydrologic properties, there is no evidence of changes in intrinsic hydrologic properties that could significantly change the groundwater travel time from the repository to the water table. Such a result suggests that the disturbed zone at Yucca Mountain is of minimal extent. Because the analyses and experiments reviewed here indicate that there are a variety of changes near the waste package and because the results are subject to uncertainty, the preliminary suggestion for the extent of the disturbed zone is a value larger than the results themselves would suggest: the boundary is proposed to be a plane 10 m below the lower boundary of the waste packages. 88 refs., 12 figs., 5 tabs

Working group reports: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project.

Science.gov (United States)

Raiten, Daniel J; Steiber, Alison L; Carlson, Susan E; Griffin, Ian; Anderson, Diane; Hay, William W; Robins, Sandra; Neu, Josef; Georgieff, Michael K; Groh-Wargo, Sharon; Fenton, Tanis R

2016-02-01

The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm and high-risk newborn infants. The future systematic reviews that will ultimately provide the underpinning for guideline development will be conducted by the Academy of Nutrition and Dietetics' Evidence Analysis Library (EAL). To accomplish the objectives of this first phase, the Pre-B Project organizers established 4 working groups (WGs) to address the following themes: 1) nutrient specifications for preterm infants, 2) clinical and practical issues in enteral feeding of preterm infants, 3) gastrointestinal and surgical issues, and 4) current standards of infant feeding. Each WG was asked to 1) develop a series of topics relevant to their respective themes, 2) identify questions for which there is sufficient evidence to support a systematic review process conducted by the EAL, and 3) develop a research agenda to address priority gaps in our understanding of the role of nutrition in health and development of preterm/neonatal intensive care unit infants. This article is a summary of the reports from the 4 Pre-B WGs. © 2016 American Society for Nutrition.

TITAN Legal Weight Truck cask preliminary design report

International Nuclear Information System (INIS)

1990-04-01

The Preliminary Design of the TITAN Legal Weight Truck (LWT) Cask System and Ancillary Equipment is presented in this document. The scope of the document includes the LWT cask with fuel baskets; impact limiters, and lifting and tiedown features; the cask support system for transportation; intermodal transfer skid; personnel barrier; and cask lifting yoke assembly. 75 figs., 48 tabs

Preliminary worst-case accident analysis to support the conceptual design of a potential repository in tuff

International Nuclear Information System (INIS)

Jackson, J.L.; Gram, H.F.; Hong, K.J.; Ng, H.S.; Pendergrass, A.M.

1984-01-01

The Nevada Waste Storage Investigations (NNWSI) Project is conducting investigations to determine suitability of a site at Yucca Mountain for development as a high-level waste repository. In support of conceptual design, a preliminary analysis has been performed to identify events that could cause radiological releases from the surface facilities during the operations period. Accidental releases were modeled short-duration release plumes, dispersed under averaged climatic conditions, using the AIRDOS-EPA code. consequences of these accidents, in 50-yr integrated dose commitments to operations personnel, to the minimally exposed member of the public, and to the general population in the surrounding area were calculated. risk to the general public from each event was also assessed. All postulated accidents result in doses to pers of the public that are lower than the 0.5 rem/accident limit set by the NRC in 10 CFR 60. For those accidents that do not involve both fire and breach of waste canisters, doses to operations personnel are behind the NRC limit for routine operations of 5 rem/yr set in 10 CFR 20. Accidents that involve fire and breach of waste canisters may cause doses to some operations personnel that are in excess of this limit

Preliminary worst-case accident analysis to support the conceptual design of a potential repository in tuff

International Nuclear Information System (INIS)

Jackson, J.L.; Gram, H.F.; Hong, K.J.; Ng, H.S.; Pendergrass, A.M.

1984-01-01

The Nevada Nuclear Waste Storage Investigations (NNWSI) Project is conducting investigations to determine the suitability of a site at Yucca Mountain for development as a high level waste repository. In support of the conceptual design, a preliminary analysis has been performed to identify events that could cause radiological releases from the surface facilities during the operations period. Accidental releases were modeled as short-duration release plumes, dispersed under averaged climatic conditions, using the AIRDOS-EPA code. The consequences of these accidents, in 50-yr integrated dose commitments to operations personnel, to the maximally exposed member of the public, and to the general population in the surrounding area were calculated. The risk to the general public from each event was also assessed. All postulated accidents result in doses to members of the public that are lower than the 0.5 rem/accident limit set by the NRC in 10 CFR 60. For those accidents that do not involve both fire and breach of waste canisters, doses to operations personnel are within the NRC limit for routine operations of 5 rem/yr set in 10 CFR 20. Accidents that involve fire and breach of waste canisters may cause doses to some operations personnel that are in excess of this limit. 18 references, 1 figure, 3 tables

Social support, volunteering and health around the world: cross-national evidence from 139 countries.

Science.gov (United States)

Kumar, Santosh; Calvo, Rocio; Avendano, Mauricio; Sivaramakrishnan, Kavita; Berkman, Lisa F

2012-03-01

High levels of social capital and social integration are associated with self-rated health in many developed countries. However, it is not known whether this association extends to non-western and less economically advanced countries. We examine associations between social support, volunteering, and self-rated health in 139 low-, middle- and high-income countries. Data come from the Gallup World Poll, an internationally comparable survey conducted yearly from 2005 to 2009 for those 15 and over. Volunteering was measured by self-reports of volunteering to an organization in the past month. Social support was based on self-reports of access to support from relatives and friends. We started by estimating random coefficient (multi-level) models and then used multivariate logistic regression to model health as a function of social support and volunteering, controlling for age, gender, education, marital status, and religiosity. We found statistically significant evidence of cross-national variation in the association between social capital variables and self-rated health. In the multivariate logistic model, self-rated health were significantly associated with having social support from friends and relatives and volunteering. Results from stratified analyses indicate that these associations are strikingly consistent across countries. Our results indicate that the link between social capital and health is not restricted to high-income countries but extends across many geographical regions regardless of their national-income level. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development and Preliminary Validation of the Time Management for Exercise Scale

Science.gov (United States)

Hellsten, Laurie-ann M.; Rogers, W. Todd

2009-01-01

The purpose of this study was to collect preliminary validity evidence for a time management scale for exercise. An initial pool of 91 items was developed from existing literature. Ten exercise/health psychologists evaluated each of the items in terms of relevance and representativeness. Forty-nine items met all criteria. Exploratory factor…

Multiple Lines Of Evidence Supporting Natural Attenuation: Lines Of Inquiry Supporting Monitored Natural Attenuation And Enhanced Attenuatin Of Chlorinated Solvents

Energy Technology Data Exchange (ETDEWEB)

Vangelas, Karen; Widemeirer, T. H.; Barden, M.J.; Dickson, W. Z.; Major, David

2004-12-31

The Department of Energy (DOE) is sponsoring an initiative to facilitate efficient, effective and responsible use of Monitored Natural Attenuation (MNA) and Enhanced Attenuation (EA) for chlorinated solvents. This Office of Environmental Management (EM) ''Alternative Project,'' focuses on providing scientific and policy support for MNA/EA. A broadly representative working group of scientists supports the project along with partnerships with regulatory organizations such as the Interstate Technology Regulatory Council (ITRC) and the United States Environmental Protection Agency (USEPA). The initial product of the technical working group was a summary report that articulated the conceptual approach and central scientific tenants of the project, and that identified a prioritized listing of technical targets for field research. This report documented the process in which: (1) scientific ground rules were developed, (2) lines of inquiry were identified and then critically evaluated, (3) promising applied research topics were highlighted in the various lines of inquiry, and (4) these were discussed and prioritized. The summary report will serve as a resource to guide management and decision making throughout the period of the subject MNA/EA Alternative Project. To support and more fully document the information presented in the summary report, the DOE is publishing a series of supplemental documents that present the full texts from the technical analyses within the various lines of inquiry (see listing). The following report--documenting our evaluation of the state of the science for the lines of evidence for supporting decision-making for MNA--is one of those supplemental documents.

Preliminary Evaluation of a Practice-Based EBVM Skills Development Program

Directory of Open Access Journals (Sweden)

Ava Firth

2016-12-01

Full Text Available Whilst there is a small body of research that investigates the development of EBVM skills in veterinary undergraduates there is a paucity of research that aims to understand the development of EBVM skills in practice-based post-graduate veterinary surgeons. This paper is a small step in remedying that shortfall. In particular, the paper provides a progress report on an RCVS Knowledge funded study that is evaluating a practice-based EBVM development program. The program is being conducted with a cohort of 20 veterinary surgeons and veterinary nurses employed in a private practice veterinary company across multiple sites. The facilitated instruction approach incorporates multiple supports including; group based and one-to-one, synchronous and asynchronous, and, face-to-face and online strategies. This paper will provide details of both the facilitation and evaluation approaches that have been adopted. The paper will also report on preliminary results of the evaluation which focuses on barriers and facilitators to EBVM development.This is a podcast of Ava and Ian's talk at the Veterinary Evidence Today conference, Edinburgh November 2, 2016.

Preliminary Study of Testosterone and Empathy in Determining Recidivism and Antisocial Behavior.

Science.gov (United States)

House, Samuel J; Laan, Jacob M; Molden, Raymond K; Ritchie, James C; Stowe, Zachary N

2017-09-01

Recidivism, repeated criminal behavior after conviction and correction of prior offenses, is a costly problem across the nation. However, the contribution of empathy in determining the risk of recidivism has received limited attention, although lack of empathy has been related to antisocial personality disorder in various studies. Studies linked testosterone to aggression, antisocial behavior, and criminality, and evidence support hormonal connections between empathy and aggression. Adult male prison inmates convicted of violent or nonviolent offenses were included in a cross-sectional study of empathy, antisocial behavior, salivary testosterone, and recidivism. Subjects underwent criminal history, Empathy Quotient, Levenson Self-Report Psychopathy Scale, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and salivary testosterone assays. Bivariate analyses indicated multiple correlations between variables. Multivariate modeling analyses found a significant relationship between self-reported conviction number and psychopathy scale score (p = 0.013). These preliminary results suggest avenues of investigation of factors contributing to recidivism risk. © 2017 American Academy of Forensic Sciences.

Preliminary assessment of the possibility of supporting the decomposition of biodegradable packaging

Directory of Open Access Journals (Sweden)

Niekraś Lidia

2017-01-01

Full Text Available This article presents a preliminary evaluation of the possibility of using grass biomass from a sports field as a compost ingredient which positively affects the degree of decomposition of the biodegradable wrappings. For 5 months the biodegradable bags were stored, both empty and filled with organic waste in the heap of grass clippings. After that period, fragments of the bags were observed under the microscope and then assessed the state of their decomposition. The results indicate that the biomass used favourably affected the process of bag degradation, however the speed of decomposition of the empty bags was quicker than the bags filled with the organic waste.

Preliminary Effectiveness Study of Coping Power Program for Aggressive Children in Pakistan.

Science.gov (United States)

Mushtaq, Asia; Lochman, John E; Tariq, Pervaiz N; Sabih, Fazaila

2017-10-01

Aggression is a characteristic feature of many psychiatric disorders. To address the scarceness for evidence-based interventions for behavioral problems in Pakistan, we evaluated the effectiveness of culturally adapted version of Coping Power Program. The purpose of the study was to determine the extent to which Coping Power Program is capable of reducing aggressive behavior and improving competent behavior, when delivered in a different culture, i.e., Pakistan. With randomized control trial (RCT) of pre- and post-testing, 112 fourth grade boys were allocated to Coping Power intervention condition and waitlist control condition. The intervention group showed significant reduction in aggression at post assessment, in comparison to control group. Boys who received Coping Power intervention also showed improvements in behavior, social skills, and social cognitive processes, with better anger control and problem solving strategies, in comparison to the control group. The results of the study provide preliminary evidence, supporting the effectiveness of Coping Power Program for Pakistani children. Despite its limitations, the results of this study are promising and suggest that Coping Power is an effective intervention to reduce behavioral problems and promote healthy and positive behaviors in children, even when implemented in different contexts with greater potential for violence exposure.

Positive and negative social support and HPA-axis hyperactivity: Evidence from glucocorticoids in human hair.

Science.gov (United States)

Iob, Eleonora; Kirschbaum, Clemens; Steptoe, Andrew

2018-06-12

While positive social support is associated with lower prevalence of disease and better treatment outcomes, negative social relationships can instead have unfavourable consequences for several physical and mental health conditions. However, the specific mechanisms by which this nexus might operate remain poorly understood. Hypothalamic-pituitary-adrenal (HPA) axis hyperactivity owing to psychosocial stress has been proposed as a potential pathway underlying the link between social support and health. Hair glucocorticoids such as cortisol and cortisone are emerging as promising biomarkers of long-term retrospective HPA activation. Therefore, the aim of this investigation was to examine the effects of positive and negative experiences of social support within key relationships (i.e. spouse/partner, children, other family members, and friends) on cortisol and cortisone. These associations were tested in a sample of 2520 older adults (mean age 68.1) from the English Longitudinal Study of Ageing. Hair samples were collected in wave 6 (2012/13). To understand the impact of cumulative exposure to poor social support, the analysis used self-reported data from waves 4 (2008/09) and 6. Covariates included demographic, socioeconomic, lifestyle, and hair characteristics. In cross sectional analyses, lower positive support from all sources and specifically from children were associated with higher cortisol. Additionally, lower positive support from children was positively associated with cortisone. Similarly, higher overall negative support was related to higher cortisol, and greater negative support from children was also positively associated with cortisone. In longitudinal analyses, there was evidence for positive associations between hair glucocorticoids and cumulative exposure to poorer social support. Experiences of low positive and high negative social support, particularly from children, were both related to higher hair glucocorticoids. Hence, social relationships of

Evidence Supporting Broader Access To Safe Legal Abortion

OpenAIRE

Faundes; Anibal; Shah; Iqbal H.

2016-01-01

Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal con...

Students' Entrepreneurial Inclination at a Malaysian Polytechnic: A Preliminary Investigation

Science.gov (United States)

Yasin, Ahmad Yasruddin Md; Mahmood, Nik Abdul Aziz Nik; Jaafar, Nik Azyyati Nik

2011-01-01

This paper reports preliminary results of an ongoing project to examine students' inclination towards entrepreneurship at a Malaysian polytechnic. The study used a self-administered questionnaire to explore the influence of entrepreneurial intent, perceived behavioral control, self-efficacy, perceived barriers, perceived support factors and…

Preliminary evidence that different mechanisms underlie the anger superiority effect in children with and without Autism Spectrum Disorders

Directory of Open Access Journals (Sweden)

Tomoko eIsomura

2014-05-01

Full Text Available Previous studies have demonstrated that angry faces capture humans’ attention more rapidly than emotionally positive faces. This phenomenon is referred to as the anger superiority effect (ASE. Despite atypical emotional processing, adults and children with Autism Spectrum Disorders (ASD have been reported to show ASE as well as typically developed (TD individuals. So far, however, few studies have clarified whether or not the mechanisms underlying ASE are the same for both TD and ASD individuals. Here, we tested how TD and ASD children process schematic emotional faces during detection by employing a recognition task in combination with a face-in-the-crowd task. Results of the face-in-the-crowd task revealed the prevalence of ASE both in TD and ASD children. However, the results of the recognition task revealed group differences: In TD children, detection of angry faces required more configural face processing and disrupted the processing of local features. In ASD children, on the other hand, it required more feature-based processing rather than configural processing. Despite the small sample sizes, these findings provide preliminary evidence that children with ASD, in contrast to TD children, show quick detection of angry faces by extracting local features in faces.

Testing a Preliminary Live with Love Conceptual Framework for cancer couple dyads: A mixed-methods study.

Science.gov (United States)

Li, Qiuping; Xu, Yinghua; Zhou, Huiya; Loke, Alice Yuen

2015-12-01

The purpose of this study was to test the previous proposed Preliminary Live with Love Conceptual Framework (P-LLCF) that focuses on spousal caregiver-patient couples in their journey of coping with cancer as dyads. A mixed-methods study that included qualitative and quantitative approaches was conducted. Methods of concept and theory analysis, and structural equation modeling (SEM) were applied in testing the P-LLCF. In the qualitative approach in testing the concepts included in the P-LLCF, a comparison was made between the P-LLCF with a preliminary conceptual framework derived from focus group interviews among Chinese couples' coping with cancer. The comparison showed that the concepts identified in the P-LLCF are relevant to the phenomenon under scrutiny, and attributes of the concepts are consistent with those identified among Chinese cancer couple dyads. In the quantitative study, 117 cancer couples were recruited. The findings showed that inter-relationships exist among the components included in the P-LLCF: event situation, dyadic mediators, dyadic appraisal, dyadic coping, and dyadic outcomes. In that the event situation will impact the dyadic outcomes directly or indirectly through Dyadic Mediators. The dyadic mediators, dyadic appraisal, and dyadic coping are interrelated and work together to benefit the dyadic outcomes. This study provides evidence that supports the interlinked components and the relationship included in the P-LLCF. The findings of this study are important in that they provide healthcare professionals with guidance and directions according to the P-LLCF on how to plan supportive programs for couples coping with cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evidence supporting broader access to safe legal abortion.

Science.gov (United States)

Faúndes, Anibal; Shah, Iqbal H

2015-10-01

Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal condition for abortion is met. The present article aims to contribute to a better understanding that one can be in favor of greater access to safe abortion services, while at the same time not be "in favor of abortion," by reviewing the evidence that indicates that criminalization of abortion only increases mortality and morbidity without decreasing the incidence of induced abortion, and that decriminalization rapidly reduces abortion-related mortality and does not increase abortion rates. Copyright © 2015. Published by Elsevier Ireland Ltd.

Preliminary investigation into the zone of support influence and stable span between support units.

CSIR Research Space (South Africa)

Daehnke, A

1999-10-01

Full Text Available stability envelopes for hangingwalls with FPFs as a function of instability height, unsupported span, support load and discontinuity orientation (g = 90o – f, where f is the friction angle associated with the fracture surfaces)........................144... Figure 8.6.8 Rockburst stability envelopes for hangingwalls with FPFs as a function of instability height, unsupported span, support load and discontinuity orientation (g = 90o – f, where f is the friction angle associated with the fracture surfaces...

Relationships among the perceived health status, family support and life satisfaction of older Korean adults.

Science.gov (United States)

Kim, Sook-Young; Sok, Sohyune R

2012-08-01

The objective of this study was to examine the perceived health status, family support and life satisfaction of older Korean adults and the relationships among them. This study was designed to be a descriptive correlation study using questionnaire. Subjects were 246 older people who were over 65 years of age in Seoul and Daegu metropolitan city, Korea. Measures were the Cornell Medical Index-Simple Korean Form to measure the perceived health status, the Family Support Instrument to measure the family support and the Standard Life Satisfaction Instrument for Korean people to measure the life satisfaction. Perceived health state was worse as average 3.3, family support was good as average 3.4 and life satisfaction was low as average 3.1. There were statistically significant positive correlations among perceived health state, family support and life satisfaction and between family support and life satisfaction. The predictors of life satisfaction in elderly were family support, age, monthly allowance and perceived health state. These factors explained 37.5% of the total variance. The major influencing factor was family support. This cross-sectional study provides preliminary evidence that to develop nursing strategy to increase family support of older Korean adults is needed. © 2012 Blackwell Publishing Asia Pty Ltd.

Toward an evidence-based system for innovation support for implementing innovations with quality: tools, training, technical assistance, and quality assurance/quality improvement.

Science.gov (United States)

Wandersman, Abraham; Chien, Victoria H; Katz, Jason

2012-12-01

An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support System [corrected] has been underresearched and under-developedThis article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.

A systematic literature search on psychological first aid: lack of evidence to develop guidelines.

Science.gov (United States)

Dieltjens, Tessa; Moonens, Inge; Van Praet, Koen; De Buck, Emmy; Vandekerckhove, Philippe

2014-01-01

Providing psychological first aid (PFA) is generally considered to be an important element in preliminary care of disaster victims. Using the best available scientific basis for courses and educational materials, the Belgian Red Cross-Flanders wants to ensure that its volunteers are trained in the best way possible. To identify effective PFA practices, by systematically reviewing the evidence in existing guidelines, systematic reviews and individual studies. Systematic literature searches in five bibliographic databases (MEDLINE, PsycINFO, The Cochrane Library, PILOTS and G-I-N) were conducted from inception to July 2013. Five practice guidelines were included which were found to vary in the development process (AGREE II score 20-53%) and evidence base used. None of them provides solid evidence concerning the effectiveness of PFA practices. Additionally, two systematic reviews of PFA were found, both noting a lack of studies on PFA. A complementary search for individual studies, using a more sensitive search strategy, identified 11 237 references of which 102 were included for further full-text examination, none of which ultimately provides solid evidence concerning the effectiveness of PFA practices. The scientific literature on psychological first aid available to date, does not provide any evidence about the effectiveness of PFA interventions. Currently it is impossible to make evidence-based guidelines about which practices in psychosocial support are most effective to help disaster and trauma victims.

A systematic literature search on psychological first aid: lack of evidence to develop guidelines.

Directory of Open Access Journals (Sweden)

Tessa Dieltjens

Full Text Available Providing psychological first aid (PFA is generally considered to be an important element in preliminary care of disaster victims. Using the best available scientific basis for courses and educational materials, the Belgian Red Cross-Flanders wants to ensure that its volunteers are trained in the best way possible.To identify effective PFA practices, by systematically reviewing the evidence in existing guidelines, systematic reviews and individual studies.Systematic literature searches in five bibliographic databases (MEDLINE, PsycINFO, The Cochrane Library, PILOTS and G-I-N were conducted from inception to July 2013.Five practice guidelines were included which were found to vary in the development process (AGREE II score 20-53% and evidence base used. None of them provides solid evidence concerning the effectiveness of PFA practices. Additionally, two systematic reviews of PFA were found, both noting a lack of studies on PFA. A complementary search for individual studies, using a more sensitive search strategy, identified 11 237 references of which 102 were included for further full-text examination, none of which ultimately provides solid evidence concerning the effectiveness of PFA practices.The scientific literature on psychological first aid available to date, does not provide any evidence about the effectiveness of PFA interventions. Currently it is impossible to make evidence-based guidelines about which practices in psychosocial support are most effective to help disaster and trauma victims.

Evaluation of Organizational Readiness in Clinical Settings for Social Supporting Evidence-Based Information Seeking Behavior after Introducing IT in a Developing Country.

Science.gov (United States)

Kahouei, Mehdi; Alaei, Safollah; Panahi, Sohaila Sadat Ghazavi Shariat; Zadeh, Jamileh Mahdi

2015-01-01

The health sector of Iran has endeavored to encourage physicians and medical students to use research findings in their practice. Remarkable changes have occurred, including: holding computer skills courses, digital library workshops for physicians and students, and establishing websites in hospitals. The findings showed that a small number of the participants completely agreed that they were supported by supervisors and colleagues to use evidence-based information resources in their clinical decisions. Health care organizations in Iran need other organizational facilitators such as social influences, organizational support, leadership, strong organizational culture, and climate in order to implement evidence-based practice.

Preliminary rock mechanics laboratory: Investigation plan

International Nuclear Information System (INIS)

Oschman, K.P.; Hummeldorf, R.G.; Hume, H.R.; Karakouzian, M.; Vakili, J.E.

1987-01-01

This document presents the rationale for rock mechanics laboratory testing (including the supporting analysis and numerical modeling) planned for the site characterization of a nuclear waste repository in salt. This plan first identifies what information is required for regulatory and design purposes, and then presents the rationale for the testing that satisfies the required information needs. A preliminary estimate of the minimum sampling requirements for rock laboratory testing during site characterization is also presented. Periodic revision of this document is planned

A review of the evidence supporting the aesthetic orthodontic treatment need indices.

Science.gov (United States)

Borzabadi-Farahani, Ali

2012-11-01

Aesthetic improvement and psychological enhancement have been cited as justifications for orthodontic treatment. This paper reviews the evidence that relates malocclusion to psychological health and quality of life and explores whether this evidence supports the most commonly used aesthetic Orthodontic Treatment Need Indices (OTNI). The relevant cited material from the MEDLINE, Web of Science, Scopus, Cochrane databases, and scientific textbooks were used. The citation rate was confirmed by using the Google Scholar. The subjective nature of aesthetic indices and the variable perception of attractiveness between clinicians and patients, and among various cultures or countries are a few limitations of aesthetic OTNI. The available evidence of mainly cross-sectional studies on the link between malocclusion and either psychosocial well-being or quality of life is not conclusive, and sometimes contradictory, to suggest these characteristics are affected by malocclusions. Further, the long-term longitudinal studies did not suggest that people with malocclusion are disadvantaged psychologically, or their quality of life would be worse off, which challenges using aesthetic OTNI to assess the social and psychological implications of malocclusion. The subjective nature of aesthetic OTNI and the minor contributory role of malocclusion in psychosocial health or quality of life undermine using aesthetic indices to assess the likely social and psychological implications of malocclusion. Consequently, using aesthetic OTNI, as a method to quantify malocclusion remains open to debate. Various soft and hard-tissue analyses are used before formulating a treatment plan (i.e., assessment of sagittal and vertical skeletal relationships). The addition of a shortened version of these analyses to the aesthetic OTNI can be a good substitute for the aesthetic components of OTNI, if an assessment of the aesthetic aspects of malocclusion is intended. This reduces subjectivity and improves the

Preliminary evidence for association of genetic variants in pri-miR-34b/c and abnormal miR-34c expression with attention deficit and hyperactivity disorder.

Science.gov (United States)

Garcia-Martínez, I; Sánchez-Mora, C; Pagerols, M; Richarte, V; Corrales, M; Fadeuilhe, C; Cormand, B; Casas, M; Ramos-Quiroga, J A; Ribasés, M

2016-08-30

Attention deficit and hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by impairment to sustain attention and inability to control impulses and activity level. The etiology of ADHD is complex, with an estimated heritability of 70-80%. Under the hypothesis that alterations in the processing or target binding of microRNAs (miRNAs) may result in functional alterations predisposing to ADHD, we explored whether common polymorphisms potentially affecting miRNA-mediated regulation are involved in this psychiatric disorder. We performed a comprehensive association study focused on 134 miRNAs in 754 ADHD subjects and 766 controls and found association between the miR-34b/c locus and ADHD. Subsequently, we provided preliminary evidence for overexpression of the miR-34c-3p mature form in peripheral blood mononuclear cells of ADHD subjects. Next, we tested the effect on gene expression of single-nucleotide polymorphisms within the ADHD-associated region and found that rs4938923 in the promoter of the pri-miR-34b/c tags cis expression quantitative trait loci for both miR-34b and miR-34c and has an impact on the expression levels of 681 transcripts in trans, including genes previously associated with ADHD. This gene set was enriched for miR-34b/c binding sites, functional categories related to the central nervous system, such as axon guidance or neuron differentiation, and serotonin biosynthesis and signaling canonical pathways. Our results provide preliminary evidence for the contribution to ADHD of a functional variant in the pri-miR-34b/c promoter, possibly through dysregulation of the expression of mature forms of miR-34b and miR-34c and some target genes. These data highlight the importance of abnormal miRNA function as a potential epigenetic mechanism contributing to ADHD.

Online emotional support delivered by trained volunteers: users' satisfaction and their perception of the service compared to psychotherapy.

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Baumel, Amit

2015-01-01

Technology could answer the substantial need in human resources available for supporting those who suffer from mental illness, by providing scalable methods to train and engage non-professionals to those who need their support. 7 Cups of Tea (7COT) platform was chosen for this study, because it provides a good case study for examining this kind of solution. The aim of this paper was to provide empirical findings regarding users' satisfaction with online emotional support provided by trained volunteers and how it is perceived in comparison to psychotherapy. An online survey was conducted among a convenience sample of 7COT users. The findings showed high user satisfaction with the support provided by 7COT listeners and, on average, users who indicated to receive psychotherapy in their past marked the listeners' support to be as helpful as psychotherapy. Relating to psychotherapy and online emotional support advantages, different advantages were found. The findings suggest that receiving support from volunteers makes users feel that the support is more genuine. The paper provides preliminary evidence that people in emotional distress may find non-professionals support delivered through the use of technology to be helpful. Limitations and implications are discussed.

Preliminary findings of an adapted evidence-based woman-focused HIV intervention on condom use and negotiation among at-risk women in Pretoria, South Africa.

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Wechsberg, Wendee M; Luseno, Winnie K; Kline, Tracy L; Browne, Felicia A; Zule, William A

2010-01-01

This article presents the results of a randomized trial in South Africa of an adapted evidence-based Woman-Focused intervention on condom use with primary sex partners. The preliminary findings show that regardless of HIV status, condom negotiation was significantly associated with condom use at the 3- and 6-month follow-ups. By intervention group, significant intervention effects were found at 6-month follow-up for HIV-positive and HIV-unknown status women in the Woman-Focused intervention who were more likely than women in the Standard intervention to report condom use with a primary male partner. Among HIV-positive women, those in the Woman-Focused group and those with greater sexual control were more likely to report condom use at the 6-month follow-up. The findings indicate that gender-based interventions for women may result in increased condom negotiation skills.

Nutrition support in hospitals

DEFF Research Database (Denmark)

Kondrup, Jens

2005-01-01

Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....

An online community of practice to support evidence-based physiotherapy practice in manual therapy.

Science.gov (United States)

Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

2014-01-01

The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital

Sustained Implementation Support Scale: Validation of a Measure of Program Characteristics and Workplace Functioning for Sustained Program Implementation.

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Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Filus, Ania

2017-07-01

An evaluation measure of enablers and inhibitors to sustained evidence-based program (EBP) implementation may provide a useful tool to enhance organizations' capacity. This paper outlines preliminary validation of such a measure. An expert informant and consumer feedback approach was used to tailor constructs from two existing measures assessing key domains associated with sustained implementation. Validity and reliability were evaluated for an inventory composed of five subscales: Program benefits, Program burden, Workplace support, Workplace cohesion, and Leadership style. Exploratory and confirmatory factor analysis with a sample of 593 Triple P-Positive Parenting Program-practitioners led to a 28-item scale with good reliability and good convergent, discriminant, and predictive validity. Practitioners sustaining implementation at least 3 years post-training were more likely to have supervision/peer support, reported higher levels of program benefit, workplace support, and positive leadership style, and lower program burden compared to practitioners who were non-sustainers.

Current Evidence Supporting Obstetric Fistula Prevention Strategies ...

African Journals Online (AJOL)

Evidences from the articles were linked to prevention strategies retrieved from grey literature. The strategies were classified using an innovative target-focused method. Gaps in the literature show the need for fistula prevention research to aim at systematically measuring incidence and prevalence of the disease, identify the ...

Decision support for emergency management

International Nuclear Information System (INIS)

Andersen, V.

1989-05-01

A short introduction will be given to the Nordic project ''NKA/INF: Information Technology for Accident and Emergency Management'', which is now in its final phase. To perform evaluation of the project, special scenarious have been developed, and experiments based on these will be fulfilled and compared with experiments without use of the decision support system. Furthermore, the succeeding European project, ''IT Support for Emergency Management - ISEM'', with the purpose of developing a decision support system for complex and distributed decision making in emergency management in full scale, will be described and the preliminary conceptual model for the system will be presented. (author)

Design review report for the hydrogen interlock preliminary design

International Nuclear Information System (INIS)

Corbett, J.E.

1996-01-01

This report documents the completion of a preliminary design review for the hydrogen interlock. The hydrogen interlock, a proposed addition to the Rotary Mode Core Sampling (RMCS) system portable exhauster, is intended to support core sampling operations in waste tanks requiring flammable gas controls. The objective of this review was to validate basic design assumptions and concepts to support a path forward leading to a final design. The conclusion reached by the review committee was that the design was acceptable and efforts should continue toward a final design review

Comparative efficacy of spirituality, cognitive, and emotional support groups for treating eating disorder inpatients.

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Richards, P Scott; Berrett, Michael E; Hardman, Randy K; Eggett, Dennis L

2006-01-01

Spiritual interventions are rarely used in contemporary treatment programs and little empirical evidence is available concerning their effectiveness. The purpose of the present study was to evaluate the effectiveness of a spiritual group intervention for eating disorder inpatients. We compared the effectiveness of a Spirituality group with Cognitive and Emotional Support groups using a randomized, control group design. Participants were 122 women receiving inpatient eating disorder treatment. Patients in the Spirituality group tended to score significantly lower on psychological disturbance and eating disorder symptoms at the conclusion of treatment compared to patients in the other groups, and higher on spiritual well-being. On weekly outcome measures, patients in the Spirituality group improved significantly more quickly during the first four weeks of treatment. This study provides preliminary evidence that attending to eating disorder patients' spiritual growth and well-being during inpatient treatment may help reduce depression and anxiety, relationship distress, social role conflict, and eating disorder symptoms.

Preliminary ECLSS waste water model

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Carter, Donald L.; Holder, Donald W., Jr.; Alexander, Kevin; Shaw, R. G.; Hayase, John K.

1991-01-01

A preliminary waste water model for input to the Space Station Freedom (SSF) Environmental Control and Life Support System (ECLSS) Water Processor (WP) has been generated for design purposes. Data have been compiled from various ECLSS tests and flight sample analyses. A discussion of the characterization of the waste streams comprising the model is presented, along with a discussion of the waste water model and the rationale for the inclusion of contaminants in their respective concentrations. The major objective is to establish a methodology for the development of a waste water model and to present the current state of that model.

Safety and preliminary evidence of biologic efficacy of a mammaglobin-a DNA vaccine in patients with stable metastatic breast cancer.

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Tiriveedhi, Venkataswarup; Tucker, Natalia; Herndon, John; Li, Lijin; Sturmoski, Mark; Ellis, Matthew; Ma, Cynthia; Naughton, Michael; Lockhart, A Craig; Gao, Feng; Fleming, Timothy; Goedegebuure, Peter; Mohanakumar, Thalachallour; Gillanders, William E

2014-12-01

Mammaglobin-A (MAM-A) is overexpressed in 40% to 80% of primary breast cancers. We initiated a phase I clinical trial of a MAM-A DNA vaccine to evaluate its safety and biologic efficacy. Patients with breast cancer with stable metastatic disease were eligible for enrollment. Safety was monitored with clinical and laboratory assessments. The CD8 T-cell response was measured by ELISPOT, flow cytometry, and cytotoxicity assays. Progression-free survival (PFS) was described using the Kaplan-Meier product limit estimator. Fourteen subjects have been treated with the MAM-A DNA vaccine and no significant adverse events have been observed. Eight of 14 subjects were HLA-A2(+), and the CD8 T-cell response to vaccination was studied in detail. Flow cytometry demonstrated a significant increase in the frequency of MAM-A-specific CD8 T cells after vaccination (0.9% ± 0.5% vs. 3.8% ± 1.2%; P cells (41 ± 32 vs. 215 ± 67 spm; P cell responses, and preliminary evidence suggests improved PFS. Additional studies are required to define the potential of the MAM-A DNA vaccine for breast cancer prevention and/or therapy. ©2014 American Association for Cancer Research.

Glycine Transporter Inhibitor Attenuates the Psychotomimetic Effects of Ketamine in Healthy Males: Preliminary Evidence

Science.gov (United States)

D'Souza, Deepak Cyril; Singh, Nagendra; Elander, Jacqueline; Carbuto, Michelle; Pittman, Brian; de Haes, Joanna Udo; Sjogren, Magnus; Peeters, Pierre; Ranganathan, Mohini; Schipper, Jacques

2012-01-01

Enhancing glutamate function by stimulating the glycine site of the NMDA receptor with glycine, -serine, or with drugs that inhibit glycine reuptake may have therapeutic potential in schizophrenia. The effects of a single oral dose of cis-N-methyl-N-(6-methoxy-1-phenyl-1,2,3,4-tetrahydronaphthalen-2-ylmethyl) amino-methylcarboxylic acid hydrochloride (Org 25935), a glycine transporter-1 (GlyT1) inhibitor, and placebo pretreatment on ketamine-induced schizophrenia-like psychotic symptoms, perceptual alterations, and subjective effects were evaluated in 12 healthy male subjects in a randomized, counter-balanced, within-subjects, crossover design. At 2.5 h after administration of the Org 25935 or placebo, subjects received a ketamine bolus and constant infusion lasting 100 min. Psychotic symptoms, perceptual, and a number of subjective effects were assessed repeatedly before, several times during, and after completion of ketamine administration. A cognitive battery was administered once per test day. Ketamine produced behavioral, subjective, and cognitive effects consistent with its known effects. Org 25935 reduced the ketamine-induced increases in measures of psychosis (Positive and Negative Syndrome Scale (PANSS)) and perceptual alterations (Clinician Administered Dissociative Symptoms Scale (CADSS)). The magnitude of the effect of Org 25935 on ketamine-induced increases in Total PANSS and CADSS Clinician-rated scores was 0.71 and 0.98 (SD units), respectively. None of the behavioral effects of ketamine were increased by Org 25935 pretreatment. Org 25935 worsened some aspects of learning and delayed recall, and trended to improve choice reaction time. This study demonstrates for the first time in humans that a GlyT1 inhibitor reduces the effects induced by NMDA receptor antagonism. These findings provide preliminary support for further study of the antipsychotic potential of GlyT1 inhibitors. PMID:22113087

Educational tool for modeling and simulation of a closed regenerative life support system

Science.gov (United States)

Arai, Tatsuya; Fanchiang, Christine; Aoki, Hirofumi; Newman, Dava J.

For long term missions on the moon and Mars, regenerative life support systems emerge as a promising key technology for sustaining successful explorations with reduced re-supply logistics and cost. The purpose of this study was to create a simple model of a regenerative life support system which allows preliminary investigation of system responses. A simplified regenerative life support system was made with MATLAB Simulink ™. Mass flows in the system were simplified to carbon, water, oxygen and carbon dioxide. The subsystems included crew members, animals, a plant module, and a waste processor, which exchanged mass into and out of mass reservoirs. Preliminary numerical simulations were carried out to observe system responses. The simplified life support system model allowed preliminary investigation of the system response to perturbations such as increased or decreased number of crew members. The model is simple and flexible enough to add new components, and also possible to numerically predict non-linear subsystem functions and responses. Future work includes practical issues such as energy efficiency, air leakage, nutrition, and plant growth modeling. The model functions as an effective teaching tool about how a regenerative advanced life support system works.

Functional requirements regarding medical registries--preliminary results.

Science.gov (United States)

Oberbichler, Stefan; Hörbst, Alexander

2013-01-01

The term medical registry is used to reference tools and processes to support clinical or epidemiologic research or provide a data basis for decisions regarding health care policies. In spite of this wide range of applications the term registry and the functional requirements which a registry should support are not clearly defined. This work presents preliminary results of a literature review to discover functional requirements which form a registry. To extract these requirements a set of peer reviewed articles was collected. These set of articles was screened by using methods from qualitative research. Up to now most discovered functional requirements focus on data quality (e. g. prevent transcription error by conducting automatic domain checks).

Scientific Evidence Supporting Policy Change: A Study on Secondhand Smoke Exposure in Non-smoking Areas of PC Rooms in Korea.

Science.gov (United States)

Hong, Soon-Yeol; Lim, Min Kyung; Yun, E Hwa; Park, Eun Young; Jeong, Bo Yoon; Yang, Wonho; Lee, Do-Hoon

2016-04-01

The objective of this study was to measure secondhand smoke (SHS) exposure in personal computer (PC) rooms with the purpose of determining the strength of scientific evidence supporting the legislative ban on smoking in PC rooms located in the Republic of Korea. From June to September 2012, particulate matter (PM2.5) and air nicotine concentration (ANC) were measured in the smoking and non-smoking areas of PC rooms in Goyang City, Korea. In 28 randomly sampled PC rooms, field investigators completed an observational questionnaire on building characteristics, smoking policies, and evidence of smoking. The geometric means (GM) of PM2.5 and ANC in smoking and non-smoking areas were compared. Evidence of smoking was identified in both the smoking and non-smoking areas of all PC rooms. The GMs of PM2.5 and ANC in both areas were high and did not differ significantly (174.77 μg/m(3) and 48.95 μg/m(3) in smoking areas; 93.38 μg/m(3) and 41.30 μg/m(3) in non-smoking areas). Overall PM2.5 concentrations were 5.5-fold higher than those listed in the World Health Organization guidelines. This study supported previous reports that a partial smoking ban did not protect individuals from SHS exposure. Furthermore, the results from our study suggest how research can support policy. Countries in which smoke-free policies are not yet comprehensive may find our results useful.

Diagnosis of feline infectious peritonitis: Update on evidence supporting available tests.

Science.gov (United States)

Tasker, Séverine

2018-03-01

Practical relevance: Feline coronavirus (FCoV) infection is very common in cats, usually causing only mild intestinal signs such as diarrhoea. Up to 10% of FCoV infections, however, result in the fatal disease feline infectious peritonitis (FIP). Clinical challenges: Obtaining a definitive diagnosis of FIP based on non-invasive approaches is difficult. Confirmation of the disease relies on finding appropriate cytological or histopathological changes in association with positive immunostaining for FCoV antigen. In FIP cases with effusions, cytology and immunostaining on effusion samples can be relatively easy to perform; otherwise obtaining diagnostic samples is more challenging and collection of biopsies from tissues with gross lesions is necessary. In the absence of a definitive diagnosis, a high index of suspicion of FIP may be obtained from the cat's signalment and history, combined with findings on clinical examination and laboratory test results. If largely consistent with FIP, these can be used as a basis for discussion with the owner about whether additional, more invasive, diagnostic tests are warranted. In some cases it may be that euthanasia is discussed as an alternative to pursuing a definitive diagnosis ante-mortem, especially if financial limitations exist or where there are concerns over a cat's ability to tolerate invasive diagnostic procedures. Ideally, the diagnosis should be confirmed in such patients from samples taken at post-mortem examination. Global importance: FIP occurs wherever FCoV infection is present in cats, which equates to most parts of the world. Evidence base: This review provides a comprehensive overview of how to approach the diagnosis of FIP, focusing on the tests available to the veterinary practitioner and recently published evidence supporting their use.

Working memory training in older adults: Bayesian evidence supporting the absence of transfer.

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Guye, Sabrina; von Bastian, Claudia C

2017-12-01

The question of whether working memory training leads to generalized improvements in untrained cognitive abilities is a longstanding and heatedly debated one. Previous research provides mostly ambiguous evidence regarding the presence or absence of transfer effects in older adults. Thus, to draw decisive conclusions regarding the effectiveness of working memory training interventions, methodologically sound studies with larger sample sizes are needed. In this study, we investigated whether or not a computer-based working memory training intervention induced near and far transfer in a large sample of 142 healthy older adults (65 to 80 years). Therefore, we randomly assigned participants to either the experimental group, which completed 25 sessions of adaptive, process-based working memory training, or to the active, adaptive visual search control group. Bayesian linear mixed-effects models were used to estimate performance improvements on the level of abilities, using multiple indicator tasks for near (working memory) and far transfer (fluid intelligence, shifting, and inhibition). Our data provided consistent evidence supporting the absence of near transfer to untrained working memory tasks and the absence of far transfer effects to all of the assessed abilities. Our results suggest that working memory training is not an effective way to improve general cognitive functioning in old age. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Facilitating the implementation of evidence- based practice through contextual support and nursing leadership.

Science.gov (United States)

Kueny, Angela; Shever, Leah L; Lehan Mackin, Melissa; Titler, Marita G

2015-01-01

Nurse managers (NMs) play an important role promoting evidence-based practice (EBP) on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality-monitoring departments, as critical to the implementation of EBP on their units. This study contributes to a deeper understanding of institutional contextual factors that can be used to support NMs in their efforts to drive EBP changes at the unit level.

Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

Directory of Open Access Journals (Sweden)

Patrícia do Carmo Silva Parreira

2014-03-01

Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

Cognitive Task Analysis of Business Jet Pilots' Weather Flying Behaviors: Preliminary Results

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Latorella, Kara; Pliske, Rebecca; Hutton, Robert; Chrenka, Jason

2001-01-01

This report presents preliminary findings from a cognitive task analysis (CTA) of business aviation piloting. Results describe challenging weather-related aviation decisions and the information and cues used to support these decisions. Further, these results demonstrate the role of expertise in business aviation decision-making in weather flying, and how weather information is acquired and assessed for reliability. The challenging weather scenarios and novice errors identified in the results provide the basis for experimental scenarios and dependent measures to be used in future flight simulation evaluations of candidate aviation weather information systems. Finally, we analyzed these preliminary results to recommend design and training interventions to improve business aviation decision-making with weather information. The primary objective of this report is to present these preliminary findings and to document the extended CTA methodology used to elicit and represent expert business aviator decision-making with weather information. These preliminary findings will be augmented with results from additional subjects using this methodology. A summary of the complete results, absent the detailed treatment of methodology provided in this report, will be documented in a separate publication.

A Review of the Evidence Supporting the Vitamin D-Cancer Prevention Hypothesis in 2017.

Science.gov (United States)

Grant, William B

2018-02-01

The vitamin D-cancer prevention hypothesis has been evaluated through several types of studies, including geographical ecological studies related to indices of solar ultraviolet-B (UVB) dose (the primary source of vitamin D for most people), observational studies related to UVB exposure or serum 25-hydroxyvitamin D [25(OH)D] concentrations, laboratory studies of mechanisms, and clinical trials. Each approach has strengths and limitations. Ecological studies indirectly measure vitamin D production and incorporate the assumption that vitamin D mediates the effect of UVB exposure. Findings from observational studies with long follow-up times are affected by changing 25(OH)D concentrations over time. Most clinical trials have been poorly designed and conducted, based largely on guidelines for pharmaceutical drugs rather than on nutrients. However, three clinical trials do support the hypothesis. In general, the totality of the evidence, as evaluated using Hill's criteria for causality in a biological system, supports the vitamin D-cancer prevention hypothesis. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

How experimental biology and ecology can support evidence-based decision-making in conservation: avoiding pitfalls and enabling application.

Science.gov (United States)

Cooke, Steven J; Birnie-Gauvin, Kim; Lennox, Robert J; Taylor, Jessica J; Rytwinski, Trina; Rummer, Jodie L; Franklin, Craig E; Bennett, Joseph R; Haddaway, Neal R

2017-01-01

Policy development and management decisions should be based upon the best available evidence. In recent years, approaches to evidence synthesis, originating in the medical realm (such as systematic reviews), have been applied to conservation to promote evidence-based conservation and environmental management. Systematic reviews involve a critical appraisal of evidence, but studies that lack the necessary rigour (e.g. experimental, technical and analytical aspects) to justify their conclusions are typically excluded from systematic reviews or down-weighted in terms of their influence. One of the strengths of conservation physiology is the reliance on experimental approaches that help to more clearly establish cause-and-effect relationships. Indeed, experimental biology and ecology have much to offer in terms of building the evidence base that is needed to inform policy and management options related to pressing issues such as enacting endangered species recovery plans or evaluating the effectiveness of conservation interventions. Here, we identify a number of pitfalls that can prevent experimental findings from being relevant to conservation or would lead to their exclusion or down-weighting during critical appraisal in a systematic review. We conclude that conservation physiology is well positioned to support evidence-based conservation, provided that experimental designs are robust and that conservation physiologists understand the nuances associated with informing decision-making processes so that they can be more relevant.

Evidence-based radiology (part 1): Is there sufficient research to support the use of therapeutic injections for the spine and sacroiliac joints?

Energy Technology Data Exchange (ETDEWEB)

Peterson, Cynthia; Hodler, Juerg [Orthopaedic University Hospital of Balgrist, Radiology, Zuerich (Switzerland)

2010-01-15

This review article addresses the best evidence currently available for therapeutic injection therapy for conditions targeting the spine and sacroiliac joints. The article is presented by spinal region. Controversies and areas of interest for further studies are identified. There is conclusive evidence supporting the effectiveness of the caudal approach for the administration of epidural steroid injections for patients with low back pain from a variety of causes. In general, there is moderate-to-strong evidence supporting the use of transforaminal therapeutic epidural injections for lumbar nerve-root compression and facet injections for joint pain arising from these joints in the cervical, thoracic and lumbar spine, but further subgroup analysis is needed to help predict which specific patients may receive the most benefit from these procedures. No randomized controlled trials, meta-analyses or systematic reviews addressing the effectiveness of therapeutic sacroiliac joint injections have been found. For some injections, corticosteroids may not provide better outcomes compared to local anesthetic injections alone. (orig.)

Using Investment Funds to Support Advancements in Healthcare

OpenAIRE

Nawar, Anthony

2017-01-01

The topic of this thesis is about using investment funds to support advancements in healthcare. The structure is designed to identify the relevant elements in a funding strategy that can be used to support healthcare companies likely to produce usable solutions. The research objective is to establish a proper investment fund strategy that supports healthcare. Additionally, it is positioned to highlight the dynamic components that outline the viable fund. The preliminary scope of the ...

A pilot training program for people in recovery of mental illness as vocational peer support workers in Hong Kong - Job Buddies Training Program (JBTP): A preliminary finding.

Science.gov (United States)

Yam, Kevin Kei Nang; Lo, William Tak Lam; Chiu, Rose Lai Ping; Lau, Bien Shuk Yin; Lau, Charles Ka Shing; Wu, Jen Kei Yu; Wan, Siu Man

2016-10-24

The present study reviews the delivery of a pilot curriculum-mentorship-based peer vocational support workers training in a Hong Kong public psychiatric hospital. The present paper reports (1) on the development of a peer vocational support workers training - Job Buddies Training Program (JBTP) in Hong Kong; and (2) preliminary findings from both quantitative and qualitative perspectives. The curriculum consists of 15-session coursework, 8-session storytelling workshop and 50-hour practicum to provide Supported Employment Peer Service (SEPS) under the mentorship of occupational therapists. Six trainees were assessed using three psychosocial assessments and qualitative methods. Compared to the baseline, the Job Buddies (JB) trainees showed an increase in awareness of their own recovery progress, occupational competence and problem-solving skills at the end of the training. Their perceived level of self-stigma was also lessened. In post-training evaluation, all Job Buddies trainees said they perceived positive personal growth and discovered their own strengths. They also appreciated the help from their mentors and gained mutual support from other trainees and from exposure with various mini-projects in the training. This pilot study provides an example of incorporating peer support and manualized training into existing work rehabilitation service for our JB trainees. Further studies on the effectiveness of service provided by peer support workers and for development on the potential use of peer support workers in other clinical and rehabilitation settings with larger subjects will be fruitful. Copyright © 2016. Published by Elsevier B.V.

Preliminary electrostatic and mechanical design of a SINGAP-MAMuG compatible accelerator

Energy Technology Data Exchange (ETDEWEB)

Grando, L. [Consorzio RFX, Associazione EURATOM-ENEA sulla Fusione, Corso Stati Uniti 4, I-35127 Padova (Italy)], E-mail: luca.grando@igi.cnr.it; Dal Bello, S.; De Lorenzi, A. [Consorzio RFX, Associazione EURATOM-ENEA sulla Fusione, Corso Stati Uniti 4, I-35127 Padova (Italy); Pilan, N. [DIE, Universita di Padova, Via Gradenigo 6A, I-35100 Padova (Italy); Rizzolo, A.; Zaccaria, P. [Consorzio RFX, Associazione EURATOM-ENEA sulla Fusione, Corso Stati Uniti 4, I-35127 Padova (Italy)

2009-06-15

Each ITER NB injector shall provide 16.5 MW auxiliary power by accelerating a deuterium beam across a voltage of -1 MV. At present two possible alternatives for the accelerator are considered: the reference design, based on MAMuG electrostatic accelerator, where the total voltage is graded using five grids at intermediate steps of 200 kV, and the alternative concept, the SINGAP accelerator, for which the total voltage is held by one single gap. This paper focuses a preliminary feasibility study of integration of SINGAP accelerator grids into the support structure of a MAMuG type accelerator; the review or design of new electrostatic shields to improve the voltage withstanding capability of the system and the preliminary design of electrical and hydraulic connections routing from the bushing to the accelerator are also discussed. Electrostatic and mechanical analyses carried out to support the design are described in detail.

Computer-based attention training in the schools for children with attention deficit/hyperactivity disorder: a preliminary trial.

Science.gov (United States)

Steiner, Naomi J; Sheldrick, Radley Christopher; Gotthelf, David; Perrin, Ellen C

2011-07-01

Objective. This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder (ADHD) to attend more effectively. Design/methods. A total of 41 children with ADHD from 2 middle schools were randomly assigned to receive 2 sessions a week at school of either neurofeedback (NF) or attention training through a standard computer format (SCF), either immediately or after a 6-month wait (waitlist control group). Parents, children, and teachers completed questionnaires pre- and postintervention. Results. Primary parents in the NF condition reported significant (P ADHD index, the BASC Attention Problems Scale, and on the Behavioral Rating Inventory of Executive Functioning (BRIEF). Conclusion. This randomized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting.

Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.

Science.gov (United States)

Bailie, Ross; Matthews, Veronica; Larkins, Sarah; Thompson, Sandra; Burgess, Paul; Weeramanthri, Tarun; Bailie, Jodie; Cunningham, Frances; Kwedza, Ru; Clark, Louise

2017-10-05

To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment.

Science.gov (United States)

Dorsey, Shannon; Pullmann, Michael D; Kerns, Suzanne E U; Jungbluth, Nathaniel; Meza, Rosemary; Thompson, Kelly; Berliner, Lucy

2017-11-01

Supervisors are an underutilized resource for supporting evidence-based treatments (EBTs) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT-relevant functions.

Use of a single implant to retain mandibular overdenture: A preliminary clinical trial of 13 cases

Directory of Open Access Journals (Sweden)

Tao Cheng

2012-09-01

Conclusion: Within the limitations of this preliminary prospective clinical study, single-implant-supported mandibular overdentures were a successful alternative treatment option for elderly edentulous patients.

Cross-cultural adaptation and preliminary psychometric properties of the Affective Reactivity Index in Brazilian Youth: implications for DSM-5 measured irritability

Directory of Open Access Journals (Sweden)

Diogo Araújo DeSousa

2013-01-01

Full Text Available Objective: To describe the cross-cultural adaptation of the Affective Reactivity Index (ARI to Brazilian Portuguese and to investigate preliminary psychometric properties of the adapted version. Methods: Cross-cultural adaptation was based on the investigation of the theoretical and operational equivalences of the original ARI in the Brazilian context, followed by a process of translation, back-translation, and review by a committee of experts. Data analysis was carried out in a community sample of 133 schoolchildren aged 8 to 17 years to investigate the following characteristics of the ARI: 1 factor structure; 2 internal consistency; 3 construct validity comparing differential relationships between irritability and anxiety dimensions and impairment; and 4 item response theory (IRT parameters. Results: A final Brazilian Portuguese version of the instrument was defined and is presented. Internal consistency was good, and our analysis supported the original single-factor structure of the ARI. Correlations of the ARI with distress-related anxiety dimensions were higher than with phobic-related anxiety dimensions, supporting its construct validity. In addition, higher ARI scores were associated with higher irritability-related impairment. IRT analysis underscored frequency of loss of temper as essential to inform about pathological states of irritability. Conclusion: The Brazilian Portuguese version of the ARI seems to be very similar to the original instrument in terms of conceptual, item, semantic, and operational equivalence. Our preliminary analysis replicates and extends previous evidence confirming promising psychometric properties for the ARI.

Evidence-based librarianship: searching for the needed EBL evidence.

Science.gov (United States)

Eldredge, J D

2000-01-01

This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).

Emergent Writing in Preschoolers: Preliminary Evidence for a Theoretical Framework

Science.gov (United States)

Puranik, Cynthia S.; Lonigan, Christopher J.

2014-01-01

Researchers and educators use the term emergent literacy to refer to a broad set of skills and attitudes that serve as foundational skills for acquiring success in later reading and writing; however, models of emergent literacy have generally focused on reading and reading-related behaviors. Hence, the primary aim of this study was to articulate and evaluate a theoretical model of the components of emergent writing. Alternative models of the structure of individual and developmental differences of emergent writing and writing-related skills were examined in 372 preschool children who ranged in age from 3- to 5-years using confirmatory factor analysis. Results from a confirmatory factor analysis provide evidence that these emergent writing skills are best described by three correlated but distinct factors, (a) Conceptual Knowledge, (b) Procedural Knowledge, and (c) Generative Knowledge. Evidence that these three emergent writing factors show different patterns of relations to emergent literacy constructs is presented. Implications for understanding the development of writing and assessment of early writing skills are discussed. PMID:25316955

Problem-Based Learning and Argumentation: Testing a Scaffolding Framework to Support Middle School Students' Creation of Evidence-Based Arguments

Science.gov (United States)

Belland, Brian R.; Glazewski, Krista D.; Richardson, Jennifer C.

2011-01-01

Students engaged in problem-based learning (PBL) units solve ill-structured problems in small groups, and then present arguments in support of their solution. However, middle school students often struggle developing evidence-based arguments (Krajcik et al., "J Learn Sci" 7:313-350, 1998). Using a mixed method design, the researchers examined the…

Moderating effects of nurses' organizational justice between organizational support and organizational citizenship behaviors for evidence-based practice.

Science.gov (United States)

Chang, Ching-Sheng

2014-10-01

Lack of existing literature on the correlation among organizational justice, organizational support, and organizational citizenship behaviors has created a research gap in previous evidence-based practice (EBP) studies on nursing personnel. To investigate whether organizational justice among nurses has a moderating effect between their organizational support and organizational citizenship behaviors in order to bridge such a gap of existing literature with the EBP study on nursing personnel. Nursing staff of one large and influential hospital in Taiwan was surveyed. Four hundred questionnaires were distributed, and 386 were collected with a valid response rate of 96.50%. SPSS 17.0 and Amos 17.0 statistical software packages were used for data analysis. Nurses' organizational support positively influences their organizational citizenship behaviors, and their organizational justice perception has a positive moderating effect between organizational support and organizational citizenship behaviors. Results call hospitals' attention to the type of individual behaviors that may improve organizational performance. When nursing staff perceive fair and impartial treatment by the organization and supportive emotional attachment, behaviors beneficial for the organization are expressed in return. Subjective perceptions of nursing staff play an important role in organizational exchange relationship; the higher the degree of nursing staff's perceived organizational justice, the higher the degree of their organizational support, perception, and exhibition of organizational citizenship behaviors such as altruistic behavior and dedication to the work. © 2014 Sigma Theta Tau International.

Preliminary Hazards Analysis of K-Basin Fuel Encapsulation and Storage

International Nuclear Information System (INIS)

Strickland, G.C.

1994-01-01

This Preliminary Hazards Analysis (PHA) systematically examines the K-Basin facilities and their supporting systems for hazards created by abnormal operating conditions and external events (e.g., earthquakes) which have the potential for causing undesirable consequences to the facility worker, the onsite individual, or the public. The operational activities examined are fuel encapsulation, fuel storage and cooling. Encapsulation of sludges in the basins is not examined. A team of individuals from Westinghouse produced a set of Hazards and Operability (HAZOP) tables documenting their examination of abnormal process conditions in the systems and activities examined in K-Basins. The purpose of this report is to reevaluate and update the HAZOP in the original Preliminary Hazard Analysis of K-Basin Fuel Encapsulation and Storage originally developed in 1991

Improving Indigenous access to cancer screening and treatment services: descriptive findings and a preliminary report on the Midwest Indigenous Women’s Cancer Support Group

Directory of Open Access Journals (Sweden)

Lisabeth D Finn

2008-01-01

Full Text Available BackgroundHigher cancer morbidity and mortality rates for the Indigenous population comparedto the overall Australian population has underlined the critical need to improve accessfor Aboriginal people to cancer treatment services. This paper describes anIndigenous Women’s Cancer Support Group (IWCSG established to supportIndigenous people with cancer and their carers/relatives and to facilitate Aboriginalaccess to cancer screening and treatment. Preliminary findings from an evaluation ofthe group are presented.MethodsThe study employed qualitative research methods to describe IWCSG operations andinvestigate the group’s effectiveness. It included one-on-one interviews with 11Geraldton-based health service providers, the IWCSG coordinator, and 10 womenwho have been linked to IWCSG support, as well as observation of group meetings.ResultsDescriptive outcomes relate to group operations, group effectiveness, group benefitsand future development of the group. A cultural strength of IWCSG is its ability tooperate confidentially behind the scenes, providing emotional support and practicalhelp directly to Indigenous people concerned about privacy and shame issues. Theimportant cultural role IWCSG plays in overcoming communication and othercultural barriers to accessing cancer treatment was unanimously recognised by healthservice providers. Aboriginal women supported by IWCSG spoke about an increasedsense of safety, trust and support in accessing and navigating mainstream cancerservices. A critical issue emerging from the research is the need for further development of effective collaborative working relationships between IWCSGmembers and health service providers.ConclusionsThe IWCSG has the potential to inform an effective model for facilitating Indigenousaccess both to cancer treatment and to mainstream treatment for a variety of healthproblems. Future research is required to explore the applicability of Indigenoussupport groups and to focus on the

Preliminary report. Preliminary findings and views concerning the exemption of kerojet fuels from the Mandatory Petroleum Allocation and Price Regulations

Energy Technology Data Exchange (ETDEWEB)

None

1978-01-01

Preliminary findings indicate the following: kerojet fuel is not in short supply; it will not adversely impact on the supply of other petroleum products subject to the Emergency Petroleum Allocation Act; competition and market forces are adequate; and it will not result in inequitable prices for kerojet or other products. Chapter II provides background information on the use, production, and distribution of kerojet. Chapter III analyzes the historical interaction of supply, demand, and price, and explores the market structure for kerojet during 1968 to 1976, prior to and during imposition of allocation and price controls. Chapter IV examines the effect upon kerojet supply, demand, price, and market structure of exempting kerojet from controls and indicates the benefits to be derived from such exemption. In Chapter V, the potential economic impacts of exemption are evaluated. Chapter VI provides a final summary of the DOE's findings and views in support of its preliminary judgment that kerojet should be exempted from allocation and price regulations. (MCW)

Detox diets for toxin elimination and weight management: a critical review of the evidence.

Science.gov (United States)

Klein, A V; Kiat, H

2015-12-01

Detox diets are popular dieting strategies that claim to facilitate toxin elimination and weight loss, thereby promoting health and well-being. The present review examines whether detox diets are necessary, what they involve, whether they are effective and whether they present any dangers. Although the detox industry is booming, there is very little clinical evidence to support the use of these diets. A handful of clinical studies have shown that commercial detox diets enhance liver detoxification and eliminate persistent organic pollutants from the body, although these studies are hampered by flawed methodologies and small sample sizes. There is preliminary evidence to suggest that certain foods such as coriander, nori and olestra have detoxification properties, although the majority of these studies have been performed in animals. To the best of our knowledge, no randomised controlled trials have been conducted to assess the effectiveness of commercial detox diets in humans. This is an area that deserves attention so that consumers can be informed of the potential benefits and risks of detox programmes. © 2014 The British Dietetic Association Ltd.

System Design for Transitional Aircraft Support

Directory of Open Access Journals (Sweden)

John P.T. Mo

2014-01-01

Full Text Available The Australian Defence Force and industry are undergoing significant changes in the way they work together in capability enhancement programs. There are capability gaps in maintaining and supporting current obligations during major asset acquisition, which has migrated into the front line of Royal Air Force Fighter Groups as a new capability. This paper examines a steady state support solution and argues that in order to interchange from one support solution to a new architecture there must be a period for transition, which may need its own interim business model and operational service. A preliminary study of several existing support solutions reveals the generic elements that need to be parameterized and traced through the support system architecture trajectory.

No Evidence for a Food-Related Attention Bias after Thought Suppression

Directory of Open Access Journals (Sweden)

Barbara Soetens

2008-01-01

Full Text Available The aim of this study was to investigate whether food-related thought suppression results in an attention bias for food cues. Fifty-nine female students took part in the experiment. All completed a modified exogenous cueing task containing pictures of foods and toys with a similar valence (presentation duration: 250 ms and 1050 ms. Half of the participants were instructed to suppress thoughts about food and the other half was given control instructions, prior to completing the exogenous cueing task. No evidence was found for an enhanced cue validity effect for food cues after food-related thought suppression. Hence, the preliminary results do not provide support for the hypothesis that thought suppression is sufficient to yield an attention bias. Since the study was the first to employ an exogenous cueing task to study the attentional processing of food cues, replication is warranted.

Peer support and peer-led family support for persons living with schizophrenia.

Science.gov (United States)

Duckworth, Kenneth; Halpern, Lisa

2014-05-01

Peer support and peer-led family psychoeducation represent two distinct and complementary recovery-oriented models to support individuals who live with schizophrenia and their families, respectively. The goals of these models focus on improving knowledge, coping, self-care, social support, and self-management strategies. These models represent important capacity-building strategies for people who live with the illness and the people who love them. This brief article is intended to provide the practicing clinician, person living with schizophrenia, and policy maker with a working knowledge of the current state of the literature in these two related fields. Practitioners should consider these resources and integrate them into their care. A person living with schizophrenia could use this review to advocate for appropriate resources and to identify career opportunities. Policy makers could benefit from an understanding of the literature to mitigate financial and cultural barriers to adopting these practices. The last 5 years have seen a dramatic expansion of the application of randomized controlled trials (RCTs) to give evidence to match the experience of people in these programs. The field has seen Wellness Recovery Action Plan (WRAP) named as evidence-based practice by the National Registry of Evidence-Based Practices. A RCT was also conducted for another peer-developed and led program called Building Recovery of Individual Dreams & Goals through Education & Support. Family to Family, the largest peer-led family psychoeducation course, was also found to have significant impact after the study and also 6 months later in RCT. Family to Family has also been named as an evidence-based practice. The field of people who are living well with schizophrenia working as resources and supports to others living with the illness is an idea that is growing momentum. This momentum has been matched by the RCT evidence. Peer support as a professional role has an emerging literature

The Significance of Ongoing Teacher Support in Earth Science Education Programs: Evidence from the GLOBE Program

Science.gov (United States)

Penuel, B.; Korbak, C.; Shear, L.

2003-12-01

study, SRI researchers used the data on student data reporting activity from different partners to identify candidate sites for case studies, where we might investigate the nature of follow-up activities provided by successful partners more closely. We worked to select 2 regional partners that had evidence of high percentages of teachers trained that reported data and that also offered follow-up to teachers. Case study researchers conducted observations within 2-3 active GLOBE schools supported by each regional partner organization and interviewed teachers, principals, and partner staff. On the basis of our observation data and transcripts from interviews, we compiled profiles of schools' implementation and analyzed the core activities of each regional partner. Researchers found that keys to promoting successful implementation in one partnership were: one partnership were: close alignment with state mathematics and science initiatives; mentors that helped teachers by modeling inquiry in GLOBE and by assisting with equipment set-up and curriculum planning; and allowing room for schools to adopt diverse goals for GLOBE. In the second partnership, keys to success included a strategic approach to developing funding for the program; a focus on integration of culturally-relevant knowledge into teacher preparation; follow-up support for teachers; and use of GLOBE as an opportunity to investigate local evidence of climate change. Both partner organizations were challenged by funding limitations that prevented them from providing as much follow-up support as they believe is necessary.

Preliminary Cost Model for Space Telescopes

Science.gov (United States)

Stahl, H. Philip; Prince, F. Andrew; Smart, Christian; Stephens, Kyle; Henrichs, Todd

2009-01-01

Parametric cost models are routinely used to plan missions, compare concepts and justify technology investments. However, great care is required. Some space telescope cost models, such as those based only on mass, lack sufficient detail to support such analysis and may lead to inaccurate conclusions. Similarly, using ground based telescope models which include the dome cost will also lead to inaccurate conclusions. This paper reviews current and historical models. Then, based on data from 22 different NASA space telescopes, this paper tests those models and presents preliminary analysis of single and multi-variable space telescope cost models.

Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review.

Science.gov (United States)

Woodman, J P; Moore, N R

2012-01-01

Complementary medicine and alternative approaches to chronic and intractable health conditions are increasingly being used, and require critical evaluation. The aim of this review was to systematically evaluate available evidence for the effectiveness and safety of instruction in the Alexander Technique in health-related conditions. PUBMED, EMBASE, PSYCHINFO, ISI Web-of-Knowledge, AMED, CINHAL-plus, Cochrane library and Evidence-based Medicine Reviews were searched to July 2011. Inclusion criteria were prospective studies evaluating Alexander Technique instruction (individual lessons or group delivery) as an intervention for any medical indication/health-related condition. Studies were categorised and data extracted on study population, randomisation method, nature of intervention and control, practitioner characteristics, validity and reliability of outcome measures, completeness of follow-up and statistical analyses.   Of 271 publications identified, 18 were selected: three randomised, controlled trials (RCTs), two controlled non-randomised studies, eight non-controlled studies, four qualitative analyses and one health economic analysis. One well-designed, well-conducted RCT demonstrated that, compared with usual GP care, Alexander Technique lessons led to significant long-term reductions in back pain and incapacity caused by chronic back pain. The results were broadly supported by a smaller, earlier RCT in chronic back pain. The third RCT, a small, well-designed, well-conducted study in individuals with Parkinson's disease, showed a sustained increased ability to carry out everyday activities following Alexander lessons, compared with usual care. The 15 non-RCT studies are also reviewed. Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson's-associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the

Psychometric Properties and U.S. National Norms of the Evidence-Based Practice Attitude Scale (EBPAS)

Science.gov (United States)

Aarons, Gregory A.; Glisson, Charles; Hoagwood, Kimberly; Kelleher, Kelly; Landsverk, John; Cafri, Guy

2010-01-01

The Evidence-Based Practice Attitude Scale (EBPAS) assesses mental health and social service provider attitudes toward adopting evidence-based practices. Scores on the EBPAS derive from 4 subscales (i.e., Appeal, Requirements, Openness, and Divergence) as well as the total scale, and preliminary studies have linked EBPAS scores to clinic structure…

Pedagogical Scholarship in Public Health: A Call for Cultivating Learning Communities to Support Evidence-Based Education.

Science.gov (United States)

Merzel, Cheryl; Halkitis, Perry; Healton, Cheryl

Public health education is experiencing record growth and transformation. The current emphasis on learning outcomes necessitates attention to creating and evaluating the best curricula and learning methods for helping public health students develop public health competencies. Schools and programs of public health would benefit from active engagement in pedagogical research and additional platforms to support dissemination and implementation of educational research findings. We reviewed current avenues for sharing public health educational research, curricula, and best teaching practices; we identified useful models from other health professions; and we offered suggestions for how the field of public health education can develop communities of learning devoted to supporting pedagogy. Our goal was to help advance an agenda of innovative evidence-based public health education, enabling schools and programs of public health to evaluate and measure success in meeting the current and future needs of the public health profession.

Preliminary environmental analysis of a geopressured-geothermal test well in Brazoria County, Texas

Energy Technology Data Exchange (ETDEWEB)

White, W.A.; McGraw, M.; Gustavson, T.C.; Meriwether, J.

1977-11-16

Preliminary environmental data, including current land use, substrate lithology, soils, natural hazards, water resources, biological assemblages, meteorological data, and regulatory considerations have been collected and analyzed for approximately 150 km/sup 2/ of land near Chocolate Bayou, Brazoria County, Texas, in which a geopressured-geothermal test well is to be drilled in the fall of 1977. The study was designed to establish an environmental data base and to determine, within spatial constraints set by subsurface reservoir conditions, environmentally suitable sites for the proposed well. Preliminary analyses of data revealed the eed for focusing on the following areas: potential for subsidence and fault activation, susceptibility of test well and support facilities to fresh- and salt-water flooding, possible effects of produced saline waters on biological assemblages and groundwaer resources, distribution of expansive soils, and effect of drilling and associated support activities on known archeological-cultural resources.

Genetic Evidence Supports the Multiethnic Character of Teopancazco, a Neighborhood Center of Teotihuacan, Mexico (AD 200-600.

Directory of Open Access Journals (Sweden)

Brenda A Álvarez-Sandoval

Full Text Available Multiethnicity in Teopancazco, Teotihuacan, is supported by foreign individuals found in the neighborhood center as well as by the diversity observed in funerary rituals at the site. Studies of both stable and strontium isotopes as well as paleodietary analysis, suggest that the population of Teopancazco was composed by three population groups: people from Teotihuacan, people from nearby sites (Tlaxcala-Hidalgo-Puebla, and people from afar, including the coastal plains. In an attempt to understand the genetic dynamics in Teopancazco we conducted an ancient DNA (aDNA analysis based on mtDNA. Our results show that the level of genetic diversity is consistent with the multiethnicity phenomenon at the neighborhood center. Levels of genetic diversity at different time periods of Teopancazco's history show that multiethnicity was evident since the beginning and lasted until the collapse of the neighborhood center. However, a PCA and a Neighbor-Joining tree suggested the presence of a genetically differentiated group (buried at the Transitional phase compared to the population from the initial phase (Tlamimilolpa as well as the population from the final phase (Xolalpan of the history of Teopancazco. Genetic studies showed no differences in genetic diversity between males and females in the adult population of Teopancazco, this data along with ample archaeological evidence, suggest a neolocal post-marital pattern of residence in Teopancazco. Nevertheless, genetic analyses on the infant population showed that the males are significantly more heterogeneous than the females suggesting a possible differential role in cultural practices by sex in the infant sector. Regarding interpopulation analysis, we found similar indices of genetic diversity between Teopancazco and heterogeneous native groups, which support the multiethnic character of Teopancazco. Finally, our data showed a close genetic relationship between Teopancazco and populations from the

Newborn screening for proximal urea cycle disorders: Current evidence supporting recommendations for newborn screening.

Science.gov (United States)

Merritt, J Lawrence; Brody, Linnea L; Pino, Gisele; Rinaldo, Piero

2018-04-20

Current newborn screening (NBS) for urea cycle disorders (UCD) is incomplete as only distal UCDs are included in most NBS programs by measuring elevated amino acid concentrations. NBS for the proximal UCDs involves the detection in NBS spots of low citrulline values, a finding which is often overlooked because it is considered to be inadequate. We retrospectively analyzed NBS blood spots from known UCD patients comparing the utility of the Region 4 Stork (R4S) interpretive tools to conventional cutoff based interpretation. This study shows the utility of R4S tools in detecting all UCDs, and provides evidence to support the nomination to add proximal UCDs to the recommended uniform screening panel. Copyright © 2018 Elsevier Inc. All rights reserved.

Family support programs and adolescent mental health: review of evidence

Directory of Open Access Journals (Sweden)

Kuhn ES

2014-07-01

Full Text Available Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be delivered as prevention programs designed to prevent the onset or escalation of mental or behavioral health problems. This review discusses the rationale for family support programs and describes the range of services provided by family support programs. The primary focus of the review is on evaluating the effectiveness of family support programs as treatments or prevention efforts delivered by clinicians or peers. Two main themes emerged from the review. First, family support programs that included more forms of support evidenced higher levels of effectiveness than family support programs that provided fewer forms of support. Discussion of this theme focuses on individual differences in client needs and program adaptions that may facilitate meeting diverse needs. Second, family support prevention programs appear to be most effective when serving individuals more in need of mental and behavioral health services. Discussion of this theme focuses on the intensity versus breadth of the services provided in prevention programs. More rigorous evaluations of family support programs are needed, especially for peer-delivered family support treatments. Keywords: intervention, parent, mental and behavioral health

Preliminary Monthly Climatological Summaries

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Preliminary Local Climatological Data, recorded since 1970 on Weather Burean Form 1030 and then National Weather Service Form F-6. The preliminary climate data pages...

The demand factors for cesareans in Portugal – some preliminary results

OpenAIRE

Tavares, Aida Isabel; Rocha, Tania

2012-01-01

The aim of this work is to determine the demand factors for cesareans in Portugal. This work is exploratory and preliminary. Data is aggregated in NUTSII , for the period 2002-10. The number of cesareans performed is count data which requires the estimation of this panel data by a negative binomial with fixed effects. The main result is the evidence that there may be induced demand for cesareans in Portugal. Further research is needed.

The Evidence Movement

DEFF Research Database (Denmark)

Hansen, Hanne Foss; Rieper, Olaf

2009-01-01

The evidence movement and the idea of systematic reviews, defined as summaries of the results of already existing evaluation and research projects, have gained considerable support in recent years as many international as well as national evidence-producing organizations have been established...

How is research evidence used to support claims made in advertisements for wound care products?

Science.gov (United States)

Dumville, Jo C; Petherick, Emily S; O'Meara, Susan; Raynor, Pauline; Cullum, Nicky

2009-05-01

To investigate the amount, type and accuracy of citations use in support of product related claims from advertisements of wound care products. Although articles submitted to most medical journals are subjected to peer review, such scrutiny is often not required for the content of advertisements. A contents survey of advertisements from two wound care journals (Journal of Wound Care and Ostomy Wound Management) from 2002-2003 and the British Medical Journal, 2002-2003. Data collected from advertisements included identification of product related claims made and any corresponding citations. Where journal articles were cited to support claims, the articles were obtained. Where data on file were cited, this material was requested. In each case the accuracy of claims in relation to the content of the supporting citation was assessed. The use of citations to support product related claims was infrequent in advertisements from wound care journals, where 35% of advertisements containing a product related claim also contained at least one citation, compared with 63% of advertisements from the British Medical Journal. Of citations that were supplied, journal articles were less common in the wound journals (40% vs. 73% in the British Medical Journal) and data on file more common (38% vs. 6% in the British Medical Journal). Where journal articles were obtained, 56% of claims in the wound care journals advertisements were not supported by the cited article, compared with 12% of claims in the British Medical Journal. The wound journals advertised predominantly medical devices. The use and accuracy of referencing in advertisements from wound care journals was poor. Nurses have increasing responsibilities for the prescribing of both drugs and devices, which must be accompanied by the ability to interpret marketing materials and research evidence critically. Nurse educators must ensure that nurse education generally and nurse prescriber training particularly, builds skills of

Weldon Spring, Missouri, Raffinate Pits 1, 2, 3, and 4: Preliminary grout development screening studies for in situ waste immobilization

International Nuclear Information System (INIS)

McDaniel, E.W.; Gilliam, T.M.; Dole, L.R.; West, G.A.

1987-04-01

Results of Oak Ridge National Laboratory's initial support program to develop a preliminary grout formula to solidify in situ the Weldon Spring waste are presented. The screening study developed preliminary formulas based on a simulated composite waste and then tested the formulas on actual waste samples. Future data needs are also discussed. 1 ref., 6 figs., 9 tabs

Evidence-Based Psychological Assessment.

Science.gov (United States)

Bornstein, Robert F

2017-01-01

In recent years there has been increasing emphasis on evidence-based practice in psychology (EBPP), and as is true in most health care professions, the primary focus of EBPP has been on treatment. Comparatively little attention has been devoted to applying the principles of EBPP to psychological assessment, despite the fact that assessment plays a central role in myriad domains of empirical and applied psychology (e.g., research, forensics, behavioral health, risk management, diagnosis and classification in mental health settings, documentation of neuropsychological impairment and recovery, personnel selection and placement in organizational contexts). This article outlines the central elements of evidence-based psychological assessment (EBPA), using the American Psychological Association's tripartite definition of EBPP as integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences. After discussing strategies for conceptualizing and operationalizing evidence-based testing and evidence-based assessment, 6 core skills and 3 meta-skills that underlie proficiency in psychological assessment are described. The integration of patient characteristics, culture, and preferences is discussed in terms of the complex interaction of patient and assessor identities and values throughout the assessment process. A preliminary framework for implementing EBPA is offered, and avenues for continued refinement and growth are described.

A text-based data mining and toxicity prediction modeling system for a clinical decision support in radiation oncology: A preliminary study

Science.gov (United States)

Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Chang, Kyung Hwan; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie

2017-08-01

The aim of this study is an integrated research for text-based data mining and toxicity prediction modeling system for clinical decision support system based on big data in radiation oncology as a preliminary research. The structured and unstructured data were prepared by treatment plans and the unstructured data were extracted by dose-volume data image pattern recognition of prostate cancer for research articles crawling through the internet. We modeled an artificial neural network to build a predictor model system for toxicity prediction of organs at risk. We used a text-based data mining approach to build the artificial neural network model for bladder and rectum complication predictions. The pattern recognition method was used to mine the unstructured toxicity data for dose-volume at the detection accuracy of 97.9%. The confusion matrix and training model of the neural network were achieved with 50 modeled plans (n = 50) for validation. The toxicity level was analyzed and the risk factors for 25% bladder, 50% bladder, 20% rectum, and 50% rectum were calculated by the artificial neural network algorithm. As a result, 32 plans could cause complication but 18 plans were designed as non-complication among 50 modeled plans. We integrated data mining and a toxicity modeling method for toxicity prediction using prostate cancer cases. It is shown that a preprocessing analysis using text-based data mining and prediction modeling can be expanded to personalized patient treatment decision support based on big data.

[Insufficient evidence supporting iron supplementation in anaemia during pregnancy].

Science.gov (United States)

Wiegerinck, Melanie M; Mol, Ben Willem J

2012-01-01

The Royal Dutch Organization of Midwives (KNOV) recently presented their practice guideline 'Anaemia in midwifery practice'. The guideline identified available evidence on diagnosis, prognosis and treatment of anaemia in pregnancy. Anaemia based on iron deficiency and subsequent treatment with iron supplementation are probably the most frequent aspects of care for pregnant women. However, there is surprisingly enough no evidence of the efficacy of iron supplementation treatment on relevant clinical outcomes in pregnant women with anaemia. We plead to make the next guideline a multidisciplinary one. Such a guideline may lead to a large pragmatic trial evaluating the efficacy of iron supplementation treatment for patients with anaemia.

Preliminary conceptual design and analysis on KALIMER reactor structures

International Nuclear Information System (INIS)

Kim, Jong Bum

1996-10-01

The objectives of this study are to perform preliminary conceptual design and structural analyses for KALIMER (Korea Advanced Liquid Metal Reactor) reactor structures to assess the design feasibility and to identify detailed analysis requirements. KALIMER thermal hydraulic system analysis results and neutronic analysis results are not available at present, only-limited preliminary structural analyses have been performed with the assumptions on the thermal loads. The responses of reactor vessel and reactor internal structures were based on the temperature difference of core inlet and outlet and on engineering judgments. Thermal stresses from the assumed temperatures were calculated using ANSYS code through parametric finite element heat transfer and elastic stress analyses. While, based on the results of preliminary conceptual design and structural analyses, the ASME Code limits for the reactor structures were satisfied for the pressure boundary, the needs for inelastic analyses were indicated for evaluation of design adequacy of the support barrel and the thermal liner. To reduce thermal striping effects in the bottom are of UIS due to up-flowing sodium form reactor core, installation of Inconel-718 liner to the bottom area was proposed, and to mitigate thermal shock loads, additional stainless steel liner was also suggested. The design feasibilities of these were validated through simplified preliminary analyses. In conceptual design phase, the implementation of these results will be made for the design of the reactor structures and the reactor internal structures in conjunction with the thermal hydraulic, neutronic, and seismic analyses results. 4 tabs., 24 figs., 4 refs. (Author)

Preliminary evaluation of beta-spodumene as a fusion reactor structural material

International Nuclear Information System (INIS)

Kelsey, P.V. Jr.; Schmunk, R.E.; Henslee, S.P.

1982-01-01

Beta-spodumene was investigated as a candidate material for use in fusion reactor environments. Properties which support the use of beta-spodumene include good thermal shock resistance, a very low coefficient of thermal expansion, a low-Z composition which would result in minimum impact on the plasma, and flexibility in fabrication processes. Specimens were irradiated in the Advanced Test Reactor (ATR) to a fluence of 5.3 x 10 22 n/m 2 , E > MeV, and 4.9 x 10 23 n/m 2 thermal fluence in order to obtain a preliminary evaluation of the impact of irradiation on the material. Preliminary data indicate that the mechanical properties of beta-spodumene are little affected by irradiation. Gas production and release have also been investigated. (orig.)

Waste Feed Delivery System Phase 1 Preliminary RAM Analysis

International Nuclear Information System (INIS)

DYKES, A.A.

2000-01-01

This report presents the updated results of the preliminary reliability, availability, and maintainability (RAM) analysis of selected waste feed delivery (WFD) operations to be performed by the Tank Farm Contractor (TFC) during Phase I activities in support of the Waste Treatment and Immobilization Plant (WTP). For planning purposes, waste feed tanks are being divided into five classes in accordance with the type of waste in each tank and the activities required to retrieve, qualify, and transfer waste feed. This report reflects the baseline design and operating concept, as of the beginning of Fiscal Year 2000, for the delivery of feed from three of these classes, represented by source tanks 241-AN-102, 241-AZ-101 and 241-AN-105. The preliminary RAM analysis quantifies the potential schedule delay associated with operations and maintenance (OBM) field activities needed to accomplish these operations. The RAM analysis is preliminary because the system design, process definition, and activity planning are in a state of evolution. The results are being used to support the continuing development of an O and M Concept tailored to the unique requirements of the WFD Program, which is being documented in various volumes of the Waste Feed Delivery Technical Basis (Carlson. 1999, Rasmussen 1999, and Orme 2000). The waste feed provided to the WTP must: (1) meet limits for chemical and radioactive constituents based on pre-established compositional envelopes (i.e., feed quality); (2) be in acceptable quantities within a prescribed sequence to meet feed quantities; and (3) meet schedule requirements (i.e., feed timing). In the absence of new criteria related to acceptable schedule performance due to the termination of the TWRS Privatization Contract, the original criteria from the Tank Waste Remediation System (77443s) Privatization Contract (DOE 1998) will continue to be used for this analysis

A preliminary design and structural analysis on the central column for supporting the full 40 .deg. Sectors at tokamak in pit

International Nuclear Information System (INIS)

Nam, Kyoungo; Park, Hyun Ki; Kim, Dong Jin; Moon, Jaeh Wan; Kim, Byung Seok; Watson, Emma; Shaw, Robert

2012-01-01

The ITER Tokamak machine is composed of nine 40 .deg. sectors shaped of torus. Each 40.deg. sector is made up of one 40 .deg. vacuum vessel (VV), two 20 .deg. toroidal filed coils and associated vacuum vessel thermal shield (VVTS) segments which consist of one inboard and two outboard VVTS. The VV/TFC/VVTS 40 .deg. sectors are sub assembled at assembly building respectively at sector sub assembly tool and then nine sub assembled 40 .deg. sectors are finally assembled at in-pit of Tokamak building. ITER sector assembly tools are the purpose built assembly tools to assemble nine 40 .deg. sectors into the complete ITER Tokamak machine at Tokamak in pit. Based on the design description document, final report prepared by the ITER organization (IO) and tooling requirements, Korea has carried out the conceptual and preliminary design of these assembly tools. Especially, the central column is the main tool, which is composed of some hollow cylinders, to support full nine 40 .deg. sectors at Tokamak in pit. Configuration and structural analysis of the central column are presented

Supporting User Involvement in Child Welfare Work: A Way of Implementing Evidence-Based Practice

Science.gov (United States)

Alexanderson, Karin; Hyvönen, Ulf; Karlsson, Per-Åke; Larsson, Anne-Marie

2014-01-01

The article describes and analyses some preliminary working methods for user involvement in child welfare. The models are based on the results of a national project in Sweden where children and young people have been involved as informants. How experiences and viewpoints from children and young people can be a source of knowledge in child welfare…

SmallWorld Behavior of the Worldwide Active Volcanoes Network: Preliminary Results

Science.gov (United States)

Spata, A.; Bonforte, A.; Nunnari, G.; Puglisi, G.

2009-12-01

We propose a preliminary complex networks based approach in order to model and characterize volcanoes activity correlation observed on a planetary scale over the last two thousand years. Worldwide volcanic activity is in fact related to the general plate tectonics that locally drives the faults activity, that in turn controls the magma upraise beneath the volcanoes. To find correlations among different volcanoes could indicate a common underlying mechanism driving their activity and could help us interpreting the deeper common dynamics controlling their unrest. All the first evidences found testing the procedure, suggest the suitability of this analysis to investigate global volcanism related to plate tectonics. The first correlations found, in fact, indicate that an underlying common large-scale dynamics seems to drive volcanic activity at least around the Pacific plate, where it collides and subduces beneath American, Eurasian and Australian plates. From this still preliminary analysis, also more complex relationships among volcanoes lying on different tectonic margins have been found, suggesting some more complex interrelationships between different plates. The understanding of eventually detected correlations could be also used to further implement warning systems, relating the unrest probabilities of a specific volcano also to the ongoing activity to the correlated ones. Our preliminary results suggest that, as for other many physical and biological systems, an underlying organizing principle of planetary volcanoes activity might exist and it could be a small-world principle. In fact we found that, from a topological perspective, volcanoes correlations are characterized by the typical features of small-world network: a high clustering coefficient and a low characteristic path length. These features confirm that global volcanoes activity is characterized by both short and long-range correlations. We stress here the fact that numerical simulation carried out in

Preliminary Stress Analysis of an IHX Tube Support Plate in Prototype SFR

International Nuclear Information System (INIS)

Kim, Sung Kyun; Koo, Gyeong Hoi

2013-01-01

In this paper, the structural integrity about the conceptual design of IHX tube support plate was reviewed and the design should be changed because of its high stress concentration at the outer rim area. For reducing its maximum stress, two alternatives were proposed and reviewed for the structural integrity point of view. In both proposing support designs, the maximum stress decreases up to the stress design limit. Tube support plates (TSPs) of the intermediate heat exchanger (IHX) in Prototype GenIV Sodium Cooled Fast Reactor (PGSFR) act to horizontally support IHX tubes against hydraulic loadings and they have numerous flow holes where a primary sodium flows downward and secondary sodium flows upward. Due to its many penetrations, its geometric shape is quite complex and structurally its integrity is quite weaker than other parts. In this study, we investigated the structural integrity of the conceptually designed IHX tube support plate. In addition, TSP's supporting concepts were proposed to increase its structural integrity, and confirmed its integrity by using a finite element analysis

Ebola Virus Shedding and Transmission: Review of Current Evidence.

Science.gov (United States)

Vetter, Pauline; Fischer, William A; Schibler, Manuel; Jacobs, Michael; Bausch, Daniel G; Kaiser, Laurent

2016-10-15

 The magnitude of the 2013-2016 Ebola virus disease outbreak in West Africa was unprecedented, with >28 500 reported cases and >11 000 deaths. Understanding the key elements of Ebola virus transmission is necessary to implement adequate infection prevention and control measures to protect healthcare workers and halt transmission in the community.  We performed an extensive PubMed literature review encompassing the period from discovery of Ebola virus, in 1976, until 1 June 2016 to evaluate the evidence on modes of Ebola virus shedding and transmission.  Ebola virus has been isolated by cell culture from blood, saliva, urine, aqueous humor, semen, and breast milk from infected or convalescent patients. Ebola virus RNA has been noted in the following body fluids days or months after onset of illness: saliva (22 days), conjunctiva/tears (28 days), stool (29 days), vaginal fluid (33 days), sweat (44 days), urine (64 days), amniotic fluid (38 days), aqueous humor (101 days), cerebrospinal fluid (9 months), breast milk (16 months [preliminary data]), and semen (18 months). Nevertheless, the only documented cases of secondary transmission from recovered patients have been through sexual transmission. We did not find strong evidence supporting respiratory or fomite-associated transmission. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

The care unit in nursing home research: evidence in support of a definition.

Science.gov (United States)

Estabrooks, Carole A; Morgan, Debra G; Squires, Janet E; Boström, Anne-Marie; Slaughter, Susan E; Cummings, Greta G; Norton, Peter G

2011-04-14

Defining what constitutes a resident care unit in nursing home research is both a conceptual and practical challenge. The aim of this paper is to provide evidence in support of a definition of care unit in nursing homes by demonstrating: (1) its feasibility for use in data collection, (2) the acceptability of aggregating individual responses to the unit level, and (3) the benefit of including unit level data in explanatory models. An observational study design was used. Research (project) managers, healthcare aides, care managers, nursing home administrators and directors of care from thirty-six nursing homes in the Canadian prairie provinces of Alberta, Saskatchewan and Manitoba provided data for the study. A definition of care unit was developed and applied in data collection and analyses. A debriefing session was held with research managers to investigate their experiences with using the care unit definition. In addition, survey responses from 1258 healthcare aides in 25 of the 36 nursing homes in the study, that had more than one care unit, were analyzed using a multi-level modeling approach. Trained field workers administered the Alberta Context Tool (ACT), a 58-item self-report survey reflecting 10 organizational context concepts, to healthcare aides using computer assisted personal interviews. To assess the appropriateness of obtaining unit level scores, we assessed aggregation statistics (ICC(1), ICC(2), η², and ω²), and to assess the value of using the definition of unit in explanatory models, we performed multi-level modeling. In 10 of the 36 nursing homes, the care unit definition developed was used to align the survey data (for analytic purposes) to specific care units as designated by our definition, from that reported by the facility administrator. The aggregation statistics supported aggregating the healthcare aide responses on the ACT to the realigned unit level. Findings from the multi-level modeling further supported unit level aggregation. A

Emotional experience with dyslexia and self-esteem: the protective role of perceived family support in late adulthood.

Science.gov (United States)

Carawan, Lena W; Nalavany, Blace A; Jenkins, Carol

2016-01-01

Despite the growing body of evidence that suggests dyslexia persists through the life span, there is a dearth of research that explores the complicating factor of dyslexia in late adulthood. Based upon stress and coping theory, this study examined whether perceived family support protects the impact of negative emotional experience with dyslexia on self-esteem. Adults aged 21 years and older with diagnosed or self-reported dyslexia were participants in a web-based survey. A total of 224 individuals completed the survey. These findings are from the 50 participants who reported to be 60 years or older. Completed measures include their perception of family support, emotional experience with dyslexia, self-esteem, and demographic variables. Preliminary analysis revealed that negative emotional experience with dyslexia negatively impacts self-esteem. Hierarchical moderated regression analysis demonstrated that positive perceived family support significantly buffers, mitigates, and protects the effects of negative emotional experiences with dyslexia on self-esteem in individuals with dyslexia in late adulthood. In this study, family support promoted self-esteem because as a protective dynamic, it helped older adults cope with the emotional distress associated with dyslexia. Implications of these findings are discussed.

Nature-based supportive care opportunities: a conceptual framework.

Science.gov (United States)

Blaschke, Sarah; O'Callaghan, Clare C; Schofield, Penelope

2018-03-22

Given preliminary evidence for positive health outcomes related to contact with nature for cancer populations, research is warranted to ascertain possible strategies for incorporating nature-based care opportunities into oncology contexts as additional strategies for addressing multidimensional aspects of cancer patients' health and recovery needs. The objective of this study was to consolidate existing research related to nature-based supportive care opportunities and generate a conceptual framework for discerning relevant applications in the supportive care setting. Drawing on research investigating nature-based engagement in oncology contexts, a two-step analytic process was used to construct a conceptual framework for guiding nature-based supportive care design and future research. Concept analysis methodology generated new representations of understanding by extracting and synthesising salient concepts. Newly formulated concepts were transposed to findings from related research about patient-reported and healthcare expert-developed recommendations for nature-based supportive care in oncology. Five theoretical concepts (themes) were formulated describing patients' reasons for engaging with nature and the underlying needs these interactions address. These included: connecting with what is genuinely valued, distancing from the cancer experience, meaning-making and reframing the cancer experience, finding comfort and safety, and vital nurturance. Eight shared patient and expert recommendations were compiled, which address the identified needs through nature-based initiatives. Eleven additional patient-reported recommendations attend to beneficial and adverse experiential qualities of patients' nature-based engagement and complete the framework. The framework outlines salient findings about helpful nature-based supportive care opportunities for ready access by healthcare practitioners, designers, researchers and patients themselves. © Article author(s) (or their

Stakeholder Support for School Food Policy Expansions

Science.gov (United States)

Pettigrew, Simone; Pescud, Melanie; Donovan, Robert J.

2012-01-01

The aim of this study was to assess the extent to which parents and school-based stakeholders (principals, teachers, canteen managers and Parents & Citizen Committee presidents) are supportive of potential expansions to a new school food policy. Eight additional policy components elicited in preliminary focus groups with parents and 19 additional…

Evidence-based radiology (part 2): Is there sufficient research to support the use of therapeutic injections into the peripheral joints?

Energy Technology Data Exchange (ETDEWEB)

Peterson, Cynthia; Hodler, Juerg [Orthopaedic University Hospital of Balgrist, Radiology, Zuerich (Switzerland)

2010-01-15

This review article addresses the best evidence currently available for the effectiveness of injection therapy for musculoskeletal conditions involving the peripheral joints. The research is presented by anatomical region and areas of controversy and the need for additional research are identified. Randomized controlled trials, meta-analyses and systematic reviews are lacking that address the effectiveness of therapeutic injections to the sternoclavicular, acromioclavicular, ankle and foot joints. No research studies of any kind have been reported for therapeutic injections of the sternoclavicular joint. With the exception of the knee, possibly the hip and patients with inflammatory arthropathies, research does not unequivocally support the use of therapeutic joint injections for most of the peripheral joints, including the shoulder. Additionally, controversy exists in some areas as to whether or not corticosteroids provide better outcomes compared to local anesthetic injections alone. When viscosupplementation injections are compared to corticosteroids in patients with osteoarthritis of the knee, the evidence supports the use of viscosupplementation for more prolonged improvement in outcomes, with corticosteroids being good for short-term relief. (orig.)

Evidence-based radiology (part 2): Is there sufficient research to support the use of therapeutic injections into the peripheral joints?

International Nuclear Information System (INIS)

Peterson, Cynthia; Hodler, Juerg

2010-01-01

This review article addresses the best evidence currently available for the effectiveness of injection therapy for musculoskeletal conditions involving the peripheral joints. The research is presented by anatomical region and areas of controversy and the need for additional research are identified. Randomized controlled trials, meta-analyses and systematic reviews are lacking that address the effectiveness of therapeutic injections to the sternoclavicular, acromioclavicular, ankle and foot joints. No research studies of any kind have been reported for therapeutic injections of the sternoclavicular joint. With the exception of the knee, possibly the hip and patients with inflammatory arthropathies, research does not unequivocally support the use of therapeutic joint injections for most of the peripheral joints, including the shoulder. Additionally, controversy exists in some areas as to whether or not corticosteroids provide better outcomes compared to local anesthetic injections alone. When viscosupplementation injections are compared to corticosteroids in patients with osteoarthritis of the knee, the evidence supports the use of viscosupplementation for more prolonged improvement in outcomes, with corticosteroids being good for short-term relief. (orig.)

Establishment and preliminary outcomes of a palliative care research network.

Science.gov (United States)

Hudson, Peter; Street, Annette; Graham, Suzanne; Aranda, Sanchia; O'Connor, Margaret; Thomas, Kristina; Jackson, Kate; Spruyt, Odette; Ugalde, Anna; Philip, Jennifer

2016-02-01

The difficulties in conducting palliative care research have been widely acknowledged. In order to generate the evidence needed to underpin palliative care provision, collaborative research is considered essential. Prior to formalizing the development of a research network for the state of Victoria, Australia, a preliminary study was undertaken to ascertain interest and recommendations for the design of such a collaboration. Three data-collection strategies were used: a cross-sectional questionnaire, interviews, and workshops. The questionnaire was completed by multidisciplinary palliative care specialists from across the state (n = 61); interviews were conducted with senior clinicians and academics (n = 21) followed by two stakeholder workshops (n = 29). The questionnaire was constructed specifically for this study, measuring involvement of and perceptions of palliative care research. Both the interview and the questionnaire data demonstrated strong support for a palliative care research network and aided in establishing a research agenda. The stakeholder workshops assisted with strategies for the formation of the Palliative Care Research Network Victoria (PCRNV) and guided the development of the mission and strategic plan. The research and efforts to date to establish the PCRNV are encouraging and provide optimism for the evolution of palliative care research in Australia. The international implications are highlighted.

Social support and leisure-time physical activity: longitudinal evidence from the Brazilian Pró-Saúde cohort study

Directory of Open Access Journals (Sweden)

Werneck Guilherme L

2011-07-01

Full Text Available Abstract Background Although social support has been observed to exert a beneficial influence on leisure-time physical activity (LTPA, multidimensional approaches examining social support and prospective evidence of its importance are scarce. The purpose of this study was to investigate how four dimensions of social support affect LTPA engagement, maintenance, type, and time spent by adults during a two-year follow-up. Methods This paper reports on a longitudinal study of 3,253 non-faculty public employees at a university in Rio de Janeiro (the Pró-Saúde study. LTPA was evaluated using a dichotomous question with a two-week reference period, and further questions concerning LTPA type (individual or group and time spent on the activity. Social support was measured by the Medical Outcomes Study Social Support Scale (MOS-SSS. To assess the association between social support and LTPA, two different statistical models were used: binary and multinomial logistic regression models for dichotomous and polytomous outcomes, respectively. Models were adjusted separately for those who began LTPA in the middle of the follow up (engagement group and for those who had maintained LTPA since the beginning of the follow up (maintenance group. Results After adjusting for confounders, statistically significant associations (p Conclusions All dimensions of social support influenced LTPA type or the time spent on the activity. However, our findings suggest that social support is more important in engagement than in maintenance. This finding is important, because it suggests that maintenance of LTPA must be associated with other factors beyond the individual's level of social support, such as a suitable environment and social/health policies directed towards the practice of LTPA.

Recruiting for Values in Healthcare: A Preliminary Review of the Evidence

Science.gov (United States)

Patterson, Fiona; Prescott-Clements, Linda; Zibarras, Lara; Edwards, Helena; Kerrin, Maire; Cousans, Fran

2016-01-01

Displaying compassion, benevolence and respect, and preserving the dignity of patients are important for any healthcare professional to ensure the provision of high quality care and patient outcomes. This paper presents a structured search and thematic review of the research evidence relating to values-based recruitment within healthcare. Several…

The evidence for the use of nutritional support in liver disease.

Science.gov (United States)

Koretz, Ronald L

2014-03-01

Although there is a well established association between malnutrition and poorer clinical outcomes in patients with liver disease, that fact alone does not prove that improving the malnutrition will improve outcome. The best way to determine if nutritional interventions are effective is to compare them to untreated control groups in well designed and executed randomized clinical trials. A recent systematic review assessed 37 trials that compared parenteral nutrition, enteral nutrition, or nutritional supplements to no nutritional therapy in patients with a variety of liver diseases. Since the publication of that review, an additional three trials have become available. Whereas all but one of the trials did have methodologic shortcomings that may have allowed the introduction of bias (which usually results in an overestimation of benefit), the trials failed to show much, if any, benefit. In fact, the single trial at low risk of bias found that more deaths occurred in the recipients of the supplements. Although malnutrition may be associated with a poor outcome, the current best evidence indicates that the provision of adjunctive nutritional support (parenteral or enteral nutrition, or nutritional supplements) to patients with a variety of liver diseases (alcoholic hepatitis, cirrhosis, hepatocellular carcinoma, liver surgery, liver transplantation, obstructive jaundice, hepatitis C antiviral treatment) does not improve clinical outcomes.

Danish evidence-based clinical guideline for use of nutritional support in pulmonary rehabilitation of undernourished patients with stable COPD.

Science.gov (United States)

Beck, Anne Marie; Iepsen, Ulrik Winning; Tobberup, Randi; Jørgensen, Karsten Juhl

2015-02-01

Disease-related under-nutrition is a common problem in individuals with COPD. The rationale for nutritional support in pulmonary rehabilitation therefore seems obvious. However there is limited evidence regarding the patient-relevant outcomes i.e. activities of daily living (ADL) or quality of life. Therefore the topic was included in The Danish Health and Medicines Authority's development of an evidence-based clinical guideline for rehabilitation of patients with stable COPD. The methods were specified by The Danish Health and Medicines Authority as part of a standardized approach to evidence-based national clinical practice guidelines. They included formulation of a PICO with pre-defined criteria for the Population, Intervention, Control and Outcomes. Existing guidelines or systematic reviews were used after assessment using the AGREE II tool or AMSTAR, if possible. We identified primary studies by means of a systematic literature search (July to December 2013), and any identified studies were then quality assessed using the Cochrane risk of bias tool and the GRADE approach. The extracted data on our pre-defined outcomes were summarized in meta-analyses when possible, or meta-analyses from existing guidelines or systematic reviews were adapted. The results were used for labeling and wording of the recommendations. Data from 12 randomized controlled trials were included in a systematic review, which formed the basis for our recommendations as no new primary studies had been published. There were evidence of moderate quality that nutritional support for undernourished patients with COPD lead to a weight gain of 1.7kg (95% confidence interval: 1.3 to 2.2kg), but the effect was quantified as a mean change from baseline, which is less reliable. There were evidence of moderate quality that nutritional therapy does not increase in the 6 minute walking distance of 13 m (95% confidence interval: -27 to 54 m) when results in the intervention and control groups were

Preliminary report. Preliminary findings and views concerning the exemption of aviation gasoline from the Mandatory Petroleum Allocation and Price Regulations

Energy Technology Data Exchange (ETDEWEB)

None

1978-01-01

Preliminary findings indicate that: the fuel is not in short supply; exemption will not have an adverse impact on supply of any other petroleum product subject to the Emergency Petroleum allocation Act of 1973; competition and market force are adequate; exemption will not result in inequitable prices; and exemption will not have adverse state or regional impacts or any other adverse impacts. Chapter II provides background information on the use, production, and distribution of aviation gasoline. Chapter III analyzes the historical interaction of supply, demand, and price, and explores the market structure for aviation gasoline during 1968 to 1976, prior to and during imposition of allocation and price controls. Chapter IV examines aviation gasoline supply, demand, price, and market structure impacts of exempting aviation gasoline from controls. In Chapter V, the potential economic impacts of exemption are evaluated. Chapter VI provides a final summary of the DOE's findings and views in support of its preliminary judgment that aviation gasoline should be exempted from allocation and price regulations. (MCW)

The ARSQ: the athletes' received support questionnaire.

Science.gov (United States)

Freeman, Paul; Coffee, Pete; Moll, Tjerk; Rees, Tim; Sammy, Nadine

2014-04-01

To address calls for context-specific measurement of social support, this article reports the development of the Athletes' Received Support Questionnaire (ARSQ) and demonstrates initial evidence for its validity. Across four studies there was support for a four-dimensional structure reflecting emotional, esteem, informational, and tangible received support. There was also support for unidimensional and higher-order models. Further, Study 3 provided some support for convergent validity, with significant correlations between the corresponding dimensions of the ARSQ and the Inventory of Socially Supportive Behaviors. Study 4 provided evidence for the nomological validity of the ARSQ. Emotional and esteem support significantly predicted self-confidence and positive affect, and tangible support significantly moderated the relationship between stress and negative affect. Collectively, these results provide initial evidence for the validity of the ARSQ, and offer researchers flexibility to adopt either a multidimensional or aggregated approach to measuring received support.

Evidence and evidence gaps - an introduction.

Science.gov (United States)

Dreier, Gabriele; Löhler, Jan

2016-01-01

, databases, information portals with processed evidence as well as specific journals and finally teaching are appropriate vehicles. One problem is the multitude of information so that knowledge gaps may affect the clinical routine despite actually existing evidence. Generally, it still takes several years until new knowledge is implemented in daily routine. Tasks: The German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (Deutsche Gesellschaft für Hals-, Nasen- und Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V., DGHNOKHC) and the Professional Association of Otolaryngologists (Deutscher Berufsverband der HNO-Ärzte e.V., BVHNO) have fundamental interest in supporting their members in generating, processing, and providing evidence as well as accompanying knowledge transfer. It encompasses the fields of diagnostics, therapy, and prognosis in the same way as prevention and applies to medicinal products as well as to medical devices or surgical procedures. The base for this is the regular assessment of evidence gaps, also in the area of established procedures, that has to be followed by a prioritization of research questions and the subsequent initiation of clinical research. In addition, large trials verifying therapies and diagnostics, for example in the context of daily conditions after approval, can only be conducted combining all resources in the ENT community. Method, results, and outlook: Together, the executive committees of the DGHNOKHC and the BVHNO founded the German Study Center of Oto-Rhino-Laryngology, Head and Neck Surgery (Deutsches Studienzentrum für Hals-, Nasen- und Ohren-Heilkunde, Kopf- und Hals-Chirurgie, DSZ-HNO). First projects have been initiated, among those a clinical trial on the therapy of sudden hearing loss supported by the BMBF and a survey on evidence gaps in oto-rhino-laryngology. It seems to be both reasonable and feasible to make available methodological expertise via such an infrastructure of a study center for physicians in

Measuring attitudes towards suicide: Preliminary evaluation of an attitude towards suicide scale.

Science.gov (United States)

Cwik, Jan Christopher; Till, Benedikt; Bieda, Angela; Blackwell, Simon E; Walter, Carolin; Teismann, Tobias

2017-01-01

Our study aimed to validate a previously published scale assessing attitudes towards suicide. Factor structure, convergent and discriminant validity, and predictive validity were investigated. Adult German participants (N=503; mean age=24.74years; age range=18-67years) anonymously completed a set of questionnaires. An exploratory factor analysis was conducted, and incongruous items were deleted. Subsequently, scale properties of the reduced scale and its construct validity were analyzed. A confirmatory factor analysis was then conducted in an independent sample (N=266; mean age=28.77years; age range=18-88years) to further confirm the factor structure of the questionnaire. Parallel analysis indicated a three-factor solution, which was also supported by confirmatory factor analysis: right to commit suicide, interpersonal gesture and resilience. The subscales demonstrated acceptable construct and discriminant validity. Cronbach's α for the subscales ranged from 0.67 to 0.83, explaining 49.70% of the total variance. Positive attitudes towards suicide proved to be predictive of suicide risk status, providing preliminary evidence for the utility of the scale. Future studies aiming to reproduce the factor structure in a more heterogeneous sample are warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

Development and preliminary validation of the Scleroderma Support Group Leader Self-efficacy Scale

NARCIS (Netherlands)

Pal, N.E.; Gumuchian, S.T.; Delisle, V.C.; Pé pin, M.; Malcarne, V.L.; Carrier, M.E.; Kwakkenbos, C.M.C.; Pelá ez, S.; El-Baalbaki, G.; Thombs, B.D.

2018-01-01

Support groups are an important resource for people living with systemic sclerosis (SSc; scleroderma). Peer support group leaders play an important role in the success and sustainability of SSc support groups, but face challenges that include a lack of formal training. An SSc support group leader

Preliminary Report Regarding State Allocation Board Funding of the Los Angeles Unified School District's Belmont Learning Complex.

Science.gov (United States)

Armoudian, Maria; Carman, Georgann; Havan, Artineh; Heron, Frank

A preliminary report of the California Legislature's Joint Legislative Audit Committee presents findings on the construction team selection process for the Los Angeles Unified School District's (LAUSD's) Belmont Learning Complex. Evidence reveals a seriously flawed process that directly conflicted with existing law and practice. The report…

Supporting Evidence Use in Networked Professional Learning: The Role of the Middle Leader

Science.gov (United States)

LaPointe-McEwan, Danielle; DeLuca, Christopher; Klinger, Don A.

2017-01-01

Background: In Canada, contemporary collaborative professional learning models for educators utilise multiple forms of evidence to inform practice. Commonly, two forms of evidence are prioritised: (a) research-based evidence and (b) classroom-based evidence of student learning. In Ontario, the integration of these two forms of evidence within…

Supporting middle school students' construction of evidence-based arguments: Impact of and student interactions with computer-based argumentation scaffolds

Science.gov (United States)

Belland, Brian Robert

Middle school students have difficulty creating evidence-based arguments (EBAs) during problem-based learning (PBL) units due to challenges (a) adequately representing the unit's central problem (Ge & Land, 2004; Liu & Bera, 2005), (b) determining and obtaining the most relevant evidence (Pedersen & Liu, 2002-2003), and (c) synthesizing gathered information to construct a sound argument (Cho & Jonassen, 2002). I designed and developed the Connection Log to support middle school students in this process. This study addressed (1) the Connection Log's impact on (a) argument evaluation ability, and (b) group argument quality and (2) how and why middle school science students used the Connection Log. Four sections of a 7th-grade science class participated. Student groups selected a stakeholder position related to the Human Genome Project (HGP) and needed to decide on and promote a plan to use $3 million to further their position as pertains to the HGP. I randomly assigned one higher-achieving and one lower-achieving class to Connection Log or no Connection Log conditions. Students completed an argument evaluation test, and impact on argument evaluation ability was determined using nested ANOVA. Two graduate students, blind to treatment conditions, rated group arguments, and impact on group argument quality was determined using nested MANOVA. To determine how and why students used the Connection Log, I videotaped and interviewed one small group from each class in the experimental condition. I coded transcripts and generated themes, triangulating the two data sources with informal observations during all class sessions and what students wrote in the Connection Log. I detected no significant differences on claim, evidence, or connection of claim to evidence ratings of debate performances. However, students used the Connection Log to counter different difficulties, and I found a significant main effect of the Connection Log on argument evaluation ability, as well as a

BIPS-FS preliminary design, miscellaneous notes

International Nuclear Information System (INIS)

1976-01-01

A compendium of flight system preliminary design internal memos and progress report extracts for the Brayton Isotope Power System Preliminary Design Review to be held July 20, 21, and 22, 1975 is presented. The purpose is to bring together those published items which relate only to the preliminary design of the Flight System, Task 2 of Phase I. This preliminary design effort was required to ensure that the Ground Demonstration System will represent the Flight System as closely as possible

The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance-challenges and future research opportunities.

Science.gov (United States)

Barratt, Christopher L R; Björndahl, Lars; De Jonge, Christopher J; Lamb, Dolores J; Osorio Martini, Francisco; McLachlan, Robert; Oates, Robert D; van der Poel, Sheryl; St John, Bianca; Sigman, Mark; Sokol, Rebecca; Tournaye, Herman

2017-11-01

Herein, we describe the consensus guideline methodology, summarize the evidence-based recommendations we provided to the World Health Organization (WHO) for their consideration in the development of global guidance and present a narrative review of the diagnosis of male infertility as related to the eight prioritized (problem or population (P), intervention (I), comparison (C) and outcome(s) (O) (PICO)) questions. Additionally, we discuss the challenges and research gaps identified during the synthesis of this evidence. The aim of this paper is to present an evidence-based approach for the diagnosis of male infertility as related to the eight prioritized PICO questions. Collating the evidence to support providing recommendations involved a collaborative process as developed by WHO, namely: identification of priority questions and critical outcomes; retrieval of up-to-date evidence and existing guidelines; assessment and synthesis of the evidence; and the formulation of draft recommendations to be used for reaching consensus with a wide range of global stakeholders. For each draft recommendation the quality of the supporting evidence was then graded and assessed for consideration during a WHO consensus. Evidence was synthesized and recommendations were drafted to address the diagnosis of male infertility specifically encompassing the following: What is the prevalence of male infertility and what proportion of infertility is attributable to the male? Is it necessary for all infertile men to undergo a thorough evaluation? What is the clinical (ART/non ART) value of traditional semen parameters? What key male lifestyle factors impact on fertility (focusing on obesity, heat and tobacco smoking)? Do supplementary oral antioxidants or herbal therapies significantly influence fertility outcomes for infertile men? What are the evidence-based criteria for genetic screening of infertile men? How does a history of neoplasia and related treatments in the male impact on (his and

Preliminary evidence for obesity-associated insulin resistance in adolescents without elevations of inflammatory cytokines

Directory of Open Access Journals (Sweden)

Cohen Jessica I

2012-06-01

Full Text Available Abstract Background To ascertain whether the associations between obesity, inflammation, and insulin resistance established in human adult studies are found among adolescents. Methods We contrasted 36 obese and 24 lean youth on fasting glucose, insulin levels, lipid profile, hemoglobin A1C, markers of hepatic function, white blood cell count, C-reactive protein (CRP and fibrinogen levels. The cytokines IL-6, TNF-α, IFN-γ, IL-10 and IL-4 and the adipokines leptin, resistin, and adiponectin were also compared between the two groups. The fasting glucose and insulin values were used to estimate the degree of insulin resistance with the homeostatic model assessment of insulin resistance (HOMA-IR. T-tests and correlations were run to examine group differences and associations between groups. In addition, regression analyses were used to ascertain whether the markers of inflammation were predictive of the degree of insulin resistance. Results Although obese adolescents had clear evidence of insulin resistance, only CRP, fibrinogen and leptin were elevated; there were no group differences in pro- or anti-inflammatory cytokines nor adiponectin and resistin. Anthropometric measures of obesity and level of insulin resistance were highly correlated to the acute phase reactants CRP and fibrinogen; however, the degree of insulin resistance was not predicted by the pro- or anti-inflammatory cytokine markers. Obese adolescents had higher white blood cell counts. In addition they had higher circulating alanine aminotransferase concentrations and lower circulating albumin and total protein than lean adolescents, possibly as a result of hepatocyte damage from fatty liver. Conclusion Unlike rodent or adult studies, we found that wide-spread systemic inflammation is not necessarily associated with insulin resistance among adolescents. This finding does not support the current paradigm that the associations between obesity and insulin resistance are, to a

Preliminary criticality study supporting transuranic waste acceptance into the plasma hearth process

International Nuclear Information System (INIS)

Slate, L.J.; Santee, G.E. Jr.

1996-01-01

This study documents preliminary scoping calculations to address criticality issues associated with the processing of transuranic (TRU) waste and TRU mixed waste in the Plasma Hearth Process (PHP) Test Project. To assess the criticality potential associated with processing TRU waste, the process flow in the PHP is evaluated to identify the stages where criticality could occur. A criticality analysis methodology is then formulated to analyze the criticality potential. Based on these analyses, TRU acceptance criteria can be defined for the PHP. For the current level of analysis, the methodology only assesses the physical system as designed and does not address issues associated with the criticality double contingency principle. The analyses suggest that criticality within the PHP system and within the planned treatment residue (stag) containers does not pose a criticality hazard even when processing waste feed drums containing a quantity of TRU greater than would be reasonably expected. The analyses also indicate that the quantity of TRU that can be processed during each batch is controlled by moving and storage conditions for the resulting slag collection drums

Adjudication Decision Support (ADS) System Automated Approval Estimates for NACLC Investigations

National Research Council Canada - National Science Library

Lang, Eric L; Youpa, Daniel G; Berman, Sandi; Leggitt, John S

2007-01-01

The present research is the second in a series of studies to test preliminary decision rules and provide automated approval estimates for a Department of Defense Adjudication Decision Support (ADS) system...

45 CFR 150.217 - Preliminary determination.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preliminary determination. 150.217 Section 150.217... Are Failing To Substantially Enforce HIPAA Requirements § 150.217 Preliminary determination. If, at... designees). (b) Notifies the State of CMS's preliminary determination that the State has failed to...

Recent mobile health interventions to support medication adherence among HIV-positive MSM.

Science.gov (United States)

Muessig, Kathryn E; LeGrand, Sara; Horvath, Keith J; Bauermeister, José A; Hightow-Weidman, Lisa B

2017-09-01

We describe recent mobile health (mHealth) interventions supporting antiretroviral therapy (ART) medication adherence among HIV-positive MSM. Keyword searches (1 January 2016-13 May 2017) identified 721 citations. Seven publications reporting on six studies met inclusion criteria. Five studies focused on MSM. Interventions primarily employed text messaging (n = 4), whereas two focused on smartphone apps and one on social media. Three studies measured intervention impact on adherence and found increased ART use intentions (n = 1), self-reported adherence (n = 1), and viral suppression (n = 1, no control group). Other mHealth interventions for HIV-positive MSM focused on status disclosure and reducing sexual risk. mHealth interventions to support ART adherence among MSM show acceptability, feasibility, and preliminary efficacy. No recent mHealth interventions for MSM measured impact on viral suppression compared with a control condition despite earlier (pre-2015) evidence for efficacy. Studies are underway that include multiple features designed to improve adherence within complex smartphone or internet-based platforms. Areas for future growth include overcoming measurement and engagement challenges, developing tools for coordinating patient and provider adherence data, testing combination interventions, and adapting efficacious interventions for new languages and geographic settings.

Evidence gap maps -- a tool for promoting evidence-informed policy and prioritizing future research

OpenAIRE

Snilstveit, Birte; Vojtkova, Martina; Bhavsar, Ami; Gaarder, Marie

2013-01-01

Evidence-gap maps present a new addition to the tools available to support evidence-informed policy making. Evidence-gap maps are thematic evidence collections covering a range of issues such as maternal health, HIV/AIDS, and agriculture. They present a visual overview of existing systematic reviews or impact evaluations in a sector or subsector, schematically representing the types of int...

The iron swords from the necropolis of Son Pellisser; preliminary advance

Directory of Open Access Journals (Sweden)

Agustín Fernández Mártinez

2016-11-01

Full Text Available This paper submits the iron swords from the necropolis of Son Pellisser (Calvià-Majorca. Although the materials that we find are numerous and still under research offer a preliminary study about three imported swords, found in burial objects, also their possible origin and way of introduction on the island. These weapons could be the first archaeological evidence that the Balearic mercenaries participated in the Wars of Sicily, between Carthaginians and Greeks, from the fifth century BC.

Corporate Social Disclosures in Southeast Asia: A Preliminary Study

Directory of Open Access Journals (Sweden)

Juniati Gunawan

2012-12-01

Full Text Available The issue of Corporate Social Disclosure (CSD has been growing remarkably both in business and academic world.  Inevitably, this topic is also exposed in Southeast Asia, a big region that plays important role in global economic issue. Applying a content analysis method, this paper aims to provide preliminary findings in CSD practices throughout the companies‟ annual reports in 2007 and 2008 for countries located in Southeast Asia.  Samples were selected for listed and unlisted various type of industries, based on the information availability internet searching. The sample collection and the subjectivity during the content analysis process are the limitations in conducting this study. In general, the results show that „human resources‟ are the main information disclosed, while in contrast, „energy‟ is the main least issue disclosed in the annual reports.  However, the findings need to be interpreted with considerations since there are limited in samples. Basically, the outcomes support the major prior studies and enhancing the discussion of CSD conducting in developing countries, while at the same time describing some countries which obtained very limited in exposures. To respond the vast increasing issues of CSD practice, this preliminary study has provided a basis to see the role of every country in CSR reporting and how they could support the sustainability development globally.

Anticoagulation and high dose liver radiation. A preliminary report

International Nuclear Information System (INIS)

Lightdale, C.J.; Wasser, J.; Coleman, M.; Brower, M.; Tefft, M.; Pasmantier, M.

1979-01-01

Two groups of patients were observed for evidence of acute radiation hepatitis during high dose radiation to the liver. The first group of 18 patients with metastatic liver disease received an average of 4,050 rad to the whole liver. Half received anticoagulation with warfarin. One patient on anticoagulation developed evidence of acute radiation hepatitis while 2 patients did so without anticoagulation. Eleven patients with Hodgkin's disease received 4,000 rad to the left lobe of the liver during extended field radiation. Four of these 11 patients were anticoagulated to therapeutic range. Only one of the fully anticoagulated patients showed changes on liver scan consistent with radiation hepatitis whereas three did so without anticoagulation. No serious sequelae from anticoagulation occurred in either group. These preliminary data suggest that anticoagulation may be safely administered with high dose hepatic radiation and that further trials with anticoagulation are warranted

Preliminary design report: Prototypical Spent Fuel Consolidation Equipment Demonstration Project: Phase 1

International Nuclear Information System (INIS)

Blissell, W.H.; Ciez, A.P.; Mitchell, J.L.; Winkler, C.J.

1986-12-01

This document describes the Westinghouse Preliminary Design for the Prototypical Consolidation Demonstration Project per Department of Energy (DOE) Contract No. DE-AC07-86ID12649 and under direction of the DOE Idaho Operations Office. The preliminary design is the first step to providing the Department of Energy with a fully qualified, licensable, cost-effective spent fuel rod consolidation system. The design was developed using proven technologies and equipment to create an innovative approach to previous rod consolidation concepts. These innovations will better enable the Westinghouse system to: consolidate fuel rods in a precise, fully-controlled, accountable manner; package all rods from two PWR fuel assemblies or from four BWR fuel assemblies in one 8.5 inch square consolidated rods canister; meet all functional requirements; operate with all fuel types common to the US commercial nuclear industry with minimal tooling changeouts; and meet consolidation production process rates, while maintaining operator and public health and safety. This Preliminary Design Report provides both detailed descriptions of the equipment required to perform the rod consolidation process and the supporting analyses to validate the design

GRIST-2 preliminary test plan and requirements for fuel fabrication and preirradiation

International Nuclear Information System (INIS)

Tang, I.M.; Harmon, D.P.; Torri, A.

1978-12-01

The preliminary version of the GRIST-2 test plan has been developed for the planned initial 5 years (1984 to 1989) of TREAT-Upgrade in-pile tests. These tests will be employed to study the phenomenology and integral behavior of GCFR core disruptive accidents (CDAs) and to support the Final Safety Analysis Report (FSAR) CDA analyses for the demonstration plant licensing. The preliminary test plan is outlined. Test Phases I and II are for the fresh fuel (preconditioned or not) CDA behavior at the beginning-of-life (BOL) reactor state. Phase III is for the reactor state that contains irradiated fuel with a saturated content of helium and fission gas. Phase IV is for larger bundle tests and scaling effects

Exploratory shaft facility preliminary designs - Permian Basin

International Nuclear Information System (INIS)

1983-09-01

The purpose of the Preliminary Design Report, Permian Basin, is to provide a description of the preliminary design for an Exploratory Shaft Facility in the Permian Basin, Texas. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers are included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description, and Construction Cost Estimate. 30 references, 13 tables

Do knowledge infrastructure facilities support Evidence-Based Practice in occupational health? An exploratory study across countries among occupational physicians enrolled on Evidence-Based Medicine courses

Directory of Open Access Journals (Sweden)

van Dijk Frank JH

2009-01-01

Full Text Available Abstract Background Evidence-Based Medicine (EBM is an important method used by occupational physicians (OPs to deliver high quality health care. The presence and quality of a knowledge infrastructure is thought to influence the practice of EBM in occupational health care. This study explores the facilities in the knowledge infrastructure being used by OPs in different countries, and their perceived importance for EBM practice. Methods Thirty-six OPs from ten countries, planning to attend an EBM course and to a large extent recruited via the European Association of Schools of Occupational Medicine (EASOM, participated in a cross-sectional study. Results Research and development institutes, and knowledge products and tools are used by respectively more than 72% and more than 80% of the OPs and they are rated as being important for EBM practice (more than 65 points (range 0–100. Conventional knowledge access facilities, like traditional libraries, are used often (69% but are rated as less important (46.8 points (range 0–100 compared to the use of more novel facilities, like question-and-answer facilities (25% that are rated as more important (48.9 points (range 0–100. To solve cases, OPs mostly use non evidence-based sources. However, they regard the evidence-based sources that are not often used, e.g. the Cochrane library, as important enablers for practising EBM. The main barriers are lack of time, payment for full-text articles, language barrier (most texts are in English, and lack of skills and support. Conclusion This first exploratory study shows that OPs use many knowledge infrastructure facilities and rate them as being important for their EBM practice. However, they are not used to use evidence-based sources in their practice and face many barriers that are comparable to the barriers physicians face in primary health care.

Evidence-Based Mental Health Practices with Children Self-Efficacy Scale: Development and Preliminary Findings

Science.gov (United States)

McMeel, Lorri S.; Leathers, Sonya J.; Strand, Tonya C.

2017-01-01

This article reviews existing measures related to evidence-based practices with children and self-efficacy and describes the development and psychometric properties of the Evidence-Based Mental Health Practices With Children Efficacy Scale. This scale was developed to assess students' and clinicians' self-efficacy in their abilities to use…

Stuttering on function words in bilingual children who stutter: A preliminary study.

Science.gov (United States)

Gkalitsiou, Zoi; Byrd, Courtney T; Bedore, Lisa M; Taliancich-Klinger, Casey L

2017-01-01

Evidence suggests young monolingual children who stutter (CWS) are more disfluent on function than content words, particularly when produced in the initial utterance position. The purpose of the present preliminary study was to investigate whether young bilingual CWS present with this same pattern. The narrative and conversational samples of four bilingual Spanish- and English-speaking CWS were analysed. All four bilingual participants produced significantly more stuttering on function words compared to content words, irrespective of their position in the utterance, in their Spanish narrative and conversational speech samples. Three of the four participants also demonstrated more stuttering on function compared to content words in their narrative speech samples in English, but only one participant produced more stuttering on function than content words in her English conversational sample. These preliminary findings are discussed relative to linguistic planning and language proficiency and their potential contribution to stuttered speech.

What Is the Evidence to Support the Use of Therapeutic Gardens for the Elderly?

OpenAIRE

Detweiler, Mark B.; Sharma, Taral; Detweiler, Jonna G.; Murphy, Pamela F.; Lane, Sandra; Carman, Jack; Chudhary, Amara S.; Halling, Mary H.; Kim, Kye Y.

2012-01-01

Horticulture therapy employs plants and gardening activities in therapeutic and rehabilitation activities and could be utilized to improve the quality of life of the worldwide aging population, possibly reducing costs for long-term, assisted living and dementia unit residents. Preliminary studies have reported the benefits of horticultural therapy and garden settings in reduction of pain, improvement in attention, lessening of stress, modulation of agitation, lowering of as needed medications...

Initial development and preliminary validation of a new negative symptom measure: the Clinical Assessment Interview for Negative Symptoms (CAINS).

Science.gov (United States)

Forbes, Courtney; Blanchard, Jack J; Bennett, Melanie; Horan, William P; Kring, Ann; Gur, Raquel

2010-12-01

As part of an ongoing scale development process, this study provides an initial examination of the psychometric properties and validity of a new interview-based negative symptom instrument, the Clinical Assessment Interview for Negative Symptoms (CAINS), in outpatients with schizophrenia or schizoaffective disorder (N = 37). The scale was designed to address limitations of existing measures and to comprehensively assess five consensus-based negative symptoms: asociality, avolition, anhedonia (consummatory and anticipatory), affective flattening, and alogia. Results indicated satisfactory internal consistency reliability for the total CAINS scale score and promising inter-rater agreement, with clear areas identified in need of improvement. Convergent validity was evident in general agreement between the CAINS and alternative negative symptom measures. Further, CAINS subscales significantly correlated with relevant self-report emotional experience measures as well as with social functioning. Discriminant validity of the CAINS was strongly supported by its small, non-significant relations with positive symptoms, general psychiatric symptoms, and depression. These preliminary data on an early beta-version of the CAINS provide initial support for this new assessment approach to negative symptoms and suggest directions for further scale development. Copyright © 2010 Elsevier B.V. All rights reserved.

Mindfulness Therapy for Maladaptive Interpersonal Dependency: A Preliminary Randomized Controlled Trial.

Science.gov (United States)

McClintock, Andrew S; Anderson, Timothy; Cranston, Saryn

2015-11-01

Existing treatments for maladaptive interpersonal dependency and dependent personality disorder do not meet basic scientific standards for effectiveness. The present investigation tested the efficacy of a mindfulness-based approach: mindfulness therapy for maladaptive interpersonal dependency (MT-MID). Forty-eight participants who reported consistently high levels of maladaptive dependency (i.e., scored higher than 1 standard deviation above the mean on the Interpersonal Dependency Inventory at two separate assessments) were randomized to either 5 sessions of MT-MID or a minimal contact control. Five self-reported outcomes (mindfulness, maladaptive interpersonal dependency, helplessness, fears of negative evaluation, and excessive reassurance seeking) were assessed at pretreatment, posttreatment, and a 4-week follow-up. Intent-to-treat analyses indicated that MT-MID yielded greater improvements than the control on all 5 outcomes at posttreatment (median d=1.61) and follow-up (median d=1.51). Participants assigned to MT-MID were more likely than control participants to meet criteria for clinically significant change at posttreatment (56.5% vs. 0%) and follow-up (42.9% vs. 0%). There was also evidence that increases in mindfulness mediated the dependency-related improvements. These results provide preliminary support for the efficacy of a mindfulness-based approach for treating the symptoms of maladaptive dependency. Copyright © 2015. Published by Elsevier Ltd.

Time domain simulations of preliminary breakdown pulses in natural lightning.

Science.gov (United States)

Carlson, B E; Liang, C; Bitzer, P; Christian, H

2015-06-16

Lightning discharge is a complicated process with relevant physical scales spanning many orders of magnitude. In an effort to understand the electrodynamics of lightning and connect physical properties of the channel to observed behavior, we construct a simulation of charge and current flow on a narrow conducting channel embedded in three-dimensional space with the time domain electric field integral equation, the method of moments, and the thin-wire approximation. The method includes approximate treatment of resistance evolution due to lightning channel heating and the corona sheath of charge surrounding the lightning channel. Focusing our attention on preliminary breakdown in natural lightning by simulating stepwise channel extension with a simplified geometry, our simulation reproduces the broad features observed in data collected with the Huntsville Alabama Marx Meter Array. Some deviations in pulse shape details are evident, suggesting future work focusing on the detailed properties of the stepping mechanism. Preliminary breakdown pulses can be reproduced by simulated channel extension Channel heating and corona sheath formation are crucial to proper pulse shape Extension processes and channel orientation significantly affect observations.

Improved support films for electron microscopy of beam sensitive specimens

International Nuclear Information System (INIS)

Taylor, J.R.; Glaeser, R.M.

1987-01-01

Preliminary results indicate that technical innovations can address the problem of beam-induced movement and provide improved prospects for high resolution imaging of beam-sensitive specimens. Second-generation experiments with microgrid supports are in progress with efforts focusing on the objectives of maximizing the contact between the carbon film and its microgrid support and on improving the flatness of microgrids. When more robust support films are available they will be used in conjunction with small spot illumination. 4 refs., 2 figs

Creating infrastructure supportive of evidence-based nursing practice: leadership strategies.

Science.gov (United States)

Newhouse, Robin P

2007-01-01

Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

Nevada potential repository preliminary transportation strategy Study 2. Volume 1

International Nuclear Information System (INIS)

1996-02-01

The objectives of this study were to build on the findings of the Nevada Potential Repository Preliminary Transportation Strategy Study 1 (CRWMS M ampersand O 1995b), and to provide additional information for input to the repository environmental impact statement (EIS) process. In addition, this study supported the future selection of a preferred rail corridor and/or heavy haul route based on defensible data, methods, and analyses. Study research did not consider proposed legislation. Planning was conducted according to the Civilian Radioactive Waste Management Program Plan (DOE 1994a). The specific objectives of Study 2 were to: eliminate or reduce data gaps, inconsistencies, and uncertainties, and strengthen the analysis performed in Study 1; develop a preliminary list of rail route evaluation criteria that could be used to solicit input from stakeholders during scoping meetings. The evaluation criteria will be revised based on comments received during scoping; restrict and refine the width of the four rail corridors identified in Study 1 to five miles or less, based on land use constraints and engineering criteria identified and established in Study 2; evaluate national-level effects of routing spent nuclear fuel and high-level waste to the four identified branch lines, including the effects of routing through or avoiding Las Vegas; continue to gather published land use information and environmental data to support the repository EIS; continue to evaluate heavy haul truck transport over three existing routes as an alternative to rail and provide sufficient information to support the repository EIS process; and evaluate secondary uses for rail (passenger use, repository construction, shared use)

A pilot trial of a stress management intervention for primary caregivers of children newly diagnosed with cancer: preliminary evidence that perceived social support moderates the psychosocial benefit of intervention.

Science.gov (United States)

Marsland, Anna L; Long, Kristin A; Howe, Chelsea; Thompson, Amanda L; Tersak, Jean; Ewing, Linda J

2013-05-01

(1) To examine the acceptability and feasibility of a stress management intervention for caregivers of children recently diagnosed with cancer. (2) To explore whether caregivers with lower baseline perceived social support derive greater benefit from the intervention than those with higher perceived support. 45 primary caregivers were randomly assigned to intervention or standard care. Of these, 37 completed measures of social support, depression, anxiety, and perceived stress at both pre-intervention (T1; mean = 24 days post-diagnosis) and post-intervention time points (T2; mean = 165 days post-diagnosis). Enrollment, retention, and satisfaction data support feasibility and acceptability of the intervention. There was no overall significant impact of participation in the intervention on levels of distress at T2. However, T1 social support moderated intervention response, with caregivers who perceived lower T1 support showing greater psychological benefit from the intervention. Primary caregivers with lower levels of perceived social support may benefit from preemptive stress management intervention.

Social support and leisure-time physical activity: longitudinal evidence from the Brazilian Pró-Saúde cohort study.

Science.gov (United States)

Oliveira, Aldair J; Lopes, Claudia S; de Leon, Antônio C Ponce; Rostila, Mikael; Griep, Rosane H; Werneck, Guilherme L; Faerstein, Eduardo

2011-07-26

Although social support has been observed to exert a beneficial influence on leisure-time physical activity (LTPA), multidimensional approaches examining social support and prospective evidence of its importance are scarce. The purpose of this study was to investigate how four dimensions of social support affect LTPA engagement, maintenance, type, and time spent by adults during a two-year follow-up. This paper reports on a longitudinal study of 3,253 non-faculty public employees at a university in Rio de Janeiro (the Pró-Saúde study). LTPA was evaluated using a dichotomous question with a two-week reference period, and further questions concerning LTPA type (individual or group) and time spent on the activity. Social support was measured by the Medical Outcomes Study Social Support Scale (MOS-SSS). To assess the association between social support and LTPA, two different statistical models were used: binary and multinomial logistic regression models for dichotomous and polytomous outcomes, respectively. Models were adjusted separately for those who began LTPA in the middle of the follow up (engagement group) and for those who had maintained LTPA since the beginning of the follow up (maintenance group). After adjusting for confounders, statistically significant associations (p time spent on LTPA (OR = 2.01; 95% CI 1.2-3.9). In the maintenance group, material support was associated with group LTPA (OR = 1.80; 95% CI; 1.1-3.1) and the positive social interaction dimension was associated with time spent on LTPA (OR = 1.65; 95% CI; 1.1-2.7). All dimensions of social support influenced LTPA type or the time spent on the activity. However, our findings suggest that social support is more important in engagement than in maintenance. This finding is important, because it suggests that maintenance of LTPA must be associated with other factors beyond the individual's level of social support, such as a suitable environment and social/health policies directed towards the

Prevalence of potentially traumatic events, depression, alcohol use, and social network supports among Chinese migrants: an epidemiological study in Guangzhou, China.

Science.gov (United States)

Hall, Brian J; Chen, Wen; Wu, Yan; Zhou, Fangjing; Latkin, Carl

2014-01-01

Addressing the health needs of Chinese migrants is a critical public health concern. Epidemiological studies are needed to establish the prevalence of potentially traumatic events (PTEs) and common mental disorders among Chinese migrants and identify protective community and social resources. Utilizing random household sampling, we are in the process of recruiting a representative sample of Chinese adults (N=1,000) in two districts home to a large number of internal migrants. Data are collected using face-to-face interviews and participant self-report methods. Chinese versions of the Life Events Checklist, Alcohol Use Disorders Identification Test, Patient Health Questionnaire and the Social Support Rating Scale measured exposure to PTEs, alcohol use disorder, depression, and social support networks. Preliminary results indicate a high proportion (68%) of the sample was exposed directly or indirectly to at least one PTE. The most commonly reported events were transportation accidents (43%), natural disasters (39%), and physical assault (26%). A total of 17% of the sample reported drinking consistent with having an alcohol use disorder. Moderate or severe depression was reported by 9% of the sample. The majority (75%) reported having three or more people to rely on for support, and 41% reported active participation in civic groups. Despite these strengths, only half the sample reported having trust in their community. Preliminary evidence from this population-level survey indicates high exposure to PTEs and a high potential burden of alcohol use disorders. The role of social networks will be explored as potentially useful for community-based intervention development.

Prevalence of potentially traumatic events, depression, alcohol use, and social network supports among Chinese migrants: an epidemiological study in Guangzhou, China

Directory of Open Access Journals (Sweden)

Brian J. Hall

2014-12-01

Full Text Available Background: Addressing the health needs of Chinese migrants is a critical public health concern. Epidemiological studies are needed to establish the prevalence of potentially traumatic events (PTEs and common mental disorders among Chinese migrants and identify protective community and social resources. Method: Utilizing random household sampling, we are in the process of recruiting a representative sample of Chinese adults (N=1,000 in two districts home to a large number of internal migrants. Data are collected using face-to-face interviews and participant self-report methods. Chinese versions of the Life Events Checklist, Alcohol Use Disorders Identification Test, Patient Health Questionnaire and the Social Support Rating Scale measured exposure to PTEs, alcohol use disorder, depression, and social support networks. Results: Preliminary results indicate a high proportion (68% of the sample was exposed directly or indirectly to at least one PTE. The most commonly reported events were transportation accidents (43%, natural disasters (39%, and physical assault (26%. A total of 17% of the sample reported drinking consistent with having an alcohol use disorder. Moderate or severe depression was reported by 9% of the sample. The majority (75% reported having three or more people to rely on for support, and 41% reported active participation in civic groups. Despite these strengths, only half the sample reported having trust in their community. Conclusion: Preliminary evidence from this population-level survey indicates high exposure to PTEs and a high potential burden of alcohol use disorders. The role of social networks will be explored as potentially useful for community-based intervention development.

Evidence-based management of ambulatory electronic health record system implementation: an assessment of conceptual support and qualitative evidence.

Science.gov (United States)

McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia; Rizer, Milisa; Huerta, Timothy R

2014-07-01

While electronic health record (EHR) systems have potential to drive improvements in healthcare, a majority of EHR implementations fall short of expectations. Shortcomings in implementations are often due to organizational issues around the implementation process rather than technological problems. Evidence from both the information technology and healthcare management literature can be applied to improve the likelihood of implementation success, but the translation of this evidence into practice has not been widespread. Our objective was to comprehensively study and synthesize best practices for managing ambulatory EHR system implementation in healthcare organizations, highlighting applicable management theories and successful strategies. We held 45 interviews with key informants in six U.S. healthcare organizations purposively selected based on reported success with ambulatory EHR implementation. We also conducted six focus groups comprised of 37 physicians. Interview and focus group transcripts were analyzed using both deductive and inductive methods to answer research questions and explore emergent themes. We suggest that successful management of ambulatory EHR implementation can be guided by the Plan-Do-Study-Act (PDSA) quality improvement (QI) model. While participants did not acknowledge nor emphasize use of this model, we found evidence that successful implementation practices could be framed using the PDSA model. Additionally, successful sites had three strategies in common: 1) use of evidence from published health information technology (HIT) literature emphasizing implementation facilitators; 2) focusing on workflow; and 3) incorporating critical management factors that facilitate implementation. Organizations seeking to improve ambulatory EHR implementation processes can use frameworks such as the PDSA QI model to guide efforts and provide a means to formally accommodate new evidence over time. Implementing formal management strategies and incorporating

Novel Approaches for Phylogenetic Inference from Morphological Data and Total-Evidence Dating in Squamate Reptiles (Lizards, Snakes, and Amphisbaenians).

Science.gov (United States)

Pyron, R Alexander

2017-01-01

Here, I combine previously underutilized models and priors to perform more biologically realistic phylogenetic inference from morphological data, with an example from squamate reptiles. When coding morphological characters, it is often possible to denote ordered states with explicit reference to observed or hypothetical ancestral conditions. Using this logic, we can integrate across character-state labels and estimate meaningful rates of forward and backward transitions from plesiomorphy to apomorphy. I refer to this approach as MkA, for “asymmetric.” The MkA model incorporates the biological reality of limited reversal for many phylogenetically informative characters, and significantly increases likelihoods in the empirical data sets. Despite this, the phylogeny of Squamata remains contentious. Total-evidence analyses using combined morphological and molecular data and the MkA approach tend toward recent consensus estimates supporting a nested Iguania. However, support for this topology is not unambiguous across data sets or analyses, and no mechanism has been proposed to explain the widespread incongruence between partitions, or the hidden support for various topologies in those partitions. Furthermore, different morphological data sets produced by different authors contain both different characters and different states for the same or similar characters, resulting in drastically different placements for many important fossil lineages. Effort is needed to standardize ontology for morphology, resolve incongruence, and estimate a robust phylogeny. The MkA approach provides a preliminary avenue for investigating morphological evolution while accounting for temporal evidence and asymmetry in character-state changes.

Does the scientific evidence support the advertising claims made for products containing Lactobacillus casei and Bifidobacterium lactis? A systematic review.

Science.gov (United States)

Meléndez-Illanes, Lorena; González-Díaz, Cristina; Chilet-Rosell, Elisa; Álvarez-Dardet, Carlos

2016-09-01

To analyse the scientific evidence that exists for the advertising claims made for two products containing Lactobacillus casei and Bifidobacterium lactis and to conduct a comparison between the published literature and what is presented in the corporate website. Systematic review, using Medline through Pubmed and Embase. We included human clinical trials that exclusively measured the effect of Lactobacillus casei or Bifidobacterium lactis on a healthy population, and where the objective was related to the health claims made for certain products in advertising. We assessed the levels of evidence and the strength of the recommendation according to the classification criteria established by the Oxford Centre for Evidence Based Medicine (CEBM). We also assessed the outcomes of the studies published on the website that did not appear in the search. Of the 440 articles identified, 16 met the inclusion criteria. Only four (25%) of these presented a level of evidence of 1b and a recommendation grade of A, all corresponding to studies on product containing Bifidobacterium lactis, and only 12 of the 16 studies were published on the corporate website (47). There is insufficient scientific evidence to support the health claims made for these products, especially in the case of product containing Lactobacillus casei. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evidence for factorization breaking in diffractive low-Q2 dijet production

International Nuclear Information System (INIS)

Klasen, Michael; Kramer, Gustav

2004-01-01

We calculate diffractive dijet production in deep-inelastic scattering at next-to-leading order of perturbative QCD, including contributions from direct and resolved photons, and compare our predictions to preliminary data from the H1 Collaboration at DESY HERA. In contrast to recent experimental claims, evidence for factorization breaking is found only for resolved, and not direct, photon contributions. No evidence is found for large normalization uncertainties in diffractive parton densities. The results confirm theoretical expectations for the (non)cancellation of soft singularities in diffractive scattering as well as previous results for (almost) real photoproduction

Preliminary Hazard Classification for the Remediation of the 100-B/C Area Remaining Sites (Confirmatory Sampling Effort)

International Nuclear Information System (INIS)

Routt, T.M.

2000-01-01

This document provides the preliminary hazard classification for the sampling and characterization activities to be conducted at the 100-B/C confirmatory sampling effort sites in support of remedial design and eventual remediation of these sites

Coordination in contractual relations: Some preliminary findings from the Malaysian housing industry

Directory of Open Access Journals (Sweden)

Suraya Ismail

2008-12-01

Full Text Available The traditional general procurement route found in many housing projects in Malaysia is conceptualized as a governance structure following the transaction cost economics (TCE approach. This approach has been used to examine governance structures in different economic sectors in several countries but evidence of its use in the context of developing countries is limited. This lack of evidence has prompted the authors to conduct a preliminary study to ascertain whether a TCE approach can explain construction governance structures in developing countries. This research does not discuss the trade-off that governs the choice of hybrids, market or hierarchies for organizing transactions. Rather, it takes advantage of existing research to substantiate the specific properties of hybrid organizations as governance structures. The main focus is coordination. Coordination is specified at two levels. At Level 1 is the coordination of specialization (i.e. the formation of the project team members and at Level 2 is the coordination mode of the contracting parties (client and contractor and the agents involved (the lead designer and project manage r. A case survey method was adopted. Preliminary findings seem to suggest that clients have used hierarchical themes in the contracts and high powered incentives to coordinate with in the contracting parties. The research findings suggest that all participants involved in the sample studied used governance structures symptomatic of a hybrid organization.

Development of Pediatric Neurologic Emergency Life Support Course: A Preliminary Report.

Science.gov (United States)

Haque, Anwarul; Arif, Fehmina; Abass, Qalab; Ahmed, Khalid

2017-11-01

Acute neurological emergencies (ANEs) in children are common life-threatening illnesses and are associated with high mortality and severe neurological disability in survivors, if not recognized early and treated appropriately. We describe our experience of teaching a short, novel course "Pediatric Neurologic Emergency Life Support" to pediatricians and trainees in a resource-limited country. This course was conducted at 5 academic hospitals from November 2013 to December 2014. It is a hybrid of pediatric advance life support and emergency neurologic life support. This course is designed to increase knowledge and impart practical training on early recognition and timely appropriate treatment in the first hour of children with ANEs. Neuroresuscitation and neuroprotective strategies are key components of this course to prevent and treat secondary injuries. Four cases of ANEs (status epilepticus, nontraumatic coma, raised intracranial pressure, and severe traumatic brain injury) were taught as a case simulation in a stepped-care, protocolized approach based on best clinical practices with emphasis on key points of managements in the first hour. Eleven courses were conducted during the study period. One hundred ninety-six physicians including 19 consultants and 171 residents participated in these courses. The mean (SD) score was 65.15 (13.87%). Seventy percent (132) of participants were passed (passing score > 60%). The overall satisfaction rate was 85%. Pediatric Neurologic Emergency Life Support was the first-time delivered educational tool to improve outcome of children with ANEs with good achievement and high satisfaction rate of participants. Large number courses are required for future validation.

Recruiting for values in healthcare: a preliminary review of the evidence

OpenAIRE

Patterson, F.; Prescott-Clements, L.; Zibarras, L. D.; Edwards, H.; Kerrin, M.; Cousans, F.

2016-01-01

Displaying compassion, benevolence and respect, and preserving the dignity of patients are important for any healthcare professional to ensure the provision of high quality care and patient outcomes. This paper presents a structured search and thematic review of the research evidence relating to values-based recruitment within healthcare. Several different databases, journals and government reports were searched to retrieve studies relating to values-based recruitment published between 1998 a...

Comparing a Mobile Decision Support System Versus the Use of Printed Materials for the Implementation of an Evidence-Based Recommendation: Protocol for a Qualitative Evaluation.

Science.gov (United States)

Camacho, Jhon; Medina Ch, Ana María; Landis-Lewis, Zach; Douglas, Gerald; Boyce, Richard

2018-04-13

The distribution of printed materials is the most frequently used strategy to disseminate and implement clinical practice guidelines, although several studies have shown that the effectiveness of this approach is modest at best. Nevertheless, there is insufficient evidence to support the use of other strategies. Recent research has shown that the use of computerized decision support presents a promising approach to address some aspects of this problem. The aim of this study is to provide qualitative evidence on the potential effect of mobile decision support systems to facilitate the implementation of evidence-based recommendations included in clinical practice guidelines. We will conduct a qualitative study with two arms to compare the experience of primary care physicians while they try to implement an evidence-based recommendation in their clinical practice. In the first arm, we will provide participants with a printout of the guideline article containing the recommendation, while in the second arm, we will provide participants with a mobile app developed after formalizing the recommendation text into a clinical algorithm. Data will be collected using semistructured and open interviews to explore aspects of behavioral change and technology acceptance involved in the implementation process. The analysis will be comprised of two phases. During the first phase, we will conduct a template analysis to identify barriers and facilitators in each scenario. Then, during the second phase, we will contrast the findings from each arm to propose hypotheses about the potential impact of the system. We have formalized the narrative in the recommendation into a clinical algorithm and have developed a mobile app. Data collection is expected to occur during 2018, with the first phase of analysis running in parallel. The second phase is scheduled to conclude in July 2019. Our study will further the understanding of the role of mobile decision support systems in the implementation

Preliminary test results from a free-piston Stirling engine technology demonstration program to support advanced radioisotope space power applications

International Nuclear Information System (INIS)

White, Maurice A.; Qiu Songgang; Augenblick, Jack E.

2000-01-01

Free-piston Stirling engines offer a relatively mature, proven, long-life technology that is well-suited for advanced, high-efficiency radioisotope space power systems. Contracts from DOE and NASA are being conducted by Stirling Technology Company (STC) for the purpose of demonstrating the Stirling technology in a configuration and power level that is representative of an eventual space power system. The long-term objective is to develop a power system with an efficiency exceeding 20% that can function with a high degree of reliability for up to 15 years on deep space missions. The current technology demonstration convertors (TDC's) are completing shakedown testing and have recently demonstrated performance levels that are virtually identical to projections made during the preliminary design phase. This paper describes preliminary test results for power output, efficiency, and vibration levels. These early results demonstrate the ability of the free-piston Stirling technology to exceed objectives by approximately quadrupling the efficiency of conventional radioisotope thermoelectric generators (RTG's)

Preliminary test results from a free-piston Stirling engine technology demonstration program to support advanced radioisotope space power applications

Science.gov (United States)

White, Maurice A.; Qiu, Songgang; Augenblick, Jack E.

2000-01-01

Free-piston Stirling engines offer a relatively mature, proven, long-life technology that is well-suited for advanced, high-efficiency radioisotope space power systems. Contracts from DOE and NASA are being conducted by Stirling Technology Company (STC) for the purpose of demonstrating the Stirling technology in a configuration and power level that is representative of an eventual space power system. The long-term objective is to develop a power system with an efficiency exceeding 20% that can function with a high degree of reliability for up to 15 years on deep space missions. The current technology demonstration convertors (TDC's) are completing shakedown testing and have recently demonstrated performance levels that are virtually identical to projections made during the preliminary design phase. This paper describes preliminary test results for power output, efficiency, and vibration levels. These early results demonstrate the ability of the free-piston Stirling technology to exceed objectives by approximately quadrupling the efficiency of conventional radioisotope thermoelectric generators (RTG's). .

Perceived Parental Attitudes of Gender Expansiveness: Development and Preliminary Factor Structure of a Self-Report Youth Questionnaire.

Science.gov (United States)

Hidalgo, Marco A; Chen, Diane; Garofalo, Robert; Forbes, Catherine

2017-01-01

Purpose: Parental acceptance of gender identity/expression in lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) youth moderates the effects of minority stress on mental health outcomes. Given this association, mental health clinicians of gender-expansive adolescents often assess the degree to which these youth perceive their parents/primary caregivers as accepting or nonaffirming of their gender identity and expression. While existing measures may reliably assess youth's perceptions of general family support, no known tool aids in the assessment an adolescent's perceived parental support related to adolescent gender-expansive experiences. Methods: To provide both clinicians and researchers with an empirically derived tool, the current study used factor analysis to explore an underlying factor structure of a brief questionnaire developed by subject-matter experts and pertaining to multiple aspects of perceived parental support in gender-expansive adolescents and young adults. Respondents were gender-expansive adolescents and young adults seeking care in an interdisciplinary gender-health clinic within a pediatric academic medical center in the Midwestern United States. Results: Exploratory factor analysis resulted in a 14-item questionnaire comprised of two subscales assessing perceived parental nonaffirmation and perceived parental acceptance. Internal consistency and construct validity results provided support for this new questionnaire. Conclusion: This study provides preliminary evidence of the factor structure, reliability and validity of the Parental Attitudes of Gender Expansiveness Scale for Youth (PAGES-Y). These findings demonstrate both the clinical and research utility of the PAGES-Y, a tool that can yield a more nuanced understanding of family-related risk and protective factors in gender-expansive adolescents.

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

Science.gov (United States)

Dolan, James G

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

Regional brain activation supporting cognitive control in the context of reward is associated with treated adolescents’ marijuana problem severity at follow-up: A preliminary study

Directory of Open Access Journals (Sweden)

Tammy Chung

2015-12-01

Full Text Available This preliminary study examined the extent to which regional brain activation during a reward cue antisaccade (AS task was associated with 6-month treatment outcome in adolescent substance users. Antisaccade performance provides a sensitive measure of executive function and cognitive control, and generally improves with reward cues. We hypothesized that when preparing to execute an AS, greater activation in regions associated with cognitive and oculomotor control supporting AS, particularly during reward cue trials, would be associated with lower substance use severity at 6-month follow-up. Adolescents (n = 14, ages 14–18 recruited from community-based outpatient treatment completed an fMRI reward cue AS task (reward and neutral conditions, and provided follow-up data. Results indicated that AS errors decreased in reward, compared to neutral, trials. AS behavioral performance, however, was not associated with treatment outcome. As hypothesized, activation in regions of interest (ROIs associated with cognitive (e.g., ventrolateral prefrontal cortex and oculomotor control (e.g., supplementary eye field during reward trials were inversely correlated with marijuana problem severity at 6-months. ROI activation during neutral trials was not associated with outcomes. Results support the role of motivational (reward cue factors to enhance cognitive control processes, and suggest a potential brain-based correlate of youth treatment outcome.

Science and evidence: separating fact from fiction.

Science.gov (United States)

Hess, Dean R

2013-10-01

Evidence-based medicine (EBM) is the integration of individual clinical expertise with the best available research evidence from systematic research and the patient's values and expectations. A hierarchy of evidence can be used to assess the strength upon which clinical decisions are made. The efficient approach to finding the best evidence is to identify systematic reviews or evidence-based clinical practice guidelines. Respiratory therapies that evidence supports include noninvasive ventilation for appropriately selected patients, lung-protective ventilation, and ventilator discontinuation protocols. Evidence does not support use of weaning parameters, albuterol for ARDS, and high frequency oscillatory ventilation for adults. Therapy with equivocal evidence includes airway clearance, selection of an aerosol delivery device, and PEEP for ARDS. Although all tenets of EBM are not universally accepted, the principles of EBM nonetheless provide a valuable approach to respiratory care practice.

Family support programs and adolescent mental health: review of evidence

OpenAIRE

Laird, Robert; Kuhn,Emily

2014-01-01

Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be deli...

Preliminary recommendations on the design of the characterization program for the Hanford Site single-shell tanks: A system analysis

International Nuclear Information System (INIS)

Buck, J.W.; Peffers, M.S.; Hwang, S.T.

1991-11-01

The work described in this volume was conducted by Pacific Northwest Laboratory to provide preliminary recommendations on data quality objectives (DQOs) to support the Waste Characterization Plan (WCP) and closure decisions for the Hanford Site single-shell tanks (SSTs). The WCP describes the first of a two-phase characterization program that will obtain information to assess and implement disposal options for SSTs. This work was performed for the Westinghouse Hanford Company (WHC), the current operating contractor on the Hanford Site. The preliminary DQOs contained in this volume deal with the analysis of SST wastes in support of the WCP and final closure decisions. These DQOs include information on significant contributors and detection limit goals (DLGs) for SST analytes based on public health risk

King County Metro Battery Electric Bus Demonstration: Preliminary Project Results

Energy Technology Data Exchange (ETDEWEB)

2017-05-22

The U.S. Federal Transit Administration (FTA) funds a variety of research projects that support the commercialization of zero-emission bus technology. To evaluate projects funded through these programs, FTA has enlisted the help of the National Renewable Energy Laboratory (NREL) to conduct third-party evaluations of the technologies deployed under the FTA programs. NREL works with the selected agencies to evaluate the performance of the zero-emission buses compared to baseline conventional buses in similar service. The evaluation effort will advance the knowledge base of zero-emission technologies in transit bus applications and provide 'lessons learned' to aid other fleets in incrementally introducing next generation zero-emission buses into their operations. This report provides preliminary performance evaluation results from a demonstration of three zero-emission battery electric buses at King County Metro in King County, Washington. NREL developed this preliminary results report to quickly disseminate evaluation results to stakeholders. Detailed evaluation results will be published in future reports.

Targeting binge eating through components of dialectical behavior therapy: preliminary outcomes for individually supported diary card self-monitoring versus group-based DBT.

Science.gov (United States)

Klein, Angela S; Skinner, Jeremy B; Hawley, Kristin M

2013-12-01

The current study examined two condensed adaptations of dialectical behavior therapy (DBT) for binge eating. Women with full- or sub-threshold variants of either binge eating disorder or bulimia nervosa were randomly assigned to individually supported self-monitoring using adapted DBT diary cards (DC) or group-based DBT, each 15 sessions over 16 weeks. DC sessions focused on problem-solving diary card completion issues, praising diary card completion, and supporting nonjudgmental awareness of eating-related habits and urges, but not formally teaching DBT skills. Group-based DBT included eating mindfulness, progressing through graded exposure; mindfulness, emotion regulation, and distress tolerance skills; and coaching calls between sessions. Both treatments evidenced large and significant improvements in binge eating, bulimic symptoms, and interoceptive awareness. For group-based DBT, ineffectiveness, drive for thinness, body dissatisfaction, and perfectionism also decreased significantly, with medium to large effect sizes. For DC, results were not significant but large in effect size for body dissatisfaction and medium in effect size for ineffectiveness and drive for thinness. Retention for both treatments was higher than recent trends for eating disorder treatment in fee-for-service practice and for similar clinic settings, but favored DC, with the greater attrition of group-based DBT primarily attributed to its more intensive and time-consuming nature, and dropout overall associated with less pretreatment impairment and greater interoceptive awareness. This preliminary investigation suggests that with both abbreviated DBT-based treatments, substantial improvement in core binge eating symptoms is possible, enhancing potential avenues for implementation beyond more time-intensive DBT.

Motivations for Botanical Use by Socioeconomically Diverse, Urban Adults: Does Evidence Support Motivation?

Science.gov (United States)

Duffy, Grace F; Shupe, Emily Stave; Kuczmarski, Marie Fanelli; Zonderman, Alan B; Evans, Michele K

2017-10-01

The study objectives were to characterize botanical dietary supplement (BDS) use and to compare the motivations for botanical supplement (BS) use to the efficacy of the botanical in a socioeconomically and racially diverse urban adult population. Subjects were from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, a 20-year prospective health disparities study with African American and white adults from Baltimore, Maryland. All study participants completed two dietary recalls and a dietary supplement (DS) questionnaire in Wave 3 (n = 2140). Diet quality was evaluated by the Healthy Eating Index-2010 and the Mean Adequacy Ratio for 17 micronutrients. A comparison of reported motivations to efficacy reported in the literature of single BS was conducted. Approximately 50% (1062/2140) of participants took DS. Of these, 8% (n = 178) reported taking either BS or BDS. It was found that BDS users had better diet quality than DS users as well as nonusers of DS. The top three motivations for BDS users were to improve overall health, to maintain health, and to supplement the diet. There is limited evidence for the efficacy of most BS. Review of the efficacy of the 15 BS reported by ≥5% of the study population revealed beneficial health roles for only fiber, gingko biloba extract EGb 761, and hawthorn berry. To the authors' knowledge, this study is the first to report a better quality diet with BDS use for a racially diverse urban population. Yet, improvement in diet is needed because overall quality did not achieve current recommendations. To improve overall health, it may be beneficial for this population to focus on dietary modifications to reduce the risks associated with chronic diseases. In general, the reported motivations for BS use were not supported by clinical evidence.

[Evidence and Evidence Gaps - an Introduction].

Science.gov (United States)

Dreier, G; Löhler, J

2016-04-01

Treating patients requires the inclusion of existing evidence in any health care decision, to be able to choose the best diagnosis or treatment measure or to make valid prognosis statements for a particular patient in consideration of the physician's own expertise.The basis are clinical trials, the results of which are ideally gathered in systematic reviews, rated, summarized and published. In addition to the GCP (Good Clinical Practice)-compliant planning, conducting and analysis of clinical studies it is essential, that all study results are made publicly available, in order to avoid publication bias. This includes the public registration of planned and discontinued trials. In the last 25 years, the evidence-based medicine (EbM) has increasingly found its way into clinical practice and research. Here EbM is closely associated with the names Archibald Cochrane and David Sackett. In Germany, both the German Cochrane Centre (DCZ) and the network of evidence-based medicine (DNEbM) were established approximately 15 years ago. In the international Cochrane Collaboration clinicians and other scientists like statisticians interdisciplinary work side by side to develop the methods of evidence-based medicine and to address the topics of evidence generation and processing as well as the transfer of knowledge. Challenge: Existing evidence primarily serves doctors to support their decision-making, but is also the basis for providing scientific proof for a health care intervention's benefit to patients and ultimately payers/health insurances. The closure of existing evidence gaps requires substantial human and financial resources, a complex organizational structure and can only succeed with the involvement of clinical and methodological expertise and specific knowledge in the field of clinical research. In addition, the knowledge must be transferred into practice, using journals, guidelines, conferences, databases, information portals with processed evidence and not least the

Informatics in radiology: web-based preliminary reporting system for radiology residents with PACS integration.

Science.gov (United States)

O'Connell, Timothy; Chang, Debra

2012-01-01

While on call, radiology residents review imaging studies and issue preliminary reports to referring clinicians. In the absence of an integrated reporting system at the training sites of the authors' institution, residents were typing and faxing preliminary reports. To partially automate the on-call resident workflow, a Web-based system for resident reporting was developed by using the free open-source xAMP Web application framework and an open-source DICOM (Digital Imaging and Communications in Medicine) software toolkit, with the goals of reducing errors and lowering barriers to education. This reporting system integrates with the picture archiving and communication system to display a worklist of studies. Patient data are automatically entered in the preliminary report to prevent identification errors and simplify the report creation process. When the final report for a resident's on-call study is available, the reporting system queries the report broker for the final report, and then displays the preliminary report side by side with the final report, thus simplifying the review process and encouraging review of all of the resident's reports. The xAMP Web application framework should be considered for development of radiology department informatics projects owing to its zero cost, minimal hardware requirements, ease of programming, and large support community.

Support Vector Machines: Relevance Feedback and Information Retrieval.

Science.gov (United States)

Drucker, Harris; Shahrary, Behzad; Gibbon, David C.

2002-01-01

Compares support vector machines (SVMs) to Rocchio, Ide regular and Ide dec-hi algorithms in information retrieval (IR) of text documents using relevancy feedback. If the preliminary search is so poor that one has to search through many documents to find at least one relevant document, then SVM is preferred. Includes nine tables. (Contains 24…

28 CFR 2.48 - Revocation: Preliminary interview.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Revocation: Preliminary interview. 2.48....48 Revocation: Preliminary interview. (a) Interviewing officer. A parolee who is retaken on a warrant issued by a Commissioner shall be given a preliminary interview by an official designated by the Regional...

Supporting patients in obtaining and oncologists in providing evidence-based health-related quality of life information prior to and after esophageal cancer surgery

NARCIS (Netherlands)

Jacobs, M.

2015-01-01

The overall aim of this thesis was to support patients in obtaining and oncologists in providing evidence-based HRQL data prior to and following esophageal cancer surgery. This thesis is divided in two parts. In Part I, we addressed the information needs of esophageal cancer patients prior to and

Evidence of an Intermediate Phase in bulk alloy oxide glass sysem

Science.gov (United States)

Chakraborty, S.; Boolchand, P.

2011-03-01

Reversibility windows have been observed in modified oxides (alkali-silicates and -germanates) and identified with Intermediate Phases(IPs). Here we find preliminary evidence of an IP in a ternary oxide glass, (B2 O3)5 (Te O2)95-x (V2O5)x , which is composed of network formers. Bulk glasses are synthesized across the 18% x 35 % composition range, and examined in Raman scattering, modulated DSC and molar volume experiments. Glass transition temperatures Tg (x) steadily decrease with V2O5 content x, and reveal the enthalpy of relaxation at Tg to show a global minimum in the 24% x < 27 range, the reversibility window (IP). Molar volumes reveal a minimum in this window. Raman scattering reveals a Boson mode, and at least six other vibrational bands in the 100cm-1 < ν < 1700cm-1 range. Compositional trends in vibrational mode strengths and frequency are established. These results will be presented in relation to glass structure evolution with vanadia content and the underlying elastic phases. Supported by NSF grant DMR 08-53957.

Robot assisted navigated drilling for percutaneous pedicle screw placement: A preliminary animal study

Directory of Open Access Journals (Sweden)

Hongwei Wang

2015-01-01

Conclusions: The preliminary study supports the view that computer assisted pedicle screw fixation using spinal robot is feasible and the robot can decrease the intraoperative fluoroscopy time during the minimally invasive pedicle screw fixation surgery. As spine robotic surgery is still in its infancy, further research in this field is worthwhile especially the accuracy of spine robot system should be improved.

Preliminary ATWS analysis for the IRIS PRA

International Nuclear Information System (INIS)

Maddalena Barra; Marco S Ghisu; David J Finnicum; Luca Oriani

2005-01-01

Full text of publication follows: The pressurized light water cooled, medium power (1000 MWt) IRIS (International Reactor Innovative and Secure) has been under development for four years by an international consortium of over 21 organizations from ten countries. The plant conceptual design was completed in 2001 and the preliminary design is nearing completion. The pre-application licensing process with NRC started in October, 2002. IRIS has been primarily focused on establishing a design with innovative safety characteristics. The first line of defense in IRIS is to eliminate event initiators that could potentially lead to core damage. In IRIS, this concept is implemented through the 'safety by design' approach, which allows to minimize the number and complexity of the safety systems and required operator actions. The end result is a design with significantly reduced complexity and improved operability, and extensive plant simplifications to enhance construction. To support the optimization of the plant design and confirm the effectiveness of the safety by design approach in mitigating or eliminating events and thus providing a significant reduction in the probability of severe accidents, the PRA is being used as an integral part of the design process. A preliminary but extensive Level 1 PRA model has been developed to support the pre-application licensing of the IRIS design. As a result of the Preliminary IRIS PRA, an optimization of the design from a reliability point of view was completed, and an extremely low (about 1.2 E -8 ) core damage frequency (CDF) was assessed to confirm the impact of the safety by design approach. This first assessment is a result of a PRA model including internal initiating events. During this assessment, several assumptions were necessary to complete the CDF evaluation. In particular Anticipated Transients Without Scram (ATWS) were not included in this initial assessment, because their contribution to core damage frequency was assumed

Immunological evidence of Zika virus transmission in Thailand

Institute of Scientific and Technical Information of China (English)

Nitwara Wikan; Yupin Suputtamongkol; Sutee Yoksan; Duncan R. Smith; Prasert Auewarakul

2016-01-01

Objective: To identify immunological evidence of Zika virus transmission in Thailand. Methods: To undertake a preliminary serosurvey of possible exposure to Zika virus, 21 serum samples from cohort of acute undifferentiated fever patients were examined for immunoreactivity to Zika, Dengue, Japanese encephalitis and Chikungunya envelope antigens by Western blot analysis. Results: Twenty of the 21 serum samples showed immunoreactivity to at least one of the antigens, with seven samples showing immunoreactivity to all antigens. Of particular note, two serum samples showed immunoreactivity only to Zika envelope antigen, with no immunoreactivity to other envelope antigens. Conclusions: This study presents the first evidence of Zika virus transmission in Thailand, although as yet the relationship between transmission and possible cases of Zika fever in Thailand requires further investigation.

Feasibility and preliminary effects of an intervention targeting schema development for caregivers of newly admitted hospice patients.

Science.gov (United States)

Lindstrom, Kathryn B; Mazurek Melnyk, Bernadette

2013-06-01

The transition to hospice care is a stressful experience for caregivers, who report high anxiety, unpreparedness, and lack of confidence. These sequelae are likely explained by the lack of an accurate cognitive schema, not knowing what to expect or how to help their loved one. Few interventions exist for this population and most do not measure preparedness, confidence, and anxiety using a schema building a conceptual framework for a new experience. The purpose of this study was to test the feasibility and preliminary effects of an intervention program, Education and Skill building Intervention for Caregivers of Hospice patients (ESI-CH), using an innovative conceptual design that targets cognitive schema development and basic skill building for caregivers of loved ones newly admitted to hospice services. A pre-experimental one-group pre- and post-test study design was used. Eighteen caregivers caring for loved ones in their homes were recruited and twelve completed the pilot study. Depression, anxiety, activity restriction, preparedness, and beliefs/confidence were measured. Caregivers reported increased preparedness, more helpful beliefs, and more confidence about their ability to care for their loved one. Preliminary trends suggested decreased anxiety levels for the intervention group. Caregivers who completed the intervention program rated the program very good or excellent, thought the information was helpful and timely, and would recommend it to friends. Results show promise that the ESI-CH program may assist as an evidence-based program to support caregivers in their role as a caregiver to a newly admitted hospice patient.

Preliminary results of studies of the Valea Morilor Upper Palaeolithic site (Chisinau, Republic of Moldova) : A new camp of mammoth hunters

NARCIS (Netherlands)

Obada, Teodor; van der Plicht, Johannes; Markova, Anastasia; Prepelitsa, Afanasie

2012-01-01

Preliminary results are presented from the studies of a newly found Paleolithic site - Valea Morilor (Chisingu, Republic of Moldova). The excavations produced unquestionable evidence of mammoth hunting (Mammuthus primigenius Blumenbach, 1799). Excavations of 2009-2010 opened an area of 1264 m(2).

Autonomy, positive relationships, and IL-6: evidence for gender-specific effects.

Science.gov (United States)

Eisenlohr-Moul, Tory; Segerstrom, Suzanne

2013-05-01

A body of evidence indicates that women value relationship-centred aspects of well-being more than men do, while men value autonomy-centred aspects of well-being more than women do. The current study examined whether gender moderates relations between autonomy and positive relationships and interleukin-6 (IL-6), a cytokine associated with inflammatory processes. Aspects of well-being consistent with gender-linked values were expected to be most health protective such that positive relationships would predict lower IL-6 only or more strongly in women, and autonomy would predict lower IL-6 only or more strongly in men. In the first study, a sample of 119 older adults (55% female) living in Kentucky were visited in their homes for interviews and blood draws. In the second study, a sample of 1,028 adults (45% female) living across the United States underwent a telephone interview followed by a visit to a research centre for blood draws. In the Kentucky sample, autonomy was quadratically related to IL-6 such that moderate autonomy predicted higher IL-6; this effect was stronger in men. In the US national sample, more positive relationships were associated with lower IL-6 in women only. When the national sample was restricted to match the Kentucky sample, moderate autonomy was again associated with higher IL-6 in men only. Results provide preliminary evidence for gender-specific effects of positive relationships and autonomy on IL-6. Further work is needed to establish the generalizability of these effects to different ages, cultures, and health statuses. What is already known on this subject? A host of previous work indicates that women value relationship-centred aspects of well-being more than men, while men value autonomy-centred aspects of well-being more than women. Further, there is some evidence suggesting that well-being consistent with gender-linked values is more health protective, such that relationships are more protective for women than for men, while

On Preliminary Test Estimator for Median

OpenAIRE

Okazaki, Takeo; 岡崎, 威生

1990-01-01

The purpose of the present paper is to discuss about estimation of median with a preliminary test. Two procedures are presented, one uses Median test and the other uses Wilcoxon two-sample test for the preliminary test. Sections 3 and 4 give mathematical formulations of such properties, including mean square errors with one specified case. Section 5 discusses their optimal significance levels of the preliminary test and proposes their numerical values by Monte Carlo method. In addition to mea...

Preliminary study of varietal susceptibility to sulfur dioxide

International Nuclear Information System (INIS)

Miller, J.E.; Xerikos, P.B.

1976-01-01

The injury response of plants to air pollutants, such as sulfur dioxide, is known to vary in severity and type for different varieties or cultivars of a species. Differences in the susceptibility of soybean varieties to sulfur dioxide have previously been noted, but sufficient information is not available concerning the sulfur dioxide resistance of varieties commonly grown in the Midwest. Results are reported from preliminary experiments concerning acute sulfur dioxide effects on 12 soybean varieties. The injury symptoms ranged from cream colored necrotic lesions (generally on younger leaves) to a reddish brown necrotic stipling (on older leaves). Differences in the severity of symptom development for the varieties was evident on both the younger and older leaves. No injury was apparent with three of the varieties

Preliminary economic evaluation of the Alkox process

International Nuclear Information System (INIS)

Silva, L.J.; Lilga, M.A.; Camaioni, D.M.; Snowden, L.J.

1991-09-01

A new chemical process has been invented at Battelle Pacific Northwest Laboratories for converting alkanes to alcohols. This new chemistry has been named the ''Alkox Process.'' Pacific Northwest Laboratory prepared a preliminary economic analysis for converting cyclohexane to cyclohexanol, which may be one of the most attractive applications of the Alkox process. A process flow scheme and a material balance were prepared to support rough equipment sizing and costing. The results from the economic analysis are presented in the non-proprietary section of this report. The process details, including the flow diagram and material balance, are contained in separate section of this report that is proprietary to Battelle. 7 refs., 4 tabs

New Evidence: Data Documenting Parental Support for Earlier Sexuality Education

Science.gov (United States)

Barr, Elissa M.; Moore, Michele J.; Johnson, Tammie; Forrest, Jamie; Jordan, Melissa

2014-01-01

Background: Numerous studies document support for sexuality education to be taught in high school, and often, in middle school. However, little research has been conducted addressing support for sexuality education in elementary schools. Methods: As part of the state Behavioral Risk Factor Surveillance System (BRFSS) Survey administration, the…

A Pilot Trial of a Stress Management Intervention for Primary Caregivers of Children Newly Diagnosed With Cancer: Preliminary Evidence That Perceived Social Support Moderates the Psychosocial Benefit of Intervention

OpenAIRE

Marsland, Anna L.; Long, Kristin A.; Howe, Chelsea; Thompson, Amanda L.; Tersak, Jean; Ewing, Linda J.

2013-01-01

Objectives (1) To examine the acceptability and feasibility of a stress management intervention for caregivers of children recently diagnosed with cancer. (2) To explore whether caregivers with lower baseline perceived social support derive greater benefit from the intervention than those with higher perceived support. Methods 45 primary caregivers were randomly assigned to intervention or standard care. Of these, 37 completed measures of social support, depression, anxiety, and perceived str...

Application of support vector machines to breast cancer screening using mammogram and clinical history data

Science.gov (United States)

Land, Walker H., Jr.; McKee, Dan; Velazquez, Roberto; Wong, Lut; Lo, Joseph Y.; Anderson, Francis R.

2003-05-01

The objectives of this paper are to discuss: (1) the development and testing of a new Evolutionary Programming (EP) method to optimally configure Support Vector Machine (SVM) parameters for facilitating the diagnosis of breast cancer; (2) evaluation of EP derived learning machines when the number of BI-RADS and clinical history discriminators are reduced from 16 to 7; (3) establishing system performance for several SVM kernels in addition to the EP/Adaptive Boosting (EP/AB) hybrid using the Digital Database for Screening Mammography, University of South Florida (DDSM USF) and Duke data sets; and (4) obtaining a preliminary evaluation of the measurement of SVM learning machine inter-institutional generalization capability using BI-RADS data. Measuring performance of the SVM designs and EP/AB hybrid against these objectives will provide quantative evidence that the software packages described can generalize to larger patient data sets from different institutions. Most iterative methods currently in use to optimize learning machine parameters are time consuming processes, which sometimes yield sub-optimal values resulting in performance degradation. SVMs are new machine intelligence paradigms, which use the Structural Risk Minimization (SRM) concept to develop learning machines. These learning machines can always be trained to provide global minima, given that the machine parameters are optimally computed. In addition, several system performance studies are described which include EP derived SVM performance as a function of: (a) population and generation size as well as a method for generating initial populations and (b) iteratively derived versus EP derived learning machine parameters. Finally, the authors describe a set of experiments providing preliminary evidence that both the EP/AB hybrid and SVM Computer Aided Diagnostic C++ software packages will work across a large population of patients, based on a data set of approximately 2,500 samples from five different

The Evidence-base for Using Ontologies and Semantic Integration Methodologies to Support Integrated Chronic Disease Management in Primary and Ambulatory Care: Realist Review. Contribution of the IMIA Primary Health Care Informatics WG.

Science.gov (United States)

Liyanage, H; Liaw, S-T; Kuziemsky, C; Terry, A L; Jones, S; Soler, J K; de Lusignan, S

2013-01-01

Most chronic diseases are managed in primary and ambulatory care. The chronic care model (CCM) suggests a wide range of community, technological, team and patient factors contribute to effective chronic disease management. Ontologies have the capability to enable formalised linkage of heterogeneous data sources as might be found across the elements of the CCM. To describe the evidence base for using ontologies and other semantic integration methods to support chronic disease management. We reviewed the evidence-base for the use of ontologies and other semantic integration methods within and across the elements of the CCM. We report them using a realist review describing the context in which the mechanism was applied, and any outcome measures. Most evidence was descriptive with an almost complete absence of empirical research and important gaps in the evidence-base. We found some use of ontologies and semantic integration methods for community support of the medical home and for care in the community. Ubiquitous information technology (IT) and other IT tools were deployed to support self-management support, use of shared registries, health behavioural models and knowledge discovery tools to improve delivery system design. Data quality issues restricted the use of clinical data; however there was an increased use of interoperable data and health system integration. Ontologies and semantic integration methods are emergent with limited evidence-base for their implementation. However, they have the potential to integrate the disparate community wide data sources to provide the information necessary for effective chronic disease management.

Preliminary Evidence for the Amplification of Global Warming in Shallow, Intertidal Estuarine Waters.

Directory of Open Access Journals (Sweden)

Autumn Oczkowski

Full Text Available Over the past 50 years, mean annual water temperature in northeastern U.S. estuaries has increased by approximately 1.2°C, with most of the warming recorded in the winter and early spring. A recent survey and synthesis of data from four locations in Southern Rhode Island has led us to hypothesize that this warming may be amplified in the shallow (<1 m, nearshore portions of these estuaries. While intertidal areas are not typically selected as locations for long-term monitoring, we compiled data from published literature, theses, and reports that suggest that enhanced warming may be occurring, perhaps at rates three times higher than deeper estuarine waters. Warmer spring waters may be one of the factors influencing biota residing in intertidal regions both in general as well as at our specific sites. We observed greater abundance of fish, and size of Menidia sp., in recent (2010-2012 seine surveys compared to similar collections in 1962. While any linkages are speculative and data are preliminary, taken together they suggest that shallow intertidal portions of estuaries may be important places to look for the effects of climate change.

Preliminary Evidence for the Amplification of Global Warming in Shallow, Intertidal Estuarine Waters.

Science.gov (United States)

Oczkowski, Autumn; McKinney, Richard; Ayvazian, Suzanne; Hanson, Alana; Wigand, Cathleen; Markham, Erin

2015-01-01

Over the past 50 years, mean annual water temperature in northeastern U.S. estuaries has increased by approximately 1.2°C, with most of the warming recorded in the winter and early spring. A recent survey and synthesis of data from four locations in Southern Rhode Island has led us to hypothesize that this warming may be amplified in the shallow (<1 m), nearshore portions of these estuaries. While intertidal areas are not typically selected as locations for long-term monitoring, we compiled data from published literature, theses, and reports that suggest that enhanced warming may be occurring, perhaps at rates three times higher than deeper estuarine waters. Warmer spring waters may be one of the factors influencing biota residing in intertidal regions both in general as well as at our specific sites. We observed greater abundance of fish, and size of Menidia sp., in recent (2010-2012) seine surveys compared to similar collections in 1962. While any linkages are speculative and data are preliminary, taken together they suggest that shallow intertidal portions of estuaries may be important places to look for the effects of climate change.

Lunar Flight Study Series: Volume 4. Preliminary Investigation of the Astronautics of Earth - Moon Transits

Science.gov (United States)

Braud, Nolan J.

1963-01-01

Preliminary information on flight profiles, velocity budgets and launch windows for Apollo and Support Vehicle flights is presented in this report. A newly conceived method of establishing a flight mechanical classification of the earth-moon transits is discussed. The results are empirical and are designed to contribute to the mission mode selection.

Epidemiological evidence of carcinogenicity of chlorinated organics in drinking water.

OpenAIRE

Cantor, K P

1982-01-01

Concern has recently been voiced over possible chronic toxicity associated with chlorination of public drinking water supplies in the United States. This paper reviews the available evidence and the studies underway to further evaluate hypothesized associations between cancer risk and byproducts of chlorination. Preliminary data from measures of halogenated volatiles and personal exposure histories from respondents in a large epidemiologic study of bladder cancer are presented. These data sup...

Perceptual support promotes strategy generation: Evidence from equation solving.

Science.gov (United States)

Alibali, Martha W; Crooks, Noelle M; McNeil, Nicole M

2017-08-30

Over time, children shift from using less optimal strategies for solving mathematics problems to using better ones. But why do children generate new strategies? We argue that they do so when they begin to encode problems more accurately; therefore, we hypothesized that perceptual support for correct encoding would foster strategy generation. Fourth-grade students solved mathematical equivalence problems (e.g., 3 + 4 + 5 = 3 + __) in a pre-test. They were then randomly assigned to one of three perceptual support conditions or to a Control condition. Participants in all conditions completed three mathematical equivalence problems with feedback about correctness. Participants in the experimental conditions received perceptual support (i.e., highlighting in red ink) for accurately encoding the equal sign, the right side of the equation, or the numbers that could be added to obtain the correct solution. Following this intervention, participants completed a problem-solving post-test. Among participants who solved the problems incorrectly at pre-test, those who received perceptual support for correctly encoding the equal sign were more likely to generate new, correct strategies for solving the problems than were those who received feedback only. Thus, perceptual support for accurate encoding of a key problem feature promoted generation of new, correct strategies. Statement of Contribution What is already known on this subject? With age and experience, children shift to using more effective strategies for solving math problems. Problem encoding also improves with age and experience. What the present study adds? Support for encoding the equal sign led children to generate correct strategies for solving equations. Improvements in problem encoding are one source of new strategies. © 2017 The British Psychological Society.

Preliminary effects of pagoclone, a partial GABAA agonist, on neuropsychological performance

Directory of Open Access Journals (Sweden)

Angela F Caveney

2008-03-01

Full Text Available Angela F Caveney1, Bruno Giordani1, George M Haig21Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; 2Neurosciences Development, Abbott Laboratories, Abbott Park, IL, USAAbstract: Pagoclone is a novel cyclopyrrolone that acts as a partial GABAA receptor agonist. Preclinical studies suggest that pagoclone may have clinical utility as an anxiolytic agent, as well as a reduced incidence of side-effects. The present study was conducted to determine whether pagoclone would affect healthy individuals’ performances on neuropsychological measures as a function of dose within the projected therapeutic range. Twelve healthy adult subjects were randomly assigned to dosage groups in a 3-way crossover study. Participants were administered neuropsychological measures six hours following dosing on Day 1 and Day 6 of administration of the drug. Dose effects were noted on measures of alertness, learning, and memory and movement time. Significant effects were also noted on measures of alertness, learning and memory, information processing and psychomotor speed. Overall, the results of this small, preliminary study do not support a finding of behavioral toxicity for these doses of pagoclone. Rather, a pattern was found of transient and mild negative effects on learning and memory scores at the highest dose administered, though these changes were small and no longer evident by the sixth day of use.Keywords: pagoclone, cyclopyrrolone, neuropsychological, memory, generalized anxiety disorder

Opportunities to preserve forensic evidence in emergency departments.

Science.gov (United States)

Peel, Matthew

2016-11-10

Victims of violence often seek assistance from emergency departments, so emergency nurses are ideally placed to identify them, and other 'forensic' patients, and protect the evidence that could support any ensuing legal process. Emergency nurses who are trained to identify, collect and preserve forensic evidence can support the identification, elimination and prosecution of suspects. This article gives an overview of forensic evidence, and explains how emergency nurses can preserve and collect samples effectively.

Brief Report: An Independent Replication and Extension of Psychometric Evidence Supporting the Theory of Mind Inventory.

Science.gov (United States)

Greenslade, Kathryn J; Coggins, Truman E

2016-08-01

This study presents an independent replication and extension of psychometric evidence supporting the Theory of Mind Inventory (ToMI). Parents of 20 children with ASD (4; 1-6; 7 years; months) and 20 with typical development (3; 1-6; 5), rated their child's theory of mind abilities in everyday situations. Other parent report and child behavioral assessments included the Social Responsiveness Scale-2, Vineland Adaptive Behavior Scales-2, Peabody Picture Vocabulary Test-4, and Clinical Evaluation of Language Fundamentals-Preschool, 2. Results revealed high internal consistency, expected developmental changes in children with typical development, expected group differences between children with and without ASD, and strong correlations with other measures of social and communication abilities. The ToMI demonstrates strong psychometrics, suggesting considerable utility in identifying theory of mind deficits in children with ASD.

Preliminary Results on Uncertainty Quantification for Pattern Analytics

Energy Technology Data Exchange (ETDEWEB)

Stracuzzi, David John [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Brost, Randolph [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Chen, Maximillian Gene [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Malinas, Rebecca [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Peterson, Matthew Gregor [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Phillips, Cynthia A. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Robinson, David G. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Woodbridge, Diane [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

2015-09-01

This report summarizes preliminary research into uncertainty quantification for pattern ana- lytics within the context of the Pattern Analytics to Support High-Performance Exploitation and Reasoning (PANTHER) project. The primary focus of PANTHER was to make large quantities of remote sensing data searchable by analysts. The work described in this re- port adds nuance to both the initial data preparation steps and the search process. Search queries are transformed from does the specified pattern exist in the data? to how certain is the system that the returned results match the query? We show example results for both data processing and search, and discuss a number of possible improvements for each.

Preliminary level 2 specification for the nested, fixed-depth sampling system

International Nuclear Information System (INIS)

BOGER, R.M.

1999-01-01

This preliminary Level 2 Component Specification establishes the performance, design, development, and test requirements for the in-tank sampling system which will support the BNFL contract in the final disposal of Hanford's High Level Wastes (HLW) and Low Activity Wastes (LAW). The PHMC will provide Low Activity Wastes (LAW) tank wastes for final treatment by BNFL from double-shell feed tanks. Concerns about the inability of the baseline ''grab'' sampling to provide large volume samples within time constraints has led to the development of a nested, fixed-depth sampling system. This sampling system will provide large volume? representative samples without the environmental, radiation exposure, and sample volume Impacts of the current base-line ''grab'' sampling method. This preliminary Level 2 Component Specification is not a general specification for tank sampling, but is based on a ''record of decision'', AGA (HNF-SD-TWR-AGA-001 ), the System Specification for the Double Shell Tank System (HNF-SD-WM-TRD-O07), and the BNFL privatization contract

CONSTRUCCIÓN DE UNA ESCALA DE AUTOEFICACIA PARA LA INVESTIGACIÓN: PRIMERAS EVIDENCIAS DE VALIDEZ / DEVELOPMENT OF A RESEARCH SELF-EFFICACY SCALE: PRELIMINARY EVIDENCE OF VALIDITY

Directory of Open Access Journals (Sweden)

Sergio Alexis Dominguez-Lara

2017-06-01

Full Text Available RESUMEN: El objetivo del presente estudio fue examinar las primeras evidencias de validez de la Escala de Autoeficacia para Investigar (EAI, por medio del análisis del contenido de los ítems. Fue evaluada una muestra de 10 psicólogos investigadores (70% varones; Medad = 47.2 años, y de 34 estudiantes universitarios peruanos (> 70% mujeres de pregrado (n = 19 y posgrado (n = 15. Los investigadores evaluaron la relevancia y claridad de los ítems, y los estudiantes valoraron la claridad de los enunciados de la EAI. Las respuestas brindadas por los jueces fueron sistematizadas mediante la V de Aiken con intervalos de confianza, obteniendo resultados favorables. En conclusiones, la EAI presenta evidencias favorables sobre la representatividad de los ítems. Se discuten las implicancias prácticas de los hallazgos. ABSTRACT: The aim of this study was to examine the preliminary evidence of validity of the Research Self-Efficacy Scale (RSE through the analysis of item contents. A sample of ten research psychologists (70% male; Mage = 47.2 years old, and 34 Peruvian college students (> 70% female, both undergraduate (n = 19 and graduate (n = 15 was assessed. The researchers evaluated the relevance and clarity of the items, and the students, the clarity of the RSE statements. The answers given by the judges were systematized through Aiken’s V with confidence intervals, obtaining favorable results. In conclusion, the RSE exhibits favorable evidence regarding the representativity of the items. The practical implications of the findings are discussed here.

Preliminary conceptual study of engineering-scale pyroprocess demonstration facility

International Nuclear Information System (INIS)

Moon, Seong-In; Chong, Won-Myung; You, Gil-Sung; Ku, Jeong-Hoe; Kim, Ho-Dong

2013-01-01

Highlights: ► The conceptual design of a pyroprocess demonstration facility was performed. ► The design requirements for the pyroprocess hot cell and equipment were determined. ► The maintenance concept for the pyroprocess hot cell was presented. -- Abstract: The development of an effective management technology of spent fuel is important to enhance environmental friendliness, cost viability and proliferation resistance. In Korea, pyroprocess technology has been considered as a fuel cycle option to solve the spent fuel accumulation problems. PRIDE (PyRoprocess Integrated inactive DEmonstration facility) has been developed from 2007 to 2012 in Korea as a cold test facility to support integrated pyroprocessing and an equipment demonstration, which is essential to verify the pyroprocess technology. As the next stage of PRIDE, the design requirements of an engineering-scale demonstration facility are being developed, and the preliminary conceptual design of the facility is being performed for the future. In this paper, the main design requirements for the engineering-scale pyroprocess demonstration facility were studied in the throughput of 10tHM a year. For the preliminary conceptual design of the facility, the design basis of the pyroprocess hot cell was suggested, and the main equipment, main process area, operation area, maintenance area, and so on were arranged in consideration of the effective operation of the hot cells. Also, the argon system was designed to provide and maintain a proper inert environment for the pyroprocess. The preliminary conceptual design data will be used to review the validity of the engineering-scale pyroprocess demonstration facility that enhances both safety and nonproliferation

Risk-informed analysis as a support to the preliminary design of the CEA GFR2400

International Nuclear Information System (INIS)

Bertrand, F.; Bassi, C.; Azria, P.; Bentivoglio, F.; Messie, A.; Balmain, M.

2012-01-01

The integration of safety issues in the early phase of the design of a 4. generation reactor of the concepts is expected. For this purpose, probabilistic insights are increasingly employed in the safety demonstration in combination with the deterministic approach in the frame of a so-called risk informed approach. The present paper deals with the safety assessment of the preliminary design of the GFR2400 developed by CEA and how it has been improved in order to fulfil deterministic criteria as well as to reach a risk level comparable to the generation III reactors. GFR2400 is a 2400 MWth, 3-loops, helium-cooled fast reactor developed at a pre-conceptual design stage whose secondary circuit is filled with a mixture of helium and nitrogen, the ternary circuit being filled with water vaporized in 3 steam generators according to a classical Rankine cycle. The resulting cycle efficiency is very close to 45 %. Considering the results obtained with a preliminary level 1 PSA (L1PSA) model, it emerged that an increased reliability of the DHR (Decay Heat Removal) function in high pressure conditions (not corresponding to a LOCA) was suitable to reduce the overall core damage frequency. On the other hand, some small break LOCA situations were not adequately mitigated according to the line of protection deterministic method. Both issues have been solved by design improvements. In addition, this final L1PSA model, characterized by success criteria based on transient calculations performed with the CATHARE2 code and performed in a perimeter extended to all representative internal initiating events at full operating power, permitted to propose design evolutions that did not increase significantly the CDF. In the same time, those evolutions enabled the DHR system to increase its redundancy level as required in the deterministic approach. Finally, a modified design has been reached implying a more extended covering of various accidental situations by means of a progressive DHR

Information processing biases concurrently and prospectively predict depressive symptoms in adolescents: Evidence from a self-referent encoding task.

Science.gov (United States)

Connolly, Samantha L; Abramson, Lyn Y; Alloy, Lauren B

2016-01-01

Negative information processing biases have been hypothesised to serve as precursors for the development of depression. The current study examined negative self-referent information processing and depressive symptoms in a community sample of adolescents (N = 291, Mage at baseline = 12.34 ± 0.61, 53% female, 47.4% African-American, 49.5% Caucasian and 3.1% Biracial). Participants completed a computerised self-referent encoding task (SRET) and a measure of depressive symptoms at baseline and completed an additional measure of depressive symptoms nine months later. Several negative information processing biases on the SRET were associated with concurrent depressive symptoms and predicted increases in depressive symptoms at follow-up. Findings partially support the hypothesis that negative information processing biases are associated with depressive symptoms in a nonclinical sample of adolescents, and provide preliminary evidence that these biases prospectively predict increases in depressive symptoms.

Characteristics of efficacy evidence supporting approval of supplemental indications for prescription drugs in United States, 2005-14: systematic review.

Science.gov (United States)

Wang, Bo; Kesselheim, Aaron S

2015-09-23

To characterize the types of comparators and endpoints used in efficacy trials for approvals of supplemental indications, compared with the data supporting these drugs' originally approved indications. Systematic review. Publicly accessible data on supplemental indications approved by the US Food and Drug Administration from 2005 to 2014. Types of comparators (active, placebo, historical, none) and endpoints (clinical outcomes, clinical scales, surrogate) in the efficacy trials for these drugs' supplemental and original indication approvals. The cohort included 295 supplemental indications. Thirty per cent (41/136) of supplemental approvals for new indications were supported by efficacy trials with active comparators, compared with 51% (47/93) of modified use approvals and 11% (7/65) of approvals expanding the patient population (Pindications, 30% (28/93) of modified indication approvals, and 22% (14/65) of expanded population approvals (P=0.29). Orphan drugs had supplemental approvals for 40 non-orphan indications, which were supported by similar proportions of trials using active comparators (28% (11/40) for non-orphan supplemental indications versus 24% (10/42) for original orphan indications; P=0.70) and clinical outcome endpoints (25% (10/40) versus 31% (13/42); P=0.55). Wide variations were seen in the evidence supporting approval of supplemental indications, with the fewest active comparators and clinical outcome endpoints used in trials leading to supplemental approvals that expanded the patient population. © Wang et al 2015.

Current evidence supporting "letrozole" for ovulation induction

Directory of Open Access Journals (Sweden)

Sujata Kar

2013-01-01

Full Text Available Aromatase inhibitor "letrozole" was first introduced as a potential ovulation induction (OI drug almost a decade back. Large number of studies has been published using letrozole for OI: In polycystic ovary syndrome (PCOS women, clomiphene citrate (CC resistant women, for intrauterine insemination and also in various protocols of mild stimulation for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI. Letrozole appears to be a good option, with its oral route of administration, cost, shorter half-life and negligible side effects. However, the verdict on efficacy and safety of letrozole is still uncertain. This review explores the current scientific data supporting letrozole for OI.

Business System Planning Project, Preliminary System Design

International Nuclear Information System (INIS)

EVOSEVICH, S.

2000-01-01

CH2M HILL Hanford Group, Inc. (CHG) is currently performing many core business functions including, but not limited to, work control, planning, scheduling, cost estimating, procurement, training, and human resources. Other core business functions are managed by or dependent on Project Hanford Management Contractors including, but not limited to, payroll, benefits and pension administration, inventory control, accounts payable, and records management. In addition, CHG has business relationships with its parent company CH2M HILL, U.S. Department of Energy, Office of River Protection and other River Protection Project contractors, government agencies, and vendors. The Business Systems Planning (BSP) Project, under the sponsorship of the CH2M HILL Hanford Group, Inc. Chief Information Officer (CIO), have recommended information system solutions that will support CHG business areas. The Preliminary System Design was developed using the recommendations from the Alternatives Analysis, RPP-6499, Rev 0 and will become the design base for any follow-on implementation projects. The Preliminary System Design will present a high-level system design, providing a high-level overview of the Commercial-Off-The-Shelf (COTS) modules and identify internal and external relationships. This document will not define data structures, user interface components (screens, reports, menus, etc.), business rules or processes. These in-depth activities will be accomplished at implementation planning time

23 CFR 645.109 - Preliminary engineering.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Preliminary engineering. 645.109 Section 645.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS UTILITIES Utility Relocations, Adjustments, and Reimbursement § 645.109 Preliminary engineering. (a) As...

Adult health study. Hiroshima preliminary report, 1958-1959

Energy Technology Data Exchange (ETDEWEB)

Hollingsworth, J W; Anderson, Jr, P S

1961-06-28

The first 4151 clinical examinations of radiation exposed and nonexposed persons in the Hiroshima Adult Health Study have been tabulated and reviewed. No evident differences in past history, medical symptoms, physical examination, laboratory findings, nor disease incidence could be related to the atomic radiation in 1945. The sample is small and represents only a portion of the first cycle of an examination procedure that is planned to continue indefinitely at approximately two year intervals. This report, consisting of a review of the program and the findings in this preliminary sample, includes extensive tabular data (Tables 28-65) from the coded medical information. It was not expected that radiation induced changes would be evident from this sample unless they were of unexpected prominence. The report was prepared primarily to describe the problems inherent in an epidemiologic medical study of this sort, and to review the type of data that can be obtained for future analyses. This analysis was conducted to pinpoint some of the problems; to assist others contemplating this type of medical study; to illuminate for ABCC the data that are being collected; and to suggest ways to use these data most effectively. 16 references, 1 figure, 65 tables.

Peer-support suicide prevention in a non-metropolitan U.S. community.

Science.gov (United States)

Walker, Rheeda L; Ashby, Judy; Hoskins, Olivia D; Greene, Farrah N

2009-01-01

Though suicide is a leading cause of death for high school age youth, the overall base rates for suicide deaths are relatively low. Consequently, very few evidence-based suicide prevention programs that address suicide death have emerged. Relative to urban areas, non-metropolitan and rural communities in particular tend to report higher suicide rates that are compounded by poor access to mental health care. In the current study, 63 high school youth participated in the three-day, LifeSavers peer-support suicide prevention training program. The goals of the program are to teach youth to engage in teamwork and listen to others without judgment in addition to recognizing the signs for youth who may be at risk for suicide. The overall aim of LifeSavers is to create a culture whereby primary prevention is active and crisis situations are preempted. Each participant in the current study completed pre-test and posttraining measures of suicide attitudes and knowledge, self-esteem, and also self-acceptance. Findings demonstrated a significant increase in knowledge and positive attitudes toward suicide prevention and also self-esteem, but not self-acceptance. Though more work is needed, these preliminary data reveal that youth in rural communities may benefit from programming such as LifeSavers that commit to advancing peer support and peer-gatekeeping efforts.

Perceived Social Support from Friends and Parents for Eating Behavior and Diet Quality among Low-income, Urban, Minority Youth

Science.gov (United States)

Steeves, Elizabeth Anderson; Jones-Smith, Jessica; Hopkins, Laura; Gittelsohn, Joel

2016-01-01

Objective Evidence of associations between social support and dietary intake among adolescents is mixed. This study examines relationships between social support for healthy and unhealthy eating from friends and parents, and associations with diet quality. Design Cross-sectional analysis of survey data. Setting Baltimore, MD. Participants 296 youth ages 9-15 years, 53% female, 91% African American, participating in the B’More Healthy Communities for Kids study. Main Outcome Measure(s) Primary dependent variable: Diet quality measured using Healthy Eating Index 2010 overall score, calculated from the Block Kids Food Frequency Questionnaire. Independent variables: Social support from parents and friends for healthy eating (4 questions analyzed as a scale) and unhealthy eating (3 questions analyzed individually), age, gender, race, and household income, reported via questionnaire. Analysis Adjusted multiple linear regressions. Alpha, pFriend and parent support for healthy eating did not have statistically significant relationships with overall HEI scores. Youth who reported their parents offering high fat foods or sweets more frequently had lower overall HEI scores (β=−1.65; SE=0.52; 95% CI: −2.66 to −0.63). Conclusions and Implications These results are novel and demonstrate the need for additional studies examining support for unhealthy eating. These preliminary findings may be relevant to researchers as they develop family-based nutrition interventions. PMID:26865358

Evidence for the treatment of co-occurring stuttering and speech sound disorder: A clinical case series.

Science.gov (United States)

Unicomb, Rachael; Hewat, Sally; Spencer, Elizabeth; Harrison, Elisabeth

2017-06-01

There is a paucity of evidence to guide treatment for children with co-occurring stuttering and speech sound disorder. Some guidelines suggest treating the two disorders simultaneously using indirect treatment approaches; however, the research supporting these recommendations is over 20 years old. In this clinical case series, we investigate whether these co-occurring disorders could be treated concurrently using direct treatment approaches supported by up-to-date, high-level evidence, and whether this could be done in an efficacious, safe and efficient manner. Five pre-school-aged participants received individual concurrent, direct intervention for both stuttering and speech sound disorder. All participants used the Lidcombe Program, as manualised. Direct treatment for speech sound disorder was individualised based on analysis of each child's sound system. At 12 months post commencement of treatment, all except one participant had completed the Lidcombe Program, and were less than 1.0% syllables stuttered on samples gathered within and beyond the clinic. These four participants completed Stage 1 of the Lidcombe Program in between 14 and 22 clinic visits, consistent with current benchmark data for this programme. At the same assessment point, all five participants exhibited significant increases in percentage of consonants correct and were in alignment with age-expected estimates of this measure. Further, they were treated in an average number of clinic visits that compares favourably with other research on treatment for speech sound disorder. These preliminary results indicate that young children with co-occurring stuttering and speech sound disorder may be treated concurrently using direct treatment approaches. This method of service delivery may have implications for cost and time efficiency and may also address the crucial need for early intervention in both disorders. These positive findings highlight the need for further research in the area and contribute to

Preliminary design county plan Zeeland

International Nuclear Information System (INIS)

1987-01-01

The preliminary design 'Streekplan Zeeland' (Country plan Zeeland, with regard to the location of additional nuclear power plants in Zeeland, the Netherlands) has passed through a consultation and participation round. Thereupon 132 reactions have been received. These have been incorporated and answered in two notes. This proposal deals with the principal points of the preliminary design and treats also the remarks of the committees Environmental (town and country) Planning (RO), Provincial (town and country) Planning Committee (PPC) and Association of Communities of Zeeland (VZG), on the reply notes. The preliminary design with the modifications, collected in appendix 3, is proposed to be the starting point in the drawing-up of the design-country-plan. This design subsequently will pass the formal country-plan procedure. (author). 1 fig

Preliminary results from the Chicago air shower array and the Michigan muon array

International Nuclear Information System (INIS)

Krimm, H.A.; Cronin, J.W.; Fick, B.E.; Gibbs, K.G.; Mascarenhas, N.C.; McKay, T.A.; Mueller, D.; Newport, B.J.; Ong, R.A.; Rosenberg, L.J.; Wiedenbeck, M.E.; Green, K.D.; Matthews, J.; Nitz, D.; Sinclair, D.; van der Velde, J.C.

1991-01-01

The Chicago Air Shower Array (CASA) is a large area surface array designed to detect extensive air showers (EAS) produced by primaries with energy ∼100 TeV. It operates in coincidence with the underground Michigan Muon Array (MIA). Preliminary results are presented from a search for steady emission and daily emission from three astrophysical sources: Cygnus X-3, Hercules X-1, and the Crab nebula and pulsar. There is no evidence for a significant signal from any of these sources in the 1989 data

The development and preliminary testing of a multimedia patient–provider survivorship communication module for breast cancer survivors

Science.gov (United States)

Wen, Kuang-Yi; Miller, Suzanne M.; Stanton, Annette L.; Fleisher, Linda; Morra, Marion E.; Jorge, Alexandra; Diefenbach, Michael A.; Ropka, Mary E.; Marcus, Alfred C.

2012-01-01

Objective This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors’ preparedness for effective communication with their health care providers after active treatment. Methods The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Results Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. Conclusion The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Practice implications Our study demonstrates survivors’ openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. PMID:22770812

The development and preliminary testing of a multimedia patient-provider survivorship communication module for breast cancer survivors.

Science.gov (United States)

Wen, Kuang-Yi; Miller, Suzanne M; Stanton, Annette L; Fleisher, Linda; Morra, Marion E; Jorge, Alexandra; Diefenbach, Michael A; Ropka, Mary E; Marcus, Alfred C

2012-08-01

This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors' preparedness for effective communication with their health care providers after active treatment. The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Our study demonstrates survivors' openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. Copyright © 2012. Published by Elsevier Ireland Ltd.

Are workplace health promotion programs effective at improving presenteeism in workers? A systematic review and best evidence synthesis of the literature.

Science.gov (United States)

Cancelliere, Carol; Cassidy, J David; Ammendolia, Carlo; Côté, Pierre

2011-05-26

Presenteeism is highly prevalent and costly to employers. It is defined as being present at work, but limited in some aspect of job performance by a health problem.Workplace health promotion (WHP) is a common strategy used to enhance on-the-job productivity. The primary objective is to determine if WHP programs are effective in improving presenteeism. The secondary objectives are to identify characteristics of successful programs and potential risk factors for presenteeism. The Cochrane Library, Medline, and other electronic databases were searched from 1990 to 2010. Reference lists were examined, key journals were hand-searched and experts were contacted. Included studies were original research that contained data on at least 20 participants (≥ 18 years of age), and examined the impacts of WHP programs implemented at the workplace. The Effective Public Health Practice Project Tool for Quantitative Studies was used to rate studies. 'Strong' and 'moderate' studies were abstracted into evidence tables, and a best evidence synthesis was performed. Interventions were deemed successful if they improved the outcome of interest. Their program components were identified, as were possible risk factors contributing to presenteeism. After 2,032 titles and abstracts were screened, 47 articles were reviewed, and 14 were accepted (4 strong and 10 moderate studies). These studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, a poor diet, a lack of exercise, high stress, and poor relations with co-workers and management. This review is limited to English publications. A large number of reviewed studies (70%) were inadmissible due to issues of bias, thus limiting the amount of primary evidence. The uncertainties surrounding

Are workplace health promotion programs effective at improving presenteeism in workers? a systematic review and best evidence synthesis of the literature

Directory of Open Access Journals (Sweden)

Cassidy J David

2011-05-01

Full Text Available Abstract Background Presenteeism is highly prevalent and costly to employers. It is defined as being present at work, but limited in some aspect of job performance by a health problem. Workplace health promotion (WHP is a common strategy used to enhance on-the-job productivity. The primary objective is to determine if WHP programs are effective in improving presenteeism. The secondary objectives are to identify characteristics of successful programs and potential risk factors for presenteeism. Methods The Cochrane Library, Medline, and other electronic databases were searched from 1990 to 2010. Reference lists were examined, key journals were hand-searched and experts were contacted. Included studies were original research that contained data on at least 20 participants (≥ 18 years of age, and examined the impacts of WHP programs implemented at the workplace. The Effective Public Health Practice Project Tool for Quantitative Studies was used to rate studies. 'Strong' and 'moderate' studies were abstracted into evidence tables, and a best evidence synthesis was performed. Interventions were deemed successful if they improved the outcome of interest. Their program components were identified, as were possible risk factors contributing to presenteeism. Results After 2,032 titles and abstracts were screened, 47 articles were reviewed, and 14 were accepted (4 strong and 10 moderate studies. These studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, a poor diet, a lack of exercise, high stress, and poor relations with co-workers and management. Limitations: This review is limited to English publications. A large number of reviewed studies (70% were inadmissible due to issues of bias, thus limiting

The Adolescent HIV Disclosure Cognition and Affect Scale: Preliminary Reliability and Validity.

Science.gov (United States)

Evangeli, Michael

2017-07-01

Globally, there are 2 million HIV-positive 10-19-year-olds. One challenge for this population is sharing their HIV status with others (onward HIV disclosure). There are no multi-item, multidimensional scales of HIV disclosure cognitions and affect for young people living with HIV. An 18-item measure of HIV disclosure cognition and affect was developed, administered to 65 adolescents living with HIV (aged 12-16 years). Data were explored using principal component analysis and preliminary construct and criterion validity assessed. Three factors were revealed: negative disclosure attitudes and feelings, self-efficacy, and positive disclosure attitudes and feelings. The full scale and its subscales were internally consistent. The total score showed statistically significant positive relationships with HIV disclosure in the past 6 months, HIV disclosure intention and self-perception. Preliminary evidence of the measure's good psychometric properties suggests it may be helpful in future clinical and research work. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Empirical evolution of a framework that supports the development of nursing competence.

Science.gov (United States)

Lima, Sally; Jordan, Helen L; Kinney, Sharon; Hamilton, Bridget; Newall, Fiona

2016-04-01

The aim of this study was to refine a framework for developing competence, for graduate nurses new to paediatric nursing in a transition programme. A competent healthcare workforce is essential to ensuring quality care. There are strong professional and societal expectations that nurses will be competent. Despite the importance of the topic, the most effective means through which competence develops remains elusive. A qualitative explanatory method was applied as part of a mixed methods design. Twenty-one graduate nurses taking part in a 12-month transition programme participated in semi-structured interviews between October and November 2013. Interviews were informed by data analysed during a preceding quantitative phase. Participants were provided with their quantitative results and a preliminary model for development of competence and asked to explain why their competence had developed as it had. The findings from the interviews, considered in combination with the preliminary model and quantitative results, enabled conceptualization of a Framework for Developing Competence. Key elements include: the individual in the team, identification and interpretation of standards, asking questions, guidance and engaging in endeavours, all taking place in a particular context. Much time and resources are directed at supporting the development of nursing competence, with little evidence as to the most effective means. This study led to conceptualization of a theory thought to underpin the development of nursing competence, particularly in a paediatric setting for graduate nurses. Future research should be directed at investigating the framework in other settings. © 2015 John Wiley & Sons Ltd.

Evidence - competence - discourse: the theoretical framework of the multi-centre clinical ethics support project METAP.

Science.gov (United States)

Reiter-Theil, Stella; Mertz, Marcel; Schürmann, Jan; Stingelin Giles, Nicola; Meyer-Zehnder, Barbara

2011-09-01

In this paper we assume that 'theory' is important for Clinical Ethics Support Services (CESS). We will argue that the underlying implicit theory should be reflected. Moreover, we suggest that the theoretical components on which any clinical ethics support (CES) relies should be explicitly articulated in order to enhance the quality of CES. A theoretical framework appropriate for CES will be necessarily complex and should include ethical (both descriptive and normative), metaethical and organizational components. The various forms of CES that exist in North-America and in Europe show their underlying theory more or less explicitly, with most of them referring to some kind of theoretical components including 'how-to' questions (methodology), organizational issues (implementation), problem analysis (phenomenology or typology of problems), and related ethical issues such as end-of-life decisions (major ethical topics). In order to illustrate and explain the theoretical framework that we are suggesting for our own CES project METAP, we will outline this project which has been established in a multi-centre context in several healthcare institutions. We conceptualize three 'pillars' as the major components of our theoretical framework: (1) evidence, (2) competence, and (3) discourse. As a whole, the framework is aimed at developing a foundation of our CES project METAP. We conclude that this specific integration of theoretical components is a promising model for the fruitful further development of CES. © 2011 Blackwell Publishing Ltd.

Evidence for Evolution as Support for Big Bang

Science.gov (United States)

Gopal-Krishna

1997-12-01

With the exception of ZERO, the concept of BIG BANG is by far the most bizarre creation of the human mind. Three classical pillars of the Big Bang model of the origin of the universe are generally thought to be: (i) The abundances of the light elements; (ii) the microwave back-ground radiation; and (iii) the change with cosmic epoch in the average properties of galaxies (both active and non-active types). Evidence is also mounting for redshift dependence of the intergalactic medium, as discussed elsewhere in this volume in detail. In this contribution, I endeavour to highlight a selection of recent advances pertaining to the third category. The widely different levels of confidence in the claimed observational constraints in the field of cosmology can be guaged from the following excerpts from two leading astrophysicists: "I would bet odds of 10 to 1 on the validity of the general 'hot Big Bang' concept as a description of how our universe has evolved since it was around 1 sec. old" -M. Rees (1995), in 'Perspectives in Astrophysical Cosmology' CUP. "With the much more sensitive observations available today, no astrophysical property shows evidence of evolution, such as was claimed in the 1950s to disprove the Steady State theory" -F. Hoyle (1987), in 'Fifty years in cosmology', B. M. Birla Memorial Lecture, Hyderabad, India. The burgeoning multi-wavelength culture in astronomy has provided a tremendous boost to observational cosmology in recent years. We now proceed to illustrate this with a sequence of examples which reinforce the picture of an evolving universe. Also provided are some relevant details of the data used in these studies so that their scope can be independently judged by the readers.

Transforming youth mental health services and supports in Ireland.

Science.gov (United States)

Illback, Robert J; Bates, Tony

2011-02-01

Young people in the Republic of Ireland do not have access to appropriate mental health services and supports, necessitating transformational change in delivery systems. Describe ongoing development and change efforts facilitated by Headstrong--The National Centre for Youth Mental Health. Discusses findings from a national needs assessment, core strategies within the change initiative, progress in system-building, and preliminary descriptive and outcome data. Five demonstration sites comprised of four counties and a city neighbourhood are operational and preliminary data are promising with respect to implementation and outcomes. Effective change initiatives require vision and leadership, competence- and capacity-building, participative planning and engagement, adequate and thoughtfully deployed resources, and a comprehensive change management approach. © 2011 Blackwell Publishing Asia Pty Ltd.

A phenomenographic investigation into Information Literacy in nursing practice - preliminary findings and methodological issues.

Science.gov (United States)

Forster, Marc

2013-10-01

Information Literacy is essential to 'evidence-based practice'; without the ability to locate evidence, evidence-based practice is rendered extremely difficult if not impossible. There is currently little evidence to show how Information Literacy is experienced by nurses or what its parameters are within evidence-based practice and therefore whether Information Literacy educational interventions are actually promoting the correct knowledge and skills. Using phenomenographic interviews the author will attempt to discover how nurses experience Information Literacy. Insights from the findings will be used to map out its parameters and to put forward a theoretical model for a course or module to develop it effectively. This article presents preliminary findings, including 7 draft categories of description of how Information Literacy is experienced in nursing. This pilot study indicates that the complete findings may be of significant potential value in the promotion and development of Information Literacy education in nursing. It is argued that such insights into how nurses actually experience the phenomenon of Information Literacy can be used to develop potentially more effective, research-based, educational interventions. Copyright © 2012 Elsevier Ltd. All rights reserved.

20 CFR 410.240 - Evidence.

Science.gov (United States)

2010-04-01

... evidence may be submitted as part of a prescribed application form if the form provides for its inclusion... disability or death due to pneumoconiosis. For evidence requirements to support allegations of total disability or death due to pneumoconiosis; for the effect of the failure or refusal of an individual to...

Feature engineering and a proposed decision-support system for systematic reviewers of medical evidence.

Directory of Open Access Journals (Sweden)

Tanja Bekhuis

Full Text Available Evidence-based medicine depends on the timely synthesis of research findings. An important source of synthesized evidence resides in systematic reviews. However, a bottleneck in review production involves dual screening of citations with titles and abstracts to find eligible studies. For this research, we tested the effect of various kinds of textual information (features on performance of a machine learning classifier. Based on our findings, we propose an automated system to reduce screeing burden, as well as offer quality assurance.We built a database of citations from 5 systematic reviews that varied with respect to domain, topic, and sponsor. Consensus judgments regarding eligibility were inferred from published reports. We extracted 5 feature sets from citations: alphabetic, alphanumeric(+, indexing, features mapped to concepts in systematic reviews, and topic models. To simulate a two-person team, we divided the data into random halves. We optimized the parameters of a Bayesian classifier, then trained and tested models on alternate data halves. Overall, we conducted 50 independent tests.All tests of summary performance (mean F3 surpassed the corresponding baseline, P<0.0001. The ranks for mean F3, precision, and classification error were statistically different across feature sets averaged over reviews; P-values for Friedman's test were .045, .002, and .002, respectively. Differences in ranks for mean recall were not statistically significant. Alphanumeric(+ features were associated with best performance; mean reduction in screening burden for this feature type ranged from 88% to 98% for the second pass through citations and from 38% to 48% overall.A computer-assisted, decision support system based on our methods could substantially reduce the burden of screening citations for systematic review teams and solo reviewers. Additionally, such a system could deliver quality assurance both by confirming concordant decisions and by naming

Evidence to Support the Anti-Cancer Effect of Olive Leaf Extract and Future Directions

Science.gov (United States)

Boss, Anna; Bishop, Karen S.; Marlow, Gareth; Barnett, Matthew P. G.; Ferguson, Lynnette R.

2016-01-01

The traditional Mediterranean diet (MD) is associated with long life and lower prevalence of cardiovascular disease and cancers. The main components of this diet include high intake of fruit, vegetables, red wine, extra virgin olive oil (EVOO) and fish, low intake of dairy and red meat. Olive oil has gained support as a key effector of health benefits and there is evidence that this relates to the polyphenol content. Olive leaf extract (OLE) contains a higher quantity and variety of polyphenols than those found in EVOO. There are also important structural differences between polyphenols from olive leaf and those from olive fruit that may improve the capacity of OLE to enhance health outcomes. Olive polyphenols have been claimed to play an important protective role in cancer and other inflammation-related diseases. Both inflammatory and cancer cell models have shown that olive leaf polyphenols are anti-inflammatory and protect against DNA damage initiated by free radicals. The various bioactive properties of olive leaf polyphenols are a plausible explanation for the inhibition of progression and development of cancers. The pathways and signaling cascades manipulated include the NF-κB inflammatory response and the oxidative stress response, but the effects of these bioactive components may also result from their action as a phytoestrogen. Due to the similar structure of the olive polyphenols to oestrogens, these have been hypothesized to interact with oestrogen receptors, thereby reducing the prevalence and progression of hormone related cancers. Evidence for the protective effect of olive polyphenols for cancer in humans remains anecdotal and clinical trials are required to substantiate these claims idea. This review aims to amalgamate the current literature regarding bioavailability and mechanisms involved in the potential anti-cancer action of olive leaf polyphenols. PMID:27548217

Evidence to Support the Anti-Cancer Effect of Olive Leaf Extract and Future Directions

Directory of Open Access Journals (Sweden)

Anna Boss

2016-08-01

Full Text Available The traditional Mediterranean diet (MD is associated with long life and lower prevalence of cardiovascular disease and cancers. The main components of this diet include high intake of fruit, vegetables, red wine, extra virgin olive oil (EVOO and fish, low intake of dairy and red meat. Olive oil has gained support as a key effector of health benefits and there is evidence that this relates to the polyphenol content. Olive leaf extract (OLE contains a higher quantity and variety of polyphenols than those found in EVOO. There are also important structural differences between polyphenols from olive leaf and those from olive fruit that may improve the capacity of OLE to enhance health outcomes. Olive polyphenols have been claimed to play an important protective role in cancer and other inflammation-related diseases. Both inflammatory and cancer cell models have shown that olive leaf polyphenols are anti-inflammatory and protect against DNA damage initiated by free radicals. The various bioactive properties of olive leaf polyphenols are a plausible explanation for the inhibition of progression and development of cancers. The pathways and signaling cascades manipulated include the NF-κB inflammatory response and the oxidative stress response, but the effects of these bioactive components may also result from their action as a phytoestrogen. Due to the similar structure of the olive polyphenols to oestrogens, these have been hypothesized to interact with oestrogen receptors, thereby reducing the prevalence and progression of hormone related cancers. Evidence for the protective effect of olive polyphenols for cancer in humans remains anecdotal and clinical trials are required to substantiate these claims idea. This review aims to amalgamate the current literature regarding bioavailability and mechanisms involved in the potential anti-cancer action of olive leaf polyphenols.

The Industrious Revolution and Early Modern Colonial Goods Trade - Evidence from the Soundtoll Online Database

NARCIS (Netherlands)

Uebele, Martin

2013-01-01

This article presents preliminary evidence of the volume of coffee trade tolled at the entry to the Baltic Sea, ca. 1700-1850, using the Soundtoll Registers Online Database (www.soundtoll.nl). The results are interpreted in the light of the “Industrious Revolution” hypothesis (De Vries 2008). The

Exploratory shaft facility preliminary designs - Paradox Basin. Technical report

International Nuclear Information System (INIS)

1983-09-01

The purpose of the Preliminary Design Report, Paradox Basin, is to provide a description of the preliminary design for an Exploratory Shaft Facility in the Paradox Basin, Utah. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling Method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers is included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description, and Construction Cost Estimate. 30 references

Electrophysiological evidence for phenomenal consciousness.

Science.gov (United States)

Revonsuo, Antti; Koivisto, Mika

2010-09-01

Abstract Recent evidence from event-related brain potentials (ERPs) lends support to two central theses in Lamme's theory. The earliest ERP correlate of visual consciousness appears over posterior visual cortex around 100-200 ms after stimulus onset. Its scalp topography and time window are consistent with recurrent processing in the visual cortex. This electrophysiological correlate of visual consciousness is mostly independent of later ERPs reflecting selective attention and working memory functions. Overall, the ERP evidence supports the view that phenomenal consciousness of a visual stimulus emerges earlier than access consciousness, and that attention and awareness are served by distinct neural processes.

Evaluation of an attention and memory intervention post-childhood acquired brain injury: Preliminary efficacy, immediate and 6 months post-intervention.

Science.gov (United States)

Catroppa, Cathy; Stone, Kate; Hearps, Stephen J C; Soo, Cheryl; Anderson, Vicki; Rosema, Stefanie

2015-01-01

Impairments in attention and memory are common sequelae following paediatric acquired brain injury (ABI). While it has been established that such impairments are long-term and, therefore, affect quality-of-life, there is a scarcity of evidence-based interventions to treat these difficulties. The current study aimed to pilot the efficacy of the Amsterdam Memory and Attention Training for Children (Amat-c: English version) using both neuropsychological and ecologically sensitive measures. It was expected that children with attention and memory difficulties post-ABI would show improved performance post-intervention on cognitive and ecological measures, with maintenance at 6 months post-intervention. Ten children with an ABI, between the ages of 8-13 years at the time of recruitment were identified through audits of presentations to a metropolitan paediatric hospital. Each child underwent screening, the 18 week intervention programme, pre-intervention, immediate and 6 month post-intervention assessments. Findings supported the hypothesis that children would show post-intervention (immediate and 6 month) improvement in areas of attention and memory, with generalization to everyday life. Preliminary results provide support for the efficacy of the Amat-c post-childhood ABI. A larger study is needed to confirm these findings, as a reduction in attention and memory difficulties will enhance everyday functioning.

The Role of Philanthropic Funding in Building Research Evidence to Support an Aging Population: A Case Study from Ireland.

Science.gov (United States)

Cochrane, Andy; McGilloway, Sinéad

2017-01-01

This case study examines the role of philanthropic funding in building capacity for aging research in Ireland, and how this investment has addressed the lack of evidence to support planning for an aging population. The funding has supported a range of initiatives including the national longitudinal study on aging (TILDA), the creation of three professorships/chairs, and the establishment of four new research centers. Important potential outcomes are emerging across other domains including research-informed policy development and the generation of health benefits. The efforts of academic researchers to ensure that their findings are readily accessible to end users and to forge robust working relationships with all stakeholders have helped to enhance the use of research findings. Overall, philanthropy has played a pivotal role in building capacity, infrastructure, and expertise in academic settings in Ireland. Moreover, this work provides an excellent example of how such efforts can begin to inform effective planning and service provision.

Georgetown University Integrated Community Energy System (GU-ICES). Phase III, Stage II. Preliminary design. Final report

Energy Technology Data Exchange (ETDEWEB)

None

1980-11-01

Results are presented for two elements in the Georgetown University ICES program - the installation of a 2500-kW backpressure steam-turbine generator within a new extension to the heating and cooling plant (cogeneration) and the provision of four additional ash silos for the university's atmospheric fluidized-bed boiler plant (added storage scheme). The preliminary design and supporting documentation for the work items and architectural drawings are presented. Section 1 discusses the basis for the report, followed by sections on: feasibility analysis update; preliminary design documents; instrumentation and testing; revised work management plan; and appendices including outline constructions, turbine-generator prepurchase specification, design calculations, cost estimates, and Potomac Electric Company data. (MCW)

Deep Underground Science and Engineering Laboratory - Preliminary Design Report

CERN Document Server

Lesko, Kevin T; Alonso, Jose; Bauer, Paul; Chan, Yuen-Dat; Chinowsky, William; Dangermond, Steve; Detwiler, Jason A; De Vries, Syd; DiGennaro, Richard; Exter, Elizabeth; Fernandez, Felix B; Freer, Elizabeth L; Gilchriese, Murdock G D; Goldschmidt, Azriel; Grammann, Ben; Griffing, William; Harlan, Bill; Haxton, Wick C; Headley, Michael; Heise, Jaret; Hladysz, Zbigniew; Jacobs, Dianna; Johnson, Michael; Kadel, Richard; Kaufman, Robert; King, Greg; Lanou, Robert; Lemut, Alberto; Ligeti, Zoltan; Marks, Steve; Martin, Ryan D; Matthesen, John; Matthew, Brendan; Matthews, Warren; McConnell, Randall; McElroy, William; Meyer, Deborah; Norris, Margaret; Plate, David; Robinson, Kem E; Roggenthen, William; Salve, Rohit; Sayler, Ben; Scheetz, John; Tarpinian, Jim; Taylor, David; Vardiman, David; Wheeler, Ron; Willhite, Joshua; Yeck, James

2011-01-01

The DUSEL Project has produced the Preliminary Design of the Deep Underground Science and Engineering Laboratory (DUSEL) at the rehabilitated former Homestake mine in South Dakota. The Facility design calls for, on the surface, two new buildings - one a visitor and education center, the other an experiment assembly hall - and multiple repurposed existing buildings. To support underground research activities, the design includes two laboratory modules and additional spaces at a level 4,850 feet underground for physics, biology, engineering, and Earth science experiments. On the same level, the design includes a Department of Energy-shepherded Large Cavity supporting the Long Baseline Neutrino Experiment. At the 7,400-feet level, the design incorporates one laboratory module and additional spaces for physics and Earth science efforts. With input from some 25 science and engineering collaborations, the Project has designed critical experimental space and infrastructure needs, including space for a suite of multi...

The Weight of Evidence Does Not Support the Listing of Styrene as “Reasonably Anticipated to be a Human Carcinogen” in NTP's Twelfth Report on Carcinogens

Science.gov (United States)

Rhomberg, Lorenz R.; Goodman, Julie E.; Prueitt, Robyn L.

2013-01-01

Styrene was listed as “reasonably anticipated to be a human carcinogen” in the twelfth edition of the National Toxicology Program's Report on Carcinogens based on what we contend are erroneous findings of limited evidence of carcinogenicity in humans, sufficient evidence of carcinogenicity in experimental animals, and supporting mechanistic data. The epidemiology studies show no consistent increased incidence of, or mortality from, any type of cancer. In animal studies, increased incidence rates of mostly benign tumors have been observed only in certain strains of one species (mice) and at one tissue site (lung). The lack of concordance of tumor incidence and tumor type among animals (even within the same species) and humans indicates that there has been no particular cancer consistently observed among all available studies. The only plausible mechanism for styrene-induced carcinogenesis—a non-genotoxic mode of action that is specific to the mouse lung—is not relevant to humans. As a whole, the evidence does not support the characterization of styrene as “reasonably anticipated to be a human carcinogen,” and styrene should not be listed in the Report on Carcinogens. PMID:23335843

Shaping the future of production in South Africa: Preliminary country readiness results

CSIR Research Space (South Africa)

Saunders, M

2017-10-01

Full Text Available • Digital Security & Data Privacy • Industry Activity • Research Intensity • Available Financing • Labor Force Skills • Inclusivity • Migration • Education Outcomes • Agility & Adaptability • Trade Linkages • Trade Performance • Trade... and target sectors and value chain segments for growth 10 PRELIMINARY – FOR DISCUSSION High Potential Followers Legacy Champions Global Leaders Sectors Where to target growth? Value Chain Which segments to focus on? Inclusive Growth How to support...

Stress Prevention and Mindfulness: A Psychoeducational and Support Group for Teachers

Science.gov (United States)

Reiser, Jenson E.; Murphy, Susan L.; McCarthy, Christopher J.

2016-01-01

A stress prevention and mindfulness (SPAM) group is described, which is a 6-week psychoeducational and support group for teachers. The group incorporated psychoeducation about stress and utilized elements of Mindfulness-Based Stress Reduction (MBSR). The group was implemented in a public charter school in the Southwest. Preliminary evaluation…

Observing, recording, and reviewing: Using mobile phones in support of science inquiry

DEFF Research Database (Denmark)

Khoo, Elaine; Williams, John; Otrel-Cass, Kathrin

2012-01-01

Teaching science can be challenging, particularly if it involves the incorporation of inquiry approaches. Collaboration and co-construction of ideas and understandings requires changing teaching and learning practices to allow students to learn how to collaborate ‘inquiry style’. There is increas......Teaching science can be challenging, particularly if it involves the incorporation of inquiry approaches. Collaboration and co-construction of ideas and understandings requires changing teaching and learning practices to allow students to learn how to collaborate ‘inquiry style...... will be presented. The findings illustrate how student use of mobile phones to video record practical group investigations was valuable in providing multimodal opportunities to expand their critical observational skills to reflect on and talk about science. Student reviewed recordings prompted the pursuit of new......’. There is increasing evidence that the use of mobile learning devices can support inquiry learning by increasing the opportunities for student participation and collaboration in the learning process. This paper reports on the preliminary findings from a New Zealand Teaching and Learning Initiative funded project...

32 CFR 644.30 - Preliminary real estate work.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Preliminary real estate work. 644.30 Section 644... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.30 Preliminary real estate work. (a) Preliminary real estate work is defined as that action taken...

Perceived Social Support From Friends and Parents for Eating Behavior and Diet Quality Among Low-Income, Urban, Minority Youth.

Science.gov (United States)

Anderson Steeves, Elizabeth; Jones-Smith, Jessica; Hopkins, Laura; Gittelsohn, Joel

2016-05-01

Evidence of associations between social support and dietary intake among adolescents is mixed. This study examines relationships between social support for healthy and unhealthy eating from friends and parents, and associations with diet quality. Cross-sectional analysis of survey data. Baltimore, MD. 296 youth aged 9-15 years, 53% female, 91% African American, participating in the B'More Healthy Communities for Kids study. Primary dependent variable: diet quality measured using Healthy Eating Index 2010 (HEI) overall score, calculated from the Block Kids Food Frequency Questionnaire. Social support from parents and friends for healthy eating (4 questions analyzed as a scale) and unhealthy eating (3 questions analyzed individually), age, gender, race, and household income, reported via questionnaire. Adjusted multiple linear regressions (α, P Friend and parent support for healthy eating did not have statistically significant relationships with overall HEI scores. Youth who reported their parents offering high-fat foods or sweets more frequently had lower overall HEI scores (β = -1.65; SE = 0.52; 95% confidence interval, -2.66 to -0.63). These results are novel and demonstrate the need for additional studies examining support for unhealthy eating. These preliminary findings may be relevant to researchers as they develop family-based nutrition interventions. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

International Assistance for Low-Emission Development Planning: Coordinated Low Emissions Assistance Network (CLEAN) Inventory of Activities and Tools--Preliminary Trends

Energy Technology Data Exchange (ETDEWEB)

Cox, S.; Benioff, R.

2011-05-01

The Coordinated Low Emissions Assistance Network (CLEAN) is a voluntary network of international practitioners supporting low-emission planning in developing countries. The network seeks to improve quality of support through sharing project information, tools, best practices and lessons, and by fostering harmonized assistance. CLEAN has developed an inventory to track and analyze international technical support and tools for low-carbon planning activities in developing countries. This paper presents a preliminary analysis of the inventory to help identify trends in assistance activities and tools available to support developing countries with low-emission planning.

Supported Employment for Young Adults with Autism Spectrum Disorder: Preliminary Data

Science.gov (United States)

Wehman, Paul; Lau, Stephanie; Molinelli, Alissa; Brooke, Valerie; Thompson, Katie; Moore, Chandler; West, Michael

2012-01-01

The purpose of this study was to examine the effects of supported employment in securing and maintaining competitive employment for people with autism spectrum disorder, a group that has typically been found to be underemployed or unemployed. This prospective study followed and collected data on 33 individuals with autism spectrum disorder as they…

Evidence from prospective cohort studies did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review.

Science.gov (United States)

Harcombe, Zoë; Baker, Julien S; Davies, Bruce

2017-12-01

National dietary guidelines were introduced in 1977 and 1983, by the USA and UK governments to reduce coronary heart disease (CHD) mortality by reducing dietary fat intake. Our 2015 systematic review examined randomised controlled trial (RCT) evidence available to the dietary committees at the time; we found no support for the recommendations to restrict dietary fat. What epidemiological evidence was available to the dietary guideline committees in 1983? A systematic review of prospective cohort studies, published prior to 1983, which examined the relationship between dietary fat, serum cholesterol and the development of CHD. Across 6 studies, involving 31 445 participants, there were 1521 deaths from all-causes and 360 deaths from CHD during the mean follow-up of 7.5±6.2 years. The death rates were 4.8% and 1.1% from all-causes and CHD respectively. One study included men with previous heart disease. The death rate from CHD for those with, and without previous myocardial infarction was 20.9% and 1.0% respectively. None of the six studies found a significant relationship between CHD deaths and total dietary fat intake. One of the six studies found a correlation between CHD deaths and saturated dietary fat intake across countries; none found a relationship between CHD deaths and saturated dietary fat in the same population. 1983 dietary recommendations for 220 million US and 56 million UK citizens lacked supporting evidence from RCT or prospective cohort studies. The extant research had been undertaken exclusively on males, so lacked generalisability for population-wide guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evidence for Alpha Receptors in the Human Ureter

Science.gov (United States)

Madeb, Ralph; Knopf, Joy; Golijanin, Dragan; Bourne, Patricia; Erturk, Erdal

2007-04-01

An immunohistochemical and western blot expression analysis of human ureters was performed in order to characterize the alpha-1-adrenergic receptor distribution along the length of the human ureteral wall. Mapping the distribution will assist in understanding the potential role alpha -1-adrenergic receptors and their subtype density might have in the pathophysiology of ureteral colic and stone passage. Patients diagnosed with renal cancer or bladder cancer undergoing nephrectomy, nephroureterectomy, or cystectomy had ureteral specimens taken from the proximal, mid, distal and tunneled ureter. Tissues were processed for fresh frozen examination and fixed in formalin. None of the ureteral specimens were involved with cancer. Serial histologic sections and immunohistochemical studies were performed using antibodies specific for alpha-1-adrenergic receptor subtypes (alpha 1a, alpha 1b, alpha 1d). The sections were examined under a light microscope and scored as positive or negative. In order to validate and quantify the alpha receptor subtypes along the human ureter. Western blotting techniques were applied. Human ureter stained positively for alpha -1-adrenergic receptors. Immunostaining appeared red, with intense reaction in the smooth muscle of the ureter and endothelium of the neighboring blood vessels. There was differential expression between all the receptors with the highest staining for alpha-1D subtype. The highest protein expression for all three subtypes was in the renal pelvis and decreased with advancement along the ureter to the distal ureter. At the distal ureter, there was marked increase in expression as one progressed towards the ureteral orifice. The same pattern of protein expression was exhibited for all three alpha -1-adrenergic receptor subtypes. We provide preliminary evidence for the ability to detect and quantify the alpha-1-receptor subtypes along the human ureter which to the best of our knowledge has never been done with

Clean energy funds: An overview of state support for renewable energy

Energy Technology Data Exchange (ETDEWEB)

Bolinger, Mark; Wiser, Ryan

2001-04-01

Across the United States, as competition in the supply and delivery of electricity has been introduced, states have sought to ensure the continuation of ''public benefits'' programs traditionally administered or funded by electric utilities. Many states have built into their restructuring plans methods of supporting renewable energy sources. One of the most popular policy mechanisms for ensuring such continued support has been the system-benefits charge (SBC), a non-bypassable charge to electricity customers (usually applied on a cents/kWh basis) used to collect funds for public purpose programs. Thus far, at least fourteen states have established SBC funds targeted in part towards renewable energy. This paper discusses the status and performance of these state renewable or ''clean'' energy funds supported by system-benefits charges. As illustrated later, existing state renewable energy funds are expected to collect roughly $3.5 billion through 2012 for renewable energy. Clearly, these funds have the potential to provide significant support for clean energy technologies over at least the next decade. Because the level of funding for renewable energy available under these programs is unprecedented and because fund administrators are developing innovative and new programs to fund renewable projects, a certain number of program failures are unavoidable. Also evident is that states are taking very different approaches to the distribution of these funds and that many lessons are being learned as programs are designed, implemented, and evaluated. Our purpose in this paper is therefore to relay early experience with these funds and provide preliminary lessons learned from that experience. It is our hope that this analysis will facilitate learning across states and help state fund managers develop more effective and more coordinated programs. Central to this paper are case studies that provide information on the SBC-funded renewable

Psilocybin with psychological support improves emotional face recognition in treatment-resistant depression.

Science.gov (United States)

Stroud, J B; Freeman, T P; Leech, R; Hindocha, C; Lawn, W; Nutt, D J; Curran, H V; Carhart-Harris, R L

2018-02-01

Depressed patients robustly exhibit affective biases in emotional processing which are altered by SSRIs and predict clinical outcome. The objective of this study is to investigate whether psilocybin, recently shown to rapidly improve mood in treatment-resistant depression (TRD), alters patients' emotional processing biases. Seventeen patients with treatment-resistant depression completed a dynamic emotional face recognition task at baseline and 1 month later after two doses of psilocybin with psychological support. Sixteen controls completed the emotional recognition task over the same time frame but did not receive psilocybin. We found evidence for a group × time interaction on speed of emotion recognition (p = .035). At baseline, patients were slower at recognising facial emotions compared with controls (p psilocybin, this difference was remediated (p = .208). Emotion recognition was faster at follow-up compared with baseline in patients (p = .004, d = .876) but not controls (p = .263, d = .302). In patients, this change was significantly correlated with a reduction in anhedonia over the same time period (r = .640, p = .010). Psilocybin with psychological support appears to improve processing of emotional faces in treatment-resistant depression, and this correlates with reduced anhedonia. Placebo-controlled studies are warranted to follow up these preliminary findings.

Evidence based practice readiness: A concept analysis.

Science.gov (United States)

Schaefer, Jessica D; Welton, John M

2018-01-15

To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.

Waste Feed Delivery System Phase 1 Preliminary RAM Analysis [SEC 1 and 2

Energy Technology Data Exchange (ETDEWEB)

DYKES, A.A.

2000-10-11

This report presents the updated results of the preliminary reliability, availability, and maintainability (RAM) analysis of selected waste feed delivery (WFD) operations to be performed by the Tank Farm Contractor (TFC) during Phase I activities in support of the Waste Treatment and Immobilization Plant (WTP). For planning purposes, waste feed tanks are being divided into five classes in accordance with the type of waste in each tank and the activities required to retrieve, qualify, and transfer waste feed. This report reflects the baseline design and operating concept, as of the beginning of Fiscal Year 2000, for the delivery of feed from three of these classes, represented by source tanks 241-AN-102, 241-AZ-101 and 241-AN-105. The preliminary RAM analysis quantifies the potential schedule delay associated with operations and maintenance (OBM) field activities needed to accomplish these operations. The RAM analysis is preliminary because the system design, process definition, and activity planning are in a state of evolution. The results are being used to support the continuing development of an O&M Concept tailored to the unique requirements of the WFD Program, which is being documented in various volumes of the Waste Feed Delivery Technical Basis (Carlson. 1999, Rasmussen 1999, and Orme 2000). The waste feed provided to the WTP must: (1) meet limits for chemical and radioactive constituents based on pre-established compositional envelopes (i.e., feed quality); (2) be in acceptable quantities within a prescribed sequence to meet feed quantities; and (3) meet schedule requirements (i.e., feed timing). In the absence of new criteria related to acceptable schedule performance due to the termination of the TWRS Privatization Contract, the original criteria from the Tank Waste Remediation System (77443s) Privatization Contract (DOE 1998) will continue to be used for this analysis.

Visual working memory supports the inhibition of previously processed information: evidence from preview search.

Science.gov (United States)

Al-Aidroos, Naseem; Emrich, Stephen M; Ferber, Susanne; Pratt, Jay

2012-06-01

In four experiments we assessed whether visual working memory (VWM) maintains a record of previously processed visual information, allowing old information to be inhibited, and new information to be prioritized. Specifically, we evaluated whether VWM contributes to the inhibition (i.e., visual marking) of previewed distractors in a preview search. We evaluated this proposal by testing three predictions. First, Experiments 1 and 2 demonstrate that preview inhibition is more effective when the number of previewed distractors is below VWM capacity than above; an effect that can only be observed at small preview set sizes (Experiment 2A) and when observers are allowed to move their eyes freely (Experiment 2B). Second, Experiment 3 shows that, when quantified as the number of inhibited distractors, the magnitude of the preview effect is stable across different search difficulties. Third, Experiment 4 demonstrates that individual differences in preview inhibition are correlated with individual differences in VWM capacity. These findings provide converging evidence that VWM supports the inhibition of previewed distractors. More generally, these findings demonstrate how VWM contributes to the efficiency of human visual information processing--VWM prioritizes new information by inhibiting old information from being reselected for attention.

Brain responses to biological motion predict treatment outcome in young adults with autism receiving Virtual Reality Social Cognition Training: Preliminary findings.

Science.gov (United States)

Yang, Y J Daniel; Allen, Tandra; Abdullahi, Sebiha M; Pelphrey, Kevin A; Volkmar, Fred R; Chapman, Sandra B

2017-06-01

Autism Spectrum Disorder (ASD) is characterized by remarkable heterogeneity in social, communication, and behavioral deficits, creating a major barrier in identifying effective treatments for a given individual with ASD. To facilitate precision medicine in ASD, we utilized a well-validated biological motion neuroimaging task to identify pretreatment biomarkers that can accurately forecast the response to an evidence-based behavioral treatment, Virtual Reality-Social Cognition Training (VR-SCT). In a preliminary sample of 17 young adults with high-functioning ASD, we identified neural predictors of change in emotion recognition after VR-SCT. The predictors were characterized by the pretreatment brain activations to biological vs. scrambled motion in the neural circuits that support (a) language comprehension and interpretation of incongruent auditory emotions and prosody, and (b) processing socio-emotional experience and interpersonal affective information, as well as emotional regulation. The predictive value of the findings for individual adults with ASD was supported by regression-based multivariate pattern analyses with cross validation. To our knowledge, this is the first pilot study that shows neuroimaging-based predictive biomarkers for treatment effectiveness in adults with ASD. The findings have potentially far-reaching implications for developing more precise and effective treatments for ASD. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Consistent evidence to support the use of xylitol- and sorbitol-containing chewing gum to prevent dental caries

DEFF Research Database (Denmark)

Twetman, Svante

2009-01-01

DATA SOURCES: Studies were identified using searches with Medline, the Cochrane Library and Google Scholar. STUDY SELECTION: Studies were screened independently and were included if they evaluated the effect of one or more chewing gums containing at least one polyol (xylitol, sorbitol, mannitol...... randomised controlled trials (RCT) of which four were cluster RCT, nine controlled clinical trials (CCT) and four cohort studies]. Two RCT had a Jadad score of three or higher. The mean preventive fraction for the four main gum types are shown in the table 1, results of all except the sorbitol -mannitol...... blend were statistically significant. Sensitivity analyses confirmed the robustness of the findings. CONCLUSIONS: Although research gaps exist, particularly on optimal dosing and relative polyol efficacy, there is consistent evidence to support the use of xylitol- and sorbitol-containing chewing gum...

Plutonium Immobilization Can Loading Preliminary Specifications

Energy Technology Data Exchange (ETDEWEB)

Kriikku, E.

1998-11-25

This report discusses the Plutonium Immobilization can loading preliminary equipment specifications and includes a process block diagram, process description, equipment list, preliminary equipment specifications, plan and elevation sketches, and some commercial catalogs. This report identifies loading pucks into cans and backfilling cans with helium as the top priority can loading development areas.

How evidence-based are the recommendations in evidence-based guidelines?

Directory of Open Access Journals (Sweden)

Finlay A McAlister

2007-08-01

Full Text Available BACKGROUND: Treatment recommendations for the same condition from different guideline bodies often disagree, even when the same randomized controlled trial (RCT evidence is cited. Guideline appraisal tools focus on methodology and quality of reporting, but not on the nature of the supporting evidence. This study was done to evaluate the quality of the evidence (based on consideration of its internal validity, clinical relevance, and applicability underlying therapy recommendations in evidence-based clinical practice guidelines. METHODS AND FINDINGS: A cross-sectional analysis of cardiovascular risk management recommendations was performed for three different conditions (diabetes mellitus, dyslipidemia, and hypertension from three pan-national guideline panels (from the United States, Canada, and Europe. Of the 338 treatment recommendations in these nine guidelines, 231 (68% cited RCT evidence but only 105 (45% of these RCT-based recommendations were based on high-quality evidence. RCT-based evidence was downgraded most often because of reservations about the applicability of the RCT to the populations specified in the guideline recommendation (64/126 cases, 51% or because the RCT reported surrogate outcomes (59/126 cases, 47%. CONCLUSIONS: The results of internally valid RCTs may not be applicable to the populations, interventions, or outcomes specified in a guideline recommendation and therefore should not always be assumed to provide high-quality evidence for therapy recommendations.

An investigation into drug products withdrawn from the EU market between 2002 and 2011 for safety reasons and the evidence used to support the decision-making.

Science.gov (United States)

McNaughton, Rhian; Huet, Gwenaël; Shakir, Saad

2014-01-15

The objective of this study was to determine the nature of evidence used to support the withdrawal of marketing authorisations of drug products for safety reasons throughout the European Union (EU) between 2002 and 2011. Products withdrawn, either by a medicines agency or a marketing authorisation holder, during the period 2002-2011 were identified by conducting detailed searches of the WHO, the European Medicines Agency (EMA) and national medicines agency websites throughout the EU plus Norway, Iceland and Liechtenstein. The scientific evidence used to support the decision was identified from a search within PubMed, the EMA and national medicines agencies websites. Information about spontaneous case reports entered into EudraVigilance and unavailable on the EMA website was received by email from the EMA. 19 drugs were withdrawn from the market, throughout the EU, for safety reasons from 2002 to 2011. Case reports were cited in 95% of withdrawals (18/19) and case-control studies (4/19), cohort studies (4/19), randomised controlled trials (RCTs) (12/19) or meta-analysis (5/19) were cited in 63% of withdrawals (12/19). Cardiovascular events or disorders were the main reason for withdrawal (9/19), followed by hepatic disorders (4/19) and neurological or psychiatric disorders (4/19). This study has shown that the level of evidence used to support drug withdrawal has improved during the past 10 years, with an increased use of case-control studies, cohort studies, RCTs and meta-analyses. This research has demonstrated that such studies have contributed to decision-making in almost two-thirds of cases.

Preliminary analysis of a 1:4 scale prestressed concrete containment vessel model

International Nuclear Information System (INIS)

Dameron, R.A.; Rashid, Y.R.; Luk, V.K.; Hessheimer, M.F.

1997-01-01

Sandia National Laboratories is conducting a research program to investigate the integrity of nuclear containment structures. As part of the program Sandia will construct an instrumented 1:4 scale model of a prestressed concrete containment vessel (PCCV) for pressurized water reactors (PWR), which will be pressure tested up to its ultimate capacity. One of the key program objectives is to develop validated methods to predict the structural performance of containment vessels when subjected to beyond design basis loadings. Analytical prediction of structural performance requires a stepwise, systematic approach that addresses all potential failure modes. The analysis effort includes two and three-dimensional nonlinear finite element analyses of the PCCV test model to evaluate its structural performance under very high internal pressurization. Such analyses have been performed using the nonlinear concrete constitutive model, ANACAP-U, in conjunction with the ABAQUS general purpose finite element code. The analysis effort is carried out in three phases: preliminary analysis; pretest prediction; and post-test data interpretation and analysis evaluation. The preliminary analysis phase serves to provide instrumentation support and identify candidate failure modes. The associated tasks include the preliminary prediction of failure pressure and probable failure locations and the development of models to be used in the detailed failure analyses. This paper describes the modeling approaches and some of the results obtained in the first phase of the analysis effort

Radiographers' preconditions for evidence-based radiography

International Nuclear Information System (INIS)

Ahonen, Sanna-Mari; Liikanen, Eeva

2010-01-01

Evidence-based practice (EBP) is essential in today's health care, but its establishment requires several preconditions from individuals and organizations (e.g. knowledge, understanding, attitudes, abilities, self-confidence, support, and resources). Previous studies suggest that radiographers do generate and use evidence in their work, but evidence-based radiography (EBR) is not yet used routinely as established practice, especially in terms of research utilization. This paper aims to describe radiographers' preconditions for EBR, and their participation in research activities. Main focus is on research utilization. Using an electronic questionnaire developed for this study, a survey was conducted: data collected from Finnish radiographers and radiotherapists (N = 438) were analysed both statistically and qualitatively. The final response rate was 39%. The results suggest radiographers' preconditions for EBR to consist of knowledge of research, significance of research activities, research-orientated way of working, and support. In addition, adequate resourcing is essential. Reading scientific journals, participation in research activities, a higher degree of education, and senior post seem to be significant promoters of EBR and research utilization. The results support the notion that EBR, and especially research utilization, are not yet well-established in Finland, and radiographers' viewpoints concerning the role and significance of research evidence and research activities still seem to vary.

The Anaclitic-Introjective Depression Assessment: Development and preliminary validity of an observer-rated measure.

Science.gov (United States)

Rost, Felicitas; Luyten, Patrick; Fonagy, Peter

2018-03-01

The two-configurations model developed by Blatt and colleagues offers a comprehensive conceptual and empirical framework for understanding depression. This model suggests that depressed patients struggle, at different developmental levels, with issues related to dependency (anaclitic issues) or self-definition (introjective issues), or a combination of both. This paper reports three studies on the development and preliminary validation of the Anaclitic-Introjective Depression Assessment, an observer-rated assessment tool of impairments in relatedness and self-definition in clinical depression based on the item pool of the Shedler-Westen Assessment Procedure. Study 1 describes the development of the measure using expert consensus rating and Q-methodology. Studies 2 and 3 report the assessment of its psychometric properties, preliminary reliability, and validity in a sample of 128 patients diagnosed with treatment-resistant depression. Four naturally occurring clusters of depressed patients were identified using Q-factor analysis, which, overall, showed meaningful and theoretically expected relationships with anaclitic/introjective prototypes as formulated by experts, as well as with clinical, social, occupational, global, and relational functioning. Taken together, findings reported in this paper provide preliminary evidence for the reliability and validity of the Anaclitic-Introjective Depression Assessment, an observer-rated measure that allows the detection of important nuanced differentiations between and within anaclitic and introjective depression. Copyright © 2017 John Wiley & Sons, Ltd.

Preliminary safety design analysis of KALIMER

Energy Technology Data Exchange (ETDEWEB)

Suk, Soo Dong; Kwon, Y. M.; Kim, K. D. [Korea Atomic Energy Research Institute, Taejon (Korea)

1999-03-01

The national long-term R and D program updated in 1997 requires Korea Atomic Energy Research Institute(KAERI) to complete by the year 2006 the basic design of Korea Advanced Liquid Metal Reactor (KALIMER), along with supporting R and D work, with the capability of resolving the issue of spent fuel storage as well as with significantly enhanced safety. KALIMER is a 150 MWe pool-type sodium cooled prototype reactor that uses metallic fuel. The conceptual design is currently under way to establish a self consistent design meeting a set of the major safety design requirements for accident prevention. Some of current emphasis include those for inherent and passive means of negative reactivity insertion and decay heat removal, high shutdown reliability, prevention of and protection from sodium chemical reaction, and high seismic margin, among others. All of these requirements affect the reactor design significantly and involve supporting R and D programs of substance. This document first introduces a set of safety design requirements and accident evaluation criteria established for the conceptual design of KALIMER and then summarizes some of the preliminary results of engineering and design analyses performed for the safety of KALIMER. 19 refs., 19 figs., 6 tabs. (Author)

TECHNOLOGY FOR INSTALLATION OF REINFORCED CONCRETE FLOOR SLABS LIGHTENED BY CORE DRIVERS WITH PRELIMINARY REINFORCEMENT STRESS

Directory of Open Access Journals (Sweden)

S. N. Leonovich

2015-01-01

Full Text Available The paper presents technology for installation of floor slabs lightened by plastic core drivers which are preliminary stressed under construction conditions.  Efficiency of such constructive solution is justified by the action of preliminary concrete compression in the tensile zone while reducing structure dead weight due to void arrangement.  The paper provides classification of systems for preliminary stress and contains recommendations on selection of the system depending on peculiariar features of the designed construction.  Main products and materials required for execution of works , requirements to stressed wire rope reinforcement, its main characteristics have been considered in the paper.Principal diagram of the lightened preliminary stressed slab stipulates arrangement of so called  dummy caisson. Strands of reinforcement ropes are located within the framework of bars passing over supporting structures (over vertical bearing structures of  the framework and voids are formed in the cells between bars by laying hollow plastic items joined together by a cage. The paper presents technological sequence of operations required for arrangement of the lightened preliminary stressed slab, schemes for equipment arrangement and characteristics of the applied devices and units (pushing device for reinforcement ropes, hydraulic jack with delivery hydraulic pump, mixing station, injection pump and others.  Recommendations have been given for execution of works in cold weather. The paper considers problems pertaining to control quality of the materials and items which are supplied to a construction site and directly execution of works on preliminary stress of a cellular slab.The executed analysis of technology permits to conclude that it is characterized by high level of applicability for import substitution. It is necessary to consider the possibility to apply the technology at objects of various application while comparing it with other

77 FR 18710 - Acetamiprid; Pesticide Tolerances

Science.gov (United States)

2012-03-28

.... Based upon review of the data supporting the petitions, EPA has revised the tolerance associated with..., EPA has reviewed the available scientific data and other relevant information in support of this... preliminary evidence suggests that clothianidin operates by direct competitive inhibition, while thiamethoxam...

Mixed-Reality Prototypes to Support Early Creative Design

Science.gov (United States)

Safin, Stéphane; Delfosse, Vincent; Leclercq, Pierre

The domain we address is creative design, mainly architecture. Rooted in a multidisciplinary approach as well as a deep understanding of architecture and design, our method aims at proposing adapted mixed-reality solutions to support two crucial activities: sketch-based preliminary design and distant synchronous collaboration in design. This chapter provides a summary of our work on a mixed-reality device, based on a drawing table (the Virtual Desktop), designed specifically to address real-life/business-focused issues. We explain our methodology, describe the two supported activities and the related users’ needs, detail the technological solution we have developed, and present the main results of multiple evaluation sessions. We conclude with a discussion of the usefulness of a profession-centered methodology and the relevance of mixed reality to support creative design activities.

Type synthesis and preliminary design of devices supporting lower limb's rehabilitation.

Science.gov (United States)

Olinski, Michał; Lewandowski, Bogusz; Gronowicz, Antoni

2015-01-01

Based on the analysis of existing solutions, biomechanics of human lower limbs and anticipated applications, results of con- siderations concerning the necessary number of degrees of freedom for the designed device supporting rehabilitation of lower extremities are presented. An analysis was carried out in order to determine the innovative kinematic structure of the device, ensuring sufficient mobility and functionality while minimizing the number of degrees of freedom. With the aid of appropriate formalised meth- ods, for instance, type synthesis, a complete variety of solutions for leg joints were obtained in the form of basic and kinematic schemes, having the potential to find application in devices supporting lower limb rehabilitation. A 3D model of ankle joint module was built in Autodesk Inventor System, then imported to Adams and assembled into a moving numerical model of a mechanism. Several conducted simulations resulted in finding the required maximum stroke of the cylinders. A comparison of the angular ranges of ankle joint and similar devices with the ones achieved by the designed device indicated a sufficient reserve allowing not only movements typical of gait, but approximately achieving the passive range of motion for the ankle joint.

A preliminary typology of caregivers and effects on service utilization of caregiver counseling.

Science.gov (United States)

Pepin, Renee; Williams, Ashley A; Anderson, Lindsay N; Qualls, Sara H

2013-01-01

Caregivers (CGs) of older adults have unique and diverse needs for intervention. The present studies describe the characteristics of CGs and caregiving situations and how these relate to CG therapy utilization patterns in a community mental health setting. Study 1: Through chart review, the researchers explored service utilization patterns and identified preliminary typologies of Caregiver Family Therapy (CFT) clients, N = 23. Study 2: By conducting a second chart review, the researchers sought to determine whether the categories that emerged in Study 1 applied to a second group of CFT clients, N = 36. Study 1: Four distinct categories of CGs emerged: High-Distress (high disorganization, high complexity), Resourceful but At-Risk (low disorganization, high complexity), Non-Committal (high disorganization, low complexity), and Model CGs (low disorganization, low complexity). Study 2: While the ability to classify CGs into category proved to have some inconsistencies, preliminary evidence suggests the ability to predict utilization once CGs were placed into category was good. In Study 2 a fifth category emerged: High Functioning but Static, which suggests CGs were on a continuum ranging from high to low on family organizational style and CG situation complexity. While caregiving situations vary widely among families and across time, this article provides a preliminary typology of CGs that may assist clinicians in tailoring CG interventions to meet the needs of their clients based on information garnered early in therapy, perhaps as early as the intake process.

Social support in the post-abortion recovery room: evidence from patients, support persons and nurses in a Vancouver clinic.

Science.gov (United States)

Veiga, Mariana B; Lam, Melanie; Gemeinhardt, Carla; Houlihan, Edwina; Fitzsimmons, Brian P; Hodgson, Zoë G

2011-03-01

The benefits of social support in post-surgical recovery are well documented; social support decreases preoperative stress and postoperative recovery time. However, a paucity of studies have examined the effect of social support in the context of pregnancy termination. This study is the first to examine the effect of postoperative accompaniment from the patient, support person and nurses' perspective. This study was carried out in two phases. In Phase I, no accompaniment was allowed in the post-anesthesia recovery room (PAR); in Phase II, accompaniment was permitted. All participants completed pre- and postoperative questionnaires. The perception of accompaniment was overwhelmingly positive in patients and support people. Patients in Phase II demonstrated a high (over 95%) acceptance of accompaniment in the recovery room. It was found that 96.8% reported they would choose to be accompanied in the recovery room again if they had to have another abortion. Support persons felt very strongly that their presence was helpful to the patient. The decrease in pre- to postoperative anxiety levels was significantly greater in those women who were accompanied. However, overall, nurses demonstrated a negative attitude towards accompaniment in the recovery room. In summary, the presence of a support person in the PAR was perceived in a positive manner by patients and support people. However, the reasoning behind the negative opinion of nurses requires further study before PAR accompaniment can be considered a possibility in the context of pregnancy termination. Copyright © 2011 Elsevier Inc. All rights reserved.

Continuous support for women during childbirth.

Science.gov (United States)

Bohren, Meghan A; Hofmeyr, G Justus; Sakala, Carol; Fukuzawa, Rieko K; Cuthbert, Anna

2017-07-06

additional information from the trial authors. The quality of the evidence was assessed using the GRADE approach. We included a total of 27 trials, and 26 trials involving 15,858 women provided usable outcome data for analysis. These trials were conducted in 17 different countries: 13 trials were conducted in high-income settings; 13 trials in middle-income settings; and no studies in low-income settings. Women allocated to continuous support were more likely to have a spontaneous vaginal birth (average RR 1.08, 95% confidence interval (CI) 1.04 to 1.12; 21 trials, 14,369 women; low-quality evidence) and less likely to report negative ratings of or feelings about their childbirth experience (average RR 0.69, 95% CI 0.59 to 0.79; 11 trials, 11,133 women; low-quality evidence) and to use any intrapartum analgesia (average RR 0.90, 95% CI 0.84 to 0.96; 15 trials, 12,433 women). In addition, their labours were shorter (MD -0.69 hours, 95% CI -1.04 to -0.34; 13 trials, 5429 women; low-quality evidence), they were less likely to have a caesarean birth (average RR 0.75, 95% CI 0.64 to 0.88; 24 trials, 15,347 women; low-quality evidence) or instrumental vaginal birth (RR 0.90, 95% CI 0.85 to 0.96; 19 trials, 14,118 women), regional analgesia (average RR 0.93, 95% CI 0.88 to 0.99; 9 trials, 11,444 women), or a baby with a low five-minute Apgar score (RR 0.62, 95% CI 0.46 to 0.85; 14 trials, 12,615 women). Data from two trials for postpartum depression were not combined due to differences in women, hospitals and care providers included; both trials found fewer women developed depressive symptomatology if they had been supported in birth, although this may have been a chance result in one of the studies (low-quality evidence). There was no apparent impact on other intrapartum interventions, maternal or neonatal complications, such as admission to special care nursery (average RR 0.97, 95% CI 0.76 to 1.25; 7 trials, 8897 women; low-quality evidence), and exclusive or any breastfeeding

Design review report for rotary mode core sample truck (RMCST) modifications for flammable gas tanks, preliminary design

International Nuclear Information System (INIS)

Corbett, J.E.

1996-02-01

This report documents the completion of a preliminary design review for the Rotary Mode Core Sample Truck (RMCST) modifications for flammable gas tanks. The RMCST modifications are intended to support core sampling operations in waste tanks requiring flammable gas controls. The objective of this review was to validate basic design assumptions and concepts to support a path forward leading to a final design. The conclusion reached by the review committee was that the design was acceptable and efforts should continue toward a final design review

Improving GRADE evidence tables part 3: detailed guidance for explanatory footnotes supports creating and understanding GRADE certainty in the evidence judgments

NARCIS (Netherlands)

Santesso, Nancy; Carrasco-Labra, Alonso; Langendam, Miranda; Brignardello-Petersen, Romina; Mustafa, Reem A.; Heus, Pauline; Lasserson, Toby; Opiyo, Newton; Kunnamo, Ilkka; Sinclair, David; Garner, Paul; Treweek, Shaun; Tovey, David; Akl, Elie A.; Tugwell, Peter; Brozek, Jan L.; Guyatt, Gordon; Schünemann, Holger J.

2016-01-01

The Grading of Recommendations Assessment, Development and Evaluation (GRADE) is widely used and reliable and accurate for assessing the certainty in the body of health evidence. The GRADE working group has provided detailed guidance for assessing the certainty in the body of evidence in systematic

Improving GRADE evidence tables part 3 : Detailed guidance for explanatory footnotes supports creating and understanding GRADE certainty in the evidence judgments

NARCIS (Netherlands)

Santesso, Nancy; Carrasco-Labra, Alonso; Langendam, Miranda; Brignardello-Petersen, Romina; Mustafa, Reem A.; Heus, Pauline; Lasserson, Toby; Opiyo, Newton; Kunnamo, Ilkka; Sinclair, David; Garner, Paul; Treweek, Shaun; Tovey, David; Akl, Elie A.; Tugwell, Peter; Brozek, Jan L.; Guyatt, Gordon; Schünemann, Holger J.

Background The Grading of Recommendations Assessment, Development and Evaluation (GRADE) is widely used and reliable and accurate for assessing the certainty in the body of health evidence. The GRADE working group has provided detailed guidance for assessing the certainty in the body of evidence in

Exploratory shaft facility preliminary designs - Gulf Interior Region salt domes

International Nuclear Information System (INIS)

1983-09-01

The purpose of the Preliminary Design Report, Gulf Interior Region, is to provide a description of the preliminary design for an Exploratory Shaft Facility on the Richton Dome, Mississippi. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers are included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description and Construction Cost Estimate

Preliminary Failure Modes and Effects Analysis of the US DCLL Test Blanket Module

Energy Technology Data Exchange (ETDEWEB)

Lee C. Cadwallader

2010-06-01

This report presents the results of a preliminary failure modes and effects analysis (FMEA) of a small tritium-breeding test blanket module design for the International Thermonuclear Experimental Reactor. The FMEA was quantified with “generic” component failure rate data, and the failure events are binned into postulated initiating event families and frequency categories for safety assessment. An appendix to this report contains repair time data to support an occupational radiation exposure assessment for test blanket module maintenance.

Preliminary Failure Modes and Effects Analysis of the US DCLL Test Blanket Module

Energy Technology Data Exchange (ETDEWEB)

Lee C. Cadwallader

2007-08-01

This report presents the results of a preliminary failure modes and effects analysis (FMEA) of a small tritium-breeding test blanket module design for the International Thermonuclear Experimental Reactor. The FMEA was quantified with “generic” component failure rate data, and the failure events are binned into postulated initiating event families and frequency categories for safety assessment. An appendix to this report contains repair time data to support an occupational radiation exposure assessment for test blanket module maintenance.

Preliminary Failure Modes and Effects Analysis of the US DCLL Test Blanket Module

International Nuclear Information System (INIS)

Lee C. Cadwallader

2007-01-01

This report presents the results of a preliminary failure modes and effects analysis (FMEA) of a small tritium-breeding test blanket module design for the International Thermonuclear Experimental Reactor. The FMEA was quantified with 'generic' component failure rate data, and the failure events are binned into postulated initiating event families and frequency categories for safety assessment. An appendix to this report contains repair time data to support an occupational radiation exposure assessment for test blanket module maintenance

IDRC evidence and innovation supports India's adaptation to climate ...

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

2018-02-23

Feb 23, 2018 ... (South Asia Consortium for Interdisciplinary Water Resources Studies, $536,500) ... The project seeks to improve the management of heat stress risks in India by ... It is expected to support at least 20 early-career researchers, train 30 officials from ... (Indian Institute for Human Settlements, $3,276,920).

Systems management support for ERCDC study of undergrounding and berm containment. Interim report. Preliminary program assessment and follow-on program development

Energy Technology Data Exchange (ETDEWEB)

1977-08-01

Interim results of a study being conducted with respect to the technological aspects of the costs and benefits of underground nuclear power plant construction in direct support of the California Energy Commission's legislative mandate in this area are presented. The program was directed towards problem scoping, methodology evaluation, program definition and planning for subsequent, more detailed investigations of underground facility designs and their potential advantages and disadvantages. The material presented describes the results of (a) systems analyses which were conducted to determine logical requirements for determination of those elements of a nuclear power plant which should be constructed underground; (b) bounding estimates of incremental plant costs for a variety of underground concepts; (c) applicable prior experience in underground facility design and construction which could be used to identify potential sources of strength and weaknessees of underground nuclear power plants; (d) estimates of seismic environments for underground construction in California; (e) preliminary descriptions of underground reactor accident scenarios; (f) bounding estimates of the consequences of such accidents, in terms of comparisons of relative emissions of radioactivity with respect to similar accidents for surface-sited nuclear power plants and (g) results of analyses of several other important technological aspects of the problem. A description is also provided of the program development work performed to provide planning and criteria for subsequent investigations to determine: (a) definitive underground nuclear power plant designs and costs, and (b) estimates of accident consequences in underground nuclear power plants.

Systems management support for ERCDC study of undergrounding and berm containment. Interim report. Preliminary program assessment and follow-on program development

International Nuclear Information System (INIS)

1977-08-01

Interim results of a study being conducted with respect to the technological aspects of the costs and benefits of underground nuclear power plant construction in direct support of the California Energy Commission's legislative mandate in this area are presented. The program was directed towards problem scoping, methodology evaluation, program definition and planning for subsequent, more detailed investigations of underground facility designs and their potential advantages and disadvantages. The material presented describes the results of (a) systems analyses which were conducted to determine logical requirements for determination of those elements of a nuclear power plant which should be constructed underground; (b) bounding estimates of incremental plant costs for a variety of underground concepts; (c) applicable prior experience in underground facility design and construction which could be used to identify potential sources of strength and weaknessees of underground nuclear power plants; (d) estimates of seismic environments for underground construction in California; (e) preliminary descriptions of underground reactor accident scenarios; (f) bounding estimates of the consequences of such accidents, in terms of comparisons of relative emissions of radioactivity with respect to similar accidents for surface-sited nuclear power plants and (g) results of analyses of several other important technological aspects of the problem. A description is also provided of the program development work performed to provide planning and criteria for subsequent investigations to determine: (a) definitive underground nuclear power plant designs and costs, and (b) estimates of accident consequences in underground nuclear power plants

Magnet-retained implant-supported overdentures: review and 1-year clinical report.

Science.gov (United States)

Ceruti, Paola; Bryant, S Ross; Lee, Jun-Ho; MacEntee, Michael I

2010-01-01

Open-field aluminum-nickle-cobalt magnets have been used in prosthodontics for many years, but success has been limited because these magnets are susceptible to corrosion by the saliva and because their retentive force is weak relative to the initial retention offered by mechanical attachments. More recently, magnets have been made from alloys of the rare earth elements samarium and neodymium, which provide stronger magnetic force per unit size. In addition, a new generation of laser-welded containers has improved protection from salivary corrosion. The current resurgence of interest in this type of attachment appears justified because, unlike mechanical attachments, magnets have potential for unlimited durability and might therefore be superior to mechanical ball or bar attachments for the retention of removable prostheses on implants. To date, no long-term prospective trials have been conducted to confirm the clinical durability of this new generation of magnets for retaining dentures on either teeth or implants. The aim of this study was to document initial clinical experiences and levels of satisfaction among edentulous patients treated with mandibular implant-supported overdentures retained using a new generation of rare-earth magnetic attachments. At the outset, all but one of the 17 patients had had several years of experience with implant-supported overdentures. During the first year, the mean overall satisfaction among these 17 patients increased from less than 70 to over 90 out of 100 (standardized visual analogue scale). No unusual difficulties were encountered in rendering the treatment or maintaining the attachments. This report offers preliminary evidence of the excellent potential of these magnets for retaining mandibular implant-supported overdentures.

Preliminary evidence for an association between a dopamine D3 receptor gene variant and obsessive-compulsive personality disorder in patients with major depression.

Science.gov (United States)

Light, Katrina J; Joyce, Peter R; Luty, Suzanne E; Mulder, Roger T; Frampton, Christropher M A; Joyce, Laura R M; Miller, Allison L; Kennedy, Martin A

2006-06-05

We have previously reported that the Ser9Gly dopamine D3 receptor (DRD3) polymorphism was associated with increased rates of obsessive-compulsive personality disorder (OCPD) symptomology. We tested the replicability of this association within a further two independent groups of individuals with a history of depression, from a clinical sample (n = 149) and a family study (n = 213). The data from the replication samples and the original sample, within which the association was found, were compiled within a meta-analysis. Although the independent samples did not replicate the original finding, the meta-analysis elucidated significant evidence supporting the association. An individual with Gly/Gly genotype is 2.4 (P = 0.017) times more likely to be diagnosed with OCPD. Male gender was also found to be a significant predictor of OCPD diagnosis (OR = 2.82, P = 0.001). An exploration of an association of DRD3 with Axis I anxiety disorder diagnoses and Temperament and Character Inventory (TCI) traits, in particular persistence, revealed no support for an association. We conclude that DRD3 may contribute to the development of OCPD.

Evidence-Based Dentistry in Everyday Practice.

Science.gov (United States)

Gudray, Kiran; Walmsley, Anthony Damien

2016-12-01

This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. Clinical relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.

Autism as a contingency-shaped disorder of verbal behavior: Evidence obtained and evidence needed.

Science.gov (United States)

Hixson, Michael D

2004-01-01

Drash and Tudor's argument that autism is a contingency-shaped disorder of verbal behavior is logical and consistent with behavioral principles, but the argument's premises have no direct empirical support and some conflicting evidence. The quantity and quality of research needed to support such a theory is compared to that found in the area of antisocial behavior in children, which has considerable evidence for a contingency-shaped etiology. Even if autism is largely inherited, this does not weaken the necessity or importance of behavioral intervention. Drash and Tudor's paper may serve a useful function by outlining areas in need of further study because a great deal more research is needed on how the early environment shapes the language, cognitive, and behavioral development of children.

Gender, social support, and well-being: Evidence from a Greek community sample

Directory of Open Access Journals (Sweden)

Konstantinos Kafetsios

2007-12-01

Full Text Available The importance of social support for psychological well-being has been aptly highlighted in epidemiological and psychological research. However, it is not clear from the existing research whether gender differences in structural (relationship status, network size, frequency of interactions with friends and functional (support satisfaction aspects of social support exist and -if they do- to what extent they affect males’ and females’ well-being. Hierarchical regression analyses of crossectional data from a Greek community sample showed that support satisfaction was an important predictor of well-being outcomes in males whereas several structural indicators were predictors of different well-being outcomes in females. Females’ anxiety, perceived stress, and loneliness were adversely affected by frequency of interaction with acquaintances. The results are discussed with regard to gender-role differences that may be underlying the social support effects on well-being, as well as related cultural values.

Evidence on Tips for Supporting Reading Skills at Home

Science.gov (United States)

What Works Clearinghouse, 2018

2018-01-01

This document begins by providing four tips parents and care takers can use to supporting childrens' reading skills at home: (1) Have conversations before, during, and after reading together; (2) Help children learn how to break sentences into words and words into syllables; (3) Help children sound out words smoothly; and (4) Model reading…

Scale dependence of the effective matrix diffusion coefficient: Evidence and preliminary interpretation

International Nuclear Information System (INIS)

Liu, Hui-Hai; Zhang, Yingqi; Molz, Fred J.

2006-01-01

matrix-diffusion coefficient, and to develop a preliminary explanation for this scale-dependent behavior

Scale Dependence of the Effective Matrix Diffusion Coefficient : Evidence and Preliminary Interpretation

International Nuclear Information System (INIS)

H.H. Liu; Y. Zhang

2006-01-01

matrix-diffusion coefficient, and to -develop a preliminary explanation for this scale-dependent behavior

Ocean thermal energy conversion power system development-I. Preliminary design report. Volume 3. Appendixes D, E, and F. Phase I. Final report

Energy Technology Data Exchange (ETDEWEB)

1978-12-18

The conceptual design of a 40 to 50 MW closed cycle ammonia OTEC commercial plant, the preliminary design of a 10 MW OTEC module analogous to the 50 MW module, and the preliminary design of heat exchanger test articles (evaporator and condenser) representative of the 50 MW heat exchangers for testing in OTEC-1 are presented. This volume includes the appendices: D) system equipment (hardware breakdown structure; 10-MW hardware listing; list of support and maintenance equipment, tools and spare parts; sacrificial anodes; M.A.N. brush; and Alclad 3004 data); E) heat exchanger supporting data (analyses/configuration, contract tooling, manufacturing plan, specification, and evaporator ammonia liquid distribution system); and F) rotating machinery (performance characteristics, radial inflow turbine; item descriptions; weight calculation-rotor; producibility analysis; long lead-time items; spares; support equipment; non recurring costs; performance characteristics-axial flow turbine; Worthington pump data; and American M.A.N. Corporation data). Also included is attachment 1 to the phase I final report which presents details of the system modeling; design, materials considerations, and systems analysis of the baseline module; system cost analysis; and supporting data. (WHK)

Evidence Supporting Intralesional Stem Cell Therapy to Improve Equine Flexor Tendon Healing

Directory of Open Access Journals (Sweden)

Sushmitha Durgam

2017-01-01

Full Text Available Clinical bottom lineCurrent experimental evidence suggests that intralesional stem cell administration improves the histological characteristics and matrix organisation of healing equine superficial digital flexor tendons (SDFT; however, the clinical relevance of these findings are not clear. Current case-based evidence suggests that cell-based therapies improve the quality of tendon healing and reduce the recurrence rates of SDFT injuries but the lack of any randomised, controlled prospective studies with function-based outcomes is still concerning, given the widespread advocacy for and use of ‘stem cell’ therapies for the treatment of equine tendon injuries. 

Theoretical role of adjunctive implant positional support in stress distribution of distal-extension mandibular removable partial dentures.

Science.gov (United States)

Xiao, Wei; Li, Zhiyong; Shen, Shiqian; Chen, Shaowu; Wang, Yining; Wang, Jiawei

2014-01-01

This preliminary study evaluated the adjunctive supporting role of diverse implant positions on stress distribution in a Class I removable partial denture (RPD) design. Nine three-dimensional finite element models were prepared to simulate mandibular RPD designs with three different loading conditions applied. Implant supported designs demonstrated lower stress value concentrations and mucosal displacement.

Neuropsychological development of cognitive abilities: a new research strategy and some preliminary evidence for a sexual orientation model.

Science.gov (United States)

Sanders, G; Ross-Field, L

1987-09-01

The organizing action that prenatal sex hormones exert on the brain has been implicated in the aetiology of sex differences in cognitive abilities and cerebral asymmetries. Prenatal sex hormones are known to determine neuroendocrine responses and subsequent adult sexual behaviour in nonhuman animals and these hormones may also influence human sexual orientation. To unify these observations, we elaborate a sexual orientation model of neuropsychological development which predicts that sex differences in neuroendocrine responses, cerebral asymmetries, and cognitive abilities are related to sexual orientation rather than to sex per se. A common problem in the study of sex differences is that biological and sociocultural explanations are confounded. The sexual orientation model suggests a new research strategy, the comparison of homosexual and heterosexual groups, for which explanations in terms of sociocultural factors would be more difficult to sustain. The available evidence supports the model: In terms of a neuroendocrine response, cerebral asymmetry, and cognitive abilities, homosexual males resemble heterosexual females rather than heterosexual males. Our conclusions lead to questions that further research in this area should address, and to a consideration of problems which such research may have to face.

Reproductive interference and fecundity affect competitive interactions of sibling species with low mating barriers: experimental and theoretical evidence.

Science.gov (United States)

Gebiola, M; Kelly, S E; Velten, L; Zug, R; Hammerstein, P; Giorgini, M; Hunter, M S

2017-12-01

When allopatric species with incomplete prezygotic isolation come into secondary contact, the outcome of their interaction is not easily predicted. The parasitoid wasp Encarsia suzannae (iES), infected by Cardinium inducing cytoplasmic incompatibility (CI), and its sibling species E. gennaroi (EG), not infected by bacterial endosymbionts, may have diverged because of the complementary action of CI and asymmetric hybrid incompatibilities. Whereas postzygotic isolation is now complete because of sterility of F1 hybrid progeny, prezygotic isolation is still incipient. We set up laboratory population cage experiments to evaluate the outcome of the interaction between ES and EG in two pairwise combinations: iES vs EG and cured ES (cES, where Cardinium was removed with antibiotics) vs EG. We also built a theoretical model aimed at exploring the role of life-history differences and asymmetric mating on competitive outcomes. In three of four cages in each treatment, ES dominated the interaction. We found evidence for reproductive interference, driven by asymmetric mating preferences, that gave a competitive edge to ES, the species that better discriminated against heterospecifics. However, we did not find the fecundity cost previously shown to be associated with Cardinium infection in iES. The model largely supported the experimental results. The finding of only a slight competitive edge of ES over EG in population cages suggests that in a more heterogeneous environment the species could coexist. This is supported by evidence that the two species coexist in sympatry, where preliminary data suggest reproductive character displacement may have reinforced postzygotic isolation.

Evidence from the Cochrane Collaboration for Traditional Chinese Medicine Therapies

Science.gov (United States)

Wieland, Susan; Kimbrough, Elizabeth; Cheng, Ker; Berman, Brian M.

2009-01-01

Abstract Background The Cochrane Collaboration, an international not-for-profit organization that prepares and maintains systematic reviews of randomized trials of health care therapies, has produced reviews summarizing much of the evidence on Traditional Chinese Medicine (TCM). Our objective was to review the evidence base according to Cochrane systematic reviews. Methods In order to detect reviews focusing on TCM, we searched the titles and abstracts of all reviews in Issue 4, 2008 of the Cochrane Database of Systematic Reviews. For each review, we extracted data on the number of trials included and the total number of participants. We provided an indication of the strength of the review findings by assessing the reviewers' abstract conclusions statement. We supplemented our assessment of the abstract conclusions statements with a listing of the comparisons and outcomes showing statistically significant meta-analyses results. Results We identified 70 Cochrane systematic reviews of TCM, primarily acupuncture (n = 26) and Chinese herbal medicine (n = 42), and 1 each of moxibustion and t'ai chi. Nineteen (19) of 26 acupuncture reviews and 22/42 herbal medicine reviews concluded that there was not enough good quality trial evidence to make any conclusion about the efficacy of the evaluated treatment, while the remaining 7 acupuncture and 20 herbal medicine reviews and each of the moxibustion and t'ai chi reviews indicated a suggestion of benefit, which was qualified by a caveat about the poor quality and quantity of studies. Most reviews included many distinct interventions, controls, outcomes, and populations, and a large number of different comparisons were made, each with a distinct forest plot. Conclusions Most Cochrane systematic reviews of TCM are inconclusive, due specifically to the poor methodology and heterogeneity of the studies reviewed. Some systematic reviews provide preliminary evidence of Chinese medicine's benefits to certain patient populations

Analytics of biometric data from wearable devices to support teaching and learning activities

Directory of Open Access Journals (Sweden)

Francisco de Arriba Pérez

2016-03-01

Full Text Available This paper introduces the preliminary results of a piece of research whose main purpose is to take advantage of data collected from wearable devices to support learning processes. This goal is approached through the application of learning analytic techniques. The innovation point is the use of data collected from wearables, that will be used in conjunction with data collected from other sources (e.g. Learning Management Systems, Student Information Systems. The paper reviews the results achieved during the last year about the relationships among biometric data collected from wearables and relevant features described in the educational literature. In this way sleep and stress have been identified as interesting areas that could be informed from data collected in wearables and processed by applying machine learning techniques. Our preliminary results show some initial promising results that need further validation, also these results show an interesting opportunity to support awareness and intervention functionalities.

An empowerment framework for nursing leadership development: supporting evidence.

Science.gov (United States)

Macphee, Maura; Skelton-Green, Judith; Bouthillette, France; Suryaprakash, Nitya

2012-01-01

This article is a report on a descriptive study of nurse leaders' perspectives of the outcomes of a formal leadership programme. Effective nurse leaders are necessary to address complex issues associated with healthcare systems reforms. Little is known about the types of leadership development programmes that most effectively prepare nurse leaders for healthcare challenges. When nurse leaders use structural and psychological empowerment strategies, the results are safer work environments and better nurse outcomes. The leadership development programme associated with this study is based on a unifying theoretical empowerment framework to empower nurse leaders and enable them to empower others. Twenty seven front-line and mid-level nurse leaders with variable years of experience were interviewed for 1 year after participating in a formal leadership development programme. Data were gathered in 2008-2009 from four programme cohorts. Four researchers independently developed code categories and themes using qualitative content analysis. Evidence of leadership development programme empowerment included nurse leader reports of increased self-confidence with respect to carrying out their roles and responsibilities; positive changes in their leadership styles; and perceptions of staff recognition of positive stylistic changes. Regardless of years of experience, mid-level leaders had a broader appreciation of practice environment issues than front-line leaders. Time for reflection was valuable to all participants, and front-line leaders, in particular, appreciated the time to discuss nurse-specific issues with their colleagues. This study provides evidence that a theoretical empowerment framework and strategies can empower nurse leaders, potentially resulting in staff empowerment. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Knowledge of evidence-based dentistry among academic dental practitioners of Bhopal, India: a preliminary survey

Directory of Open Access Journals (Sweden)

Aishwarya Singh

2015-06-01

Full Text Available This study aimed to characterize the knowledge of evidence-based dentistry (EBD among dental faculty members in the city of Bhopal in central India. A cross-sectional questionnaire was administered at two dental colleges in Bhopal City. All dental faculty members who were present on the day of the study and who agreed to participate were included in the study. A total of 50 dental faculty members returned the questionnaire. Six Likert-type questions were asked, and the percentages of various responses were used for analysis. Sixteen faculty members (32.0% strongly agreed that EBD is a process of making decisions based on scientifically proven evidence. Fifteen faculty members (30.0% strongly disagreed or disagreed with the item stating that the best and quickest way to find evidence is by reading textbooks or asking experienced colleagues. Thirteen faculty members (26.0% strongly agreed that EBD allows dentists to improve their scientific knowledge and clinical skills. It is recommended that EBD be included in undergraduate and postgraduate curricula and in intensive continuing dental education programs that are conducted for dental faculty members.

Who Supports the Successful Implementation and Sustainability of Evidence-Based Practices? Defining and Understanding the Roles of Intermediary and Purveyor Organizations.

Science.gov (United States)

Franks, Robert P; Bory, Christopher T

2015-01-01

Research on implementation science has increased significantly over the past decade. In particular, psychologists have looked closely at the value and importance of bridging the gap between science and practice. As evidence-based practices (EBPs) become more prevalent, concrete mechanisms are needed to bring these scientifically supported treatments and interventions to community-based settings. Intermediary and purveyor organizations (IPOs) have emerged in recent years that specialize in bringing research to practice. Using a framework developed by Franks (), this descriptive study surveyed respondents that self-identified as IPOs and focused on identifying shared definitions, functions, and activities. Results indicated that seven descriptive roles previously identified were supported by this survey and many common shared activities, goals, and functions across these organizations were observed. Further, these organizations appear to be influenced by the growing field of implementation science. Limitations and implications of this study are discussed. © 2015 Wiley Periodicals, Inc.

46 CFR 176.635 - Preliminary examination requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Preliminary examination requirements. 176.635 Section... (UNDER 100 GROSS TONS) INSPECTION AND CERTIFICATION Hull and Tailshaft Examinations § 176.635 Preliminary examination requirements. (a) If you exclusively use divers to examine the underwater hull plating, you must...

Preliminary Shielding Analysis for HCCB TBM Transport

Science.gov (United States)

Miao, Peng; Zhao, Fengchao; Cao, Qixiang; Zhang, Guoshu; Feng, Kaiming

2015-09-01

A preliminary shielding analysis on the transport of the Chinese helium cooled ceramic breeder test blanket module (HCCB TBM) from France back to China after being irradiated in ITER is presented in this contribution. Emphasis was placed on irradiation safety during transport. The dose rate calculated by MCNP/4C for the conceptual package design satisfies the relevant dose limits from IAEA that the dose rate 3 m away from the surface of the package containing low specific activity III materials should be less than 10 mSv/h. The change with location and the time evolution of dose rates after shutdown have also been studied. This will be helpful for devising the detailed transport plan of HCCB TBM back to China in the near future. supported by the Major State Basic Research Development Program of China (973 Program) (No. 2013GB108000)

Supported employment for people with severe mental illness: systematic review and meta-analysis of the international evidence.

Science.gov (United States)

Modini, Matthew; Tan, Leona; Brinchmann, Beate; Wang, Min-Jung; Killackey, Eoin; Glozier, Nicholas; Mykletun, Arnstein; Harvey, Samuel B

2016-07-01

Individual placement and support (IPS) is a vocational rehabilitation programme that was developed in the USA to improve employment outcomes for people with severe mental illness. Its ability to be generalised to other countries and its effectiveness in varying economic conditions remains to be ascertained. To investigate whether IPS is effective across international settings and in different economic conditions. A systematic review and meta-analysis of randomised controlled trials comparing IPS with traditional vocational services was undertaken; 17 studies, as well as 2 follow-up studies, were included. Meta-regressions were carried out to examine whether IPS effectiveness varied according to geographic location, unemployment rates or gross domestic product (GDP) growth. The overall pooled risk ratio for competitive employment using IPS compared with traditional vocational rehabilitation was 2.40 (95% CI 1.99-2.90). Meta-regressions indicated that neither geographic area nor unemployment rates affected the overall effectiveness of IPS. Even when a country's GDP growth was less than 2% IPS was significantly more effective than traditional vocational training, and its benefits remained evident over 2 years. Individual placement and support is an effective intervention across a variety of settings and economic conditions and is more than twice as likely to lead to competitive employment when compared with traditional vocational rehabilitation. © The Royal College of Psychiatrists 2016.

Scope and purpose of the preliminary planning work

International Nuclear Information System (INIS)

Kalas, P.

1976-01-01

The results of preliminary planning work are usually expressed in a number of recommendations covering mainly: long-term national policy in the field of energy resources and selection of projects to be further studied at the feasibility level. Moreover, recommendations on further actions are made including: inventory of generation and transmission facilities recommended for the implementation in order to meet the load forecasted for medium-term period, preparation of a preliminary calender of decisions to be taken for the implementation of the projects recommended, preparation of a preliminary construction schedule, preparation of a preliminary investment program, preparation of a program of necessary engineering works, and performance of study on electricity rates which would adjust existing tariffs to proposed development program of the utility. (HP) [de

Evidence supporting the use of cone-beam computed tomography in orthodontics.

NARCIS (Netherlands)

Vlijmen, O.J.C. van; Kuijpers, M.A.R.; Berge, S.J.; Schols, J.G.J.H.; Maal, T.J.J.; Breuning, H.; Kuijpers-Jagtman, A.M.

2012-01-01

BACKGROUND: The authors conducted a systematic review of cone-beam computed tomography (CBCT) applications in orthodontics and evaluated the level of evidence to determine whether the use of CBCT is justified in orthodontics. TYPES OF STUDIES REVIEWED: The authors identified articles by searching

Preliminary results of steel containment vessel model test

International Nuclear Information System (INIS)

Matsumoto, T.; Komine, K.; Arai, S.

1997-01-01

A high pressure test of a mixed-scaled model (1:10 in geometry and 1:4 in shell thickness) of a steel containment vessel (SCV), representing an improved boiling water reactor (BWR) Mark II containment, was conducted on December 11-12, 1996 at Sandia National Laboratories. This paper describes the preliminary results of the high pressure test. In addition, the preliminary post-test measurement data and the preliminary comparison of test data with pretest analysis predictions are also presented

Preliminary Evidence for a Unique Role of Disgust-Based Conditioning in Posttraumatic Stress

OpenAIRE

Badour, Christal L.; Feldner, Matthew T.; Blumenthal, Heidemarie; Knapp, Ashley

2013-01-01

Independent lines of evidence have linked posttraumatic stress symptomatology to both peritraumatic disgust (i.e., disgust experienced during a traumatic event) and posttraumatic disgust reactivity in response to traumatic event cues among individuals exposed to traumatic events. Much of this work suggests disgust, defined as a rejection/revulsion response aimed at distancing oneself from a potential source of contamination, may be important in understanding the nature of posttraumatic stress...

A language for image processing HILLS and its supporting system SDIP

International Nuclear Information System (INIS)

Suzuki, H.; Toriwaki, J.

1984-01-01

This paper presents a language HILLS and its supporting system SDIP for image processing. HILLS is a key-word type language for describing image processing procedures by using subroutine packages SLIP and SPIDER. SDIP, written in FORTRAN to keep portability, supports programming by HILLS in interactive mode including functions such as editing, translating HILLS into FORTRAN, error detection, and providing manual information. Results of preliminary experiments suggest that HILLS and SDIP are very useful tools for beginners and researchers in application fields of image processing to develop desired image analysis procedures

Designing Computer-Supported Complex Systems Curricula for the Next Generation Science Standards in High School Science Classrooms

Directory of Open Access Journals (Sweden)

Susan A. Yoon

2016-12-01

Full Text Available We present a curriculum and instruction framework for computer-supported teaching and learning about complex systems in high school science classrooms. This work responds to a need in K-12 science education research and practice for the articulation of design features for classroom instruction that can address the Next Generation Science Standards (NGSS recently launched in the USA. We outline the features of the framework, including curricular relevance, cognitively rich pedagogies, computational tools for teaching and learning, and the development of content expertise, and provide examples of how the framework is translated into practice. We follow this up with evidence from a preliminary study conducted with 10 teachers and 361 students, aimed at understanding the extent to which students learned from the activities. Results demonstrated gains in students’ complex systems understanding and biology content knowledge. In interviews, students identified influences of various aspects of the curriculum and instruction framework on their learning.

Effects of a Flexibility/Support Intervention on Work Performance: Evidence From the Work, Family, and Health Network.

Science.gov (United States)

Bray, Jeremy W; Hinde, Jesse M; Kaiser, David J; Mills, Michael J; Karuntzos, Georgia T; Genadek, Katie R; Kelly, Erin L; Kossek, Ellen E; Hurtado, David A

2018-05-01

To estimate the effects of a workplace initiative to reduce work-family conflict on employee performance. A group-randomized multisite controlled experimental study with longitudinal follow-up. An information technology firm. Employees randomized to the intervention (n = 348) and control condition (n = 345). An intervention, "Start. Transform. Achieve. Results." to enhance employees' control over their work time, to increase supervisors' support for this change, and to increase employees' and supervisors' focus on results. We estimated the effect of the intervention on 9 self-reported employee performance measures using a difference-in-differences approach with generalized linear mixed models. Performance measures included actual and expected hours worked, absenteeism, and presenteeism. This study found little evidence that an intervention targeting work-family conflict affected employee performance. The only significant effect of the intervention was an approximately 1-hour reduction in expected work hours. After Bonferroni correction, the intervention effect is marginally insignificant at 6 months and marginally significant at 12 and 18 months. The intervention reduced expected working time by 1 hour per week; effects on most other employee self-reported performance measures were statistically insignificant. When coupled with the other positive wellness and firm outcomes, this intervention may be useful for improving employee perceptions of increased access to personal time or personal wellness without sacrificing performance. The null effects on performance provide countervailing evidence to recent negative press on work-family and flex work initiatives.

Technetium removal: preliminary flowsheet options

International Nuclear Information System (INIS)

Eager, K.M.

1995-01-01

This document presents the results of a preliminary investigation into options for preliminary flowsheets for 99Tc removal from Hanford Site tank waste. A model is created to show the path of 99Tc through pretreatment to disposal. The Tank Waste Remediation (TWRS) flowsheet (Orme 1995) is used as a baseline. Ranges of important inputs to the model are developed, such as 99Tc inventory in the tanks and important splits through the TWRS flowsheet. Several technetium removal options are discussed along with sensitivities of the removal schemes to important model parameters

Preliminary Study on Testicular Germ Cell Transplantation of Endemic Species Oryzias celebensis

Science.gov (United States)

Andriani, I.; Agustiani, F.; Hassan, M.; Parenrengi, A.; Inoue, K.

2018-03-01

The research has been conducted to study some technical steps for male germ-plasm from endemic fish species such as some species of Oryzias fish in Indonesia to preserve and propagate through germ cell transplantation technology. For preliminary research, the study was started with germ cell characterization of testes, cryopreservation of TGC and the transplantation of Oryzias celebensis as candidates for surrogate broodstock of Oryzias fish male germ plasm. The data analized included the potential number of TGC as donor, the viability of cryopreserved TGC in two types of cryoprotectans and the survival rate of O.celebensis larvae as recipient after transplantation. The result showed that the average amount of TGC yielded after dissociation was 131000 ± 31349 with 74.2 % viability of TGC each. Cryoprotectan10% DMSO +glucose yielded higher viable of TGC. More than 80 % of O.celebensis larvae survived after transplantation. In conclusion, these preliminary data of O.celebensis as surrogate broodstock candidate will support the application of TGC transplantation technology in Oryzias endemic species.

75 FR 6576 - Acetamiprid; Pesticide Tolerances

Science.gov (United States)

2010-02-10

... notice of filing. Based upon review of the data supporting the petition, EPA has determined that the... relevant information in support of this action. EPA has sufficient data to assess the hazards of and to... preliminary evidence suggests that clothianidin operates by direct competitive inhibition, while thiamethoxam...

Preliminary Modelling of Radiation Levels at the Fermilab PIP-II Linac

Energy Technology Data Exchange (ETDEWEB)

Lari, L. [CERN; Cerutti, F. [CERN; Esposito, L. S. [CERN; Baffes, C. [Fermilab; Dixon, S. J. [Fermilab; Mokhov, N. V. [Fermilab; Rakhno, I. [Fermilab; Tropin, I. S. [Fermilab

2018-04-01

PIP-II is the Fermilab's flagship project for providing powerful, high-intensity proton beams to the laboratory's experiments. The heart of PIP-II is an 800-MeV superconducting linac accelerator. It will be located in a new tunnel with new service buildings and connected to the present Booster through a new transfer line. To support the design of civil engineering and mechanical integration, this paper provides preliminary estimation of radiation level in the gallery at an operational beam loss limit of 0.1 W/m, by means of Monte Carlo calculations with FLUKA and MARS15 codes.

[Efficiency of computer-based documentation in long-term care--preliminary project].

Science.gov (United States)

Lüngen, Markus; Gerber, Andreas; Rupprecht, Christoph; Lauterbach, Karl W

2008-06-01

In Germany the documentation of processes in long-term care is mainly paper-based. Planning, realization and evaluation are not supported in an optimal way. In a preliminary study we evaluated the consequences of the introduction of a computer-based documentation system using handheld devices. We interviewed 16 persons before and after introducing the computer-based documentation and assessed costs for the documentation process and administration. The results show that reducing costs is likely. The job satisfaction of the personnel increased, more time could be spent for caring for the residents. We suggest further research to reach conclusive results.

Development and feasibility testing of an intervention to support active lifestyles in youths with type 1 diabetes-the ActivPals programme: a study protocol.

Science.gov (United States)

Mitchell, Fiona; Kirk, Alison; Robertson, Kenneth; Reilly, John J

2016-01-01

The global incidence of type 1 diabetes is rising, and youths with type 1 diabetes continue to suffer poorer health than peers without diabetes. Evidence suggests youths with type 1 diabetes have physical activity (PA) levels well below the recommendations for health and have high levels of sedentary behaviour. An active lifestyle is therefore recommended to improve health. There is limited research showing effective lifestyle behaviour change in this population; therefore, an evidence gap exists between the need to promote physical activity in type 1 diabetes care and lack of understanding on how to do this. This protocol paper describes a feasibility and pilot study of the ActivPals programme-an intervention to support active lifestyles in youths with type 1 diabetes. Key intervention components have been identified from preliminary work (individual and family focus, peer mentoring, technology integration and improved communication and understanding) and are being developed into a pragmatic randomised controlled trial (RCT) supported by recruitment pathways. A steering group of health care professionals and managers will refine the intervention to patient needs. A pilot trial is providing data on intervention implementation, acceptability and feasibility. Twenty youths with type 1 diabetes are being recruited and randomised into an intervention or control group. Physical activity is being measured objectively using the Actigraph GT3X+ monitor at baseline and 1-month follow-up. Contextual factors associated with intervention delivery are being explored. This study will contribute to the development of evidence-based, user-informed and pragmatic interventions leading to healthier lifestyles in youths with type 1 diabetes.

7 CFR 1780.55 - Preliminary engineering reports and Environmental Reports.

Science.gov (United States)

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Preliminary engineering reports and Environmental..., Designing, Bidding, Contracting, Constructing and Inspections § 1780.55 Preliminary engineering reports and Environmental Reports. Preliminary engineering reports (PERs) must conform to customary professional standards...

Next Generation Nuclear Plant Project Preliminary Project Management Plan

International Nuclear Information System (INIS)

Dennis J. Harrell

2006-01-01

This draft preliminary project management plan presents the conceptual framework for the Next Generation Nuclear Plant (NGNP) Project, consistent with the authorization in the Energy Policy Act of 2005. In developing this plan, the Idaho National Laboratory has considered three fundamental project planning options that are summarized in the following section. Each of these planning options is literally compliant with the Energy Policy Act of 2005, but each emphasizes different approaches to technology development risks, design, licensing and construction risks, and to the extent of commercialization support provided to the industry. The primary focus of this draft preliminary project management plan is to identify those activities important to Critical Decision-1, at which point a decision on proceeding with the NGNP Project can be made. The conceptual project framework described herein is necessary to establish the scope and priorities for the technology development activities. The framework includes: A reference NGNP prototype concept based on what is judged to be the lowest risk technology development that would achieve the needed commercial functional requirements to provide an economically competitive nuclear heat source and hydrogen production capability. A high-level schedule logic for design, construction, licensing, and acceptance testing. This schedule logic also includes an operational shakedown period that provides proof-of-principle to establish the basis for commercialization decisions by end-users. An assessment of current technology development plans to support Critical Decision-1 and overall project progress. The most important technical and programmatic uncertainties (risks) are evaluated, and potential mitigation strategies are identified so that the technology development plans may be modified as required to support ongoing project development. A rough-order-of-magnitude cost evaluation that provides an initial basis for budget planning. This

A Comparison of Types of Support for Lower-Skill Workers: Evidence for the Importance of Family Supportive Supervisors

Science.gov (United States)

Muse, Lori A.; Pichler, Shaun

2011-01-01

The work-family literature to date does not offer a clear picture in terms of the relative importance of different types of supports for balancing work and family demands. Grounded in conservation or resources theory, we develop an integrative model relating multiple forms of social support, both formal (i.e., work-life benefit use) and informal…

Preliminary Context Analysis of Community Informatics Social ...

African Journals Online (AJOL)

Preliminary context analysis is always part of the feasibility study phase in the development of information system for Community Development (CD) purposes. In this paper, a context model and a preliminary context analysis are presented for Social Network Web Application (SNWA) for CD in the Niger Delta region of ...

An evaluation of the behaviour-change techniques used on Canadian cancer centre Web sites to support physical activity behaviour for breast cancer survivors.

Science.gov (United States)

Sylvester, B D; Zammit, K; Fong, A J; Sabiston, C M

2017-12-01

Cancer centre Web sites can be a useful tool for distributing information about the benefits of physical activity for breast cancer (bca) survivors, and they hold potential for supporting health behaviour change. However, the extent to which cancer centre Web sites use evidence-based behaviour change techniques to foster physical activity behaviour among bca survivors is currently unknown. The aim of our study was to evaluate the presentation of behaviour-change techniques on Canadian cancer centre Web sites to promote physical activity behaviour for bca survivors. All Canadian cancer centre Web sites ( n = 39) were evaluated by two raters using the Coventry, Aberdeen, and London-Refined (calo-re) taxonomy of behaviour change techniques and the eEurope 2002 Quality Criteria for Health Related Websites. Descriptive statistics were calculated. The most common behaviour change techniques used on Web sites were providing information about consequences in general (80%), suggesting goal-setting behaviour (56%), and planning social support or social change (46%). Overall, Canadian cancer centre Web sites presented an average of M = 6.31 behaviour change techniques (of 40 that were coded) to help bca survivors increase their physical activity behaviour. Evidence of quality factors ranged from 90% (sites that provided evidence of readability) to 0% (sites that provided an editorial policy). Our results provide preliminary evidence that, of 40 behaviour-change techniques that were coded, fewer than 20% were used to promote physical activity behaviour to bca survivors on cancer centre Web sites, and that the most effective techniques were inconsistently used. On cancer centre Web sites, health promotion specialists could focus on emphasizing knowledge mobilization efforts using available research into behaviour-change techniques to help bca survivors increase their physical activity.

Evidence Report: Risk of Performance Errors Due to Training Deficiencies

Science.gov (United States)

Barshi, Immanuel; Dempsey, Donna L.

2016-01-01

Substantial evidence supports the claim that inadequate training leads to performance errors. Barshi and Loukopoulos (2012) demonstrate that even a task as carefully developed and refined over many years as operating an aircraft can be significantly improved by a systematic analysis, followed by improved procedures and improved training (see also Loukopoulos, Dismukes, & Barshi, 2009a). Unfortunately, such a systematic analysis of training needs rarely occurs during the preliminary design phase, when modifications are most feasible. Training is often seen as a way to compensate for deficiencies in task and system design, which in turn increases the training load. As a result, task performance often suffers, and with it, the operators suffer and so does the mission. On the other hand, effective training can indeed compensate for such design deficiencies, and can even go beyond to compensate for failures of our imagination to anticipate all that might be needed when we send our crew members to go where no one else has gone before. Much of the research literature on training is motivated by current training practices aimed at current training needs. Although there is some experience with operations in extreme environments on Earth, there is no experience with long-duration space missions where crews must practice semi-autonomous operations, where ground support must accommodate significant communication delays, and where so little is known about the environment. Thus, we must develop robust methodologies and tools to prepare our crews for the unknown. The research necessary to support such an endeavor does not currently exist, but existing research does reveal general challenges that are relevant to long-duration, high-autonomy missions. The evidence presented here describes issues related to the risk of performance errors due to training deficiencies. Contributing factors regarding training deficiencies may pertain to organizational process and training programs for